HALIFAX -- The information surrounding COVID-19 can be overwhelming and, at times, hard to understand.
Many Maritimers have had questions about the virus itself and how to deal with it. Particularly, when some of the messaging continues to change, as the science community learns more about the disease.
Dr. Lisa Barrett sat down with CTV News Atlantic anchor Steve Murphy on Monday night to provide answers to the ever-changing questions about COVID-19.
Dr. Barrett is a medical doctor and clinician scientist with expertise in infectious disease and human immunology.
In addition to a PhD and MD from Memorial University, an internal medicine residency at Dalhousie University, and an infectious disease fellowship at the University of Toronto, her training includes post-doctoral training at the National Institute of Allergy and Infectious Diseases in Bethesda, Maryland.
During her training at the National Institute of Health in Maryland, Dr. Barrett worked with prominent American physician and immunologist, Dr. Anthony Fauci, who is a member of the coronavirus task force in the United States.
Below is a transcript of the interview:
1. I have read and re-read the advice on masks and yet still feel uncertain. Should we be wearing masks when out for essential tasks? If so what kind of fabric and how do we clean them?
- Jacklyn Parker
Dr. Barrett: With respect to masks, and again I’m going to make sure we know we are talking about masks outside the health care setting, when you go and do your usual activities, it’s a good question. Really it depends how much you think there is likelihood that you might have the virus. So these cotton masks that people are making and buying are most useful for preventing a virus you might have or not know you have from getting outside the mask, so you’re protecting those around you more than yourself. In that situation, it really does depend how much unnoticed virus we think there is in the community.
If you want to wear a mask and you’re most comfortable with it, you can wear a mask. The key part would be that we expect that people would be able to take it on and off properly, wear it appropriately which means covering your nose and your chin, and then it can be taken off, and if it is a reusable one, cleaned with regular soap and water in a washing machine and kept in a covered area until you keep it. So can you wear it, sure, but do you have to wear it? As we head past the peak it is not an obligation for people to do so. Consider it if it makes you comfor
2. If masks stop infectious droplets from being expelled, why won’t the same masks prevent droplets from getting in?
- Peter and Myra Barss
Dr. Barrett: With respect to masks, and again I’m going to make sure we know we are talking about masks outside the health care setting, when you go and do your usual activities
2. If masks stop infectious droplets from being expelled, why won’t the same masks prevent droplets from getting in?
- Peter and Myra Barss
Dr. Barrett: The mask itself, when the droplets come out of your mouth, they will go out to the outside part of the mask, and make it wet through the fabric. We know that’s not going to hurt anyone around us, because they’ve stopped the velocity of the droplets in the mask, that’s how it protects.
If you get virus that gets onto the mask from the outside from droplets, it’s still going to leech in towards you, it’s just that then it’s sitting there right in front of your face, and that’s why it’s still infectious. Only very specially designed masks with specially designed fabric will actually keep those droplets out, like the ones that are used in health care settings called N95s.
3. Won’t the viral droplets travel more than six feet once you step outside into the wind? I think it would flatten the curve a lot quicker if it was mandatory for everyone to wear masks outside.
- Patty Fraser
Dr. Barrett: The take-home message is, it’s probably infinitesimally small, the chances of finding enough droplets, because to your point, wind carries things away very quickly, and carrying all the droplets in one direction and having them smack into your face in the right amount and the right volume would be pretty challenging, especially as it disperses the further away you get.
So if you are keeping the first rule of thumb in mind, which is six feet apart still, by the time the wind spreads it further, the amount of virus has dissipated no matter if there is still a droplet or two, then your chances of getting infected are pretty infinitesimally low.
So could everyone wear a mask? Maybe. But don’t forget, we’re also starting to head into the phase where there is less virus around in the community. As we head towards that, it becomes safer to go outside, still staying socially distanced and washing your hands.
4. I am in the vulnerable population group because of my age. As society opens up what can I do to minimize my risk? Must I avoid group activities and practice physical distancing until a vaccine is found?
- Dianne Kelly
Dr. Barrett: If you’re older, you are still at some risk, but if you don’t have other risk factors and you feel comfortable, and you’re able to maintain social distance, wash your hands and don’t touch your face, and again, if you have symptoms of a cold or flu, stay home. If you want to go outside and you’re not around people who are ill, I think it’s okay to do things that public health has recommended, keeping social distancing and hand washing in mind. If you are truly uncomfortable and worried, you can wear a mask for a few weeks.
Public health has told us it’s okay to do some things, but just because you can doesn’t mean you have to, every single day, at the moment the restriction has changed.
5. There is a lot of effort on finding a vaccine at the moment, but you and others are also working on therapies. What can you tell us about your own research on treating COVID-19
Dr. Barrett: We recognize that a vaccine is going to take some time and in the meantime we have a lot of vulnerable people both in Nova Scotia and beyond that really need access to whatever we can provide in terms of therapies. Unfortunately because this is a new virus we don’t already have approved medications developed and waiting on the shelf. Therefore, many people and investigators around the world are putting together trials of already licensed medications that may limit the virus and it’s spread in the body, as well as the damage it can do by taking down the immune system.
The work that we’re doing is taking some of those medications that may be helpful and testing them in a study, as opposed to just testing them one at a time in individuals, so we can learn more about both what medications work, but also what happens to your immune system and what makes it better or worse when you get sick.
6. We’re hearing a lot of talk about Remdesivir which is an established treatment for Ebola, I believe it was shown to have some effect for SARS, what do you think about how well it works, or are you working with it?
Dr. Barrett: It’s a medication that has been tested by the government in the U.S. through the National Institute of Health. They sponsored a study where they looked at just over 1000 patients in different cycles and tested how well it worked at reducing the amount of time until recovery. Now that data is not out yet, but there seems to be a trend in reducing the amount of time until people started to feel better, and maybe a trend towards decreasing deaths, but it wasn’t clear. The devil is in the details when it comes to these types of studies and we don’t know those details yet, so we’ll keep an eye on it, it may have some impact, but I would never use the word cure when talking about Remdesivir, we still have a lot more to learn about it.
7. Is there a universal database that scientists are using to share what they have tried and what appears to help or to eliminate treatments?
- Heather Jupp
Dr. Barrett: Absolutely. In general times, scientists often work on their own publishing their information many months or years after they get some data. However, in this environment, we’ve seen scientists from around the world collaborate and put their information into various databases, both treatment and basic science data on the immune system, who work together very quickly and it’s been astounding to watch some of the information that is just starting to become available. Many databases including Canadian ones and ones across Dalhousie University, with really wonderful scientists who are going to be doing more and more research that I’m sure you’ll hear about in the next few days.
8. How effective are the swab tests for COVID-19 and are there other testing methods that are more reliable?
- Lisa Duguay
Dr. Barrett: Depends on where you are in the disease. By the swab test, I suspect she means either the one that goes into the back of the nose, or the back of the throat and nose, and that’s a pretty good test actually. It picks up the genetic footprint of the virus and it’s very sensitive early to mid in the disease. As the virus moves down into the lungs, that swab can become negative if it’s later in the disease, and eventually it potentially moves into different parts of the body and therefore the swab may be more likely to be negative.
Other tests are being developed and they’d be based on your immune response and not the direct virus itself, as well as, instead of a genetic footprint for the virus, looking for other pieces of the virus. Those are all tests that are under development, but right now none of them are sensitive enough and specific enough to be very useful to tell you what it means as a person, and therefore we don’t use them clinically yet.
9. I read an article which said there were 141 cases reported in South Korea whereby people who had tested positive and reported as being cured were found again to be affected and tested positive. Do we now know more of the possibility or even probability of this happening?
- Reginald Hebert
Dr. Barrett: That description would be one of, if you’ve gotten exposed before and gotten better, can you get infected again? We don’t know the answer to that question definitively, it is something we are studying both locally here in the province and other parts of Canada, but we don’t have the answer fully yet. We don’t know if the protection you get after you’ve been infected keeps you from getting infected again, and we don’t know how to measure it yet.
10. If you believe you’ve had COVID-19 and are recovered, you should have antibodies from the virus. How would you get tested?
- Barbara
Dr. Barrett: You could at this point, but the tests aren’t very good, so they won’t do you much good. There have been a couple that have been approved in various parts of the world and as we’ve tested them further we’ve found that they have some significant challenges. People are working very hard to get another blood test, or even an effective test that could be done at the bedside or at someone’s home that could tell us if you’ve been exposed before. But right now it’s still too early, we’re still waiting, we’ve only had a few months so give us a few more months and we’ll see where we get.
11. Is it not true that the best thing that could happen is for healthy people to get COVID-19 and then recover creating a herd immunity? If not, are we not opening ourselves up for a second wave in the fall?
- Barry Todd
Dr. Barrett: The reason we did this is that we knew that it would take longer for us to get more immunity in the community, but we also didn’t want to overwhelm the health system. That still holds. Getting people together in big herds and getting them infected all at the same time would be pretty much not a great idea, in fact in some populations for people who are vulnerable and we don’t know it, it would be a disaster, so I’d recommend not to do that.
Are we opening ourselves up for a second wave? There’s definitely going to be a second wave whether you have a COVID party or not, so in our version without the COVID parties more people stay alive, so I’d prefer to go with the version that we’re providing.
This is the fourth interview in a series of COVID-19 Q&A's with Dr. Lisa Barrett:
