Lori Walsh: South Dakota Public Broadcasting welcomes your questions about coronavirus and the disease it causes, COVID-19. You can text your questions to 605-956-SDPB, email us at [email protected]. Today Dr. Wendell Hoffman returns to the program to answer some of the questions we've gathered so far. He's a specialist in infectious diseases from Sanford Health. Welcome back, thanks Dr. Hoffman for being here.
Dr. Wendell Hoffman: Thank you. Great to be with you.
Lori Walsh: All right, let's start with what do we know about this virus, that we didn't know even a week ago? How fast are we learning about this thing and what are we learning?
Dr. Wendell Hoffman: I think the analogy I would use is that, we all feel like we're drinking from a fire hose. This is... If you take two steps back, this is just extraordinarily fascinating but at the same time, very, very sobering. And, part of the challenge is, that while we are in a pandemic, this is not an influenza pandemic. Okay?
So when we track back influenza pandemics, going back what the last 10, over the last 250 years or so, we have accumulated a lot of information about the influenza group of viruses. We kind of have much more solid predictive models that can help us. For instance, in the 2009 pandemic H1N1 and in other pandemics before the four major pandemics in the 20th century plus this one now in the 21st century. And now, we're dealing with the second pandemic of the 21st century.
But, the fundamental difference is that coronavirus is a different class of viruses and that is why it is so utterly frustrating for the public and also for those of us who are caring for these patients and trying to give guidance to predict where it's headed. So what do we know now that we didn't know a week ago? Well, some things we do, I think we have a much greater respect for how easily this virus is being transmitted.
And why, for instance, it can sort of spread in a region kind of under the radar and then suddenly begin to pop up and then explode. I think we are... That's why we're seeing all of these kind of uses of terms like hotspots and so I would say this is an evolving situation, with rapid learning and we're trying to apply the very best science that we have, not just from the United States but from around the world.
Lori Walsh: Are you making predictions and guesses on the whether or not... Governor Kristi Noem said... Here's my specific question. Governor Kristi Noem said in a recent press conference that the stay at home measures that we're taking are working. And, the big question was, is it too soon to tell that? Do we know that it's working? Do you feel like the stay at home measures are currently effective?
Dr. Wendell Hoffman: So I think the answer to that is, it's difficult to make a categorical yes to any question with this virus but I do strongly believe that the measures that have been put in place are being effective. And, I think the way you know that is to consider this in terms of two week blocks.
We've heard about the famous incubation period, which it is thought to be, at this point, around 14 days. And so, if you think about it in two week blocks, therefore, what we're seeing now, we can say in South Dakota is what was happening two weeks ago. What we will see two weeks from now is a result of what we're doing now. And so, that's why we're seeing this in two week... We kind of like to talk in two week blocks and that's why it's so important. Why our leaders in this state have really, I think, done an extraordinary job. They have got a tough...
They have to balance so many different things, both from the medical side and from the economic side, and I really am grateful for what they have done. Kind of cool, calm and collected, competent as they are receiving information and trying to apply, as nonmedical people. So yes, I do endorse what we're doing and we will see the results, I think, reflected over the next several weeks. And, all of us are hoping and expecting that the numbers of cases are going to come down, even in regions like South Dakota. States like South Dakota, where as of yesterday we were still under a hundred cases.
Lori Walsh: Right. All right, so here are some of the questions we're getting from listeners and one of the big ones I hear again and again and again is, keeping your safe yourself safe inside your house. Once you're there, getting groceries into the house, whether it's safe to order takeout. So let's start with takeout from a restaurant. Is that safe to do and what's the safest way to do it?
Dr. Wendell Hoffman: So I think it is a safe. There's no evidence, for instance, that this virus is transmitted in food or water. I mean, you have to think about it in terms of the environmental... The evidence for environmental contamination is significant and it's sobering and I think as part of the reason why the virus has spread so easily.
But, there's clearly, I'm not aware of any evidence as I sit here, that getting food from takeouts places one at increased risk or going to grocery stores. The thing at the grocery stores, like any place where people congregate, would be being in direct proximity to a person who may be asymptomatically shedding the virus or who may have mild symptoms and is not even aware themselves. Maybe they have a little stuffy nose or a runny nose because this virus kind of has the whole spectrum of symptoms.
So I would not be afraid to go to the grocery store. I would not be afraid to go get food, take out. I mean, my wife and I went and got food last night that we took out and we're trying to support our favorite businesses too, which is the other half of this equation. So no, I would not be concerned about that kind of activity.
As far as what one does in the home, I think... I'll just tell you what my wife and I do. When I come home I try to maintain, as tough as it has for me, I'm not sure it's tough for her, but we try to maintain some sense of distance. We try to clean off the non porous surfaces, where I think most of the evidence lies in terms of environmental contamination. So the hard surfaces in your home, I think to periodically wipe them down with common disinfectants because it looks like this particular class of virus, it's kind of wimpy. If I can use that word.
These are envelope RNA viruses that are very susceptible to just denaturing by even being out in the air. I mean, they start to degrade immediately and yet they can persist. I mean, some of these studies which are experimental, right? They're in a laboratory that doesn't necessarily mean that, that translate into contagious virus, but it does mean that we have to respect it. And so, in the home, maintain some sort of distance. And I mean, in our situation because I'm a healthcare provider and my risk is maybe a little bit higher than the general public, my wife and I sleep in different bedrooms.
It's just a simple thing that we can do. We use separate bathrooms, but that's me. I mean... And, I'm just trying to protect her as much as I can. And, of course she says, "Well, how do you know that you're not going to get it from me?" Because she's out and about in the community too. And, the answer is, I don't. And, that kind of goes to the other thing and I think we have to respect this virus, but we cannot fear it, in that sense. We cannot dread it.
We have to do reasonable things that will allow our lives to move forward. Because if we overreact then the virus has already won, without even affecting us. So we have to differentiate between respect and dread. And, I think we're definitely going to get through this but for those who are in their homes and sheltering in place, particularly those people who are at increased risk for further complications of COVID-19 and the elderly, I think we're going to...
I fully believe we're going to come through this, not without some pain, clearly and one has to tip your cap and just salute the health care workers all over the nation. Particularly, in these very difficult circumstances that places like New York State are facing.
Lori Walsh: So take out and grocery store. When you bring anything into your house from the things that you might purchase in the community that would [inaudible 00:09:57] necessities, do you disinfect them when you come in? Wipe them down? Does that make a difference? Or, are we doing that to make ourselves feel better?
Dr. Wendell Hoffman: I think it's probably more the latter. I mean, I've not seen any of that from CDC. I think it's in your space with countertops and surfaces. Your environment that are exposed to you, not the stuff that you necessarily bring in but it's in your space because you're in the space, your family is in this space. For instance...
And also, there's one study that came out of China where they looked at, it was a really interesting, detailed epidemiologic look at how this virus seemed to spread to secondary contacts. And, what we learned from that study, now probably, I don't know three or four weeks ago already, which just goes to tell you how quickly this is evolving because this kind of seems like one big long day. But, what that study showed was that the attack rate in households was about 15% and that study also indicated, and this was our first glimpse into the more complex question of the role that children have in our communities with COVID. Thankfully, and that they are rarely or unusually affected in a serious way.
We don't know about whether or not they can be vectors, but the point being, I'll go back to that. In your home, if you're sheltering in place with several individuals, you can still be successful in trying to prevent this. You don't have to just kind of throw up your hands and say, "Well, there's nothing I can do." No, that's not true. There are things you can do in your home. It's the same stuff, it's maintaining some distance because we know also that, you have to be in the presence of somebody who's infected for a longer than just walking by.
So we don't have to treat each other as the enemy. We have to treat the virus as the enemy. But, we also have to recognize that you have to be within that six foot parameter for more than just a short period of time, it would appear. And so, within the home, yeah social distancing, as you can practice it. It's tough because you got little kids, no doubt. And, you've got grandpas and grandmas and you're all trying to do the best thing possible as we move forward.
And then, cleaning environmental surfaces, the social distancing and washing your hands. Can't emphasize that enough. Try to avoid going to your mouth and nose, it's tough. I can't do it very well. But, I think I'm getting better at it than I was, even a week ago. And, just to be mindful of those things, I think are the three big things and then don't focus so much on what you're bringing into the home, focus on what's going on in the home.
Lori Walsh: In our remaining minute, one of our other listener questions is, what does recovered mean in this context? When we get the numbers from the Department of Health and it says there's 34 people recovered, those are the numbers from Saturday, right now. What does that mean in the last 30 seconds or so that we have?
Dr. Wendell Hoffman: Great question. So what technically what recovered means is likely that they now test negative. That's probably what it means. Clinically recovered though, the Chinese data suggests that, that in somebody who's severely ill or who has to be in the hospital, it may take up to a month before they're really feeling back on their feet. And, even longer if they've been really, really critically ill. So the story on that is, is yet pending but those are the general definitions of what recovered means.
Lori Walsh: Dr. Wendell Hoffman, we appreciate your time very much. Thank you so much. And, we'll see you next time. Be well.
Dr. Wendell Hoffman: You're very welcome. And, everybody out there be well. Be encouraged, be hopeful, we're going to do this.