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COVID-19 Q&A with an infectious disease expert

NEWS 95.7's Rick Howe invited Dr. Lisa Barrett on his show to discuss the disease and the coronavirus that causes it
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As the number of COVID-19 cases in Canada continues to rise, many people have questions about the disease and the coronavirus that causes it.

NEWS 95.7's Rick Howe invited infectious disease expert and Dalhousie University assistant professor, Dr. Lisa Barrett, on his show to get answers.

Answers have been edited for brevity and clarity.

Are we overreacting? Don't more people die from the flu?

Dr. Lisa Barrett (LB): We have a different approach to flu right now because it's a circulating virus. That means it's been around for a while and people in the community have some immunity to it, and we also have a vaccine that helps prevent some of the most serious disease. That's the difference between flu right now and COVID-19. It's brand new and nobody has immunity to it. Not everybody is susceptible to getting very sick, but people in the community are more susceptible than they would be in any other respiratory illness season. 

The reason we are trying to still contain this virus with, as people put it, over-the-top measures on occasion, is we really are still going for containment to make sure we don't have as many severe cases, and to spread them out a little bit so the spread happens more slowly and our system may then have the capacity to manage this better than other countries. 

Do I think it's over the top in terms of the measures we've taken, especially in Nova Scotia? Absolutely not. I find them to be very practical, very pragmatic and well balanced from a personal freedoms and public health perspective so far.

Will we see fewer cases as we enter the spring, as we do for the flu and colds?

LB: We don't quite know yet. Many respiratory viruses do have a seasonal component to them. This is a brand new one and because there's no existing immunity within the community, it's not quite clear yet how much spread infection and lingering infection there's going to be in the community. That's information and data we're going to gather over the course of the next month and a half. 

I have a vacation booked, should I travel?

LB: The first step for anybody who's travelling is to look at the Public Health Agency of Canada's travel advisories and see if you're going to an area that has a travel advisory. The risk of becoming sick depends on many things; if you're healthy yourself, where you travel through and what the situation is in terms of the number of cases where you're travelling.

The challenge might not be whether you get sick or not, if you're a healthy individual, it's more the case of what's going to be the inconvenience if you go away for a week and you come back, if it's been decided that everybody whose travelled not just monitors their symptoms but self-isolates.

I keep hearing about a test kit shortage in the U.S., is the situation the same in Nova Scotia?

LB: Right now we don't have any confirmed cases of COVID-19-related viral disease. Right now we have enough of the bits that go into making the test work if we're smart about who we're testing, and that's another reason for these assessment sites, to assess who really needs the test the most. Until we get bucket-loads of tests, we're being very careful, but also very specific about who we're testing.

I don't feel well, do I have COVID-19?

LB: It is flu season and it's also respiratory virus season. There are lots of other respiratory viruses and other coronaviruses, but they are ones that have been circulating for years. The key point is you really can't tell the difference between influenza, COVID-19 and other respiratory viruses by the symptoms. Often there are muscle aches and pains, feeling very unwell, fever and eventually coughing and shortness of breath.

Because you can't figure that out, everybody should be considering themselves, if they start to feel unwell, as potentially infectious to the general population.

If you are feeling unwell with respiratory symptoms it's a good idea to keep yourself at home, self-isolate, and please don't go to long term care facilities to visit people. Facetime should become your new best friend.

If you develop a fever and you feel you're getting very ill, more than you would usually, then reach out to health care systems for further advice.

If you get the flu, can you also get COVID-19?

LB: We would suspect that's true. I would say assume you can at this point and that will not go well. Get your flu shot.

My elderly relatives have underlying conditions, are they at a higher risk of severe symptoms?

LB: Yes, for many things including respiratory viruses, and more importantly, severe symptoms with respiratory viruses. We should remember, we estimate that 80 per cent of people who become infected with COVID-19 don't develop severe symptoms. But an elderly person with underlying conditions would be in a situation -- if they did get this respiratory virus of COVID-19 or another like the flu -- where they'd be very likely to have a severe course. Everyone around them should be very diligent about their respiratory hygiene -- washing their hands and staying out of crowds -- if they're going to be around them.

It does bring up another question as well about social isolation. We don't want to be so diligent that we isolate our seniors for the next 5 months, but for the next weeks when things are uncertain, it's very important to only visit when you need to, and to make sure you're being very cautious, not forever but for a few weeks.

In general, immunity gets weaker as you get older and children below the age of 10 do seem to be spared severe infection with this particular COVID-19 virus.

Where did the novel coronavirus come from?

LB: We don't know that at this point, but there's lots of speculation. Some of these viruses have similarities to other viruses that are found in animals. Often it's an animal-to-human transmission. The virus adapts, usually through another mammal other than humans to get to humans, but we don't know the answer yet. People have suggested bats and other animals but we don't know. That's part of the process we're doing now, both to understand this virus and predict if others are going to come up in the future.

If someone is experiencing homelessness and they get symptoms of respiratory illness, how do they self-isolate?

LB: I know a lot of the groups who have both primary and secondary shelters and housing projects within the province are getting together with public health, but it is something we have to think about because these folks are often very vulnerable to respiratory viruses, so I'm hoping there's going to be a plan for temporary housing to give those folks the opportunity to look after themselves and others.

Do I need to wash my hands with special soap?

LB: Just use soap, soap and more soap. This is a little technical but the virus itself has a particular lipid envelope. Any soap that has a detergent in it, if you actually let it contact all over your hands for the full 20 seconds, that envelope in the virus gets disrupted and causes the virus to not be infectious.

Why do I have to wash for 20 seconds?

LB: When you do those tests with the ultraviolet light and look at the amount of infectious particle on your hands, after 20 seconds the amount of pathogens left on your hands is very low. If you wash for less than that, it's not the same effect. 

How concerned are you about the impact of COVID-19?

LB: As a physician, infectious disease expert, immunologist and as a Nova Scotian, I am taking it very seriously. I think about it every day, but I'm also reassured by the amount of planning and the amount of changing plans that's coming up from our federal and local governments. 

I go to the websites everyday for the Nova Scotia Health Authority, for the Nova Scotia government, for the Public Health Agency of Canada. I find the information valuable, I find it's updated and I find it's sensible.

I'm worried in that I want to make sure everyone is looked after, but I do think so far the plans have been excellent and the fact that they keep changing is not something we should worry about, it's something we should be grateful for.

I'm also pretty impressed that most Nova Scotians have been so diligent in the personal protection aspect of preventing this from becoming a bigger public health threat in our province.

Meghan Groff

About the Author: Meghan Groff

Born in Michigan, raised in Ontario, schooled in Indiana and lives in Nova Scotia; Meghan is the editor for CityNews Halifax.
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