When Governor J.B. Pritzker announced the state’s stay-at-home order to slow the spread of the COVID-19 pandemic on March 20, Dr. Emily Landon of University of Chicago Medicine was at the press conference with him to follow up with a powerful speech about how important the drastic measure was to save lives. “Our healthcare system doesn’t have any slack. There are no empty wards for patients, or nurses waiting in the wings,” said Landon, an adult infectious diseases specialist and the executive medical director of the hospital’s infection prevention and control program. “If we let every patient with this infection infect three more people, and then each of them infect two or three people, there won’t be a hospital bed when my mother can’t breathe very well or when yours is coughing too much.”
Landon’s straightforward comments drew attention and praise around the country, but they’re far from her only effort to educate the public: a few days earlier, she and Dr. Allison Bartlett, a pediatric infectious diseases specialist and another leader in the hospital’s infection control program, answered questions about the novel coronavirus in a live question-and-answer session online. Here, the Weekly summarizes highlights from their expert answers to some of the most frequently asked questions about the novel coronavirus and the disease it causes, COVID-19.
How dangerous is COVID-19, the disease caused by the novel coronavirus?
“Many people who get sick will not get very sick at all. About eighty percent of people will not need much more than a number of days at home, resting, with a lot of coughing,” Landon said. But for some, the disease is more severe. About fifteen percent of people will need care in a hospital, and some go on to need critical care such as being on a ventilator. “In the end, if everyone is able to access the care they need when they need it, we expect to only have about one to two percent of people who will succumb to this illness… The real concern here is not so much about each of our own personal safety, but the most vulnerable among us need to be protected,” she said, explaining that we need to avoid having too many people sick at one time so the resources that keep most hospitalized people from dying don’t run out.
What is social distancing, and why is it so important?
Vaccines and antiviral medications are usually our key defenses for slowing and treating viral infections, but we don’t have any for COVID-19 yet. “Without them, the only way that we can keep the number of infected people out and about low is by asking everyone to stay home,” Landon said. “That way, people won’t be having as many contacts with other people,” and each infected person will infect fewer people. Without that reduction in contacts between people—social distancing—the number of infected people will grow more quickly. “Our hospitals are not set up to have fifteen to twenty percent of our population sick at one time and needing their care,” Landon said. “This is not about being personally afraid of your own bad outcome. This is about protecting the people who need to use their healthcare system when they do get sick by spreading it out as much as possible.”
“In the general community, we no longer can contain this virus,” Landon said. If we don’t slow down the spread of the disease, or “flatten the curve” of infections by reducing our interactions with others, the consequences will be severe. “There will be people who die because they cannot get in the hospital to have a bed unless we all—even those of us who won’t have a bad outcome and are going to be just fine—stay home so we slow the spread, “ she said.
What caution should I take other than social distancing?
Bartlett recommended the same precautions you should take every flu season: wash your hands often (for at least twenty seconds), cover your mouth when you cough, and be proactive about cleaning frequently touched surfaces like doorknobs.
Can asymptomatic people infect others with the novel coronavirus?
“We don’t really have a great sense of how many people are walking around potentially infected with COVID-19 without having symptoms because we aren’t testing those people,” Bartlett said, but the possibility of its being a factor is becoming more evident. “That’s another important part in why we’re recommending that people stay away from other individuals, because we don’t know who might be potentially contagious,” she said.
When I feel a cold coming on, I take supplements. Will they make a difference with the novel coronavirus?
People should be careful about taking dietary supplements, since they can interact with medication and may cause bad reactions. Landon recommended against starting new supplements, but said that she doesn’t see a problem with people continuing supplements they take regularly without incident, as long as they do not increase the dose and continue to be careful.
Does ibuprofen worsen COVID-19? Is acetaminophen better to use right now?
Bartlett said for most people, it should be okay to use either. There is some limited data that suggest ibuprofen, an anti-inflammatory medication, may worsen infections, but for the “vast majority” of people who get COVID-19 without becoming severely ill, “use of ibuprofen or not, in terms of their severity of illness, is not going to have an impact,” she said. “It will make you feel better if you have a fever…. I don’t think there’s any reason to not symptomatically treat your fever as appropriate.”
How does access to testing work?
Testing capacity has been increasing in Illinois, but shortages of materials and initial problems with testing in the U.S. mean it’s still not possible to test everyone who’s sick. Though it will be frustrating for some, “We need to make sure that we’re prioritizing testing to identify patients who could become very sick if they got coronavirus, to make sure that we can get them admitted to the hospital when they need to be, [and] making sure that we’re keeping our healthcare workers safe, and if healthcare workers do become infected, making sure it’s safe for them to go back to work. Otherwise we’re gonna run out of healthcare workers,” Bartlett said.
Someone in my house is sick, but I’m not sure if it’s the flu or coronavirus. Is it okay for me to go to work if I don’t have any symptoms?
It depends on your work and your level of risk, Landon said. Frontline healthcare providers should be tested—they, and patients they work with, need to be kept as safe as possible. “For people who work in nursing homes, in group homes, or with patients, or with elderly people—people that are at a very high risk for a bad outcome—you may want to check with your employer about what the rules are for when you can and cannot work,” Landon said.
If you have direct contact with someone who has COVID-19, you must stay home for fourteen days. “If you’re the direct contact of someone that you don’t know whether or not they have COVID, it’s a little harder to make that decision,” Landon acknowledged, saying that if you have reason to believe it may be COVID-19, you should act as if you’ve been exposed, even without a test. If you “had contact with someone who had contact with someone who had COVID, you don’t need to change your behavior right now.” If the person you had direct contact with becomes sick, you should then consider yourself exposed and act accordingly.
I’m immunocompromised, but I still have to go to work. Is there anything I can do to protect myself?
In order to maintain social distance while at work, Landon suggested interacting over the phone or through teleconferencing even on site. Workspaces should be spread out to provide more distance between people, which can be facilitated by having those who can work from home do so. For those who must be physically present, splitting work into shifts, (or more and shorter shifts) is useful as well. “Any little bit that you can do to reduce the number of human beings that you are within six feet of at any given time will reduce the risk of this disease spreading too quickly through our community,” Landon said.
Landon also highlighted the importance of cleaning surfaces regularly—every hour, even. “We know from some studies out of Singapore that even when you have sick people around, if you clean surfaces regularly, it really does help to decrease spread.”
If someone must take the CTA during this time, what are the best practices?
“I know there’s a lot of work going on with the public transportation authorities to increase the frequency with which they’re cleaning buses and trains, but we can only do so much cleaning,” Bartlett said. “Hand hygiene and not touching your face until after you’ve washed your hands are going to be important parts of how you can prevent spread.”
“Those of you who don’t need to… use public transportation, shouldn’t use it,” Landon said, “so that the people that need it in order to get to their essential jobs can take it and spread out so that they don’t have as much risk.”
What’s the point of sending kids home from school?
“Children are very unlikely to be sick from COVID-19, but they are, as far as we can tell, a very important vector in the spread of all of these infections,” Bartlett said; keeping them home is important to slowing the spread. “But we also need to respect the reason why we did this, which is social distancing,” she said. “Having giant playdates in the basement is not a good stewarding of resources. Everyone put a lot of effort into making infrastructure so that kids stay apart from each other; we need to continue to maintain that at home.”
How long does the novel coronavirus last on surfaces, including clothing?
We don’t know for sure, though more research is starting to come out on the topic. “I would say when you wear your clothes, you should wash them,” Landon said. “It is also not the time to be like, ‘Oh, I don’t need to clean off my countertops today, they’re fine.’ It’s probably a good idea to be keeping your surfaces clean and to be changing your clothes regularly and cleaning them in the washing machine.”
“This is going to be hard. It’s different than any way we’ve ever lived before,” Landon said. “But we have to do it. And it may take longer than we want it to take, and it may be different than we want it to be. And no matter how much you think that you’re going to be fine, so why do you have to do all this, ‘It’s just like the flu’—if you keep having that behavior and that thought process, there are a lot of older people and people that are immunocompromised that will die.
“It’s important that everyone take a minute to start thinking more about everyone else around them, and not just about themselves. I know that a lot of you are out there staying at home already… Keep spreading the word—electronically—and do your best,” she said. “Just be patient, and we’ll get through it together.”
Note: You can watch the entire Q&A online.
Olivia Stovicek is a senior editor. She last wrote about resources available to South Siders during the COVID-19 pandemic.