Watch: A doctor answers your COVID-19 questions
There is a lot of misinformation out there about the new coronavirus. We reached out to Henry Ford Health System to get answers to some the most pressing questions submitted by readers.
On Monday, we spoke live with Dr. Rena Daiza, a family medicine doctor with Henry Ford Health System on our Facebook page.
Check out the video:
Dr. Rena Daiza, a family medicine doctor with Henry Ford Health System, answers reader questions about COVID-19 with Beth LeBlanc of The Detroit News The Detroit News
A transcript of the discussion follows below:
Q. Is there an advantage to wearing gloves? If you touch anything I would suspect you would need to throw them away before touching another object like pumping gas or touching the steering wheel. What’s your advice on that?
A. My advice at this time is to leave the equipment to the medical personnel. We are very low on gloves, on masks, on gowns. So at this point taking normal standard precautions, washing your hands regularly, using hand sanitizer... but (not) using gloves if you're not a medical professional at this time or not in the food service industry or in an area where you would actually need to cover your hands... . Avoid touching your face, making sure you are using those hand hygiene precautions.
Q. Why is it that we're not hearing any information about how long it takes for a person to recover, for a person to be on a ventilator and are in bad shape? I know everyone’s different, but it seems like there should be an average number of recovery (days) or being on a ventilator in that case.
A. That’s a difficult question to answer Beth. The reason is because that every patient is a little bit different and it depends on their age, depends on their co-morbidities — is the person asthmatic or they have a long smoking history — those people might be on a ventilator for longer. So, unfortunately, we don’t have a solid answer. I don’t have an exact number of how long... it’s a case-by-case situation. And we do checks in the ICU every single day, we do trials to see if we can get the person off the ventilator, and again it varies from person to person.
Q. I have lung cancer, and I’m supposed to have chemo treatment this week at Karmanos Cancer Center in Detroit. I spoke to the oncologist doctor and she assured me that proper precautions are in place, but I would like your opinion on this matter.
A. So if you’re a chemotherapy patient and you have a scheduled appointment although we don’t want you going out to place, we don’t want you to miss your chemotherapy appointment — particularly if your oncologist is OK with it. And as the patient mentioned that the oncologist is taking the proper precautions in their office, please don’t miss that appointment — it's very important. Any other reason to go out you should make sure that you take every precaution or have someone else go out for you if possible, but necessary medical appointments, please don’t miss those.
Q. Can chloroquine and antibiotics help treat coronavirus like President Trump said?
A. So this is a million-dollar question. Very important question and I want to touch on this a little bit, so let me be clear: this therapy is not approved yet, it is not. That therapy was suggested because of a very small study out of China of about 20 people, and it showed there was a decrease in the viral load of the coronavirus, which is a good thing and the reason why it’s gone on to longer trials. But that’s what we need. We can’t compromise what we normally do for therapy and what we normally do large-scale randomize trials so that we know it’s safe before it’s approved and given to the public. So, I want to make a point to other providers as well please again practice evidence-based medicine. We as practitioners should be there to educate our patients and let them know that this is a potential treatment, but it is not approved at this time for treatment. So it’s very, very important for people to understand that this isn’t even if you've been diagnosed or if you have a suspected diagnoses, you shouldn’t be getting that treatment at this time. And I worry because Azithromycin, for example which is the antibiotic part of that combo, it’s widely used for pneumonia and I had a patient a couple days ago who I needed and had to prescribe it to her for pneumonia. It took seven pharmacies for me to get her that medication because we're on such a back order because of doctors over-prescribing or patients requesting these medications unnecessarily, and so I worry about that actual use of these medications, what they're approved for at this time. I don’t want a shortage for patients who actually need it. It's not approved for coronavirus at this time.
Q. If I’m a grandparent, should I not be around my grandchildren at this time especially if I’m used to watching them while their parents are at work or what have you?
A. So grandparents shouldn’t be around their grandchildren, if possible. Hopefully someone else is able to watch them. Again we know that children, although their symptoms are mild, they are carriers and our elderly are the most susceptible or concerning group. Having them avoid potential carriers is very, very important. I do not recommend that.
Q. I've seen reports of the so-called L and S strains of the COVID-19 virus. Is this conceptually similar to the different flu strains we're used to? Does contracting and surviving of one strain of COVID-19 provide cross-immunity to the others?
A. So that’s being studied right now. That is also from a very small study in China, and they found L and S strain and one was more prevalent then the other. The main thing to come out of that is it doesn’t change our management, it doesn’t change at all how we're treating patients or what were doing for patients. So although that study did come out and we are continuing to study the strain, and it’s not uncommon for a virus to mutate or have multiple strains. That is actually common.
Q. I was told I can’t get tested, but I’m feeling worse. What should I do? And if I’m at home, is there anything I can do: take medications, resting? I guess what is the recommendation?
A. Most symptoms are mild and they can be treated at home with conservative management. So, at this time, we're telling patients to avoid anti-inflammatories, things like Motrin, but taking Tylenol regularly, getting plenty of rest, plenty of sleep, taking conservative measures at home. If you are a suspected COVID-19 patient then quarantine for about 14 days is what we're telling patients, then once your symptoms resolve at least 24 hours and re-check back with your PCP.
Q. What happens if your symptoms are getting worse?
A. It depends. We are here, so if things seem to get worse, call your PCP and I have a hotline, (313) 874-1055, Monday through Friday, 8-5 hotline for patients for a virtual appointment or talk to someone. If you are home and you had an illness and the symptoms are getting worse to the point where you can’t control them at home — and what do I mean by that, fevers that aren’t controlled with Tylenol, now your developing chest pain difficult breathing, shortness of breath — that warrants a visit to the ER. But if you're not sure and stable at home, call us or your PCP. We’ll guide you with the right treatment plan.
Q. Is there a way to self-diagnose coronavirus?
A. At this time were assuming that everyone has it. That’s how we're treating this, because there are so many asymptomatic people out there that maintaining the 6-foot distance, social distancing, isolating yourself if you're ill, but there is no way to know if you have the coronavirus without a swab.
Q. What are the symptoms of coronavirus?
A. Most common of symptoms: fever of 100.4 degrees or greater, shortness of breath, a dry cough, and other symptoms were finding, but those are the most common. The combination of azithromycin and chloroquine is not approved at this time. Treatment is conservative management at home. The treatment is supportive care. Call if the symptoms get worse. That may warrant a visit to the ER.
Q. Is it possible to make homemade mask, what is the best way to do that? And who should be wearing masks at this point?
A. Masks, gloves, these things should be left at this time for the health care providers. We are in a shortage. The little that we have we are locking it up for emergency situations. That’s scary for us, that’s scary for the health care providers. Don’t wear a mask unless you're compromised. I do advise you not to make a homemade mask. Michigan is on a complete lockdown, so most people should be home anyway.
Q. Is it safe to eat takeout? What if the person preparing the food is infected?
A. Ideally if someone preparing the food is feeling ill, they would be home, use standard precautions. This is spread person-to-person respiratory droplets. Yes, we know that the virus can live for a period of time on some surfaces for some period of time, just be careful. If you get takeout, perhaps throw away the bag it came in, be mindful not to touch your face, wash your hands after you eat, wipe down the counter you were eating at, taking standard precautions is my recommendation.
Q. Is it safe to walk outside?
A. Yes, walk outside. Healthy people walk outside, go outside, but maintain the 6-foot distance. Unless it’s someone in your home you’ve already had close contact with, there will be other people out there, so maintain that distance. If you have symptoms, I do not recommend being outdoors at this time.
Q. Why is there such a higher reported rate in Michigan versus states with higher population or higher population density. Does this have to do with the testing availability or do we just have a higher infection rate?
A. I don’t have an answer for that really, but here in Michigan we have a high rate of testing. About a week ago here at Henry Ford we were testing about 100 people a day, and I thought for sure by the end of the week we would hit a 1000 people per day. Well, we're at 200 people right now, so we're not really testing that much. In fact there’s probably a lot more people infected that we don't know of, but I don’t have a good answer for that. We were hit pretty hard here in Michigan, that’s very true, the cases are going up and will continue to go up.
Q. Folks who are trying to ward off coronavirus or lessen their symptoms... do things like Vitamin C, elderberry syrup, zinc ... do those things help in that respect?
A. Vitamin C can help boost your immune system slightly; I would say it’s not going to hurt you if you want to take Vitamin C. These are not things that we recommended regularly. Mainly it’s living a healthy lifestyle is what I recommend, overall a healthy lifestyle. Are you eating healthy, are you getting enough sleep, are you getting enough water and sunlight, sit in a well-lit room, open all the windows, aside from taking supplements, it’s an overall healthy lifestyle.
Q. Are there extra or specific risks for pregnant woman?
A. Pregnant woman are known to be immunosuppressed and so that means their immune system is a little bit lower during pregnancy and the reason is because we don’t want our own antibodies to affect the baby in any way,so naturally during pregnancy a woman’s immune system is down. So, as a pregnant woman you are more susceptible to getting a virus or any other disease than the average person. So, taking a little extra precaution for a pregnant person is necessary.
Q. If you have to cough what is the safest way to do it?
A. Coughing into your elbow, that is the way to do it, if you have a napkin if you have something that you can throw away easily that you can cough into then that would be fine. Again, we know that this can be transmitted person-to-person, that is the main thing. So if you must cough just wash your hands as soon as you can, wash your clothes as soon as you can. The virus can live on surfaces, but the main transmission is person-to-person.
Q. What is it like being a doctor during this pandemic? Do you worry about infecting your family?
A. This is a very trying time for all health care professionals. I’m speaking for myself as a doctor, but I see it in our nurses, our medical staff, it is very taxing on every single health care worker. We take it personally. This is something we are fighting to protect all of you, so a tough time, very tough time, I know it’s tough for everyone. And do I worry about infecting my family, of course I do. My 87-year-old grandmother, who I normally have Sunday dinner with, I haven’t seen her for her protection. But this is a good time for me to say this even though we are physically distant from one another, please make time to call each other, to Facetime each other, to communicate with each other. I rarely, rarely, rarely encourage screen time, this is the time I encourage screen time. People are feeling alone, so reaching out to loved ones knowing they are loved.
Q. Why does it seem that children don’t get coronavirus as badly as adults?
A. So children are not exempt, I want to make that clear. Most cases across the board — 80% cases — are mild, they may not have any symptoms at all, and we know that kids have done very well for the most part. Although we do have some cases where they are not doing well, 20% of cases in our hospital right now are young people, so young people are not exempt, but perhaps with the younger children has something to do with their immune system, and I know that is something being studied at this time. But just to be clear, they are not exempt and most importantly they can transmit the virus.
Q. Everyone is talking about flattening the curve, what does that mean?
A. That goes along with the community isolation, social distancing, the reason that we are doing that is we are trying to avoid this influx at once to the ER and to the hospitals system because our hospital system is not designed and cannot handle a huge influx of ill people at the same time.
Q. What do you think is the biggest misconception about coronavirus?
A. That young people are not affected by it, and they are. Young people are not exempt from this disease. Twenty percent of our patients in the hospital with coronavirus are young people. And particularly the young people who have other conditions like asthma for example it’s a lung condition. This is a respiratory virus, so if you have underling asthma for example you're susceptible to develop complications. Unfortunately, they are carriers, and that’s why it’s important for social distancing.
Q. Is it safe to give blood right now?
A. I would say if possible not to leave the house. I know that you know the TV has mentioned that we are low on our blood supply, but if it possible even if you’re a healthy person especially here in Michigan we're on a complete lockdown. Please under only extreme circumstances leave the house. If it’s for work, if it’s for food, otherwise I recommend just staying home currently (Dr. Daiza asked us to include that blood donation is still available for healthy people by appointment only).
Q. When do you think it will reach peak numbers in Michigan or when do you think this will be over?
A. I wish I had an answer to that question, but I will say that if we are following the CDC guidelines and social distancing and only going out when we must and taking precautions. if we're sick the more we comply with CDC guidelines, the sooner this will be over for all of us. Hopefully sooner rather than later.