Your Safety Re-Entry Plan
Megan provides ways to think in terms of your family’s personal COVID response plan so you can make the next right choice for your family based on the information available.
with Megan Werdel, BA, MA
Crissy Fishbane: Something we are all dealing with right now is re-entry. Megan is a very knowledgeable woman. I’m going to let her explain her specific job because she’ll be able to do it way better than I am with regard to what exactly she does, but basically she helps design the plans regarding re-entry. We are in good hands here.
Megan Werdel: Hi! I’m Megan Grey Werdel. I am a healthcare consultant focusing on compliance-related issues. In life pre-COVID, and I still do, help surgery centers get licensed and accredited. A lot of that has to do with infection control, bloodborne pathogens, safety plans, running drills to make sure these centers are safe for their patients.
I never really thought that my knowledge would be widely helpful to people, but ever since COVID hit I have been coping by trying to find ways to make myself helpful and that has included helping businesses that are not in healthcare create their COVID plan, their re-entry or ramping back up plans. I’ve continued helping my surgery centers respond to Covid. About half of them closed their doors entirely once they had to suspend elective procedures and the rest of them have stayed open in some capacity.
I do run my company. I am inheriting it from my mother. I have been doing this for 8-years since I got out of graduate school. The company has been open since 1992. Female-run, female-owned company and I am a second-generation owner.
Like you guys, I live in Raleigh and am a mother. I am also trying to figure out how to navigate this as a business owner, as a mother, and as a consultant making recommendations for surgery centers.
What I like to do is take in a lot of information, filter it down, and make it actionable. What I hope I can help you guys do is think in terms of your family’s own COVID plan so you can make a decision when anything comes up so that you can make the next right choice for your family based on the information available.
How many of you have been confused at times at the recommendations, what you should or shouldn’t do, where the line is?
Hopefully, this helps.
Until there is a widely available vaccine, there is no activity I can tell you is completely safe. Period.
But, I can help you make decisions to make it safer.
Ultimately, the activities and the choices you make are going to be based on your family’s individual risk preferences.
You probably hear stuff like this when it comes to investments if you have 401K’s, things like that.
My first two degrees are in economics, so it’s something that we look at often – the risk-tolerance that people are willing to take on.
Background of COVID
Let’s do a little bit of a background about COVID.
Definitions. You might hear it called a few different things. There’s coronavirus obviously, COVID, Covid-19. All of those are the names for the disease that develops after being exposed to the SARS-CoV-2 virus.
If you hear different things that’s what the two means. It’s kind of like the difference between HIV and AIDS. The SARS-CoV-2 is closer to HIV and Coronavirus is closer to AIDS.
It is aerosolized. At first we thought it might be droplet based, but now it is clear that it can live for some portion of time in the air.
That’s one reason why as I give you guys recommendations I’m going to focus heavily on if you need to do things, doing them outside as much as possible because it can linger in the air inside.
Why we did this? We started social distancing. The reasons were threefold.
- To give healthcare the chance to catch up, for their test, trace, and isolate – that’s what the health departments are responsible for.
- Then also for treating the COVID patients. What we had seen in Italy with the number of patients needing ventilators far exceeded their capacity. That’s what they call flattening the curve.
- But there is also — if we had people isolate and they were giving it to fewer people and then you could crush the curve altogether. My assumption at first, and I think a lot of people were with me, if we flatten the curve doesn’t that mean the same number of people get sick just over a greater amount of time. That’s not necessarily the case. What we have seen, as this works – the good news is it’s working and we have some data to show social distancing and the shelter-in-place measures are working – we want to get the reproducibility number as low as possible. That reproducibility number is what you see sometimes as “R.”
There are two different kinds of R. There is RT which is the reproduction number right now. And there is R naught (which has a little 0 at its foot) which is the reproduction number when the virus first started before we had any kind of reaction to it.
The reproduction is — if I get sick, how many more people do I infect before I get better?
In staying home, isolating ourselves, and keeping our circles small we want to get that number below a 1, because then you have linear growth instead of exponential growth. There is no curve left in that line.
Just some background information: originally the CDC thinks there was an R naught of 5.7. Every person gave it to about 6 people. Now in North Carolina, I checked it right before I got in here, it is less than 1. That is ideal.
I’ve been tracking it since we’ve started re-entry measures and luckily it has not spiked yet, but it might.
As you make your family Covid plan, prepare for the eventuality that there might be steps backward. That’s why there are phases 1, 2, and 3. We can remain in certain phases and we can also go backward in phases.
Now I want to move onto what I am calling a Covid-footprint. When I am making personal decisions for my family I’m trying to make the decision between the trade-offs of how much exposure do I want to have, what is it easy to say no to. Different activities are going to have different risks associated with them.
Things that are outside are preferable to things that are inside because of the aerosolized nature of the virus.
Things with fewer people are preferable to things with more people.
Things that include people with higher risk factors should be avoided altogether.
I can tell you my father-in-law turned 80 yesterday and we did do an outside distanced gathering for his birthday. We were all supposed to gather at my brother-in-law’s house in Alexandria with all of the grandchildren and that didn’t happen, so we did make that decision.
But again you have to make these decisions for yourself and for your family.
Until there is a widely available vaccine, there is no activity I can tell you is completely safe. Period. But, I can help you make decisions to make it safer. Ultimately, the activities and the choices you make are going to be based on your family’s individual risk preferences.
High-Risk Populations
Let me talk about that higher-risk population. This is pulled directly from my primary care physician.
That’s anyone over 60 and anyone over 50 with co-morbidities that include hypertension, diabetes, obesity, or anyone of any age in an immunocompromised state. This could be because of medication they’re on, like my dad is on immunosuppressants, hydroxychloroquine – that was in the news a lot – that can actually cause an increase in complications related to COVID, rather than it decreasing it like some people thought it might. Other steroids, chemotherapy, and things like that.
These people should still be very careful. For that reason, things like nursing homes may not be open for visitors again until there is a widespread vaccine.
It’s tough. My husband’s aunt moved down to a nursing home in Raleigh in the midst of all this and we still haven’t seen her and it has been six weeks.
These are not easy decisions that have to be made for this high-risk population.
Now, let’s talk about high risk because I’ve gotten this question before. People that are at high risk are at a higher risk of hospitalization or death due to COVID, they are not a higher risk to other people around them.
Antibodies and Immunity
The difference between antibodies and immunity. You have Covid-19 testing and that will tell you whether or not you are currently sick with it, then there is antibody testing and that can tell you whether or not you have been exposed to it and developed the antibodies to Covid-19. Due to the nature of the testing kits, antibody testing is a bit more available right now than Covid-19 testing.
Covid-19 testing the labs are ready to test for it but there is a shortage in the swabs they are using. Until we get those swabs we are not going to see the testing widely available.
The antibody testing tells you whether you have been exposed. We don’t know yet if antibodies from COVID translate to long-term immunity. We haven’t had enough time or data points to study.
It could be like the common cold. You get some short-term immunity once you’ve been exposed and have the antibodies but it doesn’t necessarily translate to long-term like the chicken pox would.
For now, if somebody has had it they still need to take all the precautions afterward.
If a family member gets sick
Let’s talk about if somebody has had it. If you or a family member show symptoms – dry cough, fever, loss of smell or taste, sore throat sometimes, and sometimes there are some GI issues — what should you do?
First, call your primary care physician. They will determine whether or not you need to be tested for Covid-19 or whether you just need to track your symptoms. No matter what, call before you seek medical treatment because they need to be prepared with the proper isolation precautions when you arrive. If you or a family member has difficulty breathing call 911 or take them to the ER right away. That’s the threshold where you need to seek emergency treatment.
If somebody is sick in your household and you’re caring for them, this is one of the only two times I recommend wearing gloves, unless you’re a healthcare professional or required to wear them for work.
Isolation doesn’t necessarily stop once you’ve hit inside your door. The CDC recommends that whoever is sick, if you can, dedicate a room and restroom to them that is for their own use. They would sleep in another room. You would only clean their immediate area when you have to. You would try to get an N-95 mask which hopefully the health department can provide you if they test positive and you would wear gloves around this person.
The other time you do wear gloves is when you’re cleaning, not just when you’re cleaning something that you know has been exposed to Covid, but also when you’re just doing regular household cleaning.
Household Cleaning
I want to talk about household cleaning:
Wear gloves to protect your hands.
There is a difference between cleaning something and disinfecting something. The CDC recommends that for any hard surface that you’re cleaning to wash it with soap and water and then disinfect it. Whether it be with the bleach or Clorox wipes or whatever you’ve been able to get your hands on.
If you are using bleach solutions, because I know a lot of things are not available, use room temperature water unless it says otherwise on the bottle. Bleach solutions are only good for 24 hours after you mix them. So if you mix up a spray bottle you’re going to want to use it or dump it after 24 hours.
Check the EPA’s list. They have a list of disinfectants to use with the SARS-CoV-2 which causes coronavirus. A lot of times, when I’m in Target I see items that have been left on the shelf that actually do kill Covid, but it was manufactured before COVID was around and so it doesn’t say it on the label.
If you’re in the store and you can’t find anything on the label that says it kills human coronavirus, or you can’t find anything that you’ve been used to using you can pull up that EPA list right there on your phone and double-check and see. I know the Method cleaners, at least the last time I checked did not say they kill human coronavirus, but it does.
Practice routine cleaning of high touch areas — doorknobs, light switches, faucets. Those are the kinds of things that whenever you think about it at home go ahead and wipe them down with wipes or the spray or a bleach solution.
Masks
Obviously you have seen a lot of people wearing masks out in public. The CDC is recommending that you wear a fabric face-covering anytime 6 feet distance is going to be difficult to maintain. My primary care physician says just wear it anytime you’re gong to be in public indoors, or when outdoors and it will be difficult to maintain that 6 feet distance.
They are not recommended for people under the age of 2 or anyone that has trouble breathing without it, so COPD, history of lung cancer, or for whatever reason have trouble breathing. They are also not recommended for people who cannot remove it by themself.
So if you have a child that maybe falls asleep in the car make sure you take it off of them. Or if it’s an older person that’s just not able to take it off of themself than they shouldn’t be wearing a mask.
They should have some way to make it snug over your nose. The point is to make it disperse and not just spray forward.
A lot of doctor and dentist offices are requiring you to wear them, some states and cities say you have to wear them in public at all times. But, I have even heard dentist offices requiring you to wear them in the waiting area. Obviously, once you get back they’ll have you take it off so they can do their dental exam.
Because we are wearing fabric masks and it’s not a medical mask or an N-95 mask – my mask doesn’t protect me necessarily. It only blocks a small portion of things coming in. What it does is it stops the spray of that aerosolized virus if I am asymptomatically transmitting it.
That’s why similar to vaccines, it relies on the majority of people wearing those face coverings.
If it is an elderly person going out, wearing a mask isn’t going to protect them solely. It’s about everyone else that’s around wearing the mask as well.
Healthcare
Some other changes you will see if you were to seek medical treatment for any reason, not just COVID related, is visitors and drivers will probably have to wait in the car and not enter the building unless it’s somebody that has healthcare power of attorney or if the patient is a child.
A lot of my centers are not allowing anyone to come in with them unless it is that case. Even then, children can usually only have one visitor. So I don’t want you to be surprised if somebody in your family has to seek medical treatment for another reason.
Considerations When Out and About
There is a new initiative called Count Me In NC at countonmenc.org. As you start to decide your re-entry plan as a family you can go on it and see restaurants that have taken their training and agreed to abide by them and also as a patron what you can do to keep yourself and others safe.
The CDC also has a whole movement where they say Wear, Wait, Wash. When you are out and about: wear your mask, wait – meaning keep that 6 feet distance, and wash your hands frequently.
The washing of your hands is with warm water for 20 seconds. Even if you have hand sanitizer when you’re out and about go ahead and give your hands a really good wash in the sink when you get home.
Try to touch your face as little as possible. It’s really hard. I do it all the time. Ideally, you’ll use hand sanitizer anytime you put your mask on or off, just because you might be exposed to the germs when you’re touching your face.
I’m sure you’ve heard it but one of the dirtiest surfaces we touch is our phones. Anytime I’m going to wipe another surface I also take the wipe and wipe down my phone.
Speaking of wiping surfaces – every cleaning supply that has a disinfectant in it should have a wet time listed on the back of it. It will say “kills x germs in x minutes.” So, kills 99.9% of germs in 3 minutes. That means the items need to stay wet for three minutes in order for it to actually kill those germs.
Anytime you’re wiping something with a Clorox wipe or disinfectant solution, don’t wipe it dry afterward. Allow it to air dry so it can have the chance to fully kill those germs.
I wanted to pack as much information into this as I could, but I know you guys have some specific questions.
Groceries
Crissy Fishbane: Megan, what is the general consensus on what to do when groceries come in the house?
Megan: I’m always going to give you guys a little bit of a spectrum. The safest thing to do would be to wipe down anything that is wipeable outside before you bring it indoors or to leave it if it’s something that can be left for three days. That is for hard surfaces typically how long it can live.
The decision that I made is to remove it from the bags and anything hard I do wipe. I don’t know about the turnover in your house but the box of cheez-its is porous and can’t really be wiped and I can’t really leave it for three days without my son eating it. But I have the pop-top containers that I will dump it in if he doesn’t get to it first.
So on one end sanitize everything and leave it outside for three days and on the other end let your child lick the box as it comes in the door, and then just pick something in the middle there.
Protecting Children While Out
Member: I know a lot of us are staying home with children right now, my daughter is 10-months-old and my husband is still going into work and I am working remotely. There have been times I have had to go out with her that I have avoided doing because I don’t know how to protect her since she can’t wear a mask. How do they recommend children under 2 being protected?
Megan: The safest thing is to not at all. The good thing is that everyone else wearing the mask is what is protecting her. That’s why the majority of people should be wearing masks – to protect the people that can’t.
Her not wearing a mask doesn’t necessarily put her at greater risk, it might put her at risk of being the carrier that then transmits to others.
When I’m out with my son my biggest concern is making sure he’s not a germ factory to pass it to other people.
If you need to take her out, things like bringing hand sanitizer, bring something to wipe down the cart yourself even if you see people already wiping them down, and don’t be afraid to use your voice.
I used my voice the other day in Target where I was with my son because I had to be and a group of teenagers came barreling in between another woman and myself who were safely distancing. They had no masks or anything and almost ran into me. I pulled out my camp counselor’s voice and said, “GUYS, 6 feet!”
So, don’t be afraid to use your voice, wipe everything down, and limit the contact you have with other people. Things like using Apple Pay instead of a credit card, cash would be the least clean version of payment at this time.
Think through every step before you get there. With my son who is four, I need to think through what is the bathroom break going to look like. There are times I just opt to let him pee on a tree in public versus taking him into a public restroom. So for your daughter, it might be making a plan for how you’re going to change her diaper.
Homemade Hand Sanitizers
Cindi Michaelson: We have a question in the messages. If you cannot locate hand sanitizer is homemade sanitizer a good next choice?
Megan: Yes, but it has to be 70% alcohol by volume. I know that there is a lot of information online how to do that. I have been able to find more off-brand hand sanitizer.
There are two different kinds of hand sanitizer. There is ethanol and isopropyl alcohol and they have to have different concentrations.
I have seen people using alcohol and aloe, but you have to use a specific concentration of each. When you’re shopping, look at the tags because a lot of people think that ethanol or ethylene glycol are the only option for hand sanitizer but isopropyl is also used in healthcare and is now more widely available.
So it has to be 60% ethanol or at least 70% isopropanol and that is from the CDC’s website.
Asymptomatic and Pre-symptomatic
Cindi Michaelson: Megan, can you go into more detail about individuals that are asymptomatic. I know that means they can spread it,but what does it mean for them? Do they have the potential to get worse? How can someone be asymptomatic?
Megan: Yes. So there is a difference between asymptomatic and pre-symptomatic and you might not know the difference until after the fact.
Asymptomatic means you never have symptoms. Pre-symptomatic is the days before you show the symptoms.
The two days before the person first shows Covid-19 symptoms have been shown to be their most contagious time, which is really tricky because they don’t know that they have it and they are still out and about.
There are all sorts of viruses that do spread asymptomatically, and that’s the danger there right?
When we are doing all these screening questions when you go into places, and temperature checks, and things like that, the person may be a carrier and not have shown symptoms yet.
So, asymptomatic is never shows symptoms but could potentially pass it on to people and pre-symptomatic is they haven’t shown them yet.
Cindi: So for an asymptomatic person it would never progress from them having full on COVID?
Megan: Correct.
Member: How long is someone that is asymptomatic contagious for? Is it the same amount of time as someone who actually gets COVID?
Megan: The CDC, as far as safety precautions go, says two weeks. In my clients, it has been more like 10 days, but that’s healthcare that has had exposures that have been passed onto other people. I think the two weeks gives you a full window of exposure — if somebody is in a home that has had a person that has tested positive for Covid-19 they all have to quarantine for two weeks from the onset of symptoms or until individual people test negative for Covid-19 two times 24 hours apart.
The doctor will take care of that for you. Telling you when you can go back out into the world.
COVID in Children
Cindi: Can you clarify how it’s presenting in children?
Megan: All the CDC has for sure said is that it can be more mild in children.
Anecdotally, the people I know that have had it their children have had little to no symptoms.
There were a few reports of a skin condition, but right now the CDC says there is not enough information to link it to.
Summer Camps
Member: A lot of my girlfriends are thinking about summer camps for their 2 and 3-year-olds. What should they be looking for at their centers, at these programs?
Megan: Personally, my son’s camp was canceled for all summer, but I would have let him go given the information we have and based on when the camp would have started.
My husband actually works for the YMCA and they made the decision not to run camps for the pre-school aged children, but they are running camps for school-aged children. The reason for that is they are doing strict social-distancing, keeping less than 10 people per group, and the kids are wearing masks and you just can’t really get pre-schoolers to do that.
The Y did successfully run what they call Camp Hope for essential employees from two weeks after the stay-at-home order was placed. It took two weeks to get it up and running and they had no known exposures through that program.
Things they should be looking for: are they keeping the group smaller than 10 people? How often are they disinfecting? What kind of documentation do they have that they’ve trained the staff in disinfectant procedures and isolation procedures? What’s their plan if someone does show symptoms? Are they doing screenings outside that include temperature checks and symptom screening? But, again people still have asymptomatic transmission, so that’s why that cleaning once they get inside and making sure people maintain distance is important.
My son is going to be home with one of my good friend’s daughters who just graduated high school. That’s going to be the only person coming in to be with him while my husband and I work full time this summer.
Member: Are they required to tell other parents if the family member of another household has Covid and you’re going to summer camp with their kid?
Megan: The good news is that’s up to the health department and not up to the place itself. So the health department, in their Isolate, Test, and Treat they have a whole equation for how long did this person spend with this person? Were they wearing a mask the whole time? Was hand-washing practiced? Then they determine who has to be tested and who has to be notified by that.
If a person tested positive for COVID, the lab that got the positive test result is responsible for telling the health department. So a lot of times that camp or business is finding out about it from the health department and then the health department has the plan that they work through about notifying all the people they’ve come in contact with.
Member: Is that a statewide or countywide thing?
Megan: That’s Wake County.
Risk to Children
Member: I have an almost 4-month old son as well as a three-year-old daughter, so when they say kids are they lumping in infants with that…
Megan: As far as having more mild symptoms?
Member: Yeah, I’m just worried. I know she can have a common cold or sniffles but that could lead to something like RSV in him, so I’ve been kind of treating our family as high-risk.
Megan: According to the physician that I spoke with the high risk is just the over 60, over 50 with comorbidities, and anybody that’s immunocompromised.
Member: One of the questions I’ve been discussing a lot with friends – and I have a lot of friends in California where the shelter-in-place was quite a bit stricter than it was here – pediatricians there have talked about how the isolation to a certain degree is actually more harmful to the children than the risk of sending them back to daycare. Our daycare opened today to all families. We’ve made the decision to keep them home at least another month and then we’ll see, but I guess do you have any insight into…
Megan: Are you thinking about it from a developmental perspective?
It’s tough to say. That is not necessarily my area of expertise. Does your pediatrician have any resources on it? Because I’d say that’s where to start.
My husband says a boat is safest in harbor but that’s not what it was made for.
So, I have a son that is thriving in isolation, a bit too much and he won’t leave the house now, so I can tell you that the temptation is definitely there to get him out of the house.
In a weekly mental health session we had through the Locality, we had a licensed therapist on and a mom of a ten-month-old asked the same question and the therapist said she’s getting all the stimulation she needs from the parents. Certainly, teachers are going to have their work cut out for them when it comes to socialization, especially in little ones. That’s why I sent my son to school – he can do play-based learning at home, but I really wanted him to be there for the socilalization.
As for the risk of it, again when I’m making that arithmetic for my son I’m not necessarily making it because of his risk if he got Covid-19, and I feel like that’s the silver-lining of this and it would be much more challenging if the inverse of this was true and it impacted children more. But, my arithmetic is then for my parents and my husband’s parents, personally. And that’s why I’ve chosen to keep my son at home.
Member: You talked a little about that you’re going to have a babysitter for your family situation. A couple of us have talked about the coronavirus bubble and creating a bubble of friends and family members that are practicing the same ways. How do you know that your childcare provider that’s coming into your home isn’t out in public not wearing a mask? Are those questions that parents should be asking everyone that comes in contact with our kids? How do you live?
Megan: I think you certainly can. It’s weird times. But, coming into contact with people less than 6 feet is now a conversation that people used to have with sexual partners because every person you come into contact with you’re coming into contact with all the people they came into contact with.
I think we are headed for a time where you can ask people what kind of protocols they’ve been following. Also, offer that up yourself.
Full disclosure, I have two family members that treat COVID patients. My family are the people I see. So when friends asked for outside hangs I said no, because I’m willing to take that risk for myself but not for you.
What Can We Do This Summer?
Member: I have a four-year-old. All of her camps have been cancelled. But, it’s summertime. What can we do? Can we meet other people outside to play? I feel like this is going to be our normal for a while, but I don’t know what is safe to do with her outside of the house.
Megan: So I can’t tell you what is safe, but I can tell you what is safer. Outside is safer than inside and always have a potty plan. Right now the CDC isn’t recommending any gatherings, even outside. But obviously the state with phase 2 has said you can have 25 people outside and 10 people inside. It’s a little arbitrary, but that is a smaller group of people in the instance of contact tracing. Those numbers help them from a macro-perspective. It doesn’t necessarily keep your family as safe as possible.
Outside is better than inside. I do know some pools are re-opening. I’m just going to talk about pool safety real quick.
Bring your own stuff. Puddle jumpers, kickboards, toys, a lot of stuff will not be provided by pools which they may have before. Try not to have them share. You’re still going to want to have them maintain 6 feet distance even when you’re in the pool, although when you’re in the pool nobody should be wearing masks.
Member: What about playgrounds when they open? Would you let your kid play on one?
Megan: Would I? Yes, but I would clean his hands immediately after. There is some evidence that it can live on the surface of playgrounds, exactly how long that is unclear. That’s why the actual playground equipment is closed right now. I’d rather let him climb a tree than a jungle gym right now.
Member: Do you think municipalities and parks are going to get those playgrounds clean before they open or do you think they will just eventually cut the tape and we are going to go for it?
Megan: Well that’s the thing right? None of this re-opening is necessarily happening because there is scientific evidence that it should. Which is why we all have to make these decisions for ourselves.
The cleaning for me as a mother would only be helpful to me if they’re doing it daily, if not hourly. Then it gives you a false sense of security where you’re still being exposed to every other kid who’s touched the surface within the time that the virus can survive versus not just the kids that are actually playing on it.
There are two risks. There’s it living on the surface and then there are the kids playing on the playground at the same time as your child.
Swimming – it doesn’t survive in the chlorinated water so that at least takes one of those factors out, and then you just have the other kids swimming in the pool at the same time.
You have to know your kid. My kid is pretty timid. There are different age ranges and what you can expect from them and then there is also what your kid can do. Set them up for success.
Testing and Vaccines
Member: Do you think at some point we are all going to be required to have an antibody test?
Megan: An antibody test, no. It can be useful for an epidemiological perspective, but not necessarily for you. We don’t know yet that it translates to long-term immunity.
So I don’t think that people will have to have antibody testing.
Also, people tell you that they’ve been tested. Know the difference between Covid-19 testing and antibody testing. Antibody testing is typically a blood test and the Covid-19 test is typically a nasal swab which is also why the antibody test might be more available right now because of the nasal swab shortage.
When it comes to being required, no. I don’t even think eventually people will be required to have the vaccine. I think it will be like other vaccines are and then we can rely on that herd immunity from a certain percentage.
When vaccines come out they’re going to be first available to healthcare professionals and the immunocompromised and those high-risk people. Even when the vaccine gets through trials, they have to develop or mass produce it. Then they have to get it to people and that can take some time.
It’s been a long time since we’ve had to do this. When you hear things like it took four years to create this vaccine and it took so many years to create that vaccine. Technology has come a long way since then.
Basically, all of my minutes are spent trying to mitigate the impact of COVID, whether it be for surgery centers, businesses, or people. I make fabric masks. I’ve made 300.
People will send me emails saying they had hoped this would go away but they guess now they will get a mask. I don’t think it’s going to go away until there is a widespread vaccine.
Member: Do you anticipate this is something we will need to be vaccinated every year for like the flu or will it be a one-time vaccination?
Megan: The flu is not the most transmissible but it keeps coming back up because it’s versatile and it mutates quickly. We are not seeing the same level of mutation in Covid-19. There have been some people that thought they saw some in Korea, but we’re not seeing the rates we would see if that were the case. They would continue to be getting higher. So, hopefully, no. Hopefully, it will just be one vaccine more similar to polio.
Member: There’s a lot of rumors that this is going to come back with a vengeance in the fall. How true do you think that is?
Megan: There are a couple of reasons why this might get stickier in the fall and require some more rounds of isolation. One is because of the flu season. It’s going to get very confusing what is COVID and what is flu. That doesn’t necessarily mean there are higher rates of COVID, but it might just take more time to figure it out. The other reason is why the flu spikes in the fall too. Cooler temperatures mean people stay indoors more. So, yes, things could get more complicated for this in the fall for those two reasons.
Traveling
Member: I have to take a family trip up to Massachusetts to get a teenage cousin, most likely flying. Besides hand sanitizer and face masks, is there anything else we should be thinking about?
Megan: The real issue is the recycled air because of the aerosolized nature of it. Do you guys have older family members that you would see? That would be my main concern.
If it were my family, once we got back we would not see the grandparents for at least two weeks. And surface wipes, which I’m sure you’re aware of. But other than that it’s the recycled air which you can’t really do anything about.
Member: Do you think it’s a very risky thing to do right now?
Megan: It depends. I have a little joke that the only thing doctors and economists have in common is that they like to say “it depends.”
A lot of people aren’t flying now, right? It is riskier because of the nature of travel. But, if you think about in the car at gas stations and bathroom breaks you’re coming into contact with a lot there too. So it’s a fewer amount of people but you’re coming into contact with more of whatever they have to share with you versus a drive.
If it were my family I’d insist on a drive because that’s what I feel like I have more control over, and we have control over so very little these days.
As you make your family Covid plan, prepare for the eventuality that there might be steps backward. That’s why there are phases 1, 2, and 3. We can remain in certain phases and we can also go backward in phases.
Phase 3
Member: In your opinion do you think we are moving towards a phase 3 relatively soon here in North Carolina?
Megan: I do, barring any major outbreaks. It does depend on if people make wise decisions. However, there is a separation between the scientifically sound decision and the governments decision to re-open things. We are still hovering below that number 1.
Member: Do you think we will see public sporting events and concerts?
Megan: Were I a betting woman, I don’t think that those in-person sporting events and concerts will resume before there is a widely available vaccine.
Public Buildings
Member: We were just in the hospital. They didn’t say anything like stay at home for two weeks or anything like that. Do you think we need to be staying away for two weeks?
Megan: You were there for non-COVID related reasons? I don’t think if you’re not showing any symptoms you need to. I was in a surgery center today for unavoidable reasons, work-related. They are doing a really good job screening people. Hospitals and doctors offices are really pretty safe. My brother-in-law is a hospitalist and he treats COVID patients on a regular basis. He feels he is a lot more likely to get it from the grocery store than from there because of all the isolation precautions they have. A lot of them have also beefed up their HVAC systems to have the proper air exchanges so that it doesn’t linger in the air very long at all.
Member: Speaking of the air filtration systems — I just got an email from my daughter’s pre-school saying they installed a medical-grade air purification system that eliminates all germs, bacteria, coronavirus that would potentially enter the environment. How credible is that and how reliable is that?
Megan: Because it’s aerosolized, it sounds like what they are doing is increasing the air exchange and that’s how many times per hour the air in a room completely turns over. In most OR’s that’s 25. That’s not immediate though. Whatever it is it takes time. Whoever is in the classroom with the kid would still potentially be an exposure. This is from the CDC, it has time in minutes required for removal for 99.9% efficiency. They calculate this using the air volume so it’s automatically apples to apples.
If there are 20 air exchanges which is what my endoscopy rooms are and that’s pretty high, it takes 21 minutes to filter 99.9%. It’s still in the air for 21 minutes in endoscopy centers. That’s something to consider. I don’t think it’s false claims. They wouldn’t be able to get away with that right now. But this is what the high end would look like. Then you clean the air but surfaces are still a risk.
We should go in with our eyes open, not a false sense of security. If it’s the decision we choose to make still with the information – and the CDC has tons of great information, you could go through and get information from no other source and have plenty to make decisions for your family from the CDC.
Crissy: Megan is there any way to get in touch with you if participants have more questions?
Megan: Yes, the easiest would be to DM me on Instagram @greyandcoinc
Megan is an experienced Consultant with a demonstrated history of working in the health care industry. She is skilled in Regulatory Compliance, Accreditation Preparation, Quality Improvement, Public Speaking, Healthcare Management, and Safety Education. Megan is Vice President of Grey and Company Inc.
