This pace is not sustainable: Dr. Rai on how COVID stresses our hospitals
GREEN BAY, Wis. (WBAY) - “It’s an hour-by-hour situation in Green Bay and in the Valley if we have a bed or not. It’s a pretty critical situation. If we don’t see that back down, this pace is definitely not sustainable,” says Prevea Health President and CEO Dr. Ashok Rai on the COVID-19 situation in our area.
Dr. Rai joined us on Action 2 News This Morning Thursday to give us an update on the hospital situation and why no one should compare COVID-19 to flu.
Dr. Rai joins us each Tuesday and Thursday. Have a question? Email email@example.com.
The state is averaging about 2,000 new cases of COVID-19 per day. How long can hospitals sustain the outbreak?
“It really depends on how many of those patients actually need to come into the hospital. That’s really what the concerning part is, and more and more do. People say, well you only have 80, 130 patients in Green Bay in the hospitals. Understand that that those are beds that are needed for other medical patients. That’s what’s causing that total strain. So when you see 2,000 cases a day, and then you start to look at the percent that are probably going to need a hospitalization and understand that capacity is essentially at it’s limit; it’s an hour-by-hour situation in Green Bay and in the Valley if we have a bed or not. It’s a pretty critical situation. If we don’t see that back down, this pace is definitely not sustainable.”
BROWN COUNTY SPIKE
Brown County reported 245 new cases of COVID-19 Wednesday.
“I’ve always said try not to look at it day by day because we don’t know about the testing timing. Was that all from one days worth of tests or two days worth of tests? Especially coming off a weekend. Midweek seeing that type of spike definitely caused all of us some great concern.”
The state of Wisconsin has activated a field hospital on State Fair Grounds in West Allis.
“Number one, we’re obviously thankful for the state for setting this up. We hope not to need it. As it stands today, at least the Green Bay hospitals, I don’t think there’s an intent to transfer anybody today to it. It’s got very strict admission criteria to get there. You have to be pretty healthy, actually, that may seem weird, to get there. In other words, requiring a low amount of oxygen. Being under a certain weight limit to be accepted down there. So you’re really close to going home when you’re going down there. This isn’t somebody out of the emergency department that has to come in for intense therapy is going to be transferred to Milwaukee. No. This is somebody who has been in the hospital probably in the last day or so of their admission, and transferred down there to create room for the next person. Hope we don’t need that. As you can see, that’s not a hospital bed. That’s a cot. You’re not allowed to have visitors. It’s definitely a desperate situation. We appreciate it being set up. We hope we don’t have to use it.”
COVID VERSUS FLU
"Influenza spreads but definitely not like COVID does. It doesn’t spread from an asymptomatic carrier, you never know you have it and you’re getting other people sick. When you have the flu, you know you have the flu. Probably the biggest difference is on the outpatient side, we have therapeutics. So when you get influenza, if it’s early enough, we can give you medication to make you better. We don’t have that for COVID. And we’re nine months into COVID and it hasn’t really gone away and we’re starting to see surges. Versus influenza, which we definitely know is seasonal. Calling it the flu, any kind of comparison to the flu is just wrong. It’s comparing an apple to an orange, definitely. Outside of them both being viruses and affecting your lungs, I think the comparisons should stop at that point.
“It’s [flu] not a nine-month issue. It’s definitely a seasonal issue. We’ll start to see it [flu] late October, early November. By April, we start to see it dissipate. COVID’s obviously not showing any signs of dissipation right now.”
SWABBING BOTH NOSTRILS
“If you remembered early on when we started testing for COVID-19, we used a very long swab, kind of in the back of the nose, and it was a really deep sample. We call it a nasopharyngeal sample. As testing evolved since May, we were able to start getting equivalent results using a nasal sample, not having to go as far back, a lot more comfortable. But to get adequate amount of sample to test for the virus, we need to be able to swab both sides.”
MASK AND SEVERITY OF COVID-19
Does wearing a mask reduce the severity of COVID-19 in someone who catches the virus?
“It’s a great debate because it’s actually going on in the scientific literature right now. A doctor named Monica Gandhi wrote a nice article in the New England Journal of Medicine around this and some theories that she has and some data to back it, but it obviously needs to be researched more, that if you’re wearing a mask, the viral load, the amount of virus you’re exposed to, is much smaller than say, if you’re not wearing a mask. So the infection is milder. You could have zero-to-few symptoms. And it will then give you some sort of 90 days of immunity. Big issue there--hasn’t been proven. So right now the only reason to wear a mask is to prevent you from giving COVID-19 to somebody else. Remember, we’ve only had six months to study this. People are studying to see if a mask can maybe also help you from getting less infected, but still being infected.”
HOSPITAL OVERCROWDING AND NURSING HOMES
“Unfortunately, the COVID situation is affecting more than the hospitals and clinics, it also affects nursing homes. If a nursing home has any kind of outbreak--and remember the state defines an outbreak in a nursing home as one case, one staff member, one patient--they may not be able to, depending on how they’re structured, take any more patients. Even though it would be safe, the state says no. That creates a backlog in a hospital of other patients that need to leave, not enough room for everything. Not only COVID patients, but the strokes and heart attacks. So COVID is actually causing the whole system to back up right now.”
COVID-19 VERSUS H1N1
What is the difference between COVID-19 and the H1N1 swine flu?
“First of all, the incubation period for H1N1, you know, one day to two days. Incubation period for COVID-19, up to 14 days. So you would know you’re infected right away with H1N1 and you could be quarantined right away, or you’d stay home at that time. COVID-19 you could be out there spreading it. Spreads much more rapidly. With H1N1, we were looking at younger people and pregnant women that were more severely affected. The opposite with COVID-19. H1N1 was mainly a respiratory virus that if your lungs failed, other organs were failing. COVID-19 directly affects more than just your lungs. Your heart. Your brain. So a lot of differences between the two, on top of it, affecting more people and killing more people, COVID-19 that is, versus H1N1.”
VACATION DESTINATIONS AND COVID COUNT
How are visitor COVID cases counted?
“I’ve had to ask this question a couple times of our public health in the state, and it’s the county that you live in. So when you get tested and you write down where you live, that’s what goes in the Wisconsin computer system called WEDSS. And that’s how it’s reported. Number one, it’s dependent on where you live and where you say you live. But it’s the county in which you live in.”
SYMPTOMS AND WHEN TO GET TESTED
“If you’re in quarantine, it means you’ve been exposed to COVID-19. We recommend you get tested around day five or day six because that’s the highest chance of you showing you have an infection. It’s 14 days. You can’t test yourself out of quarantine. Nor do you need a test to get out of quarantine. It’s 14 days. You’re done. Your employer should not be requiring a test to get back to work.”
MASKS AND BACTERIA
“The mask is not doing a whole lot of harm in that situation. That’s your normal flora, that we would say. It’s what’s in your body anyway. You’re breathing out a small amount, and you’re going to have it already in your body, so it’s not going to cause you to become infected in any way by wearing a mask.”
COVID AND PERSPIRATION
“It is harmless. It is important to understand that COVID-19 is transmitted through respiratory droplets. That’s what we know as it stands today, so other secretions not. There are some concerns about other areas that it could be transmitted in, but what we do have proof in, it’s respiratory droplets. So perspiration is not on the list of a concern right now.”
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