Last week, we asked health leaders your questions about coronavirus. But there were so many good questions, we didn’t get a chance to answer them all.
So Idaho Matters is back this week with Dr. Dave Pate, the former CEO of St. Lukes and a current member of the governor’s Coronavirus Task Force.
Read the full interview here:
Gemma Gaudette (host): You're listening to Idaho Matters, I'm Gemma Gaudette. Last week we asked your questions of health leaders working to end the coronavirus crisis here in Idaho. You sent in so many great questions, though, that we actually didn't have enough time to get to all of them. So that's why today we've asked Dr. David Pate to come back on the show to help get to the bottom of your COVID-19 questions. If you remember, Dr. Pate is the former CEO of the St. Luke's Health System, and he is now on the governor's coronavirus task force. Dr. Pate, it is always good to have you with us.
Dr. David Pate: Oh, glad to be with you.
GG: All right. So first, listener question, what temperature does the virus live on?
Dr. Pate: Well, you know, that is a really interesting question because it appears that the virus likes cooler and drier environments. And so this is one of the things that has led to some hopefulness that as we approach the summer months and particularly in those parts of our country and parts of the world, that will be hot and humid, that the transmissibility of this virus may go way down. I don't think too many of us are so optimistic that we think it will go away. I mean, there are some that think that's possible. I'm not in that group. But I do think we have reason to be hopeful that the amount of virus activity and the number of infections may go down. We don't know that. But fingers crossed.
GG: So if you say like hot and humid, I mean, we would look at a place like Florida, let's say that that might really see a respite. We're high desert here in in Idaho. So we get hot and we get dry. Would we potentially then see maybe a drop in numbers? I mean, not completely gone, but I mean, we don't have that humidity.
Dr. Pate: Yes. And we're not quite sure which factor is more important, the temperature or the humidity. But we do think that both play a role. So again, I think even here in Idaho, we can be hopeful that we're going to see the transmission go down. But we certainly can't be confident of that at this time. And time will tell. Clearly, I think when you have cooler temperatures, you know, people do tend to be congregated indoors and that aggravates the risk for transmission as well, just having crowding, whereas in warmer months, people get outside, they're less close together. And that's going to help for a whole different reason.
GG: So another listener question, how long until those who are sick are no longer contagious?
Dr. Pate: We don't know the answer to that with precision, but what we believe is that if you get the illness and you wait until you've been asymptomatic, that is, feeling fine, no fever, no respiratory symptoms, et cetera. If you've been feeling fine for three days and and if that period of time is at least a week, we feel pretty comfortable with you being able to return to work or other activity.
GG: A listener question, she says, I have a 25 year old daughter who is an E.R. worker. She has asthma. How high risk is asthma for COVID-19?
Dr. Pate: You know, it's interesting. You would think that that would be a significant risk factor. It it hasn't shown up to be so far. In fact, things like obesity, high blood pressure, diabetes and of course, age seem to all be much more important factors. I certainly wouldn't dismiss the fact that she has asthma, but there's just not a lot of information at this point to tell us that that's going to significantly increase her risk.
GG: Another listener question, one of the latest facts about transmission cannot be transferred on surfaces. And if that's a yes, should we be cleaning all of our grocery items that we bring into our house?
Dr. Pate: So the answer is yes. So we we believe that the most prevalent way that the virus is transmitted from one person to another is what we call droplets. And what that means is that when somebody who is infected with the virus coughs or sneezes, the virus particles exit the nose or mouth surrounded by some secretions. And for that reason, we think people that are within six feet, although there are some who say up to 10 feet, but people within six feet could be at risk that this droplet would transmit from that person to them where they might breathe it in or swallow it in work or otherwise get contaminated with it. And we think that's the most prevalent way that this is spread. However, there have been studies looking at how long does the virus stay on surfaces? And now these studies are typically done under a particularly controlled conditions. And so this answer may vary depending on circumstances. But it does appear that the virus can survive on some surfaces up to about three days. The worst surface appears to be plastic. It seems to be able to stay on plastic for prolonged periods of time. Next of all the substances that were tested were stainless steel. That's probably closer to two days. And then the least was cardboard, which perhaps this could last, it could survive eight hours to a day. And then the the very best surface of those tested was copper. And it only stayed on there for six to eight hours. So, you know, I think the best advice about surfaces is that particularly surfaces in public areas, you ought to just assume those are contaminated. So if for some reason you need to touch one of those surfaces, then of course, immediately wash your hands. But I think, you know, the best food rule would be if you can avoid touching those surfaces, countertops, those kind of things, banisters, even elevator buttons, those kinds of things to the extent that you can avoid that. Probably best to do so if you need to then wash your hands, you know. At home, we do believe most of the common disinfectants work perfectly well at killing this virus. So, you know, clean your countertops with disinfectant. You can use the wipes that you can get in stores and so forth. One tip is let it stay on wet. So in other words, after you wipe down your countertops, just leave that. Don't follow it up with a paper towel and try to dry. At least let it just air dry. That may be that may be helpful.
GG: That's good advice because I have that tendency to dry it out after, so, that's good advice. Another listener question. This person says I am a pharmacist. My question is, should patients taking, I think I'm saying this right, proton pump inhibitors unnecessarily stop taking them. Perhaps their stomach acid could help destroy the coronavirus, increasing survival.
Dr. Pate: You know that is certainly an interesting hypothesis. I've not seen anything medically that would support that or prove that point. You know, I think that at this point we have to keep in mind that probably whatever reason a patient has been told is the need that they need to take a proton pump inhibitor is probably, that underlying condition is probably more of a threat to them than is Coronavirus. So I would at this point, absent more medical studies or guidance, I would not be making the recommendation for people to stop that medication.
GG: Do we know if the virus lives on raw vegetables?
Dr. Pate: You know that that's another question we do not know. You know, certainly we don't think it would be a long time if that's the case. I think the thing that we would be more concerned about, which isn't happening in most of our community, is people going in to buffets, things like that, where people would just be, a lot of people might be touching, you know, the spoons, the serving utensils, perhaps even the food and certainly that would be a threat that we wouldn't want people to take. But in terms of at your home, you know, I think it's probably a good practice just to wash your fresh vegetables anyway. And I think if you thoroughly wash your vegetables, most of us are not going to have any concern about that.
GG: Another listener wants to know, does it live on clothes?
Dr. Pate: Another good question. We don't have a definitive answer, but we believe there is a possibility that the virus could survive on clothes, bed linens, things like that, for some period of time. So if somebody is sick at home, we certainly would encourage frequent washing of clothes and bed linens. Based on everything we know just a regular washing machine, with regular detergent should be plenty to kill the virus. So I wouldn't overly worry about that. But yes, we do think that that is a possibility.
GG: We're continuing our conversation with Dr. David Pate as he answers all of our listener questions. Another listener wants to know, why don't we have the quick test kits like they do in South Korea?
Dr. Pate: Yeah, we... the FDA, and it may have been yesterday, time is a bit of a bore. Oh, boy. But I think it was yesterday, it might have been the end of last week, that the FDA actually approved what we call point of care testing. And what this testing is, is while the typical test that's been available in the United States could take four or five hours to run. And oftentimes, given the transport of it all, we're oftentimes not getting answers for one, two, three, four days. This new test -- and I heard the vice president say yesterday that it was going to be distributed or made available by the end of this month -- can do a test in 45 minutes. So the advantage is it's much faster. The disadvantage is that testing equipment that we have thus far has much more limited capacity than our other testing. So whereas we are now developing testing machines that can run up to a thousand samples at a time, with these point of care tests, typically you're going to be limited to something on the order of about 30 tests a day. So you can't do a lot of them, but you can do them faster. I don't know if that's what your listener was referring to, but that is definitely coming online. The listener may also be referring to: there are some kits that companies were preparing to actually send to your home that you could do. Most of those still involved that you would take the sample and you have to mail it back in, so it was still going to be a matter of days. There is... Although that that testing has hit a road bump: The FDA, I think because of concerns that there are some fake tests out there on the market, told these companies they cannot do this for now. So that's on hold. And that didn't really even get started before the FDA put that on hold. And then the other thing that's just being done in very limited circumstances but may come available soon is some new testing that uses a completely different method than the current way we test that could potentially be done in a matter of something like fifteen minutes. That that is not widely available now. And I don't know the timeline when that will come available. But clearly we are moving in the direction of getting faster turnaround on these tests.
GG: So last listener question, after recovering from COVID-19, are you immune or can you get it a second time?
Dr. Pate: That is the million dollar question. We don't know that answer with precision. First of all, it's just too early. We just don't know. Second, the kind of testing that we have right now mostly just detects the presence of the virus. If you want to answer the question, is someone immune? Then typically the way we would do that is by measuring an antibody level in the patient that would tell us that, OK, they're making antibodies to this virus, so we know they're immune. That testing capability is being developed. I don't think it will be a long time until we'll have that capability, but we are not doing that testing right now. There have been -- the reason I hedge in my answer is, it is true that with most of these viruses and certainly with the more common type of corona viruses, people do develop some immunity -- and so we're certainly thinking and believing at this time that people will develop immunity from the infection. But there have been a couple of cases reported that they're not particularly clean. There's a lot of variables. So we're not sure exactly what to make of it. That suggests there are some individuals that may have turned positive again after they supposedly cleared the virus. So that's why I'm hedging on my answer. But we believe that the majority of people will develop immunity. One question is, as most people are aware, only a small percentage of people develop severe illness. There are a lot of people that get very mild illness. And then there's a very few people that are truly asymptomatic. And so what we don't know this at this point is those people that are truly asymptomatic, do they become immune? And that would that will take some time to answer. But I would tell your listeners at this time, we believe the majority of people that do have the infection will be immune.
GG: So that was it for the listener questions. I have one quick question before I let you go. Since we spoke last week...
Dr. Pate: I'm not shocked!
GG: Of course I do. Right. I always have questions. Since we spoke last week, we've seen a number of cases more than doubling here next week. So we know that, I mean, we're getting more tests, right? We're giving more tests. So therefore, we're going to see more cases. So is it safe... Is it a safe bet to think that maybe in another week we're going to see these numbers, maybe double, possibly triple in Idaho?
Dr. Pate: I do believe we're going to see some continued significant increases. So a couple of things. One is that... You alluded to the point that we're doing more testing, which is absolutely correct. We're still not doing the amount of testing that any of us would like, but we are doing more testing and therefore we are going to identify more people with this virus. And many of those people have very mild illness. But what I look at is who's showing up in the hospitals and how sick are they? And unfortunately, what's made me concerned is that up until yesterday, if you were to ask me, I would have told you I was feeling fairly encouraged. But because we've had a very small number of people hospitalized and most of those, in fact, all of those hospitalized had done very well. We haven't had any deaths. And I'm knocking on wood over here. And those most all those patients have gone home. And in fact, including if I've been given correct information to patients that were in their 80s. So, again, you know, it's important for us to realize that older people certainly are at higher risk, but it's not a death sentence. It's certainly a lot worse, but it's not a death sentence necessarily. But as of yesterday, we started seeing some patients show up in the hospital that are quite sick. And and in fact, some that are requiring the assistance of ventilators. So to me, I think we've entered into a new phase. I think that when you see cases like that, it tells you that wherever they were, that Corona virus was probably circulating in their environment for three or four weeks. And so now we've seen that. I do expect to see our numbers ramp up. Now, with that said, I don't want people to think I'm sounding an alarm. I think, first of all, you know, we are in the bottom 10 states with the amount of coronavirus activity. That's very good. I want to stay there. Number two, I do think in Idaho we benefit from the low population density that we have. We're not a New York City or Seattle or L.A. and I think we're definitely benefiting from that. Third of all, we've had more time. We were, I think, second, the last state to get a case. And that gave us more time to prepare, more time to educate the public. And I've been very pleased to see how people are reacting that, you know, people are largely staying home, working from home and taking actions to minimize contact. I can't remember the last time I saw somebody shake hands. So I think we're doing the right things. And I think because we've had more time to do those things, I am very hopeful that we will blunt the curve that we otherwise would see. Time will tell. And what we've got to encourage Idahoans is even though we are sitting a lot prettier than some of our surrounding states and certainly New York, which is just being devastated by this, we cannot become complacent. We have to keep this up. And I think what the governor's concerned about, what the work group is concerned about. What I'm concerned about is, given that we do have low levels of this infection, are people going to get complacent? Are people going to get the itch, especially with the improving weather, and start getting complacent and going back to being around crowds and relax their measures to prevent this disease? And if we do, it's going to be bad. So we've got to keep it up.
GG: I want to thank you so much for joining us today. I am sure this will not be the last time we will be chatting with you. I appreciate you answering these questions. It's so good to get fact versus fiction or, you know, any rumors that may be out there. So just appreciate your time so much.
Dr. Pate: Well, my pleasure, Gemma. Anytime.
GG: And talking with Dr. David Pate, he is part of the Idaho's Coronavirus Task Force. This is Idaho Matters.
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