On Thursday, March 19, 2020 Congressman Dr. Ami Bera and Sacramento County Director of Health Services, Dr. Peter Beilenson joined host Scott Syphax for a discussion of the coronavirus/COVID-19 pandemic response in Sacramento County. Watch the episode here.
Following are excerpts from the episode including questions from our audience and producers. The interview has been condensed and edited for clarity.
How many people are currently being tested per day?
“What we have so far from the CDC, we can test about 50 people per day at our health department lab. … We triage those folks to be seniors with serious symptoms and test positive, to test them, and we also are testing health care workers who have been exposed to people with the virus. So, that’s all we’re testing right now. However, … we just started getting LabCorp, Quest, and Roche – all national companies – starting to do the testing, but there’s still a very inadequate number of tests available. So, for example, we want to do the drive-thru testing that’s been going on in a couple of other places in the United States, but we can’t do it yet because we don’t have enough testing material.”
– Dr. Beilenson
If I’m showing symptoms right now, where should I go? What should I do?
“You should not, if they are mild symptoms or very modest symptoms, you should not go out. You should not go directly to your doctor’s office because his or her waiting room will be a place that you could spread the virus. For most people, for about 81 percent of people, and both internationally and nationally now, it appears that the cases are mild to moderate or asymptomatic, without symptoms. So most people can handle this at home with just anti-fever medications like Tylenol and fluids, et cetera. So check first with your doctor by phone to see if you should go in.”
– Dr. Beilenson
Are there any ways that we could be using telemedicine as patients right now in order to stay in our homes and stay in place but get the care or the advice that we need?
“The first emergency bill that we passed made telemedicine available to the Medicare population. The second one we passed last week in the emergency declaration by the president will allow Medicaid and others the ability to do telehealth and telemedicine. Places like WellSpace and others that care for a lot of the indigent population, they’re going to need to have that ability where they can FaceTime with that patient and use other methodologies. Absolutely if we’re going to get ahead of this, folks can stay home, and their doctors can interact and check on them. And that’s going to be necessary because we’ll otherwise overwhelm our capacity.”
– Congressman Bera
What should I do if I am living with someone who becomes ill?
“If the other person tested positive, the person who tested positive goes into an isolation room in the house and appoints one person, usually a spouse or a significant other, to be the kind of go between. So it may mean the spouse may end up getting ill, but at least you limit the number of people that are exposed to the individual.”
– Dr. Beilenson
The stay-at-home order, how long do you think that it’s likely that will be in place?
“It’s in place right now for two-and-a-half weeks but will clearly need to be in place for longer. That was just a sort of stopgap. My guess is, if you look at, as the congressman was talking about, South Korea and China and their epidemic curve, this way, it’s coming down fairly dramatically to the point where China had no new cases, I think, for the first time in any given day in weeks and weeks and weeks. So I would venture to guess probably eight to 12 weeks.”
– Dr. Beilenson
“Why are we allowing vacationers that are returning to the USA, particularly from countries like Italy and other places in Spain that have been hard afflicted, to come back into the US and not putting them into a mandatory quarantine?” Gene, from Elk Grove
“You’re starting to see the whole world kind of shut down and international travel shut down. Early on, the president did the travel ban from China which was at the epicenter. That did buy us some time and slow things down but we knew that wasn’t going to prevent the virus from showing up on our shores. We do think folks that are coming from endemic countries – places like Italy and elsewhere, Spain now – most of those folks are probably coming back, but I do think that the president’s travel order is that they are supposed to self quarantine for 14 days.”
-Congressman Bera
“Isn’t this just a winter virus that, much like other flu-like viruses, when it gets warm, usually these types of viruses kind of dissipate and get weaker in terms of affecting populations?” – Don, from the VA
“There is some evidence that may be slightly truthful, particularly when it gets more humid and people will go outside more in the warmer weather. However, there are some arguments against that in that the flu – for example, which comes on an annual basis – we have immunizations for, vaccines for. And so a lot of people both get the flu and are vaccinated against the flu so by the spring, you have herd immunity, which you may not have with this novel new coronavirus. So we’re not sure yet.”
– Dr. Beilenson
How are we going to know whether all of the things that we’re putting in place – sheltering, social distance, all these things – whether or not they’re actually having the impact that we anticipate that they might?
“Once we get full testing on board, seeing the incidents go down will be one thing. The other thing to look at is the hospital capacity. Make sure the hospital capacity is not being overtaxed. If that stays below a threshold, we’re in good shape.”
– Dr. Beilenson
We hear a lot about at-risk populations, and we talk a lot about seniors, but are there certain at-risk populations in addition to seniors that are more susceptible? People who have, for instance, say type I diabetes or rheumatoid arthritis or something like that.
“Lung disease and cardiac disease, heart disease, are clearly related to the chronically ill who have underlying conditions that put them at greater risk, and as well as those that have diseases of immunosuppression, decreased immune systems, those kinds of issues are just as important. And frankly, someone who’s … 55 with emphysema is probably more at risk than a 72 year old very healthy person.”
– Dr. Beilenson
What is the state of the economy right now, and what are the projections that you and your colleagues are looking at?
“Let’s think about this in the short term, immediate things. I don’t think anyone thinks we’re not going into a recession, so we are going to go into a recession. We now have to think about at the federal level, how do we shorten that recession, how do we make sure it’s not a deep recession, so we can position ourselves to get out of this. But all of us believe that that recession’s coming. Short term, we passed a bill to help the workers that were immediately impacted, largely those hourly workers, those tip wage workers, et cetera. The ones who if the restaurant closes, they’re going to immediately be impacted. Folks that may not have paid family leave or other benefits like that. Now we’ve got to help the small businesses because they’re also disproportionately going to be impacted. That’s the bill that’s being negotiated right now.”
– Congressman Bera
Is there anything that we should be doing as neighbors to try, under the confines of the order, that we should be doing to try and help out small businesses or help out our neighbors?
“For what’s allowed under the stay home order includes a lot of, as essential activities, are visits to a lot of small businesses, particularly grocery stores, pharmacies, even hardware stores, because you need to go to hardware stores to get materials for your house. So there are a sizable number of businesses that will be covered under essential activities.”
– Dr. Bielenson
Some people are calling this the “Wuhan virus” or the “China virus,” and we’re seeing incidences of discrimination against people who are of Asian, Pacific Islander background. What would you ask us to be mindful of during these times in terms of this virus and how it is that treating each other is going to be part of the solution to getting us through this?
“Look, this is a virus that may have emerged in China, but it’s a virus. It’s not a Chinese virus or American virus or an Italian virus. It’s agnostic. It doesn’t know religion; it doesn’t know ethnicity or culture. We are going to have to work with the Chinese because they are going to have information that is going to be valuable to how we address that here in the United States and learn about how to do mitigation best. So, we should call it COVID-19. We should call it novel coronavirus if we want. But we shouldn’t attach it to one particular ethnic group, and that leads to bigotry and racism, and you’ve seen some of those incidents here. I would tell us … we’re all in this together whether you’re Indian American, Italian American, Chinese American, et cetera. We’re all Americans. This is a time for us to come together as a community, come together as a country, really come together as a globe and try to help one another out.”
– Congressman Bera