Celebrating gives people the energy to press on during difficult times, said Joseph Betancourt, MD, vice president and chief equity and inclusion officer, in his introduction to the “Celebration of Unity, Heritage and Mass General Latino/a/x Front Line Staff” event.
In this video, Paul Biddinger, MD, director of the Massachusetts General Hospital Center for Disaster Medicine, and Rochelle Walensky, MD, MPH, chief of Infectious Diseases at Mass General, answer frequently-asked questions about COVID-19 to shed more light on the nature of the virus and how you can protect yourself and your loved ones.
Walensky: I'm Dr. Rochelle Walensky, Chief of Infectious Diseases at Massachusetts General Hospital. We recognize that these are uncertain times and people are scared.
Biddinger: And I'm Dr. Paul Biddinger, I'm the Director of the Center for Disaster Medicine at Mass General Hospital. Dr Walensky and I would like to take a moment to answer some of your questions and try to help you understand what is happening with this outbreak and how to protect yourselves and your families.
Q: What is coronavirus, and where did it come from?
Walensky: The coronavirus as we believe emerged from bats. Most coronaviruses come from bats, probably jumped from bats to another animal before it comes to the human. The viruses generally cause a spectrum of diseases from very benign diseases, like the common cold, to more severe diseases like MERS, SARS and now COVID-19.
Q: What can I do to protect myself from coronavirus?
Biddinger: In order to protect yourself, it's really important to try and not have your eyes, your nose, your mouth exposed to the droplets with coronavirus. That means being very aware of touching your face. It means washing your hands thoroughly, more than 20 seconds each time with soap and water, and it means covering your cough if you yourself are ill. Try and stay six feet away from other persons and avoid people who appear ill.
Q: What is the scope of the disease and who is at most risk of dying from it?
Walensky: We know that people can present with actually no symptoms at all, whereas some people can get quite sick with the disease. About 80% of people have mild to moderate disease and do quite well at home. Another 15% will require hospitalization, and an additional 5% will require critical or ICU level care. We know that people tend to do poor with the disease if they are elderly over 70, if they have immuno-compromising disease, cardiovascular disease, liver disease or other chronic lung disease.
Q: What lessons did we learn from experiences from Wuhan, Italy and other places?
Biddinger: We've learned how we can do our best to make sure that our health care resources are available for patients who most need them. We've learned that it's safe to stay at home for patients with fever and mild symptoms, and we've learned that patients should come to the hospital if they have chest pain, trouble breathing or severe dizziness.
We've also learned how to protect our hospitals and our health care workers and make sure that we can surge in our abilities to care for patients with intensive care needs such as needs for a ventilator and other critical care resources.
Q: With regards to testing, how do they test people? Why is it so hard to get a test?
Walensky: The test is actually quite a simple test. It's a swab that goes in your nose and in your mouth to test for the virus. Once that test is done and is sent to the lab and we look for virus in the lab. The turnaround time can be as short as several hours to a day or two depending on where the test is done. And the test can be conducted really in any site, to not necessarily needs to be in the hospital.
As of March 21st, we still have some testing shortage and we're really encouraging people to only get a test if they are symptomatic. If they are symptomatic and they test positive, we can use that information to understand how people should be isolated.
Q: I’m not old or in a high-risk category and I feel fine. Do I really need to do social distancing?
Biddinger: We know for a fact that social distancing saves lives. It protects the lives of those who are most vulnerable, including those who are older, as well as those with chronic health conditions. But it takes every single one of us to participate in social distancing in order for the strategy to work. I know especially young people may not feel that they are vulnerable, and may not be as willing to socially distance, but parents, please tell this to your children, and for those who are younger listening now, understand that we all have to play our part for this response to work.
Q: Isn’t coronavirus a lot like the flu? Is it more contagious than the flu?
Walensky: The coronavirus has varied similar symptoms as the flu with fever and cough. But when we talk about how the coronavirus is spread, it's very different than the flu for two important reasons. First, the coronavirus is actually about twice as infectious as the flu. Secondly, we actually don't have a vaccine for the coronavirus, where we do for the flu, and 50% of people get vaccinated for the flu every year.
Taken together you have both a more infectious virus and no immunity in the population from vaccination, which is why it's so important that we take the measures we're taking.
Q: How long will this pandemic last? How will I know when things are getting better?
Biddinger: There is no way to know for certain how long this outbreak will last, but we can look to history for some guide. In previous influenza pandemics including the most severe pandemic in 1918, the waves tend to last about two to three months and that's actually about what we saw in China. No one can make a prediction for certain of course, but we'll know when things are starting to get better when we see the rates of new cases beginning to decline.
Q: If I get a cough and a fever, how worried should I be? What should I do?
Walensky: That question very much depends on who you are. If you are planning on staying home with a cough and fever anyway, you're likely to do quite well and what you should do is self isolate and make sure you can protect your family from getting similar symptoms. However, if you're at high risk, somebody over the age of 70 with immunocompromising diseases, cardiovascular disease, diabetes, chronic lung disease, then I would urge you to reach out to your primary care provider and see if they can arrange a test for you.
Q: If I need to travel, what is the safest way to do so?
Biddinger: I understand why people have concerns about traveling, but some people certainly have to travel for personal or other reasons. Airplanes are not nearly as concerning as many people may fear. In fact, the air exchanges are sometimes more than even a hospital has, and really the risk of infection is limited to about two rows in front, two rows behind and two seats to your left and right.
But when you're out in public, whether it's in a train or in an airport, make sure that you wash your hands frequently, you're careful about the surfaces that you touch, and you try and maintain a distance of six feet or so between you and other people whenever possible.
Q: Once I recover from the virus am I still contagious? Can I get it again?
Walensky: We generally keep people in self-isolation after being diagnosed with COVID-19 for around 14 days to ensure that when they come out of isolation, they're not contagious for other people. That's a critical control mechanism for the disease. We don't know actually if you can get COVID-19 again, but we believe not, and there are active studies examining this question.
Q: How will the virus run its course?
Biddinger: When a new virus like COVID-19 enters a community, all it sees is opportunity because none of us is immune. However, as more and more people are infected, more people become immune, and it gets harder and harder for the virus to be transmitted. In addition, when we practice good social distancing, we take away the opportunity for the virus to be transmitted. And between that social distancing and growing immunity, ultimately this outbreak will collapse under its own weight, and we will get through this wave.
Q: Will warm weather make coronavirus go away?
Walensky: We are hopeful that things will improve with coronavirus as the warmer weather comes. We know that other coronaviruses like the cold viruses do get better over the summer, as does influenza. There are three important things that we're watching. First, by the time summer comes, a lot of people will have already had the disease and will be immune.
The second is human behavior. Many people gather inside in the winter and get outside in the summer and that will help decrease the spread. And then finally, we believe people's immune system is quite a bit better over the summer.
Q: I think I have Covid-19? Should I go to the hospital? What should I do?
Biddinger: What we know is that more than 80% of cases of COVID have mild illness, and people don't need to see their doctor or come into the hospital, but everyone should watch for their symptoms. If you feel like you're having increasing trouble breathing, if you have pain in your chest, if you feel very dizzy, or you're too weak to eat and drink effectively, then call your doctor or come into the emergency department. But call first.
Q: Will the virus come back in the fall of 2020?
Walensky: We don't know if the coronavirus will come back after the summer into the fall, certainly the 1918 flu pandemic did re-emerge after the summer, and we need to be vigilant. There are three important factors that we're going to be looking at. First, we hope that patients who have had the disease already will be immune, and that will help person to person transmission.
Second, we're hopeful that we'll have a lot more tests. We will be able to scale up testing broadly and that if you have the disease you can self-isolate quickly. And third, we're hoping that science will emerge so we will be better informed on how to best treat the virus.
Biddinger: On behalf of Dr. Walensky and myself, we would very much like to thank you for watching. We hope that we've been helpful to you in providing answers to some of the questions we know that you have. We know that in these challenging times, people want answers to help them understand what's happening.
Walensky: I've spent my entire adult life learning, studying and being on the front lines of infectious diseases. These are scary times, but we will get through it. There are legions of providers and health care workers out there working for you. Thank you.
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