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This Healthy Conversations COVID-19 podcast was recorded on July 30, 2020.

Prakash Chandran (Host):  In the midst of this pandemic, it’s difficult to determine the accuracy or falsehood of the information we’re getting around Coronavirus. Fortunately, infection experts and professionals are debunking the myths and confirming truths about COVID-19. We’re going to talk about it today with Chris Ecker, Infection Preventionist at Tenet Health. This is Healthy Conversations, the podcast from Tenet Health Central Coast. I’m Prakash Chandran. So, Chris, it’s great to have you here today. Let’s just start with the question, is there any drug at all that cures COVID-19?

Chris Ecker, MPH CIC (Guest):  No, unfortunately not. This virus in particular is new to humans so none of the medications that we had kind of preexisting really affect it that much unfortunately. As far as preexisting medications you might have heard of like to get a little bit of insight. You may have heard of like remdesivir. We’ve been prescribing that. At best, it kind of slightly improves the patient’s outcomes. It’s by no means a cure. We really only prescribe it if we catch the symptoms early. It will shorten the symptomology maybe by a few days. But it’s definitely not a cure. There are kind of ICU techniques that have been found to be pretty helpful like steroids, anticoagulants, Actemra. These kinds of things help if as you may have heard COVID-19 kind of increases blood clotting to an extreme level. So, those will help with that. Proning, just lying the patient on their stomach actually has been shown to increase oxygenation to the lungs. But I know the one that’s gotten a lot of attention is hydroxychloroquine. So, I wanted to give a little bit of background about that because I’ve definitely looked into it.

At first, in March, it was very promising because it was shown to kill the virus in vitro or in the petri dish in the lab. And so, they had hoped that would also work for humans. But a lot of studies have been done since then and they are showing that it does not reduce symptoms in people. It doesn’t decrease risk of catching COVID-19 and it doesn’t help with the treatment of the patients and actually on top of all that, it can cause irregular heartbeat which can lead to cardiac arrest. And definitely since there’s so many kind of competing opinions about hydroxychloroquine, I wanted to cite my sources and if you bear with me for a second, it’s called – if you would like to read a study called Outcomes of Hydroxychloroquine Usage in United States Veterans Hospitalized with COVID-19. They actually studied over 800 patients in a Veterans Hospital that had been diagnosed with COVID-19. About half were given hydroxychloroquine, about half not. The study found no real benefit from the hydroxychloroquine.

So, unfortunately, we hoped for that one, but it’s really been shown to not be that effective.

Host:  Yeah, that’s the one that I was hoping – I’d heard so much about but it’s really interesting to hear that research study and kind of sad to hear that we don’t really have anything yet. Something else that was brought up in the media was around consuming external bleach or disinfectants to protect you. Can you talk a little bit about that and maybe either some of the dangers around it or why people started saying that in the first place?

Chris:  Oh sure. Yeah well first of all, absolutely do not do those things. Please do not ingest bleach or even put it on your skin. The reason bleach is so good at killing bacteria and viruses and mold is that it reacts very strongly against organic material. The problem is our bodies are made of organic materials. So, it’s very harmful. And then as far as UV light goes, UV light is great but the problem is there are only certain wavelengths of the UV light that are effective at killing viruses and it kills them by kind of damaging their DNA and RNA but again, our bodies need our DNA and RNA so we can’t use that wavelength of UV light on our bodies without pretty bad side effects.

Host:  Yeah. What about – I saw kind of early on, this video online where someone was using like a hair dryer in their nose accompanied with a spray bottle, right? I don’t know if you’ve seen that. But I’m curious about extreme temperatures both hot and cold. Does that have any effect on the virus at all.

Chris:  It does but unfortunately, the extremes – extreme hot, extreme cold are so extreme we don’t really encounter them in our like normal environment. It has to be so hot or so cold to kill or inactivate the virus that it’s not really any kind of feasible way to deal with the virus for humans. And I would definitely caution anyone with blowing hot air up your nose, that sort of thing. The more you dry out your nasal passages, the more you actually make yourself susceptible to not necessarily COVID but any kind of sinus infection or any other bacteria that might kind of get in there. So, I would not use a hair dryer in my nose.

Host:  Okay, this is good advice. So, let’s talk about who can contract COVID-19. There’s a lot of thought around there that this really only affects adults or people – a much older people with preexisting conditions. Can you talk a little bit about that?

Chris:  Oh sure. Yeah, I’ve heard a lot of kind of talk on the news about can children get it, that sort of thing. We’ve actually known since the beginning; children definitely can contract COVID-19. In fact, a few dozen children in America under 15 have died from contracting COVID-19. So, they definitely can get it. Children definitely can suffer severe symptoms in addition to dying. Do they tend to get less severe symptoms? Sure. But it doesn’t necessarily mean that they are safe from this and in fact, small children have even been shown to develop a unique syndrome called MISC or multisystem inflammatory syndrome. And it’s thought to be kind of the body’s immune response to contracting COVID-19 and it’s typically a really painful swelling of the heart, kidneys, blood vessels in response to the virus. So, if any children experience like fever, rash, swollen hands or feet, stomach pain; they definitely need medical attention in relation to MISC or even relation to other infections.

Host:  Yeah, I wanted to ask you about that. Because it seems like shelter in place was ordered a couple of months into this and people seemed to listen at the beginning. And it looked like the curve was either flattening or starting to go down. And then obviously, a lot of things happened here. And after that, people I think just got tired of being inside and now it seems like this has resulted in an increase. So, can you talk a little bit about those dynamics and your opinion on why we are where we are today?

Chris:  Yeah absolutely. San Luis Obispo County did a great job even now where as far as kind of central to southern California goes. We’re more fortunate than a lot of other counties. But the county’s timeline kind of was we had our fist cases in early March. We had the lockdown and business shutdown in mid-March. And then they ended the lock down and business shutdowns around late May early June. I looked into it. during the months of March, April, May, during the lockdown Slow County averaged about 25 new cases per week. Since one week after the lockdown ended and businesses were allowed to reopen, the county has averaged about 150 new cases per week. So, that difference in the spread of the virus is about six times worse lockdown versus post-lockdown. And just as an example, between March 1^st and May 27^th, the county had about 263 positive cases. Just in the last week, we had over 350. So, the lockdown, the business shutdown definitely helped the spread, definitely flattened the curve as they say.

But yes, it’s definitely since the lockdown was lifted, the spread has really risen.

Host:  So, let’s talk about how you protect yourself from COVID. I think there’s been a lot of talk around herd immunity, getting to a place where we’re all protected but that certainly doesn’t seem to be the case given the numbers that you just mentioned. How does one go about staying safe?

Chris:  Yeah, there is a lot of talk about herd immunity. I know some countries kind of gravitated towards that in the beginning. Unfortunately, we’ve definitely found that to achieve a herd immunity requires a lot of deaths. So, we do not want to do that. The best way that just listeners or anyone can protect themselves from COVID, the best way to avoid COVID-19 is by avoiding other people unfortunately. Try not to go out unless it’s necessary, just food, gas, work, that sort of thing. If you do go out, wear a mask definitely. It helps protect other people from you and other people’s masks protect you from them. And definitely use hand sanitizer. It’s great like if you go to the grocery store, as soon as you get back in your car, but beyond that, outdoor businesses are safer. But especially indoor ventilation kind of closed off systems are much higher risk. But in essence, the best way to avoid COVID is just to avoid people.

Host:  And I did want to spend some time on the virus itself. I think a lot of people don’t really know what COVID-19 is. And I guess my question would be is it a type of flu or cold? And then also, then talk a little bit about what the relationship between underlying conditions and this virus is.

Chris:  COVID or well I guess the virus is technically called SARS-COV2, but it causes the infection known as COVID-19. It is a virus. And the cold and the flu are also viruses. And humans even get infected by other coronaviruses which is a type of virus. But this is the first time that this specific virus, SARS-COV2 has been affecting humans. So, that’s why there’s such an issue because we have no immunity to it. we have no experience with it. Interestingly, the risks of a rare virus like this jumping from animals like bats to humans has been known for a long time. It’s been identified that this virus likely came from Chinese Horseshoe bats, but studies have said that that’s a real possibility and had humans and these animals not interacted, the virus likely wouldn’t have jumped to humans. So, the concern with that then is also that there are – there’s pandemic potential viruses in pigs, in chickens that could easily cross over to humans and create this whole system again.

And then as far as kind of underlying conditions with the virus. It’s kind of similar to any other virus for people who are older, immunocompromised, diabetic, that sort of thing. It definitely tends to affect them more, kind of puts them more at risk if they do get infected of having severe symptoms. But yeah, it’s also important to note that a lot of people even without any underlying symptoms, very young, very healthy; are getting it. Some are dying. A lot are experiencing long term affects; weakness, feeling sicker than they’ve ever felt but for weeks or months at a time. So, we look at lot at the rate that people are dying but it’s also important to note how bad it is even if you don’t. So, you definitely want to take every precaution you can.

Host:  Yeah. I definitely think people don’t take this seriously enough and I would bucket myself in that category as well. I think as so much time passes, you kind of forget that getting it, even though it’s not fatal, it just can be miserable to go through and that also, that if you catch it, and you’re asymptomatic; you could spread it to other people. So, I think one of the things you mentioned is the best way to avoid getting and contracting COVID is to avoid people. As we wrap up here, is there anything that you really want our listeners to know, just given all of the research that you’ve done and the facts that you’ve collected?

Chris:  Sure. Well I feel like – personally I feel like it’s important for people to know, it’s perfectly natural right now to feel anxious, scared, angry about the situation. So, if you are feeling any kind of negativity like that lately, we’re literally living through a historic global pandemic. It’s a big thing. It’s okay to feel those things. But I caution everybody that I think our tendency is to gravitate toward seeking solace in promises of like easy answers and lies and kind of thinking that there’s a secret answer out there that people just haven’t thought of that’s going to fix things and it’s really not. It’s unfortunately just something that we have to be patient with and try to take care of ourselves and I just encourage everybody to try their best to be patient and really think about things and take care of themselves.

Host:  Yes. And it sounds like, and correct me if I’m wrong, the only way to really beat this is if everyone really takes all the precautions that we mentioned today so we get to the point where people aren’t infected and that could take a long time and then we finally get to a place where it just doesn’t exist in our geography or our demographic any more. Is that correct?

Chris:  Yeah. I think the hope is that if we can be patient, protect ourselves, a vaccine will be created that either kind of provides immunity, long term or even just kind of like the flu shot is something that we just need to get kind of on a yearly basis, that sort of thing just to strengthen our immunity. But yeah, I think definitely, this is a really hard time. But if we look at like 2025 and look back at it, we’ll think wow, that was really hard time, but we will have made it through. And I think it’s important to keep that kind of long term view to give people optimism, especially if they are having kind of a hard time right now.

Host:  Well Chris, I think that is the perfect place to end. I really appreciate your time today. This has been hugely informative. That’s Chris Ecker, Infection Preventionist at Tenet Health. Thanks for checking out this episode of Healthy Conversations. If you found this podcast helpful, please share it on your social channels and ve sure to check out the entire podcast library of topics of interest to you at www.tenethealthcentralcoast.com/about/podcast. This has been Health Conversations, a podcast from Tenet Health Central Coast. Thanks and we’ll see you next time.