We are five United States based-physicians in internal medicine and psychiatry. We were asked by TeamBlind to host an AMA to answer healthcare delivery and public health-related questions related to COVID-19. TeamBlind provided us with this tag for the duration of this AMA. Ask us anything. Disclaimer: Our responses are for informational purposes only and should not be used as direct medical care or advice. If you have specific questions or concerns about your current medical condition, please contact your own, local healthcare provider or report to the nearest emergency department. We will try to present the most up to date, validated information that we are able. We will also avoid politicized questions. We will stop taking questions at 9 PM PST. #covid-19 #coronavirus
Should I be wearing a mask when I go outside?
CDC recommends wearing cloth face coverings in public settings where other social distancing measures are difficult to maintain (e.g., grocery stores and pharmacies) especially in areas of significant community-based transmission. This recommendation was new as of yesterday, the reason being some people infected with COVID-19 can be asymptomatic or pre-symptomatic yet still contagious. Non-medical masks can help prevent these people from spreading the virus to others. It is not intended to protect yourself from others, the best thing for that is staying home as much as possible, stay 6ft or greater away from others when outside the home, wash your hands frequently, and avoiding touching your face.
Yes. The only reason the do not recommend professional grade is that they don’t want you buying up the low supply
Why does some people refer this virus to being mainly targeting old/preexisting condition, but some young people are also getting the critical condition? Is the virus still mutating? How do you suggest someone that wants to play basketball alone in a park?
While the severity and mortality (risk of death) is likely higher in older people and those with other chronic medical problems, it has not been unexpected to affect young healthy people as well. I do not think there is concern for the virus mutating but more that we are just learning more and more about the virus with the increasing number of cases we can track. Playing basketball in a park alone would be ok in most locations with shelter in place orders but would be good to check with local or state restrictions. Just stay >6 feet away from others, don't share equipment with other people at the park, and wash your hands after playing and before touching your face!
Has any new guidance been given regarding if pregnant women can pass it to their unborn child?
We don't know definitively yet, but it doesn't seem like. As per the CDC, "No infants born to mothers with COVID-19 have tested positive for the COVID-19 virus. In these cases, which are a small number, the virus was not found in samples of amniotic fluid or breastmilk.".
Do the babies and/or breast milk have the antibodies?
What is the exit strategy of the current shelter in place policy? What need to be in place before life can gradually transit back to normal (some level of social distancing is necessary for months if not a couple of years)? In your opinions, are state governors and health officials on track to lead the country (or states) beyond the aggressive shelter in place measure?
This is a great question but I am unaware of an answer to it at this point. I think once we start to see the curve flatten and the US reach its peak number of cases, more attention will be put to a safe plan to lift restrictions, with the understanding we will need to watch for additional surges following the loosening of restrictions.
That very much depends on the trajectory of the virus. Testing is absolutely key to ramp up dramatically to get a sense of how prevalent the disease is. Best estimation right now is that less than 1/2 of the population will get infected with this current wave of the virus. That means that there is still millions of people who have the chance to get the virus after this wave has passed, which leaves the door open for exponential growth again if we relax these policies too quickly. The total cases need to be extremely low before these policies can be cut back because of this chance for exponential growth. Low to the point that we can still track individual cases as they come up and quarantine effectively.
How does the American response compare to those countries?
*those=other
There are even regional differences within the United States which appear to have impacted COVID-19's spread. They include availability of testing, aggressiveness of government-sanctioned social distancing and surge capacity of hospitals. Overall, however, the United States was delayed in acknowledging the scope of the problem esp from a federal level, and many measures incl widely available testing are lagging behind.
Do you expect the virus to go away with summer-like weather?
We know so little about the virus that answering is pure speculation. Need to assume that it will not.
Assume it won't. Countries in the Southern Hemisphere are dealing with COVID-19 outbreaks and they are just exiting their summer.
Is social distancing the best option we have as a society ? I am finding it to be psychologically disturbing other than causing financial havoc. I believe that the psychological effects that it will eventually have to people will be far worse than the actual number of Covid-19 deaths - when compared to H1N1 for example.
The psychological and financial effects of this I agree are truly devastating. However, COVID-19 is different from H1N1 in that there is more asymptomatic spread and unfortunately is requiring significantly more healthcare resources. Social distancing has been shown as an effective way to slow the spread of the virus and as of right now is the best strategy we have.
If social distancing is ruining you psychologically, you probably have bigger problems in your life than this virus.
How long will the quarantining continue?
It is difficult to answer this and may vary between communities. Note that quarantine, isolation, shelter in place, and stay at home are all different. Quarantine is typically for people who are exposed to the virus whereas shelter in place/stay at home are orders for the general public. I would expect months of some type of restrictions in most places, but very hard to say.
Some models predict that if social distancing is continued through May, then the first wave of the epidemic will be completed by June. However, stopping too early with social distancing can lead to a second peak of infections, which is what we want to avoid. Below is a visualization tool for the US and state by state showing estimated time for infections/resource use. https://covid19.healthdata.org/