Dr. Rai answers questions on killing the coronavirus, wearing masks in public and symptoms
"The longer we wait, the worse this is going to get." That's the warning from Prevea Health President and CEO Dr. Ashok Rai on fighting the spread of coronavirus in Wisconsin.
Dr. Ashok Rai joined us Monday to answer more of your questions about the coronavirus outbreak and offer advice to the community on fighting COVID-19.
for local national and international coverage of the pandemic.
Over the weekend, Wisconsin recorded its highest single day increase in cases. The number of cases grew by 100 from Saturday to Sunday.
"We know the spread is there in our state, and we know that we have community spread in our state, so it's predictable that this number will keep going up until we actually do something about it," says Dr. Rai. "Really all we can do right now is shelter in place. The social distancing is working, but now it's time to really clamp down as a state. We don't want to turn into New York. We don't want to most definitely turn into an Italy. But we do know the strategies have worked in places to slow it down. We just as a state need to implement those."
Grocery stores and retailers have said they've seen an unprecedented surge in shoppers. That leads to large crowds in one place. Grocery stores are not under the ban on gatherings of 10 or more because they are considered essential.
"Outside of getting groceries and that can be in and out, you can socially distance in that process. And going to the pharmacy for needed medications, there's not a whole lot of other reasons to leave your house right now," says Dr. Rai.
"Act like everybody around you has coronavirus. Act like everything you're touching has it, and every place you go into is filled with it. If you can keep that mentality and that will keep you home, that will keep us all safe.
"We're not asking this to be a permanent lifestyle. But the longer we wait, the worse it's gonna get. The quicker we can get to a situation where we control this, where we sit inside our homes, the faster we can get to that situation of shelter in place and do that for maybe one, two, three, four weeks, we can actually get our lives back."
"There's no reason we should be going out in public places right now, exposing ourselves, touching things that have coronavirus on it if we don't have to. So there has to be a better way to do that. We need our government to act upon that. That would obviously be the state and the governor need to act upon that because it's a statewide issue. But April 7 should not be a call to go out and bring our most vulnerable out in the public and touch things over and over and over again," says Dr. Rai
"Once again let's act like everything we touch has it on it. So once you're done touching it, before you touch your face or touch anything on your body, wash your hands, use a hand sanitizer," says Dr. Rai. "If you can get in that habit every time, whether it be your mail, your takeout food, the grocery bags you bring inside your home, act like everything has it on it. So it'll apply to mail, it'll apply to everything else. That's a good practice. That's a really good habit to get into right now."
"We need to shut the state down. Other states have done it and they'll tell you they did it too late. We have an opportunity to learn from New York. If you look at a picture of Manhattan in Times Square today it's empty. That should be the streets of Green Bay two weeks ago. A short term pain here will get us back to our normal lives sooner," says Dr. Rai.
"We're not doing all that great. As you saw a 100-case jump there. Social distancing is working a little bit, but it's obviously not working completely. The only thing we know how to do combat coronavirus is to give healthcare time. We need to get that curve down," says Dr. Rai.
"I know a lot of news came out over the weekend that there's a test that can give you an answer in 45 minutes, and we're really thankful for that, but it doesn't exist here in Brown County yet. Understand that there's only a couple of machines in the area that can run that. And they can't run 1,000 at a time, they can run maybe about 8-10 at a time," says Dr. Rai.
"So we're not at that point where we can do mass testing, but we're starting to see manufacturing ramp up. But understand that's just one aspect of testing. We still need to get the nasal swabs--that's what we put up inside your nose to get the sample--we need those, those are in really short supply right now. And we need personal protective equipment, because obviously we need to put that mask on, we need to put that gown on every time we test you. Now there's way to do that safer, and we've worked on that over the last week. So right now we can test those who are at risk. If your physician's office tells you to go someplace, that means that you need a test. Otherwise you cannot drive up and get one today.
"These are really for the high-risk patients that we have told to go there. Literally, we will tell you to go there. Either from our virtual platform or you've called our nurse line, and that goes for all the health systems. If we feel you need to be tested, then you have high enough risk factors. Say you have a fever, and other symptoms. You also have diabetes or COPD, or maybe you work in healthcare putting you at higher risk and you've had contact where having a test will help us treat you. That is when we'll send you in for testing. You'll go to the drive-up site. You'll call a phone number. We'll give you instructions on how to drive up. Personal protective equipment is put on the staff and they will come out to your car and they will get a sample, and you will drive away.
"The purpose of that drive-up testing right now is to protect us in healthcare and protect you from having to interact with us if you don't have it. So we're creating that barrier. The purpose of this is not mass testing right now. It's not that you can just drive up, place your order and come up to the window. We don't have that right now."
"That sore throat, the fever and that shortness of breath--the inability to feel like you're really catching a good breath. Other people have had some stomach symptoms, some uncomfortable ones. There's a broader array right now--a broader range--so if you're feeling any one of those symptoms you should be talking to us. Our number one recommendation is we're going to tell you how to treat that symptom, but we really don't have a treatment for conoravirus other than stay home and quarantine."
"You want to use really good habits in washing your hands. So, we'll start with 20 seconds, sing the ABCs. If there's an ability to use paper towel then use that. Leave the water running until you have paper towel in your hand. Dry your hands off and then use that paper towel to turn off the water. If they don't have an ability to kick the door open, use that paper towel to open that door and then throw that paper towel away," says Dr. Rai.
"The hand dryers, if that's your only option then use that. Technically, your hands should be clean after you've done that so the water leaving your hands should be clean as well."
"There's two aspects of social isolation. One is obviously maintaining that distance. The other is staying at home and not being exposed to people you haven't been exposed to yet. There's one difference in being exposed to the family you live with every day and that family that may be coming from other areas and especially those who are at risk--grandma and grandpa, anybody over the age of 60. So I think right now our recommendations are to shelter in place. To act like everyone has the coronavirus like you have it. And you wouldn't want to give it to your fellow family members. Even if you're six feet apart. Because that's pretty hard to maintain in a social gathering like that," says Dr. Rai.
"Obviously, if you can keep your children home please do. Some of that daycare operation is necessary for those who are mission critical--jobs who have to go to work, such as those who are in healthcare, nurses physicians, respiratory therapists, medical assistants, their kids need care while we need them on the front line. But if you're not in a mission critical type of position, your children should be staying with you. That's the safest place to have them. We need to continue to figure out the childcare situation for those who need to work," says Dr. Rai.
"There's some great research and great papers out about CT Scans to do that. As a global screening tool it's pretty difficult, because obviously if we're screening you we think you have it. There's a lot of precautions that need to happen, what we need to wear the personal protective equipment. What we need to do is clean the CAT scan after every patient. That can be an hour or two of shutting the machine down. So it's a really good tool for those admitting in the hospital to get a baseline and then to stage them as their disease progresses. But right now not a practical one as a screening tool--yet," says Dr. Rai.
"I love that everybody wants to help. Everybody's asking, 'what can I do?' Making a cloth face mask right now will give us a benefit if we run out of personal protective equipment, but it will not protect us now. And hopefully we'll never need it," says Dr. Rai.
"The CDC says pretty much it's a last step. That means that we're completely out of ways to protect ourselves. And it won't give us a whole lot of protection. It may give people a false sense of security if they're wearing it now, so it's not for use today.
"There are other things this community can be doing for each other now than making those face masks. Take care of your health care workers. Figure out childcare for them. Help out in those ways. If we need masks, we'll figure that out at some point."
"We do a lot of training on how to put on your personal protective equipment, how to take it off to minimize any kind of risk. It's a personal decision, obviously, for that healthcare worker. They should be protected. The whole intent of wearing PPE is to create that protection," says Dr. Rai.
"That's one of those questions that we don't know yet. That's why we need this time to figure it out. There's been an occasional case reported outside of Asia on this situation, but we haven't seen it rampantly. So if we thought there could be a secondary infection with it, you would think we would be seeing a lot more of that coming out of the countries that have been battling this, that have been doing it for more than 14 days. But for right now, we can say that we're cautiously optimistic that you can't, but we can't say that for sure right now," says Dr. Rai.
"Right now there's fact and fiction. Fact is right now we know that alcohol-based cleaning products will kill it. We don't know about temperature and the virus's ability to live and die in it. So right now, I wouldn't say freezing it or heating it will kill it. We know what will and that's good hygiene and cleaning," says Dr. Rai.
"What we should be saving masks for is those in healthcare and those who have symptoms, to prevent the spread. If you're wearing a mask or a bandanna, there is still a good amount of particles that are going to get through that. It may seem like cloth is solid, but it's not. Things get through it. If you took it under a sink and water will go through cloth, so you have to understand those respiratory droplets, which are even smaller than that, are going to get through cloth. So I think it's a false sense of protection. You shouldn't be going out unless you really have to. And when you are, you should be acting like you have it, like everybody's has it. You should be maintaining that distance, that six feet. And really good hand hygiene, that's what you should be doing," says Dr. Rai.
"There's this unfortunate perception among those who are young that it's not that bad. We have 20-year-old people, 21-year-old people--even younger and in between ages--on ventilators on both coasts right now. We know that it hurts people that are younger. We just know that it hurts people who are older at a higher rate, but you are not protected if you are young."
The Wisconsin Department of Health Services says COVID-19 is spread via coughs and sneezes.
"This is similar to how influenza is spread. The virus is found in droplets from the throat and nose. When someone coughs or sneezes, other people near them can breathe in those droplets. The virus can also spread when someone touches an object with the virus on it. If that person touches their mouth, face, or eyes, the virus can make them sick," says DHS.
, "It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes, but this is not thought to be the main way the virus spreads."
for Wisconsin's guide to COVID-19.
Here's how you can prevent the spread (INFORMATION FROM DHS)
* Avoid close contact with people who are sick. \
* Stay at home as much as possible. Cancel events and avoid groups, gatherings, play dates, and nonessential appointments.
* Stay home when you are sick, except to get medical care.
* Wash your hands regularly for at least 20 seconds. If soap and water are not available, use an alcohol-based hand sanitizer with at least 60% alcohol.
* Cover your mouth and nose with a tissue when you cough or sneeze or use the inside of your elbow.
* Stay at least six feet away from other people.
* Clean frequently touched surfaces and objects daily (e.g., tables, countertops, light switches, doorknobs, and cabinet handles).
for a guide on how to properly disinfect your surfaces.