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Essential health information from local experts

‘Just Be Smart’ ~ SMH Expert Answers Your COVID-19 Qs

With SMH Infectious Disease Specialist Manuel Gordillo, MD

 

Our community has been dealing with the COVID-19 health crisis for nearly three months — three very long months. It’s understandable that we are all feeling “quarantine fatigue” and are anxious to get back to our normal routines and normal behaviors. But, as a community, are we really there yet? 

Can we safely return to our pre-pandemic behaviors — given the status of COVID-19 infections and community spread in our area, and considering where we are globally with understanding the novel coronavirus and establishing an effective vaccine, proven treatment and testing access for all?

To a degree, yes, but there are caveats.

“Just be smart when you go out,” explained Dr. Manuel Gordillo, who leads Sarasota Memorial’s infectious disease department as medical director. 

Choose outdoor activities rather than indoor ones, he advised. Practice physical distancing (6 feet minimum). Keep groups very small; activities that involve a lot of people congregating are higher risk. Wear masks, not just for your protection, but more importantly for everyone else's protection. 

“I know it's sometimes difficult to wear a mask and uncomfortable,” Dr. Gordillo added. “But this is what's going to prevent us from going back to where we were in February.”

And don't forget the basics: practice hand hygiene and physical distancing, cover your cough, and stay home, if you're feeling sick. These are the most important things we can do, he added. 

Ask An Infectious Disease Expert Q&A with Dr. Gordillo

In recent weeks, the Healthe-Matters’ inbox has been flooded with reader questions about COVID-19 and how we can safely move into the so-called “new normal.” We sat down with Dr. Gordillo to get his expert insights on these questions.

Why are COVID-19 cases still going up in Sarasota? ~ Gerogia F.
Actually, the numbers of positive COVID-19 cases are not going up. They have been gradually coming down since mid-April. And now, we're at a sort-of plateau. We’re seeing about four to 10 cases a day, and a lot of that is driven by small clusters, such as those in assisted living facilities. Last week, for instance, one nursing home accounted for about 45 new cases in a single day. But in general, it's been coming down slowly for weeks.

Recommendations & Precautions

Is it safe to be around someone who had COVID-19 and recovered? ~ Bill C.
It is, if they have hit certain benchmarks in their recovery, but everyone should continue to practice physical distancing and wear a mask in social situations.

When you have COVID, you’re contagious for about 10 days after symptoms started. For the vast majority who have COVID-19, we recommend quarantining until 10 days after symptoms presented and they have been symptom free for at least three days. That means being fever-free without the use of fever reducers and respiratory symptoms improving for three days or more.

At that point, they can go back to work or start socializing again, as studies have shown that at that point in time, they’re not contagious. 

Is it safe to send children to summer camp this summer? ~ Debbie B.

We don't know how safe it is going to be. But to reduce risk, both the federal Centers for Disease Control and Prevention (CDC) and the American Camp Association offer recommendations for parents, campers and camp administrators. With these recommended changes for physical distancing and reduced capacity, summer camps will certainly look different this summer than last summer. 

My husband is scheduled for an MRI of his heart in late June. I’ll be accompanying him, and I’m a breast cancer survivor. We're very afraid to go to the hospital. What extra precautions should we take to ensure both of us are safe at the hospital? ~ Pam V.

Actually, I feel very comfortable coming to work at Sarasota Memorial each day. I don't feel threatened by coming here, whereas going to some other businesses I might feel anxious or uncomfortable.

Local businesses have made tremendous inroads in establishing new safety practices. But hospitals have been dealing with infectious diseases for many decades and have been responding to COVID-19 for several months. By now, at least in the U.S., hospitals have developed safe infection prevention practices that are models for other businesses. 

At Sarasota Memorial, for example, I can't even count all the things that we've done during this pandemic to ensure the health and safety of staff and patients. 

Hand hygiene is practiced impeccably in the hospital. We have asked everybody to wear masks while walking in the halls, on the units and other places. We check everybody at the door for symptoms; we check their temperatures; we provide them with a mask before they come in. We have restricted visitors with very limited exceptions. In the places where we don't have visitation, it’s we don't want folks to bring the virus into the hospital. We test patients before they have surgery. We monitor all employees throughout the day. We send them home when they're ill. 

So hospitals, in general, tend to be among the very safest places to go right now.

Testing

I think I had COVID-19 but never got a test. Would you suggest getting an antibody test now? ~ Karissa B.

The best way to find out whether you’ve had COVID-19 is to do an antibody test, BUT be careful with false positives. This is a major caveat!

The accuracy of the test will depend on the prevalence of the disease in the population. The prevalence in Sarasota is very low. Even though the disease has been here for nearly three months, less than 3% of our population has been affected by the disease. So, if you test the entire population, you're going to get a lot of false positives at the current rate.

Will asymptomatic people test positive for COVID-19 or only for the antibodies? For how long are they able to infect others? ~ Nadia L.

Asymptomatic people can test positive for COVID-19 when samples are collected using the nasal swab or the oropharyngeal swab. Antibody tests are not a good way to test whether someone is asymptomatic, because they are not an effective way to detect the disease. The best detection test is the PCR test, the nasal swab.

Asymptomatic infections are still a major issue, because most respiratory diseases generally don't have a long asymptomatic period. COVID-19 appears to sometimes have a long asymptomatic period, where you have no symptoms before you actually develop an illness such as a fever or a cough, and some people never develop symptoms. This obviously makes it difficult to detect those who asymptomatic.

Travel Precautions

Our county has one of the highest instances of COVID-19 in our state. Yet, my family members plan to drive 1,000+ miles to their Sarasota home this week. None have been tested, nor have they completely self-isolated. I'm concerned for their safety and others’. Should they quarantine once they arrive? Any safety tips for long-distance road trips? ~ Phillip S.

We obviously do not recommend taking these types of long road trips right now, unless they are critical and absolutely necessary.

The state of Florida formally asks that visitors (long term or short term) self-quarantine for two weeks if they have been in Louisiana or the Tri-state area of New York, Connecticut and New Jersey (and a list of international locations). That is state mandated. Now, if you've been in another area where there is ongoing transmission and a high incidence of a disease and you're coming here, then you really should self-quarantine after arrival as well. 

When essential travel means driving long distance (and likely staying in hotels, using public restrooms and eating at restaurants), stick to the basics: diligently practice hand hygiene, physical distancing and mask wearing in public places. Plan to use restaurant drive-thus instead of eating inside restaurants. When you use public restrooms, be mindful of hand hygeine and wear a mask. 

I also recommend reading through the Florida Department of Health’s tips for domestic travel: Click here.

My husband (84) and I (74) have been in Florida for the season and plan to fly back to Connecticut. When would be the best time to go: June or wait to see whether the number of cases might go down? ~ Mary E.

Travel increases your chances of getting and spreading COVID-19. If you fly back in June, it should be for an essential reason — like you have to go to work or to deal with a medical issue. Just returning because you want to return is probably not a good enough reason. 

Having said that, sitting on an airplane is fairly low-risk for COVID-19 infection, as long as there's enough physical separation between the seats. The problem with air travel is going through in the airport, using public restrooms and getting stuck in bottlenecks, where there are lots of people — from all over the world — in one place and no opportunity to physical distance.

Be sure to wear a mask and make sure you have access to hand hygiene and hand sanitizers. 

So if it’s June or some other time, I say you should probably wait for the other time — but we don't know when that time will be.

Be sure to visit the CDC and Florida Department of Health websites for more guidance on domestic travel.

For more Q&As with Dr. Gordillo and other Sarasota Memorial medical experts, click here.

 

** NOTE: The information above was last updated May 22, 2020. For the most up-to-date COVID-19 info, we recommend also visiting the CDC’s website at https://www.cdc.gov/coronavirus/2019-nCoV/index.html. **
 

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Posted: May 22, 2020,
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Author: Ann Key
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