CDC has the most comprehensive information on everything you need to know about COVID-19. Most of the answers in this Q&A are based on inforamtion from CDC, Unicef, and the "Ask Our Doctors" event that was conducted by the Kerala Association of Washington (KAW). The doctors that answered the questions's at the KAW event are front-line responders in this crisis. These doctors are from hospitals in Washington state, so their answers to some of the questions may not necessarily be applicable elsewhere. I have translated the answers to English, so I apologize in advance for any misunderstandings or incorrect grammar. Also, the answers are based on what doctors knew at the time and are subject to change as the world is learning more about this virus every day.
Isn't the coronavirus just like the flu?
No. The flu virus is from a whole other family of viruses. SARS-CoV-2, the virus that causes COVID-19, spreads much quicker and more easily than the flu. The flu virus can only spread to less than two people (R0 – 1.3). SARS-CoV-2 can spread to over 2 people (R0 – 2.3). According to the information we have now, COVID-19 is more dangerous than the flu. 1 in 1000 people die from the flu. However, 1 in 100, or greater than that, are thought to die due to COVID-19.
What are your top 3 recommendations for staying safe?
1. Hand hygiene
2. Social distancing
3. Self-quarantine if you are sick
Will extreme heat really kill the virus? If so, how hot does it need to be for the virus to die?
There is no evidence yet that high temperatures will kill the virus. We don’t know how hot it needs to be for the virus to die. At hospitals we disinfect surfaces to keep them clean of the virus, we don’t use heat. The spread of the virus in tropical areas is still being studied so we are not sure yet what the effect of heat is on the virus.
How safe is buying food from restaurants?
It is safest to make your own food in this situation. We cannot be sure of how much personal hygiene and safety precautions the people making and handling our food in restaurants are taking or following. We don’t know if the utensils they use have bodily fluids of some sort or if while making it the chef sneezed or coughed. If you are getting take-out or getting food delivered, you cant know if the person who delivered it is infected or if they had coughed or sneezed on your package. If it is possible to do away with buying restaurant food, that may be the safest.
Should I take precautions with packages delivered to me?
Yes. We don’t know if the person who delivered it or packaged it is sick or not. If it is not extremely important, leaving the package out for a few hours or a day wouldn’t hurt. If it is time sensitive, practice hand hygiene, after taking everything out of the package wash your hands for 20 seconds. If you want more information, WHO (World Health Organization) has a video on how to best wash your hands. In a time when this virus is spreading quickly, keeping up with hand hygiene is the best way to prevent it.
The elderly and those with low immunity are said to be most susceptible to the virus: will it still affect children and young adults with conditions such as diabetes, asthma, or down syndrome as much as the elderly?
The virus is affecting children. In a recently released report from China, 2000 children had been affected by the virus. There was only one recorded fatality, a 14 year old, and it is unknown if the child had underlying illnesses. In the US, 40% of the people affected were younger than 60 so it can’t be said that the virus doesn’t affect young adults. Even in China, the mean age for those affected was 25 and above, so we can’t say that children are 100% protected. People all across the board—elderly, children, children with underlying conditions—are susceptible. Children with down syndrome may have cardiac defects so they will be susceptible to the virus. Recently a 40-year-old physician in Seattle was put on ventilator due to the effects of the coronavirus. he had no conditions of any sort, so it really is all people that are being affected by the virus.
What are the criteria for COVID testing?
Initially, the criteria was that people had to come in contact with someone who was positive for COVID-19 or that they traveled to affected countries recently. However, this has now been declared a pandemic, if you are exhibiting a fever, shortness of breath, cough, and/or body pains, you will be tested for COVID-19. If symptoms are not bad enough to admit, you will be sent home to self-quarantine. You will get results about 2-3 days after the tests. The healthcare provider will contact you as soon as they have your results. Call your doctor if you feel you are sick, do not go to hospital without making the call. Doctors are now doing telephone consults in order to talk to people who are worried about their condition. If you are going to the ER to get tested, call beforehand to let them know you are coming so that the ER staff can prepare themselves and ready an isolation room for you if it is needed. If you have gloves and a mask, it may be best to wear it.
What precautions are you, as a doctor, taking to make sure you don’t get the virus?
I don’t bring the bag that I take to work inside the house, I keep it in the garage and take it on my way out for work the next day. My stethoscope and all my other things stay outside and never make inside my house. If you have a laptop you can wipe it down before entering the house, so you can use it inside. It may be useful to set up a bleach station in your garage to wipe your things down with Clorox or something of the sort. If you don’t have a place where you can immediately go wash your hands as you enter your place of living, setting up a handwash station or hand-sanitizer where you enter may be a good idea. If you are going to a grocery store or something, wipe down the cart before you touch it.
I gown up and wear protection before going into a room in which I know has a COVID patient. If I need to talk to the family or the patient again after I have exited the room, I call them by phone and let them know instead of going in again. I wash my hands well and clean my stethoscope after each patient. I clean my phone constantly. I have a “COVID car” that I take to work, nobody else is allowed in that car. All of my things—my bag, my coat, etc.—are all in that car. Some doctors change in the garage itself before entering the house. I go straight to a bathroom and shower as soon as I get in and put my clothes in the wash.
If you are a carrier but don’t exhibit symptoms, are you still contagious?
Yes, definitely. According to the information right now, the thought is that you are contagious even if you don’t exhibit symptoms.
How does COVID-19 virus spread?
The virus is thought to spread mainly from person-to-person.
Between people who are in close contact with one another (within about 6 feet).
Through respiratory droplets produced when an infected person coughs or sneezes.
These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs.
The virus first comes in the throat, so would gargling in the primary stages be helpful to preventing the virus worsening?
Gargling, just like with a common cold or a sore throat, can soothe the throat, but it wont cure or prevent COVID-19.
If a family member gets the virus, how should the rest of the family proceed?
Dedicate one room and, if possible, one bathroom for the infected person. Have one person as a designated caretaker for them. If there is any room in which the infected person comes in contact with others, the infected person should wear a mask. If the infected person has trouble breathing and cannot wear the mask, the designated caretaker and any other people who come in contact with the infected person should wear masks. Anything that the infected person uses should be constantly disinfected (phone, doorknobs, etc.). After the infected person has recovered, the room that was dedicated to them, clothes they wore, things they touched, etc. must be disinfected.
Is it true that if you keep your mouth wet at all times (drink water every 15 min) then the virus will go into the stomach instead of the lungs?
It can't yet be proven whether this is true or not. Many of these claims that come around on social media don't have facts to support them and are merely rumors. Please, if you have any doubt in the claims you read, don’t spread it further. However, drinking lots of water is never a bad thing.
Is it true that taking ibuprofen can leave you more susceptible to the virus?
We do not have a very clear idea on this. It is true that those who take ibuprofen will likely have more fever, cough, and body pains. This rumor is likely based more on correlation, and correlation does not imply causation, as you cannot prove that taking ibuprofen causes extreme COVID-19 symptoms. There are medical experts who will one day say not to take ibuprofen and the next say it’s okay to take it. Due to the situation we are in, however, it may be better to, out of an abundance of caution, take Tylenol instead. In time we may learn more about the affects of ibuprofen on symptoms of COVID-19. Tylenol is actually better for when you have a cold because ibuprofen is likely to cause heart burn. Since we are in an uncertain situation, it is best to take Tylenol for now.
How long does the virus last in the air?
In a controlled environment, the virus was shown to stay in the sir for up to 3 hours, but we don’t know how that will extrapolate over to the real world.
What is the recovery rate for those with COVID-19?
Recovery rate for those with mild symptoms (cough, shortness of breath, possible pneumonia) is usually about 2-3 weeks. Recovery rate for those with severe symptoms (more difficulty breathing, the amount of oxygen in your body will decrease, 50% lung usage) is about 3-6 weeks.
Should I wear a mask?
Earlier, doctors were saying that people should not wear masks if they do not have the virus. However, in light of recent studies, the CDC changed their recommendation, suggesting that people should wear face masks if they are going out. Many people have been found to spread the virus even if they don’t show symptoms at the time. This can be due to a person being asymptomatic (not showing symptoms) or pre-symptomatic (not yet at the stage of showing symptoms). The CDC’s current recommendation is that, if you need to go out to a place where interaction with other people in unavoidable or social distancing is not possible, you should wear a cloth mask to cover your nose and mouth. Surgical masks and N-95 respirators are not recommended because those are critical necessities for first responders to the COVID crisis.
What do I do if I came in contact with someone who tested positive for COVID-19?
You can quarantine yourself for two weeks to check yourself for symptoms. If you don’t show symptoms by the end of the two weeks, you should be fine.
Can I go out for walks?
As long as you stay 6 feet away from other people, it is good to go out for walks and get some form of exercise.
How about playground for kids?
It's not very safe in general. Avoid indoor playschools. Outdoor playground equipment aren't cleaned or disinfected usually, so even if it's just your children at the same, it doesn't make it safe. If you must use, carry disinfectant wipes and clean the surfaces before use.
Can you get the virus again if you already recovered from it once?
There has only been one report of a person getting the virus after having already gotten it, which was a person from Japan. We do not know as of now if a person who already got the virus can be infected again or if the virus will change, so it is best to follow hand hygiene, social distancing, and other safety precautions to make sure you are keeping safe from the virus, even if you have already been infected once.
Is it safe to travel?
That’s not the easiest question to answer. There are risks either way: it is possible that you can get the virus staying here, but there are a lot of variables that go into you staying safe while traveling—if the vehicle is clean, if the people around you while travelling are infected, if there are people where you are going that are infected. It may be safer to stay here and not travel, but it really depends on your situation and how confident you feel in travelling.
What is the effect of the virus on pregnant women?
There is not much information on the effects on pregnant women. However, in the first trimester of pregnancy, having a severe fever could affect the child or cause miscarriage. Usually, if there were effects on pregnant women we would have heard by now, but we haven’t heard anything yet, which is reassuring.
What percentage alcohol in hand rubs and disinfectants is needed to kill the coronavirus disease (COVID-19)?
Hand sanitizer or alcohol rub to clean surfaces should contain at least 60% alcohol to be effective. [Source: UNICEF]
Can I catch the coronavirus disease (COVID-19) from my pet?
No. There is no evidence that pets such as cats and dogs can spread the virus that causes COVID-19. To be safe, people who are sick shouldn't have contact with their pets. [Source: UNICEF]
How long does the virus survive on various surfaces?
4-9 hours on metal and a maximum of 25 hours on cardboard surfaces. The studies are still being done on how long the virus will stay on these and other surfaces and how long the virus can last in the air. For this reason, you should be constantly cleaning down surfaces you use often. Dispose of cardboard boxes.
For people who haven’t taken regular flu vaccinations, would you recommend taking it now?
Yes. Flu vaccine is always a must. Whatever vaccine there is, if there is a vaccine and you don’t have side effects, please just take it.
Can this virus mutate again and become a bigger pandemic?
It is already a big pandemic. This virus mutating and becoming worse than it is now is possible but the probability of it happening is very low.
What is the result of the recent vaccination test?
A company called Moderna in Seattle started testing COVID vaccinations on Monday March 16. Vaccine trials have 4 phases. The first phase test the vaccine on people without the virus to see the toxicity levels of the vaccine. Phase 2 and 3 a larger group is tested to see how effective the vaccine is. Right now, the vaccine testing is on Phase 1 and should go on for about 6 weeks. At the end of the 6 weeks, if there is no problem with the toxicity, they will move on to Phase 2. Phase 2 will have about 300 people and if the vaccine is effective, they will move on to Phase 3 with about 3000 people. Usually, it takes about 12-18 months for the vaccine to go through all the testing and to start being mass produced. It is very rare for the vaccine to be made quicker than that time. They already have all the volunteers they need for testing.
We are supposed to be social distancing, but I know people who are holding/having sleepovers, playdates, hanging out with friends: should that be happening?
It is not recommended. If the children share toys, then wash the toys with soap. We don’t know if the kids have the virus, and if they do, they may transmit it to the other people in your home. That being said, playdates and all are still extremely discouraged.
Should We Cancel Our Travel Plans Due to Coronavirus (COVID-19)?
Recommendations for travel are changing every day. Check the Centers for Disease Control and Prevention (CDC) website for the latest updates