With SMH Infectious Disease Specialist Manuel Gordillo, MD
As our community moves into a new chapter of the evolving COVID-19 pandemic, many of our Healthe-Matters readers have reached out with new concerns and new questions — from how we should protect ourselves in this new normal to deciding factors for allowing kids to be kids again and the likelihood of a secondary outbreak.
In this “Ask An Expert” post, Dr. Manuel Gordillo, who oversees Sarasota Memorial’s Infection Prevention and Control Department, answers readers’ most common questions about the novel coronavirus and the disease it causes, COVID-19.
What is the probability of a 'second wave' of the COVID-19 outbreak, in your opinion? Is Sarasota Memorial Hospital prepared to take a surge if that happens? ~ Lucy from Longboat Key
There is a significant risk of resurgence. Humans have not changed. The virus has not changed. The main thing that has changed is the way we behave — by distancing ourselves.
As communities go back to the pre-pandemic way of behaving — by relaxing physical distancing, etc. — then obviously, there is a huge risk of having a so-called “second wave,” even multiple waves. And it's probably going to happen. As I said, there is no reason why it would not happen, if we're going to go back to our previous behavior.
The key is going to be detecting the trend early and intervening to quell it early on — not like what happened in the country in February, when there were COVID-19 cases identified but little action to try to stop it from spreading across the nation.
Are we prepared to detect cases early and intervene — testing everyone who shows symptoms, tracing all their contacts and quarantining those identified? That's going to be the key issue.
I do believe Sarasota Memorial Hospital is well-prepared to handle a second wave. Our leadership has done a very good job of showing how prepared the healthcare system has been from the very beginning. We've never been as stressed as other facilities — like those in New York, Italy or New Orleans. We feel very confident that Sarasota Memorial has the resources and capacity to deal with whatever may come.
I am 67 years old, my partner is 78, and we are both in excellent health. With public spaces “re-opening,” what should seniors do to protect themselves? ~ Diane S.
I would recommend that seniors — everyone, really —continue doing what they've been doing these past several weeks: physical distancing, using face masks and following instructions for hand hygiene from the Centers for Disease Control and Prevention (CDC), the Sarasota Health Department and the Florida Department of Health (frequently wash for 20 seconds with soap and water, or use alcohol-based hand sanitizer). And avoid touching your nose, eyes and face. These are all critical to maintaining your health, and they will continue to be critical for the foreseeable future.
If you exercise physical distancing and you're wearing a mask, you're probably safe — as safe as it's going to get. You're not going to be any safer today than later in the year.
When should we wear masks? Just when shopping? Or when walking, cycling or spending time outdoors? ~ Bob G.
In general, infectious disease experts support the universal use of face masks when you will be — or may be — closer than 6 feet to anyone outside your household. Even if you will be outdoors, if there’s a chance you may be within 6 feet of someone other than your household members, then wear a mask or face covering.
Wearing a mask is extremely, extremely important because it creates a barrier between your mouth and others, preventing you from transmitting COVID-19 before you may know you have the disease. (People can have COVID-19 for three days before developing any symptoms, or may be asymptomatic.)
It’s equally vital that people in our community continue practicing physical distancing, in order to prevent the spread of COVID-19.
We cannot rely on immunity yet. Even if you've had the disease, we don't know for sure whether you cannot get it again. We think you cannot, but that has not been conclusively demonstrated.
What are the guidelines for spending time with people outside your household; for example, visiting with grandchildren? ~ Bob G.
If you look at all of the guidelines, none offer specifics on this, because each child and each situation is so different.
Keep in mind that children, even though they may not have symptoms, they can still carry the virus. They can be asymptomatic and transmit it, or they can have a very mild illness with just a runny nose, and they'd still be contagious.
If your grandchild is a teenager, he/she likely can follow instructions and remain at a safe distance, wear a mask and wash hands before visiting, etc. But a toddler on the other hand is less likely to understand or follow these important rules.
With children, the determining factor is whether a child has behavior control and he/she can stay at a certain distance and follow instructions. If he/she cannot do that, I don't think we're ready at this point — maybe later on or when we have vaccines, when there's other new knowledge, antivirals, etc., and then we can take a few more risks. But not at this point.
I have a kindergartner and a middle-schooler. Is it safe for me to allow them to play outside with friends yet? ~ Samantha C.
As mentioned above, it really depends on that child. It’s possible that your middle-schooler has the behavior control to abide by physical-distancing rules. If he/she can do this and will wear a mask, practice appropriate hand hygiene and not touch his/her face while playing outdoors, then it may be safe with a limited number of close friends.
It’s doubtful that a kindergartener can have such self-control. So no, I would not yet recommend playdates for that age group. We’re just not there yet, as far as having a handle on community spread, treatment and preventing the disease.
Do we need to worry about becoming infected with COVID-19 from handling mail, packages or groceries? ~ Susan B.
Can it happen? Yes, but it would be extremely unlikely. There've been millions — perhaps billions — of exposures of this kind, and nobody has been able to directly link a COVID-disease outbreak with a situation of that kind.
If you have an opportunity to wipe down mail, packages or groceries with disinfectant or soap, go for it. But sometimes you can't, and the potential risk of transmission is very, very low.
It’s more important that you practice hand hygiene after touching anything that comes from outside your home. After handling groceries or mail, wash your hands with soap and water for 20 seconds, or use alcohol-based hand sanitizer, if you have it available. Do not touch your eyes, nose or mouth before doing hand hygiene, because that's where it can get you — the virus transferring from your hands to your respiratory tract.
When will it be safe to travel domestically? When will it be safe to travel internationally? ~ Peter T.
At this point, we don't know when it is going to be safe. I think whenever you travel —domestically or internationally — there is some risk. I would say don't travel right now, unless you absolutely must.
Do the people who are asymptomatic ultimately form antibodies to the virus and become noncontagious? ~ Mary C.
People who have had asymptomatic COVID-19 have been found to have antibodies, but we still do not know at what rate and to what extent. By extrapolating from what happens with other human coronavirus, we believe these people may have some degree of immunity. But this remains to be proven and is one of the crucial insights that we must learn in the next several months.
Have a question for Dr. Gordillo or another SMH expert? Send it to firstname.lastname@example.org.
** NOTE: Information above was last updated May 13, 2020. Data and information related to COVID-19 are continually evolving. For the most up to date info, we recommend visiting the CDC’s website at https://www.cdc.gov/coronavirus/2019-nCoV/index.html.