Medical College Of Wisconsin Doctor Answers Your Coronavirus Questions
Although conversations about the coronavirus are really inescapable, there are still a lot of misperceptions and questions about the disease. For Bubbler Talk, we've been asking listeners what they want to know about the disease and how it's spread.
Dr. Joyce Sanchez is an assistant professor at the Medical College of Wisconsin who specializes in infectious diseases. She is here to help answer some of your coronavirus questions:
Do we know how the disease developed?
Things certainly started in Wuhan, China, and we know that they started in connection with a seafood market in Wuhan. A lot of the genetic information that's been shared has linked this particular coronavirus to one that is related to bats.
We also know that based on previous experience with SARS and MERS that there was an intermediate host, an intermediate animal that subsequently came into close quarters with bats and subsequently transmitted the virus to people.
Is there more than one strain of coronavirus?
There are seven different coronaviruses that we know of. Four that we have lots of experience with and identified in the 1960s that cause approximately 30% of cases of the common cold. The coronaviruses that have become more problematic that cause lower respiratory tract infections, viral pneumonia, and some of the really bad sequela, we're seeing now are SARS from 2002, MERS from 2012, and now SARS-CoV-2, which causes COVID-19.
As for SARS-CoV-2, what's going on with this pandemic, there are definitely differences in genetic sequences, different strains of this virus from region to region.
However, those genetic differences have not proven to translate to differences in how the virus actually behaves, such as how transmissible it is or the severity of diseasxfe that it may cause particularly in those who are susceptible. So small changes, but in real life, how that translates there's really no difference that we're seeing.
Can you get the virus twice?
The quick answer is that we don't entirely know right now.
Our experience with the other four seasonal coronaviruses, we see some short-term immunity, but that doesn't really translate into long-term immunity over the years.
Are CPAP machines, normally used for sleep apnea, helpful for people with coronavirus?
By the time you tip over to needing more aggressive measures like non-invasive ventilation or CPAP, we're really talking about getting you intubated, and on a ventilator sooner in a more elective, more controlled fashion as opposed to waiting where you've passed that tipping point and now we're emergently putting you on a ventilator.
But my understanding from our experts in that field is, if you are already on it for sleep apnea or some other sleep disorder, that you should continue to use that.
When will coronavirus testing be available to everyone?
We'd love to be able to test every single person.
We're really limited by the supply chain. Every little component of these kits is assembled via supply chain and if there is a breakdown of one component of that kit, then the whole kit is nonfunctional, so you need every piece of it.
The private sector has been ramping up. Our laboratory associated with the Medical College of Wisconsin actually has more tests than anywhere else in the state, which is great. But it's still not enough to provide testing for everybody who needs that. So we're still prioritizing people who are the most medically vulnerable.
Do we have drive-thru testing sites in Milwaukee? If so, where are they?
Froedtert and the Medical College of Wisconsin do.
If you have any questions about whether or not you should be tested and want to know the locations if you qualify for testing, call 414-805-2000. (Other health providers provide other testing services.)
Will social distancing end the pandemic sooner, or it really just about making the caseload of patients more manageable, but ultimately extending the length of the pandemic?
I'm going to call social distancing — physical distancing because that's what it is, you can still be social virtually, or from afar.
Physical distancing might lengthen it. The problem is, if you don't take these measures and you overwhelm the system, then we're in a predicament like Italy, where you're rationing the number of ventilators. You're rationing the number of people who can get into the hospital. Ultimately, physical distancing is in the best interest of everybody.
Is it all right for children to spend the weekend with one parent then move to another home? Or let's say you care for someone in another home but you live somewhere else. Is it safe to do that and what precautions should you be taking if that's something you need to do?
You have to do what works.
What I would recommend for those who are going from house to house, like this case, is to try to minimize contact with other communities. So for the husband and wife, or ex-husband and wife, if they can stay home, great. If they can telework, great. I know not everyone has the luxury of doing that. Not everyone has the luxury of paid time off either. So that is a problem. So, keep the kids within those two confined homes and absolutely minimizing anyone else who is entering the home, unless it's absolutely necessary.
If you have an elderly family member who gets homecare from a nurse, or a nanny who has to come in because you're a health care worker or an essential worker who has to go out for your work, then, that's what we have to do and take the proper precautions. So the hand washing that will never change, coughing into your elbow will not change, keeping surfaces that are high touch countertops, laptops, phones as clean as possible and disinfecting them often that also does not change.
Can you get the disease from petting someone else's dog?
The good news here is to my awareness, we've not seen any data where dogs can actually contract illness but they can serve as something in the medical community that we call a fomite, a fomite is any surface by which virus can be spread onto. And then if someone touches that surface and then touches their face without handwashing, you can contract the illness.
What does the data tell us about the next few months? Can other countries that have begun to lift shelter-in-place guidelines give us insight to how to get through this?
The current projections are that we're probably going to reach our peak or inflection point, at least in the Milwaukee and southeast Wisconsin area, in the next couple of weeks — so mid to end of April, potentially the first week of May.
In terms of lessons we've learned, is in South Korea, how they were able to more quickly flatten their curve primarily through massive testing and contact tracing efforts. So I think now that we've learned about the supply chain issue and how to better prepare for that in the future.
One other thing that we've learned is that in Wuhan, they've definitely started lifting some restrictions. But at the same time, I do have some concern that there's still some low-level virus in communities, we may see an uptick in cases again. So I think being very diligent about slowly lifting restrictions step-by-step, day-by-day, basic reevaluating, so that way we're not left in the same situation as we were a couple of months ago.
If you are a former health care worker who wants to help, what should you do?
I don't know personally if there's any mechanism to come back and work and get recredentialed but something that you could definitely look into.
Then educating the public. So if you're a former nurse, you have a science and medical background, debunking some of the myths that are out there. Some myths include that patients who are African American are not susceptible. That's not true. In fact, it's said those communities are the hardest hit here in Milwaukee. Encouraging hand hygiene, encouraging people to stay home and stay safe, rather than not believing what's going on.
To end on a hopeful note, if you're somebody who wants to help health care workers, how do you go about doing that?
Certainly, everyone can shelter in place. That's the number one thing that we as a public, no matter what your occupation or vocation is, can do to contain the spread of disease.
If you're someone who has donated blood before or even if you haven't donated blood, calling into Versiti, the Blood Center of Wisconsin and donating blood is helpful.
If you suspect you've contracted the illness or know you have contracted COVID-19, and if you've recovered, we are looking for plasma donors who we can actually take the antibodies from and administer to people who are in the hospital.
During this pandemic, WUWM's Bubbler Talk is focusing on the coronavirus and its impact on the Milwaukee area. If you have a question, submit it below.