Schools? Beaches? Restaurants? COVID-19 questions answered
Coronavirus researcher Ben Neuman, a professor at Texas A&M-Texarkana, is said to have grown more SARStype viruses in the lab than anyone else alive, and he served on the panel that named the coronavirus now upending our world. (Officially, it’s SARS-CoV-2.) He’s also a good-humored explainer of science. This week, he once again agreed to answer Houstonians’ questions.
We have tons of questions about sending kids back to school. Let’s start by asking: What’s your family going to do? Will you send your kids back to school in person this fall?
For my family, if we don't have the right measures in place, the answer would have to be no. And I'm not sure what the right measures would look like right now. It just doesn't seem particularly safe to be in the same building as a lot of other people at this time.
It's going to be a trade off, some kind of balancing decision, for most people: Safety vs. you’ve got to go out to work and need to do something with your kids during the day. And of course, the kids need an education.
Rebecca asks: When returning to the classrooms, do the students and teachers bear the same level of risk?
We got some data on this this week. In a study of day cares, they found a large number of children being infected. The breakdown of people infected was about half adult, half children. Since day cares have a lot more children than adults, that means the risk is very high for the people watching the children.
[When people discuss schools, the focus is often on the very small number of young children who die of COVID-19.] We've been taking this approach that if you are not susceptible — like in the highest risk group — then you can do whatever you want. The problem is, that that leads to more coronavirus, and eventually coronavirus reaches the people that you're trying to protect.
We need an approach that isn’t quite zero-tolerance for transmission but that approaches that. We need to get rid of this virus.
Ana asks: If I go have a beer outside in a friend's yard, and we sit more than 6 feet apart, do we still have to wear masks?
The question is really, “Is this an acceptable risk?” And yeah, that's probably acceptable.
Maybe you sit 10 feet apart — 6 feet is not a magic number. Imagine that a cloud of viruses hangs around you like that cloud of dust that always followed Pigpen from “Peanuts.” It's going to go with you wherever you go. You're going to leave a little bit behind that we can't see it, but it's there.
Being inside another person’s cloud, or having them inside yours, is the thing that you're trying to avoid. You want to minimize contact with those clouds. It’s like smoking. There's no amount that's OK. It's all bad. You have to figure how how much risk works for you.
Elizabeth says that after she tested positive, she looked up the CDC guidelines to see when she could stop self-isolating. The CDC said to wait until three days after the fever was gone and 10 days after the first onset of symptoms. But she thinks both those recommendations seem wildly out of date, especially since she never had a fever, never had a cough. What do you think?
Elizabeth knows her stuff. That’s exactly right.
We now know that the virus is going to last inside you at least two weeks after the last symptom, whatever it is. And if you don't have enough symptoms that you can actually tell what they are, then you need to be extra careful or you need to get multiple negative tests. After you've had two negative tests, like, a week apart, then you're probably OK to rejoin society. But until then, you should treat yourself as if you have the virus and take the appropriate precautions.
Elizabeth also asks, “If a person is totally asymptomatic, how would they know when to stop self-isolating?”
Again: Two negative tests, a week apart.
Cynthia asks: Why isn't a good test available? The current tests seem to give so many false negatives as to make them useless.
What you're running into is called “the limit of detection.” This is a bugger for every single virus.
For instance, a lot of times we detect things with fluorescence; I've been working in a physics lab for the last couple weeks. If you want to get a signal from a fluorescent thing with the best equipment out there, you need something like 10 billion individual fluorescent tags.
The problem is, we’re never going to have more than about 100,000 coronavirus copies on a swab. That’s not even close to enough.
So we rely on a technique called amplification. We take those 100,000 or 10,000 copies of the virus, and we copy-copycopy them. Then we try to detect that. Even then, we can only barely detect it.
If enough virus copies didn’t land on the right part of the swab — if the swab only got a few thousand — then the test will be negative, even though the person may have the virus.
Susan asks: Would you let your kids play baseball?
I don't think any one game of baseball is worth potential longterm damage to your kid. That's a terrible answer to have to give. But that's just the way the science looks at the moment.
I don't mind someone being in deep left field. But I mind being at first base and having a runner come up to you. I mind being the catcher. I mind being the umpire. I mind there being a dugout at all. And I mind high fives after you do a good job, which are fairly natural.
I also mind all the parents being in the stands, no matter how far apart. That is a large risk.
Jodi asks: “If two people — say, a couple — both have confirmed positive COVID tests, can they isolate together? What if one of them is symptomatic and the other is not?”
It's good if the asymptomatic person can take care of the other person. An asymptomatic person is probably the best person to care for someone with COVID.
Also, we know now that high levels of cortisol, a stress hormone, predict a bad outcome from COVID. So anything you can do that comforts and supports a person who is ill is going to help, as long as it doesn't get you infected. And hey, if you're already infected, you don’t have to worry about that: You're already infected.
You should still wear a mask. You don't need any more virus. But taking care of the sick person is a really nice thing that you'd be able to do.
That cortisol study: Was it done on people in a hospital? Or where?
They looked at people who were coming into the hospital. They measure their cortisol levels on that day. There are different reasons why a person could have a high cortisol level. It may be because the virus is doing terrible things inside of them, or it may be additional stress. But a high level of cortisol predicted that the patients were more likely to go on a ventilator and more likely to die.
So what should I do to lower my cortisol? Should I meditate?
Sure. Or just find something that you like to do. I think the answer there is different for everybody. For me, it's picking up fossils. They're great little things.
Emma asks: “As restaurants are now the only businesses where people can take off their masks inside for a long period of time, because they're eating and drinking, is eating out — and especially being a restaurant worker — the riskiest thing to do right now?”
Yes, absolutely. Just eating in a restaurant — oh my gosh, it is risky.
I really feel for the people who are working at those restaurants because they need the money. It’s an environment where they are most likely going to be exposed at some point, and also where they’re most likely not going to know that they were exposed. Restaurant patrons who test positive probably won’t remember the server they exposed a week-and-a-half earlier.
Does takeout food still seem safe?
Yes. And keeping these places open because you like them, or you like the people who run them, is a nice thing you can do.
Mary is watching stats about COVID-19 infections. She wants to know: “How are the daily positive numbers reported? Are these numbers of positive tests reported in real time from the previous 24 hours? Or are the positive cases batched by some labs and reported every few days?” Why do we see such big spikes?
There are a couple of big spikes in the data from when they've gone back and reanalyzed samples and then they just report them all in on batch, even though the tests came from different times.
If you look at the numbers for Texas, you’ll see that the graph goes up, up, up, up, down, down, up, up, up, up, down, down — and that the downs usually fall on Monday and Tuesday. You might look at that and think, “That’s weird.”
The reason is, what’s reported on Monday and Tuesday are really Saturday and Sunday numbers, and not as many people get tests on weekends.
The numbers are usually highest on Wednesdays. That’s because they’re really the numbers from Mondays, after the weekend, when more people are getting tested, or they receive all those test results that hadn’t been submitted on Friday night.
What else should Houstonians be thinking about? As we’re watching cases surge, watching our ICUs fill up, what should we do?
There are big changes that need to be made. But these are things that are going to take millions of dollars and like countylevel, city-level or maybe statelevel authority.
The best thing that individuals can do is just to keep themselves safe. Don't let your guard down when you're outside. Limit the amount of time that you are voluntarily in a room with other people.
In general, Houston's been doing its part. The Houston area was really effective for awhile in keeping the virus down. Thank you on behalf of the state.
There was a while where Houston and Dallas were basically making the state of Texas look respectable, while most other places were just letting the virus go wild. And ... yeah. Here we are.