hello I'm Shaun Gerson burger Dean of the UNLV School of Public Health and on behalf of UNLV and the Southern Nevada Health District I would like to invite you to our panel discussion today on covin 19 featuring several of our local public health experts before we begin I would like to thank UNLV UNLV TV and the Greenspun College of urban affairs for helping produce this event I would also like to thank some of our broadcast partners that includes Vegas PBS Cox Communications Clark County television the Las Vegas review-journal and we thank them for assisting us as well so Nevada has been impacted significantly by the corona virus over the last year as long as as well as others in our local community and our nation we've taken some proactive responses under the direction of our governor to try and prevent the spread of this virus so first we have transitioned our schools our colleges and our universities to online education we've told all of our non-essential businesses to close and of course we've been directed to stay home for Nevada and these are really important things under the direction of our governor so Nevada now with this heightened level of public health awareness here and across the nation now more than ever we need to effectively communicate accurate scientifically based information to the public in a way that they can use and they can apply and that is our goal here today so to accomplish that task we have a panel of experts and we will be discussing several different areas first is general information about infectious diseases and how they spread second we're going to discuss the local state and federal responses to this coronavirus pandemic then we'll talk about some of the public health prevention practices but most importantly live a work and then finally we will talk about what you can do to be safe well at home so with that I would like to had an introduce our panelists that we will be discussing these topics with today so first I would like to introduce dr.
Francisco C dr.
C is the chair of the department environmental and of occupational health here at the University of Nevada Las Vegas in the School of Public Health he has over 30 years experience with infectious diseases and prior to coming to UNLV he has significant federal experience where he worked at the Centers for Disease Control and Prevention and he worked in 2003 on the SARS outbreak investigation thank you for joining us dr.
C second it's my pleasure to introduce dr.
Brian Lavis dr.
Lewis is an assistant professor of epidemiology and biostatistics at the UNLV School of Public Health he is an infectious disease epidemiologist and prior to coming to UNLV he was the senior epidemiologist at the Southern Nevada Health District where he has tremendous experience also working with SARS hepatitis and some other local outbreaks thank you for joining us today dr.
Lewis and finally we have I'd like to introduce to you dr.
Witt Crouch our dr.
Crower is the Medical Investigator at the Southern Nevada Health District he is also an emergency physician and so he has tremendous experience in that area and he comes from us to the office of epidemiology and disease surveillance and I think he'll be bringing us a unique local perspective today so with that I'd like to start with a few questions for each of you so there's a lot of things that make us sick and so a lot of those can be bacterial or they can be viral could you talk to us a little bit maybe dr.
C about the difference between bacteria and virus and how they make us sick yeah bacterial are our cellular organisms and they they could grow inside the body and something good and bad but viruses they don't grow outside but they could stay there for a few hours but they need to get inside the body and inside a cell once they're inside ascetic of multiply so or the respiratory viruses that we're dealing now like karana virus they're easier to spread because they're airborne and they need to get through your nasal passages or your mouth or your eyes that's why we want to make sure the people don't touch your face and and and wash your hands as much as possible so that's the difference between viruses and bacteria okay so those those viruses then survive outside of the body do they multiply outside of the body and they don't multiply also the body they could say also the body for several hours I think studies have shown that plastic could be or they could stay for a longer period of time but eventually those die because they don't want multiply outside the body okay so we know that we're most interested of course in the corona virus itself but the corona virus isn't just one there's a whole series of corona viruses could you tell us a little bit about the differences between those corona viruses and kind of what makes this one unique dr.
laters so the quarter viruses are a family of viruses we keep calling this one corona virus but it is one specific type of coronavirus there are four corona viruses that circulate every single year and they cause the common cold they're one of the causes of respiratory disease that we see every single year in the community so we've all been infected by them in our lives there's something that we deal with on a regular basis we've had three different corona viruses that have a much more serious disease we had SARS in 2003 we have Middle East respiratory syndrome which has been going on the last few years and we have this current virus that causes the disease kovat 19 so it's a large family of virus we conveniently just call them corona viruses right now we're talking about one specific type of chronic virus that's just emerged in human populations interesting so one of the things we're worried about is that we get exposed to this virus so could you tell us a little bit about how do people get exposed to viruses how do we expose each other and how do we kind of spread them around dr.
Crower do you mind starting on it sure so different viruses have different mechanisms of spread for this grown up virus it's it's spread and where it's believed to be spread mostly through the respiratory route so someone coughs or sneezes a large number of large droplets are spread in the air and in close proximity to where you're coughing or sneezing and then someone else will inhale those particles or those particles will contaminate a surface someone else will touch that surface and then rub their nose or the mouth and inoculate themselves so there's some controversy about whether this virus is also spread through aerosols which are very small particles that stay in the air for a longer period of time it's suspected that that doesn't play a large role in transmission but in certain settings like healthcare settings where people do procedures which can aerosol ice particles for example when you're giving someone a nebulizer treatment or something like that then it's more likely spread in that sort of setting but for the most part we're talking about large droplets for example when you know someone we've seen that graphic of someone sneezing and there's a black background and all you see all those large droplets and that's kind of what we're talking about for for coven 19 so when those droplets get sneezed out so how do they actually get you know obviously they go on to the next person but then how do they infect that next person how does that happen so so the virus is present in those large droplets and those droplets need to be exposed to your or the virus needs to gain entry into your mucous membranes so so as dr.
C said through the eyes or the nose or the mouth and so basically you're either you're inhaling those particles or you're touching something and then you're rubbing your face you're rubbing your nose and there's the virus gains entry and it's not until they the virus gains entry into your cells that it starts to replicate Parsley's the parts that could go is about two meters that's why we're observing the two meter or six foot distance social distancing was the software the virus could travel and so but eventually they'll drop down because of gravity but and then they could also drop around when you when you touch your mouth or your coffee or sneezing then it could survive in some inanimate object work your hours so that's why it's very important to people wash your hands to prevent the spread of the virus sure one of the questions that I get asked a lot is can I get it from food and so dr.
Davis would you like to maybe address that question I'm sure this is not a disease that has spread through food it's not something that you're going to eat and will cause disease that way so you really don't need to be concerned about the foods that you're bringing into your house whether they're from the grocery store or from a restaurant the concern is really interaction with others because it's spreading through the air if the the person delivering your food coughs or sneezes on you that's where the risk of disease is going to be but it's not the the food's themselves so there's really no reason to change our eating behaviors because that's not a way to get this particular disease okay so one of the things we hear a lot in the news recently too is that there's a lot of susceptible populations so first maybe you could tell us you know who's susceptible to this one of the things we like to do is if we know who's the most susceptible or have the worst response to that if we protect them we try to protect everybody so who are some of the groups that might be the most susceptible to so in terms of getting the disease basically anybody breathing is going to be potentially exposed to this disease so it doesn't matter whether you're young or old you get anybody can get this particular disease the thing that we're concerned about is the way different people react to it as you get older your immune system gets a little bit weaker so that's why we see people in the older age groups more likely to have a serious disease more likely to need hospitalization and also more likely to die unfortunately and the same is true for underlying health conditions so if you have certain conditions that make your immune system a bit weaker if you have uncontrolled diabetes things like that that can really lead to immune problems and that's going to put you at higher risk and if you have lung damage from COPD you're a smoker things like that those types of things cause physical damage to the body which may make it a little easier for the virus to get in but it's a lot tougher for your body to to deal with that if it's harder for you to breathe on a normal basis once you get infected it's going to cause more serious problems so why should young people care right we always talk about the elderly and the most sensitive but why should the young people be concerned about this as well so everybody can get this that's I think the most important message here is it doesn't matter what age you are everybody can be infected while young people aren't likely to die from it they can take it home and give it to those family members who are older and have those immuno compromising conditions so even if it isn't going to be a life-threatening illness for you it could still be a problem for the people that you care about dr.
C did you want to add something there I think that's a main point that they say it's a novel coronavirus that means it's a new virus none of us has been exposed to it so none of us has immunity to it so all of us are susceptible to this virus but the older people tend to have lower immunity so they would be more susceptible compared to the younger people but if everybody's susceptible to it we just react differently to it you know younger people may think that their risk is low and the risk of having a severe illness is low but it's not it's not zero so even if you're thinking of this from a purely selfish perspective just so you know what's gonna happen to me I'm even if you're in your 20s you know it is still possible to die from this disease your chances are smaller than you know if you're elderly or if you are being compromised but but your chance is not zero so you know from both a public health perspective and from your own perspective it's important that we do what we can to prevent the spread of this disease well it's been helpful talking a little bit about the disease and how it spreads and and the virus to me and how it spreads and how it works so but I want to change gears a little bit and talk a little bit about our local kind of federal and state responses to this but before I do that there's a couple of terms that seem to get thrown around kind of universally and I want to see if you could tell us maybe the difference between those we've heard determine outbreak we've heard the term epidemic we've heard the term pandemic could you tell us maybe doctor labels again what is the difference between those three and why is that important so when we talk about an outbreak of disease we are seeing more disease than would be expected in a population at given time for something like this it's a brand new disease so we expect no cases of this so as soon as we start to see transmission in a community that's basically instead of an outbreak it basically means the same thing as epidemic the terms are pretty much interchangeable and you can use them interchangeably without any problems sometimes people refer to outbreaks just being a smaller geographic group or one school or one household but it basically just means there's more disease than normal pandemic is when that outbreak spreads across borders so if we see international spread it's just an outbreak at a large level so pandemic doesn't mean the disease is any worse than you would find in an outbreak it just means that it's found in a lot more places so what we're talking about is just the geographic distribution of that particular disease so we know that obviously this is spread pretty much worldwide and one of the things we would expect is that everyone would be kind of responding in the same way having the same message whether they're state local and federal government but that doesn't seem to be the case could you tell us a little bit about how different governments regions areas respond to you cove in nineteen and why they're not all the same important thing to notice the the level you're working with so we expect the federal government to be the one that coordinates all the activities plus the facilitation and also the funding and then the local governments state city local community county level I don't want to implement the the prevention that measures so it's a it's a group and United Front away to do work together on this one so we see that from kind of the federal level which is it's a great perspective what about a memo in the kind of local or or state levels well responds to some sort of problem like this in our community we have to recognize that every community is need unique they have their own resources and they have their own challenges so the way we respond to it in Las Vegas isn't going to be the same response that's appropriate in Elko or in Carson City or anywhere else in Nevada it's based on what's happening in your local community so even though the whole world is dealing with this it takes on the unique flavor of wherever it's spreading so we have to build our responses around that and think about what we can do locally to stop it the recommendations that we give our nevada specific but then beyond that we have to think about what does that mean exactly for Clark County because we're not the same as other places in our state so one of the other terms that we've heared use that we've used in our state is that we've declared a state of emergency so when you hear that word emergency everybody kind of panics what does it really mean to declare a state of emergency so the state of emergency is like a public declaration that allows for the mobilization mobilization of resources so the fact that I governor sis lack declared a state of emergency for Nevada allows allows us to adjust our response perhaps to you know for things like allocation of resources and licensing and things like that it allows us to to tailor our response and not to just to go through our usual mechanisms so sometimes in a situation such as this we want to mobilize and act very quickly sometimes going through the usual sort of more bureaucratic channels is is not ideal and so state of emergency really allows us to to act in the way we need to act in an emergency and the president declared a national emergency soldier Congress that we need the funding to be allocated different communities in our country so then Congress would meet and that's what they did and they started to fund provide the funding for this for this epidemic so again I want to switch gears a little bit we all know we've been told to do a lot of things right you're supposed to wash your hands you're supposed to clean services but I want to look at and see when we're doing that that we're doing it collectively so can we start with washing of hands right we all know we're supposed to wash our hands but we need to know how to do it correctly so what are we doing wrong when we're washing our hands incorrectly so the challenges with hand washing are either not doing it long enough or not being thorough in the process when you're watching your hands it needs to happen for 20 seconds because the whole goal of washing your hands is to remove whatever viruses are on your hands and flush them down the drain so you're physically removing them and as part of that you want to make sure you're covering every nook and cranny of your hands you're not just rubbing a few parts of the hands and missing others because that's not going to remove the virus so you have to do it long enough obviously you have to use soap and water and you want to be very thorough to make sure moving as much virus as possible from your hands we also like to add to that [Music] dr.
leaders say you know I think if you've ever watched like people scrubbing in for surgery and how versions are meticulous in in washing their hands and they get all the surfaces the Front's the backs the between their fingers the fingertips their thumbs and I think when you see in an ordinary life I think people you know sometimes they just like rub their fingertips together but this is you know situation because we're trying to you know reduce the amount of virus on our hands it pays to be thorough so one of the things that happens is we have public restrooms and public bathrooms and we try and go in there and wash our hands we have all the automated soap dispensers and automated water but talk about what things people do wrong when they wash their hands in public areas especially if they have to turn the faucet on or off that not everything is automatic like we have at home yeah I think especially when people are using you know public restrooms and things like that I think the places where we're most likely to recontaminate our hands after washing it's probably the the faucet and then the door on the way out so you know most people you know you use your hand to turn on the faucet and then you wash your hands really thoroughly but if you use your hand to turn off the faucet then your recontaminate insane goes with when you're walking out the door if you're using the door handle on the way out you're recontaminate yourself so one of the strategies is to help with this is after you wash your hands take a paper towel use that to turn off the faucet use another paper towel to open the door and then it's important to have things like you know no touch no touch trash receptacles so as you're on your way out and you're using a paper towel for the door you can throw it in the trashcan without having to stick your your hand through a flap or something like that so we need a little strategy right when we go in the bathroom to make sure that the paper towel dispensers aren't being retouched and the door handles and faucets so what about anything you want to Brad add decals you can't just think about yourself washing the hands you have to think about the person in front of you maybe they didn't wash their hands maybe they were touching all those surfaces before you did so even if you're very meticulous about things you're basically picking up whatever the previous person left on all those surfaces almost like you didn't wash your hands in the first place so obviously we use soap there's all there's a thousand different kinds out there right so we have antibacterial soaps and we have the hard soaps and the liquid soaps or any of these recommended or better or what's the what's the common ology we need to know about so what soaps should we be using soap and viruses soap is soap it doesn't matter what sort of fancy additives or perfumes or anything are in there soap is going to be effective because it physically helps you remove those things from your hands antibacterial soap doesn't mean anything because we're not talking about it bacteria we're talking about a virus so even the cheapest basic bar of soap is going to work to wash your hands you don't have to do anything special you know to spend a lot of money soap is equally effective in washing your hands excellent so the other thing that we're hearing all over the news is that we should be using hand sanitizers and so I know they're a little difficult to find right now but what and why do we use these so again we know we're supposed to be using but I want to know why we're why we're using what's the purpose of using hand sanitizer solution well you have no access to soap and water there you have to use hand sanitizers but you make sure that though the sanitizer have at least 70% alcohol to be effective including the virus sanitizers is they develop them for abuse of medical settings between hand-washing where you didn't have the ability to wash your hands constantly because that could be very taxing on the skin as well so that's a challenge in medical settings we need to wash your hands all the time if your hands are visibly soiled though the sanitizer won't work if you have stuff on your hands the alcohol can't get through to kill whatever's in there so the hand sanitizer you're basically trying to kill those viruses but you shouldn't rely exclusively on the hand sanitizer it's a nice thing to do when you don't have easy access to soap and water you can use it between hand washing but it shouldn't replace hand washing there's no substitute for soap and water hand sanitizer buys you a little more time but you know we all know that in our normal lives we can't have constantly clean hands we're constantly touching things we're opening up doors so the last step I think that's helpful is just not touching your face so if you have dirty hands and you touch your face that's how you get the virus into your your nose or your mouth so you know even if you're in a situation where you don't have soap or you don't have hand sanitizer then then don't touch your face in touch your face so like the soap we talked about this you know 20 second hand washing technique is there anything special we need to do with hand sanitizer you know is there anything we need to do that we run / or is that nutcase sanitizer on rub it until it dries don't lie pit off on a towel or something else it has to basically have a enough time in contact with the virus to kill it so you'll want to be wiping it off you want to leave it on there and keep rubbing your hands until it evaporates and that's the amount of time you should use that sanitizer so one of the other prevention techniques that we've been told to do is to regularly clean services which is generally a good idea any way to clean services but we're cleaning we're now thinking about this coronavirus so tell us a little bit about how and why we might clean a surface detector pressure so the idea is the corona virus can remain viable on a surface for in a certain period of time and you know these s we've seen different estimates based on sars and MERS and other corona viruses and these estimates can be from hours to potentially even days so the idea is that the surface is that you're most likely to touch and those should be the ones that we disinfect on a regular basis and so you're trying to basically inactivate or kill the virus on these surfaces so that people who touch it aren't then able to infect themselves so high-tech surfaces are things like you know anything with a button elevator buttons door handles handrails at home you know phones are one of the most common high-tech surfaces we're constantly touching it throughout the day and so this is one area that I think most people probably haven't built listen to their routine so I know this is being sort of a change for me so you know when I go home I'm disinfecting my phone like my keys trying to make sure that whatever I am bringing from outside the home is not going into our home yeah any other surfaces or areas that people would like to alert us about to make sure we're cleaning on a regular basis it's this applied since people complain about running right now I'm not running out of supplies I think you can do your own solution at home for example you can put one cup of bleach plus nine cup of water and mix them those are simple solution that we use for cleaning surfaces table chairs your television I think that inanimate object that you've touched frequently so you can help your home made type of chemicals they could use to clean as possible in your home what do you really need to clean so if you're coming from outside if you're bringing things in that's how the virus is introduced if other people come in or if you're in common areas that's how a virus can be left on a surface but if you live alone wiping down all the surfaces in your house on a regular basis really aren't going to isn't going to do anything to protect you because you're the only one that could contaminate them so you need to be realistic about what type of surfaces you need to clean but if you don't leave your house for several days and nobody's come in it's not like the virus would be introduced and you and cleaning isn't going to provide really any extra protection in that case and we want to make sure enough to get that all over our food as well too right because it's cleaning agents and things we want to be careful with are concerned about products coming from outside so they're wiping down hands and bottles and boxes and things like that but you have to be careful with the chemicals you use around your food because a lot of those are fine for surfaces but not something you want to eat right so another one of the prevention techniques that we've heard about is is trying to sneeze or cough correctly right if there is such a thing it's almost alarming now when we hear somebody call for sneeze everybody looks so could you tell us a little bit about what is the what's the right way to sneeze or the right way to cough I know that sounds kind of strange but I got shower do you mind sure so basically your strategy is when you're coughing or sneezing you don't want all those particles to to be spread everywhere in that 6 foot radius and so the ways you do that are things like sneezing – a Kleenex sneeze into a tissue and you have it against your mouth before you sneeze and most of those particles are caught in the Kleenex and then throwing that and Kleenex away and washing your hands so if you don't have a tissue with you then sneezing into the click of your elbows another good strategy we don't want people sneezing their hands because sure you're not going to spread those particles everywhere but then you're gonna touch stuff and you're gonna contaminate things so you're much less likely to you know type something with inside of your elbow so that's the strategy behind that so when you sneeze into that Kleenex you said something in there that you want to make sure and throw that away so some people have handkerchiefs they have Kleenexes they have other things or if you've copped into your arm so then what do we need to do with those things do we do we launder them do we throw them away we don't want to you know stuff put them up our sleeve or in our pocket right because they're full of viruses so what's your recommendation what do we do with those things doctor label thing like the tissue throw it away don't reuse it those things should be discarded this is really a bad time to use a handkerchief for something like that use disposable tissues that can be thrown away when it comes to your clothes you really don't need to do anything special just wash them like you normally would dry them on the highest setting that's recommended and that's really all you need to consider when you're thinking about fabrics that you may have sneezed in or could have some viral particles on them so part of the sneezing is as you mentioned trying to reduce those the virus and those droplets from going all over the place and and one way you can do that is with a mask so there seems to be a lot of misinformation out there about masks there's people wearing them all over the place to you know to the store to the supermarket at home hospital settings could you tell me about when and how we should wear a mask and when it's the most effective time to do that masks so the the base a surgical mask or some some masks that don't filter you know really like 95 minutes so the basic surgical masks the biggest effect of that is just stopping the spread of the large droplets as you said and so it's it's not really for those masks it's not really about preventing you from getting infected it's preventing the wearer from infecting others and so that's really the the biggest value of those masks you know in a healthcare setting the situation is slightly different physicians and nurses and and health care providers are getting in really close contact with with patients who are sick they may be performing procedures that are likely to aerosolize the particles for example II for example if someone is is in intubating someone like putting a breathing tube when someone is having a real difficult time breathing that can actually aerosol ice particles so that they're really small particles and in that setting the n95 becomes critical to to help protect the healthcare provider but for someone who's just walked walking around in community you know there's there's very minimal protection that that's something like that would provide them because you're you're not really being bombarded with these particles all the time so so just to summarize you know the main protection for most people for a mask is preventing you from infecting others healthcare setting when you're using those n95 masks it's not as simple as just handing out a bunch of masks to the staff there's a whole process that goes along with it to make sure the mask is the right shape for your face that it seals around your mouth and that you know how to take it off if you have a mask that's doing a great job of filtering out the virus and the first thing you do is grab it with your hands now that's on your hands so it's not as simple as just putting on the mask there's a whole process that goes on around it so just buying at 95 mask isn't necessarily going to provide them the protection you think it well because they have to be used and fitted properly it is a piece of personal protective equipment and it's really tailored to an individual you just say you are someone who you know had a stash of masks at home because you're wearing a mask doesn't mean you no longer have to take those other steps you still need to avoid you know rubbing your eyes you still need to wash your hands things like that so we don't want people to have a false sense of security just because they're wearing like a surgical mask in you know it may be helpful in some situations but you still need to take those other precautions yeah it's good to know that all these things work in concert right that washing the hands the cleaning the surface the masks and all those so so we do see the the masses everybody's wearing the cloth mask some of those are disposable obviously we've already talked you should take those off and throw them away but what about the cloth ones right those are designed to be reused you mentioned you don't to just kind of take those off and roll them up and stick them in your pocket what should we do with those once we've worn them and once we want to kind of launder them or clean them we would still wash it away just like you would any other fabric so wash them on a hot temperature dry them on a hot temperature but really you have to think about what happens between when you're washing it if you have that Maslin and it's filtering out particles and you're touching it think of the the furnace filter you change out your house when it gets dirty the same sort of thing happens with whatever that mask is filtering out even though you can't see it all those particles are on the outside of that mask so you still just can't take it off put it back on repeatedly over the course of the day without thinking about how you're touching whatever that mask was supposed to filter out supplies including masks because in the worid well people are you know using it a lot and there should be a priority for a good question a solution and by other speakers here the hyper is for medical workers to use them and also patients were interested so those were not interested the likelihood of you getting infected from others less so it's if you give the medical workers and the first patient more opportunity use them rather than you use it because your you're not infected but you're just worried about it well and one of the ideas here is that obviously we're stopping those particles removing another thing that we can do and another prevention technique promoted by Public Health there's been this new word that we all got to talk about it new words of social distancing but there's a couple of words in there we talked about we've talked about quarantine self quarantine isolation social distancing could you tell us what the difference is between those and then again what's the purpose of doing that so basically all of those terms are ways that we can physically separate ourselves from others isolation is a medical term we've used quite extensively it talks about what to do if a person is sick so someone is sick they need to be separated from other people so that may be staying in a separate room or special rooms and hospitals with certain kinds of airflow that that keep you from spreading your disease to other people the idea of quarantine is we're keeping you away from other people but not because you're sick but because you've been exposed to somebody and you could become sick we're concerned that there is some potential for spread before your symptoms start so this way if you're quarantined from the time you're exposed and you do get sick you won't put other people at risk the idea of self quarantine is just doing it at home we're asking you to do it rather than having some legal intervention or a legal requirement that you do so but the basic idea is keeping you away from other people so that you don't develop disease social distancing is just the broad idea of putting physical separation between you and others if the virus can spread about six feet when you're coughing or sneezing you want to be beyond that so you don't want to be lining up close to people if you're in a store that's why we're asking people to stay home because it's going to minimize contact between you and other people and stop you as a link in that chain of disease transmission that that's a good information so I know you mentioned a little bit now what do I do if I get sick so if you're at home and you're starting to feel sick there's a lot of information out there but what do we what are we supposed to do what do you tell people if I'm not feeling well do we want them to go to the ER do they go to the doctor what are they supposed to do well one of one of the difficult things about this disease is that it can start off very mild then many people may have mild symptoms throughout their whole course so you know if you feel like you are coming down with a cold or having flu-like symptoms the first step is to please don't go to work a lot of people are staying home but some people are still going to work so one of the most important things is please stay at home if you this is a time where because these symptoms can overlap with like common cold symptoms we want if you start to feel sick also practice social distancing from your family members so we want to really try not to transmit this to other people now we know that testing has been an issue nationwide so in an ideal situation anyone who has you know any cold symptoms would get tested and unfortunately that's not only feasible right now but what people can do is they can reach out to their health care provider figure out if they have symptoms that would warrant testing and their health care provider could facilitate that that testing but one thing we we don't want people to do is you know just say you have mild cold like symptoms we don't want you to rush to the hospital or to the merese Department to get tested right now the hospitals of emergency departments they're getting inundated with with very sick people and we want to conserve the resources at the hospital for people who who really need emergent treatments or people who may need oxygen people who may need to be put on a breathing machine and so if you you know have very mild symptoms that you go to the hospital then then that'll take away a time resources from from other people now it can be hard sometimes for people to distinguish when they need to go to the hospital or not but I think a rule of thumb is that you know if for your current symptoms if you wouldn't if a year ago you wouldn't have gone to the hospital for those symptoms like you had cold symptoms and a year ago you wouldn't have gone to a hospital for those symptoms then then I think it's appropriate to not go to the hospital at this time really it's it's working through your through your primary care provider and another thing is that you know there are a lot there's a lot even if people do have kovat 19 that they can do to sort of help with the symptoms so so things like fever reducing medications and things like that that will go a long way to helping you feel better and sort of managing your symptoms the most important thing to remember with this coronal virus epidemic is that there's a high rate of asymptomatic carrier because people are infected but they have no signs and symptoms of the disease so about 80% of the people who are interested with a very mild sim no symptoms or mild symptoms to start and only about 20% would have symptoms like pneumonia in there but 10% will be hospitalized all those 10% 5% would have more severe infection that really require intubation other type of procedure but the most important remember is that there's a lot of people who are infected but have no symptoms that's why we're practicing all the social distance isolation cell quarantine to avoid exposure so in other words it's it's it's very important to treat people as if they're infected and observe all the different because in our measures so obviously there's a lot of people that are getting sick do we have anything on horizon is there a cure there are remedy is there a vaccine and when might we expect to see that well when it comes to treatments there's a number of different chemicals that are being tested all sorts of different drugs are being tried right now to see what is effective against coronavirus and these are being tried in hospital settings around the world to find something that can reduce the death rate or reduce the severity of disease but we don't have a particular one right now that's right commanded we're also not telling anybody to self treat with anything's they may have heard about because really there's no proof that these things work and a lot of them can have dangerous side effects so we're working on different treatments we're just not at that point when it comes to vaccines the process of producing a vaccine is conceptually simple but it takes a long time to actually test it and show that it works you have to vaccinate a bunch of people and compare them to to people who are unvaccinated to see that there's actually a difference in the development of disease and that takes months to years so it's going to be 12 to 18 months at least before we're having serious conversations about a vaccine being available assuming that it actually works and assuming that with this virus you wind up getting long-term immunity which is also something we don't know we don't know what happens 12 months after you're infected if you can get infected again or if you get it once in her life and that's it because we haven't had more than three or four months experience with this virus and we can't say what's going to happen in a year two years five years down the road so there's a lot of things we don't know and that makes it challenging to make decisions about using a vaccine if we even have one yeah it's rest of irises it takes a long time to develop a treatment or a vaccine for viruses was it's very harder it's harder compared to bacterial or antibiotics I didn't use that to treat them important to remember is that there's not much bullet for this one and usually it's combination strategies all these things that were talking about from hand-washing the social distancing to isolation toward all combination factors like this would help instruct the epidemic we did that with SARS in 2003 and it which happened one now in one China the cases are going down not because they they're doing this and if you look at the statistics is maintaining at the same level in in China what the rest of the world is it's also going up because we're looking for this magic water but there's none it's a combination to all these strategies that will work together this yeah obviously we want to talk a little bit about all these prevention strategies and why they're so important to implement because they can really help slow the spread of this disease and I think you know because things like vaccines or potential you know successful trials with drugs are you know at least months away potentially years you know this this is really why some of these social distancing measures are being promoted is because you really want to delay that peak and want to make that peak not as high so fewer numbers of cases and spread out over a longer period of time and we buy ourselves some time to do things like discovering effective vaccines so it's been a good discussion about all those prevention techniques but now we want to kind of take those into the home environment so a lot of individuals have been sent home to stay home with their families what if you go home and one of your family members is sick and has been exposed how do you protect them how do you protect the other individuals in that house and what what are the practical things they can do around the house to not spread this to all members of the family so just like everything else we've talked about today there it's about putting a physical distance between you and other people so you have to think about it just the people who are generally in your home and then there's the people caring for the sick person so if you can put a physical distance between you and that sick person that's going to reduce disease transmission risk so if you have an extra room that's where that person can stay by themselves they have their own bathroom that's the ideal situation so you're physically going to separate them and have them in a room separate from everyone else and the only person were and touching or being in contact with that stick person should be the caregiver you don't want to have the the elderly grandparent as they caregiver for somebody because they're at much higher risk of a serious disease if they were to be infected and so then you really have to start thinking about cleaning surfaces around your house hand-washing and being very careful anytime you're having interactions with that sick person this is its ideal if you have a separate room but we know most people don't have the ability to do that everywhere you have potentially a lot of people living in a one or two bedroom apartment and so it can be challenging to put that distance there but it may be that you set up their bed kind of in the by an open window have everyone has kind of stay away from them whatever it is keeping some distance and then pretty much not having contact with that person except for the ones who are going to be providing direct care I think what dr.
Leyva said was exactly right I think the issue of air circulation is very important I think keeping if you are in a situation where that person doesn't have their own room or something like that keeping windows open improves their circulation makes it much less likely that these particles are gonna stay in the air for a longer period of time yeah but so you know when if we know that someone's sick at home and we know that they have kovat 19:00 you know these these measures become extra important and so people need to to be much more strict about you know keeping that distance about sanitizing things then then just in our ordinary lives things like laundry and trash cans and you know unfortunately people are sick there's usually a large pile of Kleenexes what do we how do we deal with that so that we don't expose other people anything different we should do there I think you know things like having the no touch trash receptacles so making sure that you're not having to physically use your hand to open up a trash can is important throwing away things like dirty Kleenex is you want to have a situation where you're not sharing dirty utensils so you know this is not the time for communal eating and sitting around the table if someone is sick at your home you want to make sure that they're eating in separate location but things like you know washing your dishes the normal detergents and stuff should inactivate this virus and the same way of you know laundry in your clothes and things like that so but you know anytime you're potentially touching something that could be contaminated make sure to wash your hands afterwards I would say if you have gloves at home that'd be the time to wear the gloves if you're taking out somebody else's trash or handling soiled laundry that's just going to provide one extra barrier between you and the contaminated material but just because you're wearing the gloves doesn't mean you stop the hand-washing you wear the gloves in addition to the hand-washing you're trying to stop the contamination in the first place we still have to remember to to practice good hand-washing especially in a situation like that and if you do have a sick person at home this is the time where masks could be very important so if they're you know if they are having to come out of their room or their area of the house then having them wear a mask and will help the perfect potentially prevent them from infecting others there's some good practical advice for folks at home but sometimes we still have to go out right we run out of groceries or we have some emergency in our house we got to fix a leaky pipe or something so what can and what are our businesses doing to try and help us to also follow these prevention practices that we talked about what things have we seen or what things should they be doing doctor sir I've seen that that people observe their social distancing like it's a small store you can see that they say we along with two or three customers at the time or when you fall in line to pay your bill you also observe the distance about six feet away from each of each other so you observe those precautions so that you don't get exposed or to other people you know anything else we're seeing in stores well a lot of it has to do with just thinking about how you separate people physically there can be a bit of a challenge in some of the stores because if you go to the grocery store there are certain products that everyone wants to purchase and so you have people congregating around the milk or the bread or things like that so there's not much the stores can do in those situations other than only allow one person in the store at a time because you'll have people coming together but you need to think ahead as an individual even in the the ideal situation you need to follow the rules still of staying distance from another person you may have to wait a few seconds for the other person to walk away but think about how you're going to come in contact with them and try to minimize it even if the stores doing something to try and minimize the amount of times you're touching things I've been to places where you know they won't touch your card you put the card in that's it and they change their practice where you normally would hand them the card and they would swipe it for you but just little things like that minimize the amount of time you're having contact with other people and the potential for disease spread the axiom wiping down grocery carts and other things when you enter the stores – which I think are some good practices so with that a lot of people are trying to avoid going outside and avoid doing things so they're ordering all sorts of things online so that's you know a group of people that we need to thank they're working double-time right now or shipping and delivery people so what what practices have we seen in like shipping and delivery that are also trying to follow these prevention practices yeah I think if I think you said exactly right that we need be very thankful that there are people who are still working you know in these warehouses they're shipping out products there are people delivering those so we need to not definitely not take those people for granted it we are fortunate in that it's probably the easiest that's ever been to self quarantine because you know you eat groceries and you can't you can't leave and you can just order it with a click of a button so yeah I mean I think those are all very useful in our modern lives I think we've seen a bunch of commercials where businesses are really starting to understand this now and their advertising don't touch delivery so they are happy to come to your house leave it on the doorstep and and not have direct contact with you so if that delivery person is bringing something up and you don't need to go out and physically take it from them or sign a receipt or something like that let that person go back to their truck and drive off before you're gonna walk outside and potentially put them at risk they're coming in contact with hundreds or thousands of people a day and you don't want to increase that risk for them becoming sick so think about that delivery person and what you can do to protect them not just the things you need to do to protect yourself from whatever disease they may be carrying as well yeah I know a lot of folks come in now they do touch list delivery and you know set things on the porch and and try not to have you signing on the keypad so there's been a lot of information about that so one of the things that we also I think are struggling from is there's this information overload and every website and YouTube and place has got information about what to do about coronavirus so could you tell us about what are some of the most credible sources maybe from a local perspective and a federal perspective about where people should go to make sure the information they're reading and they're getting is good quality accurate scientifically based information dr.
Steve you mind starting about some of the federal resource level CDC website is the most credible all in terms of prevention but for research in terms of new medications or current vaccine development you can go to nih website so CDC job or NIH that go those are very important federal resources but the academia is also a good source so Johns Hopkins corner bars that JQ that edu is also very good source of information I think if you're interested in finding out what's happening at the local level than the Southern Nevada helped us rate a website is very useful so there's a short and you are all for the current virus page it's as an HD info / coronavirus or as an HD info / co' good 19 and I would add there are all sorts of reports every single day about case counts we track the number of cases we track the number desks there's no sports on TV so people have to follow some sort of number from day to day those numbers are rather complicated so just because we saw an increase from one day to the next doesn't mean it's the end of the world it doesn't mean that there's been a huge change in the disease trying to interpret those numbers is very challenging even for those of us who are working with this every single day because it doesn't show exactly what's happening today it's kind of what happened a couple weeks ago and it's based on how many people were testing and things like that so I would basically not follow it day by day and say here well the numbers went up two percent that's means something well it really doesn't they're very difficult to interpret and I think you're gonna drive yourself nuts and freak out quite a bit if you constantly watch those numbers and try to make more sense of them then and even people who deal with them everyday you can do not focus on those prevention techniques rather than watching all the numbers so as a public health professional one thing we promote every single day is that people try and stay healthy right that they eat right and they exercise and they do all these things that's changed a little bit too right our gyms our workout facilities all those areas are closed I'm getting a lot of questions about how can I stay healthy during this and how do I do that without violating all those things we talked about earlier so might you have any recommendations on how people can stay healthy and eat right and do the things that we want them to do every day well I think first of all nutrition is important so I mean you know all the fruits and vegetables and things we're still able to access them in stores I think those we want to be as healthy as possible eating nutritious meals we want to be getting plenty of sleep so sleep has an important effect on your immune system so you know now it's not the time to stay up all night you know reading reading the news even though it's very tempting so make sure you're getting adequate sleep I think exercise is great as long as you're doing it in such a way that you're not potentially exposing yourself to other sick people so you know if you can if you can exercise in your home or if you know if you're jogging outside as long as you're not getting in close proximity to others then yeah now's the time to do it Derk your latest I know you wanna interview to see tonight a lot of questions about that you know can I go out running in a group of people well know the rules we have on stores or anything else in public are the same ones we're going to follow for any time we're out doing an activity but it doesn't matter what that activity is if you're doing with a group of people that's a bad idea if you're not walking by yourself that's fine are you and the the people you live with go out together you also have to think about how people congregate so going to the park may be a great idea but if everybody has that same great idea all of a sudden you have a lot of people on it space that you normally wouldn't so you really have to think about how you're going to physically separate yourself from other people no matter what you're doing when you go outside whether you're going to the store or you're going out for a jog or a bike ride or something like that it's all about avoiding that direct contact with other people as much as possible yeah well I won't follow up on that a little bit because there's just so many things about this that it happened you know there's dog parks right so now's a great time everybody wants to go and walk their dogs and get their pets exercise you know how can we tell them to be safe there or people like to ride bicycles that's another great area we hear about how can they do those things safely we want them to exercise but we we don't want them to to cause harm well with cycling and doing individual activities like that it's all about going by yourself for what the people you live with not doing it as a social event as well as the exercise and that's one of the challenges with a dog park yes it's nice to let the dogs go run around but it's a social event for the owners just as much as it is for the dogs so again if you have a bunch of people coming together that's going to be a problem and of course you want your dogs to go out and play and have fun but that can be a bit of a challenge right now we don't want the entire community going to the one dog park because there's no way to physically separate yourself from others now it's not a risk from getting a disease from the dog or anything like that it's a risk of the other people that are all going to that same location and especially in a dog park there's no way to really keep your dogs apart they're gonna run up and get a little scuffles and you have to go pull them apart so that puts you at risk of being around other people and you want to avoid that as much as possible right so one of the things that it's become a little bit socially awkward is we in the United States typically greet people right we give them a handshake we give them a hug we give them a high-five how can we do that in a way that doesn't make individuals feel awkward or displaced in some way shape or form but show them that really we respect them as a human and that we don't want to transmit the spread of this diseases so how can we kind of break down that that social awkwardness we get when we encounter somebody you know on the street or at the dog park or wherever it is well listen learn from other culture in Japan they bow their head in China China they just nod their head or in Thailand don't say so a tea like this so there are different ways of greeting people so you don't have to really have contact with each other but they're probably newer ways that people can do it like I don't got this part well whatever they do it but younger people will be ways of with each other nowadays yeah I know when anyone approaches me and says hey I want to shake your hand because I have a cold I usually go well it's pretty awesome and thank you for respecting that and respecting my health I do want to give you all a few minutes to just kind of wrap up and give everybody a little take-home message and so if we don't mind you want to start with that doctor latest some kind of parting words or words of advice for you work with infectious diseases you tend to think of the world as a chain of transmission everybody you come in contact with could be a source of disease for you and somebody you could spread the disease to so really think about that and I think the message of stay home for Nevada is very important staying home is going to limit that contact with others and then those important steps you take of hand-washing and all that that's what we need to do right now to stop that chain of transmission for meats to point the one is there's no magic bullet so it's a combination of strategies that we should all practice together and the second point is to look at the social implication of this epidemic as a nation person I could feel that there's an increase in anti Chinese or anti-asian and two we should avoid that because our enemy is the virus not really the people who are infected or affected by the infection I think at the end of the day this is very disruptive but the measures we're taking now really I think will save lives and shorten the decrease number of people get infected so so it's important for us to keep on these measures I think that's a great point that you know inconvenience for us could mean saving a life of somebody else and following those specific areas well I do want to thank the three panelists today I think this has been an very site full it was Ifill helpful I hope that individuals learned a little bit I do want to thank RK u NV radio station for broadcasting this as well and I also want to encourage you to think about how we apply all these different areas whether they're social behavioral changes environmental changes healthcare changes or based on the principles of Epidemiology and biostatistics that's what public health does I would encourage you to check out our UNLV School of Public Health at UNLV edu forward slash public health and you can find more information about degrees or careers like these individuals on our panel so thank you all very much for coming thank you thank you [Music] you.