COVID-19 mythbusting with epidemiologists

cloth face masks piled on top of a wooden table
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We sat down with two epidemiologists to set the record straight on common misconceptions surrounding COVID-19.

Episode Transcript

Lindsey Hendrix:

Hey guys, Lindsey here. Before we get into this interview, I just wanted to give you a heads up and apologize. We had a little bit of a technical issue toward the middle of the show. We had internet lag, which I’m sure most of you are familiar with at this point. We apologize that some of the audio got a little bit broken up, but it was still an amazing conversation. I think you’ll still get a lot out of this. These two experts in public health and epidemiology are amazing and they provide so much valuable information. Please bear with us. We apologize for that little glitch, but enjoy the show.

Lindsey Hendrix:

We bring you advice and compelling insight on the latest in health, medicine and scientific discovery. From tips for getting better sleep, to discussions about major issues, like health disparities in America, we’ll talk about it. You’re listening to Texas A&M Health Talk, part of the Texas A&M Podcast Network.

Hello and welcome to Texas A&M Health Talk. I’m your host, Lindsey Hendrix. Today, we are so, so, so, so lucky to have these two guests with us. They’ve been on the media tour all over the country, so you’ve seen them on national news, state news. We’ve got a couple of celebrities here with us. We’ve got Dr. Angela Clendenin and Dr. Rebecca Fischer. They’re both professors over at the Texas A&M School of Public Health. Thank you both so much for being here.

Angela Clendenin:

Oh, you’re welcome.

Rebecca Fischer:

Thank you so much for having us.

Lindsey Hendrix:

Can we just take a moment to appreciate and bask in what rock stars public health professionals are right now? Oh my gosh. Y’all are in high demand and y’all are just crazy, crazy busy right now.

Rebecca Fischer:

Well, I’m super excited that people now know what public health is, and recognize it, and hopefully recognize it’s value.

Angela Clendenin:

I used to tell people that, this is something that public health students have been training for and even public health practitioners have been training for all their lives. It’s like the public health Olympics. This year, we’re going for gold and we’re going to get it.

Lindsey Hendrix:

Oh, yes. Y’all are doing amazing work and I know y’all are probably losing a lot of sleep right now, so I appreciate you joining us here early in the morning on a Thursday. Obviously, we’re going to talk about the big public health issue that’s going on right now with COVID-19. I just want to start by setting the scene a little bit. We’re at the end of July, this will air at the beginning of August. How are we doing right now in the state of Texas, as far as COVID-19 goes? There was a headline just yesterday in Newsweek that said, “Texans are dying every six minutes from COVID-19.” It seems like it’s worse here than in any other areas of the nation. Would you say that’s accurate?

Rebecca Fischer:

I would say Texas is in a really precarious situation right now. We watch the data on a near daily basis, particularly in Texas and then in our local counties where we live and work. We really saw the number of cases and the number of deaths accelerate in Texas and that’s something … That’s a metric that we really looked at, more than just the raw numbers. Of course, every person, if it’s 10 fatalities in an area, that’s significant. That’s important to public health professionals and to the public. But when we see those numbers really skyrocket … We saw something like a 30 percent increase in cases one week recently and that slowed down a little bit, which I think is giving us hope.

Angela Clendenin:

And one of the things that is also really concerning, is when you look across Texas, obviously Texas is a really large state with a very varied type of population and some of the hottest spots are in areas where we have extremely vulnerable populations. These are populations that typically have more comorbidities that lead to more severe illness. They are ones that have either socioeconomic or cultural language barriers to testing and access to health care. It’s always concerning when you have an increase in cases, but when you also see that it seems to be targeting some of these really vulnerable areas and vulnerable populations, that’s additionally concerning as well.

Lindsey Hendrix:

Yeah, absolutely. Here, I live in South Texas. Actually, in Corpus Christi. I know our area is experiencing a surge in cases. We’ve called for health care workers to come help with surge capacity at our hospitals and ICUs. I know it’s pretty bad down here. Are there other parts of the state? I know y’all are in Bryan-College Station, which is where our university is. How are other parts of the state looking?

Rebecca Fischer:

Lindsey, we’re really concerned about our rural populations. In particular, counties that don’t have their own health departments and are sort of watching and waiting to get their information from the news on the state about what’s going on in their local communities. That’s really a challenge. Our rural communities might have delayed access to health care or delayed access to testing, if at all. We worry about under-reporting, so cases that are there that don’t get diagnosed, don’t get counted, deaths that don’t get attributed to COVID-19.

Then, I will also echo the South Texas piece. Our southern members of Texas A&M University that we’re a part of, but their communities at large. There’ve been quite a lot of data just emerging about the effect on our Hispanic communities and we don’t fully understand why we see Hispanics affected more than we anticipated initially. In particular, the young age of Hispanics who are affected. We hear a lot of the news about the older age being so vulnerable and it looks like in our Hispanic populations, the younger ages are heavily effected and that will be something important to understand.

Angela Clendenin:

Lindsey, you hit on something really important too about how communities are calling in for health care workers to provide surge support. Hospitals across the state are required to have an emergency management plan to deal with surge capacity, large surges in numbers of patients. In some places, that surge plan is working really well. They have the beds and they have the physical capacity to expand the number of patients that they’re able to take on and to deal with, even at the higher acuity level that sometimes needs intensive care, or perhaps ventilation. However, in order to care for those patients, those beds require a staffing-to-patient ratio that we’re not able to maintain in some places because those people that have that higher level of certification to take care of a higher acuity patient are in short supply. Hospitals are looking and they’re saying, “We have the beds, we have the physical capacity, but we’re very concerned about our staff and the ability to staff those beds.”

Lindsey Hendrix:

Yeah, absolutely. And so, we’re here at the Health Science Center educating people as well as we can, as quickly as we can to get them out there to make sure that we don’t run into a situation like this again in the future.

I saw a graph the other day that shows the United States as a whole is up there in the ranks as far as cases go. I saw that we were up there with Brazil, India, Russia and there were some other South American countries on that. Now, let me qualify this by saying, I am not a statistician, I’m not an epidemiologist or public health professional, so I might be reading this graph completely wrong. I’m sure there’s other people out there, like me, that are pouring through this data and are being given this data on a daily basis. Nonetheless, I’ve heard that the U.S. is experiencing more cases than most other countries, in particularly more than any other wealthy countries. Why do y’all suppose that is?

Angela Clendenin:

One of the things that I like to focus on when people ask about things like that is, two things. One, Americans typically have a very strong sense of independence. As individuals, we value individual freedoms and liberty. We don’t have a strong central federal government, or even a strong central state government in many states to mandate things that would help us engage in the appropriate behaviors. But at the same time, I feel like we have some really densely populated areas and in those areas, they typically tried to do a phased opening and the actions that we took in doing so, I think people took that to mean we were in the clear and we were okay and it was okay to behave in ways that led to increased transmission and spread. And so, I feel like we are in a time period where we’re trying to put the cat back in the bag, and I don’t know that necessarily we’re going to be able to do that very effectively.

Rebecca Fischer:

That’s so true. This is happening to us in a very strange time. There’s a lot going on in our country. There is a lot of discussion. Something that is really important for this response is a sense of collective responsibility and accountability, some unity. Even the messaging and the information, the scientific information people are getting is so discordant at times, and politicized, and polarized. And so, that climate makes it tough for us to know what to do and how to pull together. All of the public health guidance that is coming out about how to protect ourselves and others against COVID-19 are tried and true methods, that we’re applying it and learning how to use for COVID-19.

We don’t have all the scientific answers, so we don’t have absolute pieces of information about how effective each strategy is. But, we have viruses that we know a lot about. We have outbreaks and epidemics that we know a lot about. And so, applying these tools to COVID-19 is our most effective strategy, but it really requires everybody to pitch in and do their part. We don’t have a vaccine yet. We don’t have effective treatments across the board. The only thing we have is working together for prevention. That’s really, I think, key because it is something that relies on individual behaviors.

Lindsey Hendrix:

Yeah, I think it’s wild. I’ve never seen a health issue be so politicized and I think maybe it’s because we’re in an election year or something. I’ve never seen people question the science so much. Have you guys experienced that before?

Rebecca Fischer:

I always think that a healthy amount of debate … And scientists will even agree. Some debate, some healthy banter, even verbal wrestling. We see this all the time. Scientists disagree with each other, but this is how we move forward. This is really in the basic tenets of science and scientific discovery, so that is frankly encouraged in our field. But, I think when we get outside of that scientific realm … And so, politicians are arguing about the science. That becomes a bit different.

Angela Clendenin:

It’s one of those things, Lindsey, where science and scientific evidence should be informing the political process, not telling the politists to create and implement evidence-based policies. Unfortunately, emergency management and emergency preparedness tend to get very political in nature because it involves resources, it involves spending. The things that we do have a very definitive economic impact. They have a very definitive social impact. And so, you can’t always extricate what you need to do for public health and emergency response from that political side of things. The fact that we’ve had a few missteps early on, at the very beginning of this thing, has somewhat opened the door for that increased banter and politicization of the process. It’s also not just the disease that we’re battling, but we’re also battling the public opinion as well.

Rebecca Fischer:

Angela, you make me think about the fact that as an epidemiologist, I’ve been involved with many disease outbreaks and epidemic response and investigations. As epidemiologists and public health practitioners, we sort of know what needs to be done. We don’t usually have politics stepping into the process, so I think public health practitioners out there probably have their heads spinning thinking, “What is going on? How do we operate in this new environment?” I think it is challenging to the public health, having local health authorities responsible for making decisions, but then have political outcomes, and ramifications, and economic, and all of these things that we don’t consider on a day-to-day basis, or we don’t have such a big thing to handle on a day-to-day basis. That everybody, I think, is sort of reeling.

Lindsey Hendrix:

Yeah. But, like you said, there are tried and true things that the public can do to help slow the spread. Let’s go down that list of things. I mean, we’ve heard, “Let’s wear a mask when we’re out in public and can’t physically distance. Wash our hands frequently. Watch our distance.” And then there’s contact tracing, which you both are involved in. Can you dive into those a little bit and explain why we should do those things and how important it is for this?

Rebecca Fischer:

Sure. I’ll start at the top of the list with wearing face coverings. This primarily is protective for the person who is … Or the primary barriers for the person who’s doing the exhaling, or the coughing, or the talking. The person, as well, wearing the mask to prevent droplets from entering their respiratory tract is also protectant somewhat. We encourage the use of these as really an added bonus to all of the other things. This is an added physical barrier to that physical separation. Physical separation is also rooted in the basic science and what we know about transmission. Again, it’s a droplet primarily that we’re concerned about that will travel, that will exit through coughing, breathing, talking, singing. If we can all sort of maintain that bubble, which is really tough and awkward for us, because we’re not used to doing that and we don’t really know how to do that in most of our interactions.

Rebecca Fischer:

But that six foot bubble is where we expect … If we are infected and we are exhaling something, then we have this barrier around us where it’s going to fall and hit the ground and be inactivated. It can’t infect anybody. Now, I will say, important to remember is that what we know about this disease presentation is up to half of individuals who are infected and are going through the disease course do not show signs or symptoms. What that means is that any one of us could be infected, if we had an exposure, and not know it. This is really important, and the masking, and the physical distancing, and all of these prevention measures because we could be the one out there who is transmitting the virus. And the hygiene, washing hands and using hand sanitizer, really cleaning those common touch surfaces.

Rebecca Fischer:

We always tell our COVID-19 patients that we interact with, those toilet flushers, and fridge doors, and faucets. Things that get touched a lot that don’t have a lot of time in between and maybe we’re not cleaning every few minutes. Because there is some, although we think smaller risk of transmission. Smaller than through the respiratory route, that a virus could be deposited onto, say, a fridge door from a sick family member and then somebody else in the family would pick it up and inadvertently place it into their eyes, ears, nose and mouth. I mean, this is how we see flu passed and colds. Think of all the things mom taught us about how to stay healthy in the winter, this is exactly what we need to do.

Angela Clendenin:

And so, to add to what Dr. Fischer’s saying, it’s about transmission. The way that we end an epidemic or a pandemic is to break that cycle of transmissions, so there’s a lot of behavioral types of things that we can do, that Dr. Fischer just covered. But the other side of that is the actual case investigation and contact tracing. And the principle behind that is taking people who have the disease, they’ve been diagnosed with COVID-19 and getting them isolated away from the rest of the population to stop that cycle of transmission from a diagnosed case to the population. But, we realized that the time that they become contagious to the time that they get diagnosed, they’re in contact with a lot of people. And so, we investigate the case and we get the information on who have you been around, considering they need to be less than six feet away from you and longer than 15 minutes.

Angela Clendenin:

Then we want to reach out to those people and let them know that they’ve been potentially exposed and we want them isolated, so that they … While they may be pre-symptomatic and not contagious, that we’re getting them out of the population and we’re watching them and we therefore stopped any potential spread from them, while we’re waiting to see if they develop the disease or not. It’s another way of being able to stop that cycle of transmission by taking those who have the disease, those who have been potentially exposed to the disease, getting them isolated out of the community until they either recover from the disease or they don’t develop the disease. Then, we just ended that cycle of transmission. But what Dr. Fischer indicated, with 50% of the people being asymptomatic, not only are they not getting diagnosed, but they don’t know that they’ve been in contact with other people, so they’re not going to identify who their close contacts were so that train of transmission continues.

Lindsey Hendrix:

People [crosstalk 00:19:39] who aren’t experiencing symptoms can still transmit the disease? Has that been proven?

Rebecca Fischer:

Yes, that’s correct. We think that that infectious period can begin up to two days before you have symptoms. Then remember, not everybody’s going to develop symptoms or their symptoms are going to be so mild they think they have allergies, or a little bit of fatigue, or “I didn’t get much sleep,” or, “I drank too much the night before.” These are all the things that we hear, so these are real people with COVID-19. It’s just tough to tell in the beginning. And so, somebody may not be infectious on day one when they’re exposed, but that person can become infectious very quickly within a couple of days.

Lindsey Hendrix:

Amid all of this, all of the spikes in COVID-19 cases and schools are talking about reopening. Here at Texas A&M, we have committed to reopen in the fall in just a couple of weeks. A lot of our students are going to be coming back to campus and about 50% of the course selections at A&M will be offered face-to-face. And I think officials estimate that about 75% of our student body will have at least two classes in person. How is the university going to do this and welcome all of these students, faculty, staff, collaborators, visitors back to campus while keeping the campus community safe?

Rebecca Fischer:

Well, we don’t know everything that the provost of the university has up their sleeve, but we are privy to some of it and we know that the university is taking really extensive measures for protection. Some of those are physical measures. And so, students will be sitting separate from each other, so that physical separation in the classroom. They’ve doubled up twice a day classroom cleanings. And then as faculty members, of course, we encourage that our students can use all those protective behaviors to protect themselves and others. Dr. Clendenin and I are engaged with a self-reporting form, so individuals have the opportunity to confidentially report if they think they have been exposed to someone with COVID-19, or if they have symptoms, or if they themselves tested positive and it allows … Again, a confidential way for us to reach out to them and help provide them with the information and then initiate, if we need to, the case investigation and contact tracing.

Rebecca Fischer:

I just wanted to add to what Angela said a few minutes ago about the contact tracing. We really want people to see this as a health promotion and education opportunity. We’re not really … It is not our goal to collect details of it amass these details and little bits of information on people. Gosh, we wish we didn’t have to, but we want to reach people and provide them with information and give them the opportunity to feel empowered over their own health. When somebody with COVID-19 is sharing the information with us about their contacts, please know that we are going to reach out to those individuals with really the intent to help them and provide them with information that they need to take their health into their own hands. And then, when we are contacting you as a contact, a potential exposure, we try to put anxiety and fear aside and really try to get to information, and resources, and health promotion. That is the goal of this portal. That, we are doing for Texas A&M members across the state.

Angela Clendenin:

It really is important, to highlight what Dr. Fischer was saying about reaching out to contacts, particularly when we’re dealing with the cases and especially when they’re college students. Sometimes they don’t feel like they have permission to give somebody someone else’s cellphone number, or email address, or contact information. But in this instance, it’s almost like you’re doing them a favor by giving [inaudible 00:23:53] 19, not realize it, and not have access to information and resources that could really help them. And so, everything is confidential. We cannot stress that enough. It is not released to anyone that doesn’t need to know and when we call a contact, we are not allowed to share information about the person who’s the case, or even enough information about the potential exposure where they could identify who the case was. That case confidentially is absolutely protected as well.

Rebecca Fischer:

These are trained people on the phone. The folks in our Ops Center, our COVID Operations Center, they receive training in SARS-CoV-2 and COVID-19. They receive training in what clinical presentations are likely. They receive some virology lessons and immunology, so they’re equipped to handle some of these questions. These are largely individuals with health backgrounds, so we have a lot of graduates, epidemiologists and folks from other health backgrounds. Then, they also receive training on how to ask questions in a sensitive manner, how to be empathetic and how to be communicators. We really are trying to put good folks out there to talk to and provide a good and reliable source of information so that you can trust us when we call and talk to you.

Lindsey Hendrix:

When you are calling somebody, how do they know that it’s you guys or that it’s the county calling to conduct the contact tracing and case investigation? What are some fail safes that people can do to protect themselves, in case there are scammers out there? Because I’m sure there will be.

Angela Clendenin:

That’s a great question and it’s something that we’ve struggled with for a long time. When the county was calling people, our county in particular bought a singular phone system for every department within the county. And so, it’s not unique to any one department and we realized not quite early on that people were getting calls that showed up on caller ID, depending on how their phones were set, as Brazos County Court. And so, what we would do in that case is we’d leave a voicemail saying who we are. We’d give a name and a number that they can call back, which is usually the main number for the Brazos County Health Department, and we tell them to ask for either the individual or ask for a member of the epi team to be able to return their call. Now, when we’re calling from our Ops Center that Dr. Fischer referenced, it shows up on caller ID right now as Texas A&M Direct. We’re trying to get that fixed so it’s Texas A&M HSC.

Angela Clendenin:

But depending on a person’s settings, it could still show up as unknown. But they should always be able to leave a voicemail identifying that they’re calling from either Brazos County health district, or their local health authority, or they’re calling from Texas A&M and this is why they’re calling and here’s a number to call back. Then that serves kind of as that dual verification process. One other thing that we’re doing is we’re creating a co-op website that will have information, like what Dr. Fischer was talking about, that empowers people to help them understand the disease, and why we do the things that we do, and what sorts of behaviors they should be engaging in. But it’ll have our pictures. It’ll have a description of our team. It’ll have a number. Things that they can use to see that we are real, we are legitimate. And we should not be asking things like social security numbers. We should not be asking things like bank accounts, anything financial.

Angela Clendenin:

We’re HIPAA compliant, so we do try to identify the person that we’re speaking to by their name and their birthdate. We understand the hesitancy with information. In the society we live in today, information theft, identity theft is a very real threat and it is a very real threat to our pandemic response. We’re trying to put measures, even as simple as our caller ID, into place so that people know that it’s a legitimate phone call.

Lindsey Hendrix:

Just to give context to our listeners, because we just started diving in and saying Texas A&M is going to be calling people and doing these case investigations. This is part of an inter-agency agreement that was put into place between Texas A&M University and the local Brazos County health district to conduct contact tracing on campus for the campus community and to also provide surge support for the county at large. The center that we’re referencing is called the COVID Investigations Operations Center, and it was really a brainchild of the provost and Texas A&M leadership, both at the university and the system level.

Angela Clendenin:

That does go back to your question about, how are we going to keep people safe when they come back face-to-face? The credit, again, goes to the Texas A&M administration. They recognized the impact that bringing students, thousands of students back into Bryan College Station could have on our county health district and how important it is, if we want to continue to have face-to-face class opportunities this fall and try to return to some sense of normalcy, that we had to be quick, and flexible, and responsive when we start to see cases appearing and increasing in our communities.

Angela Clendenin:

In order to do that, we’ve put a system into place where we can be quickly responsive, isolating those people, like we talked about before, that are cases and contacts, supporting our local health district with surge capacity to be able to deal with the increase in cases that we’ve brought into our community by holding class. The credit really goes to them for recognizing this in advance and empowering us to be able to build a system that seems to be working and it’s working well enough that we’re extending it to the other system member entities as well.

Lindsey Hendrix:

Oh, that’s great. This model then is set up to be replicated in other areas of the state as well?

Angela Clendenin:

So, [crosstalk 00:30:16] … Oh, go ahead.

Rebecca Fischer:

Well, I was going to say, not so much that the model is replicated. I think it’s a very unique model because it was really the brainchild of Texas A&M reaching out to the county, so a very unique situation. A large university with resources and the capacity to do that, and so not every place can do that. But certainly, we would encourage partnerships with local universities. We know that in Austin, Texas there’s a similar model with the University of Texas, Dell Medical School, and we are happy and we do talk to other institutions about possibilities, and lessons learned, and what we’re doing that they might be able to replicate. But the model for Texas A&M really is centered in Bryan College Station so that we have a dedicated team to be contacting individuals, say, in Dallas, in Corpus and West Texas and that sort of thing.

Lindsey Hendrix:

Right. Let’s pretend for a minute that we’ve got a captive audience of students. And hopefully, we do have some students who are tuning in to this. What do you want to tell them so badly? What is their role and responsibility in slowing the spread of COVID-19 and protecting their community?

Rebecca Fischer:

I want to say, students, we hear you. We don’t speak the same language. We’re trying desperately. We are moms and a little ahead of you in terms of our life years. We hear you. We want to protect you. We’re trying to give you tools … We’re trying to find those tools, and that language, and those resources. We really can use your help. Talking to your peers, helping us understand how to reach you, things we want you to avoid. In our perfect world is social gatherings, parties, and not just avoid going to bars where wearing a mask is quite difficult and you’re in a confined close space, but also casual social situations where you might feel relaxed. Maybe you have a small birthday party and it’s only 10 people you invite, but throughout the course of the evening those masks might come off. We get more relaxed. And we really want to try to avoid those situations.

Rebecca Fischer:

Young individuals, including in the college age group, seem to suffer less severe disease. That’s pretty well documented. However, there are some that still suffer severe disease. There are still some that suffer fatal outcomes. What we don’t want to see, and Texas A&M campus is across the state of Texas, is for our college students to end up in the hospital. And we certainly don’t want any of our student members to suffer a fatality. We’re really working toward that end. Please know that it’s a real possibility that we’re trying to avoid and every misstep in our behaviors or carelessness that we do, we could be facilitating that virus to spread to a person who, whether they know it or not, is vulnerable to severe disease or may have an underlying health condition that their friends and their peers don’t know about. We really want to appeal to an emotional side of our students. We want to appeal to a sense of service, and responsibility, and unity.

Rebecca Fischer:

But at the same time, we want to be hopeful and optimistic. There are great activities that are safe for us to do. Going for a walk, interacting with others socially that does not involve close proximity. There are a lot of things that we can do and the school’s trying to be safe, but we want everybody to be hopeful and know that we’re going to get through this on the other side.

Lindsey Hendrix:

Nice.

Angela Clendenin:

Texas A&M has a long history of Aggies helping Aggies. That’s what we really want to reach and to kind of pull on those heart strings as well, that, like Dr. Fischer said, we hear you. We don’t want to be cliché, but we are all in this together and the sooner that we can all do our part and engage in these behaviors, once we’re all together here in the fall, the sooner we will be able to get on the other side of this. And so, how this progresses in our community and the types of things that we’re going to be able to do or not do, it really falls back down on each and every single one of us caring enough about the people around us to do the right thing and wear the mask, even though it’s hot in Texas. Maintaining that physical distance. And I know that we have had since March, people telling us the 50 million things that we cannot do. But, psychologically, let’s focus on the things that we can.

Angela Clendenin:

And even those activities that you think you can’t do, sometimes you can adapt them a little bit and still be able to abide by the physical distancing or the mask wearing and engage in them. It’s a time to be creative and maybe invent some new activities, or fix some old activities so that we can continue to engage those things that nourish our physical and mental self, while we try to get to the other side of this thing. It’s not impossible. It just takes that selfless service and that commitment to being the 12th man. The Aggies helping Aggies. That means, Aggies young, and Aggies old, and future Aggies, and old Aggies, all of us doing our part to keep each other safe. We set the example. Across the state, if we can follow this, then others will follow too and Aggies will lead the way, like they always have.

Lindsey Hendrix:

Awesome. I think that’s so true. We’re so lucky to be a part of a community that really stands on those core values. I mean, we really, really do embody those core values of respect, excellence, selfless service, leadership and all of those. Students, we’re counting on you, we’re counting on you.

Rebecca Fischer:

That is so true.

Lindsey Hendrix:

Now, I want to go through a speed round. I’ve got a list of claims here that I’ve heard surrounding COVID-19. These are mostly misconceptions. There might be some half-truths here. But, what I want to do is read a claim and then I want you to set the record straight on that claim and respond with the truth. And so, give concise of answers as we can in just a couple of sentences or so. And we can go back and forth. You can each answer the question. All right, you ready?

Angela Clendenin:

Okay.

Lindsey Hendrix:

Okay. The first one we kind of touched on earlier. It’s about face masks. Wearing a cloth face mask can protect the wearer from COVID-19, the person wearing the mask?

Rebecca Fischer:

That is true. Most of the information out there suggests that it’s the person who is infected wearing the mask is preventing droplets from being exhaled to somebody else, to reach somebody else. That is true. And you think about that person wearing a face covering that then protects many individuals. The wearer of the face mask, this face covering, it’s not unidirectional. If there are droplets containing virus out there in the air, this mask will trap those as well. It’s just protecting the one person, versus protecting the multiple individuals.

Angela Clendenin:

And the bigger issue on that is making sure they’re worn correctly. Covering the nose, covering the mouth, making sure that it fits snugly. It’s uncomfortable, but they’ve even shown with some of the fitted types of masks for health care workers, you’re still getting a good oxygen supply through those, it’s just a little more moist than you’re used to getting. But you’re getting air, it just needs to fit comfortably.

Rebecca Fischer:

Yeah, and the wearer who’s being protected, remember that if you are being protected and that mask is working for you, then the outside front of your mask is a dirty zone, so you don’t want to touch the outside front of your mask when you’re taking it on and off. Pull your little ear loops or your around the head piece.

Lindsey Hendrix:

And so, how often should you change out your mask or wash your mask?

Rebecca Fischer:

If you’re wearing your mask a lot, then you can wash it on a daily basis. If you’re wearing it just when you go inside the grocery store and you pull it off and you want to wear it again, you can put it into a paper sack or an enclosed area so that it doesn’t … Again, if it’s dirty, doesn’t get anything on other surfaces. But if you’re wearing it a lot, then you want to wash it frequently. Then of course, if you are somebody who’s sick who is masked, you should be doing that more frequently or discarding it and replacing it with a new mask.

Lindsey Hendrix:

Okay. Here’s the next claim I’ve heard. And this is a followup to this question. Only people who are sick should wear a face covering when out in public.

Angela Clendenin:

That would be incorrect. Absolutely, as Dr. Fischer said, these are not unidirectional, so if a sick person is wearing a mask, it’s keeping them from spreading droplets, but it’s also keeping whatever’s on the outside from getting in. And so, it is not just for the protection of the sick. It’s for the protection of those who are not sick as well.

Rebecca Fischer:

Then remember that we have a lot of folks out there who are infected and don’t know it, because they don’t have sick symptoms. They may not be coughing, but they could be spreading those viruses. And everybody who gets infected with SARS-CoV-2 starts out without any symptoms, so every single person who is infected starts out symptom-free and may develop symptoms or may not. Remember, your mask is protecting you when you don’t know you’re sick.

Lindsey Hendrix:

Got it. Okay. Fever, cough and shortness of breath are the only symptoms of COVID-19, true or false?

Rebecca Fischer:

False. False. Really, anything you can think of that you might see with the flu. This is not the flu, but mirroring some of those symptoms. We see stomach pain, vomiting, diarrhea. A very common one is losing the sense of smell or taste. Also, I hear, a very strange sensation to have. Most people have a headache, so many headaches are reported, especially early on. Fever may develop. Again, roughly in 50% to 80% of individuals will develop a fever at some point during the course of their illness, but not usually the first thing. What else, Angela? Fatigue, weakness. Really, the thing that just echoes in my head is folks saying, “I felt like I just had allergies,” so congestion, runny nose, sore throat or scratchy dry throat, rash.

Angela Clendenin:

One of the things that we’ve heard a lot too is that this whole loss of taste and smell, people have had that before when they’ve had sinus infections, but this is above and beyond that in terms of sensation. The headaches are above and beyond just your average stress headache. People that don’t have migraines are saying that this feels like what I would imagine a migraine to feel like. It really is important that you recognize that this symptom list started with three and now it’s 12 symptoms. If you’re experiencing one of the symptoms that is at an unusual level for you, that’s probably an indicator that you need to get checked out.

Angela Clendenin:

And certainly with some of the more severe ones, like shortness of breath. If you’re experiencing shortness of breath, then maybe your lips are turning blue or something to that effect, you need to go to a doctor right away, to an emergency room. That’s a really serious symptom that especially if it gets worse, before you make that call. Pay attention to what your body’s telling you. Know what your normal is and things that are above and beyond normal are a good indicator that there might be something else going on as well.

Lindsey Hendrix:

Okay. Next claim. Kids under 10 years old cannot spread COVID-19.

Rebecca Fischer:

Not true. Again, kids seem to be less likely to suffer severe disease. We know that they’re often being infected. They might show milder disease syndrome slightly different. We hear a lot of rash of hands and feet, loss of appetite, fussiness. But, kids under 10 can pick up that virus. Even if they don’t act sick, they could be passing it to family members. Also, they could pick it up from a family member. Their teenage brothers and sisters might be culprits when they’re out interacting with folks and bringing it back to their families. Don’t be afraid to get your kids tested. If you take your kid to the testing site and they say, “Oh, your kid is probably fine. They’re probably not going to be that sick.” You can insist on testing and it’s smart if your child has been in contact with other kids and we need to reach out and notify them that they may also be infected. Because remember, kids have contact with parents, and have contact with grandparents, and with teachers. And so, there’s a chain here of transmission that we want to make sure doesn’t happen.

Angela Clendenin:

Yes, children can be transmitter and carriers of the disease. They can have the disease. If a child has an underlying comorbidity, they can also have severe complications. It presents a little differently in some cases, but it’s important to realize that just because they’re under 10, they’re not immune and they play a very important role in transmission.

Lindsey Hendrix:

Okay. Next claim. Once you have had COVID-19, you can’t get it again.

Rebecca Fischer:

This is unknown. Not just do Angela and I not have an absolute question for this, but we can’t lose, because the answer really scientifically is not understood yet. What we do see from the literature is that most people develop some kind of immunity. What we don’t know is … Let’s say someone with antibodies. Antibodies is what we use to protect ourselves from reinfection or from disease. We can say that most people develop antibodies. We don’t know if those antibodies keep us from getting infected again and we also don’t know how long those antibodies last. For some diseases, like measles where we get a vaccine or get measles and then those antibodies last forever and keep us safe and immune, we don’t know that for SARS-CoV-2 antibodies. But, we do think that there’s at least short-term, if not longer, immunity.

Rebecca Fischer:

It looks like we are pretty confident in at least a three month for most people. But this is the kind of thing that we can’t rush knowing. We can’t speed up learning this piece of information. We literally have to follow people over time to see what happens to them a year from their infection. Although it seems we’ve been in this situation for a very long, an uncomfortable period of time, we still need to wait and see.

Angela Clendenin:

That’s been the big challenge of COVID-19 is because it is a novel disease that we have not experienced in our society before, the experts that people would normally turn to to be able to give them those kinds of answers, don’t know the answers. And we’re all learning about this together. From an epidemiological perspective, that’s kind of, I guess, one of the frustrations of being an epidemiologist is that everything that we need to know, we won’t know until we get on the other side, and we can look back retrospectively, and follow things over time, and be able to look at what we knew when, and how, and moving forward. There’s a lot of answers to come, it’s just going to take some time.

Lindsey Hendrix:

Right, right. Okay. Now, I got a couple of doozies.

Angela Clendenin:

Oh, boy.

Lindsey Hendrix:

COVID-19 was created by scientists to test the world’s public health response. It’s a conspiracy.

Rebecca Fischer:

I can say that virologists have debunked this. This is not a virus that could have been created in a laboratory. I will tell you that the virology statement is that we don’t know enough to have done this. This is too scientifically complex. Admittedly, we want to know everything about viruses, but the scientific knowledge is not there to have created that sort of thing.

Angela Clendenin:

People need to realize that coronaviruses are a family of viruses. There are a lot of them out there. There are probably coronaviruses out there that we haven’t seen yet. Viruses mutate over time, and so we’ve known for a very long time that at some point a virus is going to mutate and enter into our society and cause a global problem. We just didn’t know which one and we don’t know how to pick which one. And so, it’s one of these things that it’s a family of viruses that are out there. And so, it would not be uncommon for one of them to have mutated and get into our society without having to have been lab-created.

Lindsey Hendrix:

Right.

Rebecca Fischer:

Let’s be clear, this kind of event happens all the time. Viruses are out there doing their thing that viruses do. A lot of viruses move from animal’s feces to … Can get into another species. And usually, it just hits a dead end. Sometimes viruses jump from animals to humans. We know this for a lot of diseases that we know a lot about. But, it’s sort of a rare chain of events that it would be so successful in that it could create an epidemic, let alone a global pandemic.

Lindsey Hendrix:

Right, right. Okay, another one. The media, politicians and officials are hyping up COVID-19. It’s not as bad as they claim it is. More people die from the flu every year then are dying from COVID-19.

Rebecca Fischer:

Well, I can say in Texas that more people die from COVID-19 this year then have died of the flu in the past. When I pulled up the numbers this past weekend looking at the mortality rate of influenza and pneumonia in the state of Texas, for the latest data available public, which is for 2018, already this year for COVID-19 in Texas we have surpassed that number. I would suggest that the media is not hyping it up. I would say that if anything, they are trying to alleviate some fear and anxiety, as their role in media. This certainly deserves a lot of attention. It doesn’t deserve a lot of fear, and stigma, and anxiety, but a really thoughtful response to a very dangerous virus and a very important public health threat is warranted.

Angela Clendenin:

It goes back again to trying to provide that information to people so that they’re empowered to take care of their own health. We’re starting to see some of the longterm health effects in some people, not everybody, but in some people from having COVID-19. It is a very serious illness and we need to respect it. The more that we can put out in the media that provides that education, it’s not hyping it, it really is trying to make it something that people see, and respect, and they know that it’s in our communities, and they know that we’re going to have to live with it for a while.

Lindsey Hendrix:

Yeah, absolutely. This is a real thing. The numbers speak to the magnitude of this pandemic, so let’s take it seriously everybody. Now, the final thing is more of a question than a claim, but I know a lot of people are concerned about how rapidly the world is trying to come up with a vaccine for COVID-19, for SARS-CoV-2. I think some people are skeptical about getting vaccinated once that becomes wildly available. Should people be skeptical of it or should they go ahead and get vaccinated?

Rebecca Fischer:

I would say that not just for a vaccine against SARS-CoV-2 infection, but for any vaccine, scientists work tirelessly for this. In my previous role, I worked alongside vaccinologists at the Sabin Vaccine Institute at Baylor College of Medicine, so I saw them working on vaccines constantly and these processes take years sometimes. A little bit hesitant about the language, “Warp speed,” vaccine production in terms of what that really makes people think is possible. The process is a long process. There are set trials and tests that are performed that we can’t shortcut. Because again, some of these take time and they’re watch and observe what happens, including observe what happens in a real-life setting. I think it is tough to say that we could really speed that up.

Rebecca Fischer:

That being said, we do know a lot about coronaviruses. We know a lot about vaccines. We know a lot about how to construct vaccines so that they can be effective. We can borrow knowledge from those vaccines and then production pipelines can be set up in advance to push those out. My hope is that no vaccine would make it to market or to public use that hadn’t been fully vetted and gone through the scientific rigor that is necessary and required for any vaccine. If that’s the case, which I think should be the case. I mean, I have no reason to believe otherwise. There shouldn’t be a vaccine released into the public that was unsafe. I think the real question would be, how effective is that going to be? Especially given what we know and we don’t know, as we just covered about immunity and how long that lasts. We don’t know if this is a vaccine that we would get every season, like with influenza vaccine, or if it’s something that would be available to a few individuals, such as just frontline workers and health care providers. There are a lot of unanswered questions about the vaccines.

Angela Clendenin:

We’ve experienced coronaviruses before. We’ve had SARS with its outbreak. There’s MERS, which is Middle East Respiratory Syndrome. We’ve had scientists working with answers to coronaviruses, the siblings of COVID-19 as it were, for years. And so, their knowledge of how these things work is good. It’s still growing and it’s advancing, so it feels like almost we have a little bit of a head start. There are policies in place. I hate, again, to politicize response, but we have a policy called Project Bioshield, which works with vaccine and therapeutic manufacturers to expedite the process of getting something from concept to deployment.

Angela Clendenin:

It doesn’t mean that they shortcut any of the safety concerns and the safety testing, but it may reduce the amount of time that you follow a cohort. But it’s one of those things where you have to kind of sometimes weigh the greater good. They’re not going to take shortcuts that are going to put people at risk, but they are going to find ways that they can move it from bench to bedside so that we can try to have an answer for COVID-19 sooner, rather than three years down the road or four years down the road. But, like Dr. Fischer said, what we don’t know about the immune response and the potential immunity to COVID-19 that our bodies generate, what that vaccine is going to look like. Is it only going to be 50% effective? Is it going to be 75% effective? Are we going to have to have it every year? Is it something like a measles vaccine that provides lifelong immunity? Those are questions that we don’t have the answers to right at this time.

Lindsey Hendrix:

In the meantime, until there’s a vaccine, which could be awhile down the road, let’s all protect each other and take the measures that we talked about earlier in the show. Anything y’all would like to end this on? Any advice or calls to action that you want to present to our listeners?

Rebecca Fischer:

I would just appeal, again, to sort of this sense of responsibility and collective action. Taking care of each other, while we’re taking care of ourselves. Be cognizant of those that are around us, our loved ones and others. Be conscientious. Be thoughtful. We’re thinking about things that we never thought about before, how many times I touch my face. Did I clean my hands before I touched the shopping cart? All of these things. Our commercial partners have put guides on the floors of stores for us. I think this is really funny, but so helpful. If you’re standing a foot in front of that line and you’re a little close to the customer in front of you, just back up a little bit, because that person’s health should be protected as well as yours.

Angela Clendenin:

On top of that, again, it goes back to, this is a new disease that’s invited itself into our world, and it’s going to be with us for some time, and it doesn’t pick and choose who has it and who doesn’t and how those people’s bodies react to the disease, so we need to be respectful not only of one another by engaging in appropriate behaviors, but respecting the disease itself and understanding that the one way we can kind of chorale it is to behave appropriately and engage in good, well thought out, tried and true methods to break the cycle of transmission.

Rebecca Fischer:

And be creative. We both, we talk about this fairly often. We want people to find creative ways to enrich their emotional, and social, and physical wellbeing, while remaining safe from the virus that causes COVID-19.

Lindsey Hendrix:

Awesome. Well, I think we can just end this show on saying there is a light at the end of the tunnel. I think we will get through this, eventually. It might not end with the year when we pop off fireworks on January 1st, but it will be over sometime soon. Just as long as everybody does their part, right?

Angela Clendenin:

Absolutely.

Lindsey Hendrix:

Awesome. Well, thank you guys so much for being here, taking time to be on our show. We really appreciate it. I know this won’t be the last time we talk. Hopefully, we’ll have you back on. Y’all, take care.

Rebecca Fischer:

Thanks. You too. Bye-bye.

Lindsey Hendrix:

Thanks. Bye. And thank you listeners for tuning in. I hope you really enjoyed this episode and got something from it. Remember, in this case, just this once, don’t pass it back. Wear a mask. Keep your distance. Be creative. All right, guys. Until next time, stay healthy.

Tim Schnettler:

Thank you for joining us on Texas A&M Health Talk, a production of the Texas A&M University Health Science Center. Visit us on the web at vitalrecord.tamhsc.edu, where you’ll find answers to all of your health questions. Until next time, stay healthy.