Stay Informed
MEDICAL AND MENTAL HEALTH UPDATE
Today I’ll give you some inside scoop on what I’m hearing, seeing, and discussing with my medical colleagues in DC and around the country this week—and then sharing with my patients in the office.
Namely: DOCTOR TALK (translated into normal words).
Aerosol alert! More news about viral transmission via aerosols came out this week.
What’s the deal? Researchers at the University of Florida released a (not-yet-peer-reviewed) study demonstrating that it is possible to capture and isolate live virus from aerosols collected at a distance of 7 to 16 feet from patients hospitalized with COVID-19—which is farther than the six feet recommended in social distancing guidelines.
Sounds scary, right? Well, before you hit the panic button and wrap yourself in cellophane, let’s back up. We already know that coronavirus can be spread by aerosols (the tiny mist of particles that we emit when talking, sneezing, etc). What’s NEW here is the ability to find coronavirus inside a tiny particle this far away from an infected person.
BUT WAIT: this study, while very cool and interesting, still does NOT tell us whether the amount of virus in those 16-foot-away particles is enough to infect an actual HUMAN. It’s also very likely that the masks we already wear would prevent far-flung viral particles from entering our bodies anyway. All of this warrants more study and is NOT reason for panic, despite the New York Times’ headline “A Smoking Gun.” (IMHO, we are already doing fine in the panic department.)
UPSHOT? The major source of transmission for coronavirus has not changed: we know that coronavirus is spreading mainly through the larger respiratory droplets that fall within six feet from our faces (and closer if we wear a mask!) Our best defense is still MOSH PIT. We already should be socializing six feet apart and outside to prevent spread by aerosols that get nicely conveniently swept away by nature’s breeze. Another upshot that’s not new? Indoor ventilation matters. For schools, subway trains, and other closed spaces, good ventilation will only help reduce viral transmission from aerosolized particles.
So does this Florida study make me change my own behavior or counsel patients any differently? NOPE. If you show me data that the amount of virus in an aerosol from a 16-foot-distance is ENOUGH to infect a human being who is already wearing a mask, then I will change my mind.
What is a superspreader?
We think that 80% of people infected with coronavirus spread the virus to 1 or 2 people, and that 20% of people spread it to 8 or more people. The superspreader phenomenon does NOT mean that the virus remains airborne for longer than we think—like the measles virus which can hang in the air for hours. Superspreading can happen simply because of transmission via droplets. Think: crowded bars, campers singing together, indoor parties, etc.
Masks are finally catching on.
They work!! Wearing a mask is NOT a political issue whatsoever. Wearing a mask is about science, public safety, and respecting others.
New studies over the last few weeks confirm what makes sense intuitively: that masks not only prevent other people from catching our germs, they somewhat prevent the wearer from getting sick, too.
(More next week about eye protection and the hideous yet strangely comfortable goggles I’m wearing here.)
We are learning that some people with COVID-19 feel unwell for quite a while.
It seems that particularly people with more severe cases of COVID-19 can have lingering symptoms like fatigue, difficulty breathing, chest tightness for quite some time—even months. We are calling these people “long-haulers.” How common is this phenomenon? The virus is too new to know, but time and more research will ultimately help determine who and why some people have a long “tail” of symptoms.
Testing.
The testing landscape continues to be abysmal in the U.S. We still don't have a nationally coordinated program, there are long delays in getting test results (which can render the test useless), and understandably the public remains confused about which test and when. I will revisit this issue again for sure!
I continue to advocate for Michael Mina’s plan to use rapid, cheap, self-administered tests. The technology exists. We just need to get them OUT THERE TO THE PUBLIC. If and when we blanket the country with these tests, they have the potential to be game-changing.
Russia’s vaccine.
Russia has a vaccine. Hmmm….While I certainly hope it goes well, it reminds me of the Saturday Night Live skit from the 90s called “Bad Idea Jeans”: it’s just not a good idea to take a vaccine that has not been adequately tested for safety and efficacy. Administering that vaccine without phase 3 trial safety and efficacy data would be akin to boarding a brand new airplane that you’d been promised was “really great” but had never flown in the air. Buckle up!
That’s all for today.
Join me TOMORROW at 12:30 ET on Instagram live! I will be talking with Dr. Hina Talib, adolescent medicine physician in New York City, about the back-to-school landscape—and its mental and physical effects on our high school and college students.
I will check in next week. Until then, be well.