Covid-19 with doctor

Expert Question and Answer for COVID-19

Have a question about the Coronavirus (COVID-19)?

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

Dr. Odelia Braun MD JD

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)

Why are people buying toilet paper?

Dr. Odelia Braun MD JD

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.

Why are all the bars closing?

Dr. Odelia Braun MD JD

This virus is easily transmitted from person to person, without the infected person even knowing they areinfected. 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.

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

Dr. Odelia Braun MD JD

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.

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

Dr. Odelia Braun MD JD

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.

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

Dr. Odelia Braun MD JD

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.

What is my probability of infection for COVID-19?

Dr. Odelia Braun MD JD

  • 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.

What is my probability of infection while grocery shopping?

Dr. Odelia Braun MD JD

  • 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.

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

Dr. Odelia Braun MD JD

  • 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.