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M

ac Ernest is a retired physician. Before moving to Oriental in 2014,

Mac Ernest

Mac was the Chair of the Dept of Obstetrics and Gynecology at Carolinas Healthcare in Charlotte. Prior to that he was Professor of Obstetrics-Gynecology at Wake Forest medical school in Winston-Salem.

In addition to patient care and teaching, his research has included studying infectious diseases.

Mac has agreed to provide a series of columns about COVID-19. This column was prepared with the assistance of Sharon Stephenson MD and Ros Cheetham MSc.

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It’s here! We are getting some relief from significant and impactful limitations inflicted by the novel coronavirus called SARS-CoV-2 which as of May 22, 2020 has caused infections in all 100 NC counties, and which continues to remain a growing threat to our state.

(click chart to see larger image)

We have been fortunate in Pamlico County to have had such a limited number of cases to date. However, we must remember that of the counties that surround us, we have the second highest incidence of COVID-19 cases (Craven is the highest).

Given the persistence of this virus with our relaxing regulations, how can we optimize our health as we enter into Phase 2? Governor Cooper has clearly outlined policies and procedures to follow as we move forward, with specific guidelines to protect customers and businesses, and it is important to be familiar with them. There are some over-arching principles, however, that you should consider to remain safe.

1. Wear a mask or face covering when around others to protect THEM. Surgical and homemade masks protect others from the aerosolized droplets that may contain coronavirus that exit our mouth and nose when we exhale, cough, sneeze, sing, preach, order food, greet our friends, …you get the picture. We cannot avoid exposing others unless we cover our mouth and nose.

2. Remember that many, and likely MOST, people who are infected and infectious do NOT have symptoms. The CDC estimates that a third of coronavirus infections are asymptomatic, and 40% of transmission occurs before people feel sick. The folks around you who appear healthy may still be infectious.

3. Expect those around you that remain within 6 feet for more than brief periods to wear a mask or face covering for those same reasons. They are respecting and protecting YOU with their mask.

4. Recall that the chance of infection goes up as you get closer to the source but also increases the longer you continually breathe recirculated air in a closed space. A recent study noted that the virus can remain in droplets in the air for as long as 3 hours. When you have the choice, outside seating will minimize your chance of exposure.

5. Understand that size of the closed space is also important. Air at an enclosed mall would be expected to contain fewer virus particles (not NO virus particles, just likely FEWER virus particles) than air in an enclosed business with lower ceilings and less square footage. The safest place for social gatherings, whether they be in restaurants, concerts, or worship services, is outdoors with a breeze and sunshine where the virus is dispersed or destroyed more quickly than indoors.

6. Act as if EVERYTHING you touch could be contaminated with coronavirus, including door handles, railings, cellphones, clothes, credit cards, and everything that others have touched or breathed on. Sanitizing surfaces is important, but will not remove EVERY virus particle to which you could be exposed.

7. Wash your hands with soap and water EVERY time before you eat or drink to allow the lather to physically remove virus particles from your skin and rinse them down the drain.

From the Governor’s Executive Order No. 141 is the following recommendation which pertains to many of us in Pamlico County and which is extremely important:

“People who are at high risk of severe illness from COVID-19 are very strongly encouraged to stay home and travel only for absolutely essential purposes. The Centers for Disease Control and Prevention (“CDC”) defines high-risk individuals as people 65 years or older and people of any age who have serious underlying medical conditions.”

Bottom line: Humans need social interactions and as health restrictions are lifted, we need to celebrate but remain vigilant, especially those of us at highest risk. We need to remember that there will likely be coronavirus in our surroundings, on our clothes, and even on our skin. We need to also recall that the only harmful coronavirus is one in contact with the mucus membranes of our eyes, mouth, or nose. Protecting those entry points is the key to reducing risk and optimizing health.

References:

https://files.nc.gov/governor/documents/files/EO141-Phase-2.pdf

https://www.nejm.org/doi/full/10.1056/NEJMc2004973

https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-scenarios.html

https://www.erinbromage.com/post/the-risks-know-them-avoid-them

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