Dr. Rai on testing, Memorial Day, and advice for hair salons and gyms
How is Brown County doing when it comes to COVID-19 testing? What should people remember as they go back to business?
Prevea Health President and CEO Dr. Ashok Rai joined us on Action 2 News This Morning Wednesday to give us some updates, advice on summer sports and travel, and the latest on testing.
to view the number of COVID-19 cases in Wisconsin and percent of positives.
"I don't want people to read too much into the lowest number or the highest number of positives. You really have to look at it from a percentage standpoint. The lowest number of tests being done in a day likely is because the way the resulting is done on these tests. Let's take Brown County for example .And this is happening all over the state. A test is done here. Later in the day, it's couriered down to Madison. From the time it hits Madison, they have about 48-to-72 hours to process that test, then result that test back. So what you're seeing on a Tuesday is probably the results of what happened over the weekend. It's important to know that drive-up testing at the Resch and Casa Alba with limited hours on Saturday and closed on Sunday. So it's not shocking you'd have a low number of test results. We're going to see those peaks and valleys in numbers. That's why it's important to understand the percentage of positives and not fixate we had this many positives or this many negatives on a certain day," says Dr. Rai.
Community-wide testing for all people who live or work in Brown County ends on Friday, May 22.
to schedule a time at the Resch Center, 820 Armed Force Dr, or Casa Alba Melanie, 314 S. Madison St.
Testing for people with symptoms will continue.
"It's important to know that testing doesn't end on Friday. These two testing sites will wrap up the current operation with the National Guard. That's the plan. Public Health could change their opinion between now and Friday. But right now, the plan as stated is for the National Guard to leave because surveillance testing will have been completed. Surveillance testing is what started last week when they started testing people without symptoms. That needed to happen to look at a snapshot of Brown County after the breakout was completed to see what was going on in Brown County. Do we still have significant issues? Or do we need to keep testing? It's important to know that we will probably have peaks and valleys of this mass testing going forward as well. There may be another breakout. There actually likely, logically will be another breakout. Where there will either be focused testing or even broader testing throughout the county. But this current project will be wrapping up. Going forward, if you have symptoms, you should still be tested. And you will be able to be tested. There will be resources throughout the county to make sure you can get a tested, through health symptoms and other public entities, to make sure you can get tested if you have symptoms," says Dr. Rai.
"Right now we're still calculating all the numbers but it looks like, at least early on, that the people who don't have symptoms have a very low positive rate. Less than two percent of them are positive. That's a good sign in a sense of looking at the community. But remember, it's a very small number of people compared to all of Brown County. And it's very early to tell. As we start to get more results on Friday and throughout next week because of the delay in testing results, we'll probably have a better picture of what's going on with people without symptoms. But so far, it looks like it's a pretty small number."
"Until COVID is really out of society we're never going to be in the clear. We could have breakouts due to people going to a bar, or people going to a game. We're going to have that going forward. Obviously, we would have loved to have phased into a situation with some rules around it, that way if there was a breakout we would know to pause and be able to deal with it. We don't have that luxury any more. How long will it take after people started going out to understand that? Well, it takes about five days on average, and up to 14 days to have your first symptom. But it's important to understand that once again, you could have people who don't have symptoms having the disease, and in those areas where the right thing is not being done, where they're not socially distancing, where they're not screening people, where they're not wearing masks, all it takes is one person to basically light a match and the whole place lights on fire with COVID within hours. And that's how rapidly this disease spreads. That's why we need, even as we open up, need to be smart about it."
The CDC has released guidance for businesses on cleaning and disinfecting and maintaining a safe work place.
to view those recommendations.
"The good thing that the CDC has done--it's about about 66-pages long I think--and it goes by different categories. What to do if you have a restaurant, what to do if you have a school or daycare. But some of the consistent guidelines are really around making sure you're cleaning everything very well, making sure you're maximizing your ability to socially distance, making sure that you're using face masks when you can. But really important for employers to understand is one of the biggest things the CDC recommends is screening your employees or your students as they come through the door. If anybody has a symptom or a fever, they should be sent home and tested--really tested, then sent home and isolated. I think some people misinterpret that that if it's a mild symptom, go get tested and come back to work and we'll find out what the results are. That's an absolute no. Any type of symptom, just send them to a testing site, get them tested, send them home, wait that 48-to-72 hours for that result to come back and then go from there. That will keep businesses kind of alive and running much longer, and keep all of your employees and your customers healthy, whether it's a manufacturing environment or a retail environment or a school," says Dr. Rai.
"Right now, the CDC and the WEDC have put out recommendations. You can't be farther than six feet when you're cutting somebody's hair. So both the customer and the stylist should be wearing a mask. That's what's going to help the most. Good cleansing and cleaning of equipment, washing of hands. If you're going to wear gloves make sure you're wearing it for that one person and then changing for the next one. Other really good suggestions is get rid of the waiting room. Have us wait in the car. Text us when you're ready. It's more comfortable that way. Touchless payment systems. Can I use my phone to pay? What are ways we can avoid contact? Those are all the right things to be doing," says Dr. Rai.
"Be patient. Understand that we all want them to be safe. We want to be safe themselves. We want to be safe ourselves. A rule that a company is doing, whether it be around masking, around having you wait around a different area, or not bringing a visitor in, all of that is to protect their employees. They want to stay in business. And they're trying to protect you, too. So things aren't going to be normal. They're going to be a 'new normal.' And I think we should all be patient and nice to each other in that process."
"We're going to keep getting recommendations from the CDC and the WEDC on this. As much as we can physically distance that's great. Obviously the athletes can't do that as much, but the fans definitely can. The coaches definitely can. Use proper protection. Spread those bleachers out. Don't be sitting shoulder to shoulder with people you don't live with. Use your head in all of this. I think we've learned over and over the right thing to do. If we can keep remembering them hopefully we can stay safe. Probably the biggest thing in summer sports is if your child or you has any kind of symptom, pull them out that day. It's not worth it bringing them in and exposing everybody else. If you have a symptom get tested. Get your child tested," says Dr. Rai.
"It's being used in some of our sickest patients. Actually, we're expanding it thanks to the government giving us more, to more patients now. So I think we'll be close to a dozen doses--or a little more than that--that we've been given by the government. It has actually been approved by the government to be used under an emergency situation. So you have to apply on a per-patient basis and hope to get that allocation. So far, patients continue to do well in our ICUs. We've had people come off the ventilator. But you have to remember, they've been on there a long time. So the whole point of remdesivir is not some sort of miracle cure, we inject it, and the person wakes up. It's going to shorten that amount of time that they need to be in the ICU. And we won't know that for days to weeks to see how well it's working. But you know, across the country in research studies it's worked. We're really hoping the best for our patients right now," says Dr. Rai.
Gov. Tony Evers has announced a $1 billion effort to expand testing, supplies, and contact tracing. The money is from the federal CARES Act.
"Hospital systems need to have the infrastructure to take care of COVID patients, have the right personal protective equipment. But the most important thing is the ability to test people who need to be tested. And that comes through expanding the infrastructure within health care well beyond the hospital. Ninety-eight percent of this is fought outside the hospital walls. So making sure the money gets to the right places there. And then making sure the money is going into testing. So more companies, buy more equipment, getting more Wisconsin innovation so we can test even more here everyday. That's a really good place to spend the money. Because that's what it's going to take to control further breakouts, especially in a state that has no rules going forward," says Dr. Rai.
"Depending on what happens with breakouts we're always going to need more personal protective equipment. We're going to need more stockpiles of it in the state, because we will see different waves. As far as equipment goes, more in-house testing is necessary. Having to wait two-to-three days by sending a test to a different part of a state--that's OK during the early stages of the disease--but really our efforts should be how much testing we can take to the community rather than the community samples having to leave. And I think that's a priority the state needs to work on and is working on," says Dr. Rai.
All we have to do is remember the same things we've talked about over and over. Keep that physical distance with people you don't live with. Wear a mask if you're within six feet of people. Great hand washing techniques. And just be smart out there. It's great weather out there. It's really easy to physically distance outside, much easier than it is inside, so I think the warm weather is a good thing. Hopefully people will just pay attention to those recommendations going forward," says Dr. Rai.
"A couple practicality points. Hopefully the staff is all wearing masks so they're not transmitting the virus to you--and hopefully you're trying not to transmit it to them--by making sure that tables and people are spaced out more than six feet of each other. And if they're within six feet, wearing a mask. Obviously when you're eating or drinking you need to take your mask off. So just make sure you're six feet away from everybody unless you live with them. And that's just a recommendation that can be in a bar, a restaurant, a gym, a barbershop, you name it."
"I think we'll get more and more education from the WEDC and the CDC going forward on businesses reopening, but I think it's all going to relate around maintaining distance. Reducing crowds. Good hand washing. And masking when possible. You may have to make an appointment to go to the gym for the weight room because they may be restricting how many people can be in there. It may be every third treadmill that's turned on, not every single one. They're going to try to get spacing out, try to get good cleaning in there. Masking for their employees, anybody who is within six feet, try to reduce that situation. We want people to be healthy. We want them to work out. We want to make sure they do it safely. It's going to be a new normal. So it may not be 100 people in the weight room right now. It may be 10. Those are good recommendations to reduce that transmission," says Dr. Rai.
"In our area, it can be ordered today. Or providers can draw your blood and send it off to Mayo Clinic or send it off to Quest Labs and they can get that antibody test for you. It's pretty easy to get right now. The important part is to understand the why. Really all the antibody test tells you right now is you've been exposed to COVID. It doesn't tell you if you're immune. We won't know that for awhile. If it's negative, it doesn't mean you don't have COVID. It just means that you haven't mounted an antibody response to it. So it's important to remember the why. So that's why it has to have a physician order associated with it. All it's going to do is talk about exposure."