Covid-19 with doctor

Expert Question and Answer for COVID-19

Perkins Coie interviews Emergency University about Modern Pandemic Tracing

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What is Covid Quarantine? Do I really have to stay home for 14 Days after a Covid exposure?
The Next Pandemic: Mental Health During COVID-19
Part 5 of Boosting Your Immune System: Flavonoids: What are they, what do they do, and why are they important?
Part 4 of Boosting Your Immune System: Does selenium help boost your immune system to prevent COVID-19?
Part 3 of Boosting Your Immune System: Does zinc play an important role in fighting COVID-19?
Part 2 of Vaccine series: M-RNA Vaccines
Part 2 of Boosting Your Immune System: Is Vitamin D Deficiency Linked to a higher COVID-19 Mortality?
Part 1 of Boosting Your Immune System series: Can I boost my immune system to protect myself against Covid-19?
Part 1 of Vaccine series: What's happening with Covid-19 Vaccines August 2020
Part 1 of 2, Is it safe for students to go back to school? What do the numbers say?
What is the difference in the ages of people who become infected versus those who die of the infection?
Should we continue to wear masks?
Can the Coronavirus be spread by mosquitos?
Comparing CDC data on influenza deaths to Johns Hopkins COVID-19 deaths is like comparing apples to oranges.
Can my hair or beard hold onto the COVID19 virus and make me sick?
Am I supposed to wear a mask while in my car? Are the filters in my car enough to protect me inside or do I need to wear a mask? I was driving the other day and noticed that no one was wearing a mask while driving and my neighborhood has narrow streets/sidewalks, so people walking their dogs or out for a run were only about 1-2 feet away from my car.
What is magical about the 6-foot social distancing number?
I heard that people are getting infected by the bottom of their shoes. They walk around outside and then bring their shoes home. Is there evidence to back this up? Are we supposed to disinfect the bottom of our shoes now?
Will the freezing temperatures of my freezer or chilling temperatures of my refrigerator kill the Coronavirus for food items that may have been contaminated?
When will testing be made available to each California resident? If we aren’t all tested, how do we rule out who may have already had the disease and don’t need treatment or have developed antibodies versus the asymptomatic person?
What is the ELISA test, and why is it so important?
How effective is the current COVID-19 swab test in telling us whether someone is infected or not?
I have only "industrial vinyl" gloves, which say they are for "non-medical use only". Does this mean they are useless against this virus and I should not bother or are they better than bare hands?
Can you catch coronavirus from blood?
How serious is the coronavirus compared to other viral outbreaks? Is it more deadly?
Why are people buying toilet paper?
Why are all the bars closing?
I am over 80, what is your advice on whether I can go to the store to buy groceries?
I keep hearing things about drinking alcohol will help; Is this true?
Because I am young, does this mean I am far less likely to contract the virus?
What is my probability of infection for COVID-19?
What is my probability of infection while grocery shopping?
What is my probabilty of infection while traveling through an airport?

What is Covid Quarantine? Do I really have to stay home for 14 Days after a Covid exposure?

M. Tavens MD | Published on 10-19-2020

The short answer is yes. Studies show it can take that long to develop Covid disease and become contagious to others.

Let’s start with a clear definition; Quarantine is the time, after potential exposure to a disease, that you need to stay home and away from other people. This timing varies by disease type and is based on how long it takes to develop each disease type after potential exposure.

We have been using quarantines to prevent disease spread since at least biblical times. The word comes from Italian, when they used quarantines to limit the spread of Bubonic Plague.

Quarantine is for the potentially exposed (people at high risk of getting Covid).

The CDC defines Covid exposure as:

  • within 6 feet of someone with Covid for 15 minutes or more
  • you provided care at home to someone with Covid
  • direct physical contact with a person with Covid (hugging, kissing)
  • shared eating or drinking utensils
  • the person with Covid sneezed, coughed or got respiratory droplets on you
  • traveled from an area of high or increasing Covid or attended large social or mass gatherings

Where did this 14 day recommendation come from? Studies show that for people who do develop Covid symptoms about 95% will have symptoms 5 days after exposure. 98% will have symptoms start by 11 days and by day 14, 99% will have symptoms. People are most contagious before they develop symptoms and it appears that at least 30% never have symptoms. Staying home, when you know you have been exposed is an important part of our getting Covid under control.

LABELS:
statistics,
behavior

The Next Pandemic: Mental Health During COVID-19

Dr. Odelia Braun MD JD, M. Tavens MD | Published on 09-23-2020

Experts are seeing skyrocketing rates of mental health issues both in the general population and in survivors of Covid-19. We are all being affected by the anxiety and stresses of the Covid-19 pandemic and this is driving a new pandemic of mental health problems. Concerns for illness, grief, job loss and financial insecurity are taking a toll.

How Serious is the problem?

A recently published CDC study revealed that 41% of U.S. residents surveyed, reported experiencing mental health effects as a result of the pandemic. A full 31% reported anxiety or depression, 26% reported trauma/stressor related issues from the pandemic and 13% have started or increased their use of alcohol and other drugs.

10% of those surveyed reported suicidal thoughts within the last 30 days. More than 40 states in the U.S. report significant increases in opioid deaths with some reporting opioid deaths that have more than doubled in the last year. While opioid prescriptions are down, due to increased awareness of physicians, opioid mortality is now often linked to the increased use of fentanyl- a very potent opioid- laced into street drugs.

After a summer of nationwide violence and protests, and an additional 3 months of pandemic related stress, these numbers likely underestimate the severity of the problem.

Covid-19 Survivors and Mental Health

There is also growing evidence of mental health issues specific to Covid-19 survivors. Early study results are concerning. One study looked at survivors, 1 month after hospital discharge. The study found that 56% of survivors suffered from serious mental health issues including depression, anxiety and insomnia. 28% of Covid-19 survivors exhibited symptoms of Post Traumatic Stress Disorder (PTSD).

If you would like to explore your sense of well-being, we encourage to take our free Mental Health Awareness Program at https://www.emergencyuniversity.com/training/mental-health.

If you or someone you know is suffering from significant mental health issues, encourage them to reach out to their doctor and mental health care providers for support.

National Suicide Prevention Lifeline
Available 24 hours. English, Spanish support
1-800-273-8255

SAMHSA’S National Helpline: 1-800-662-HELP(4357)
a free, confidential, 24/7/365 treatment and information service for individuals
and families facing mental and/or substance use disorders.

LABELS:
statistics

Part 5 of Boosting Your Immune System: Flavonoids: What are they, what do they do, and why are they important?

Dr. Odelia Braun MD JD, M. Tavens MD | Published on 09-22-2020

Flavonoids are a diverse group containing thousands of compounds that naturally occur in plants. There has been a lot of interest in these compounds in the last few years because of their known health benefits. Examples are Curcumin (turmeric), Resveratrol (red wine and grapes) and Quercetin (red, blue and purple food like berries, and also kale). Flavonoids are known to have roles in fighting off viruses, keeping blood vessels healthy (a Covid-19 target), and in keeping the immune system healthy. Flavonoids also help Zinc do its work. The US National Institutes of Health is actively studying flavonoids for use in preventing and treating Covid-19.

Food Sources of Flavonoids are obtained from eating a colorful diet

  • Red, purple and blue food; berries, red cabbage, red onion, grapes and red wine
  • Teas especially green tea
  • Greens foods especially kale, broccoli and parsley
  • Dark chocolate!
  • Red kidney beans, pinto beans, black beans
  • Spices like cinnamon, turmeric, mustard
  • Citrus fruits

Should you take a flavonoid supplement?

To absorb flavonoids, you need a healthy gut. The good news is that all high flavonoid foods help you achieve a healthy gut. Also, most plant foods have multiple types of flavonoids in them, so there is synergy. Flavonoids appear to be safe to consume, so taking a supplement is a reasonable choice to make. Look for a respected brand that contains a variety of flavonoids. The scientific studies on Covid usually include Quercetin in their flavonoid mix.

LABELS:
statistics,
treatment

Part 4 of Boosting Your Immune System: Does selenium help boost your immune system to prevent COVID-19?

Dr. Odelia Braun MD JD, M. Tavens MD | Published on 09-15-2020

Selenium has multiple roles in the immune system, one of which is to block viruses from entering cells, a critical step in virus infections. Studies published in the 1990s revealed that individuals with selenium deficiency were more likely to be critically ill when infected with RNA viruses such as COVID-19.

A recent study from China determined that individuals who became infected with COVID-19 in Selenium deficient areas of China had significantly higher Covid-19 death rates than individuals in areas of China with normal Selenium levels.

Selenium status is one of several risk factors that may impact on the outcome of COVID-19 infection, particularly in populations where Selenium intake is sub-optimal or low, such as areas in China and Europe.

Selenium also plays a role in protecting the heart and other organs from damage during infections.

Should you take a selenium supplement?

Only a small amount of Selenium is required for proper functioning of the immune system. The majority of individuals in the US ingest sufficient Selenium in their diet. Food sources include pork, beef, turkey, chicken, fish, shellfish, and eggs as well as some beans and nuts, especially Brazilian nuts, contain Selenium.

Kidney dialysis patients, individuals with severe gastrointestinal conditions, those living with HIV infection or who have had bariatric (weight loss) surgery tend to have low levels of Selenium. Selenium supplements may be beneficial for these individuals.

Because high levels can cause toxicity, the majority of healthy adults do not need to take a Selenium supplement. We recommend you discuss taking a Selenium supplement with your physician, to determine if it will benefit you, and the recommended dosage.

LABELS:
statistics,
treatment

Part 3 of Boosting Your Immune System: Does zinc play an important role in fighting COVID-19?

Dr. Odelia Braun MD JD, M. Tavens MD | Published on 09-08-2020

We have long known that Zinc has important roles in fighting infections. Zinc possesses a variety of antiviral properties both alone and potentially in conjunction with anti-viral medication. Zinc is particularly important in COVID-19. Studies conducted in live cell cultures demonstrated that Zinc blocks the Covid-19 virus from reproducing. Zinc also acts to maintain a tight healthy barrier in the linings of our nose, sinus and lungs. Several recently published studies suggest that Zinc supplementation may be of benefit for prevention and treatment of COVID-19.

Zinc deficiency results in a compromised immune system. Zinc deficiency increases your risk for contracting viral infections. U.S. Government studies reveal that up to 25% of adults over age 60 are Zinc deficient. Many common diseases like diabetes and gastrointestinal disease, and conditions including pregnant and breast-feeding woman, can result in low Zinc levels.

Since milk, red meat and poultry are excellent sources of Zinc, individuals eating vegan and vegetarian diets need higher Zinc intake. Lastly, many common medicines, including some blood pressure medicines, block zinc absorption.

Should you take a Zinc supplement?

Always start by eating a healthy varied diet. In addition to milk, red meat and poultry, whole grain products, baked beans, chickpeas, cashews and almonds are excellent sources of zinc. Zinc can interfere with common prescription medications, and excessive Zinc can cause problems. It is recommended that you discuss taking Zinc supplements with your physician to ensure it is safe for you, and to understand what dose is right for you. Because Zinc can interfere with many common nutrients and medicines, be sure to take it 2 hours before meals or medications.

LABELS:
statistics,
treatment

Part 2 of Vaccine series: M-RNA Vaccines

Dr. Odelia Braun MD JD, M. Tavens MD | Published on 09-08-2020

Vaccines are intended to sensitize your body’s immune system to prepare for an unwanted invader. In the United States, the two vaccines that have entered Phase 3 clinical testing are both mRNA vaccines. Both Moderna and Pfizer initiated Phase 3 clinical trials in July, with a goal of testing the vaccine on 30,000 diverse volunteers who reflect the broad spectrum of the U.S. population. Their goal is to conclude the study by the end of October 2022, and report on the vaccine’s safety and efficacy. Both companies have recruited over one half the necessary volunteers for testing as of the end of August 2020. mRNA vaccines are atypical vaccines that scientists have been working on in various forms for over a decade.

Antigens (Ags)—the “invaders”-- are substances that are foreign to your body, such as bacteria and viruses, that stimulate your immune system’s white blood cells to generate proteins called antibodies (Abs). These antibodies bind to the foreign antigens, and interfere with their ability to survive or replicate.

Traditional vaccines work by administering an antigen which has been killed or neutralized into your system. The body “sees” this inactive antigen and is “fooled” into building up an army of antibodies, so that when you are later exposed to the live antigen, your body has a ready army, which attacks the antigen/microbe and prevents infection.

mRNA vaccines work very differently. RNA is the genetic code for an antigen. The “m” stands for messenger. The mRNA vaccine is injected into the individual. The mRNA attaches to and enters the body’s own cells, where it replicates and releases thousands of copies of the antigen. Covid-19 mRNA vaccines contain key portions of the Covid-19 virus genetic code, such as a critical portion of the “spike” protein. Theoretically, these antigens will stimulate the body’s immune system to generate a large and strong army of antibodies against Covid-19.

Will mRNA vaccines work and why are we trying this new technology?

Scientist have been working on developing mRNA vaccines for many years, but as of yet, none have been successful. The advantage of mRNA vaccines is that they are faster to develop and easier to mass produce than traditional vaccines. It is also theorized that mRNA may stimulate a much stronger and more complete immune system response.

The problem is that mRNA tends to be unstable. It is a messenger molecule. Its usual job is to deliver a message and then rapidly fade away. Because of this, it is hard to keep the vaccine in a stable form for transport.

Researchers are also concerned how long it will be stable and effective inside the body. Early studies on mRNA vaccines for Covid-19 are promising but not yet proven. Still to be determined are the significance of the side effects, and what populations they will be effective for.

LABELS:
statistics,
treatment,
vaccine

Part 2 of Boosting Your Immune System: Is Vitamin D Deficiency Linked to a higher COVID-19 Mortality?

Dr. Odelia Braun MD JD, M. Tavens MD | Published on 08-21-2020

Vitamin D plays critical roles in fighting off viruses by helping your body make specific infection fighting compounds. A recent study in Europe demonstrated a higher COVID-19 mortality in countries where citizens have a higher prevalence of Vitamin D deficiency.

Vitamin D is called the sunshine vitamin because our main source is sunlight. When the sun shines on our skins, our bodies turn it into Vitamin D. So be certain to spend time outdoors.

Fish, of all varieties are also an excellent source of Vitamin D. A high fish diet could explain why countries such as Finland, Denmark and Norway, have a very low incidence of Vit. D deficiency, despite long periods without significant sunshine.

Approximately 8 % of individuals in the U.S. are Vitamin D deficient. However, this does not tell the whole story. Individuals with darker skin pigmentation have higher rates of Vitamin D deficiency. Deficiencies as high as 30% have been documented in Black Americans and 13% in Hispanic Americans. It may be noteworthy that individuals with darker skin pigmentation also make up a disproportionate share of COVID-19 deaths. Of course, any correlation with Vit D deficiency is confounded by many other variables, such as socio-economic status, and pre-existing underlying medical conditions.

Vitamin D deficiency is more common in the elderly, individuals who have limited time outdoors, have darker skin pigmentation, are overweight, or have severe kidney or GI disease. Vit D. supplements may be very beneficial to support the immune system in these circumstances. The recommended amount for healthy adults is 800 IU/D. If you have any of the conditions described above, you may need more.

In order to effectively absorb Vitamin D supplements, they must be taken with a meal that includes fats or oils. Unlike Vitamin C, the body cannot easily rid itself of excess Vitamin D, and therefore excessive Vitamin D supplements can be toxic. Speak with your physician to determine if you should be tested for Vitamin D deficiency, and whether Vitamin D supplements would benefit you.

LABELS:
statistics,
treatment

Part 1 of Boosting Your Immune System series: Can I boost my immune system to protect myself against Covid-19?

Dr. Odelia Braun MD JD, M. Tavens MD | Published on 08-21-2020

YES! You can pro-actively boost your immune system. Ensuring you consume critical nutrients and engaging in healthy behaviors can reduce your risk for many medical conditions. These actions can also potentially reduce the severity of your illness, and help you heal faster if you do get sick. As of August 2020, we have early studies specific to boosting your immune system for Covid-19, and many years of studies on flu and other virus infections that demonstrate that your lifestyle choices can, indeed, make a difference.

The Immune System is a complex, sophisticated system composed of organs as well as numerous types of attack and scavenger cells that circulate in your blood stream, these are stimulated when your body detects a foreign organism. It also includes defensive chemical compounds and proteins such as antibodies that are created and released in your body. The immune system acts to defend us against attacks from undesirable invaders, such as viruses, bacteria, and even cancer cells. You can think of the immune system as an army of warriors protecting us from enemies including infections like Covid-19.

The immune system and Vitamin C

Vitamin C is essential for optimal functioning of the immune system. Vitamin C is a potent anti-oxidant, which means it neutralizes toxic free radicals. It is theorized that much of the damage caused by COVID-19 is caused by the body’s inability to defend itself against the overwhelming numbers of free radicals.

Vitamin C deficiency results in impaired immunity and greater vulnerability to infections.

In turn, infections themselves, significantly reduce the body’s vitamin C levels, due to the body’s continuous utilization of Vitamin C in fighting the infection. Some physicians suggest ingesting more Vitamin C if you are fighting an infection. Several peer review studies suggest higher doses of Vitamin C are more effective in reducing severity and duration of illness caused by bacteria or viruses.

Vitamin C is not made within your body, so it must be consumed, most effectively by including Vitamin C rich foods in your diet. Food sources include papaya, bell peppers and citrus fruits, like limes, lemons and oranges. However, for most of us, the body easily clears out unneeded Vitamin C, so it is generally safe to take a Vitamin C supplement. Prior to initiating supplements, it is important to discuss your plan with your physician, to ensure it does not interfere with any medical condition or medications you may be taking.

LABELS:
statistics,
treatment,
testing

Part 1 of Vaccine series: What's happening with Covid-19 Vaccines August 2020

Dr. Odelia Braun MD JD, M. Tavens MD | Published on 08-20-2020

There are currently over 100 Covid-19 vaccines in development globally. Eight of these vaccines are now in the all-important Phase 3 clinical testing trials.

What process does the FDA require to ensure that vaccines are safe for use in people?

Traditionally, vaccine developers first test the viability and effectiveness of the proposed vaccine in laboratories, petri dishes and test tubes. If the vaccine appears to be effective, developers initiate testing on various animal models to assess efficacy and understand side effects and potential toxicities. These initial stages usually take many months to many years. Only if a vaccine appears effective and safe in animals, do human trials begin.

In order to speed the availability of an effective vaccine to address the COVID-19 pandemic, World Health and Research Organizations have reduced the requirements to move from the laboratory stage, to animal studies, and into human clinical trials. In many cases, vaccine developers have been permitted to initiate human trials prior to realizing final results from their animal trials.

Human clinical trials undergo three phases.
In Phase 1, the vaccine is administered to small groups of people, usually 20-50 volunteers. During phase 1, dosages are assessed to maximize efficacy and minimize toxicity. Toxicity, side effects and effectiveness are all assessed.

If the vaccine produces safe and promising Phase 1 trial results, Phase 2 is initiated by testing the vaccine on several hundred people. Developers focus on people that represent the population most likely to receive the vaccine. For Covid-19, this requires testing on a wide range of ages, both men and woman, with varying health issues, and from a variety of genetic backgrounds.

During Phase 3, the vaccine is tested for efficacy and safety on thousands of people. Does the vaccine induce the desired immune response? Is the immune response effective in preventing the disease and/or reducing the severity of the disease? How long does the immunity last?

What’s happening with Covid-19 vaccines in the US?

Two vaccines currently under development in the US have begun Phase 3 clinical trials as of July 27, 2020.

The US Government has created Operation Warp Speed and invested/pledged billions of dollars in funding to speed development of a Covid-19 Vaccine. To further speed the availability of the vaccine for human use, the government/FDA have approved concurrent vaccine manufacturing during Phase 3 clinical trials. If the Phase 3 clinical trials are successful, vaccine doses will be ready immediately to administer to the public.

However, this is another departure from traditional pharmaceutical and vaccine development. Normally, pharmaceutical developers are required to complete their Phase 3 clinical trials, provide the FDA with conclusive evidence that the pharmaceutical is both safe and effective in order to receive FDA approval. Only then does manufacturing begin.

The normal timeline for vaccine development is 5-20 years. Scientists, pharmaceutical developers and government agencies seeking to provide a COVID-19 vaccine within 1-2 years have dramatically changed the development landscape. Yet to be seen, is whether a safe and effective vaccine can really be developed with this accelerated timeline, even with streamlined testing requirements. In the next segment, we will review some of the most promising vaccines, available clinical results, and projected timelines.

LABELS:
statistics,
treatment,
testing,
vaccine

Part 1 of 2, Is it safe for students to go back to school? What do the numbers say?

Dr. Odelia Braun MD JD | Published on 07-23-20

There are approximately 83 million children and teenagers ages 0-19 who comprise student populations in the U.S. through primary and secondary schools. 13 COVID-19 deaths were reported in the 0-9 year-old age group between Jan 22nd and May 30th, 2020 according to the CDC. 33 COVID-19 deaths were reported in the 10-19 year-old age group during the same period. 1.5% of all COVID-19 cases in the U.S. occur in the 0-9 year old age group, and 3% of U.S. COVID-19 cases occur in the 10-19 year old age group The case fatality rate, (the number of deaths/number of cases of COVID-19) is .06% and .07% respectively.

By comparison, CDC reported 4,076 fatal injuries in the 0-9 year old age group, and 9,359 deaths in the 10-19 year old age group in 2018. Students in the 0-9 year old age group are 309 times more likely to suffer fatal injuries, than expire due to COVID-19 illness. 10-19 year old’s are 283 times more likely to suffer fatal injuries, than expire from COVID-19 infection.

In the 0-9 year old age group - 76% of fatalities were caused by unintentional injuries and 18.2% from homicide. In the 10-19 year old age group, 45 % of fatalities were a result of unintentional injuries, 32% from suicides, and 20.5% as a result of homicides. Leading cases of unintentional fatalities include motor vehicle crashes, suffocation, drowning, poisoning, fire and falls.

LABELS:
statistics

What is the difference in the ages of people who become infected versus those who die of the infection?

Dr. Odelia Braun MD JD | Published on 06-26-20

When we look at the age groups of people contracting the virus compared to deaths, there is a significant difference in the groups contracting the virus verses those dying from the virus.

Younger groups (18-44 and 45-64) account for the majority of infections, however, the virus is far more deadly in the older age groups (70+). If we can slow down the infection rates in the 18-64 group, we will inturn reduce the chances of the virus finding a way into groups who have a greater risk of dying from the virus.

The best way we can slow the spread of this deadly virus is to practice rigorous social distancing, constant handwashing and wearing some type of face covering when out in public places. Until we have a vaccine or herd immunity these, combined with increased testing, are simply the most effective tools we have in slowing the spread.

LABELS:
contamination,
statistics

Should we continue to wear masks?

Dr. Odelia Braun MD JD | Published on 06-16-20

Absolutely! At least in public. Particularly in spaces that are confined, such as stores, meeting rooms, or bathrooms. Masks should be worn while riding in any mass or multi-person transportation vehicle such as buses, trains, planes, taxis, and Ubers. It is also advisable to wear a mask in an auto if there are one or more non-family members in the car. In fact, many recommend that public transportation and taxis not allow more than one person to sit in a row to maintain proper social distancing.

However, masks are not necessary in your own home, or in your personal car or truck, when you are alone or with family members. Masks are not required at your workstation, provided your workstation is a minimum of 6 feet or 2 meters from the nearest occupied workstation. The coronavirus is still alive and hotspots of transmission and illness are still occurring in the US and around the globe. Until we have a vaccine, effective preventative or early treatment, or strong evidence that person to person transmission is no longer occurring, the most effective tools in our arsenal will continue to be wearing a mask, frequent handwashing with soap and social distancing.

Lots of commercial and non-profit organizations are now making masks of all fabrics, shapes, and designs. The most effective masks are those that are comfortable to wear, and easy to breathe in while wearing. Masks that are not comfortable or are difficult to breathe while they are on, will not be worn. Try various masks on. Masks with nose clips and air pockets in front of the nose are most likely to allow for easy breathing. Masks that allow the mask material to be sucked into your nostrils, can be very attractive , but are very difficult to tolerate for long periods of time. Try to wear the mask for 10-15 continuous minutes. If you cannot tolerate it for that duration, you will not wear it. Everyone’s face and nose are different. What is comfortable for one person, may not be for another, so go out and try on some masks, choose the one that’s right for you. Happy Masking!

LABELS:
PPE

Can the Coronavirus be spread by mosquitos?

Dr. Odelia Braun MD JD | Published on 05-28-20

According to official guidance from the World Health Organization (WHO) there is no information or evidence to suggest that the new coronavirus could be transmitted through mosquito bites.

Coronavirus is a respiratory virus, and the main mode of transmission are viral droplets released into the air when an infected person coughs or sneezes. For a mosquito to become infected with a virus, it must be present in the blood the mosquito feeds on. COVID 19 is a respiratory virus that mostly remains within the lungs and respiratory tract of infected people, and rarely gets into the blood. Additionally, for a mosquito to transmit the virus, the virus must be able to first replicate inside the mosquito before transmitting it to a person. Neither the new coronavirus nor any other type of coronavirus has been shown to do that.

LABELS:
contamination

Comparing CDC data on influenza deaths to Johns Hopkins COVID-19 deaths is like comparing apples to oranges.

Dr. Odelia Braun MD JD | Published on 05-18-20

Between 2013-2014 and 2018-2019, the CDC reported yearly estimated influenza deaths ranging from 23,000 to 61,000/year. As of May 1, 2020, 1/3 of a year, there were 65,753 deaths from Coronavirus SARVo2 (COVID-19).

But are these numbers truly comparable. The number of COVID-19 cases in the US on May 1, 2020 was reported by Johns Hopkins University as 1,131,030 and the number of deaths was 65,753. The numbers reported by the Johns Hopkins University are the actual counts of patients who are reported as having tested positive for COVID-19 and the number of deaths based on the patient’s death certificates.

The CDC does not present influenza data as actual counts of patients, but as annual calculated estimates, based on an algorithm that assumes many cases and deaths due to influenza are not reported. When the same methodology of counting actual reported cases and deaths is applied to influenza, the number of deaths/year range from 3448 to 15,620.

During the week ending April 21, 2020, 15,455 COVID-19 deaths were reported in the U.S. and 14, 478 COVID-19 deaths were reported during the previous week. The CDC has reported actual deaths, during the “peak week” of influenza seasons between 351- 1626 deaths/week. The average number of influenza deaths during the peak of influenza season was approximately 752. The average number of COVID-19 deaths during its current peak is 14,966. These numbers suggest that on average, COVID is up to 20 times more deadly than influenza.

LABELS:
statistics

Can my hair or beard hold onto the COVID19 virus and make me sick?

Dr. Odelia Braun MD JD | Published on 05-15-20

Usually viruses survive on porous surfaces, such as hair for lesser durations than that of smooth surfaces, such as steel or glass. Our hair, including beards, is covered in natural oils that cover the strand as a protectant. These oils do contain some antimicrobial properties that can limit how well organisms bind to hair. However, we cannot rely on natural oil production alone as it varies for each person and hair type.

However, we cannot rely on natural oil production alone as it varies for each person and hair type. COVID 19 infects us through the mucosa (nose, mouth etc.), therefore the risk is low that the virus would be contracted from the hair. However, if you are concerned, I recommend washing your hair daily. Using Shampoo will kill and remove both bacteria and viruses, including COVID-19. As the risk is very low, compared to hands, there is no reason to feel you now need to wash your hair multiple time as day.

The exception to this is someone who has a beard and is also positive for COVID-19. If this person coughs or sneezes, the beard will most likely trap some of the large, virus laden droplets. If this person were to then have physical contact with someone else, such as by kissing, then there is a much higher chance of transmission.

LABELS:
contamination

Am I supposed to wear a mask while in my car? Are the filters in my car enough to protect me inside or do I need to wear a mask? I was driving the other day and noticed that no one was wearing a mask while driving and my neighborhood has narrow streets/sidewalks, so people walking their dogs or out for a run were only about 1-2 feet away from my car.

Dr. Odelia Braun MD JD | Published on 04-28-20

No, if you are traveling alone in your vehicle with the windows up, there is little chance of catching COVID19 from someone passing by. The use of car’s HEPPA filters is designed more to capture pollens and dust, so they are not manufactured, nor tested to see if they are able to capture pathogens (germs). Even if your HEPPA filter is not rated to trap viruses, some filtration is always better than no filtration.

I would wear a mask inside of the car under the following circumstances (not an exhaustive list):

  1. Traveling with others, such as in a carpool situation or driving someone to the store.
  2. Work in a profession where you drive others, such as Lyft, Uber, taxi, etc.
  3. Traveling with someone in a high-risk group, such as seniors and immunocompromised.
  4. You are actively coughing or sneezing, so you do not contaminate the car. This is especially important and should also include wiping down the inside of the car if the car is used by others.
  5. Are driving with the windows down and pedestrians or other vehicles could be within 6 feet of your open window.
LABELS:
masks,
social distancing,
PPE

What is magical about the 6-foot social distancing number?

Dr. Odelia Braun MD JD | Published on 04-27-20

When an individual infected with corona virus coughs or sneezes, small drops of virus filled liquid are sprayed out. If you are standing within 6 feet, these droplets may enter your nose or mouth. Research from MIT recently discovered that a sneeze could theoretically travel up to 200 feet! So why six feet? Different sized droplets are sprayed from coughing or sneezing. The larger the droplet, the more virus particles they contain. Since larger particles are heavier, they tend to fall to the ground faster and the majority of the time they fall within 6 feet.

In addition, research suggests that the corona virus may be aerosolized through simply talking or exhaling. It is not yet understood the real-world impact of this finding. Even if no one is actively coughing or sneezing, if you are standing within 3.5 feet (WHO) of a person, you may be in their breathing zone and inhaling potentially infectious particles. This is the reasoning behind the 6-foot rule. If someone is actively coughing or sneezing, the further you are away from them the better, as smaller droplets may remain airborne for at least an hour.

LABELS:
social distancing

I heard that people are getting infected by the bottom of their shoes. They walk around outside and then bring their shoes home. Is there evidence to back this up? Are we supposed to disinfect the bottom of our shoes now?

Dr. Odelia Braun MD JD | Published on 04-16-20

A study published in the medical journal of Emerging Infectious Diseases (EID) in April showed that healthcare workers assigned to ICU wards did have detectable coronavirus on their shoes. Unless you are working In a healthcare facility where corona patients are being cared for, it is very unlikely that the average person is at risk of coming into contact with the virus through shoes.

The CDC has said that even if a small amount of the virus does get on your shoes, it is not thought to be the main way the virus is spread. In addition to the CDC, Dr. Amesh Adalja, who is an infectious disease specialist at John Hopkins said that “while it is biologically possible to that the coronavirus can be transmitted via all sorts of objects, including shoes and fabrics, this is likely not a major mechanism of infection”. “This is not a major risk I would worry about”, Adalja said.

If you are concerned about tracking in the virus on your shoes, consider picking one pair to wear when you are out and about and remove them before entering your home. Cleaning of your shoes by hand is not recommended as you risk contaminating your hands in the cleaning process.

LABELS:
contamination

Will the freezing temperatures of my freezer or chilling temperatures of my refrigerator kill the Coronavirus for food items that may have been contaminated?

Dr. Odelia Braun MD JD | Published on 04-14-20

Freezing fresh produce or other food in attempts to kill viral matter is not effective. Consider the fact that freezing is how they preserve viruses in the lab. The same holds true for the refrigerator.

If you are concerned about the virus, I would recommend wiping down the plastic with a soapy cloth. The soap will kill any of the virus, making the packaging safe to place in freezer or fridge. It is also worth noting, the virus lives on plastic on average between 48-72 hours, so if the packaging sits for longer than this, the chance of infection is greatly reduced.

For vegetables and fruit, as of today, the FDA does not have any evidence of anyone becoming sick from the virus being transmitted from produce. However, it is advisable that all produce be properly scrubbed under running water. It is not recommended that soap be used on produce, but the brush used for scrubbing should be washed with soap after it has been used.

LABELS:
contamination

When will testing be made available to each California resident? If we aren’t all tested, how do we rule out who may have already had the disease and don’t need treatment or have developed antibodies versus the asymptomatic person?

Dr. Odelia Braun MD JD | Published on 04-10-20

Under current testing, we are conducting approximately 5,193 tests per 1 million of the population. When compared to other states, such as New York (18,613 per 1 million) or Louisiana (17,456 per 1 million), California is pretty far behind, and it is doubtful we will catchup. However, there is a test in development that addresses your question about antibody testing, and the intent is to roll this test out on a mass scale.

The test you currently see being used is a swab test, known as RT-PCR testing and only tests to see if the person currently has COVID19. The test does not indicate if the person has antibodies, which would mean they were already exposed to the virus and may no longer be susceptible.

The new test under development, called an Antibody or ELISA test, will tell us who has COVID19 antibodies. Once fully implemented, the test will allow those who test positive for antibodies to resume normal activities, while keeping those who test negative at home.

Researchers at Stanford and other institutions have already made significant progress in this endeavor and are currently in the trial phase of testing. Unfortunately, there isn’t a timeline yet on when it will be approved for mass use, but many are optimistic we may see them within the next 2-3 months.

LABELS:
testing

What is the ELISA test, and why is it so important?

Dr. Odelia Braun MD JD | Published on 04-09-20

The current COVID-19 swab test does NOT tell us if an individual has previously been infected, and is now immune.

When the body is exposed to a foreign agent, such as the coronavirus, it mounts an internal defense. The body’s immune system produces infection-fighting proteins called antibodies, that remain in the individual’s blood long after the infection has passed. In order to determine if an individual has previously been infected with the virus, a blood test that looks for antibodies to the specific virus is required.

An effective test that measures these antibodies is the ELISA test (Enzyme Linked Immunosorbent Assays). It is a very sensitive test and is practical enough to use for mass screening purposes. The ELISA test, has been developed for many other viruses, including HIV, varicella-zoster (chickenpox virus) and has been developed for other coronaviruses, including SARS and MERS. It has not yet been developed for the coronavirus COVID-19.

Development of a coronavirus specific ELISA test would be an extremely important development that would assist public health officials in better determining the timeline of this pandemic, and the level of immunity in the general public. It would also be extremely beneficial in getting U.S. workers back to work.

Multiple genetic researchers have concluded that the coronavirus’s genetic composition is not changing dramatically, as it spreads like wildfire across the globe. This is very good news, because it suggests that once you have formed antibodies to the coronavirus, you are immune to it, and will not become ill with it again.

It also means that even if others around you may be unknowingly infected, if you are immune, they cannot infect you. This knowledge will allow us to send individuals who are immune safely back to work. Dr. Deborah Birx, a member of the National Task Force for coronavirus, challenged the most prestigious virology labs in the country to develop an ELISA test as rapidly as possible, prove its viability, and make it available as rapidly as possible. Since the ELISA test is widely available for other viruses, there is reason to believe that developing a coronavirus specific ELISA test can be rapidly developed.

Dr. Birx challenged our medical professionals and scientists to develop a coronavirus specific ELISA test by the end of April.

LABELS:
testing

How effective is the current COVID-19 swab test in telling us whether someone is infected or not?

Dr. Odelia Braun MD JD | Published on 04-09-20

The current COVID-19 swab test used in the U.S. requires a healthcare professional to swab the inside of a patient’s nose and send the mucus sample to a professional laboratory. A technique known as Reverse Transcriptase Polymerase Chain Reaction,or RT-PCR, is used to look for coronavirus genetic material. The patient’s sample is added to chemicals that strip the mucus sample down to its basic RNA. In the laboratory, enzymes are added to transcribe the RNA to DNA. The test then seeks toidentify specific DNA genes found only in the coronavirus. If the testing process identifies 2 genes specific to the coronavirus, the test is considered positive. If only one gene is detected it is considered inconclusive.

A positive test means the individual has coronavirus in their system. The individual is infected and can transmit or spread the virus to others. Several research studies have concluded that the COVID-19 swab test is only 70-80% sensitive. This means that 20-30% of the time, the individual’s COVID-19 swab test result is negative, but the person is actually infected with the coronavirus.

Research demonstrates, however, that the test is very specific (98% specific). This means that if your test is positive, you are definitely infected and can spread the virus to others. Some physicians and researchers ask, “Why, if our testing fails to identify 30% of the people who actually have the illness, should we test”? That’s actually a really good question. The answer varies depending on the purpose of the testing. In the U.S. where wide-spread testing is generally not conducted, but is limited to patients who are very ill, doctors use it to confirm their suspicion, and hopefully, in the near future, to guide the patient’s treatment. Patients may be comforted by knowing what is wrong with them.

In other countries, who tested early and often, testing was used to rapidly identify infected people and immediately place them into strict quarantine. Public health officials tracked contacts of people who tested positive, tested these contacts, and ifcontacts tested positive, they were quarantined. This was a very effective tool in countries such as South Korea, Hong Kong, Taiwan and Vietnam, all in close proximity to China to slow the spread of infection.

Importantly, due to the relatively low sensitivity of the COVID-19 swab test, if you have typical symptoms of coronavirus such as fever, dry cough, fatigue and muscle aches, you should assume that you have the coronavirus, irrespective of your test results. Your physician may request that you re-take the test if you continue to have symptoms that do not get better, or symptoms that progress, such as shortness of breath, the hallmark of “getting worse.”

LABELS:
testing

I have only "industrial vinyl" gloves, which say they are for "non-medical use only". Does this mean they are useless against this virus and I should not bother or are they better than bare hands?

Dr. Odelia Braun MD JD | Published on 04-01-20

Industrial gloves will absolutely provide protection. Here’s the real difference between the two types of gloves:

Medical grade gloves must pass a series of technical tests to see if they meet the safety requirements put forth by the FDA. Gloves are tested for puncture and abrasion resistance, they are run through tension and elongation tests, and are also tested for chemical substance resistance.

The guidelines and requirements from the FDA are hard and fast, if the glove does not pass the tests, it is not considered “approved” by the FDA, however, this does not mean that if a glove is not safe to use. These gloves are safe to use as they must still meet certain levels of chemical penetration and puncture resistance. It just means that they missed the mark to be considered medical grade gloves.

Therefore, unless you are working in a hospital or other healthcare setting where medical gloves are required, the industrial grade gloves will afford you more protection than not using gloves at all.

LABELS:
PPE

Can you catch coronavirus from blood?

Dr. Odelia Braun MD JD | Published on 04-01-20

Many diseases can be spread through blood and blood products. Fortunately, COVID-19, like many other respiratory diseases, does not seem to be one of them. To date, there have been no reported cases of blood transfusion-transmitted coronavirus.

LABELS:
contamination

How serious is the coronavirus compared to other viral outbreaks? Is it more deadly?

Dr. Odelia Braun MD JD | Published on 03-31-20

The mortality rate (death rate) is higher than some, such as Influenza A, but lower than other viral pandemic/epidemics we have encountered.

Mortality Rates
Influenza A: .1%. (1 person out of 1000 people who contract Influenza A will die).

COVID-19: currently estimated at 2.5-4.5% (25-45 out of 1000 people who contract COVID-19 will die)—(This number may be inflated due to lack of testing. A large number of asymptomatic or mildly symptomatic people who are infected are not tested).

Other recent viral pandemic/epidemics have higher mortality rates or case fatality rates (CFR) For example:

  • Ebola – 50% CFR (500 people per 1000)
  • MERS – 34.4 CFR (340 people per 1000)
  • SARS – 14% CFR (140 people per 1000)
  • H1N1 – 11% CFR (111 people per 1000)
LABELS:
statistics

Why are people buying toilet paper?

Dr. Odelia Braun MD JD | Published on 03-26-20

Panic buying behavior occurs when the brain switches into survival mode. Panic overrides rational decision making. According to Dr. Ali Fenwick, human behavior expert at Nyenrode Business University, there are 4 main reasons why people behave in this fashion:

  1. Survival mode
    When the brain detects a threat, such as the current pandemic, the more primitive part of the brain takes over, and its main objective is to keep you alive. This suppresses or distorts rational thinking. As an example, despite repeated government assurances there will not be a disruption to the food supply, the primitive part of the brain continues to fear the lack of food, and buys and hoards food, to ensure survival. Under these circumstances, people desperately need to feel in control. Purchasing toilet paper allows them to achieve a sense of control.
  2. Herd behavior
    The fact many people are purchasing toilet paper, leads still others whose rational thinking process has been diminished toassume that purchasing toilet paper must be important. Mimicking the behavior they see around them makes them feel safe.
  3. Sense of control
    In uncertain times, individuals can feel a frightening loss of control. They seek out actions that give them the perception of control. We don’t feel as though we can control the spread of disease, the stability of the financial markets, the ability of our healthcare system to support us. However, in our plentiful consumer-oriented economy, we can purchase goods easily. We want and need to be successful. We can purchase online, we can have products delivered, we can pick up at the store, we can shop in the store. Since, goods are plentiful, we will succeed when we attempt to buy food, drinks, and cleaning products. And therefore, we will buy, buy, buy. We have succeeded, we are in control.
LABELS:
behavior

Why are all the bars closing?

Dr. Odelia Braun MD JD | Published on 03-17-20

This virus is easily transmitted from person to person, without the infected person even knowing they are infected. As such, it is critical for everyone create and maintain a 6ft buffer (social distancing) around them. This is impossible in a packed bar. Think of the environment in most bars: lots of people, music or other noise so you are forced to move closer to a person in order to talk; the sharing of drinks, and maybe even physical contact on a good night. Simply ordering your drink forces you to lean in so there is less than 2 feet between you and the bartender. All these actions create the absolute perfect scenario to spread COVID-19.

LABELS:
behavior

I am over 80, what is your advice on whether I can go to the store to buy groceries?

Dr. Odelia Braun MD JD | Published on 03-17-20

The current store recommendations are that anyone over 65 years of age should remain indoors. This is important because research has concluded that anyone you encounter could be capable of transmitting the virus, even if they’re not showing any signs, such as coughing. You are also at risk of picking up the virus when you touch a shopping cart, handles in the refrigerator/freezer section and countertops that virus filled droplets have fallen upon, then inadvertently touching your mouth nose or eyes. If at all possible, take advantage of grocery delivery services, or have family, friends, neighbors to do your shopping. As a last resort, if you must shop for yourself, many stores have set up special hours for seniors.

LABELS:
social distancing

I keep hearing things about drinking alcohol will help; Is this true?

Dr. Odelia Braun MD JD | Published on 03-17-20

There isn’t any truth in this at all. Alcohol will not kill the virus. While it may have a short-term uplifting effect, more likely it will proceed to depression and hopelessness.

LABELS:
treatment

Because I am young, does this mean I am far less likely to contract the virus?

Dr. Odelia Braun MD JD | Published on 03-17-20

Current data does indicate that the younger population (less than 30y/o) is better able tolerate the coronavirus infection. Less than 2% of symptomatic young people require hospitalization.{' '} This does NOT mean that young people are less likely to become infected. {' '} Since most young people have mild or no symptoms even if they are infected, they are rarely tested.

Emerging data from Europe shows an increase in hospital admissions in the 20-50 year old age group, as high as 40% of new admissions. We are not sure why. It is important to understand that even though you do not feel ill, or have symptoms, you may still be infected with the virus, and are able to infect others. We need our young population to understand that they are extremely important in curbing the virus. This is why social distancing in all age groups is so important.

LABELS:
contamination

What is my probability of infection for COVID-19?

Dr. Odelia Braun MD JD | Published on 03-17-20
  • Several studies published in the past few days create even more uncertainty, as they have confirmed both the existence of airborne transmission, and asymptomatic transmission
  • An article in the New England Journal of Medicine published yesterday concluded that the coronavirus can be transmitted when an infected person exhales, or breaths out normally. The infected person exhales viral particles into the air just by breathing normally. Therefore, we can no longer assume that we will avoid being infected just by avoiding people who are coughing and sneezing. The study demonstrated that virus particles that are exhaled can live in the air for up to 3 hours, and that these particles can transmit infection. So, anyone, including young people, who appear perfectly healthy, may be exhaling contagious viral particles.
  • In a second study out of Northern Italy, investigators randomly tested 3000 individuals in their community. 50-75% of the individuals who tested positive for coronavirus, did not have any symptoms. This suggests that transmission of disease from asymptomatic healthy people is not only possible, but may be a major source for spreading the disease.
LABELS:
statistics

What is my probability of infection while grocery shopping?

Dr. Odelia Braun MD JD | Published on 03-17-20
  • Generally speaking, you should not go to the grocery store at all, if you can order your groceries online and have them delivered.
  • This is especially true if you are older (>60 years old, or have underlying chronic diseases such as heart or lung disease, diabetes, cancer or other diseases that affect your immune system. Serious disease in the elderly rapidly increases by the decade, as does the associated mortality.{' '}
  • If you are under 40, and you visit the grocery store, you may well contract the infection, but the likelihood is that your disease will be like a mild flu. However, although you may feel perfectly healthy, the Italian study suggests you may already be infected, and your presence in the grocery store may serve to transmit the disease to others.{' '}
LABELS:
statistics

What is my probabilty of infection while traveling through an airport?

Dr. Odelia Braun MD JD | Published on 03-17-20
  • Airports are even higher risk because of the greater numbers of people, the close proximity between people, and the likelihood of close contact, having people breath, sneeze and cough on you, and touching surfaces that virus droplets may have landed. Each of these factors, would result in a greater likelihood of becoming infected.
  • Right now, in the US, I recommend that you order your groceries online and have them delivered, and avoid all public transportation especially airports, except in the most critical of circumstances.
LABELS:
statistics