Retired Docs, Nursing, Med Students: California Wants You

Speaker 1: 00:00 Governor Gavin Newsome announced this morning he's launching a new California health Corp and an effort to expand staffing for hospitals, dealing with a surge of Corona virus patients, Speaker 2: 00:10 technicians, administrators, doctors, nurses. Uh, we are calling on you, uh, to step up and step in and meet this moment. Speaker 1: 00:19 The number of people with confirmed cases of Corona virus in California is nearing 6,000. San Diego now has over 500 nationally. Many infectious disease experts say they expect Corona virus cases to peak in the next several weeks, but how many people may be infected. And what does that mean for San Diego? Joining me is dr Francesco [inaudible], the medical director of infection prevention and clinical epidemiology at UC San Diego health and dr [inaudible], welcome to the program. Speaker 3: 00:50 Thank you for hamming. Having me, Speaker 1: 00:53 isn't it likely that different sections of the country will see their peak in cases at different times? For instance, is New York with nearly 60,000 cases likely to see a peak before? We do, Speaker 3: 01:07 yes. Uh, definitely there will be peaks depending on doubling time, but also depending on the density of the population. And so clearly we are different, uh, than New York, which has very high density and therefore, uh, the social distancing measures and, and other mitigation measures will have less effect in some areas compared to an area that is more spread out like San Diego. Speaker 1: 01:41 So do you see California beach being on track to become the next New York as, as we've heard speculated? Is that, is that likely to happen in your opinion? Speaker 3: 01:51 I think California started social distancing measures earlier, uh, in the local spread. And so, uh, our measures if, uh, enforced, uh, and changed and adapted to the local needs, uh, and the local modeling that is being done, uh, maybe effective. We have the advantage of having had a kind of a dry run with the evacuees and so public health systems and hospitals across California, we're able to try out the systems and prepare a little bit more. I think that right now the importance of mitigation strategies is an N the following of these mitigation strategies is, is extremely important and will help us flatten the curb as a, as um, has been said. Speaker 1: 03:06 What are our counties number of confirmed cases just over 500. Tell us about how we're doing in preventing Corona virus. Speaker 3: 03:13 We look at the doubling time right now the doubling time is about six days. Uh, we expect as the epidemic unfolds here in San Diego County, we expect that doubling time to become much shorter and so more cases, uh, diagnosed. Uh, and that also clearly is an effect of increased testing capacity both at the County level, uh, but also in the different hospitals. We are about on track with 20% of patients diagnosed with Corbett needing hospitalization, uh, 9% needing intensive care and our death rate is slightly lower than clearly lower than what is being seen in New York at 1.4% of cases that is clearly, you know, is clearly expected to increase Speaker 1: 04:15 older people in those with health conditions remain the most vulnerable to serious disease. But we've seen many younger people get coven 19 and last week we had a 25 year old County resident with no underlying conditions who died. What are we learning about who is at risk? Speaker 3: 04:33 I think that the question is a underlying disease. Even if you're young, you, you may have underlying pulmonary disease. It is unclear if, uh, if, uh, vaping and, uh, damage to the lungs you to vaping, uh, is, is of of any, has any influence here. Uh, and clearly we need to know more. What I would say is that yes, the majority of persons, uh, succumb being, uh, from this disease are older and with comorbidities, however, you know, exceptions can occur. And, and, and what I would say is a lot of times we see, because of less access to care, we see people hesitating to come to the hospital even though they are having CBS symptoms. And, and that is one of the unintended consequences of a healthcare system that, that, you know, does not have universal coverage. Speaker 1: 05:43 What are you seeing at UC San Diego health in terms of the number of patients with Corona virus symptoms? Speaker 3: 05:49 So we have, uh, over the past week we have increased significantly in testing capacity and um, have also partnered with other health system to uh, serve as a platform for testing and therefore we're diagnosing, you know, more people. We've seen an increase in our in house positive, uh, corporate positive patients, uh, and an clearly increased screening with, with uh, an increase in [inaudible]. I think we are preparing for the worst and hoping for um, a much lower acuities uh, course. But what we're preparing is, um, in having ICU capacity and uh, in ventilation capacity, Speaker 1: 06:44 let's go over a few things. We know about Corona virus. I see a number of people these days walking around with face masks on. Is that something we should do? Speaker 3: 06:55 So that is is right. There's a lot of concern and that has also happened in healthcare. You've seen, uh, the opinion piece from a tool Gawande in the new Yorker last Sunday that led to several, uh, institutions. So healthcare institutions recommending universal masking of their healthcare workers and their patients. As a County. We have developed for the healthcare systems. We have gone to a County wide, wide permissive masking, which means that health care workers who feel they are at higher risk of contracting or wish fewer better in in using a face mask, we are providing these face masks, uh, to these healthcare workers. We're definitely more aggressive in masking patients and particularly regardless of symptoms of COBIT and particularly for those situations that require a lengthly face to face contact for the population at large. I think the first and foremost is really to follow social distancing rules, right? Which means that you have to have that six feet distance one from another. We do not want to congregate in, in groups. We do want to have excellent hand hygiene and we do want to clean as often as possible our work area so that we avoid contamination of the surfaces. Speaker 1: 08:44 Well, let me tell, ask you about surfaces. We know that this virus can live on surfaces for a certain amount of time, but do we have any evidence though of someone actually getting the virus from an surface? Speaker 3: 08:56 Well, you know, we, we touch these surfaces with our hands, right? And then our hands touch the mucosa and, and our mucosa and that's how we can get infected. There is some suggestion that that is what might occur. And therefore the recommendations to clean your work area and to clean your hands often. Speaker 1: 09:22 How concerned should people be about touching things like items in the grocery store, take out containers, things like that. A lot of people have been wiping those things down with disinfectant wipes if they have them. Uh, is that a good idea or is that just a waste of time? Speaker 3: 09:39 So I think, let's go back to what we didn't discuss slight right is, is how is coronavirus spread the spread. The evidence, the preponderant evidence is that Corona virus is spread through large droplets created by the cough generated by the cough or sneezes. And these droplets are large and heavy and travel in the air for six feet or less. And basically that is the fundamental risk, the major mode of transmission that has been seen with coroner virus. So clearly if those droplets fall. So the, the what is the best thing to do is to respect that six foot difference. And that's why we really recommend physical to put a physical barrier to put a physical distance, uh, between persons so as to avoid any generation of this, these droplets. Uh, the other possibility is exactly that, these droplets then for on surfaces, uh, when we cough, uh, that we are very near to and therefore cleaning our hands, uh, often and, and cleaning our work surface is a good idea. Now clearly packages, uh, opening packages. It's not by breathing on these things. I think that you take out the things in the packages and you wash your hands and uh, if you have wipes, yes, wipe down what you're, you know, going to touch. But the, but the bottom line is washing hands, right? Speaker 1: 11:31 Doctor, if someone thinks they have Corona virus but it's not a serious case, they're being advised to quarantine themselves. What else would you recommend they do besides staying at home and quarantining themselves? Speaker 3: 11:45 Uh, I think that watching how their symptoms evolve and if, uh, they feel that getting short of breath or that their cough is really bad or that they have a high fever, then seeking care earlier than later is, is, is clearly very important. I've been speaking with dr Francesco [inaudible], the medical director of infection prevention and clinical epidemiology at UC San Diego health and dr [inaudible], thank you so much. It was a pleasure and thank you.