Q&A With Dr. Eric Yazel

GENERAL

Q. What is the official explanation that makes COVID-19 so much more dangerous than the flu? There continues to be misinformation shared on this particular topic. People continue to use the example that “more die from the flu each year…”

A: We have no inherent immunity to COVID-19. The flu changes to some degree each year, but our immune system still recognizes it. COVID-19 does not. When it is all said and done COVID-19 will have a mortality rate probably from 0.5 – 08% which is still a lot higher than the flu. We have already had 6 times the COVID-19 deaths in Indiana than we do during the entire flu season, and we are nowhere near the end of the outbreak. Kentucky’s numbers will be similar.

Q. Do you think any cases that people are diagnosed with COVID-19 could in reality be the flu? (which is what it would have been diagnosed as before this pandemic)

A: I do. We are calling a lot of our patients with flu like symptoms clinical COVID-19 and telling them to stay home due to lack of testing. However, flu season is really trickling down by early April, so very few of our patients the last few weeks are likely being misdiagnosed as flu. This was a much more common phenomenon in early-mid March.

Q. How long can someone carry the virus not knowing it?

A: Unfortunately, people can carry the virus for 14 days or longer and have zero symptoms. The thought is they are less infectious when this scenario exists but risk is still there.

WORKPLACE (Employer/Employee)

Q. Here’s a scenario – A young employee not at high risk for COVID-19, no known exposure, comes down with a sore throat, fever, earache – thinks it is strep throat like he/she gets from time to time. Supervisor advises not to come to work and contact primary care physician or BluMine Health. Employee chooses to call her PCP. They do not have he/she come in to be tested (for anything) and gives antibiotics. Tells employee to stay home until he/she feels better. Are we okay to bring employee back to work after 72 hours with no fever and much improved symptoms?

A: At this point unfortunately, I think we have to consider COVID-19 in almost all these presentations. I would recommend adopting the “7 days after symptoms improve or 72 hours fever free,” whichever is longer. Would be advantageous to have them seen though, if they had classic strep findings and tested positive, you are done there.

Q. It’s allergy season and we are uncertain how to determine if it’s COVID-19 risk or just seasonal colds. What should we do?

A: This is extremely difficult as up to 80% of COVID-19 patients have mild or no symptoms. We will be happy to screen them and assist. Fever would be one warning sign that it is something more than allergies, but is not 100% sensitive by any means.

Q. What do you recommend for HR as to how to respond to employees who report co-workers who have been out of state and/or visited relatives recently?

A: At this point, COVID-19 is widespread in many communities so travel within the United States does not change guidance. We are not quarantining just based on travel anymore. If they have contact with a known positive, they should symptom monitor daily.

Q. Will BluMine Health be able to do the antibody testing when it is available? Any time frame on when it might be available?

A: BluMine Health is exploring options. Antibody testing is becoming available at some locations as we speak and both Indiana and Kentucky have enhanced antibody testing as part of their re-opening plan. Still we need to have some caution as the sensitivity of some of these tests can be problematic.

Q. Do you recommend employers arrange to take temperatures of employees when they report to work?

A: I do. It helps from an HR standpoint to show that you made every effort to protect your workers. Also temperature testing can weed out any team members that come to work ill to avoid using time off.

Q. Your thought on employees wearing cloth masks to work because they are fearful of being exposed to others?

A: The CDC guidelines have opened up to this. Unfortunately this is due to lack of supply not gold standard protection. I think cloth masks can provide some limited protection. I do worry that people who wear them will touch their face more often which is worrisome, but they also serve as a constant reminder that they should be maintaining infection precautions.

Q. Who should take temperatures of employees and how to safeguard that person?

A: I would recommend employees take their own temperatures. Have someone watch from a 6 foot or more distance to ensure compliance.

Q. If the employee takes their own temperature what safeguards/PPE should they wear?

A: Gloves definitely since multiple people will be using the same thermometer. No masks or other protection is necessary.

Q. For those who work indoors, at desk, should desks be 6 feet apart at a minimum? How can we distance as we move around indoor space?

A: Essentially just do the best you can within the space confines that you have. Limit lining up for anything within the facility, stagger trips to the bathroom, copy machine, etc. No gatherings around the water cooler, coffee machine or lunchroom.

Q. Will BluMine Health be able to take the temperatures before employees return to work?

A: I will defer to the individual clinics here. For specific information contact your local BluMine clinic.

Q. Does the thermometer need to be cleaned after each employee’s use if they’re not wearing gloves?

A: I definitely would recommend wearing gloves. If possible any thermometer with single use disposable parts would be ideal.

Q. How would you clean the thermometer after employees touch it, then, should the employee wear gloves to take their own temperature?

A: Definitely wear gloves. Recommend wiping down with a bleach wipe too.

Q. So if someone is returning to work and someone has a fever or symptoms, do we send them to you or send them home?

A: Both. Essentially get them away from others. Have them contact us for further advice/instructions depending on their symptoms.

Q. How long can someone carry the virus and not know it?A: Unfortunately, people can carry the virus for 14 days or longer and have zero symptoms. The thought is they are less infectious when this scenario exists but risk is still there.

Q. As an employer, the best you can do is to continuously educate your employees, promote social distancing and stress good hygiene at work and at home. As someone whose parent is a transplant patient, we have used daily FaceTime calls to talk to grandparents. When we check on them, we stay outside on opposite ends of the porch. It’s hard but you have to do it to be safe. We have messages 3 times per week to our employees promoting social distancing and hygiene.

A: This is an excellent game plan. Education is key. It’s a hard time right now, lots of gray areas and rapidly changing recommendations. Setting a few times each week for updates is key as is education.

MENTAL WELLNESS

Q. What can we do to support the mental well-being of our employees?

A: Great question. Be supportive and understanding. They may have family members they are worried about, kids at home all of a sudden doing e-learning. Be flexible with them. Also encourage a regular routine. Avoid overstimulation with social media and the news media.

Q. Many of us are working from home or simply unable to go to the gym like we did previously. Do you have suggestions to stay fit from home that we can realistically stick to doing?

A: Get outdoors. Aerobic activities. There are tons of online resources for workouts that can be done using regular equipment you have in your home. Schedule it into your day.

Q. As an employer, what should I do to support mental health? Are there concerns I should watch for and do you have recommendations on how to handle “warning signs”?

A: I recommend maintaining contact. Watch for changes in behavior, angry social media postings, changes in personal hygiene – any changes from the norm. Reach out to them if you see these. Let them know you care and they are supported. Use your local mental health resources. A lot of them have new programs and telehealth available during this time.

Q. What can we do to support our Work At Home teams? When do you see these folks will be able to return to normal office work?

A: Try to encourage maintaining a daily routine. Keep them engaged and be creative with ways to interact. When to return to office/work is the million dollar question. I think a gradual re-opening in May with things returning to some degree of normalcy by July is realistic.

Q. I’ve seen articles on developing a routine and health benefits of doing so. Is this fact or fiction? If fact, can you recommend some healthy routines?

A: Absolutely. I would recommend setting a specific wake up time. Start with some exercise. Then allow 15-30 minutes of media. That’s it. Then work. Take a break in the afternoon to get outdoors. Try to keep night available for family time.