On this last episode, we look back on 23 years of joyous, difficult and always informative conversation.
A growing number of local officials — including those in Anne Arundel County, Maryland — are working to slow the spread of the coronavirus by requiring people to wear face coverings in public spaces. Experts say these regulations will reduce the risk of people getting sick. So, why is mask-wearing so hotly debated? What does the latest science tell us about how the virus is spreading? And how do we have these tough conversations with friends and family who aren’t taking the pandemic seriously?
In times of uncertainty, we look to medical professionals for guidance. Emergency physician and public health expert Dr. Leana Wen joins us to share her expertise and answer your essential questions.
Produced by Julie Depenbrock
- Dr. Leana Wen Emergency Physician, Visiting Professor, George Washington School of Public Health
KOJO NNAMDIYou're tuned in to The Kojo Nnamdi Show on WAMU 88.5, welcome. Later in the hour Bug Guy, Mike Raupp joins us for Kojo for Kids to talk about all the bugs of summer. But first a growing number of local officials including those in Anne Arundel County, Maryland are working to slow the spread of the coronavirus by requiring people to wear masks in public spaces.
KOJO NNAMDIExperts say these regulations will reduce the risk of people getting sick. So why is mask wearing so hotly debated? And how do we have conversations with friends and family who simply aren't taking the pandemic seriously? Joining us to discuss protecting the health of ourselves and others and to answer your coronavirus questions is Dr. Leana Wen, an Emergency Physician, a Professor of Public Health at George Washington University and a Columnist for The Washington Post. She formerly served as Baltimore's Health Commissioner. Dr. Wen, thank you for joining us.
DR. LEANA WENAlways a pleasure to join you, Kojo.
NNAMDIThe coronavirus pandemic has transformed life in the Washington region and around the world. What began here as a slow trickle nearly five months ago has grown to more than 150,000 confirmed infections and close to 6,000 deaths in D.C., Virginia and Maryland. Dr. Wen, I'm wondering what's happening now with the rise of COVID cases and how are we in the D.C. region doing?
WENWell, we are not doing well as a country at all. Actually we are in a worse place in the U.S. than we were back in March, because at that time even though we were seeing explosive spread that was primarily in one epicenter in the New York region. And now we're seeing multiple places across the country in Texas, Florida, Alabama, Georgia, California and others. And while we are doing relatively better in the D.C.-Maryland area, and in fact we are increasing our steps to reopen.
WENI do worry, because what starts in other parts of country won't stay there, and I think it's important for all of us continue to be on guard and recognize just how contagious this virus is. And also that we need to think carefully about our priorities, because if the priority is going to be to reopen schools safely in the fall maybe we need to keep certain establishments including indoor bars and restaurants closed or at least in a much more limited way for now.
NNAMDIPeople are tired of the pandemic. It's summer time and people are desperate to socialize. So how do we navigate these interactions with friends and family safely?
WENYeah. It's a great question and I definitely understand that quarantine fatigue is real, especially because we're going to be living with COVID-19 for some time. Even if we have a vaccine or treatment it still may be quite a few months before we get those, and they may not be 100 percent effective. And so we do need to learn to live with this virus. Right now the single most important thing we can do is to recognize that outdoors versus indoors makes it a lot less likely to acquire and transmit COVID-19.
WENSo in fact some studies show that being outdoors will reduce transmission by 18 to 19 times. And especially now that the weather is nice I would recommend for people to plan their activities outdoors. So don't gather indoors even if it's with your friends and extended families indoors. Instead, meet in a backyard, meet in a park. Stay at least six feet apart, but that way you can still -- even though this isn't ideal, you can still walk to have people over in your house. At least this is a way to safely socialize. See your loved ones, but make sure again that you're outdoors not indoors.
NNAMDIHere is E.W. in Washington D.C. E.W., you are on the air. Go ahead, please.
E.W.Yes. Thank you for taking my call, Kojo. Yes, my question is for something as basic as washing hands regularly, which we hear a lot of course with social distancing and I mean basic. Why don't we hear just as much about eating well to fortify the immune system? I mean, foods with, you know, good vitamins and the ability to drink a lot of water to keep your system flushed. Why don't we hear, you know, a lot of that as well? I think that would be very helpful. I just wanted to hear that.
NNAMDIDr. Wen, I suspect that's something we should be hearing about pandemic or not.
WENYeah. Absolutely. And I think, E.W., you make a really good point that we should be working to improve our health as much as we can, because we do know that there are chronic medical conditions that make your likelihood of having severe illness from COVID-19 even more. So, for example, having diabetes, having heart disease, lung problems, etcetera, increase your chance of having severe illness. And the more risk factors you have the more your risks are of having severe illness.
WENI guess, you know, we should definitely be improving our health as much as possible recognizing two limitations. One is that for many people that's a privilege that people may be living in food deserts where they don't have access to healthy foods and may not have the medical care that they may need to have optimal health. The other limitation too, of course, is that it does take time to improve health. And so that's why while you're aiming to improve your overall health you should still take these public health measures like the physical distancing, the handwashing and absolutely wearing masks as well.
NNAMDIHere is Patty in Annapolis, Maryland. Patty, you're on the air. Go ahead, please.
PATTYYes. Thank you so much. My concern is that there are some residents at a senior resident community in Annapolis who are not adhering to the guidelines about the social distancing and wearing of masks. And since there has been some changes -- daily changes about the infection rate and some of the demographics aren't targeting younger members of a family, I just felt that there should be more emphasis on getting the word out in Anne Arundel County specifically that the wearing of masks and social distancing is really crucial for everybody's health.
NNAMDIThank you very much. That is the current policy in Anne Arundel County. And, Patty, I'm glad you raise the issue of seniors not wearing masks because, Dr. Wen, the time apart from loved ones can be especially difficult for older people in general than older relatives who are isolating. Is there a way for grandparents to safely see their grandchildren?
WENYes. I actually wrote about this last week, and I'm glad that you mention this, Kojo. So, yes, absolutely, the one thing that everyone can do right now safely is to see people outdoors. I keep on emphasizing this, because this is so important. I completely understand how isolating it would be especially for older adults, who may have limited mobility and who just really want to see their grandchildren. So see people outdoors in an open space, backyard or a park. Everybody can bring their own food. If you're staying at least six feet, you don't need to wear the mask the entire time around one another. Of course, you can as an additional safety precaution.
WENBut if you're outdoors at least six feet you don't need to wear the mask. Just don't share food or drinks. Ideally don't hug, although if that's something that's really critical and you want to have one hug, you can do that, but in doing so I would recommend for everyone to be wearing a mask during the hug. Wash your hands a while in advance. Turn your face away from one another during the hug and keep the hug short. Also little kids, small kids, can hug their grandparents around their knees. That would also be safer than hugging them to their face.
WENAnd then there's one more thing too. If everyone stays -- if there are two families that want to see one another. If both families stay isolated for two weeks leading up to that encounter that would also be safe. And that way the grandparents can hold and cuddle their grandchildren. That may be very difficult for some families, who have to go to work or kids who must be in daycare, but that is another way for grandparents to see their grandchildren too.
NNAMDIHave older relatives been interested in seeing your baby?
WENSo yes, but unfortunately they live very far away. My father lives in Vancouver. My husband's mother lives in South Africa. And so for them because there's this very significant international travel involved they can't do that. However, we have had our loved ones come and visit us in person in our yard as I would encourage other people to do. Zoom is great, but that yard time or park time is very important too.
NNAMDIAs the region continues to reopen we are also bracing for a resurgence in cases. And in some parts of the region it's already happening. Virginia on Friday saw the highest number of new coronavirus cases in more than a month. What mitigation efforts are important here?
WENYeah, so the most important things and I know we keep on emphasizing this, but it's because we don't have other tools available. When we look at other countries and what they have been able to do they have the same tools that we do, which includes restricting indoor gatherings, wearing face masks and washing our hands. Ultimately those are the tools at our disposal.
WENAnd I think that places like Virginia, but also the D.C.-Maryland area, we need to look at firmer guidelines of restricting indoor gatherings and having the surveillance and tracking, because if we find out, for example, that certain settings like indoor bars are the cause of multiple super spreader events, the we need to be even more targeted in our approach to shut down certain things or limit certain establishments, again, in order to protect all of us in the long run.
NNAMDIAre there certain safety measures you feel have been done away with too quickly?
WENWell, arguably across the country reopening occurred too soon. Well, we look the White House's own guidelines on reopening, basically none of the states met those guidelines for reopening. More than half of the states were actually experiencing increases in cases while they reopened. And this is the reason why we have seen such a quick resurgence in COVID-19.
WENWhen we compare what happened in the U.S. versus other countries or even what happened in the New York region compared to other regions, the most successful examples of reopening occurred after they were able to suppress the number of cases to a low enough level that we were able to then do testing, contact tracing to be able to isolate each new case. Right now the CDC estimates that we are only picking up on one in ten cases of coronavirus, and that's just untenable. That means that there is so much community transmission that's occurring against this backdrop of reopening.
WENSo it's no surprise that we're seeing this surge. And I do fear that even though, D.C.-Maryland seem to be doing better for now that it's only a matter of time before we do see a resurgence and have to implement measures to shut down again.
NNAMDIHere is Arfen in Northern Virginia. Arfen, your turn.
ARFENHi. Thank you for taking my call, Kojo. My comment and my kind of, you know, kind of issue is in regards to the mask working. I work at a restaurant in Northern Virginia. And I find it, you know, difficult to implement this mask policy. Even though it's an order in the states, people come in without masks. And I find I have to be, you know, sort of rude, but I try to do it as quiet as possible.
ARFENI'm wondering if that's, you know, maybe the political climate here and why the scientific community isn't more at the forefront of the, you know, taking the lead on this, and especially with your comment regarding the rising cases and our reopening quickly. Here in Virginia we reopened in the middle -- for the second phase in the middle of June. And then third phase July. So, you know, it just kind of emphasizes and advocates more people to come out.
NNAMDIOkay. Arfen, we've got to take a short break, but when we come back, we'll have Dr. Wen respond to that question and talk about what the World Health Organization is currently doing since you talked about the scientific community. I'm Kojo Nnamdi.
NNAMDIWelcome back. We're talking with Dr. Leana Wen, an Emergency Physician, and Professor of Public Health at George Washington University. Dr. Wen, Arfen was concerned about what the scientific community was doing. He seemed to be suggesting that scientific community needs to be doing more so that people, for instance, would stop going to the restaurant at which he works without wearing face masks. But I wanted to talk about how the World Health Organization is currently reconsidering how the coronavirus spreads in the air. What can you tell us about that and what it means when it comes to role of masks?
WENAbsolutely. So our guidance around masks has changed since the beginning. And I do think it's important for us to acknowledge that, because some people may say, well, it sounds like you're giving contradictory advice. Well, I would say we've learned more and as we have evolved in our understanding our guidance also has to change.
WENSo there are two things that have changed. One is that we now know about asymptomatic transmission. Actually a recent study showed that maybe 50 percent of all the cases of coronavirus that are transmitted are from people who do not show symptoms. So that's really important, because in the beginning we were saying, well if you're sick, stay home. And that's still true. If you're sick, don't go out. But we now know that many people may be transmitting who just don't show any symptoms at all and who are unknowingly spreading it to others.
WENThe second thing that's changed is what you mentioned, Kojo, about the way that coronavirus is transmitted. We initially understood this to be transmitted through respiratory droplets. So if you cough or sneeze, these are the droplets that are heavy that carry the virus that then drop to the ground quickly.
WENWe now have quite convincing evidence that coronavirus is transmitted through aerosols when you breathe or speak these are microscopic particles that carry the virus that can linger in the air for up to three hours. Now we don't know that that virus can still transmit and make somebody infected after three hours, but because of those microscopic droplets, that's the reason why we're saying everybody should be wearing masks. And that's again why if you're indoors you should certainly be wearing a mask. If you're outdoors and cannot maintain that six foot distance, wear a mask. But that's why that outdoor air helps so much, because it dilutes those respiratory droplets and therefore make it much safer for us to be there.
NNAMDIA listener tweets, "I'm a frontline essential worker. I already got COVID and did my quarantine. I am back at work. Am I at less risk from the virus than my other co-workers? Should I be the one doing the riskier work?"
WENSo the answer is, we don't know. There are a lot of unanswered questions right now about immunity. If we look at other coronaviruses and COVID-19 is a type of coronavirus. If we look at other coronaviruses, you do get immunity for some time. But we're talking on the order of months. And that immunity is not going to be complete, and there are some cases being reported, not confirmed, but there's some cases being reported of people getting reinfected after having an infection before. So I would not want people who have had coronavirus to think that they are immune from getting it again.
NNAMDIHere is Terry in Washington D.C. Terry, you're on the air. Go ahead, please.
TERRYHey, thanks Mr. Nnamdi and thanks Dr. Wen. You know, I am sitting here. I'm coming off three deployments, two to New York and one to South America to combat this virus. And I'm waiting for my next deployment. As I sit here, I am thinking, we have made all the arguments about masks and distancing that are going to influence the people who have the ability to understand that set of circumstances.
TERRYPerhaps we could do better by helping people understand what an ugly, horrible death COVID-19 is, and in the absence of any kind of national strategy to mandate masks, perhaps we can help people understand that this is not a benign thing. And I would welcome your comments on that. I think we need a national strategy that complies with the evidence.
NNAMDIThank you very much for you call. Maybe that's what Arfen was talking about, Dr. Wen.
WENI mean, I cannot agree more on all the points that this is not at all a harmless virus. This is not like the flu. This is not like a cold that many people get permanent damage to their lungs and kidneys and heart, and even have strokes even if they do end up surviving COVID-19. And at the end of the day this has to not be about politics and partisanship. This has to be about public health.
WENSomething as basic as wearing a mask has unfortunately become politicized. And it's up to all of us to say this is something simple and basic that we can do in order to protect one another. It's our way of showing respect for each other, to show that we care and that in this time of a pandemic this is about all of us being in it together and watching out for one another's health and well-being.
NNAMDIHere now is Tom in Silver Spring, Maryland. Tom, you're on the air. Go ahead, please.
TOMHi. Thanks so much for taking my call. I have a specific question and it's about Anne Arundel County, but also about an activity I think a lot of people are doing this summer, which is going to the beach. Since it's outside and in the sunshine, we were at the beach this weekend with our family. And nobody was wearing masks except for us. And then eventually we took ours off.
TOMWe basically stayed six feet away from people. But as people walk by your little camp on the beach not wearing masks there are a lot of instances where people are close, but only for a few seconds. So I know there aren't necessarily hardened fast rules about outside, but I was wondering if you could give us some guidance, Dr. Wen, about the beach.
WENYeah. So I think being outdoors is wonderful. It's great for your physical health. It's great for mental health. I think it's also a good way to fight quarantine fatigue to have some semblance of normal. So if you normally like going to the beach, I think you should go, again, outdoors much better than indoors.
WENAnother factor in the likelihood of transmission is time of exposure. And so if somebody walks past you for a couple of seconds even if they're within six feet, the chance of you acquiring coronavirus that way is minimal. So I would still say, bring a mask. Have a mask with you especially if you're going to be in a situation where you can't be distanced within six feet of someone. Try to keep your distance at the beach as much as you can. Try to stay six feet away from others especially if you're going to be there for a while as in if you're going to be on your beach towel instead of walking around. Definitely make sure you're at least six feet away from other parties.
WENIf you cannot keep that distance, then come back, when it's not as crowded. But otherwise, going to the beach is a great idea. In that short time when somebody passes you within six feet, it's very unlikely to increase your risk of COVID-19.
NNAMDIAnd now here is Evelyn in Chevy Chase, Maryland. Evelyn, you're on the air. Go ahead, please.
EVELYNHi. I thank you for taking my call. I am trying to socialize with a group of women friends and we were wondering is there a difference between sitting in a screened porch that has, you know, the open air and six feet apart as opposed to being outside six feet apart.
WENYes. It's a good question. There is a difference, because you could imagine in a screened porch depending on how open it is to the outside and how many sides of the screened porch are actually the wood or the brick or something else you're essentially more indoors than outdoors. So if you are going to be in a screened porch, try to open the door or whatever other windows there are as much as you can. Blowing a fan also helps to circulate that air and in general I would recommend being fully outdoors rather than in a screened in area if possible.
NNAMDICarol in Fairfax has a question. "What should parents do to protect themselves once our kids go back to school?"
WENYeah. This is a question that we're going to be asking throughout the fall and in winter. I mean, the single most important thing that determines whether it's safe to send kids back to school is how much transmission of the virus there is in our community. You can imagine if you're living in a community with ongoing surges and hot spots of a virus, you can't keep the school safe, because people in the community are not safe.
WENAnd the same thing applies for when our kids go back, we should be keeping ourselves safe and reducing our own risk as much as we can. And in the school environment also doing everything we can in concert with the school to reduce risk. So plans, for example, for kids to not be in congregate spaces like lunch rooms together. Having kids be separate in their own pods so they're only associating with a certain group of other kids, and having active surveillance mechanism to detect outbreaks before they become larger. All these are important things to limit the risk in the school environment, although we should also be limiting our own risks, because overall we have to keep the risks in the community as low as we can.
NNAMDIOkay. Dr. Leana Wen, an Emergency Physician, a Professor of Public Health at George Washington University and a Columnist for The Washington Post. She formerly served as Baltimore's Health Commissioner. Dr. Wen, as always, thank you so much for joining us.
WENThank you, Kojo.
NNAMDIGoing to take a short break, when we come back Bug Guy, Mike Raupp, joins Kojo for Kids to talk all about the bugs of summer. Adults can listen, but only kids can call. I'm Kojo Nnamdi.
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