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Dr. Rai on coronavirus, kids, fall sports, and state tests

"Looking at that percent of (positive results) is really important."
Published: Jul. 23, 2020 at 11:37 AM CDT
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GREEN BAY, Wis. (WBAY) - It’s been a record-setting week for coronavirus cases and testing in Wisconsin. Prevea Health President and CEO Dr. Ashok Rai was on Action 2 News This Morning on Thursday to answer viewers’ questions about the coronavirus in our community.

ON WEDNESDAY’S 4.8% TESTING POSITIVE

“I’ve always said we’ve got to look at things in 14-day increments, but I’m never not going to celebrate a good number like that. So it’s great that the number was so low yesterday. Actually day -- yesterday -- and the day before that it was 7.7%, I think, or in that ballpark, so that’s much better than the two days of the 10-percentile range that we saw. And we just really want to hope that this negative trend -- and we may see a peak or two in there -- but we start to have a consistent negative trend down of that percent positivity. That lets us know that we’re getting better.

“Remember, we really want that magic number to be below 3 percent.”

ON THE VARYING TEST RESULTS

“It’s important to remember that there isn’t one lab. Like, when we started out in March there was the state lab that everything went through, and then we had a Milwaukee lab running it, as well. So things were a little bit more consistent. Now, tests are being sent to a multitude of labs in the state, which is great, but every lab has a different turnaround time -- most around 24 to 72 hours.

“So a test done on Saturday, and if you look at a worst-case scenario of 72 hours, that’s when you start getting your Tuesday results, and they’re going to be the lower numbers because testing sites aren’t open for as many hours on Saturday and Sunday. So when you look at numbers, say, on Thursday and Friday, you’re really looking at a representation of what happened Monday and Tuesday, which are some of the days that we have the highest level of testing. Remember, that’s the total number of tests being done.

“And you asked me what number to focus on, and once again, that’s the percent of positivity, because that takes away some of that how many tests were done, and you know, we had 1,100 positives. Well, 1,100 positives over 10,000 tests or 1,100 positive over 15,000 are two different numbers. So really, looking at that percent of positivity is really important.”

ON DR. FAUCI’S COVID-19 COMMENTS

“There’s a lot of viruses that we live with every day that are pretty well controlled that we don’t hear about, and I think that’s what Dr. Fauci is trying to say, is that the whole goal here isn’t to hope one day it just suddenly disappears, it’s about getting it under control through vaccinations and treatment, and understanding that testing and screening for it is probably going to be part of our lives for a very long time. But it’s not that the virus and how it’s affecting our lives so negative right now is going to be there for a long time, but just to know that it’s still going to be around us.”

ON QUARANTINING AFTER TESTING POSITIVE

“So the CDC actually changed their recommendations on Friday. I know this is really frustrating, but we keep learning more about coronavirus every day. So the CDC recommendations as they stand today is, after you have your first symptom, it’s 10 days going forward from there and the last day. So the last 24 hours, your symptoms should be resolved without medication -- Tylenol, ibuprofen to hold down a fever -- for you to be out of your isolation period. It used to be 10 days plus 3 days. Now it’s 10 days plus a day.

“And what they also found in the studies that led to this decision is, after you have your first symptom, you are most infectious for the next 10 days. You are going to...the virus that they kept isolating in peoples’ nose, it was replicating. In other words, it was a ‘pre-live’ virus. It was infectious. They have also found that after that 10 days, you will keep testing positive or you can keep testing positive for up to 12 weeks, but what they were getting there was the genetic material of the virus that was not replicating. In other words, it wasn’t infectious.

“So really what they did away with was this, get tested until you have to go back to work situation or go back to playing. Actually, the PGA is debating this today in some articles I read this morning. What it comes down to is, for 10 days after your first symptom, you’re infectious. After that, if you continue to test positive they don’t feel you’re infectious or as infectious for up to 12 weeks. Those numbers change if you’re severely immunio-compromised -- and really, in that position, a physician, specifically an infectious disease doctor, should be making the decision when you are safe to get back into the public.”

ON KIDS AS VIRUS CARRIERS

“The research is a little split on this. Remember, kids, we’re talking from zero to 18 years old, so you kind of have to break them up into different age groups. So say an older kid above 10 years old to 18, usually their physiology, their size is getting close to being adult size, and we’ve seen in some articles they spread it just as much as an adult.

“When you look at younger children, say an infant to to a smaller child, there isn’t great research into whether they can spread it or are spreading it as much as an adult. A lot of work is being done there -- and remember a lot of this research is looking back and a lot of the people we tested early on were adults because they’re the ones who get affected the most by it, they get sickest. Now if the children don’t get sick and they can also be at risk for that after-effect, that Kawasaki-like syndrome, so a lot of research hasn’t been done on tested children yet, so we don’t know. But we do know in older children that they spread it like adults.”

ON THE VIRUS ON YOUR SKIN

“we have different research for skin, for plastic, for paper. I think we’ve debated the surface thing for a while now and a lot of research is still being done, like I said, on the first question we’re going to frustrate you. We’re going to learn more and change our opinion on this. What we have learned is while the virus lives on surfaces you’re likely not going to get infected as badly as if you got it from a respiratory particle. In other words, for you to get infected from a surface, whether it be skin, plastic, the table in front of me is that the virus, you have to have a good amount of it on that surface. You have to then have it transferred to your hands, get a good amount of it, and then you almost immediately have to put it in your mouth or your nose for you to get infected -- unlike inhaling it, which gives you a really large amount of the virus in your body to get infected.

“So yes, it can live on your skin. We have varying different lengths of time for different surfaces, but probably the most important thing is it’s not the most common way you’re going to catch the disease. You still could, so it’s still important to wipe things down and definitely wash your hands.”

ON TRAVELING WITH UNDERLYING HEALTH CONDITIONS

“If you don’t live with people and you suddenly decide to go live with people -- in other words, three families decide to get together in a cabin -- your chance of spreading the disease if one person is carrying it goes up significantly.

“So, number one, make sure if you’re going do it -- which we’d recommend, you know, you find a different way -- but if you’re going to do it, make sure nobody has symptoms, checking temperatures and everybody has not been in a situation where they could have been exposed recently. The second part of that is, if you have three people who are immune-compromised in any way -- have COPD, have cancer, have diabetes -- those people definitely should be staying home. We don’t want to add the risk to that situation. So it’s a risky situation to begin with, and you’re adding more risk to that.”

ON WIAA FALL SPORTS

“If we looked at how we were supposed to reopen the state in a phased-in manner to prevent significant breakouts and then make sure that we had the capacity, we didn’t do that, and we had some breakouts purely due to that reason. If you’re going to do anything in a smart manner, you want to phase it in. And you want to phase in the most important thing and then everything else you want in life.

“So I would say that educating the children would be the number-one priority, and physical fitness is extremely important for our children, as is competitive sports. I have children that play, as well, and I want them back on the field, but really the priority should be let’s try school out, let’s make sure it’s safe, let’s not use up valuable testing resources to make sure that we can do athletics safe. Focus on one thing, make sure we have that right, then open it up to another thing, which would be athletics.

“I think as much as I want to see fall sports for high school students, and I understand the huge implications for seniors, especially, for the NCAA and all the money that’s involved in that decision, we really want to make sure that the children are safe and society stays safe. So let’s focus on education first, make sure we’re doing that right, and then phase in sports.”

ON SCHOOL LUNCHES

“You know, like we handle masks in a bar and restaurant, you take it off when you eat, you put it back on when we’re done. Make sure the kids are physically distanced -- which can be a little difficult, and I think lunch time is going to be a little difficult to manage -- but really they’ll flip [the mask] down when they eat, put it back on when they’re done eating and try to maintain that distance.”

ON AIR CONDITIONERS AND VIRUS SPREAD

“A lot of work needs to be done on this, and there’s going to be different studies. And remember, one air-conditioning unit, whether it be wall-mounted, is it a house, you know, outside air conditioner, what’s the air exchange from the outside to the inside. All of that needs to be taken into account. So I think a generalized statement, by saying air-conditioning is bad for COVID, is probably not the right thing. It really depends on how much air is being exchanged with the outside. In other words, getting rid of the bad air, bringing in good, outside air, and how often is that happening. That’s really important. The recirculating of air within an enclosed environment, if COVID is there, probably not a good thing. But once again, it really depends on the type of HVAC system we’re talking about.”

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.

Copyright 2020 WBAY. All rights reserved.

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