On our Sunday, March 8 show Dr. Caitlin Eccles-Radtke joined us for a conversation about COVID-19. She’s an infectious disease and infection prevention specialist at Hennepin Healthcare. You can listen to the entire show via podcast using this link: https://wccoradio.radio.com/media/audio-channel/healthy-matters-3-8-20
David Hilden, MD:
I have Dr. Caitlin Eccles-Radtke in the studio in Minneapolis. Dr. Eccles-Radtke is an infectious disease expert and has been helping lead our COVID-19 efforts at Hennepin Healthcare. So Caitlin, thank you for being on the show and welcome.
Caitlin Eccles-Radtke, MD:
Thanks for having me, Dave.
David Hilden:
So could you tell our listeners, first of all, you’re an infectious disease doctor. Tell me what your role is in helping guide our efforts on COVID-19.
Caitlin Eccles-Radtke:
I wear a lot of hats at the hospital, but one of them is being the medical director for infection prevention. With that, we have a team of people who are involved in emergency preparedness. Hennepin Healthcare actually opened what we call the Incident Command Center back on January 23rd. So we’ve been working in getting prepared for this for a long time now. It’s a very multidisciplinary approach with lots of teams, anyone from supply chain to telehealth to pharmacy to the emergency room to clinics, et cetera, who all are working together to get ready and be prepared and know how to take care of patients with COVID-19 when we see one.
David Hilden:
It’s amazing to me, who is not an emergency preparedness guy – not an infectious disease expert – it’s amazing to see the number of people who rise at times like this. They just shine in their expertise, and I’ve seen that at our hospital, including Dr. Eccles-Radtke. But also we have people from our emergency department, and like you just said we have people from the supply chain, the people that have to purchase products if you will, and the infection prevention people. So it is really an incredible mobilization if you will of a very large team of people. Now normally, Caitlin, you’re in infection prevention at the hospital. What are your usual activities when COVID-19 is not up and about?
Caitlin Eccles-Radtke:
I do a mix of both inpatient and outpatient care. So inpatient would be consults to other physicians who need help with diagnostics and treatment for people with infections. And in the clinic I do primary care for patients living with HIV. In addition to that, for infection prevention we do a number of monitoring things looking for different types of infections within the hospital and making sure we prevent them, so patients don’t get sick while they’re with us.
David Hilden:
So Caitlin literally advises our CEO and our executive leadership team along with her team of infection prevention colleagues. So let’s get into coronavirus if we could. Why is this one so different? Why is this particular outbreak so different?
Caitlin Eccles-Radtke:
You know, in some ways there are a lot of similarities with this virus to things like the flu and other respiratory viruses. But the part that’s different is that it’s new, and we just don’t necessarily know everything about it yet, because things are unfolding on a daily basis as you mentioned. We don’t know how long people get sick for, necessarily. We don’t know what special populations it affects more than others in some regards. And so, we’re just learning a lot of things as we move forward, and I think that’s the thing that makes people scared, is what you don’t know.
David Hilden:
Yeah, I sort of likened it to, you know, you’re not terribly scared about being hurt in a car accident, but many people are afraid of air travel, for instance, when it’s the car accident that’s the more dangerous one. I always think of, well, influenza is so common and so many people get sick from that, and coronavirus is not. But it is scary because it’s so new. Does that mean that the human population has never been exposed to this before? Is that why it’s so new?
Caitlin Eccles-Radtke:
This type of virus, so coronavirus is sort of a family of viruses. So when you hear “coronavirus,” right now everyone’s talking about this new one, COVID-19, or this novel coronavirus. But there’s actually other viruses that fit within the coronavirus family, including SARS and MERS are sort of the abbreviations, Middle Eastern Respiratory Syndrome and Severe Acute Respiratory Syndrome. Those are both also coronaviruses. So we can look at those from the past and make some guesses on how this current coronavirus may continue to act, but every one’s a little bit different. So we’re just not completely sure what it may do.
David Hilden:
So you said it’s part of this large family of viruses. Do we know how it is spread from person to person?
Caitlin Eccles-Radtke:
We do. It is spread through basically respiratory droplets. So anytime you cough or sneeze, that is sort of the biggest way that this gets spread between people.
David Hilden:
What about just being in a room with somebody? You know, there’s somebody across the room.
Caitlin Eccles-Radtke:
In general, we say the infectious risk is if you’re within six feet of someone for two minutes or longer. That’s an estimate. But someone across the room who may be coughing, you’re probably fine as long as it’s a big enough room.
David Hilden:
I’ve heard that six feet and being two minutes next to somebody closer within six feet. I can just imagine a world where we’re all standing sort of like as far away from possible. I don’t want to make light of it, but they even made a joke about that on Saturday Night Live last night, where they did a skit where they were showing all the actors and none of them were getting within six feet of each other. So I know that’s making light of a serious situation, but it’s sort of true. If you’re further away from people, those droplets don’t get on you, I guess. They don’t float in the air, is that right?
Caitlin Eccles-Radtke:
Right now the thought is they float through the air just a short distance within that six feet window, but we don’t think that they float further than that.
David Hilden:
So let’s get to the recommendations, if we could. I know that people know about hand washing and what they should do about not touching their face and wearing masks and all that. But I want to make sure we get it out there. So what are the current recommendations, for instance, your own hygiene?
Caitlin Eccles-Radtke:
I think exactly what you said. The most important things are making sure you’re washing your hands, we say 20 seconds or longer, so humming things like “Happy Birthday,” “Twinkle Twinkle Little Star,” those should be long enough for that if people need a guideline. Wiping down your computer screen at work, or wiping around the house with just kind of routine cleaner. They say 60% or more alcohol will help kill the virus. Otherwise, in addition to that, I would say cover your cough, and if you have to cough or sneeze, sneeze into your arm, don’t sneeze on your hands where you may go and touch something afterwards. It’s really just getting back to routine infection control practices like that, that are really going to help you stay healthy and if you’re sick, not spread it to someone else.
David Hilden:
It does sound kind of funny, again not in the hysterically funny way, but odd that we are telling people things that maybe we’ve known about other infection prevention strategies. Washing your hands and not sneezing on each other seems like basic advice, but it’s shocking. I think what a lot of people are finding is how often we touch our face. I don’t think we realize. Now everybody’s so conscious of it. Why is touching your face a problem?
Caitlin Eccles-Radtke:
That’s how things get spread, and this virus is known to be spread through mucus membranes, so things like your eyes, your nose, and your mouth. So we really don’t think much about it, but let’s say you shook hands with someone who was sick, and then itched your eye or rubbed your nose. There’s a chance that you could pick up the virus from someone else that way. So that’s why we’re recommending: Really try to wash your hands, not touch your face, nose, mouth, eyes, all of that. Just another tool to try and keep you healthy.
David Hilden:
Caitlin, let’s talk a little bit about just the signs and symptoms of COVID. Is there any way to tell from other illnesses? So what would people be feeling if they had this thing?
Caitlin Eccles-Radtke:
That’s a great question. It’s a lot of common things that go with respiratory infections: cough, in more severe cases trouble breathing, and people often will have a fever as well. On rare occasion, people can have gastrointestinal symptoms like some diarrhea, but that is not as common. The main things to look for really are fever, cough, trouble breathing.
David Hilden:
That sounds like flu.
Caitlin Eccles-Radtke:
You’re right. It’s very similar, and that’s the trouble with the timing of this virus, is that it’s hitting during flu season. So we have a lot of people coming in who are worried they may have it, and actually are testing positive for the flu.
David Hilden:
That segues, if you will, into some of the other questions that I’ve been hearing a lot. Okay, so I’m sitting at home and I have those symptoms. I haven’t traveled to China, I haven’t traveled to Italy, none of those things, but I have a fever or I have a cough. What would a person do in that situation, if they are not from one of those high-risk places?
Caitlin Eccles-Radtke:
What we are messaging to people is that if you have symptoms, say fever, cough, respiratory symptoms, if you’re not feeling that sick we really recommend people stay home, because we don’t have any treatments other than supportive cares like fluids, Tylenol to bring your fever down, rest. Those are all things you can do at home. You know, by coming in you run the risk if you are sick with something of spreading it to other folks. So if you have mild symptoms, we just recommend staying home. If you have any questions or concerns, call your doctor. The doctors lines, nurse lines, telehealth lines are all prepared to answer your questions, but please call no matter what if you think you might need to come in. And if you’re very sick, that’s another situation right? Let’s say you’re feeling like you’re really having trouble breathing. Call if possible, but know you can still use the 911 ambulance services as normal.
David Hilden:
I understand, and as most listeners in the Upper Midwest would probably be aware of by now, there is one case, one confirmed testing positive case of COVID-19 in Minnesota. My understanding, and I will admit to not being fully informed, but that this particular individual, for lack of a better word, did everything “right.” This person did call the clinic, and this person wore a mask to get tested, and then has been staying home and avoiding other people. That sounds like maybe what people ought to do, exactly what this individual had done.
Caitlin Eccles-Radtke:
That is correct. I have to give big kudos to this person to paying attention to what’s going on in the news and guidelines, et cetera. There is one case in Minnesota as you mentioned. The bit that I know is that he was on a cruise ship, and so he had risk, which is reassuring that we’re not just seeing someone in the community where it’s spreading around and they had no known risk factors. And he did do everything right. He stayed home until he decided he needed to get tested or ask more questions or get help. He called in first. He wore a mask. And then by calling in, that allows the healthcare provider some time to get ready for him, have a plan, have the room ready, get all of their personal protective equipment on. To my knowledge, the Minnesota Department of Health does an investigation after someone tests positive, and what’s really reassuring is he hadn’t been in contact because he hadn’t been feeling good and stayed home. He hadn’t been in contact with many people, so that’s really a good thing.
David Hilden:
Yeah, I agree with that. Kudos to this gentleman and sorry that he happens… that you don’t feel well. But I think that we’ll talk more about how serious the illness is, and we’ll talk about what people ought to do about schools and travel and vaccines. We have a lot more to talk about. I understand there might be somebody who has a question exactly about that on the phone lines. As listeners might know, I’m calling from Illinois. But I believe we do have some other callers on the line who might want to have a question about self-quarantine.
Question from listener:
How do they disinfect pillows in hotel rooms between visits? Also, how do you self- quarantine in an apartment building?
Caitlin Eccles-Radtke:
Both good questions. The first one, disinfecting pillows. Hotels and other establishments have their own routine, not just specific to COVID-19, but their own routine sanitizing processes. So by washing and bleaching and doing all of those things, there should be no concern that your pillowcase or bedsheets would have this if you were to stay in a hotel. The second question you asked was about self- quarantining in an apartment building. It’s a little bit tough, of course, when you live in an area where other people are there. I don’t think people need to self-quarantine if they’re feeling well. So if you’re feeling fine, you can go out and about and undergo you’re daily business. If you’re feeling sick, we recommend staying home, not going out, and asking your healthy friend or family member or someone if you need groceries or things like that to help bring you something. Does that answer your question?
David Hilden:
You know, you have to be relatively close to people, do you not?
Caitlin Eccles-Radtke:
To get the infection, you mean?
David Hilden:
Yeah, yeah. So if someone is in their own apartment building, and you’re not right next to other people for a long period of time, that’s a reasonably effective way to isolate from each other.
Caitlin Eccles-Radtke:
Yeah, that’s correct. So again, we say six feet away from someone… or being within six feet of someone and being around them for two minutes or more. So what we call a close contact is the highest risk for getting sick. So if you’re just in the apartment next to someone who is ill, you should be just fine.
Denny Long, co-host of Healthy Matters:
There is a text, doctors, that says this: Does having the pneumonia vaccination help with protection from the coronavirus late stage complication?
Caitlin Eccles-Radtke:
As of right now, we have no specific vaccines for coronavirus. The pneumonia virus vaccines are for a different type of bacterial infection called pneumococcus or pneumococcal pneumonia. So that pneumonia shot won’t help anything in this situation.
David Hilden:
I was going to follow up on a couple of these things. Do people, when you get very, very ill, develop secondary bacterial infections from corona?
Caitlin Eccles-Radtke:
With any virus, if someone has bad respiratory disease from it, so flu, coronavirus, et cetera, you can be at risk for developing a secondary bacterial pneumonia. That’s a great question. If you have the pneumonia shots, that will protect you from a different bacterial pneumonia, if you were to be really sick a viral illness like COVID-19.
David Hilden:
If I could have one more, then we’ll go back to the text lines, but I’m sitting in a hotel room right now, looking at the pillows. So to follow-up on the previous question, does laundering generally, not just for people in hotels, but laundering of clothing, is that an effective way to eliminate the virus off of our clothes, Caitlin?
Caitlin Eccles-Radtke:
Yeah, I think it is. Just going through the normal cleaning process should be just fine.
Denny Long:
A couple of texts: They want to know how long the virus can live on surfaces.
Caitlin Eccles-Radtke:
We don’t know exactly how long. I’ve heard different estimates, like maybe around four days or longer, which you think, Oh my goodness, that’s a long time. But if you do practice routine cleaning at home and wiping things down, and of course we have daily cleaning practices within the hospital too, that has been shown to kill pretty much all of the virus. So just make sure you’re wiping things down with cleaning solution with 60% alcohol or more. That is a great way to keep surfaces clean.
David Hilden:
Good morning, one and all. I hope you are having a good Sunday morning, bright and early due to Daylight Saving Time. Thank you for tuning in and listening to our program today. We are doing a full hour on the COVID-19 coronavirus situation with my friend and colleague, Dr. Caitlin Eccles-Radtke. She is an infectious disease expert and is the medical director of the infection prevention program at Hennepin Healthcare. I do want to just give a shout out to all of our infection prevention colleagues at times like this. It involves just a whole array of professions. At Hennepin, we have others, a gentleman named Dr. John Hick is an emergency preparedness expert. Julie Curti is a nursing leader, who heads up that aspect of it. And there’s just a whole team of people at our hospital and at all hospitals in the Upper Midwest who are working to keep us all safe. I do have to just tell the public, although I’m not an infection prevention specialist, I go to be feeling better about his whole COVID thing knowing that this team of people is leading us.
David Hilden:
So back to you, Dr. Eccles-Radtke. Let’s talk a little bit about the state of testing in Minnesota specifically. Do we have enough test kits? How do people get tested? Who should be tested? Could you comment on those kinds of things?
Caitlin Eccles-Radtke:
Sure. It’s been a little frustrating initially just because there was a glitch with the test through the CDC earlier on, in early February. But within the last week, the Minnesota Department of Health has gotten test kits, so we are able to test within the state as opposed to having to send tests to the CDC. Then you asked about who should get tested. Right now there are guidelines on the CDC’s website that talk about anyone can get tested if they feel sick and if their doctor thinks it’s appropriate. So as we only have a select number of test kits so far and know that we are going to get more as time comes, we’re really focusing on people who are at risk. That includes people with symptoms, so fever, cough, trouble breathing, who are coming from a high risk area where the virus has been known to have infected a lot of people. Or if someone has a close contact with a person known to have COVID-19, they for sure will get tested. Other people who we are considering testing are people who have a respiratory illness without another known source and who are sick. So as of now we can’t test everybody, and so we’re really focusing on those who are at highest risk first.
David Hilden:
Perfect. I want to ask you a little bit about travel if I could, Caitlin. I know that we can’t give blanket statements about, yes, you should or no, you shouldn’t. But what are we telling people currently about the safety of specifically air travel?
Caitlin Eccles-Radtke:
The CDC website is actually an amazing resource. There are different levels of travel restrictions, Level 3 being the highest, meaning you really just shouldn’t go there unless there’s some extenuating circumstance. Level 2 recommending not traveling, especially if you’re maybe high risk for getting a virus. We can talk about that in a bit. Level 1, where they recommend practicing usual precautions. So some of the highest level travel restrictions would be to China, Iran, Italy, and South Korea. We’re just recommending that people don’t go there right now. Japan is a Level 2, so we are recommending people not go there if they can avoid it, but it’s a little bit lower risk, and so on.
Caitlin Eccles-Radtke:
You know, people having been asking me a lot about, Should I travel around the United States. That answer might change every day. It really depends on where the known cases are and where you’re going, and also if you’re well and healthy and can travel or if you’re someone maybe who has underlying lung disease or heart disease, who may be at higher risk. So I think the best recommendation I can give is to just check with your provider, look at the CDC’s website, look at Minnesota Department of Health website, and check out that map to see where cases are happening, and then make a smart decision for yourself.
David Hilden:
That sounds like terrific advice. You mentioned people might be at higher risk. Who would that be?
Caitlin Eccles-Radtke:
What we’re seeing is about 81% of the cases are mild, so that’s about four out of five people who get mild symptoms, a little cough, cold, flu-like symptoms, and then it passes. The people that are higher risk for severe disease are people who are older. We’ve seen increased risk in people who are obese, and we’ve seen increased risk in people who have underlying medical conditions like heart disease, lung disease, and diabetes.
David Hilden:
I seem to remember reading, and I don’t even know if this has been verified or true, but the initial cases in China were in older men who smoked. Is that true?
Caitlin Eccles-Radtke:
That is correct. They found that older people in general are higher risk, and men over women. And smoking any time, I mean here’s a little plug for just working on quitting smoking, smoking any time will increase your risk of a whole slew of various medical conditions, from lung disease to putting you at risk for other types of respiratory infections to cancers to heart disease to stroke. So it’s really important, if you didn’t think about stopping smoking previously now might be a good time.
Listener:
Good morning, everyone. My question is if you’ve had your flu shot, does that protect you at all from the coronavirus?
Caitlin Eccles-Radtke:
Thanks for calling in. At this time we have no known vaccines against coronavirus. So your flu shot will work to protect you from the flu, but it doesn’t have any effect on the coronavirus.
Denny Long:
There’s a text too, doctors, that I find interesting too, because I was asked this question the other day: If you have had the coronavirus and recovered, do you then have immunity?
Caitlin Eccles-Radtke:
I think we just don’t know the answer to that yet because this is so new. We’re just seeing people starting to recover from this as it has popped up. So the assumption with other diseases is that you develop some immunity, but what we don’t know yet is whether or not that protects you from ever getting it again, or if you were to get it again would you have a milder case. I’m just not sure yet.
David Hilden:
Yeah, I will do that. I want to just comment on that one, and then we’ll go back to the phones. I have heard people all over the map on, “I want to get it so that I’ll be immune.” I’ve heard even politicians and people on national venues say that we should just get everybody exposed so we can get it over with. That’s the ridiculous end, because that would mean many people get very ill and many people die. All the way down to people who say, well, we should have our healthcare people, maybe it would be okay, those who survive can be the ones to do the caregiving. Have you heard thoughts along those lines, Caitlin?
Caitlin Eccles-Radtke:
I have, I’ve heard a few things. My first recommendation is: Don’t go trying to get this. The reason for that is even if you may be someone who doesn’t have underlying medical or health conditions and you may do well and not get very sick from it, the risk of you spreading it to someone else who is higher risk is there. We don’t want to put our vulnerable populations at higher risks. The other issue with this is: Because there’s so many cases around the globe right now and that it’s spreading, you may think most people do just fine so it’s not a big deal. But the number of people, if you look at the percentages of people who get really sick from it, could very well overwhelm our healthcare system in terms of needing supportive cares in terms of the ICU or breathing help or things like that. So I really recommend people still try not to get sick from this, and practice routine infection control precaution.
David Hilden:
In our line of work, we talk about “flattening the curve” of a number of cases. I think we’re quite ready in our hospital systems, but if too many people get it we would not have enough respirators and we would not have enough equipment. Isn’t that true?
Caitlin Eccles-Radtke:
That’s completely correct. Our goal is to stop this from spreading fast, so anyone who gets sick we can take care of and get them better before the next round of people come in. Whereas, if everybody came in at once, it would be a lot more difficult.
Listener:
Which is better, hand sanitizer, soap and water, or maybe just warm water if nothing else is available?
Caitlin Eccles-Radtke:
I would recommend just washing your hands with routine soap and water for 20 seconds or longer. But really hand sanitizer is just as good. Most of those are alcohol-based, and so either one is fine. We just recommend using something.
Denny Long:
Will taking vitamin D and C or supplements like those to boost hour immune system help protect against effects of COVID-19 if you contract it?
Caitlin Eccles-Radtke:
In general, those probably won’t do much to prevent the infection, but there’s no studies or data out there to show that at this time. That said, I have no qualms with people taking over the counter vitamins C and D. If you feel like it’s giving you some benefit, I say go for it.
David Hilden:
I had some questions about parents and their kids. We hear a lot about school closings and all that, but it’s also true that this is a milder disease in children as far as we know. What do you think, Caitlin, about parents and kids? Should they feel okay sending their kids to school and things like that?
Caitlin Eccles-Radtke:
We really haven’t seen a big impact of this virus on children, so that’s a great thing. You think about things like the flu and other colds and kids often get sick, and kids are spreaders. So the good news so far is that this really isn’t hitting children in a way that it’s hitting adults. So I think at this point kids are okay to go to school, you know, teaching them good hand washing techniques is great. There may be a time once we see more cases in our community where the state will decide to close schools, but as of right now I think it’s safe for kids to go. We’re not seeing community spread, and that keeps parents in the workforce, too, which is really important, especially healthcare providers in this setting, but everyone.
David Hilden:
Are you doing planning? Or I should say, are we doing planning at our hospital, and then by extension all hospitals for workforce issues? For instance, what if all the nurses have their kids home? Or what if anybody, the doctors, get sick? Are we doing planning along those lines?
Caitlin Eccles-Radtke:
We are. One thing we’re starting to ask people to do is know who your resources are. Right? So for a nurse or a physician or anybody, if schools get closed, who may need to be home with their kids, we’re asking them to work together and come up with a plan. So whether that plan is having your kids stay home with their aunt or uncle, with a grandparent, with a neighbor, start thinking about that now so that when it does happen you’re ready for it. I’ve seen some really good camaraderie within teams in the hospital. One of our specialties, they’ve actually already been sitting down as a group and came up basically with a daycare plan. It rotates, I think, through different people so most everyone can still work, and they only may have, say, one person out at a given time.
David Hilden:
Caitlin, talk about masks if you will. Do they help people?
Caitlin Eccles-Radtke:
There’s sort of different answers for this. It depends on who and where you are, and if you’re sick or not. So what I mean be that is in the healthcare setting, for sure. You are taking care of sick people all the time, you want to protect yourself. We use for people coming in sick to the hospital and needing testing for COVID-19, we recommend what are called the N95 masks or the respirators. For the general public, if you’re not sick there is no need, and we ask that people don’t go nuts buying a whole bunch of masks, if there are any left in all honesty, because it really doesn’t help you if you’re just wearing a simple mask walking around town. That said, people who are out in the community, if you’re sick and need to go somewhere and you’re coughing, wearing a mask is recommended because it helps catch any sort of sneezes, coughs, respiratory droplets that you may be putting out into the atmosphere.
David Hilden:
So maybe it’s the sick people who should be wearing them.
Caitlin Eccles-Radtke:
Correct.
David Hilden:
Yeah. I like your comment about if you can even find any. I know we have an adequate number of masks at our hospital. Actually we’ve counted them, we know what we have. But they are for the right purpose, it’s for the healthcare workers and people who are ill. They’re not for the general public to go walking around wearing.
Caitlin Eccles-Radtke:
That is correct. I think one of the biggest concerns with various hospital systems across the world will be shortages of medical equipment like masks and things like that. I know that certain companies are ramping up production of masks and moving resources from one area to another to be able to create more. So that is being addressed, but it is a fear.
David Hilden:
Could you talk about a vaccine? What’s the state of that?
Caitlin Eccles-Radtke:
You know, I know that there’s a lot of very, very smart researchers within our country looking at this, moving quickly, trying to work on it. But at this point in time it’s just too soon. It does take time for trials to happen, things to get tested, approvals to go through. So I think we are months to a year out at least, and I would say I guess we shouldn’t rely on that right now.
David Hilden:
That sounds like sound advice to me. I think that maybe some year, next year or the year after or the year after, we might be giving people their coronavirus vaccines, but it isn’t going to help us in 2020, it doesn’t sound like. I’m actually amazed at the science that has come out relative to this, that the scientists have been able to do a test for this virus using a PCR technology, for those of you who know laboratory work it uses a reverse PCR technology. In a matter of just weeks to months we’ve been able to develop tests for this, even though the virus is basically brand new. So just a little shout out to the scientists out there.
David Hilden:
Caitlin, can you just comment a general comment about trying to address people’s fears about this thing. It’s everywhere. It’s on the news. Every day we’ve got the general public practically counting cases in their community. It’s on our consciousness almost everywhere you go. People are reevaluating how they greet each other. Should we be doing foot taps or doing like the namaste bow that they do in yoga class? Should we be doing fist bumps to people? It’s really permeating our individual lives. Can you comment about how much people should be worried about this? Is it over hyped? Is it real? Could you just make some comments about that, please?
Caitlin Eccles-Radtke:
Of course. I think we as human beings are routinely more afraid of things we don’t know about. Right? So that is the scary thing here for people, because one, we just don’t quite know everything about this virus yet since it’s new. And people are always afraid of things, I would say, that they can’t control. Right? So feeling that lack of control is scary. What I would recommend to people is: Really work on those techniques that are within your control to keep healthy and not spread things.
Caitlin Eccles-Radtke:
To your point about greetings and things, one thing we’re going to see more and more of, which is tough for people because we are social beings, is something we call “social distancing.” So you know, big meetings, events, et cetera, are getting canceled as a technique to try and keep large groups of people away from each other. I would just recommend it’s okay to say to someone, “Hey, it’s nice to see you. I’d normally shake your hand, but I’m going to not this time in efforts to just not spread anything.” I think that’s okay, too. But I think what people need to remember is even though this is a big new thing, take a step back, think about what you would do with the flu or other coughs and colds, and follow those practices. Then you have some control over keeping yourself healthy.
David Hilden:
That sounds like really good advice. If you’re with somebody and you’re maybe in a group setting and they’re shaking your hand, maybe you’re at church passing the peace around… I know congregations have been talking, what do you do there. Maybe it’s okay for the time being to, Nobody take it personally, we’re going to bump elbows, or we’re just going to greet each other from an arm’s length, maybe. I think that’s maybe an okay thing to just do for a little bit, a little while. Do we know, is this thing seasonal? Is it going to get better in the summer like flu? Or do we not know that, Caitlin?
Caitlin Eccles-Radtke:
I think we just don’t know yet. It’s going to be sort of a wait and see. Obviously that would be great if that happens and slows things down. I do think even if that occurs, we’ll probably see stuff pop back up in the fall. But it could very well continue to go through the summer, and I don’t have a crystal ball but I kind of expect that it may.
David Hilden:
One would kind of hope, because viruses tend to for odd reasons and not entirely understood, they do better in the dry air. It’s something about the droplets, they seem to do better in the winter. At least that’s what most viruses do. It would be nice if this one did that exact same thing, and maybe this will be a springtime thing at least in the worst of it, and then it might get better in the summer. But we just simply don’t know.
Denny Long:
We have a bunch of text messages. See if we can’t do a little lightning round here. Texter says: I work at a bank and work with other people’s money. How at risk am I? Any ideas other than using hand sanitizers?
Caitlin Eccles-Radtke:
I actually don’t think I’ve gotten that one before. As they say, money is dirty. I would say, again, just going back to your routine infection control practices; using hand sanitizer regularly; not touching your face, nose, mouth, eyes. That’s a good thing.
Denny:
There’s another text, doctors, that says: I am scheduled for total knee replacement late this month. Would you expect elective surgeries to be postponed?
Caitlin Eccles-Radtke:
I think that’s going to be sort of a day to day thing. Later this month you may still be okay. If it were later out, it’s just hard to know because this is so new, what direction it’s going, how many cases we’ll have in three days, five days, seven days. So I would say just watchful waiting. Don’t cancel anything yet, and take guidance from your healthcare system.
Denny Long:
And a caller wanted to ask if one is inactive, does being inactive hurt you?
Caitlin Eccles-Radtke:
There has been some data that people who are obese or overweight are at higher risk. But inactivity as a sole factor, we just don’t know.
Denny Long:
All right. Well, we are just about out of time. Any final thoughts, Dr. Hilden?
David Hilden:
Well, I just want to thank my colleague and friend. I’ve known Caitlin for many years, and she is just a wealth of information and knowledge. Thank you so much, Caitlin, for helping educate us and for giving us good, factual information today.
Caitlin Eccles-Radtke:
Thanks for having me.
COVID-19:
What’s it all about?
On our Sunday, March 8 show Dr. Caitlin Eccles-Radtke joined us for
a conversation about COVID-19. She’s an infectious disease and infection
prevention specialist at Hennepin Healthcare. You can listen to the entire show
via podcast using this link: https://wccoradio.radio.com/media/audio-channel/healthy-matters-3-8-20
David Hilden, MD:
I have Dr. Caitlin Eccles-Radtke in the studio in Minneapolis. Dr.
Eccles-Radtke is an infectious disease expert and has been helping lead our
COVID-19 efforts at Hennepin Healthcare. So Caitlin, thank you for being on the
show and welcome.
Caitlin Eccles-Radtke, MD:
Thanks for having me, Dave.
David Hilden:
So could you tell our listeners, first of all, you’re an infectious disease
doctor. Tell me what your role is in helping guide our efforts on COVID-19.
Caitlin Eccles-Radtke:
I wear a lot of hats at the hospital, but one of them is being the medical
director for infection prevention. With that, we have a team of people who are
involved in emergency preparedness. Hennepin Healthcare actually opened what we
call the Incident Command Center back on January 23rd. So we’ve been working in
getting prepared for this for a long time now. It’s a very multidisciplinary
approach with lots of teams, anyone from supply chain to telehealth to pharmacy
to the emergency room to clinics, et cetera, who all are working together to
get ready and be prepared and know how to take care of patients with COVID-19
when we see one.
David Hilden:
It’s amazing to me, who is not an emergency preparedness guy – not an
infectious disease expert – it’s amazing to see the number of people who rise
at times like this. They just shine in their expertise, and I’ve seen that at
our hospital, including Dr. Eccles-Radtke. But also we have people from our
emergency department, and like you just said we have people from the supply
chain, the people that have to purchase products if you will, and the infection
prevention people. So it is really an incredible mobilization if you will of a
very large team of people. Now normally, Caitlin, you’re in infection
prevention at the hospital. What are your usual activities when COVID-19 is not
up and about?
Caitlin Eccles-Radtke:
I do a mix of both inpatient and outpatient care. So inpatient would be
consults to other physicians who need help with diagnostics and treatment for
people with infections. And in the clinic I do primary care for patients living
with HIV. In addition to that, for infection prevention we do a number of
monitoring things looking for different types of infections within the hospital
and making sure we prevent them, so patients don’t get sick while they’re with
us.
David Hilden:
So Caitlin literally advises our CEO and our executive leadership team along
with her team of infection prevention colleagues. So let’s get into coronavirus
if we could. Why is this one so different? Why is this particular outbreak so
different?
Caitlin Eccles-Radtke:
You know, in some ways there are a lot of similarities with this virus to
things like the flu and other respiratory viruses. But the part that’s
different is that it’s new, and we just don’t necessarily know everything about
it yet, because things are unfolding on a daily basis as you mentioned. We
don’t know how long people get sick for, necessarily. We don’t know what
special populations it affects more than others in some regards. And so, we’re
just learning a lot of things as we move forward, and I think that’s the thing
that makes people scared, is what you don’t know.
David Hilden:
Yeah, I sort of likened it to, you know, you’re not terribly scared about
being hurt in a car accident, but many people are afraid of air travel, for
instance, when it’s the car accident that’s the more dangerous one. I always
think of, well, influenza is so common and so many people get sick from that,
and coronavirus is not. But it is scary because it’s so new. Does that mean
that the human population has never been exposed to this before? Is that why it’s
so new?
Caitlin Eccles-Radtke:
This type of virus, so coronavirus is sort of a family of viruses. So when
you hear “coronavirus,” right now everyone’s talking about this new
one, COVID-19, or this novel coronavirus. But there’s actually other viruses that
fit within the coronavirus family, including SARS and MERS are sort of the
abbreviations, Middle Eastern Respiratory Syndrome and Severe Acute Respiratory
Syndrome. Those are both also coronaviruses. So we can look at those from the
past and make some guesses on how this current coronavirus may continue to act,
but every one’s a little bit different. So we’re just not completely sure what
it may do.
David Hilden:
So you said it’s part of this large family of viruses. Do we know how it is
spread from person to person?
Caitlin Eccles-Radtke:
We do. It is spread through basically respiratory droplets. So anytime you
cough or sneeze, that is sort of the biggest way that this gets spread between
people.
David Hilden:
What about just being in a room with somebody? You know, there’s somebody
across the room.
Caitlin Eccles-Radtke:
In general, we say the infectious risk is if you’re within six feet of
someone for two minutes or longer. That’s an estimate. But someone across the
room who may be coughing, you’re probably fine as long as it’s a big enough
room.
David Hilden:
I’ve heard that six feet and being two minutes next to somebody closer
within six feet. I can just imagine a world where we’re all standing sort of
like as far away from possible. I don’t want to make light of it, but they even
made a joke about that on Saturday Night Live last night, where they did a skit
where they were showing all the actors and none of them were getting within six
feet of each other. So I know that’s making light of a serious situation, but
it’s sort of true. If you’re further away from people, those droplets don’t get
on you, I guess. They don’t float in the air, is that right?
Caitlin Eccles-Radtke:
Right now the thought is they float through the air just a short distance
within that six feet window, but we don’t think that they float further than
that.
David Hilden:
So let’s get to the recommendations, if we could. I know that people know
about hand washing and what they should do about not touching their face and
wearing masks and all that. But I want to make sure we get it out there. So
what are the current recommendations, for instance, your own hygiene?
Caitlin Eccles-Radtke:
I think exactly what you said. The most important things are making sure
you’re washing your hands, we say 20 seconds or longer, so humming things like
“Happy Birthday,” “Twinkle Twinkle Little Star,” those should be long enough
for that if people need a guideline. Wiping down your computer screen at work,
or wiping around the house with just kind of routine cleaner. They say 60% or
more alcohol will help kill the virus. Otherwise, in addition to that, I would
say cover your cough, and if you have to cough or sneeze, sneeze into your arm,
don’t sneeze on your hands where you may go and touch something afterwards.
It’s really just getting back to routine infection control practices like that,
that are really going to help you stay healthy and if you’re sick, not spread
it to someone else.
David Hilden:
It does sound kind of funny, again not in the hysterically funny way, but
odd that we are telling people things that maybe we’ve known about other
infection prevention strategies. Washing your hands and not sneezing on each
other seems like basic advice, but it’s shocking. I think what a lot of people
are finding is how often we touch our face. I don’t think we realize. Now
everybody’s so conscious of it. Why is touching your face a problem?
Caitlin Eccles-Radtke:
That’s how things get spread, and this virus is known to be spread through
mucus membranes, so things like your eyes, your nose, and your mouth. So we
really don’t think much about it, but let’s say you shook hands with someone
who was sick, and then itched your eye or rubbed your nose. There’s a chance
that you could pick up the virus from someone else that way. So that’s why
we’re recommending: Really try to wash your hands, not touch your face, nose,
mouth, eyes, all of that. Just another tool to try and keep you healthy.
David Hilden:
Caitlin, let’s talk a little bit about just the signs and symptoms of COVID.
Is there any way to tell from other illnesses? So what would people be feeling
if they had this thing?
Caitlin Eccles-Radtke:
That’s a great question. It’s a lot of common things that go with
respiratory infections: cough, in more severe cases trouble breathing, and
people often will have a fever as well. On rare occasion, people can have
gastrointestinal symptoms like some diarrhea, but that is not as common. The
main things to look for really are fever, cough, trouble breathing.
David Hilden:
That sounds like flu.
Caitlin Eccles-Radtke:
You’re right. It’s very similar, and that’s the trouble with the timing of
this virus, is that it’s hitting during flu season. So we have a lot of people
coming in who are worried they may have it, and actually are testing positive
for the flu.
David Hilden:
That segues, if you will, into some of the other questions that I’ve been
hearing a lot. Okay, so I’m sitting at home and I have those symptoms. I
haven’t traveled to China, I haven’t traveled to Italy, none of those things,
but I have a fever or I have a cough. What would a person do in that situation,
if they are not from one of those high-risk places?
Caitlin Eccles-Radtke:
What we are messaging to people is that if you have symptoms, say fever,
cough, respiratory symptoms, if you’re not feeling that sick we really
recommend people stay home, because we don’t have any treatments other than
supportive cares like fluids, Tylenol to bring your fever down, rest. Those are
all things you can do at home. You know, by coming in you run the risk if you
are sick with something of spreading it to other folks. So if you have mild
symptoms, we just recommend staying home. If you have any questions or
concerns, call your doctor. The doctors lines, nurse lines, telehealth lines
are all prepared to answer your questions, but please call no matter what if
you think you might need to come in. And if you’re very sick, that’s another
situation right? Let’s say you’re feeling like you’re really having trouble
breathing. Call if possible, but know you can still use the 911 ambulance services
as normal.
David Hilden:
I understand, and as most listeners in the Upper Midwest would probably be
aware of by now, there is one case, one confirmed testing positive case of
COVID-19 in Minnesota. My understanding, and I will admit to not being fully informed,
but that this particular individual, for lack of a better word, did everything
“right.” This person did call the clinic, and this person wore a mask
to get tested, and then has been staying home and avoiding other people. That
sounds like maybe what people ought to do, exactly what this individual had
done.
Caitlin Eccles-Radtke:
That is correct. I have to give big kudos to this person to paying attention
to what’s going on in the news and guidelines, et cetera. There is one case in
Minnesota as you mentioned. The bit that I know is that he was on a cruise
ship, and so he had risk, which is reassuring that we’re not just seeing
someone in the community where it’s spreading around and they had no known risk
factors. And he did do everything right. He stayed home until he decided he
needed to get tested or ask more questions or get help. He called in first. He
wore a mask. And then by calling in, that allows the healthcare provider some
time to get ready for him, have a plan, have the room ready, get all of their
personal protective equipment on. To my knowledge, the Minnesota Department of
Health does an investigation after someone tests positive, and what’s really
reassuring is he hadn’t been in contact because he hadn’t been feeling good and
stayed home. He hadn’t been in contact with many people, so that’s really a
good thing.
David Hilden:
Yeah, I agree with that. Kudos to this gentleman and sorry that he
happens… that you don’t feel well. But I think that we’ll talk more about how
serious the illness is, and we’ll talk about what people ought to do about
schools and travel and vaccines. We have a lot more to talk about. I understand
there might be somebody who has a question exactly about that on the phone
lines. As listeners might know, I’m calling from Illinois. But I believe we do
have some other callers on the line who might want to have a question about
self-quarantine.
Question from listener:
How do they disinfect pillows in hotel rooms between visits? Also, how do
you self- quarantine in an apartment building?
Caitlin Eccles-Radtke:
Both good questions. The first one, disinfecting pillows. Hotels and other
establishments have their own routine, not just specific to COVID-19, but their
own routine sanitizing processes. So by washing and bleaching and doing all of
those things, there should be no concern that your pillowcase or bedsheets
would have this if you were to stay in a hotel. The second question you asked
was about self- quarantining in an apartment building. It’s a little bit tough,
of course, when you live in an area where other people are there. I don’t think
people need to self-quarantine if they’re feeling well. So if you’re feeling
fine, you can go out and about and undergo you’re daily business. If you’re
feeling sick, we recommend staying home, not going out, and asking your healthy
friend or family member or someone if you need groceries or things like that to
help bring you something. Does that answer your question?
David Hilden:
You know, you have to be relatively close to people, do you not?
Caitlin Eccles-Radtke:
To get the infection, you mean?
David Hilden:
Yeah, yeah. So if someone is in their own apartment building, and you’re not
right next to other people for a long period of time, that’s a reasonably
effective way to isolate from each other.
Caitlin Eccles-Radtke:
Yeah, that’s correct. So again, we say six feet away from someone… or
being within six feet of someone and being around them for two minutes or more.
So what we call a close contact is the highest risk for getting sick. So if
you’re just in the apartment next to someone who is ill, you should be just
fine.
Denny Long, co-host of Healthy Matters:
There is a text, doctors, that says this: Does having the pneumonia
vaccination help with protection from the coronavirus late stage complication?
Caitlin Eccles-Radtke:
As of right now, we have no specific vaccines for coronavirus. The pneumonia
virus vaccines are for a different type of bacterial infection called
pneumococcus or pneumococcal pneumonia. So that pneumonia shot won’t help
anything in this situation.
David Hilden:
I was going to follow up on a couple of these things. Do people, when you
get very, very ill, develop secondary bacterial infections from corona?
Caitlin Eccles-Radtke:
With any virus, if someone has bad respiratory disease from it, so flu,
coronavirus, et cetera, you can be at risk for developing a secondary bacterial
pneumonia. That’s a great question. If you have the pneumonia shots, that will
protect you from a different bacterial pneumonia, if you were to be really sick
a viral illness like COVID-19.
David Hilden:
If I could have one more, then we’ll go back to the text lines, but I’m
sitting in a hotel room right now, looking at the pillows. So to follow-up on
the previous question, does laundering generally, not just for people in
hotels, but laundering of clothing, is that an effective way to eliminate the
virus off of our clothes, Caitlin?
Caitlin Eccles-Radtke:
Yeah, I think it is. Just going through the normal cleaning process should
be just fine.
Denny Long:
A couple of texts: They want to know how long the virus can live on
surfaces.
Caitlin Eccles-Radtke:
We don’t know exactly how long. I’ve heard different estimates, like maybe
around four days or longer, which you think, Oh my goodness, that’s a long
time. But if you do practice routine cleaning at home and wiping things down,
and of course we have daily cleaning practices within the hospital too, that
has been shown to kill pretty much all of the virus. So just make sure you’re
wiping things down with cleaning solution with 60% alcohol or more. That is a
great way to keep surfaces clean.
David Hilden:
Good morning, one and all. I hope you are having a good Sunday morning,
bright and early due to Daylight Saving Time. Thank you for tuning in and
listening to our program today. We are doing a full hour on the COVID-19
coronavirus situation with my friend and colleague, Dr. Caitlin Eccles-Radtke.
She is an infectious disease expert and is the medical director of the
infection prevention program at Hennepin Healthcare. I do want to just give a
shout out to all of our infection prevention colleagues at times like this. It
involves just a whole array of professions. At Hennepin, we have others, a
gentleman named Dr. John Hick is an emergency preparedness expert. Julie Curti
is a nursing leader, who heads up that aspect of it. And there’s just a whole
team of people at our hospital and at all hospitals in the Upper Midwest who
are working to keep us all safe. I do have to just tell the public, although
I’m not an infection prevention specialist, I go to be feeling better about his
whole COVID thing knowing that this team of people is leading us.
David Hilden:
So back to you, Dr. Eccles-Radtke. Let’s talk a little bit about the state
of testing in Minnesota specifically. Do we have enough test kits? How do
people get tested? Who should be tested? Could you comment on those kinds of
things?
Caitlin Eccles-Radtke:
Sure. It’s been a little frustrating initially just because there was a
glitch with the test through the CDC earlier on, in early February. But within
the last week, the Minnesota Department of Health has gotten test kits, so we
are able to test within the state as opposed to having to send tests to the
CDC. Then you asked about who should get tested. Right now there are guidelines
on the CDC’s website that talk about anyone can get tested if they feel sick and
if their doctor thinks it’s appropriate. So as we only have a select number of
test kits so far and know that we are going to get more as time comes, we’re
really focusing on people who are at risk. That includes people with symptoms,
so fever, cough, trouble breathing, who are coming from a high risk area where
the virus has been known to have infected a lot of people. Or if someone has a
close contact with a person known to have COVID-19, they for sure will get
tested. Other people who we are considering testing are people who have a
respiratory illness without another known source and who are sick. So as of now
we can’t test everybody, and so we’re really focusing on those who are at
highest risk first.
David Hilden:
Perfect. I want to ask you a little bit about travel if I could, Caitlin. I
know that we can’t give blanket statements about, yes, you should or no, you
shouldn’t. But what are we telling people currently about the safety of
specifically air travel?
Caitlin Eccles-Radtke:
The CDC
website is actually an amazing resource. There are different levels of
travel restrictions, Level 3 being the highest, meaning you really just
shouldn’t go there unless there’s some extenuating circumstance. Level 2
recommending not traveling, especially if you’re maybe high risk for getting a
virus. We can talk about that in a bit. Level 1, where they recommend
practicing usual precautions. So some of the highest level travel restrictions
would be to China, Iran, Italy, and South Korea. We’re just recommending that
people don’t go there right now. Japan is a Level 2, so we are recommending
people not go there if they can avoid it, but it’s a little bit lower risk, and
so on.
Caitlin Eccles-Radtke:
You know, people having been asking me a lot about, Should I travel around
the United States. That answer might change every day. It really depends on
where the known cases are and where you’re going, and also if you’re well and
healthy and can travel or if you’re someone maybe who has underlying lung
disease or heart disease, who may be at higher risk. So I think the best
recommendation I can give is to just check with your provider, look at the
CDC’s website, look at Minnesota Department of Health website, and check out
that map to see where cases are happening, and then make a smart decision for
yourself.
David Hilden:
That sounds like terrific advice. You mentioned people might be at higher
risk. Who would that be?
Caitlin Eccles-Radtke:
What we’re seeing is about 81% of the cases are mild, so that’s about four
out of five people who get mild symptoms, a little cough, cold, flu-like
symptoms, and then it passes. The people that are higher risk for severe
disease are people who are older. We’ve seen increased risk in people who are
obese, and we’ve seen increased risk in people who have underlying medical
conditions like heart disease, lung disease, and diabetes.
David Hilden:
I seem to remember reading, and I don’t even know if this has been verified
or true, but the initial cases in China were in older men who smoked. Is that
true?
Caitlin Eccles-Radtke:
That is correct. They found that older people in general are higher risk,
and men over women. And smoking any time, I mean here’s a little plug for just working
on quitting smoking, smoking any time will increase your risk of a whole slew
of various medical conditions, from lung disease to putting you at risk for
other types of respiratory infections to cancers to heart disease to stroke. So
it’s really important, if you didn’t think about stopping smoking previously
now might be a good time.
Listener:
Good morning, everyone. My question is if you’ve had your flu shot, does
that protect you at all from the coronavirus?
Caitlin Eccles-Radtke:
Thanks for calling in. At this time we have no known vaccines against
coronavirus. So your flu shot will work to protect you from the flu, but it
doesn’t have any effect on the coronavirus.
Denny Long:
There’s a text too, doctors, that I find interesting too, because I was
asked this question the other day: If you have had the coronavirus and
recovered, do you then have immunity?
Caitlin Eccles-Radtke:
I think we just don’t know the answer to that yet because this is so new.
We’re just seeing people starting to recover from this as it has popped up. So
the assumption with other diseases is that you develop some immunity, but what
we don’t know yet is whether or not that protects you from ever getting it
again, or if you were to get it again would you have a milder case. I’m just
not sure yet.
David Hilden:
Yeah, I will do that. I want to just comment on that one, and then we’ll go
back to the phones. I have heard people all over the map on, “I want to
get it so that I’ll be immune.” I’ve heard even politicians and people on
national venues say that we should just get everybody exposed so we can get it
over with. That’s the ridiculous end, because that would mean many people get
very ill and many people die. All the way down to people who say, well, we
should have our healthcare people, maybe it would be okay, those who survive
can be the ones to do the caregiving. Have you heard thoughts along those
lines, Caitlin?
Caitlin Eccles-Radtke:
I have, I’ve heard a few things. My first recommendation is: Don’t go trying
to get this. The reason for that is even if you may be someone who doesn’t have
underlying medical or health conditions and you may do well and not get very
sick from it, the risk of you spreading it to someone else who is higher risk
is there. We don’t want to put our vulnerable populations at higher risks. The
other issue with this is: Because there’s so many cases around the globe right
now and that it’s spreading, you may think most people do just fine so it’s not
a big deal. But the number of people, if you look at the percentages of people
who get really sick from it, could very well overwhelm our healthcare system in
terms of needing supportive cares in terms of the ICU or breathing help or
things like that. So I really recommend people still try not to get sick from
this, and practice routine infection control precaution.
David Hilden:
In our line of work, we talk about “flattening the curve” of a
number of cases. I think we’re quite ready in our hospital systems, but if too
many people get it we would not have enough respirators and we would not have
enough equipment. Isn’t that true?
Caitlin Eccles-Radtke:
That’s completely correct. Our goal is to stop this from spreading fast, so
anyone who gets sick we can take care of and get them better before the next
round of people come in. Whereas, if everybody came in at once, it would be a
lot more difficult.
Listener:
Which is better, hand sanitizer, soap and water, or maybe just warm water if
nothing else is available?
Caitlin Eccles-Radtke:
I would recommend just washing your hands with routine soap and water for 20
seconds or longer. But really hand sanitizer is just as good. Most of those are
alcohol-based, and so either one is fine. We just recommend using something.
Denny Long:
Will taking vitamin D and C or supplements like those to boost hour immune
system help protect against effects of COVID-19 if you contract it?
Caitlin Eccles-Radtke:
In general, those probably won’t do much to prevent the infection, but
there’s no studies or data out there to show that at this time. That said, I
have no qualms with people taking over the counter vitamins C and D. If you
feel like it’s giving you some benefit, I say go for it.
David Hilden:
I had some questions about parents and their kids. We hear a lot about
school closings and all that, but it’s also true that this is a milder disease
in children as far as we know. What do you think, Caitlin, about parents and
kids? Should they feel okay sending their kids to school and things like that?
Caitlin Eccles-Radtke:
We really haven’t seen a big impact of this virus on children, so that’s a
great thing. You think about things like the flu and other colds and kids often
get sick, and kids are spreaders. So the good news so far is that this really
isn’t hitting children in a way that it’s hitting adults. So I think at this
point kids are okay to go to school, you know, teaching them good hand washing
techniques is great. There may be a time once we see more cases in our
community where the state will decide to close schools, but as of right now I
think it’s safe for kids to go. We’re not seeing community spread, and that
keeps parents in the workforce, too, which is really important, especially healthcare
providers in this setting, but everyone.
David Hilden:
Are you doing planning? Or I should say, are we doing planning at our
hospital, and then by extension all hospitals for workforce issues? For
instance, what if all the nurses have their kids home? Or what if anybody, the
doctors, get sick? Are we doing planning along those lines?
Caitlin Eccles-Radtke:
We are. One thing we’re starting to ask people to do is know who your
resources are. Right? So for a nurse or a physician or anybody, if schools get
closed, who may need to be home with their kids, we’re asking them to work
together and come up with a plan. So whether that plan is having your kids stay
home with their aunt or uncle, with a grandparent, with a neighbor, start
thinking about that now so that when it does happen you’re ready for it. I’ve
seen some really good camaraderie within teams in the hospital. One of our
specialties, they’ve actually already been sitting down as a group and came up
basically with a daycare plan. It rotates, I think, through different people so
most everyone can still work, and they only may have, say, one person out at a
given time.
David Hilden:
Caitlin, talk about masks if you will. Do they help people?
Caitlin Eccles-Radtke:
There’s sort of different answers for this. It depends on who and where you
are, and if you’re sick or not. So what I mean be that is in the healthcare
setting, for sure. You are taking care of sick people all the time, you want to
protect yourself. We use for people coming in sick to the hospital and needing
testing for COVID-19, we recommend what are called the N95 masks or the
respirators. For the general public, if you’re not sick there is no need, and
we ask that people don’t go nuts buying a whole bunch of masks, if there are
any left in all honesty, because it really doesn’t help you if you’re just
wearing a simple mask walking around town. That said, people who are out in the
community, if you’re sick and need to go somewhere and you’re coughing, wearing
a mask is recommended because it helps catch any sort of sneezes, coughs,
respiratory droplets that you may be putting out into the atmosphere.
David Hilden:
So maybe it’s the sick people who should be wearing them.
Caitlin Eccles-Radtke:
Correct.
David Hilden:
Yeah. I like your comment about if you can even find any. I know we have an
adequate number of masks at our hospital. Actually we’ve counted them, we know
what we have. But they are for the right purpose, it’s for the healthcare
workers and people who are ill. They’re not for the general public to go
walking around wearing.
Caitlin Eccles-Radtke:
That is correct. I think one of the biggest concerns with various hospital
systems across the world will be shortages of medical equipment like masks and
things like that. I know that certain companies are ramping up production of
masks and moving resources from one area to another to be able to create more.
So that is being addressed, but it is a fear.
David Hilden:
Could you talk about a vaccine? What’s the state of that?
Caitlin Eccles-Radtke:
You know, I know that there’s a lot of very, very smart researchers within
our country looking at this, moving quickly, trying to work on it. But at this
point in time it’s just too soon. It does take time for trials to happen,
things to get tested, approvals to go through. So I think we are months to a
year out at least, and I would say I guess we shouldn’t rely on that right now.
David Hilden:
That sounds like sound advice to me. I think that maybe some year, next year
or the year after or the year after, we might be giving people their
coronavirus vaccines, but it isn’t going to help us in 2020, it doesn’t sound
like. I’m actually amazed at the science that has come out relative to this,
that the scientists have been able to do a test for this virus using a PCR
technology, for those of you who know laboratory work it uses a reverse PCR
technology. In a matter of just weeks to months we’ve been able to develop
tests for this, even though the virus is basically brand new. So just a little
shout out to the scientists out there.
David Hilden:
Caitlin, can you just comment a general comment about trying to address
people’s fears about this thing. It’s everywhere. It’s on the news. Every day
we’ve got the general public practically counting cases in their community.
It’s on our consciousness almost everywhere you go. People are reevaluating how
they greet each other. Should we be doing foot taps or doing like the namaste
bow that they do in yoga class? Should we be doing fist bumps to people? It’s
really permeating our individual lives. Can you comment about how much people
should be worried about this? Is it over hyped? Is it real? Could you just make
some comments about that, please?
Caitlin Eccles-Radtke:
Of course. I think we as human beings are routinely more afraid of things we
don’t know about. Right? So that is the scary thing here for people, because
one, we just don’t quite know everything about this virus yet since it’s new.
And people are always afraid of things, I would say, that they can’t control.
Right? So feeling that lack of control is scary. What I would recommend to
people is: Really work on those techniques that are within your control to keep
healthy and not spread things.
Caitlin Eccles-Radtke:
To your point about greetings and things, one thing we’re going to see more
and more of, which is tough for people because we are social beings, is
something we call “social distancing.” So you know, big meetings,
events, et cetera, are getting canceled as a technique to try and keep large
groups of people away from each other. I would just recommend it’s okay to say
to someone, “Hey, it’s nice to see you. I’d normally shake your hand, but
I’m going to not this time in efforts to just not spread anything.” I think
that’s okay, too. But I think what people need to remember is even though this
is a big new thing, take a step back, think about what you would do with the
flu or other coughs and colds, and follow those practices. Then you have some
control over keeping yourself healthy.
David Hilden:
That sounds like really good advice. If you’re with somebody and you’re
maybe in a group setting and they’re shaking your hand, maybe you’re at church
passing the peace around… I know congregations have been talking, what do you
do there. Maybe it’s okay for the time being to, Nobody take it personally,
we’re going to bump elbows, or we’re just going to greet each other from an
arm’s length, maybe. I think that’s maybe an okay thing to just do for a little
bit, a little while. Do we know, is this thing seasonal? Is it going to get
better in the summer like flu? Or do we not know that, Caitlin?
Caitlin Eccles-Radtke:
I think we just don’t know yet. It’s going to be sort of a wait and see.
Obviously that would be great if that happens and slows things down. I do think
even if that occurs, we’ll probably see stuff pop back up in the fall. But it
could very well continue to go through the summer, and I don’t have a crystal
ball but I kind of expect that it may.
David Hilden:
One would kind of hope, because viruses tend to for odd reasons and not
entirely understood, they do better in the dry air. It’s something about the
droplets, they seem to do better in the winter. At least that’s what most
viruses do. It would be nice if this one did that exact same thing, and maybe
this will be a springtime thing at least in the worst of it, and then it might
get better in the summer. But we just simply don’t know.
Denny Long:
We have a bunch of text messages. See if we can’t do a little lightning
round here. Texter says: I work at a bank and work with other people’s money.
How at risk am I? Any ideas other than using hand sanitizers?
Caitlin Eccles-Radtke:
I actually don’t think I’ve gotten that one before. As they say, money is
dirty. I would say, again, just going back to your routine infection control
practices; using hand sanitizer regularly; not touching your face, nose, mouth,
eyes. That’s a good thing.
Denny:
There’s another text, doctors, that says: I am scheduled for total knee
replacement late this month. Would you expect elective surgeries to be
postponed?
Caitlin Eccles-Radtke:
I think that’s going to be sort of a day to day thing. Later this month you
may still be okay. If it were later out, it’s just hard to know because this is
so new, what direction it’s going, how many cases we’ll have in three days,
five days, seven days. So I would say just watchful waiting. Don’t cancel
anything yet, and take guidance from your healthcare system.
Denny Long:
And a caller wanted to ask if one is inactive, does being inactive hurt you?
Caitlin Eccles-Radtke:
There has been some data that people who are obese or overweight are at
higher risk. But inactivity as a sole factor, we just don’t know.
Denny Long:
All right. Well, we are just about out of time. Any final thoughts, Dr.
Hilden?
David Hilden:
Well, I just want to thank my colleague and friend. I’ve known Caitlin for
many years, and she is just a wealth of information and knowledge. Thank you so
much, Caitlin, for helping educate us and for giving us good, factual
information today.
Caitlin Eccles-Radtke:
Thanks for having me.
