Author: KUSA, 9NEWS Staff
9NEWS Director of Reporting Chris Vanderveen and 9Health Expert Dr. Payal Kohli hosted a Reddit “Ask Me Anything” (it’s generally called an AMA) on Thursday to answer a wide range of questions about the COVID-19 pandemic.
Those ran the gamut from everything about why the media isn’t reporting “good news” about hospitalizations and recoveries (spoiler alert: it actually is) to if it’s safe for schools to reopen in Denver.
Dr. Kohli and Vanderveen have been reporting on the COVID-19 pandemic for months and offered their insights about the trends they’re seeing, when it’s right to be skeptical, and where we go from here. Check out some of the questions and answers below.
Questions about numbers
Question: “Cases have been spiking but deaths have been steadily falling. Obviously we should expect a delay in deaths, but when should we expect to see deaths start to rise again?”
Answer: “Remember that death is a lagging metric. So there is a lag at every step of the way. First exposure … then lag … then positive case … then lag … then hospitalizations … then lag … then come deaths. So deaths can occur three to four weeks after infection exposure and two to three weeks after case counts increase.” – Dr. Kohli
Question: “Do you have any insight into why Dr. Samet’s COVID model for Colorado has been consistently one of the most dire predictions for our state but has been the least accurate as well?”
Answer: “A few thoughts of mine I want to share on models:
1. No model is perfect, by definition. It is full of intelligent scientific assumptions, but assumptions nonetheless.
2. Models are meant to be adaptive. So one of the biggest inputs in the models is human behavior, which keeps changing. So as the inputs change, the outputs change.
3. Models are meant to predict the worst case scenario. A good model makes us change our behavior so that the future predictable by the model is never actually realized.”
Is a clear face shield safe?
Question:“Hello. I have a clear plastic face shield. Are there any situations in which this more comfortable option could stand in for a face mask?”
Answer: “There is evidence that face shields do provide barrier protection and have some efficacy in protecting the wearer from droplets getting in as they cover the portals of entry (mouth, eyes, nose). Whether they offer protection from droplets getting out (protect others) is not as well established.
“Face shields offer a number of advantages. While medical masks have limited durability and little potential for reprocessing, face shields can be reused indefinitely and are easily cleaned with soap and water, or common household disinfectants. They are comfortable to wear, protect the portals of viral entry, and reduce the potential for autoincoculation by preventing the wearer from touching their face. People wearing masks often have to wear them to communicate with others around them; this is not necessary with face shields. The use of a face shield is also a reminder to maintain social distancing, but allows visibility of facial expressions and lip movements for speech perception.
“Most importantly, face shields appear to significantly reduce the amount of inhalation exposure to influenza virus, another droplet-spread respiratory virus.” – Dr. Kohli
States that are seeing surges in cases
Question: “If you were to describe the situations in Arizona, Texas, Florida, etc … who are spiking using terms non-medical people can understand, how would you do that? What’s the score/quarter of the game so far?”
Answer: “What happened in those states is relatively straightforward. These states opened too early without following the White House gating criteria (which were checkpoints). They also opened aggressively with an “all or nothing” approach to opening up everything at once.
“It’s simple: if you put people together, the virus spreads. If the virus is around, it spreads. If you have both situations occurring together, the virus spreads exponentially.” – Dr. Kohli
Bonus Answer: “I think it’s still early. Minus a vaccine, we are going to see some states pop at various — and oftentimes unpredictable ways. I’m a firm believer in taking a note of hospitalizations, ICU utilization, vents and positivity. I know it seems like a tired cliche, but I really do want to see what happens with hospitalizations and ICU use in two weeks in those states. I know some cities are already popping (Houston, for example), but the key is can the system handle the influx of patients. As for what quarter we are in? I’d say midway through second quarter. But hey… I’m just a journalist :)” – Chris Vanderveen
Question: “Why in the world are we even discussing re-opening in the middle of a pandemic?”
Answer: “I think there is general consensus that keeping the economy closed carries with it massive problems as well. Millions and millions out of work with no way to pay rent or bills. That’s not insignificant. And people will die as a result of that as well. The key is to handle it in a way that doesn’t overwhelm the medical system. We can’t eradicate it, but we can keep it at a low level that poses a more insignificant risk.” – Chris Vanderveen
Disinformation about the virus
Question: “What do you say to people who believe all the disinformation that is downplaying the seriousness of the situation and arguing against preventative measures such as wearing masks and shutdowns of public places (restaurants, theme parks etc …)?
“I am in Upstate NY and while we’re not NYC, we took most of the same preventative measures that NYC did and shut down early. We’ve never had a massive blow up in cases/hospitalizations because of those measures and it has a lot of people in my area believing that COVID-19 is “over-hyped” or a hoax.
“I really struggle when talking with people that I like/love and they tell me ‘masks don’t do anything’ or ‘this is the mainstream media trying to make sure Trump doesn’t get re-elected.’ People that I used to respect and value their opinions have almost instantly lost that from me due to these comments and their behaviors regarding our current situation.”
Answer: “Here’s where I say skepticism is better than cynicism. I think it’s healthy in our time to want to question why we would shutter the economy for weeks in order to try to quash a virus. But it’s not ok to be cynical here. Makes for bad decisions. Here in Colorado we are doing quite well, and, I believe, that has something to do with our early decisions to close along with an early spike. I would say handle this like anything these days. Have a civil conversation and when someone elects to continue to stay uncivil, maybe it’s time to walk away.” -Chris Vanderveen
Question: “Why is the USA taking the virus so lightly compared to the rest of the world? I see people walking in the streets without protection, bars opened, no social distance … Are U.S. people less prone to contract the virus?”
Answer: “Great point! I think one of our biggest challenges here in the U.S. has been lack of consistent messaging from the leadership about the risks of the virus and the advantages of wearing masks.
“Imagine this.. if you could actually see the virus particles coming out of someone’s cough or see the virus floating around in the air, wouldn’t you want to cover your mouth and nose and socially distance from others? Of course you would!
“So I think one of the reasons for the lack of compliance is a plain and simple lack of understanding and the second among some others is a lack of belief in the science or what the experts are saying.” – Dr. Kohli
Question: “Why do you and the others in the media continually post stories about spikes and surges rather than talking about falling deaths and how the ICUs are not overloaded?
“Does the media have an incentive to continually push fear with so-called spikes and surges? What numbers quantify a ‘surge’ or a ‘spike’ to NEWS 9 – or are those completely arbitrary words with no numbers behind them?
Do good news stories about non-overloaded ICUs and falling death counts bring fewer views than those about spikes and surges?”
Answer: “I think the key (and honestly something us in the press have not done a great job with) is always trying to add perspective to a story. Numbers without context can seem scary. I will say here in Denver — a state that right now is doing quite well — we have not shied away from good stories. Stories on recovery. Stories that our hospitals are well below capacity. It’s one of the reasons why I also stay away from case counts alone. Cases alone don’t mean much. I want to see hospitalizations, vent use and positivity. That’s where I go… Thanks for question.” – Chris Vanderveen
Question: “I know someone who has coronavirus, but claims to be better over a week and a half period. In the past 48 hours they have been downtown Denver, had drinks at DIA and got on a plane. What can I do? I’m sure they didn’t recover so fast? Is it possible to recover completely in a week and a half?”
Answer: “The ‘recovery period’ for coronavirus is highly variable and largely depends on how sick you even got with the virus. Some people who are asymptomatic don’t really need to ‘recover’ because they didn’t have significant symptoms. On the other hand, some have been reporting symptoms for months after infection.
This is different from the period that someone is infectious or ‘shedding virus’ in their secretions which can infect others. In general, before we call someone ‘noninfectious’ the CDC recommends a ‘testing-based strategy’ that they have two consecutive negative tests for coronavirus and then we can be sure that they are likely not actively infectious to others. -Dr. KohliThe psychological toll of the virus
Question:“Hi, thanks for doing this AMA! My question is regarding the psychological toll of the virus. Personally, I have noticed an intense fear about my family’s health, worry about finances, anger at political entities for not doing more, and frankly missing the physical contact of people I love. I imagine most people have experienced a higher amount of anxiety and depression. Do you have any recommendations for how to cope? Most of what I have seen comes down to ‘self care’ and meditation but it barely scratches the surface of something so stressful. Thank you!”
Answer: “Great question. [It’s] one that I have pondered for some time as a journalist working this remarkable story. I think it’s best to give yourself some time to take a break. It’s become a cliche, but this really will be a marathon, not a sprint. And — based upon what’s happening in TX and AZ, for example, we still have months to go. Rely on support systems. Take care of yourself. And don’t hesitate to take a day off (if you can)… I have actively encouraged our staff here to do that. We need some time away.” – Chris Vanderveen
Question: What barriers are preventing app-based contact tracing in the U.S.? I’m aware that the apps struggle to fill the entire niche of support that people-based contact tracing provides, but it seems at this point that app + people will be needed to fulfill the massive spikes in cases across the country.
Answer: One of the biggest barriers has been privacy concerns about using such technology and whether the American people would allow this type of surveillance on their phones/devices. – Dr. Kohli