Despite Days Of Low New COVID-19 Cases, Idaho Doctors Warn About Fall Spike

Sep 9, 2020

After several days of new COVID-19 case numbers below 200, Idaho health officials are holding their breath hoping the decline will be sustained. But, if the spikes we saw after Memorial Day and the 4th of July are any indication, we very well could see our numbers increase with the Labor Day holiday now in the rearview. 

So, what does this mean for you and your family? Every Wednesday, Idaho Matters brings on a panel of medical experts to answer your coronavirus questions and sort out fact from fiction. You can submit a question by emailing idahomatters@boisestate.edu. 

Our panel of doctors today:

  • Dr. David Pate, former CEO of St. Luke's Health System and a current member of the Idaho Coronavirus Taskforce
  • Dr. Laura McGeorge, St. Luke’s Health System Medical Director, Primary and Specialty Care
  • Dr. Darin Lee, Emergency Room physician and VP of Medical Affairs, Saint Alphonsus Medical Center in Nampa

Read the full transcript here:

GEMMA GAUDETTE: You're listening to Idaho Matters, I'm Gemma Gaudette. Every Wednesday, we bring in a panel of doctors and other health professionals to get us updated and to also answer our questions about coronavirus. So if you have a question for our doctors today, make sure you send us an email: idahomatters@boisestate.edu. Joining us today, Dr. David Pate, former CEO of St. Luke's Health System, as well as a current member of the Idaho Coronavirus Taskforce, Dr. Laura McGeorge, St. Luke's Health System medical director, Primary and Specialty Care. And Dr. Darin Lee, emergency room physician and vice president of Medical Affairs at St. Alphonsus Medical Center in Nampa. Happy Wednesday, everybody.

ALL: Hello, Gemma. Hi, Gemma. Hello. GAUDETTE: Dr. Pate, can I start with you, and can we get just an overview of where Idaho is with COVID? We have been seeing a downward trend, yet we had a three day holiday weekend and schools are opening back up. So my question is, is what we are seeing with this downward trend -- do you think is it going to last or could those numbers go back up?

DR. DAVID PATE: Yeah, sadly, I don't think this is going to last. I certainly am pleased that the numbers are going down and this is certainly good news. But first of all, let me put it into perspective. Even though it's going down on most days, our number of new cases are still more than what we were at our first peak back in March and April. Secondly, our hospitals have twice as many patients with COVID in them today as we did at the worst point in that first surge. So, you know, the first thing is just put it in perspective. Yes, things are getting better, but certainly this does not mean that COVID has gone away or things are safe. And then, as you mentioned in your question, Gemma, there's a whole bunch of things that from an epidemiological standpoint are getting ready to get changed and I fear changed for the worse.

So as you mentioned, we just had the Labor Day weekend. We wouldn't expect to see changes yet, but I'm sure we will. And we know that recently we've been having a lot of exposures related to people getting together in backyard barbecues, family, nonfamily... So I certainly do expect a number of cases from that.

On top of it, just as you mentioned, for a lot of schools, they just resumed in-person classes just yesterday. And I think from what I've seen, schools have varying degrees of comprehensive operational plans, some far better than others. And I think we will see problems at the schools that don't have as robust operating plans.

And then, you know, on top of everything, when people see the numbers go down, they typically begin to use less caution. So that may aggravate it. We've got colleges and universities getting going and that has been a problem across the country with spreading cases further, with the cases coming down. As you've heard, Central District Health is talking about the potential reopening bars.

And then we also have sports getting kicked off. And and then we have the upcoming cold and flu season. So, I mean, I think you can list almost 10 different things that are not going to be good factors for us. And I suspect in the next several weeks we should be seeing probably what is going to be the beginning of another surge.

GAUDETTE: Dr. Lee, I'm curious to know what you are seeing at St. Alphonsus. Dr. Pate mentioned, you know, more patients coming in. Is that a trend you've been seeing within your organization?

DR. DARIN LEE: So I would echo a lot of what he said. We saw a lot more patients coming in. And as you know, admissions to the emergency department or admissions to the hospital are a lagging indicator of cases. But we have seen over the last couple of weeks that we're seeing less patients presenting to the emergency department. There are other places they are presenting, but we're seeing less cases, which is reflected in the Idaho numbers that we're seeing. But as Dr. Pate mentioned, this is -- we've been doing a lot of mitigation efforts to try to get to this point right now. And as we see that some of those mitigation efforts are being pulled back, we do expect that that again, will it lead to an increased number of cases. We have to remember that the total number of people in Idaho who have contracted COVID and those who would test positive for antibodies is still very, very, very low. So there's still a huge population of the public that is still susceptible to this virus. And as we change things, which is definitely happening, if you just read the news and what people are doing -- and and I think he's correct as well, as people see the numbers come down and they start to become less cautious and we'll see an impact from that.

GAUDETTE: And Dr. McGeorge, same question. What are you seeing with with St. Luke's?

DR. LAURA McGEORGE: Yes, thanks, Gemma. Our numbers too, again, just like Dr. Lee was speaking about, we are seeing our hospital numbers coming down. I agree  with both Dr. Pate and Dr. Lee that, again, you know, with what is going on in the community, with the sports, with schools, going back, with gatherings that we've seen over Labor Day, we certainly will expect to see numbers go up again, and I want to really reiterate that we are learning. COVID-19 is a new disease and we are learning a lot. But what we have seen really with both peaks so far is that the first thing we'll start to see is that cases may go up in the community and then we may see hospitalizations go up. And then is where we are after that, there's always a lag between cases, hospitalizations, and even then mortality tends to lag even behind that. So for now, yes, we also are seeing a dip in our hospitalizations. Our numbers now in the hospital are about as far down as they were during our peak in April. So it's not great, but it is much better than it was, say, end of July.

GAUDETTE: And I'm curious about Central District Health yesterday moving Ada County into the yellow category. Now, Dr. Pate -- and I'm curious about it because that going into that yellow category allows for schools to open in some type of capacity with, you know, in-person learning. And as you mentioned, then bars could potentially reopen. Is there a concern that with going into the yellow category really before we've actually truly even been a week into K-12 school, that they're making this move and could we see that uptick?

PATE: Well, Gemma, that's exactly what I'm afraid of, you know, the Central District Health is certainly caught in a tough spot. They're trying to provide some metrics that are less subjective, more able to be followed, and so people can kind of see how we're going. You know, the problem is that it doesn't take into consideration all these prognostic factors that I mentioned to you at the beginning of the show, of all the things that are lined up and what can happen, the public health data and determination for where we are is really just a snapshot in time: 'OK, here's where we are.' So I do fear that what's going to happen is we just went into yellow this week, but when they look at these numbers in two weeks, we'll probably be going back into red. And, you know, I don't know if our communities are well served by this going in and out, but certainly they're facing a lot of pressure from these bars and others that want to be open. And I think the other thing that has just frankly been appalling to me is given all the advice that the public health districts have come out with and the assessments of the community spread, we've then seen some school districts just essentially disregard it and act in extreme difference to what that advice and status is, so it's really a tough spot.

GAUDETTE: And Dr. Lee and Dr. McGeorge, I'm curious about your thoughts on these categories and Ada County going into the yellow when we've just come out of the Labor Day weekend and school is starting. And Dr. Lee, your thoughts on that?

LEE: Yeah, I think it's, you know, this is really difficult because, you know, everybody like myself, I'd love my kids to go back to school and we'd all like to to kind of go back to some sense of normality. But this is -- it's so hard to judge ahead of time. And so we're watching trends. But if you ever watch and see how those trend lines go, there's a wide berth of what they can do. So if you continue to do the same thing, the trend tends to go in a down way. But as you change, like Dr. Pate said, you're going to see a change. I mean, it's it's not hard to imagine what's going to happen when we have larger gatherings, when we open bars. I mean, I have two children, and I can tell you they don't know how to social distance. You know, they try and they're happy wearing their masks and doing those things. They like to wash their hands. But, you know, one of the most important things is social distancing. And they're just really difficult when you're dealing with children. And then bars are probably very similar. I mean, they will set things up and they will try their best. But it's just difficult to maintain that social distance and allow the most effective means of stopping the virus to take place.

GAUDETTE: And Dr. McGeorge, your thoughts on that?

McGEORGE: Yes, thanks. I, gosh, I know we all want to see our kids back in school. And I think there is a lot of evidence that it's important -- kids depending on different challenges, they may have, it is very difficult for them to learn by distance or virtually. That being said, it does have to very much be balanced by what's going on with this pandemic. I think, you know, it's challenging because the children probably at the age where they most need in-person schooling, are also the ones that perhaps Dr. Lee was referring to who really are the most challenged with being able to remember to wash their hands and watch their distance and keep those masks on. I do think that there are things that the schools can do to mitigate the risk. And those are very well published on the CDC's website on what the schools can do. Some of that is alternating days of who's going to school and maybe doing some other things. So there are ways to mitigate it. But there's there's no doubt that going back to school definitely does increase the risk of COVID-19 spreading.

And it is very true that we don't know post Labor Day what will have happened. I'm hoping that there was less, you know, socializing without masks, without distance. I'm hoping there's less of that than went on over 4th of July. But we're really going to know when we start to see the numbers and really keep a close eye on the numbers. And then the other thing to remember is, you know, we live in a part of the country where we can't be outside all the time. And as the weather turns later on in the fall, it will definitely be more challenging, whether it's in schools or other environments, to do that social distancing and be safer. We do know that being outdoors is a better situation than being indoors with other people.

GAUDETTE: Dr. Pate, we have a question from Cathy and she says she loves the show and she listens all the time to the doctor roundtable. So, Cathy, thank you for that. But here is her question: 

LISTENER QUESTION: I've been watching the numbers of confirmed COVID-19 cases going down and feeling like we're getting a hold of this virus. But after listening to last week's program about limited testing of asymptomatic people, I'm wondering if that's part of the reason. And I would also like to know why this has changed. Is it because of a lack of tests or testing agents or is it because of new recommendations from the CDC?

PATE: Well, so a number of things. First of all, I just go back to the point I made earlier, that, yes, we're seeing cases go down. But again, let's keep this in perspective. We're still in a worse place than we were back in March and April. So it's good news, bad news. And we've always been missing asymptomatic people. Yes, we do pick up some on testing, and there's been some periods of time where we've been able to do more asymptomatic testing than others. But I don't think it's made a material difference. And, you know, the estimates are that there's, you know, another 4-10 times whatever the number of cases of asymptomatic people out there. But we've always been limited. Our testing has been limited. Our test kits, our test regents, our testing equipment. There's been many, many limitations, not to mention the cost. And that's a real barrier to doing asymptomatic testing, because really, if you think about a disease transmission, like what we have, if you were going to try to control this by just testing everybody, you'd have to be testing people on probably at least a weekly basis. And at one hundred hundred and forty bucks a pop, whatever it is, that quickly becomes untenable.

Our real option is when we can get rapid tests that are inexpensive because even with, you know, there's a lot of variability in terms of when you get test back some sometimes we can get a test result back in a day or two other times it's a week or two. And frankly, telling somebody who's asymptomatic that they were negative a week ago isn't particularly helpful because of risks that may have occurred since then.

And then as to the point of the CDC, I think all of us saw that recommendation for what it was, that was political interference. I don't know anybody that's embraced that part of the guidance. So I don't think that's really a contributor. I think it's just that we have limited testing. We've had a lot of cases. And those cases that are being reported are largely symptomatic and there's a lot of them. So let's just all kind of understand that we still have a lot of spread out there, a lot of risk out there. It is good it's going down. But for the reasons I mentioned earlier, it may not last long.

GAUDETTE: And Dr. McGeorge, we have a question from Jessica and her husband, and she would like to hear from all of the doctors about this. But I'd like to start with you, Dr. McGeorge:

LISTENER QUESTION: As of right now, what are the doctors' thoughts on regional travel during the holiday season of 2020? And if people are planning on traveling even with a mask on, would it be safe to hug family members?

GAUDETTE: So, Dr. McGeorge, your thoughts on that?

McGEORGE: Gosh, I can really sympathize with this question. My  own family celebrated my father's 80th birthday via Zoom, so it's not only you. It's tough. And not being able to visit. I personally think I still am very concerned about travel and visiting. And there are several things you have to think about. So one is, if you are going to visit someone, a) first thing to think about is are you going to introduce risk to them? And so that really means have you in what you do, whether it's masking, social distancing, handwashing, exposures, just general risk of exposure, are you now introducing that risk to whomever you visit. And you have to think about them. Are they elderly, frail, immune compromised, even if they're not any of those, are they following the general health guidelines of wearing masks and social distancing? And so because they also could then put you at risk. Other things to really think about is where are we in the pandemic? And as Dr. Pate has outlined a couple of times, I mean, we are -- even though we're in a better spot than we were a month ago, we are still seeing significantly more COVID-19 now than we were back during our initial the first peak. So there is no avoidance of risk. When you travel, there are things you can do to mitigate the risk. I mean, certainly traveling in your own car just with household members is less risky than than going through an airport or on a bus or something like that. But still, there are always going to be risks.

The last thing I would say it's just a practical perspective, is we have seen different states as well as the CDC have different, or changing guidelines and rules, if you are returning to the state and even different employers have rules if you've traveled and then want to return to work. So there certainly have been situations where people feel comfortable or feel like it's OK to travel and then they're kind of stuck because the state then expects them to quarantine when they return from a high risk area. So just that's really a practical point. But but there's no really no guarantee with travel that you won't get COVID-19.

GAUDETTE: And Dr. Lee, any other thoughts on that question?

LEE: Yeah, I would just echo everything that Dr. McGeorge has said. The only thing I would add and that question is that I don't think it would be safe to hug your family members. That seems like a really good way to transmit, even if you're both wearing masks. So things like that, which are things that you can do to mitigate, you know, you can wash your hands, you can wear a mask. But trying to avoid those type of really close interactions would be best avoided if you are going to make that travel.

GAUDETTE: And Dr. Pate, your thoughts?

PATE: Yeah, I think Dr. McGeorge really laid it out well, and Dr. Lee's comments are good and you know, I think the other thing is we need to assess where we are in -- I assume we're talking mostly about December. You know, we need to see where we are. As I've mentioned, I think the disease activity is going to be worse, not better. And the higher the disease activity, then the more dangerous it is. So let's check and see how the disease activity is and then get back on Idaho Matters back in November or December and ask us the question again. But I agree with everything Dr. McGeorge and Lee said.

GAUDETTE: And Dr. Lee, before we take a break, we have another travel related question. And this the the person says:. 

LISTENER QUESTION: My wife and I plan to fly to the Midwest to visit family at the end of October. Is it safer to wear two masks on the plane than one, maybe a surgical mask over a cloth mask with a filter? Would that be hard to tolerate for several hours? What do you think?

LEE: Well, as someone has had to wear several masks -- N-94 plus a surgical mask -- that is not an easy thing to do. And I don't think you're really going to have a lot of benefit from wearing two mask versus one. Remember the the point of the mask is you're trying to avoid droplet transmission to another person and so having one mask on I think would be appropriate. A surgical mask is considered to be a little bit better than a cloth mask, but either one of those would be appropriate, when you're talking about masking, I don't think that you would get a lot of benefit from wearing two masks. It is something you can do. You know, I sometimes wear it for 8-12 hours and it's not fun, but, you know, it's not unsafe. It's just I don't think that in that situation, you're going to get a lot of extra protection with those particular masks.

GAUDETTE: Dr. Pate, before we get to our listener questions, I'd like to talk a little bit about this vaccine trial being halted. I believe it's AstraZeneca yesterday, temporarily halted its phase three trials of a possible coronavirus vaccine after one patient suffered some type of health issue. So the trial was halted. Is this common in trials like this? And if it is just one person, is it normal, I guess, to halt the trial?

PATE: Yeah, so it's certainly not a rare event, and, you know, what happens is after we go through phase one and two trials, which may be as a few dozen patients, and then go into phase three trials where I think most of these companies are trying to use something on the order of 30,000 subjects. We are going to see things. Now, as Dr. Lee and Dr. McGeorge know, not everything we see is due to the vaccine. So there are still people that get illnesses all the time, whether they're getting a vaccine or not. What I think is that this is incredibly reassuring, frankly. There's been a lot of concern about 'is a vaccine going to be rushed? Is it going to be safe?' And I have to give kudos to AstraZeneca here. You know, it's one person. It's a subject in U.K. They don't know that it's due to the vaccine. But in an abundance of caution, they've paused the study to look at this and make sure that it's not the vaccine causing this. And I think that's wonderful because they know that they're going to pay a price for that. In fact, their stock fell 6% yesterday over this, but they did the right thing.

I think the other thing that's very promising is we heard nine pharmaceutical companies come together and pledge that they would not ask for early approval of their vaccines that are going to study them. And so while we've got some reason not to trust our federal government and to be a little bit disappointed with the FDA, I think that actually we're seeing really good behavior from these pharmaceutical makers. And so we'll keep that study participant in our prayers, hope that this turns out not to be anything serious. And we'll especially hope it doesn't turn out to be something related to that vaccine, because I'm particularly interested in that vaccine, as it uses a -- it's got a little tweak to it that might mean that it'll give us more durable immunity. We're waiting for those study results, but I hope it works out.

GAUDETTE: Dr. McGeorge, we have a question from Dan. He sent this on Twitter. He says: 

LISTENER QUESTION: What seems to be the difference between the European and Asian strains of the virus? And why is the European strain not as lethal?

McGEORGE: Yeah, so the virus started out, of course, it was originally a strain from Asia and early on in the spring there was actually a mutation. And the mutation is just one single point on that DNA can then cause a change in the proteins. And what that mutation did was it actually changed one of the proteins on the sticky part of the virus that sticks to the cells that it tends to infect. And so we do know that this virus, the European strain, likely actually is more contagious than the original Asian strain. However, I don't think that there's any evidence -- have not seen any evidence that the European strain per say is more lethal. It just is that it's likely more contagious. It is the dominant strain now in the U.S., although both strains are in the US.

GAUDETTE: So, Dr. McGeorge, is that why I read a news article the other day saying when we get this second wave in the U.S. that we could see a lot more cases but less fatalities?

McGEORGE: Well, you know, viruses just like just like everything else, I mean, DNA mutates, so we actually could see another mutation. I mean, there have been other mutations, but but this is the most significant change. So certainly there could be other mutations. I think the death rate -- So I think that there's so many variables. It is possible that if you have something more contagious and less lethal, you would have a lower death rate. I mean, certainly we know that influenza, for example, is highly contagious. And even though it is lethal, can be lethal, it is less lethal than COVID-19. So the lethality of the virus or a mutation could make a difference. I don't think that's really what's going on here. I think one of the things with lethality, with the COVID-19 virus is a couple of things. One is, as it has gone on, we've learned things. I mean, some things that maybe back in February and March in the world were just being tried with patients with severe COVID disease. We have now learned some things and made some changes. And there are some therapies available, although not super effective, there are some things that have been shown to be helpful. The other issue, though, with lethality really has to do with overwhelming the health care in that community. And we saw that -- certainly saw that in Italy. I think we saw that in New York. I think when you look at the lethality back in April in New York, it was higher than we're seeing now. And at least some of that may be that we now understand more and have learned more, but a lot of that is is that the health care infrastructure was just absolutely oversaturated and really challenged to meet the needs of all the patients. And that infrastructure is not just beds and buildings. It is people that are able to take care of really sick patients. So that's a respiratory therapist, critical care nurses and doctors, particularly, again, doctors that are specialized and able to take care of hospitalized and critically ill patients.

GAUDETTE: Dr. Lee, Tiffany just emailed us saying:

LISTENER QUESTION: So many people who are getting very mild symptoms are quick to assume they just have a cold. So she's curious about two things. Do we know how prevalent the prevalent the common cold is right now in the Treasure Valley? And then secondly, what is more contagious or cold or COVID? Do we even know those answers?

LEE: Well, that's a good question, and I would say just from my experience in emergency department, I haven't seen a lot of what I would say cold symptoms yet. I think I've seen a few here that -- But again, you have to remember that even cold symptoms can be COVID-19 and coronavirus is a common cold as well. So the viruses can be very similar and so it can be difficult to tell those two apart. I find this this question to be especially difficult when you're managing people with a more benign -- or the symptoms are as bad. So people who have a runny nose, cough, cold symptoms. During the summertime, it was easy to say that a lot of those people probably had COVID because we're not seeing a lot of the the colds that go through in the fall. But as it starts to get full time, we're going to get that mix. We're going to get some people who will have mild COVID-19 symptoms. We're going to get some people who have normal cold symptoms. And so finding those two out is really something where testing will be really helpful. But the thing to remember is that whether you have a cold or whether you have COVID-19, you should really probably not be around other people. And so when you talk about the practicality of it, that if you're sick, you should be staying home and whether that's COVID-19 or whether it's, you know, one of the other coronavirus and other cold ones, you should still be staying home. And so as we get more rapid testing, we'll hopefully be able to tell a little bit better in people whether or not they have COVID-19 or not.

GAUDETTE: But that is so critical. Like if you're not feeling well at all, even if it feels like just a cold, right now, you need to stay home. Good advice, Dr. Lee. 

Dr. Pate, an anonymous listener from Nampa, has a question. She says: 

LISTENER QUESTION: Recently there has been more coverage in the national news about long haulers, COVID patients who have had residual and long lasting health problems of all kinds resulting from contracting COVID. Are these patients being monitored and tracked here in Idaho by the medical community? And if so, how are they receiving help and what research is being done?

PATE: So we're still trying to understand what is going on, there clearly is something going on we've had -- for people that don't know what the term long haulers is. I was talking with a group this morning and they thought, oh, well, maybe that means that truck drivers are at high risk. No, we're not talking about truck drivers. We're talking about people that have contracted COVID and then four, five, six months are still having profound symptoms. And when we look at these groups -- there's not many studies on them, but there's been a couple -- when we look at these groups, one study found these were people on average in their late thirties. Another study showed it was people averaging age in low 40s. There is a slight female predominance, which is interesting because males typically get more severe disease than females. So this is quite interesting and we don't understand that. And they they have a range of symptoms. But what is really striking about this is that many of these people were considered themselves very, very healthy before this happened and quite active and now find that just getting out of bed is fatiguing, that they may have to stop when just climbing one flight of stairs because they're tired. So they're having some profound effects. There is no reporting of these cases that I'm aware of. And it may come, but currently there's no reporting of them. They are getting cared for. There's a few centers, not many in the country that have set up special programs to care for these kind of patients. Most that I'm aware of are already booked up for a year, so it's very hard to get into. So most of this care is going to be delivered by the primary care physicians. And then I'll just say one last thing to tie in. The other thing that we have recently discovered recently of concern is a high frequency of myocarditis and inflammation of the heart muscle in people after COVID. And so some of these long haulers do complain of palpitations, chest pains, shortness of breath with exertion. These are people now, in light of the fact that we've discovered this myocarditis probably need to get an evaluation to make sure that their hearts are OK.

GAUDETTE: Dr. Pate, maybe you can answer this, and if not, we can go to our other doctors. Aleisha just wrote in:. 

I recently became aware that the Idaho House of Representatives passed a resolution to suspend all COVID restrictions on approximately August 25. While I realize this would still need to pass the Senate, does anyone know what the status of this legislation is?

PATE: I have not heard or how likely it is to pass the Senate, so I don't have any information on that.

GAUDETTE: Right. I was looking myself, and I don't believe we actually know where it is, so it may be suspended and the next legislative session doesn't start until January. So this issue would not even be taken up until January. So just for FYI, for anyone who was paying attention to the special session, we have to wait until until January to frankly see where we are with our numbers. And that is something like this would would even go to the Senate.

Dr. McGeorge, Elizabeth wants to know this. She says she was in a doctor's office this last week and the PA told her that she doesn't trust the COVID numbers in our state. So she told Elizabeth that if someone tests positive for COVID-19 in Idaho, their entire household is then also counted as positive. And Elizabeth says: 

LISTENER QUESTION: This does not sound right to me. Can you sort this out?

McGEORGE: Yes, I would say it's actually the opposite of that and so what has happened again -- there was conversation earlier in this podcast about not having enough testing to test asymptomatic people and contacts. There are some situations where there is contact tracing done, but in general, if one person has symptoms of COVID and they are tested and test positive, that one person is then reported for having COVID. And certainly early on when we had the drive up tent testing, there could be five people in a family in a car with symptoms consistent with COVID. And we just tested -- let them choose who they felt was the sickest in their family or most likely and tested that person. And then we just assume and they need to behave as if they also have COVID. But those four other cases in the car never got tested and therefore never were reported. There are other situations and I've seen them in the local press, the situations where people have documented COVID-19 and they have other family members who are sick at home and who they just presume have COVID-19 but never went through the testing. So it's very clear that the numbers are actually undercounting of even symptomatic people with COVID, let alone all the asymptomatic people that we've missed.

GAUDETTE: So let's be really clear on this. If you have not personally had a COVID test, you are not going to be counted as having COVID.

McGEORGE: Correct.

GAUDETTE: Dr. Allison just wrote in and she says:. 

LISTENER QUESTION: If I get COVID-19 and I recover, should I seek to donate my antibodies? And if so, are there any places in our area that's collecting or using antibodies in treatment?

PATE: Yes, if she wants to donate her plasma, and that's very generous of her, she can contact the American Red Cross and that she can access they will [inaudible] and determine whether she does have antibodies and if they're suitable for the convalescent plasma.

GAUDETTE: So go to the American Red Cross, because I do believe locally they are collecting that.

PATE: That's correct.

GAUDETTE: Yeah, and and Dr. Lee, Ingrid just sent us this email and she says:

LISTENER QUESTION: Can you explain how a statewide positivity rate is calculated when reported results from the hospitals are different and how home tests will be used or tests by employers to influence the positivity rate? Does that make sense?

LEE: Yeah, and, you know, I can speak mostly from a hospital standpoint and maybe Dr. Pate can speak to the statewide. But in the hospital we have a known number of people that we test a known number of people that test positive. And so that's how we come up with our positivity rate. And speaking with other hospitals around the system, that's pretty similar. How the home tests and these employer tests will come into it is a little unclear. I don't know that they have the same reporting requirements to the state. And so that may be difficult to calculate. But again, we're always dealing with a number that's not going to be exact, whether it be because we're not testing people, whether it be because some of those tests are outside of our system and reported in other ways. And so I think I would -- I mean, there's a lot of questions about the numbers and testing and things like that. And I think the idea is not to look at a single point, but more to look at the data overall. What is our overall sort of rate of of patients or people who have tested positive? What is our overall rate of hospitalization? Things like that I think are much more important than that specific number. Those are things you can use to help predict what's going to happen. But you'll see, there's going to be variation in different reporting, whether you're looking at the newspaper, whether looking at the Idaho website. So I just would caution people to not look at the numbers so closely in that regard. But just as a general sense, because you can get a sense from looking at them as to whether or not we're doing well or whether or not we're not.

GAUDETTE: And Dr. McGeorge, maybe you can answer this. Chris in Salmon emailed us wanting to know where is the best source for accurate COVID case counts.

McGEORGE: Yeah, you know, again, to what Dr. Lee just said, there are multiple sources. I look at the GlobalEpidemics.org website, which is a public health website, I think it was put out by Harvard, also Brown School of Public Health as part of that, Harvard Global Health Initiative. And you can really drill down to the area also and see where we are with COVID. And I think in Idaho, being a large state, it's very helpful to look in the region or in the county to see where we are. There was a time, maybe about six weeks ago that our rate -- and I don't know if people remember the huge surge that they were having in the south and Houston was on the news -- And there was a time that our current rates in Canyon County were higher than they were in Harris County, which is the home of Houston. So I think it's really important to kind of keep an eye, not just on what's going on nationally, but how it can vary county to county within the state of Idaho.

GAUDETTE: And I want to leave on a bit of levity because we don't get to do that normally, especially on this program on Wednesdays with our medical experts. But Dr. Lee, your wife wrote in and wanted to say in regards to hugging people, she said it's nearly impossible for her not to hug people, but she knows that it's always a risk. So she just tries to make it a, quote, "very dry hug" and she turns her head and makes it quick. So still probably not the best thing to do.

LEE: Sounds like my wife.

GAUDETTE: I figured it might.

I want to thank all of you for taking this entire hour out of your day to talk with us. Just so appreciate your factual, accurate information.

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