With Phase 1 Underway, Idaho Doctors Assess Phased Reopening
We’re back again this week with our panel of Idaho doctors to answer more of your COVID-19 questions. Five days into Phase 1 of the reopening, Idaho Matters is here to help get your questions answered.
Joining Idaho Matters this week to share their expertise are:
Have a question for the panel? Leave us a voicemail with your question and we may use it on next Wednesday’s show. Here’s the number to call: 208-426-3625.
Read the full transcription here:
GEMMA GAUDETTE: This is Idaho Matters, I'm Gemma Gaudette. Our medical experts are joining us this Wednesday to get us updated on the very latest on coronavirus here in Idaho. Joining us today, Dr. David Pate, former CEO of St. Luke's Health System and a current member of the Idaho Coronavirus Taskforce, Dr. Andrew Southard, St. Alphonsus emergency medical director, and Dr. Kenny Bramwell, medical director for St. Luke's Children's Hospital. Good to have you all with us again.
ALL: Thank you, Gemma.
GAUDETTE: Absolutely. Dr. Pate, I want to start with you. Where are we? What's the latest with the coronavirus taskforce?
DR. DAVID PATE: Well, lots of things going on, of course. We've just entered into stage one at the governors reopening plan. So we are picking our metrics to observe closely, to watch the progress and make sure that we become aware of any early signs that we're having an uptick in cases. We're also very excited about the governor appointing the new testing task force because there's been a lot of unclear and misleading information out about testing and so really excited this group has come together to issue some state guidance on testing. So that's going to be very good. And then, of course, you know, we do have to expect and plan for the next wave of this coronavirus activity. And so we are continuing to look at models, continuing to observe what's going on in other parts of the world and other states. We'll get a chance now to look at the southern hemisphere as they enter into their flu season to perhaps give us some ideas of what we might be facing this coming fall.
GAUDETTE: And Dr. Southard, I know you are, of course, looking closely at what's happening over the next two weeks since we're in the middle of this Phase 1 reopening. Well, what are you, a) hoping to see with this? But what are you concerned that you might see as we reopen?
DR. ANDREW SOUTHARD: We're hoping to see the number of patients we're treating and the emergency department going down for COVID-like illness and also seeing the number of tests that we're getting back and testing, having less positives. That's what we hope to see. What, obviously, we'd be concerned about, is after the reopening, if people are starting to be in closer contact and then start to become ill and start coming to the hospital and we start seeing testing going up in terms of both the number of tests, but also getting positive test results, that would be most concerning for us. So that's what we're really watching right now.
GAUDETTE: And Dr. Bramwell, what about our kiddos? I mean, we're weeks away from summer break officially starting. And parents are, you know, in order for the economy to restart, I mean, people to get back to work, right? So it's this idea of, well, OK, do we put them in summer camps? Do we put them in daycare? What's safe, what's not? There's a lot of questions and concerns out there around our kids right now.
DR. KENNY BRAMWELL: Now, there's a great question, Gemma. I don't know that we have definitive answers about many of them yet. I will share with you that we have so far not needed to admit any children to the children's hospital here in Boise with COVID-positive test results. So that's actually really great news. The more challenging sort of long term questions that you raise are are really good. And I think we still need to come around. You know what? What does this mean? In my house, I think summer has started already with my teenagers. They're done with school and no one's making them do regular things. So that's kind of where we are. And I suspect many families are struggling with the same thing. How do we introduce any sense of order and normal sort of summer activities in a setting where we're all very concerned about people getting ill or causing other people to be ill? We've got to come around that as a society. I don't think we have yet.
GAUDETTE: And another question regarding summer and this, Dr. Bramwell, feel free to answer or anyone else. So we know that in the city of Boise, city pools are closed for the summer. However, Roaring Springs and Meridian says that they will open. And, you know, there's always the river. How concerned should we be about bodies of water and their safety in regards to COVID-19 as we move into these hot summer months that we see?
BRAMWELL: Well, Gemma, I think the main concern is that people in large groups tend to be real close to one another and that this virus can be passed pretty freely back and forth between people who may not intend for that to happen. You know, we have to have some way to still recreate and we're going to have to balance our desire to recreate with our desire to stay safe and keep everybody from becoming too sick or getting sick too quickly, as we've talked about before.
GAUDETTE: But should people be concerned about the virus being spread, I guess, in a body of water, I understand that if you're if you're in a crowded pool and someone has it, the likelihood is if you're not at that distance, you may be exposed. But how about, you know, like a chlorinated pool? Will the virus -- do we know if the virus will definitively be killed by, let's say, you know, a chlorinated pool?
BRAMWELL: I've not seen anything, any information about the number of viral particles that could be in a pool or that would be in a pool, depending on the symptomatic other people that are in the pool or asymptomatic people in the pool? You know, I think that the governor's recommendations are sound where we're trying to avoid large groups of people and small bodies of water, just like we're trying to avoid large groups of people in small airspaces. Having said that, I think there are going to be places where you can go in and recreate on the river where it's really easy to be far, far apart from other people.
GAUDETTE: Dr. Pate, are you concerned as we move into the summer, and look, we've all been cooped up, people want to get outside, the weather is going to be really beautiful. Is there a concern that that social distancing in some cases will go by the wayside just because everyone's going to want to be outside and recreating?
PATE: Yeah, I think that's a natural concern and certainly we've seen instances of that. And, you know, to the extent that we are successful in keeping these cases down, you know, people will naturally become less concerned, not thinking that the way to keep it down is to keep up the social distancing. So it is a concern. You know, I have previously talked about that we do have some hope that the transmission of this virus will be decreased outdoors. We certainly think it's safer to be outdoors than cooped up inside with other people. We don't think it probably spreads as well outdoors. It also does appear that UV light, which you would be getting from the sun, is going to keep the virus down. And there's been hopes that we would actually just see a decrease in coronavirus over the summer like we do with other cold and flu viruses. The problem is, first, we don't know that's gonna be the case. And second, there still remain so many people susceptible to this virus that we suspect that whatever benefit we might get from the heat, humidity outdoors may be outweighed by the large number of people that are susceptible to this virus.
GAUDETTE: We're going to take a quick break and come back with some listener questions right after this. More with our medical experts here on Idaho Matters. Our panel today: Dr. David Pate, former CEO of St. Luke's and a current member of the Idaho Coronavirus Task Force, Dr. Andrew Southard, St. Alphonsus emergency medical director, and Dr. Kenny Bromwell, medical director for St. Luke's Children's Hospital. We have a voicemail from listener Alan. Let's get to his question.
LISTENER QUESTION: Yes, my name's Alan. I live in Aspen and I have a question about transferring that from money and things people touch in stores. Can you get it from that? Thank you.
GAUDETTE: So getting back to Allan's question, we know that places like Dutch Bros are no longer accepting cash over concerns, just like Allan's question. So is our money safe? I mean, what about, you know, when we go to the grocery store and we're dealing with cash or even credit cards?
SOUTHARD: It's a pretty good question, and I guess the bottom line is anything that you can touch with with your hand, and you can sneeze on your hand, you can transfer it to another person. So I would include money in that. What the actual risk is, is going to be hard to say. But I think if you're exchanging money, the best thing to do that after exchange it, just like you do with other objects, will be to wash your hands afterwards. I've personally been keeping a little bottle of alcohol sanitizer in my car just because it's amazing how many times you touch something that someone else has touched in the course of going about your day. So that'll be my kind of suggestion and take on it.
GAUDETTE: And then we the listener, Dave, he sent us this email. He said that he tested positive for Influenza A in January, fully recovered. Then in March, he had a similar instance, was not tested, though. But he says he had flu/COVID-like symptoms. Both illnesses started with severe body and headache, lethargy developing into a long lasting dry cough with some loss of taste and smell. His question is, could the January illness have possibly been COVID-19 or could the second illness have been another bout of influenza A?
PATE: Well, Gemma, this David Pate, so it's hard to know. The first thing is, if he tested positive for influenza A in January, then he likely had influenza A, and that was a time when we were seeing the influenza here. Now, there is nothing that prevents people from getting more than one infection at a time. And in fact, in looking at COVID cases across the world, there are patients that have not only COVID, but another respiratory virus as as well. So I certainly can't rule that out. But my guess is in January, he really had influenza as far as what happened in March. It could be anything, because keep in mind, first of all, if he did have influenza A in January, I would not think he would have influenza A again in March. It would have to be a different strain, most likely. And we've had about five different strains of influenza viruses, predominantly an A strain and a B strain. And there's no reason he couldn't have gotten an influenza B. But there's also a lot of other respiratory viruses. And then when we were testing somewhere around up to 7-10% of people who did have these symptoms did have COVID. So it's entirely possible, but it's not something we can make a conclusion about.
GAUDETTE: And then Meg had a question and she says, "in part of the phases of Rebound Idaho, requiring all employees of businesses to wear face coverings to stop the spread of COVID-19. Why is that not part of it?" She says she's been shocked at the lack of face coverings at grocery stores, takeout restaurants, coffee shops. So she wants to know if there should be a requirement or why isn't there a requirement?
BRAMWELL: The hardest thing, this is Kenny Bramwell, is that most of these recommendations and suggestions haven't gone much farther than that. They haven't reached the point of being a law or certainly not a law that we have chosen to enforce here in Idaho. So I think that we largely depend on the goodwill of people and the cooperation of people to try and protect one another. To be fair that the recommendations about masks have changed a fair amount over the last month or so. But it certainly seems reasonable that if we're all trying to do our best, that we'll wear masks in public. But I think the enforcement of that is going to be pretty minimal.
GAUDETTE: So I'm going to throw myself under the bus here totally and completely. I wear a mask every time I go in to a building. So if I am going to the grocery store, which I don't go very often, I wear a mask. If I am exercising outside and going for a run and I do not get around anyone. I do not wear a mask because I'm outside, I'm by myself or I'm with my husband who I live with. Should I or other people be wearing masks outside, because that's what I'm noticing, how helpful are they, if you're outside exercising, if you are not in a crowd of people? And you can tell me I'm wrong and should be wearing one!
PATE: No, Gemma, this is David Pate. You're doing it exactly correct. So the purpose of the mask is to deal with... Some significant percentage, we don't know, we think it's about perhaps around 25%, around a quarter of people who can be asymptomatic or pre-symptomatic. And yet they're shedding the virus. And we shed the virus when we are talking, coughing, sneezing, singing, any of those things. So the purpose of the mask is actually to protect others from us because who knows, perhaps we're shedding the virus. So the only time that's a risk is when we are in close proximity to others. So you wear the mask when you're inside or outside, if you cannot effectively do the social distancing. But if you are in a situation where you are well social-distanced, maybe in your own home or outside, like you described, there is no need for you to wear the mask. And so you're doing it exactly right.
GAUDETTE: And Dr. Bramwell, I'm curious about in the fall when we, fingers crossed, have kids go back to school. From your perspective, do you think it will be a good idea to have not just students, but even faculty and staff, wear masks as... Especially because you know we're going into fall and, you know, the weather starts to change. Is that a recommendation you would like to see?
BRAMWELL: To be fair, I haven't seen anything described about that from any of our national bodies at this point. I think everybody's going to have to try and figure out if we hold school again, is that possible to do with social distancing? And the answer is probably not, at least the way schools are currently set up. So what can you do to mitigate or to minimize risks? Certainly masks, I think, would be part of that. Much like what Dr. Pate was just suggesting about being inside with other people and being around them for a prolonged period of time where masks are felt to be helpful. But the real question is, will school be open in a regular way? Will we have normal gatherings like this? There are other countries, Sweden comes to mind, who who didn't shut school down at all. And we'll have to see how things go, though, admittedly, initially, it seems like there are numbers of cases spiked quite a bit or or spiked more than surrounding countries. So I don't know that we have a really good handle on where we're going to land yet. I haven't seen anything from our school district friends yet. Certainly, I think for now, school is out of session. But the question becomes what to do if you have a class of 20 where they are by and large, sitting two and three feet from each other. Is that manageable or will we reach a point at that point where we say we think this is going to be OK and we're going to ask everybody to wear masks? We don't think that it's necessary for people to stay at home any farther. I think that's up in the air.
GAUDETTE: We're going to take a quick break. We'll be back right after this... Continuing our conversation with our medical experts here on Idaho Matters. We have a question from Glenn and he says,"Everyone talks a lot about social distancing and how it has definitely helped keep spread of the disease and deaths to a minimum. Comparing data and actual facts across our country and world. Is there proof this is as effective as these folks indicate?"
SOUTHARD: This is Drew Southard, I think it is a pretty important psychological and social question, because for me and the emergency department, I get two views: one is outside, just going around and seeing what the world looks like. And then there's the other view inside the emergency department where it's vastly different. You're actually seeing some really sick people and watching people die with this disease. So it's hard. I think if you just live in a world where, you know, you drive by, the hospital looks the same, you're outside, you don't see kind of this other reality. And so there's kind of a tendency to suggest that maybe this isn't really as bad as we think. And part of that, I think, is because we've done a very good job with the social distancing. So that's my personal take on it, is it has been effective. I think all the models that we looked at previously, they changed. And it's not because they were wrong. It's because we had an intervention. And then now we're seeing what that intervention has done. And so it's kind of a misstep in logic to say, well, we're doing better and we probably need to do what we did. We're doing better because what we did and I think that's a really important piece for the public to understand.
GAUDETTE: Yeah. Really good information there. A question from Robert. He said, "What restrictions are there on someone who lives in California and flies to Boise to visit their spouse who lives in Boise? Is there a quarantine time for them? What about airline travel? Any restrictions?" Well, I can say to Robert that in Phase 1 is that we still have a 14-day quarantine for anyone who does not live in Idaho, who travels to the state. But from there, I guess the other question is, should people be doing nonessential travel right now? Because that's restricted as well.
PATE: And Gemma, this is David Pate, and we would not advise that people travel, if not a really good reason for it. Of course, it depends on the specifics: where are you traveling to? How are you traveling? Certainly traveling in your own family car is going to be a different risk than getting on an airplane with a lot of other people. So. But certainly at this point in time, we know that people that are in areas that still have a lot of active transmission of this virus, and that is certainly true of a lot of places in the United States and certainly in the world that if they travel from one of those high risk areas and come into Idaho, they pose a threat and could certainly spread the coronavirus significantly. So we do discourage any unnecessary travel at this time.
GAUDETTE: And our final question, and I've only got two minutes left, another question from Glenn. He says, "It seems as though on both a national and state level, almost the entirety of decision-making surrounding COVID-19 came from only medical professionals. And shouldn't other community partners have been involved?" Who would like to take this one?
BRAMWELL: I'm a little biased on this one. Gemma, my answer is finally. But to be fair to other perspectives. Now, this is a public health crisis and a health care crisis. I think that physicians have an insight there, particularly with what Drew was just talking about. He sees what things are like as he drives around and he sees what things are like inside the hospital, which is a view the civilians don't have. I think that it's really helpful that the physicians have been involved to the degree that they have. I don't think that they've been the only voice at the table, but I think that since this is unexplored territory, they've had more of a voice than they have previously.
GAUDETTE: Well, and you really are the people on the frontlines and the medical professionals. You all went to medical school. I did not. So I appreciate your perspective and what you are bringing to us, to our listeners. Thank you for your time. Thank you for your perspective. Thank you for the facts. I think that is critically important right now as we continue to move through this. I want to thank all three of you for taking time out of your day today and coming on the program.
ALL: Thank you. Thanks. Thanks, Gemma.
GAUDETTE: We've been talking with Dr. David Pate, former CEO of St. Luke's Health System and a current member of the Idaho Coronavirus Taskforce, Dr. Andrew Southard, St. Alphonsus emergency medical director, and Dr. Kenny Bramwell, medical director for St. Luke's Children's Hospital.
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