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Dr. Rai: Sources of coronavirus infection are more widespread

This most recent breakout affected more people in their 20s. "Now we’re starting to see people older than that."
Published: Jul. 21, 2020 at 10:15 AM CDT|Updated: Jul. 21, 2020 at 11:42 AM CDT
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GREEN BAY, Wis. (WBAY) - Wisconsin recently added more than 10,000 coronavirus cases in 2 weeks, and the percentage of COVID-19 tests coming back positive has trended upward every day for the past five days.

Prevea Health President and CEO Dr. Ashok Rai is back on Action 2 News This Morning to answer viewers’ questions about the pandemic and staying healthy when there’s a rising percentage of active cases.

GREEN BAY FACE MASK REQUIREMENT

“I think it’s important to understand the ‘why masking?' first. Back in March we said, ‘Don’t wear a mask.' Then in April we started to say ‘Wear a mask.'

“When it came to March and the early parts of the coronavirus, remember we’re learning every day, and the science is going to change as the science actually develops. So initially we said don’t wear a mask because it’s not going to protect you from the coronavirus. In other words, it’s not going to protect you from getting it. Still today, masks offer very little protection for you to get it. What we started to see in April was something very unique about this disease, is that it was being spread by people who did not have symptoms -- they were either asymptomatic the whole time or they were pre-symptomatic. In other words, they could spread the disease before their first cough or before their first fever. And knowing that it’s an invisible enemy, per se, the only thing that would protect or mitigate people from catching the disease was to wear a mask to prevent that spread.

“So it’s kind of like other health ordinances. Take smoking ordinances, for example. We used to be able to smoke on planes, then you used to be able to smoke only on certain sections of planes. Smoke in a restaurant, then you had the smoking section in a restaurant. And what we discovered over time, that no matter where that was in an indoor setting, that that secondhand smoke harmed people. So there’s no smoking publicly.

“Think about wearing a mask, preventing COVID-19 from escaping your mouth. You’re preventing an invisible enemy, invisible secondhand smoke, from hurting other people. So like other health ordinances, which are in the best interest of public health, such as a smoking ban, having people wear masks to prevent the spread of COVID-19 while it’s still prevalent in our area, and doing it inside, makes sense. So there’s kind of a comparison there, and that’s why the ordinance is being presented.”

BACK-TO-SCHOOL PLANNING

“I think the single most important message is, number one, understand that the schools are trying to do their best to mitigated the spread. In other words, try to prevent spread once it happens inside a school. That has the underlying fact that there’s a low chance of it actually entering the school. In other words, the percent positivity has to be at a low level. That’s the number of positive tests versus the total number of tests being taken in an area. Right now in the state of Wisconsin, that’s pretty high. Over 10 percent is a really high number, and it’s been trending in the wrong direction. We went 5, 6, 7, now 10 [percent]. You want that number below 3 percent ideally, and that’s what we need to be able to focus on for schools. They have all the right plans if we have a low number of cases in the area -- so it’s really area-specific -- and making sure that the case total number, or the percent positivity, is lower.

“Back in March and April we asked you to flatten the curve for health care so we could be able to take care of other patients and prepare for this. Now essentially we’re asking you to flatten the curve to keep the economy going so people don’t have to go backwards and to get kids to school. So the only ways we know how to flatten the curve is physically distance, stay home if you can, and wear a mask. Not a whole lot of tools available to us. But they are what they are. And if we flatten that curve, kids could possibly get back to school.”

HOW RELIABLE IS TESTING?

“It really depends on how you’re doing, and there’s different types of COVID-19 tests, but let’s talk about the most common, the one based on genetic material, or the PCR test. If it’s negative, you have a pretty good confidence, about 95%, that you’re negative. If you’re having significant symptoms that are still consistent with COVID-19 and we can’t find another cause for them, there may be a reason to take another test; there could be a false negative. They are rare, but they do exist, and what we want to be able to do is, if you’re still having symptoms and you come back negative, still isolate yourself until those symptoms have another cause or they go away.”

TESTING AND CONTACT TRACING

“More testing is exactly what we want to do, and we’ve opened up sites throughout the community using the same exact test kits and same exact funding through the state. What we did instead of having the mass sessions and longer lines is we spread that out throughout the community, and you can see that online where to go to get tested. Either insurance will pay for it or we’ll send it to the state and it is free. But it doesn’t actually improve contact tracing. Remember, contact tracing isn’t done at the time of test, it’s actually done after the result is positive, so it doesn’t matter if we do [Resch Center] or Casa Alba or a site in central Ashwaubenon. Wherever that is, contact tracing is done in the background. But as we start to see more prevalence, we’re going to have to open up more sites and we’re going to put it where peple live so it’s easier for them to get to.”

(You can sign up for testing at MyPrevea.com. You do not need to be a Prevea patient but you will need to create a MyPrevea account. Similarly, you can register at MyBellinHealth.org or contact your local health department and inquire about testing.)

WHERE IS COMMUNITY SPREAD TAKING PLACE?

“We don’t talk to [contact] tracers directly, but we get our data and we look at employers, we talk to patients, and it’s definitely changed over time. March and April we had four buildings in town, in manufacturing plants that we had an issue, and the things dissipated pretty well. Then we started to see more cases. We really look at the service industry -- you know, bars, restaurants, retail -- where we started to see more spread, and that was over the last couple weeks.

“Now we’re starting to see different age groups. Initially we were in this breakout seeing 20-29 year olds. Now we’re starting to see people older than that. It’s really widespread. So there’s not one specific area. There’s still the service industry, because there’s so much of that indoor, face-to-face contact that’s the highest risk, but you’re seeing it in other industries, too -- parts of health care, in retail outlets, so kind of everywhere right now.”

FLYING

“First of all, the airline is going to ask about symptoms. If you have symptoms, you have to delay [taking] that flight. They’re going to check your temperature. If you have a temperature, you’re going to need to be tested and delay the flight. Most important thing, they’re requiring masking. They understand that will stop the spread within the enclosed space, and they’ve spaced people out a little more. The most important thing you can do is make sure you have a mask that you’re comfortable wearing the entire flight and making sure it’s an appropriate mask that covers your nose and mouth and your chin. I always like to recommend taking sanitizing wipes with you -- and they’ll sanitize your seat, but you know a second sanitization never hurts -- and have plenty of hand sanitizer if you can’t wash your hands.”

NECK GAITERS

“I have a mask with me, and I’ll put it on. You’ll notice I only adjust it from the outside, and my ear pieces. Around my nose it’s sealed, and it sealed around my chin. So if a neck gaiter comes down here and it seals the chin area and it’s over the nose, then it’s an appropriate facial covering. If not, people who let it drift above the nose or those who let it drift above their chin, then it’s not. Sometimes I’ve seen people wear a neck gaiter who let it drift up; that’s inappropriate.”

Neck gaiter
Neck gaiter

FACE SHIELDS

“I think it’s an unfortunate misunderstanding because a lot of people watch us in health care having a face shield on. What they forget is, we’re wearing a mask and a face shield, and ask us, ‘Why are you wearing a shield?' We’re wearing the shield actually to protect the eyes and to protect a secondary barrier from getting the disease from somebody else. So really, a face shield is there, it does not prevent you from spreading the virus to others because obviously it leaks around and it leaks down. It doesn’t have that good seal around the chin and the nose, so a face shield is not a replacement for a mask. No evidence of that at all. Why do we wear a face shield? To protect ourselves from it coming into our eyes. Usually we wear a face shield with goggles.”

SINGING IN CHURCH

“A mask does prevent the particles from being expelled forward, so when they looked at singing [without a mask] they said six feet is not enough; you need to double or triple that amount, because your singing is expelling those particles much farther. What a mask does, it prevents the particles. You still need six feet, but you don’t need more than six feet, so a mask does help. There is a little bit with that force expulsion side to side, so you definitely want to make sure you have that six feet left and right, not just to your front, when you’re seeing.”

HOW TO ASK A QUESTION

Dr. Rai will continue to join us on Action 2 News This Morning on Tuesday and Thursday. We’ll also carry it on Facebook Live. Have a question for Dr. Rai? Email news@wbay.com.

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