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Got Questions? We've Got Answers!

Q&A With Advent Health Advisors & AIV Guests

March 31, 2020

As part of our guest features series, we bring you the facts and insights from Dr. Grieper and Melinda Grieper who are on the frontlines in Central Florida hospitals, leading teams caring for COVID-19 patients.

With the increasing amount of 'fake news' and misinformation circulated on social media, it's of great value hearing directly from the experts themselves. We thank Dr. Grieper and Melinda Grieper for taking time out of their extremely busy schedules to share this with us!

So by now most people know what Covid-19 is & how it is contracted. However, few people know the symptoms. Can you list the 4 main symptoms one would have if one was to catch it & what one can do to get through it from home?

Most common symptoms of COVID-19 are: fever, dry cough, shortness of breath, and tiredness.

Interestingly, about 30% of patients also report a loss of taste and smell.

Home care is appropriate for persons with mild infection and those who can adequately isolate themselves from others. Drink a lot of fluids to stay hydrated, get rest, and over-the-counter medicines will help with symptoms.

It is also essential to know the emergency warning signs as well and to seek medical attention immediately if they appear. Warning signs include, but are not limited to: trouble breathing, new confusion or inability to arouse, bluish lips or face, persistent pain or pressure in the chest, sustained fever is higher than 100.4, which is not responding to medications, or a fever of 103 or higher.

Hospitals & doctors have reported that many of us will contract it with mild symptoms, & many will recover without needing a visit to the hospital. Is that an accurate assessment?

Yes, it is accurate that the vast majority of infected persons will be considered "mild." Meaning there is no or mild pneumonia. As of the CDC's data up to March 16, 2020, about 80% of the infected persons did not require hospitalization.

This finding is very similar to data recently published by the Chinese Center for Disease Control & Prevention, which reported 80.9% of the cases were considered mild, and only 1 in 5 people experienced severe or critical illness. Some people might not have symptoms at all!

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Art in Voyage
Art in Voyage
Art in Voyage
Art in Voyage

Past infections, such as Ebola in Africa or H1N1 a few years back, have not led to a complete shutdown of the world. This is often used on social media as a point of reference. Help us understand the significant difference here?

There are 2 significant differences between the H1N1 "Swine Flu" pandemic of 2009 and the current COVID-19 pandemic. The CDC estimated that there were 60.8 million cases of swine flu and about 12,500 deaths – making a mortality rate of about 0.02%. Current statistics are showing a mortality rate for COVID-19 at around 2%. The 2% doesn't sound like a lot but can translate to millions of more deaths.

The H1N1 was also less contagious. The expected number of individuals who could catch the swine flu from a single infected person was 1.46, and for COVID, that number is estimated to be 2-2.5 currently.

The symptoms of H1N1 typically show up 1-4 days after contracting the virus. COVID-19 seems to have an incubation time of 4-14 days; the person may have no or very mild symptoms and, therefore, could be spreading the virus for up to 2 weeks before ever feeling ill.

Then add in the era of social media. The spread of inaccurate information and myths about COVID-19 spread faster than the virus itself. While there is a reason for concern, misinformation has also led to unnecessary hysteria and hoarding of products needlessly.

We get, day after day, the number of people infected & the fatalities. Yet, we do not get any numbers for successful recoveries. Based on your personal experience, help us understand the ratio/percentage of a successful recovery & what individuals are most at risk.

The rate of recovery is astoundingly high! As of the latest data from the WHO, 96% of the active cases are considered mild, leaving 4% in serious/critical condition. Of all of the closed cases, meaning recovered or death, 85% are recovered. 15% is still a significant number, especially for the loved ones of those who passed due to COVID-19. However, the ratio is in favor of those infected to have recovery.

The population at highest risk is a topic of great interest to those of us in the medical field. The apparent populations are those persons with a compromised immune system, the elderly, and those with pre-existing chronic illness. Statistics are further showing that about 70% of all cases are male. COVID-19 is infecting persons of all ages.

By now, all of us have heard of the importance of social distancing. Can you tell us why it is crucial to the healthcare system?

"Flattening the curve" is a Public Health term that has been used a lot in the media lately. This is what social distancing is meant to do for the healthcare system. By reducing the number of persons infected at once and slowing the spread of the virus, we allow resources of the system to be utilized more efficiently.

Let's face it, our Emergency Rooms and hospitals are already operating at or close to capacity every day, without COVID-19.

When I was a kid, I was always told that if I get the flu or any virus, it was necessary to allow my body to fight it, & as a result, build an immunity to it. While protecting the weaker individuals, isn't there a long term benefit in allowing our body to fight?

Herd immunity is a phenomenon that occurs every flu season. It is when enough people in a specific population have immunity to a particular virus, then the rest of the population becomes less likely to become infected. Think of a person with measles standing in the middle of a circle of people who have had the measles vaccine. The measles will not spread due to the immunity of the circle, or heard, around it.

COVID-19 is a new virus that no one yet had immunity and also so different that it needs its own vaccine, according to WHO. That leaves every human susceptible to the infection. Once a vast majority of people have been infected with COVID-19 and survived it, herd immunity will come into effect after our bodies have created the antibodies to the virus. Most experts estimate a "good herd immunity" at about 90 to 95% of the population to have recovered and become immune to the virus.

This will be a highly studied aspect of COVID-19 as it is a new virus, and we don't yet know how protective the antibody response is long-term.

It's fair to say everyone agrees with the need to tackle this ASAP. Yet, many of us don't seem to understand what the long term plan is. We know this shut down isn't sustainable for extended periods. Does the healthcare system, in general, know what the grand plan might be?

The Grand Plan right now is to control the spread of the virus and reduce infection rates. That will give us time in healthcare to properly care for everyone who needs us. We need to bide some time to find treatments that work and, hopefully, a vaccine.

This is what you hear in the media as the Mitigation Strategy. It allows us to protect those in our community who are more susceptible to infection as well as to protect our healthcare workforces. It is a delicate balance of minimizing deaths from infection and the economic impact of viral spread.

There are complicated decisions ahead for governments. However, how we individually respond to information on how to prevent transmission will be just as important as the government's actions. We have to keep the community informed of how to avoid infection and, in turn, that will help manage the economic downturn by being able to lift mitigation measures safely.

Other than the social distancing, how can people help healthcare workers, but also themselves in building a stronger resistance to this virus?

There are several ways to protect yourself from COVID-19. Of course, the best approach is to avoid being exposed to the virus, hence the social distancing. Many of the other methods of protection is going back to the basics!

- Washing your hands with soap and water for at least 20 seconds or using hand sanitizer with at least 60% alcohol
- Avoid touching your eyes, nose, and mouth with unwashed hands
- Clean and disinfect frequently touched surfaces around you daily
- Stay at home if you're sick
- Cover your mouth and nose if you cough or sneeze
- If you are not sick, don't wear a facemask unless you're caring for someone who is ill

Last but not least, let's end on a positive note!

While the news and numbers can be overwhelming and scary, we need to focus on what we know so far about COVID-19. We know that about 80% of us who are infected will have a mild case and will be ok. We know how it is spread. We know what to do to slow the infection rates down.

We also know we will be doing some hard work to get ahead of this and flatten the curve that we spoke about. We have already started that work with the many strategies we have seen put in place throughout our communities. We will be socially isolated and uncomfortable for a short time. However, we will get through this. There is a light at the end of the tunnel.

Many brilliant medical professionals and scientists are working diligently on finding the right treatment protocols and, ultimately, a vaccine. I see those healthcare providers every day, thinking outside the box and searching for the moment that the cure is found. While we are hard at work and giving our all, we need you to help us out.

Please help slow the spread so we can provide the best care possible to every patient and give us a moment to find the treatments that work. I promise you that we are working hard and want to beat this quickly and efficiently. Again, we will get through this together!