Last week I wrote about COVID fatigue. This week I thought I would write about COVID awareness. I did a similar Q&A to this one early on in the pandemic, and in retrospect, it has proven to be accurate. That blog post was based on available data at that time. This blog post is based on more current information. My goal is to present these questions and answers in an understandable format, as I believe that knowledge is power.
I am a physician who trained at Northwestern’s Feinberg School of Medicine. Although I specialized in treating disorders of the mind (psychiatrist), I was trained in all areas of medicine as a medical student. Before becoming a medical doctor, I obtained a graduate degree, where I studied microorganisms’ biochemistry. I have also worked in research centers, where I participated in basic research on cancer and multiple sclerosis. Years ago, I was part of a research team that used monoclonal antibodies as a research tool. It is incredible to see these agents now being used to treat medical illness. Although I’m not a specialist in infectious disease, I can read scientific information and determine good data from bad information.
What is this virus?
This virus belongs to a large family of viruses called coronaviruses. These viruses have a common characteristic: they have a “crown” (or corona) of protein spikes on their surface. These spikes can attach to specific receptors on host cells, which allows the virus to inject its contents into the cell. The virus uses the “machinery’ in the host cell to reproduce (or replicate). This process, and how the body reacts to it, can cause illness and death.
How does one contract this virus?
The virus has to enter a host’s body through a vulnerable site. These places include the mouth, nose, and eyes. You cannot contract the virus by just touching it. However, you can touch a contaminated surface and then rub your mouth, nose, or eyes to inoculate yourself with the virus. You can also contract the virus by more direct means. If someone with the virus coughs, they send a spray of droplets into the air. The virus can exist in very high concentrations in these droplets. If they land on your face, they can infect you. These droplets are pretty heavy, and most of them will fall to the ground within a few feet of being “coughed up.”
It now seems likely that the virus can also float in the air. In these situations, the virus can travel further.
Can you tell me more about airborne spread?
It is likely that the virus can be spread in smaller particles that are expressed when a person exhales. These particles are lighter, so they can travel further and potentially infect a person who is further away than 6 feet from the infected individuals. However, the conditions have to be just right for this to happen-I’ll talk more about that later.
If you understand the answers to the following question, you will have a firm understanding of the relative risk of any activity that you may want to do.
The most important answer in this post:
What are the factors that make it likely that someone will get infected by this coronavirus?
The number one factor is called “the infectious dose.” That is the number of particles of virus needed to cause a successful infection. Different viruses have different infectious doses. It is unclear how many virus particles are required to cause a COVID infection, but the number is likely considerable. In other words, if you somehow accidentally inoculate yourself with only a few viral particles, you won’t get sick. Four main factors determine if exposure to the virus will infect you.
- The concentration of the virus-the higher the concentration, the higher the infection rate.
- The length of exposure to a virus-the longer you are in a place contaminated with the a virus, the more virus you are exposed to.
- The viability of the virus-viruses are fragile. A freshly expressed virus will be more potent (virulent) than one that has been drying on a surface.
- The vulnerability of the host. For instance, individuals with weakened immune systems can be infected by fewer virus particles than a person who has a robust immune system.
How likely is it that you will infect yourself with a virus by touching an inanimate object (like a package) and then touching your face?
It is doubtful that you will infect yourself in this manner. If there is a virus on a surface, it is likely that the virus’s concentration is low and that the potency is low. However, there are some cases when the risk can be higher. For instance, an infected person coughs into their hand, which you then shake. You then touch your face and inoculate yourself. Or a person coughs on a hard surface like a credit card touchpad. Immediately afterward, you use the same touchpad for your transaction. You then rub your nose.
Beyond specific cases, it is unlikely that you will contract the virus from an inanimate object. There is no compelling evidence that you have to wash your groceries or sterilize your mail.
Then I don’t have to wash my hands?
NO, YOU HAVE TO WASH YOUR HANDS AS RECOMMENDED. It is a simple precaution that is easy to do. We are always touching our faces with our hands. By making hand washing routine, you eliminate those times when you could be exposed to a high virus concentration.
Why should I socially distance?
Remember that it is proven that you can contract the virus by respiratory droplets and that these droplets can only travel a short distance. By staying at least 6 feet from individuals, you place yourself in a safer zone, as most large droplets will have fallen to the ground before then.
This airborne thing frightens me? Do I have to be afraid to breathe?
NO. Airborne transmission seems to be most significant in specific situations that cause higher viral exposure to the recipient. These are situations that increase small particles in the air, such as talking loudly, shouting, and singing. These airborne particles then need to be trapped in an enclosed space (like a room). Lastly, a person needs to be exposed to this environment for a more extended period. Here are a couple of examples where airborne infections could occur:
- Attending a church service where there is singing.
- Hanging out at a bar where there is a lot of loud talking and shouting.
- Having a leisurely meal in a noisy restaurant where everyone has to “speak up” to be heard.
What is a super spreader, and what is a super spreader event? Why do these individuals and events occur?
There seem to be specific individuals who can spread the virus more effectively to others. Also, there appear to be situations that seem to spread the virus to more individuals than in other cases.
We understand some of the reasons for this (see my answers above), but we still don’t fully understand why some people or situations are more infectious than others.
What can I do to protect myself when flying?
Airplanes have effective air cleaning systems, and so it is most likely that you will become infected by a person who sits close to you on an airplane rather than someone who is many rows away. Therefore it is critical that everyone on a plane wears a mask. Also, try to keep your hands to yourself and consider some eye protection. Wash or sanitize your hands as needed.
Are outdoor rallies safe?
In general, a well ventilated outdoor event will be safer than a poorly ventilated indoor event. However, you can make such an event even safer by socially distancing, hand washing, and wearing a mask. Remember, if someone close to you has COVID, they can quickly transfer the virus to you by their proximity in any setting.
Why should I wear a mask? The CDC initially said I didn’t need to. What about my civil rights?
The CDC based its initial recommendation on two factors. The INITIAL data didn’t support layperson mask-wearing, and there was a shortage of masks needed by first responders. Their recommendations changed when it became abundantly clear that masks (even homemade ones) could prevent the spread of COVID. This fact has been shown over and over; it is not in question. Masks save lives.
As far as your civil rights, let me be direct, if you believe that not wearing a mask somehow demonstrates that you are a patriotic American, I am here to tell you that you are being played, and played most cruelly. This simple act (mask-wearing) can not only prevent you from getting sick; it can save the lives of others.
We do things all of the time necessary for both our’s and the greater society’s safety. It is illegal to drive while intoxicated, you are not allowed to smoke in public places, and factories are not allowed to dump toxic chemicals into our public water systems. These are just a few of many examples. Please don’t be played by others. Masks save lives.
Why do some people die from COVID, and others have no symptoms?
There are likely many factors, but the answer to this question is that we don’t completely know. However, we do know some groups are more vulnerable than others. Older individuals and those with certain medical conditions are at the highest risk. However, sometimes young and healthy individuals die from this disease too. It also appears that some younger individuals develop problems after they recover from their initial infection.
Do we have a cure for this virus?
Contrary to what you may be hearing from politicians, the answer is no. However, data has been examined from many thousands of cases, and we have been able to refine our treatment of this disease based on that information. We know that certain drugs, like steroids and anticoagulants, can help with recovery when given in the right situations and at the right time. Other modalities, like serum treatments and monoclonal antibodies, may help some individuals. We are getting a handle on when a person needs assistance with their breathing and what works best to treat particular issues. As our knowledge improves, so does the survival rate of infected individuals.
Is it true that we have more cases because we are doing more testing?
This is an outright lie, a manipulation to make things sound better than they are. There is no other way to say this. We know that we have more infections based on multiple streams of information that include testing results and hospitalization stays, community information, and COVID mortality numbers.
Testing gives us a window into the virus’s activity at any location and also lets us know how successful our efforts are in combating a virus in any particular area. Any action to limit or discourage testing is criminal, in my opinion. Limiting testing allows the virus to flourish. Limiting testing makes it worse for everyone. Imagine if someone said that they were going to limit unwanted pregnancies by limiting pregnancy tests. Ridiculous, no?
I need to get on with my life, but how can I?
Go back to the “most important answer” above. What we can do for a week is different from what we can do for months. What is the safest way to work? How can I socialize responsibly? How can I modify my life to get what I need while being safe? Base your decisions and actions on thoughtful reflection and reliable data. In life, there are reasonable risks and foolish risks.
Why are some people asymptomatic and others very ill?
At this time, we don’t know.
Can asymptomatic people spread the virus?
It is unclear how infectious asymptomatic people are, but YES it appears that they can infect others. Some asymptomatic individuals genuinely have no symptoms. Others may have mild symptoms that they ignore. Still, others may be infected and will show signs in a day or two. If you practice CDC guidelines, you are in the best position to protect yourself.
Will I be back to normal once I recover from COVID?
We are seeing cases where individuals have long-term effects that range from neurological complications to breathing problems. It is unknown how these individuals will be impacted years from now.
I don’t follow CDC guidelines and I’m fine. Therefore, COVID is a hoax!
I’m glad that you are both healthy and lucky. However, a single (or small group) of individuals does not determine a pandemic. The data is out there, the numbers are in the millions.
Is a vaccine the solution to all of our problems with this virus?
NO, but it is a critical step. At this time, we still don’t know how effective a vaccine will be, or how long its effectiveness will last. However, once it is determined to be safe and reasonably effective, I plan on getting innoculated.
Will we get through this?
Of course, we will. However, we need to use the information we obtain from this pandemic to implement changes to deal with future pandemics effectively. Remember, knowledge is power.
I hope this Q&A has answered some of your questions on COVID. To the best of my knowledge, the answers are accurate as of 10/29/2020
BTW Comments have been turned off as I was getting hundreds of SPAM messages from a Spanish bot. If you want to email me, you can take my web address prefix and add @gmail.com.