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COVID-19 Q&A with Dr. Ken Kirton

4/6/20

In stressful situations such as the COVID-19 pandemic we are facing, streamlined or simplified information can provide clarity and reassurance on how to navigate each day. This knowledge may provide a greater sense of control and help to lessen fear and anxiety. This week, Ken Kirton, MD, Chief of Staff at Freeman Regional Health Services, responded to questions regarding COVID-19 that everyone may use to navigate their daily personal and work journey.

What is COVID-19?
It is an infection that primarily affects the respiratory system.

How is the virus spread?
By coming in close contact with a person (within 6 feet) and that infected person coughs or sneezes: when in close proximity, a non-infected individual inhales these droplets and could become infected. This type of exposure can be lessened by the infected person wearing a mask or covering their sneeze/cough with their elbow, thus lessening how much virus they put into the air. The second way is when a person who has no infection touches a surface that has virus on it and brings their hand to their face. This is a more common way for this particular infection to transmit from person to person. Surfaces that could potentially have virus on them, would include a surface that someone with the infection touched after touching their face, or a surface exposed to the virus from sneezing or coughing and the virus in the air settles on it. This mechanism of spread of the virus from one individual to another can be lessened through good hand hygiene principles.

How easy is it to spread?
Some viruses are difficult to spread from one person to the next and require significant, repeated exposure. Other viruses are easily transferred from one person to another and require less exposure to move from infected person to a non-infected person. This particular virus is more easily transferred from person to person. This makes it more difficult to limit spread and more likely that many people will become infected and ill all at once.

How serious of an infection does this virus cause?
Most people who become infected will experience minimal symptoms or symptoms consistent with a very serious cold. Unfortunately, a significant number of individuals who become infected will experience severe, life-threatening complications. Many who become seriously ill will require hospitalization, supportive oxygen therapy and mechanical ventilation to give them the opportunity to survive this illness. It is important to know that some individuals will be more likely to experience worse outcomes. Individuals who have chronic health problems like diabetes, heart disease, lung disease, or cancer, those who are on immunosuppressive medications and the elderly have consistently been hit much harder by this disease and have a significantly higher chance of dying as a result of complications.

How can I protect myself, my family and my community?
Space, time and good hand hygiene protocols

Space?
Interacting in fresh air locations carries less risk of spread than indoor spaces, as long as good hand hygiene is used. The tighter the space, the more likely spread can occur. The current recommended minimum distance is 6 feet of personal space.

Time?
The shorter the length of time a person is in a place where they might become exposed, the less likely either airborne transmission or hand contact with an infected surface could occur.

Hand hygiene?
This involves frequent handwashing with soap and water for 20 seconds while following a process that prevents recontaminating your hand as you turn the water off and dry your hands. An alternative solution is to use hand sanitizer that meets virus killing standards. To use hand sanitizer correctly, ensure that the surface of the hands are wet and allow the sanitizer to evaporate rather than wiping it off. Hand hygiene includes strategies to decrease touching of potentially infected surfaces as well as decontamination with a cleaner approved for sanitizing virus contaminated surfaces. It also includes limiting bringing your hands to your face through either change in habits or a barrier over your face to remind you not to touch the nose and face except when hands have been cleaned or sanitized. One strategy is to wear a face mask/cover to lessen hand to face exposure; this is an occasion when reusable and washable face covers can play a role.

Why not simply let the virus sweep through the community and get it over?
The reason is that without social distancing, this particular virus spreads so quickly that our medical system will be overwhelmed and be unable to provide adequate care to the number of very ill individuals all at once. In addition, if the medical system is overwhelmed, then it would be difficult to provide other types of medical care that individuals may require (like for heart attacks, acute surgeries, delivering babies and cancer care).

What are your recommended strategies to deal with anxiety, fear and feelings of hopelessness?
Getting fresh air and exercise, helping others, maintaining spiritual life, planning for the future and developing a routine

Getting fresh air and exercise?
Fresh air and exercise are safe and healthy. They promote a sense of being free from the external restraints while being in a safe space. They allow you to take back control over part of your life. Consider working on outdoor projects. 

Helping others?
Find a small way to do something for another fellow human being: a phone call, an email, a card, or another act of kindness. No act is too small. I am amazed how small demonstrations of kindness can have powerful effects. These acts can help others to cope, but they also help you.

Maintaining spiritual life?
Work to maintain your spiritual life. It will be different, at least for now, but it is still the most powerful force in most people’s lives.

Planning for the future?
Think about what and how you will do and experience exciting things in the future. Plan while recognizing amendments to plans will alter what will be possible. Even if those plans do not work out exactly as you might have hoped, being hopeful fights hopelessness. 

Developing a routine?
Work to provide routine and structure to your day. We humans are creatures of habit. Try to structure your day to help achieve adequate sleep. If you are struggling, then reach out for help. People care and will feel better about themselves by helping you.

Any further advice?
Focus on the positive and possible as well as the frightening and sad.