"We need to double down": Dr. Rai stresses physical distancing as peak approaches

GREEN BAY, Wis. (WBAY) - Right now, graphs show Wisconsin is set to reach a peak April 13 when it comes to coronavirus.

What exactly does that mean? And could that date change?

Prevea Health President and CEO Dr. Ashok Rai joined us Friday on Action 2 News This Morning to give us updates on the peak, possible treatments and testing and equipment in our area. Watch the videos in the story for all three segments.


"The peak is about not deaths right now. It's about resource utilization. That's what that graph keeps talking about. Yes, it's supposed to peak Monday (April 13), that could change tonight, that could change tomorrow, because new data is being fed in over time into that peak. But the point of that peak is that's supposed to be the peak. The only way that you come down from that peak is somewhat doubling down right now on all the recommendations--hand washing, masking, physical distancing. We need to double our efforts, triple our efforts right now. Everybody needs to be doing it for that peak to go away, which means coming down from that. Remember we said to get back to life we need 14 really good days of boredom, of nothing happening, of the death rate going down, of the infection rate going down, before we can even approach the conversation of how we can slowly get back to our lives," says Dr. Rai.


"If we want that peak to go down, if we want Monday to be our peak, we have to double and triple our efforts. And that means--we have a wonderful holiday coming up--we have to find a different way of socializing without being in person. Easter, I'm very nervous about it. I'm kind of glad the weather's not going to be so great. Hopefully people will stay home. We are really, really begging people to stay home, maintain that physical distance. Visit people by drive bys, by social media, by video chat--whatever medium it could be other than getting together," says Dr. Rai.


"It's an unfortunate thing. It's something we were praying for everyday that wouldn't happen here. The reality of this virus is we knew it would. It's such a different type of virus, such a different type of death to explain. Not only does it hit us in such a hard way for those who get in the hospital--from what we see in the CT scans, to how we have to ventilate them--but even the process of dying, not being able to have your family at your bedside, your friends at your bedside. It's tragic. The tragedy just keeps stacking up for this country," says Dr. Rai.

"There's only one way to prevent it and that's through the physical distancing we've been recommending."


"We're actually seeing an increase in cases. We expected this increase, unfortunately, just given the normal path of this virus and its growth throughout the country. So we are not seeing a decrease yet. The only way we're going to see a decrease is everybody start listening to what we're saying. The physical distancing, the hand washing and the masking," says Dr. Rai.


"There is really no reason not to. Some people think they're too macho to wear a mask. There's nothing more macho than saving a life to be honest with you. So by wearing a mask, have the attitude that every time you put your mask on you're saving a life. You're preventing the spread of coronavirus. You're saving lives by masking. You're saving lives by washing your hands. You are saving lives by physical distance. That's the attitude we need everybody to have. So wearing a mask--that's not a sign of shame, that's not sign of sickness. It should be nothing you should be embarrassed about. It should be something you should be proud about, that you're out there saving lives. So everybody should be doing it," says Dr. Rai.

"The point of the mask is not preventing you from catching COVID-19. Pretend like you have it and you're trying not to get the rest of society sick. And you're trying to prevent yourself from touching your nose and mouth. Those are the things we want people to remember. Save the medical PPE for health care. But more importantly, put a mask on, maintain your distance, physically separate. There's no reason for a social gathering at this point. There will come a time when we all get to get together as a society, I promise you that. But that time goes farther and farther out the longer and longer we wait on the recommendations we've given you."


"When it comes to the Personal Protective Equipment, unfortunately, a lot of our PPE in this country was made abroad. And it's a worldwide crisis, so everybody is scrambling for it. And there's a bidding war. And there's crime associated with it. People stealing masks. So it's a complicated supply chain situation in the middle of a pandemic. It's very unfortunate when it comes to PPE right now. That's why we're stressing--when we talk about masking--don't use health care masks. Leave that for health care. We need that to take care of you eventually," says Dr. Rai.

"When it comes to testing it's also really disappointing. We have safeguards in the United States through the FDA to make sure tests work and they don't hurt you. But it's not only the testing that's limited, it's the equipment required to do the tests. The nasal swabs. The largest producer of the nasal swabs is in Italy, one of the countries hardest hit by COVID-19. So when you have a worldwide supply chain associated with this and you have a worldwide pandemic, it's additive. So all of our supply chain issues are very frustrating right now. We wish we had testing three weeks ago. We wish we had it a month ago. We still don't have it in Green Bay today.

"First of all, we should all be acting like you have COVID-19. You should be staying at home. If you have symptoms you should be staying at home. There is a select population that needs to be tested. The state has said that. Those tests we can do. Because we have limited swabs we are using it on those patients. Those who are in the hospital. Those that are in a nursing home or what we call congregant environment. Those who are in health care are getting tested. Only so we can better quarantine them. That is the main reason for testing right now. Not to find out if you have it or not."


"This goes beyond the essential workers that are working today. But it's going to be our new normal when we start to slowly get back to work. There are a lot of things we can do to stay safe. Physical distancing at work is going to be important. That universal masking that we talk about. We always--probably for awhile now be wearing a mask. And that includes those of us who are going out and public and those of us at work wearing a mask as well. And then really good hand washing, creating more hand sanitizing stations throughout the work place. And Dr. [Anthony] Fauci's right, staggering shifts. Creating as much time and space between people as possible are things that employers need to start thinking about," says Dr. Rai.

"It's important to remember whether they have symptoms, test positive, everybody has it--act like that. Those that definitely test positive should be out of work for the CDC-recommended time period. Those who have symptoms should be out of work for that time period. They don't need to be tested, they just need to be out of work for a certain amount of time. Everybody else in that workplace needs to mask. Prevent that transmission from person to person, create six feet of separation at minimum, and have hand washing stations or sanitizing stations available to you."


"The concept of herd immunity over time makes sense, in a sense that we want, over time, either through immunizations or through exposure, for people to get herd immunity. And it can build really quickly in a virus that maybe doesn't overwhelm the health care system. What's so different about COVID-19 than any other virus that we've seen in our lifetime--and that includes any kind of flu, any kind of situation we've seen in our own lifetimes--is how quickly this virus spreads. How quickly it overwhelms the health care system. And that's the same health care system you depend on for heart attacks and strokes and having a baby. And when that's overwhelmed, it's kind of a vicious cycle of people dying. It's really unfortunate what we're seeing across the world. So to go out and say, 'Let's just go out there and get herd immunity right away, let's get our peak done with'-- that's at the cost of millions of lives. That attitude is somewhat inappropriate right now. We need to pace ourselves. We need to keep that peak of cases below that threshold of what health care can take care of. That way it can take care of the whole society at the same time without a needless loss of life," says Dr. Rai.


"Really, I worry about people wearing gloves. What you're doing at that point, is you're not washing your hands. You're likely going to touch your nose and mouth with that. And remember, everything we touch has COVID-19 on it--that's the mindset we want you in. So if you're wearing a pair of gloves and you touch something and you haven't had a chance to wash your hands and you touch something again, you now spread the virus. So all you're doing with gloves is spreading it from item to item, person to person. So unless you're in health care where we know how to put on our gloves and take them off after every single encounter, which means we go through a lot of gloves-- if you're wearing that same pair of gloves for an hour or two hours in the work force, all you're doing is propigating the spread of the virus. What you should be doing is after every encounter, every single touching, using hand sanitizer or even better, washing your hands," says Dr. Rai.


"We call nursing homes or prisons congregant situations in which people are living together in close quarters. It's important to know that this community had a little bit of time to plan versus New York or Washington, and they've done a great job at planning," says Dr. Rai.

"Our nursing homes have created COVID wings. So if somebody is positive, there's a wing specifically dedicated for them. Even if they suspect that. So the nursing homes have a step ahead of other nursing homes in the country. Our local ones have done a great job.

"Our prisons have done the same thing. They've partnered with health care, they've come up with plans on how to screen inmates, how to segregate them, quarantine them for lack of a better word. So I really do believe they could be a hot spot, it's one of our areas we're most nervous about, but there are plans in place for that."


"I think it's getting out there--a little slower than I'd like it to--but I think it's getting out there. Because they're being affected. They're getting infected. They have friends that now have COVID-19. We have 20-year olds in the hospital across the country. And we're seeing deaths in younger people as well. This is real across all ages. Unfortunately, that's an age group that traditionally, no matter what we're talking about, what disease process or behavior we're talking about, sometimes has that "S" walking around on their chest. That needs to stop right now. We need everybody to be physically distancing," says Dr. Rai.


"People are working night and day on different treatments and trials. Our physicians have registered to participate in some of those trials. The plasma one is one we've registered for, where you're taking antibodies from someone who has had COVID-19, survived it, gotten their blood, spun that down to plasma, and then re-infusing that plasma into somebody who's really, really sick," says Dr. Rai.

"There are some trials happening at UW-Madison, at Mayo, and we're registering for those."


"It really depends on what tier you're in. If you're in a hospital, if you're in a congregant setting, or you're in health care, that result can come back in 24 hours. Public health will step in at that point and act," says Dr. Rai.

"If you're tested and it takes a few days, you've already been isolating yourself, once again we'll call you, public health will call you, we'll continue your quarantine for a specific time period and we'll monitor your symptoms before we recommend you get back into public."


"Right now we've seen some cases out of China where there is a supposed secondary infection. What's hard about that without really good testing and antibody testing, is that did they truly get a second infection or is it still the first infection that's lasting longer in them? Only time will tell. Right now, from the way the virus is designed and what scientists are saying publicly, is we do believe it is a one-and-done situation. But we don't have proof of that yet, so we have to act very carefully going forward with those recommendations," says Dr. Rai.


"Yesterday, HSHS, Prevea, Bellin, Aurora Baycare, we all got together and we had a chance to share our plans for a surge. I'm very proud of how people have come together and led this situation as health care leaders about sharing what we're going to do. How many beds do you have today? How many beds could you have tomorrow? How many doctors do you have on the frontline today? How many could you pull into that situation tomorrow? Ventilators, ICUs, you name it. Everybody's got a plan and it's great to know that. Our number one goal was to double our capacity in Brown County. I feel that we're very close to that. If we were to hit with a massive surge, we hope that never happens, but the planning is very important at this point. What we saw in New York, what we saw in Washington, we are learning from them and making sure we plan so we don't become them," says Dr. Rai.