The risk of spreading or contracting COVID-19 is still present as quarantines and restrictions are lifted and more and more of “normal life” returns.
To help our readers keep themselves and their loved ones safe, the Watchman asked Dr. Richard Wallace, Chairman of the Department of Microbiology, Chief of Infectious Diseases and Professor of Medicine and Microbiology at UT Health East Texas, to talk about ways that people can navigate a world where COVID-19 is still a risk.
We asked for both general recommendations and looked at specific examples to talk about the risks associated with that activity.
This interview has been lightly condensed.
Why is COVID-19 so serious?
“We’ve had two other viruses that belong to this family which turned out to cause disease in humans — SARS and MERS,” Wallace said. “One of those was very aggressive, virulent, but not very contagious. The other one was more contagious like a regular cold virus, coronavirus, but wasn’t very aggressive. So neither one of them lasted very long. This is the best of the best — maybe you should say the worst of the worst. This one is highly contagious and potentially lethal.
“We don’t have a vaccine for any coronavirus. Yet. So it makes scientists a little more nervous than like influenza, for which we’ve made many, many vaccines and we understand how to make it and we know how effective they are. This is a family of viruses for which we’ve never made a vaccine, so although it may look simple and it may look like it’s going to work, scientists are a little more nervous.”
General safety recommendations
Age and any underlying diseases have a lot to do with how sick you get and whether you die or not, Wallace said, so those with higher risk should do more to mitigate risk.
“If you’re in the high-risk category, you need to do the most you can to keep from getting the virus,” Wallace said. “Those are pretty well defined. Age is a major factor just by itself, but other diseases that weaken the overall health of the individual from heart disease to high blood pressure, obesity, diabetes, you can imagine. All of those make infectious diseases, influenza for example, a much more serious disease. So this is no different.
“Having said that, that’s the majority of the patients who get very ill. But it’s not all of them, and even young people and children are at risk, although the risk is substantially less. So the older you are, the more of these diseases you have, the more careful you need to be.”
That means staying home and avoiding large groups of people, Wallace said, which may mean doing things like going to church virtually instead of in-person.
“That may be very difficult, I mean, going to church may be a really important thing to do for a number of older people, but it also carries a much greater risk in that you have more people in a smaller environment,” Wallace said. “So for example, finding ways to participate, learning how to use the computer and learning how to use visual sharing experiences for everything from church to — I have some people that are taking senior gardening classes (online). It’s limiting your exposure to the outside.”
Face masks can serve different purposes depending on the type of material, Wallace said. Cloth masks are used to protect others from you, while a surgical mask or N95 mask can protect you from others.
“The cloth masks help protect others because the moisture droplets that you generate get hung up in the mask,” Wallace said. “But the moisture droplets from COVID are not particularly stopped. So it doesn’t provide protection for you if you were to go out in the public. You provide protection for others, and if everybody wears a mask you’re in good shape. But if only half the people wear cloth masks, then half the people potentially are generating or could generate the virus and you’re wearing a mask that doesn’t protect you against that. So the cloth mask works if everybody wears it, otherwise you need a medical mask, the so-called surgical masks, which are available, and they provide significant protection if you have to go out.”
Shopping is a necessity, and Wallace says people should look at ways they can minimize risk. Some stores have priority hours for senior citizens. Others offer pickup services or have made changes to their store layouts. Going early or very late can minimize exposure, Wallace said.
Wallace was frank about the biggest risk: young people.
“We’ve always said that young people think they’ll live forever, and they drive that way, they drink that way, and they live that way,” he said “You can say, well, this is not such a bad disease. But if you happen to be the one, you could end up dying from the disease. The people that I think we need to spend the most amount of time with is trying to address younger people and helping them understand that there is a risk for them as well and they need to follow these guidelines.
“I think one of the hard parts here is, it’s my opinion that our lives have been changed forever. We will never go back to the way we were before. We will never be free of this virus or other viruses like it. We will have to take precautions in some fashion, and so you’re just trying to minimize your risk and decrease the number of people who get the infection at any one time. I think that’s when our biggest losses were in terms of people getting terribly ill and people dying is when it happens all at once like in New York City. We just were overwhelmed.”
Now on to some specific examples:
Can you hug people?
“I would not do it if someone is symptomatic at all, in other words if they have a cold or some sort of respiratory illness,” Wallace said. “I happen to think that hugging your children is one of the risks that I’m willing to take. Not everybody believes that, but I know the risks that I’m taking and I also know the benefits that I will receive and they will receive for hugging each other. Other people, not family members? I tell them ‘Here’s my hug.’ I don’t give it to them, but I tell them ‘I want to give you a hug.’
“It is one of the life-breathing events that I think it’s very hard to live without, certainly within your own family. But if somebody’s sick or somebody’s been exposed to being sick, the family needs to be very careful and very protective, especially for older people. They need to know who’s been ill or not been ill, who’s been out and around and for whom maybe you should save your hugs. But for most of your kids, I still hug them.”
Can kids safely participate in youth sports program or play with their friends again?
“It depends on the sponsors and how careful they are about what they’re doing. We just have to modify how we do it and be smart about it. You can’t make your risk zero. But if you were to get sick and you said ‘Listen, I did everything I could do,’ then you can’t feel bad about it. That remains a risk. But I think for youth sports, you need to know what are they doing to protect my son or my daughter there?
“It’s like the adult sports. We’re going to go back to adult sports, but you’ll never be the same and we have to optimize protecting the players and the spectators.”
Can you have a girls’ night out at a restaurant or bar?
“I’m very uncomfortable because I don’t know what restaurants are doing,” Wallace said. “Some places have rules about 25 percent occupancy. So everybody’s at least 10 feet apart. But because it takes a long time to eat, it’s not like you’re passing somebody in the hallway. It could be an hour. This is one of the most dangerous places you can be.
“The other thing I think people should remember is in the laboratory scientific studies that have been done, six feet is the minimum distance for which there is some protection. Eight feet is better, 10 feet is better. Six feet is the minimum.
“Going to a restaurant the way you did before COVID? Not a chance. Bars? Same thing. I watch all these people go and these young people, it’s like ‘It’s OK, the governor said I could go!’ You’re taking a terrible risk. Remember the governors and the White House are caught between money and risk, and they’re willing to take a bigger risk with your lives than we the medical profession are, and that’s why we’re not on the same page.
But I think we’re going to get better. I think we’ll learn how to protect ourselves better. We’re just now starting. For example, plexiglass, there’s almost no scientific studies about whether or not they would provide you with a physical barrier. Most of the engineering in terms of ventilation... those were all designed for a different time, different place. They were designed for air-conditioning. They weren’t designed to protect you. Much of what we’re having to do in the research labs, in the scientific labs, they were designed for other purposes. They were not designed to ‘What direction does the air flow?’
So one of the things they discovered in the nursing homes was the people who were at the start of the ventilation where the air came out of the vents never got sick. The people who were at the end of the row where the air bypassed everybody else and then went into the vents just above their heads, those people all got sick. I think our ventilation systems are all going to have to be re-engineered so that you’re in the right place.”
Can you ride on an airplane?
“Unless they had an N95 mask, a real one, I wouldn’t get on an airplane,” Wallace said. “Sorry. Cloth masks are almost no protection. The surgical masks protect the other people around you, but some of the people may be wearing cloth masks and they’re not going to help you. So N95 masks, people are not supposed to use them, but if I had to go and travel, I would see what I could do to identify one of those masks. It’s the only thing that really protects you against COVID with some level of security.
“So right now in my opinion, restaurants, bars, airplanes, those are your maximum risk areas. Very little has been done to modify it, and I don’t see the airplanes saying that we’re only going to fill 25 percent of the seats.”
If you’re meeting up with a group of people, is meeting outdoors better than indoors?
“Yes,” Wallace said. “There are some scientific studies to show that where the droplets go indoors depends a lot on then ventilation. If you don’t know the ventilation, you don’t know where it’s going. Outdoors, especially if there’s some breeze, the droplets are dispersed widely. The fewer the droplets in your area, the lower your risk. Is being outside safer? Absolutely. And the more the breeze, the better you are.”