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COVID-19: Your Questions Answered

Should you worry about the virus being transmitted in the mail? Jefferson experts answer this question and more.

Editor’s note: This article was updated from an earlier version originally posted in March 2020.

Here, we share questions from Jefferson Health’s social media followers (plus a few of our own) about the COVID-19 pandemic and answers from experts in infectious disease, research, mental health and more.

What local or national trends do you expect in the fall as far as virus spread or mitigation?

“We thought the virus might subside over the summer, but we’ve actually seen spikes recently. So I’m not sure what that means for the fall. In general, the fact that more people are wearing masks in public means we probably won’t see quite as many respiratory illnesses in the fall. Flu season may come a little later and may be reduced because of the precautions we’re taking for COVID-19.” – Dr. John Zurlo, Division Director of Infectious Disease, Thomas Jefferson University Hospitals (TJUH)

How will flu season affect the pandemic?

“Back in March, we were testing patients for COVID-19, the flu and other respiratory illnesses all at the same time. We’ve stopped testing for all three, but I imagine we’ll go back to testing for multiple illnesses once flu season picks back up. It will be a challenge to look for other viruses during cold and flu season because many of the symptoms are the same.” – Dr. Zurlo

Other than remdesivir, are there promising treatment options? What are they, and what impact do they have?

“There are many treatments currently being tested. Dexamethasone is a steroid that may be used in conjunction with remdesivir. Those who test positive for COVID-19 and require supplemental oxygen are candidates for both of these treatments. We also have a lot of antivirals being tested in clinical trials. There’s also currently a Japanese drug being tested in the U.S. that’s orally-active. This would be especially helpful for those who are high-risk but don’t have severe symptoms because it would allow them to be treated from their home instead of risking exposure to others in the ICU. We’ve also been testing a method where we take plasma from COVID-positive survivors and infuse it into people with COVID-19, but the results are not yet clear.”  – Dr. Zurlo

Dr. Nicholas Ruggiero, Director of Structural Heart Disease and Non-Coronary Interventions at TJUH, discusses specific COVID-19 treatments for cardiology patients:

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How worried should we be about COVID-19 spreading through surfaces, such as groceries or the mail?

“This is definitely an uncommon means of transmission for the virus. It’s mostly spread airborne or through droplets. But it’s important to wash your hands frequently, especially after visiting a public place like the grocery store or touching shared surfaces such as packages, and before eating or touching your face.” – Dr. Zurlo

“While it is possible that virus could be transmitted from surfaces, we’re not seeing cases of that as a sole mode of transmission. I recommend focusing on hand hygiene and interval cleaning of high-touch surfaces or items, such as your cell phone, but not massive wipe downs of everything that arrives to your home like groceries and mail. A more effective approach to safety in the context of COVID-19, and the upcoming cold and flu season, includes mask-wearing, frequent hand hygiene, practicing social distancing and keeping social circles small.” – Dr. Patricia Henwood, Emergency Medicine Physician and leader of the Emergency Medicine COVID-19 Task Force at Jefferson Health

How can we best ensure we are keeping our bodies healthy during this time?

“Staying healthy isn’t just about not getting sick. Maintaining mental and physical health helps people fight disease more effectively. You can break a sweat with high energy workouts at home.” – Toril Hinchman, Director of Fitness and Wellness, Jefferson Health [Editor’s note: There are a number of workout apps to download, and many Philly-area gyms are running online classes. You can also follow one of Hinchman’s routines.]

“It’s also important to recognize the heightened level of stress and anxiety we’re under. From using technology to stay connected with friends and colleagues to allowing, but limiting, how much time you spend on reading news or worrying.” – Dr. Deanna Nobleza, Director of the Student Personal Counseling Center, Jefferson

How long is someone who has COVID-19 infectious?

“Based on virologic and epidemiologic studies, we believe that COVID-19-infected patients are infectious from a few days before symptom onset to around 10 days after symptom onset.  Even for these individuals who test positive after 10 days, studies have not been able to detect infectious virus from these individuals.  Remember that the current nucleic amplification methods we now use to diagnose COVID-19 infection measure genetic fragments rather than whole, infectious virus.  These fragments can sometimes last for many weeks after infection.” – Dr. Zurlo

If you get COVID-19 once, can you get it again?

“There have been some reports of people testing positive once and then again a few weeks after their symptoms have gone away. But we still don’t have a firm answer. Therefore when individuals who have been diagnosed with COVID-19 and whose symptoms have resolved, then develop new symptoms, we recommend testing again for COVID-19.  If the test is positive, and we cannot find an alternative diagnosis, we treat them as a recurrent infection.

We don’t yet know if natural immunity from the infection exists. There’s something different about the immunological response to this virus compared to others, and we don’t fully understand it yet.” – Dr. Zurlo

If I delayed a non-essential or COVID-19-related appointment during the surge, is it safe to return to the hospital now?

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How do I know if I have to come in-person or if a telehealth visit is appropriate?

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What precautions should pregnant women take?

“Pregnant women are possibly at a higher risk of complications if they contract COVID-19, especially severe or critical disease, and so doctors specializing in maternal-fetal medicine are recommending pregnant women contact their providers regarding their scheduled visits. Many visits can be done via telehealth, while some tests and ultrasounds may still require an in-person visit to ensure mom and baby are healthy and safe. With rapidly changing recommendations, though, the best advice is to check with your doctor about care during COVID-19 pandemic.” – Dr. Vincenzo Berghella, Director of the Division of Maternal-Fetal Medicine, Jefferson Health

What are some of the lingering effects of the virus that clinicians are seeing from coronavirus-positive survivors?

“So far, we’re seeing a high percentage of COVID-19-positive survivors have lingering symptoms for at least a few weeks. This is more likely to happen for high-risk patients, like those who are older or immunocompromised.” – Dr. Zurlo

How effective is hand sanitizer compared to hand soap in relation to the virus?

“Both soap and hand sanitizer are effective. At home, use soap. It tends to be milder on your skin and easy to come by. The soap works by breaking open a sort of film of grease or lipids that covers the virus. Without its lipid cover, the virus can’t infect cells. Hand sanitizer is great to carry around when you do need to go outside. A good rule of thumb is “sanitize in, sanitize out.” In other words, before you grab a door handle and go into a shared space like a grocery store, sanitize your hands. Then sanitize again, after you’ve left to disinfect against anything you’ve touched that might have the virus on it.”– Dr. Matthias Schnell, Professor and Chair of Microbiology and Immunology, Jefferson Health

How can we best address caution fatigue for the public?

“We need to continue constantly educating the public. The Departments of Health in Pennsylvania and New Jersey are doing a good job in continuing to push the message. In reality, the easiest way to open the economy is to have as many people follow the guidelines as possible. Philadelphia residents are doing a good job of wearing masks even as the weather has gotten hot. Restaurants are moving seating into the street to make sure they can maintain social distancing. I’m concerned about what may happen when cold weather hits, but we need to keep taking these precautions for the foreseeable future in order to work back towards a sense of normalcy.” – Dr. Zurlo

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COVID-19, From the Experts