The Ledger is holding an online coronavirus Q&A from 10-10:30 or so with Dr. Amina Ahmed, an infectious disease expert with Atrium Health’s Levine Children’s Hospital. She’ll take your questions on medical-related aspects of the coronavirus. Feel free to join now or read the discussion later.
Thank you Tony for your efforts in keeping us informed and providing invaluable information. We appreciate your support of the Charlotte community as well as Dr. Ahmed's willingness to participate online with us. Thank you both!
Our time has drawn to a close – thank you to everybody for participating. And a big thank you also to Atrium Health and Dr. Ahmed for your time this morning. Stay safe, everybody.
Good morning. This is Tony Mecia with The Charlotte Ledger. This morning, we are holding a Q&A with Dr. Amina Ahmed of Atrium Health. She is an infectious disease expert.
We are grateful that Atrium has made her available to answer medical-related questions about the coronavirus, such as how it spreads and the best advice for you to stay safe and healthy. We will go for 30-45 minutes.
If you have a question for Dr. Ahmed, feel free to ask it. She went to medical school at UNC and is an expert in infectious diseases, with a focus on pediatrics. She will not be answering questions about public policy, economics or anything that is not medical-related.
Being a coronavirus, which notoriously mutate frequently, can we ever really have a true vaccine? Or is an effective drug therapy a more reasonable expectation?
Thus far, although there may be strains, we are not seeing this virus mutate as influenza does. For influenza, although it mutates, the annual vaccine actually addresses the mutation by incorporating antigens or proteins from the new mutations. That is why we need an annual influenza vaccine- different mutations or strains pop up every year. For coronavirus, if mutation is observed, it makes vaccine development more difficult but still possible...There are many different types of vaccines being developed and I am hopeful one will be a good candidate. At the same time, there are numerous clinical trials ongoing for antiviral therapy, and I am hopeful those will also offer some options to mitigate the disease process.
Thank you to everyone who participated. It was a pleasure to join you today. Please continue to practice social distancing and follow all of the guidance relating to washing hands, wearing masks and other protections being advised by health experts.
Hello Dr Ahmed I would like to hear what you think about herd immunity and is that possibly what California has as their cases are so much lower than a NY for example and yet they have the most nonstop flights to China in the country? Thanks!
It is as yet too early to say how much herd immunity can be expected, and herd immunity works best with, for example, vaccines, where a large proportion of the population is protected in a reliable fashion. We are still learning about immune responses, those in symptomatic and asymptomatic, and we are still trying to figure out why some populations are seeing more disease than others. Multiple factors are being looked at such as underlying disease (recognized or not), crowding, genetic predispostion, etc. Thus, at this time, it is difficult to say why some populations are more affected than others.
My husband and I are trying to limit trips out in public to just one trip to the grocery every 1 to 2 weeks. I'm wondering what steps you take to be safe when you have to make those types of trips out? We use a face mask, wipe our hands before we go in, do our shopping, grab a wipe on the way out, then wash our hands at home, unpack our groceries, and wash our hands again. Are we doing it right?
Yes! Although face masks are being recommended, remember that the best protection afforded by a mask is not to you but to others- it keeps your droplets from getting on others. You are protected if someone is within 3-6 feet of you with a mask, but hand washing is what is protecting you from acquiring infectious virus that may be on surfaces from someone else's droplets. So, protect yourself from secretions from others (don't share drink cans, utensils and stay far away from those sneezing/coughing) and protect yourself from virus that may have been deposited by droplets by washing your hands.
Dr. Ahmed, I know this may not be your area of expertise, but as a business owner, we are trying to plan for the long term, but with so many competing narratives, it's hard to do. I'm read a lot of articles saying that we should plan for several starts and stops to the outbreak which would correspond to easing stay at home orders and re implementing them when outbreaks pop up again.
What are your thoughts? Is this something that will likely keep popping up until a vaccine is widely available?
The pandemic has certainly impacted businesses and economy, and those implementing stay at home orders are keenly aware of that. What you describe for "reentry" is certainly one approach that has been discussed. At the hospital, we are coming up with tiers to reintroduce clinic visits and non urgent surgery and non-emergent surgery. Similarly, for businesses, a tiered approach is being considered. However, we are still learning about this virus, and thus, as you mentioned, if we end up going backwards, we may need to be prepared to institute more social distancing measures. The pandemic has been an amazing exercise in learning on the job, and it is important to remember that the back and forth is because we have to adjust as we learn. Finally- we are all hopeful that a vaccine will allow us to deal with this virus as we deal with influenza or other vaccine preventable diseases, so that although the virus will be out there, it will not cause as many infections or deaths.
Dr. Ahmed, I keep hearing that the peak infection date is moving back, which sounds good because we are flattening the curve, but also makes me wonder if the physical distancing will need to be in place longer than originally envisioned. Do you have a sense of when life might start to return to normal and what that would look like?
This is a question that my kids ask me every day! They want the social distancing to be over, which I realize all do. The pushing forward of the peak is very encouraging, and it is my thought that as long as we continue to be careful and continue social distancing to some extent, the peak will be flatter the more we push it out. It is impossible to predict a date for when "return to normal" may be as we are assessing daily, but we at the hospital and those at the county and state level are already discussing staged or tiered approaches to returning to normalcy, or a new normalcy.
Great question...I think about this a lot. At this time, we really don't know if, like influenza, viral activity and circulation in the community will die down in the summer. We are concerned that even if activity declines in the summer, it may resurface in the fall, just like influenza does. It is a coronavirus, and many of those circulate year around, with peak activity at certain times, but since this is a new virus, the re-circulation later in the year still means it can cause a lot of infections because of the lack of immunity. We are hopeful that a vaccine will help with building people's immunity so, even if it does come back, at least the vaccinated may be immune and hopefully protected.
Seems like there might be some technical difficulties, but I’ll throw this out there and hopefully you’ll get a chance to answer. Obviously we’re all going to great lengths to break chains of transmission of the virus — can you give any kind of definitive answer about how long the virus survives on packaging surfaces? With so many of us depending heavily on deliveries, I’ve had questions from my family about whether we need to be wiping down everything that comes into the house. Thanks!
That is a very good question, and there are, unfortunately, very limited data on this. There was one study published in New England Journal; everyone is quoting that study but please keep in mind it is one study. The study suggested that the virus can remain on various surfaces from hours to days. However, what we don't know is if that virus on surfaces would actually lead to infection if touched. Thus, my advice would be to always wash hands after touching surfaces- as often as you can, but especially before eating or doing any activity which will put your hands near your mouth or eyes.
Dr. Ahmed, Are you currently seeing patients and how are you protecting yourself from asymptomatic patients? Are you wearing full PPE for all visits? How about your staff?
Good morning! I am seeing patients, and as the epidemiologist, I am in and out of the hospital. I am wearing a surgical mask at all times, as we recommend for all our healthcare workers. There is a concern that asymptomatic persons may be contagious, but it is difficult to say who is contagious or not. Thus, we are screening all visitors for symptoms and most visitors are wearing their own masks. And of course, always good handwashing so that we can avoid being infected by anyone- symptomatic or asymptomatic- who may have touched something and transmitted the virus.
Is there any realistic hope of antibody testing becoming available in the near future (or some other way to tell if someone has already had this coronavirus infection?
Yes! In fact we are looking to on-board a serological test in the next couple of weeks. It is unclear to whom this will be offered. It is also unclear if a positive test will mean that the person is "forever" immune or protected from reinfection. We will have more answers about this as the test is rolled out. In addition, Atrium is partnering with Wake Forest to launch a large national study looking at symptoms in of volunteers in the community; as part of that, we will be offering in home serological testing. Please be on the lookout for news about that research study!
Dr. Ahmed, thank you for doing this Q&A. I have 3 children, and they are getting stir-crazy without being able to see their friends. My youngest child, age 8, has been wanting to play outside, to 'chalk-the-sidewalk' with her friends and things like that, but I wonder if you'd advise against having kids play outside together?
I hear you and can relate! Although this is a very difficult situation to be in, one thing I want to point out is that we have very little data in children. We are not testing most because of limited tests. Thus, there are many children out there with mild symptoms who may in fact have COVID-19. Thus, I cannot stress enough the continued efforts at social distancing. Most children will handle the infection well, but they can pass it on to others who may be more severely infected. I would try to socially isolate within your household if possible.
Thank you Tony for your efforts in keeping us informed and providing invaluable information. We appreciate your support of the Charlotte community as well as Dr. Ahmed's willingness to participate online with us. Thank you both!
Our time has drawn to a close – thank you to everybody for participating. And a big thank you also to Atrium Health and Dr. Ahmed for your time this morning. Stay safe, everybody.
Dr. Ahmed, what are some of the most common misconceptions that you hear about the coronavirus?
OK, Dr. Ahmed is online. Thank you for your patience. She's working to answer the questions that have been posted.
Still working to get Dr. Ahmed online here - hold tight, we're working on it. Appreciate your patience
Dr. Ahmed, are you with us?
These sometimes take a few minutes to get going as people come in
Good morning. This is Tony Mecia with The Charlotte Ledger. This morning, we are holding a Q&A with Dr. Amina Ahmed of Atrium Health. She is an infectious disease expert.
We are grateful that Atrium has made her available to answer medical-related questions about the coronavirus, such as how it spreads and the best advice for you to stay safe and healthy. We will go for 30-45 minutes.
If you have a question for Dr. Ahmed, feel free to ask it. She went to medical school at UNC and is an expert in infectious diseases, with a focus on pediatrics. She will not be answering questions about public policy, economics or anything that is not medical-related.
Being a coronavirus, which notoriously mutate frequently, can we ever really have a true vaccine? Or is an effective drug therapy a more reasonable expectation?
Thus far, although there may be strains, we are not seeing this virus mutate as influenza does. For influenza, although it mutates, the annual vaccine actually addresses the mutation by incorporating antigens or proteins from the new mutations. That is why we need an annual influenza vaccine- different mutations or strains pop up every year. For coronavirus, if mutation is observed, it makes vaccine development more difficult but still possible...There are many different types of vaccines being developed and I am hopeful one will be a good candidate. At the same time, there are numerous clinical trials ongoing for antiviral therapy, and I am hopeful those will also offer some options to mitigate the disease process.
Thank you to everyone who participated. It was a pleasure to join you today. Please continue to practice social distancing and follow all of the guidance relating to washing hands, wearing masks and other protections being advised by health experts.
Our website has a host of resources: www.atriumhealth.org/coronavirus, including symptom checkers and a hotline you can call.
Stay safe and healthy!
Hello Dr Ahmed I would like to hear what you think about herd immunity and is that possibly what California has as their cases are so much lower than a NY for example and yet they have the most nonstop flights to China in the country? Thanks!
It is as yet too early to say how much herd immunity can be expected, and herd immunity works best with, for example, vaccines, where a large proportion of the population is protected in a reliable fashion. We are still learning about immune responses, those in symptomatic and asymptomatic, and we are still trying to figure out why some populations are seeing more disease than others. Multiple factors are being looked at such as underlying disease (recognized or not), crowding, genetic predispostion, etc. Thus, at this time, it is difficult to say why some populations are more affected than others.
My husband and I are trying to limit trips out in public to just one trip to the grocery every 1 to 2 weeks. I'm wondering what steps you take to be safe when you have to make those types of trips out? We use a face mask, wipe our hands before we go in, do our shopping, grab a wipe on the way out, then wash our hands at home, unpack our groceries, and wash our hands again. Are we doing it right?
Yes! Although face masks are being recommended, remember that the best protection afforded by a mask is not to you but to others- it keeps your droplets from getting on others. You are protected if someone is within 3-6 feet of you with a mask, but hand washing is what is protecting you from acquiring infectious virus that may be on surfaces from someone else's droplets. So, protect yourself from secretions from others (don't share drink cans, utensils and stay far away from those sneezing/coughing) and protect yourself from virus that may have been deposited by droplets by washing your hands.
Dr. Ahmed, I know this may not be your area of expertise, but as a business owner, we are trying to plan for the long term, but with so many competing narratives, it's hard to do. I'm read a lot of articles saying that we should plan for several starts and stops to the outbreak which would correspond to easing stay at home orders and re implementing them when outbreaks pop up again.
What are your thoughts? Is this something that will likely keep popping up until a vaccine is widely available?
Thanks,
Nathan
The pandemic has certainly impacted businesses and economy, and those implementing stay at home orders are keenly aware of that. What you describe for "reentry" is certainly one approach that has been discussed. At the hospital, we are coming up with tiers to reintroduce clinic visits and non urgent surgery and non-emergent surgery. Similarly, for businesses, a tiered approach is being considered. However, we are still learning about this virus, and thus, as you mentioned, if we end up going backwards, we may need to be prepared to institute more social distancing measures. The pandemic has been an amazing exercise in learning on the job, and it is important to remember that the back and forth is because we have to adjust as we learn. Finally- we are all hopeful that a vaccine will allow us to deal with this virus as we deal with influenza or other vaccine preventable diseases, so that although the virus will be out there, it will not cause as many infections or deaths.
Dr. Ahmed, I keep hearing that the peak infection date is moving back, which sounds good because we are flattening the curve, but also makes me wonder if the physical distancing will need to be in place longer than originally envisioned. Do you have a sense of when life might start to return to normal and what that would look like?
This is a question that my kids ask me every day! They want the social distancing to be over, which I realize all do. The pushing forward of the peak is very encouraging, and it is my thought that as long as we continue to be careful and continue social distancing to some extent, the peak will be flatter the more we push it out. It is impossible to predict a date for when "return to normal" may be as we are assessing daily, but we at the hospital and those at the county and state level are already discussing staged or tiered approaches to returning to normalcy, or a new normalcy.
What is the current thinking on the likelihood that the virus could go away on it's own like the seasonal flu? Thank you.
Great question...I think about this a lot. At this time, we really don't know if, like influenza, viral activity and circulation in the community will die down in the summer. We are concerned that even if activity declines in the summer, it may resurface in the fall, just like influenza does. It is a coronavirus, and many of those circulate year around, with peak activity at certain times, but since this is a new virus, the re-circulation later in the year still means it can cause a lot of infections because of the lack of immunity. We are hopeful that a vaccine will help with building people's immunity so, even if it does come back, at least the vaccinated may be immune and hopefully protected.
Seems like there might be some technical difficulties, but I’ll throw this out there and hopefully you’ll get a chance to answer. Obviously we’re all going to great lengths to break chains of transmission of the virus — can you give any kind of definitive answer about how long the virus survives on packaging surfaces? With so many of us depending heavily on deliveries, I’ve had questions from my family about whether we need to be wiping down everything that comes into the house. Thanks!
That is a very good question, and there are, unfortunately, very limited data on this. There was one study published in New England Journal; everyone is quoting that study but please keep in mind it is one study. The study suggested that the virus can remain on various surfaces from hours to days. However, what we don't know is if that virus on surfaces would actually lead to infection if touched. Thus, my advice would be to always wash hands after touching surfaces- as often as you can, but especially before eating or doing any activity which will put your hands near your mouth or eyes.
Dr. Ahmed, Are you currently seeing patients and how are you protecting yourself from asymptomatic patients? Are you wearing full PPE for all visits? How about your staff?
Good morning! I am seeing patients, and as the epidemiologist, I am in and out of the hospital. I am wearing a surgical mask at all times, as we recommend for all our healthcare workers. There is a concern that asymptomatic persons may be contagious, but it is difficult to say who is contagious or not. Thus, we are screening all visitors for symptoms and most visitors are wearing their own masks. And of course, always good handwashing so that we can avoid being infected by anyone- symptomatic or asymptomatic- who may have touched something and transmitted the virus.
Is there any realistic hope of antibody testing becoming available in the near future (or some other way to tell if someone has already had this coronavirus infection?
Yes! In fact we are looking to on-board a serological test in the next couple of weeks. It is unclear to whom this will be offered. It is also unclear if a positive test will mean that the person is "forever" immune or protected from reinfection. We will have more answers about this as the test is rolled out. In addition, Atrium is partnering with Wake Forest to launch a large national study looking at symptoms in of volunteers in the community; as part of that, we will be offering in home serological testing. Please be on the lookout for news about that research study!
Dr. Ahmed, thank you for doing this Q&A. I have 3 children, and they are getting stir-crazy without being able to see their friends. My youngest child, age 8, has been wanting to play outside, to 'chalk-the-sidewalk' with her friends and things like that, but I wonder if you'd advise against having kids play outside together?
I hear you and can relate! Although this is a very difficult situation to be in, one thing I want to point out is that we have very little data in children. We are not testing most because of limited tests. Thus, there are many children out there with mild symptoms who may in fact have COVID-19. Thus, I cannot stress enough the continued efforts at social distancing. Most children will handle the infection well, but they can pass it on to others who may be more severely infected. I would try to socially isolate within your household if possible.