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Staying Safe During the 3rd COVID-19 Surge

Facebook Live with Dr. Joe Gastaldo – November 19, 2020 from OhioHealth on Vimeo.

There is still a lot of confusion surrounding a COVID-19 vaccine. With FDA approval being right around the corner, we wanted to hopefully provide some clarity. So we sat down with OhioHealth’s system medical director of Infectious Diseases Joseph Gastaldo, MD, during a recent Facebook Live event to get some answers.

Note: If you want to hear Dr. Gastaldo’s answers to our questions, we’ve provided time stamps in our story, to help you find the answer in the video above.

As you read on, keep in mind that this information shouldn’t replace the advice of your doctor. If you have additional questions, visit the Centers for Disease Control and Prevention COVID-19 website.

Ohio’s stay home advisory and statewide curfew starts 11/19/20. Why do I have to do this again? 00:52

As a country, our first case of confirmed COVID-19 was on January 20, 2020. That’s not an anniversary that I want to celebrate. At this point, we all have COVID fatigue, but this doesn’t mean we can ignore the problem at hand. Let me break down the COVID-19 timeline so far, in hopes to shed light on why we need another stay at home advisory.

I like to call the first surge a “baby bump.” In the spring, there was a lot we didn’t know. We were focused on flattening the curve, which lead to a severe shutdown. Schools, businesses, gyms, churches, hospital visitation restrictions…everything shutdown. As a result of that, we did, in Ohio and in Central Ohio, flatten the curve. However, as we transitioned into the summer months, businesses opened up again. As people got together, the virus was able to spread more easily. At this point, the bump had grown and was less like a baby bump and more similar to a hill. Now, the temperature is dropping as winter approaches, putting us in a dangerous situation. People are spending more time indoors watching football games and celebrating holidays, which is causing the amount of COVID-19 cases to rise. When people hangout with others who are not a part of their household, especially if they’re not practicing mitigation strategies and spending time inside, cases rise. And my concern is the rate that we’re going up now. So, the COVID-19 case timeline is as follows: we had our little baby bump, our bump grew into a hill, and now our current trajectory is a mountain that we have not even reached the peak of yet.

I’m worried I’ll come off as rude if I ask my guests to wear masks in my home. What should I do? 03:33

In this situation, I wouldn’t worry about how others perceive your safety precautions. Let’s look at the basics again: number one, it’s a very contagious virus. Number two, you can be asymptomatic or minimally symptomatic and not know you have this infection. And number three, it’s all about protecting those who are at-risk. If you look at that inclusive list, being overweight, high blood pressure, diabetes, heart disease, lung disease, someone with a weakened immune system…that is a huge part of the population, and it probably includes many people’s family members and friends. So we really need to focus on protecting those individuals.

Having people come into your home is a risky situation. You not only have to worry about suboptimal ventilation of air, but also the issue of mask removal. When you invite people over, most of the time it’s to eat or drink, and you have to remove your mask for these activities. Therefore, practicing mitigation strategies indoors, both in your home and other’s homes, is something you should consider if you make the decision to spend time indoors with those not in your household.

On a similar note, we all need to continue to practice mitigation strategies when going out in public. Scientifically, wearing a mask does save lives; It does help mitigate the spread of this virus. But I think there are opportunities in public for us to do a better job with mitigation strategies. It’s more than just wearing a mask…it’s wearing the mask the right way. Make sure you are covering your nose, mouth and chin. Do not wear your mask underneath your nose or underneath your chin.

How do I shift myself out of the March mindset? 06:11

The March mindset really refers to when COVID-19 was a confusing, new concept. Since March, we have learned a lot about COVID-19. The more we learn, the better prepared we are to fight this virus. Therefore, I want us all to move away from the “March mindset” and look forward. Yes, we’re still learning, but we know so much more about this virus than we did back in March. As we continue to learn more with each month, I believe a lot of anxiety, pain and suffering will be in the rear-view mirror. We will likely have a limited supple of a vaccine in December of 2020. Starting in 2021, this availability will become widespread. I hope this information provides comfort to those still stuck in the March mindset.

Is it safe to take the vaccine as soon as it’s available to me? 08:40

Absolutely. Let me talk about the vaccine approval process a little bit. Traditionally, the average time for a vaccine to get approved is 11 years; we can’t be living this way for 11 years. This is where Operation Warp Speed comes into play. Operation Warp Speed is a 24/7 process, with the same vaccine safety review in place, that was set up by the federal government. Overall, it is a much more efficient way of getting a vaccine approved, and I feel very comfortable with this approval process. If I had access to a COVID-19 vaccine that had emergency use authorization, I would receive that vaccine today.

Can I get COVID-19 again after already having it? 10:37

Reinfection has been reported, but is rare. We are still waiting on more research to be done in this area. So the technical answer is yes. Currently, there are a couple things that we don’t know: we don’t know yet with certainty, if you have COVID-19, how long you have any type of immunity for. The immune system is very complicated; there’s more to it than an antibody response. Also, the immune system is different for every person. It changes as you age and can be weakened from diseases, viruses and some medical treatments, such as chemotherapy. Immunologically, this virus is most likely going to behave like other human, common cold coronaviruses, but we just don’t know yet for certain. So again, we just need to wait for more research to be done.

Is it safe for me to work out without a mask or workout around people who are not wearing a mask? 11:44

Going anywhere where people gather is a risky situation. However, if you do choose to go to a gym, you really need to double down on mitigation strategies. This includes wearing a mask, physical distancing and hand hygiene. Gyms are full of commonly touched items, such as weights, and everyone around you is working up a sweat. So you really have to be mindful and protect yourself and others in a gym.

It also really depends on your gym routine. If you’re running on a treadmill, it’s going to be difficult to wear a mask. If you’re a power lifter and need someone to spot you at a gym, that’s one more person that needs to get closer than 6 feet to you. Outside of your gym routine…what’s the ventilation like in your gym? Are they limiting capacity? There are many factors to consider in this situation. If going to the gym is part of your resiliency, then you need to do what’s best for you. But it is a calculated risk, so make sure to practice mitigation strategies.

What steps should I take if someone in my bubble has been exposed to COVID-19? 13:58

I would recommend following these steps. However, it’s also important to find out what kind of exposure it was. High risk exposures, as in greater than 15 minutes and less than 6 feet apart, intimate contact or the shared use of a utensil, are riskier. But, if it’s a situation where they’re six feet apart, both wearing masks and the ventilation is good, I would not consider that a high risk exposure.

Is there anything I can take, such as vitamin C or zinc, to ensure a less serious outcome if I do get COVID-19? 15:01

As a man who believes in science and evidence-based medicine, I have to say that there’s no magic medicine or supplement that’s going to boost your immune system. The best advice I can give is to continue to exercise, eat a healthy, balanced diet and, overall, take care of yourself. The one thing I will say when it comes to supplements is this: vitamin D deficiency is associated with a higher severity of COVID-19 illness. That being said, I’m not telling anyone to go and take vitamin D. Vitamin D is a fat, soluble vitamin, and can be very dangerous if you take too much of it. Therefore, the best thing to do is go and talk to your doctor if you’re worried about having a vitamin D deficiency.

I like to swim at the gym. Is that safe? 16:37

If you’re going to a pool that has lanes closed down and you’re really the only person swimming, then that’s a safer situation as long as you don’t socialize while there. But again, nothing is zero risk. So you need to assess your risk tolerance, if you’re contemplating going to the gym.

How can I take care of my children that are going into school? 17:57

Schools, generally speaking, are safer due to the required mitigation strategies. What’s risky is the activities kids do in their private lives outside of school. Whether it’s a play date, after school club or an after school event, people gathering is very risky.

How long does the virus stay on surfaces and should I be washing items that come into my home? 19:42

A lot of it has to do with the environment of what that item is. If you go to a grocery store, you want to inspect your package and make sure it’s not contaminated; that there’s no bodily fluids on it. When I come home, I inspect my groceries, put them on the shelf and then I sanitize my hands.

How can my family and I stay safe while traveling? 20:36

When it comes to travel, driving is safer than flying. If you make the decision to fly, you really have to double down on your mitigation strategies. That means wearing a mask properly, keeping your distance as much as you can, continuously washing and sanitizing your hands and not touching your eyes, nose or mouth. COVID-19 must come in contact with the cells in your mucous membranes or your airway, so if you can block access, you can avoid infection. A common tip I like to tell people is to set an alarm on your phone to go off every 15 to 20 minutes to remind you to sanitize your hands.

If I’m exposed to COVID-19 more than once, how do I handle quarantining? 21:39

The CDC does give guidance on this. They say that, if you have had COVID-19, within 90 days, if you have another high risk exposure, it’s not recommended that you have to quarantine. Immunologically, that makes sense. But again, it depends on the timeframe of when you first got COVID-19 to the second time.

With Thanksgiving next week, and many other holidays right around the corner, we wanted to see if you could break down this graphic on staying safe for us. 22:20

Infographic describing Thanksgiving activity safety levels during COVID-19 pandemic

Safe celebration ideas:

  • Dining with household members:
    This is the safest situation. What is risky about a holiday dinner is inviting people from outside of your household.
  • Attending a virtual dinner with family and friends:
    This is also just as safe. While I understand a virtual get-together is not the same as the real world experience, it’s the best case scenario to avoid spread. We’re really asking everyone to consider thinking outside the box where you could still have that family connection, without risking exposure and increasing spread
  • Participating in online shopping deals:
    Going out to a mall where there’s a lot of people shopping is a riskier proposition. With online shopping, not only is it a lot safer, but you can also look for special deals easier.
  • Watching sporting events, parades and movies at home:
    This is a great recommendation that I support. While I do love watching football games in person, this year we have to pause on attending big events.

How should I handle moderate risk holiday activities? 24:20

Mitigation strategies are very foreign. The thought of people having to be extra cautious in their own home makes makes me feel uncomfortable. But, if you’re inviting people over, the situation becomes risky and warrants mitigation strategies. Think of it as opening up your home to the public; it’s not as safe as a virtual event or dinner with only your household. If you do decide to invite people over from outside of your household, remember to practice all the mitigation strategies; mask-wearing, hand-washing, social distancing…they all work synergistically.

If I move into a new home during the pandemic, do you suggest cleaning surfaces and carpet before moving in? 25:00

Well, if you’re moving into a new house, I would hope that it has already been cleaned. But yes, my recommendation in that report would be to move into a clean house. It doesn’t have to be sterile, as it’s a personal living space and not a hospital room, but a good cleaning would be very beneficial.

What’s next in the vaccination process? 25:51

Currently, there are two vaccines that have received a lot of press in the last couple of days. They are both messenger RNA vaccines, one made by Pfizer, then one made by Moderna. Pfizer has announced that likely, in the next couple of days, they are officially going to ask for FDA emergency use authorization. They have met all of their safety considerations, they have had enough people enrolled in their study and their study shows very good efficacy. So the next step would be for the FDA to accept or deny their application, and they have already stated that this process is going to be completely transparent.

A few days after the FDA signs off on a candidate vaccine, it will then go on to the CDC. The CDC’s process will most likely take 7 to 10 days to complete, and will also be a transparent process. Looking ahead, if I had to guess a best case scenario, I think there will be a limited approval of a vaccine sometime in mid-December.

When deciding whether or not to get the vaccine (once available), what are some things I should consider? 27:14

To start, there is a vaccine priority matrix available online for anyone to read. This was created a few months ago by the National Academy of Science, and everyone in the country, including OhioHealth and Ohio State, is using that as a framework to prioritize who gets the vaccine. Initially, tier 1A is our healthcare workers, and tier 1B are at-risk individuals. Before the vaccine is available, the Advisory Committee on Immunization Practices, which is part of the CDC, will give the official vaccine priority that everyone will follow from there.

If you have access to a vaccine, my advice would be to not only consider getting it, but to educate yourself on the vaccine approval process to increase your comfort level. I am very aware of what that process looks like under Operation Warp Speed, and therefore feel very comfortable with the safety and efficacy of the COVID-19 vaccine.

How can I be a good consumer of information in order to avoid spreading misinformation? 28:48

I call that the info-demic. Since COVID-19 first came on the scene, there’s been a lot of misinformation, especially about how the virus has spread, masking and the use of personal protective equipment, medications and vaccines. With so much misinformation out there, it can get really confusing looking for accurate information.

My recommendation is to really do your due diligence when looking at information online. Is it a reputable news source? Is it somebody who is a social media influencer? When it comes to COVID-19, you really have to understand and appreciate people’s credentials. For example, I’m a board certified infectious disease doctor. I’ve been studying infectious diseases for a significant amount of my adult life. A social media influencer most likely doesn’t have medical credentials, and therefore is only posting their opinion. So you really have to find someone that’s going to report the facts, and not someone who’s giving you an opinion piece. Find someone who really understands science and evidence-based medicine.

This article is based off of a live interview conducted on Facebook on November 19, 2020. Due to the changing nature of COVID-19, some information might be dated. Always check with the CDC for the latest changing information concerning COVID-19.


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