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Are gloves a good form of protection against COVID-19? Dr. Shafinaz Akhter, infectious disease expert at Chester County Hospital, answers that and more in our next COVID Conversation.

You can view this conversation in the video below or read the accompanying transcript.

VIDEO:


 

TRANSCRIPT:

Hello, I am Dr. Shafinaz Akhter, infectious disease expert at Chester County Hospital, thank you for joining me for our next COVID Conversation.

Thank you for the questions you have submitted for us to answer, we have selected the top 10 submissions and will address those in this episode.

I want to also thank the community for all of your support, generosity and love during this time. Each of us has experienced a new way of life for the last couple of months in an effort to protect ourselves, and our friends, families and neighbors. It has been inspiring and heartwarming to witness how the community has come together to fight COVID-19.

And now for our top 10 questions.

Question 1 - (0:51): If an individual has tested positive for COVID-19 and does not have a fever but is experiencing a cough, how long are they considered contagious and when can they be around their family again?

The short answer is that we do not know for sure.

We think that people are contagious for about 2 days BEFORE the onset of their symptoms and likely for at least 7 days after their symptoms have started. By the time people start feeling better, they are likely much less contagious. Some people, usually the sickest, can have viral RNA in their respiratory tract for weeks, but this does not mean that they are contagious for that whole time.

RNA stands for Ribonucleic Acid and it is part of the genetic makeup of viral particulars in the case of COVID.

The CDC suggests that you are contagious for at least 7 days from when your symptoms have started or after 3 days when you feel better (usually no fever without using fever-reducing medication)- whichever is longer. The cough can last for weeks as can the loss of smell and probably does not correlate well with being contagious.

I would say that, without fever, try to isolate for at least 7 days. Give yourself 3 full days where most things have returned to normal, except for cough. You are likely OK to be around your family again at that point.

This should all be prefaced also by who you have around you. If close contacts have complicated medical conditions, like cancer or chemotherapy or organ transplantation, I would advise extra caution.

Question 2 - (2:26): Can pets get infected with the virus too?

We know that there have been reports of cats (both domestic cats and tigers and lions) developing mild respiratory symptoms and testing positive for COVID. A few dogs have also tested positive.  There have been no reports of pets passing COVID to their owners.

Question 3 - (2:52): What hygiene steps should you take at home, especially after leaving the house for essentials, should I change and wash my clothes upon return?

We think that COVID is transmitted through droplets- this means that the virus is released in the respiratory secretions when a person with infection coughs, sneezes, or talks.  
These droplets can infect another person if they make direct contact with the mucous membranes- in other words- if those droplets end up in the nose, mouth or eyes. Infection can also occur if a person touches an infected surface and then touches his or her eyes, nose, or mouth. Droplets typically do not travel more than six feet and do not linger in the air. So, all this means that sticking to your clothes is probably not a main way that COVID is spread.  You would have to have someone cough on your clothes and then touch the affected area quickly and promptly touch your eyes, nose or mouth.  It’s not impossible but not very likely either. I would say if you wear a mask and keep your hands clean- especially before touching your face- this is the best protection.

Question 4 - (4:04): Many people are wearing gloves while shopping and out in public - is this a recommended approach to protecting oneself?

The problem with wearing gloves is that people feel that they are “cleaner” than your bare hands. If you touch a contaminated surface with either your bare hands or gloves and then touch your face- the risk is the same. The trick is to keep cleaning your hands and simply having gloves on does not remove that need.

Question 5 - (4:35): What are the chances of catching COVID-19 while wearing a mask if others are not?

We think that masks are generally most effective at stopping the spread of infection and play a smaller role in preventing the acquisition of infection. So, if you are sick, your secretions are not being spread very well if you are wearing a mask. However, if someone around you is sick and not wearing a mask- they can still spread the virus. Remember that their secretions would still need to make their way to your nose, mouth, or eyes and this may be reduced if you are wearing a mask. BUT, people often fiddle with their masks and touch their faces and don’t clean their hands as often as they should.

Question 6 - (5:21): If a previously infected patient tests negative, can they still shed the virus?

Another question where we do not know for sure. The most common way that we test is using a swab in the nose and looking for viral RNA.  As I said before, some people can have viral RNA in their respiratory tracts for weeks but this does not mean they are shedding the whole time or may only have very small levels of viral RNA or it could be dead viral particles that we are detecting. The more confusing issue is that studies suggest that some people (probably less than 5%) can test negative through this assay and then test positive again. We do not know if this means that they have reactivated their infection, become infected again, or that the negative tests were not accurate.

Question 7 - (6:16): How is the hospital caring for patients with suspected or known infection?

The care of COVID positive patients is largely supportive. In other words- we give them oxygen and sometimes have to place them on a ventilator to help them breathe. We can perform dialysis if their kidneys are not working well and patients are also receiving blood thinners to try prevent some of the clotting complications that we and others have seen. We basically support the body while it fights off and heals from the infection.

Some patients also receive antibiotics which do not fight the COVID virus itself but can attack bacterial infections that can go along with the viral infection. We have given a few patients convalescent plasma which is a blood product obtained from people who have survived and healed from their own COVID infection and have antibodies that help fight it. Finally, we have at least one patient on an antiviral medication called remdisivir which has activity against the virus itself.

Question 8 - (7:23): Is it safe to come to the hospital for tests and procedures?

Yes. Every department throughout the hospital adheres to strict infection control measures - frequent hand washing, regular cleaning and disinfecting, as well as practicing social distancing and wearing PPE. As we begin to ramp up our surgeries, testing and procedures all of these mitigation efforts will remain in place. As our community returns to the hospital for care, their safety is our top priority. Our staff and patients will continue to wear masks and we will continue to practice social distancing out of an abundance of caution.

Question 9 - (8:08): Are 15 minute tests available, as mentioned by the President?

We are really lucky in having rapid accurate testing performed in our remarkable microbiology lab. Our most commonly used test takes about 45 minutes to perform. The Penn Healthcare system has decided NOT to use the 15 minute assay because there were concerns of how accurate the test is. We feel that waiting the extra 30 minutes for a much better test is worth it.

Question 10 - (8:42): What data is needed for the hospital to ramp up essential healthcare services again?

We are moving towards restarting essential healthcare services but need to be thoughtful and safe in this process. One of the main things we need to know is if the patient is infected with COVID but may not have any symptoms or very mild symptoms. Clearly, performing essential services while infected may not be the safest option. Making sure we have testing performed prior to procedures is very important. We would also want a safe way to allow support for the patient to be present and a good place for patients to go after the procedure is performed if they need rehab. This is all part of our resurgence plan which is alive and rapidly expanding.

As all of us work together to stop the spread, please remember to follow these simple tips to keep you and all those you love well.

  • Stay home
  • Wash your hands often
  • Avoid touching your face
  • Cover your cough and sneeze
  • Wear a mask in public
  • Practice social distancing

That concludes our COVID Conversation - thank you for your support and all that you are doing to stop the spread.

 

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