Selected Podcast
COVID 19: What You Need to Know
Erica Kaufman-West, MD, Board Certified Infectious Disease Specialist, provides important information on COVID-19, including how the virus spreads and simple steps people can protect themselves and their loved ones from becoming infected.
Featuring:
Medical School Georgetown University School of Medicine, Washington, D.C.
Residency Cedars-Sinai Medical Center, Los Angeles, California
Fellowship in Infectious Disease
West Los Angeles Veterans Administration Medical Center
Cedars-Sinai Medical Center
UCLA-Olive View Medical Center
Erica Kaufman-West, MD
Dr. Erica Kaufman West is a Board Certified Infectious Disease Specialist with Franciscan Physician Network. She is on the front lines battling COVID 19 at Franciscan Health hospitals in northern Indiana.Medical School Georgetown University School of Medicine, Washington, D.C.
Residency Cedars-Sinai Medical Center, Los Angeles, California
Fellowship in Infectious Disease
West Los Angeles Veterans Administration Medical Center
Cedars-Sinai Medical Center
UCLA-Olive View Medical Center
Transcription:
Scott Webb: COVID-19 has most of us sheltering in place, social distancing and washing our hands more than ever. It also has many of us confused and anxious. Joining me today to help us all understand how COVID-19 is spread and how we can stay physically and mentally. Well during this time is Board Certified Infectious Disease Specialist in the Franciscan Physician Network, Dr. Erica Kaufman-West. This special COVID-19 Podcast is brought to you by Franciscan Health. I'm Scott Webb. So Dr. Kaufman-West, you are an infectious disease specialist and I'm so thankful to have you on today. Do you believe that Americans really understand how serious COVID-19 is and if not, what do we need to know?
Dr. Kaufman-West: Well, I think Americans are starting to understand the virus and the disease that causes, I think that as we see the number of cases rise in various cities across the country and not just large cities like Los Angeles or Chicago or New York, but also in smaller areas and smaller cities and rural areas. I think that people are starting to see how dangerous this virus is.
Host: Well. Yeah. And it does bring up some concerns. Some questions I have too. I think we think we know how it's transmitted. But let's go through this. For example, when it comes to shaking hands, should we just stop shaking hands in general, with respect to COVID-19 the flu and everything else. Should that just be something we don't do anymore?
Dr. Kaufman-West: To start the way the virus is transmitted is by droplets. And what that means is so when you cough, if you don't cover your mouth or when you sneeze, you know those droplets fly out of your mouth at like 100 miles per hour literally. And so covering your cough and sneeze becomes very important. And because then you create a physical barrier. So those droplets don't fly everywhere on the person next to you and all over the counter that the desk or whatever's in front of you. Those particles then, the little spiddles that are landing on the keyboard and the telephone, those are what's infectious. And so if you touch that with your hands, you're not going to get sick. So this does not eat through your skin. It doesn't get under your fingernails. It doesn't go into the cracks of your fingers or hands. It just stays on your hand until you rub your eye, you know, pull at your nose, bite your fingernails. That's how the virus gets into you. And so I feel like there's been this huge rush to not touch anything or to put gloves on before you touch anything. But if you put a glove on and you touch the keyboard and then you touch your nose, nothing, you haven't changed anything.
And so the issue is as we keep saying hand hygiene so you don't have to stop shaking someone's hand, for example, in a normal flu season, as long as you then don't touch your eyes or nose or mouth. The problem that as humans we touch our eyes and nose and mouth our face, approximately two dozen times every hour or two hours. It's an incredible amount of times that we touch our face. And so the issue is stop touching your face and wash your hands often, and you probably won't have an issue. Because we are incapable of doing both of those things on a regular basis, then it becomes more important, especially under pandemic situations to not touch other people because of where they, you know, what they might've done if they wiped their nose or if they coughed in their hand and then they're going to shake your hand. So that's sort of the issues of transmission. I feel like people are, are misunderstanding that it's really the droplets that are the issue and those droplets getting into your mucus membranes as opposed to just touching something is not going to infect you.
Host: How about when we receive deliveries or we go grocery shopping? Do we need to wipe everything down? If I buy some bananas at the store, do I need to bring them home and wipe all of them down before we eat them?
Dr. Kaufman-West: Good question. I always recommend that people wash their fruits and vegetables. Bananas are a little different cause we don't usually cut through the skin of a banana. But even things that you cut through like an avocado, right? You cut that open. But if you haven't washed the outside of it, any germs that are on the outside, including more of an issue would be bacteria, that you would cut through and then put into your food. So you should always, no matter if there's a pandemic or not, wash all of your fresh fruits and vegetables before you eat them. People like will grab a grape at the grocery store and pop it in their mouth and that makes my stomach turn. Like you don't, you don't want to do that. So, that's the first lesson is wash off fruits, fresh fruits and vegetables. The second thing is do you have to wipe down, you know, the paper towel roll or something like that that you bought? The answer's no. It's just important to wash your hands. So if you pick up a package from outside, you know, you go get your mail, it's probably a good idea to set that down. Wash your hands and then don't touch your face. Those are always going to be my answers for things is wash your hands and don't touch your face.
Host: We've discussed some of the things here, but social distancing, which is a term that's sort of new to all of us and in general just staying home. Is that the way, the best way to flatten the curve here?
Dr. Kaufman-West: Yeah, so the virus is, I tell people the virus is not like a pack of wolves, right? It's not going to come to your house. It's not going to jump into your backyard and it's not going to break down your door. The way the virus is spread is person to person. So if you are not around any other people, you cannot get the virus, and that's the whole point of staying home. It's the whole point of closing bars and restaurants, it's the whole point of closing public parks. It's the whole point of not having movie theaters open is so that we are not sitting next to each other passing this virus from person to person. If everyone were able to stay home, the virus would have no one to keep it alive, right. That virus cannot stay alive unless it's in a person and has cells to replicate it. So staying home keeps you protected and it keeps your loved ones protected. And that's really, you know, that's what they talk about, flattening the curve. It's really decreasing the amount of people that are out there mingling and available to be infected.
Host: Exactly. And so the thing I want to talk to you about is perhaps one of the misconceptions that young people can't get COVID-19 what I'm seeing and hearing is that young people, early twenties and even kids, you know, my kid's age, going to the park, playing basketball, congregating, mingling, acting as if this is like the common cold and it's no big deal. It is a big deal. I'll rely on you, the expert. Tell us why it's such a big deal. And, and can young people get it right? Let's, let's set them straight.
Dr. Kaufman-West: Yeah, sure. So we know that children do get COVID-19. We know that in little kids, mostly under 10, it's pretty mild. And they do, they seem to recover and do fine. The older we get, the more difficult the illnesses, meaning the more symptoms and the worse you feel. And then the older you get, the higher the mortality rate is, in general. So we do know that 20 year olds do die from COVID-19, we know that 30 year olds die from COVID-19, but most 20 and 30 year olds are going to recover without having those catastrophic consequences. They don't feel well. They're going to have, you know, two to five weeks of feeling pretty terrible, but they, they're going to get through it. The bigger thing is that those young people need to think about who they come in contact with. So those young people probably have parents who are in their forties or fifties and they probably have grandparents who are 70 and they have uncles and basketball coaches who are 60, so it's all of those people that they come in contact with that they are ultimately saving.
So when you have a bunch of 20 and 30 year olds that go out and they get sick, that's not a big deal for them. But when they come back home and their mom takes care of them or they, you know, their grandma stops by and makes them dinner because they're not feeling good. It's those exposures and those people getting infected where we really see the fatality rates rise. So if I were going to say anything to young people, I would say it's hard as a young person to give up your spring break. It's hard as a young person to not have your prom. It's hard as a young person to not do those things that you have been looking forward to doing for two and three and four years. And I can empathize with that. But when you take a step back and you look at what can I do as a young person to save my family, what can I do as a young person to save my grandma, to save my uncle? The answer is very clear. It's stay home.
Host: So let's talk about the most special time perhaps for woman in their lifetime might be when they're having a baby, when they're pregnant, when couples are pregnant. Let's talk about pregnancy and COVID-19. Now I've heard that fetuses are protected from the virus, but of course the moms aren't. So what's fact and fiction here? What do we need to know? What do moms to be need to know about COVID-19?
Dr. Kaufman-West: Well, the first thing is that we don't have a lot of data, which is, which is good and bad. It means that not a lot of pregnant women have gotten infected, but the data that we do have mostly comes out of China so far. And what we know is that those mothers, those very few mothers that did deliver, had healthy children, they themselves did find during delivery and there was, did not seem to be any adverse effects on those children that were born. They did test the babies and while we would expect the babies to have antibodies, so in a way they're kind of protected because they do have the mom's antibodies. They did find that a couple of those babies did test positive. So they're not exactly sure if those babies picked it up sort of on the way out, you know, through the birth canal or in the handling after the birth or if there was some transmission through the placenta. So that part is not known yet. But so far what we know is that those pregnant moms seem to deliver healthy babies. The birth process itself is a little bit different as you can imagine. The baby does not get to snuggle with mom. The mom does not get to breastfeed right away. We don't want that baby to get infected. So you have to keep the mom's face away from the baby, which is, you know, hard to do when you're breastfeeding. So the mom can pump milk and they can feed it to the baby through a bottle. But as far as like that typical newborn snuggling right after delivery, we unfortunately can't allow that when moms are positive.
Host: I think lastly, Doctor, you know, there's so much we don't know, but there's so much you do know and you've been so helpful today. What's your sense of things? Are we closer to the beginning or the end? When we consider the goals of flattening the curve, making sure the test is available to everybody, and dare I say, you know, developing a vaccine. Where are we in this timeline, at least in your opinion?
Dr. Kaufman-West: Obviously the more people can stay home, the less people are going to get infected, the less supplies will run out of, the more hospital beds will be available. All of those things. I think that there's still a lot that can be done in the vast majority of this country to decrease the amount of people that are exposed and ultimately infected. And that's, I mean that's really my hope in doing this interview is to stress to people that it's not hopeless, that there is still a lot that people can do and just staying home helps us healthcare workers tremendously. We don't want to see you here. We don't want to see your grandma here. We don't want to call you and tell you that, you know, we don't have enough ventilators for your loved ones. Those are all things that no doctor wants to have to do. And so if everybody can stay home and do their part, you make our job a whole lot easier.
Host: And like you, I hope that, you know, through this, through podcasts like this that people learn it's not hopeless and there is light at the end of the tunnel. Right.
Dr. Kaufman-West: That's exactly right.
Host: Well doctor, thank you so much for your expertise and your wisdom and your advice today. Really awesome having you on. Thanks so much. To take a COVID-19 risk assessment, visit our website at franciscanhealth.org/COVIDaware. We hope you found this podcast to be helpful and informative. I'm Scott Webb. Stay well and thanks for listening.
Scott Webb: COVID-19 has most of us sheltering in place, social distancing and washing our hands more than ever. It also has many of us confused and anxious. Joining me today to help us all understand how COVID-19 is spread and how we can stay physically and mentally. Well during this time is Board Certified Infectious Disease Specialist in the Franciscan Physician Network, Dr. Erica Kaufman-West. This special COVID-19 Podcast is brought to you by Franciscan Health. I'm Scott Webb. So Dr. Kaufman-West, you are an infectious disease specialist and I'm so thankful to have you on today. Do you believe that Americans really understand how serious COVID-19 is and if not, what do we need to know?
Dr. Kaufman-West: Well, I think Americans are starting to understand the virus and the disease that causes, I think that as we see the number of cases rise in various cities across the country and not just large cities like Los Angeles or Chicago or New York, but also in smaller areas and smaller cities and rural areas. I think that people are starting to see how dangerous this virus is.
Host: Well. Yeah. And it does bring up some concerns. Some questions I have too. I think we think we know how it's transmitted. But let's go through this. For example, when it comes to shaking hands, should we just stop shaking hands in general, with respect to COVID-19 the flu and everything else. Should that just be something we don't do anymore?
Dr. Kaufman-West: To start the way the virus is transmitted is by droplets. And what that means is so when you cough, if you don't cover your mouth or when you sneeze, you know those droplets fly out of your mouth at like 100 miles per hour literally. And so covering your cough and sneeze becomes very important. And because then you create a physical barrier. So those droplets don't fly everywhere on the person next to you and all over the counter that the desk or whatever's in front of you. Those particles then, the little spiddles that are landing on the keyboard and the telephone, those are what's infectious. And so if you touch that with your hands, you're not going to get sick. So this does not eat through your skin. It doesn't get under your fingernails. It doesn't go into the cracks of your fingers or hands. It just stays on your hand until you rub your eye, you know, pull at your nose, bite your fingernails. That's how the virus gets into you. And so I feel like there's been this huge rush to not touch anything or to put gloves on before you touch anything. But if you put a glove on and you touch the keyboard and then you touch your nose, nothing, you haven't changed anything.
And so the issue is as we keep saying hand hygiene so you don't have to stop shaking someone's hand, for example, in a normal flu season, as long as you then don't touch your eyes or nose or mouth. The problem that as humans we touch our eyes and nose and mouth our face, approximately two dozen times every hour or two hours. It's an incredible amount of times that we touch our face. And so the issue is stop touching your face and wash your hands often, and you probably won't have an issue. Because we are incapable of doing both of those things on a regular basis, then it becomes more important, especially under pandemic situations to not touch other people because of where they, you know, what they might've done if they wiped their nose or if they coughed in their hand and then they're going to shake your hand. So that's sort of the issues of transmission. I feel like people are, are misunderstanding that it's really the droplets that are the issue and those droplets getting into your mucus membranes as opposed to just touching something is not going to infect you.
Host: How about when we receive deliveries or we go grocery shopping? Do we need to wipe everything down? If I buy some bananas at the store, do I need to bring them home and wipe all of them down before we eat them?
Dr. Kaufman-West: Good question. I always recommend that people wash their fruits and vegetables. Bananas are a little different cause we don't usually cut through the skin of a banana. But even things that you cut through like an avocado, right? You cut that open. But if you haven't washed the outside of it, any germs that are on the outside, including more of an issue would be bacteria, that you would cut through and then put into your food. So you should always, no matter if there's a pandemic or not, wash all of your fresh fruits and vegetables before you eat them. People like will grab a grape at the grocery store and pop it in their mouth and that makes my stomach turn. Like you don't, you don't want to do that. So, that's the first lesson is wash off fruits, fresh fruits and vegetables. The second thing is do you have to wipe down, you know, the paper towel roll or something like that that you bought? The answer's no. It's just important to wash your hands. So if you pick up a package from outside, you know, you go get your mail, it's probably a good idea to set that down. Wash your hands and then don't touch your face. Those are always going to be my answers for things is wash your hands and don't touch your face.
Host: We've discussed some of the things here, but social distancing, which is a term that's sort of new to all of us and in general just staying home. Is that the way, the best way to flatten the curve here?
Dr. Kaufman-West: Yeah, so the virus is, I tell people the virus is not like a pack of wolves, right? It's not going to come to your house. It's not going to jump into your backyard and it's not going to break down your door. The way the virus is spread is person to person. So if you are not around any other people, you cannot get the virus, and that's the whole point of staying home. It's the whole point of closing bars and restaurants, it's the whole point of closing public parks. It's the whole point of not having movie theaters open is so that we are not sitting next to each other passing this virus from person to person. If everyone were able to stay home, the virus would have no one to keep it alive, right. That virus cannot stay alive unless it's in a person and has cells to replicate it. So staying home keeps you protected and it keeps your loved ones protected. And that's really, you know, that's what they talk about, flattening the curve. It's really decreasing the amount of people that are out there mingling and available to be infected.
Host: Exactly. And so the thing I want to talk to you about is perhaps one of the misconceptions that young people can't get COVID-19 what I'm seeing and hearing is that young people, early twenties and even kids, you know, my kid's age, going to the park, playing basketball, congregating, mingling, acting as if this is like the common cold and it's no big deal. It is a big deal. I'll rely on you, the expert. Tell us why it's such a big deal. And, and can young people get it right? Let's, let's set them straight.
Dr. Kaufman-West: Yeah, sure. So we know that children do get COVID-19. We know that in little kids, mostly under 10, it's pretty mild. And they do, they seem to recover and do fine. The older we get, the more difficult the illnesses, meaning the more symptoms and the worse you feel. And then the older you get, the higher the mortality rate is, in general. So we do know that 20 year olds do die from COVID-19, we know that 30 year olds die from COVID-19, but most 20 and 30 year olds are going to recover without having those catastrophic consequences. They don't feel well. They're going to have, you know, two to five weeks of feeling pretty terrible, but they, they're going to get through it. The bigger thing is that those young people need to think about who they come in contact with. So those young people probably have parents who are in their forties or fifties and they probably have grandparents who are 70 and they have uncles and basketball coaches who are 60, so it's all of those people that they come in contact with that they are ultimately saving.
So when you have a bunch of 20 and 30 year olds that go out and they get sick, that's not a big deal for them. But when they come back home and their mom takes care of them or they, you know, their grandma stops by and makes them dinner because they're not feeling good. It's those exposures and those people getting infected where we really see the fatality rates rise. So if I were going to say anything to young people, I would say it's hard as a young person to give up your spring break. It's hard as a young person to not have your prom. It's hard as a young person to not do those things that you have been looking forward to doing for two and three and four years. And I can empathize with that. But when you take a step back and you look at what can I do as a young person to save my family, what can I do as a young person to save my grandma, to save my uncle? The answer is very clear. It's stay home.
Host: So let's talk about the most special time perhaps for woman in their lifetime might be when they're having a baby, when they're pregnant, when couples are pregnant. Let's talk about pregnancy and COVID-19. Now I've heard that fetuses are protected from the virus, but of course the moms aren't. So what's fact and fiction here? What do we need to know? What do moms to be need to know about COVID-19?
Dr. Kaufman-West: Well, the first thing is that we don't have a lot of data, which is, which is good and bad. It means that not a lot of pregnant women have gotten infected, but the data that we do have mostly comes out of China so far. And what we know is that those mothers, those very few mothers that did deliver, had healthy children, they themselves did find during delivery and there was, did not seem to be any adverse effects on those children that were born. They did test the babies and while we would expect the babies to have antibodies, so in a way they're kind of protected because they do have the mom's antibodies. They did find that a couple of those babies did test positive. So they're not exactly sure if those babies picked it up sort of on the way out, you know, through the birth canal or in the handling after the birth or if there was some transmission through the placenta. So that part is not known yet. But so far what we know is that those pregnant moms seem to deliver healthy babies. The birth process itself is a little bit different as you can imagine. The baby does not get to snuggle with mom. The mom does not get to breastfeed right away. We don't want that baby to get infected. So you have to keep the mom's face away from the baby, which is, you know, hard to do when you're breastfeeding. So the mom can pump milk and they can feed it to the baby through a bottle. But as far as like that typical newborn snuggling right after delivery, we unfortunately can't allow that when moms are positive.
Host: I think lastly, Doctor, you know, there's so much we don't know, but there's so much you do know and you've been so helpful today. What's your sense of things? Are we closer to the beginning or the end? When we consider the goals of flattening the curve, making sure the test is available to everybody, and dare I say, you know, developing a vaccine. Where are we in this timeline, at least in your opinion?
Dr. Kaufman-West: Obviously the more people can stay home, the less people are going to get infected, the less supplies will run out of, the more hospital beds will be available. All of those things. I think that there's still a lot that can be done in the vast majority of this country to decrease the amount of people that are exposed and ultimately infected. And that's, I mean that's really my hope in doing this interview is to stress to people that it's not hopeless, that there is still a lot that people can do and just staying home helps us healthcare workers tremendously. We don't want to see you here. We don't want to see your grandma here. We don't want to call you and tell you that, you know, we don't have enough ventilators for your loved ones. Those are all things that no doctor wants to have to do. And so if everybody can stay home and do their part, you make our job a whole lot easier.
Host: And like you, I hope that, you know, through this, through podcasts like this that people learn it's not hopeless and there is light at the end of the tunnel. Right.
Dr. Kaufman-West: That's exactly right.
Host: Well doctor, thank you so much for your expertise and your wisdom and your advice today. Really awesome having you on. Thanks so much. To take a COVID-19 risk assessment, visit our website at franciscanhealth.org/COVIDaware. We hope you found this podcast to be helpful and informative. I'm Scott Webb. Stay well and thanks for listening.