So we do know quite a bit about the risks of COVID.
As I said, 80% never become symptomatic.
20% do become symptomatic and of those 20% who are
symptomatic, many of them are hospitalized and about of those
hospitalized 15 to 20 percent end up being seriously ill.
The ones who are most at risk then of becoming seriously ill or dying
are those who are older, meaning over 60. And the older you are, the higher the risk.
Those individuals who have underlying diseases - diabetes, severe lung disease,
heart disease, kidney disease - those people are at higher risk of having serious
consequences of COVID.
We've seen very few cases in children. They appear in general to have mild disease.
So the answer is older individuals are at higher risk of many respiratory
infections including influenza and other respiratory illnesses. So certainly if
you have a parent, grandparent, great grandparent, and you are ill - meaning with
respiratory symptoms, fever, shortness of breath, cough - then you should not visit
older people, particularly if they are frail enough to be in a nursing home you
should wait till you are, your disease has resolved before you visit them.
Turning it around, what can the older persons do themselves?
Again, particularly those that are frail with multiple other underlying medical
problems should obviously screen people before they come visit, certainly asking
your children, your friends, please don't visit if you're ill. And second of all,
particularly if we start seeing community acquisition, meaning cases in
the community that are acquired and we don't know about, then to the extent
possible they should try and avoid situations where they're sitting for
long periods of time with many people around them. Things like movie houses
would be an example and they should obviously try and see smaller groups of
people and not into large groups of individuals. Obviously if they see
someone near them who's coughing, sneezing, and particularly not using a
tissue while they're shopping, they should move more than six feet away.
It is true for droplet spread diseases, you know the official guidance
is three to six feet. I'm being conservative, stay six feet apart.
But that's about as far as the droplets go. Now we have some true airborne diseases,
which COVID is not an airborne disease, but they would include things like
chicken pox, tuberculosis for instance, measles, all of those can be transmitted
over many different feet. But COVID is not like that. COVID is only transmitted
by a maximum of six feet as far as we know.
It's a respiratory disease. These tend to peak in anywhere from early or mid fall
to early spring, so as we go into spring and then into summer I think that
the number of respiratory infections from COVID as well as from other
respiratory viruses like influenza will go down quite a bit. Although I can't
guarantee that for COVID because all of us, most of us are susceptible.
And I do expect, again just my personal opinion, that next year when we have our
respiratory season in the winter we will see COVID peak again, and then after that
it'll just become a circulating, less common than flu, but circulating
respiratory infectious disease.
We need to save the masks for the people most at risk. There are certainly some
groups of patients that should be wearing a mask, particularly when they're
in social gatherings. Certainly a cystic fibrosis patient, if they might be near
other cystic fibrosis patients, should be wearing a mask because they can transmit
pathogens. Or highly immunocompromised patients who have undergone a
bone marrow or recent organ transplant, heart, or lung, certainly based on their
physician's advice. If they're in groups a mask is very reasonable. So there are
certain groups of patients who should be wearing a mask. Should everybody
else be wearing a mask while they're walking around the street, going to the
supermarket? The answer is no, because we do need to conserve the masks, save the
masks for our patients and other friends who need it for more serious medical
problems, and for our health care providers when they're in close
proximity to a potentially infectious patient.