COVID-19: What you need to know for your physical and mental health

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AUGUSTA, G.A. (WJBF) – As The Means Report takes on the COVID-19 virus, it’s not with numbers when it comes to positive or presumptive cases. It is in general terms so that hopefully you can walk away with a better grasp of what we’re all dealing with right now. Maybe, once we all hear the facts, everyone might settle down and ease off the panic button.

Brad Means: And our special guest to kick everything off is no stranger to the airwaves. He is Dr. Jose Vazquez, he is the chief of infectious diseases at the Medical College of Georgia at Augusta University. Dr. Vazquez, thanks for all you’re doing and for really pressing the pause button long enough to come in here.

Dr. Joes Vazquez: Thank you very much, thanks for having me.

Brad Means: It’s my pleasure. The last time we met, as you so kindly reminded me, was to talk about Ebola. A threat that never really materialized, at least not in the United States, like people thought. This one has.

Dr. Joes Vazquez: Yes.

Brad Means: Did you think this day would come?

Dr. Joes Vazquez: I did, I did. This is something that’s been going on since the beginning of time. We’ve had pandemics and epidemics for thousands and thousands of years and they’ve been documented. So we knew it would happen and we knew the smaller the world gets with air travel, the quicker any of these viruses from anywhere in the world will end up in the United States and North America.

Brad Means: You say it happens all the time and that it’s happened since the beginning of time. How do we not notice it more? Are our immune systems just that great?

Dr. Joes Vazquez: Well I think there are some viruses that are around us that we don’t know of at this point in time that make us sick. It’s not uncommon for you to go to the doctor’s office and feel sick and your doctor says, well, we think you have a flu bug and that’s it. And frequently it goes away because we have what’s called herd immunity, which is if it’s a low-level virus, it produces antibodies and protects us from others that we have never been exposed to, like this coronavirus definitely impacts us because it’s a brand new virus to our system and because of that, everybody gets sick.

Brad Means: Brand new to our system. Do you think it’s real or manmade?

Dr. Joes Vazquez: No, I think it’s real. At this point in time, this virus was actually looked at about five or six years ago by some researchers at the University of North Carolina. It looks like a virus that’s found, actually, in snakes. So they actually published on that, so this could have been foretelling, really. Most of the virus comes from a coronavirus that was found originally in snakes. I hate to point to the term jumped because viruses don’t jump, but somehow it’s actually made it into other animals and from other animals it made it into humans.

Brad Means: Well, it’s probably not the most productive thing to ask you about at this point to say, could we have gone back when we first saw the beginnings of this and done something about it, so I’ll just ask you right now, what’s the best way people can avoid it? And the reason I ask that question is because I think it’s to stay inside and never go out of your house. Some people think it’s to live life as normal.

Dr. Joes Vazquez: How ’bout somewhere in between? Certainly the key, and everybody’s heard the term social distancing. You and I are about five feet, which is good. That’s a perfect distance for us to be. We know that these droplets travel probably four to five feet, in that area, number one. Number two is, and I think more important for anything else is if you’re sick, if anybody’s sick, anybody in your family is sick, please don’t go outside, please don’t mingle with the population, please don’t go to work. That’s how people get in trouble and that’s how we have gotten these explosions and these episodes. For instance, the outbreak in New Rochelle, New York was started because of something that started in a church. The one in Seattle was because of a nursing home. Obviously that was very early and they were caught off-guard.

Brad Means: It is difficult and it is counterintuitive, it seems, to the way we’re wired as humans to shelter in place, or to exercise that caution, to find that middle ground you just mentioned if you feel great. But feeling great might fool you, right?

Dr. Joes Vazquez: Correct, that’s absolutely. So we do know that one or 2% of the population so far has the virus. I’m not saying they’re sick, but they carry the virus, and those are dangerous because one person mingles with who knows, 20 or 30 people throughout the day, and those 30 people will mingle with other 30 people. So within 24 hours you can have 200-plus individuals infected, right? The other part of it is about 80 to 85% of individuals have a very low-grade respiratory tract infection, a common cold, if you will, and those are the ones you’ve seen in the news that have been recovering rather frequently. And those are easy, those are the ones that tend to go to work and those are the ones that’ll go to the store and touch everything and touch your fruits and vegetables and everything, and that’s something else to worry about, right? Only about 10 to 15% get really sick where they actually have to be admitted into the hospital. As a matter of fact, so far of the ones we’ve seen, only one has had to be admitted to the hospital.

Brad Means: Let me go back real quickly, and I know that were gonna eat up all our time if I’m not careful, go back to the fruits and vegetables. What do we do when we get those home to make sure everybody’s stuff is wiped off ’em?

Dr. Joes Vazquez: So that’s a good point. So number one is everything that you touch at the store needs to be cleaned when you come back home. So what cleans fruits and vegetables? Soap, regular soap will clean off and kills the virus because it has this fatty layer that is inactivated by just plain old soap. We’re getting to the point that we may lose all our hand sanitizer, right? You can’t even find it anywhere.

Brad Means: You can’t.

Dr. Joes Vazquez: The best thing you can do is soap, soap and water, soap and water. And then brush, just like you wash your hands, washing them for 20 seconds to 30 seconds, cleaning everything, all the debris off of the fruits and vegetables. That’s an area that I’m definitely concerned about. As you go in there and you start picking the ones that you like and putting back the ones that you don’t.

Brad Means: Right, you touch everything.

Dr. Joes Vazquez: Correct.

Brad Means: As of this taping, the last thing I heard President Trump say when it comes to the number of people we can be around is groups of 10.

Dr. Joes Vazquez: Right.

Brad Means: So my question is can we go over to people’s homes? Can we let our children spend the night with others or shoot basketball in the driveway or do things that humans do, 10 and under?

Dr. Joes Vazquez: I would say that is safe as long as those individuals that you’re mingling with or interacting with are asymptomatic. There is gonna be a risk factor anyways. We can’t shelter in our homes for two weeks, which I think probably to me is gonna be not enough. Probably gonna have to go on a little bit longer than that. Being outside helped because it disperses, right, the aerosol. So it’s a lot safer to be outside if you wanna go and run, ride your bike, maybe camping is a good idea, getting away, as I’ve mentioned before. Camping, fishing is a good idea to get away from people, that’d be great. So you don’t have to just go out and mingle and go to restaurants and go to theaters. You can go out and do a lot of outdoor activities are a lot safer than they are as long as you keep it in small groups, and in small groups that are not sick.

Brad Means: Not to belabor the point, but let’s say you’re throwing a football or shooting a basketball and you’re going to have touched the basketball, touch your face. Is there danger there, am I overthinking it?

Dr. Joes Vazquez: No, touching the face is the key. So you can throw a football, you can shoot a basketball, do not touch your face. That is probably the most important theme of all of this because it doesn’t penetrate the skin, it has to get into our body by either the eyes, the nose, or the mouth.

Brad Means: Doesn’t penetrate the skin?

Dr. Joes Vazquez: No, it does not penetrate the skin. So if it’s on your hands, it’s okay. The problem is when it gets onto mucus membranes, your eyes, your nose, and your mouth. That’s how it starts to replicate.

Brad Means: Take me through the life cycle, as quickly as you can, of a virus. Does it eventually peter out and die?

Dr. Joes Vazquez: You mean on an individual, or in general?

Brad Means: Yeah, I mean I guess, well, in general. And what I mean is if I hide in my house or if I practice all the things you’ve advised, it eventually gives up and moves on.

Dr. Joes Vazquez: Well, we don’t know that. Influenza doesn’t give up and move on. Influenza just changes, but that’s a different type of virus that mutates, that’s why it comes back every year. We don’t know enough about this coronavirus for us to say. It hasn’t mutated yet but we don’t know if it will. We do know there is now some recent study showing that as the temperature goes up and humidity goes up, the virus living on surfaces and living starts to drop. That is true. So our hope is that as it gets warmer here, and we’re a lot luckier than the northern folks are, right, it gets warmer and muggier, then it’s gonna be better.

Brad Means: Dr. Vazquez, let me ask you if my interpretation is correct about the coronavirus, and it’s this. It’s not that it’s going to come into our bodies and kill all of us, it’s that it’s going to come into our bodies and we’re going to shed it on the most vulnerable and overload your healthcare system.

Dr. Joes Vazquez: That is what we are scared of, right? That’s why we have the telehealth, the telemedicine, the drive-throughs and the walk-ins is the fact that most individuals, as I mentioned before, have very few symptoms, have a cold. But those individuals, perhaps, will go and see grandma and grandpa that are at home, that are 70 or 80 years old. Those are very susceptible. Those are the ones that would end up in the emergency room. If those end up in the emergency room with severe pneumonia, they go into the intensive care unit and as I’m sure you’ve heard, respirators are not easily found. And there’s a set quantity of respirators right now. That is our big concern. So that’s why a lot of our screening here at AU is actually being done outside the hospital and not inside the hospital, trying to not overload. Recognizing that we still have an entire patient population of trauma, of surgery, of individuals with many other diseases that we have to take care of at the same time, and we have to protect not only those patients but protect the personnel. Because the personnel that are in a hospital get infected or get exposed, those individuals are out for 14 days. So we could lose nursing personnel, respiratory therapists–

Brad Means: We don’t want that.

Dr. Joes Vazquez: We even have physicians, actually, that are out on quarantine right now.

Brad Means: In your heart of hearts, in your scientific heart of hearts, when do we get our lives back?

Dr. Joes Vazquez: I’m thinking in the summer. I’m thinking we still have a few months to go.

Brad Means: June, July, August?

Dr. Joes Vazquez: I would think so. I think–

Brad Means: No, which one?

Dr. Joes Vazquez: I don’t have a crystal ball. I’d love to, if not I probably would be forecasting this, but I think with the little bit that we know at this point in time, and what we’re doing to flatten the curve, which is what we’re trying to do, right? Diminish the exposure and diminish the disease. And the fact that the temperature is gonna go up and individuals will then go outside and do things instead of staying indoors, I’m thinking that we’re looking at a couple of months, at least, to do this.

Brad Means: I can’t tell ya how much I appreciate your time, Dr. Vazquez. I believe, not to overstate anything, but when this is over, you’re gonna be remembered and MCG at AU and all the folks there are gonna be remembered for their service on the frontlines. Thank you for that.

Dr. Joes Vazquez: Thank you very much, thanks for having me.

Brad Means: Absolutely.

Dr. Joes Vazquez: My pleasure.

Brad Means: Absolutely. Jose Vazquez, you’ll see a lot more of him on our news, thank goodness. It’s good to have great minds like that working on this. When we come back, speaking of minds, how do we maintain mental health in our households? Especially when it comes to our children processing all of this? A psychiatrist from AU in a moment.

Part 2

Brad Means: Welcome back to this very special edition of The Means Report where we are trying to put the coronavirus in perspective, both from a physical health standpoint, and I think Dr. Jose Vazquez did a masterful job of that in our first segment. Watch it online later if you missed it. And now in our second segment, the mental aspect of this pandemic and how we can process and handle that. Dr. Dale Peeples is a child and adolescent psychiatrist at the Medical College of Georgia at Augusta University. No stranger to The Means Report and he’s back with us during this odd time in our lives. Dr. Peeples, thank you for what you do and for being here.

Dr. Dale Peeples: I appreciate y’all having me, thank you.

Brad Means: Can we talk to our children about this? I know when we’ve talked about other topics, bullying, addiction, you say it’s age-dependent. Is the same thing applying here when it comes to this, be careful what you say depending on age?

Dr. Dale Peeples: That’s definitely true, and a good way to kinda feel that out is really to begin with the child, ask them what their thoughts are about this, what concerns they have. Really allow them to start the conversation.

Brad Means: How do you handle things when you’re not sure what’s going on? And that’s why I was asking a lot of questions about kids with Dr. Vazquez, ’cause I wanna know what’s going on but if a parent or a caregiver has that uncertainty, can you say I don’t know to the child?

Dr. Dale Peeples: That’s a insightful point. Children really do look at their parents and sort of model their response to anxiety to how they see the adults in their life managing it. So really the more we can kind of present a calm, in control picture to kids, really the better they’ll handle it as well too. But at the same time we don’t wanna mislead, we don’t wanna downplay situations. So we do wanna give ’em as factual information as we possibly can.

Brad Means: I have seen, or let me just say that in a better way, I have heard of some parents telling their children everything is fine, this is overblown, you’re okay, carry on as normal. Is that misleading and is it dangerous to just say everything’s hunky dory?

Dr. Dale Peeples: Well, you know this situation has really changed so fast and perhaps a week or two ago, that might not have been unreasonable. But it seems like this really is here with us now and probably that is a little bit Pollyanna. Parents probably would be a little bit better advised to be honest about this is here in our community, obviously there are precautions being put in place. You can’t notice that school’s not canceled. So kids are gonna see that discrepancy between what’s going on and this cavalier attitude if we’re not a little bit more frank with them right now.

Brad Means: How can you tell if it’s getting to them, if it’s too much?

Dr. Dale Peeples: So we’re really looking for symptoms of anxiety and depression, right? So if we’re seein’ that kids are looking sad, looking withdrawn, they’re a little bit more irritable, they’re having trouble with their sleep, they’re complaining about physical headaches, stomachaches, those physical complaints that we associate with anxiety, those might be keys that perhaps this is getting to them.

Brad Means: How do you counter that in the home? What if you are sheltering in place? What if you are kinda sticking to the rules of don’t leave the house ’til we’re certain about this? As a family unit, help us keep them happy.

Dr. Dale Peeples: Right. So you know if you’re following all those precautions, I’d reassure them that, well, we’re doin’ everything we can here, there’s probably nothing we need to worry about for our own health and safety. And then I’d probably try to work at getting their mind on something else, really look at distraction. How can we keep busy since we’re all kind of holed up here in the house together? And that can really be a challenge right now. Since movie theaters are closed, the libraries are closed. So you’re kind of thinking about, well, what can we do online, digitally? That’s probably the easiest way to go.

Brad Means: What about structure? Are you a fan of schedules and routines during this time? ‘Cause it feels like early spring break.

Dr. Dale Peeples: Yeah, absolutely. I do think kids really thrive on structure and many schools, again, kind of closed up shop for the week but they’ve sent work home. And trying to have a structure during the day where kids are focusing on some of that work, getting it done, that’s gonna keep their minds busy. It’s gonna remove one less thing for them to worry about when they have to return to school, they’re not gonna feel like they’re behind. So I think it is really good to kind of have a plan to move through the day like that.

Brad Means: What are some unhealthy habits we should recommend? You and I have talked about video games before and everything that’s coming through on the media and on your screens, how can we sorta control that? Or should we allow that as sort of a stress reliever?

Dr. Dale Peeples: Yeah, yeah, so social media, I think it can be really good right now to keep in touch with friends and family, to talk to people, but it’s probably not where you wanna go for your news.

Brad Means: It sure is not.

Dr. Dale Peeples: Because there’s just a lot of false information out there and that could increase anxiety. So I’d be mindful about lookin’ at the news on social media. With your kind of gaming and television consumption, try to keep it broken up a little bit, you know? Try to not binge play too much, you know. Take a break every 45 minutes, get up, move around, stretch, grab a bite to eat. Try not to let this interfere with your sleep routine. It’s important to maintain healthy sleep. And for the older viewers out there, be mindful about alcohol consumption during these times too. You don’t wanna have this create other problems.

Brad Means: Talk about that more specifically, what do you mean? Because for some people, that is an outlet and I wanted to talk about college kids being home and the early spring break vibe that’s permeating this nation. Talk about alcohol consumption, what’s good, what’s bad.

Dr. Dale Peeples: Yeah. So The Lancet just released a review article on risks associated with–

Brad Means: Just drinking too much?

Dr. Dale Peeples: With extended stays inside. Longterm alcohol consumption, increased drinking, increased alcohol use, was one of the bigger risks. So I think it is somethin’ to be serious about. These can be trying times if you’re on quarantine, so you don’t wanna really turn to that as your coping strategy.

Brad Means: Is it overstating it to say that if you didn’t have a dependence on a substance before all this, you might depend on it after we’re finished if you overdo it during the pandemic?

Dr. Dale Peeples: Exactly.

Brad Means: What about friends and the role that they can play in our children’s lives? I know you mentioned it’s okay to keep in touch on social media, how ’bout phone calls, how ’bout those limited visits Dr. Vazquez talked about and the difference a friend can make?

Dr. Dale Peeples: Absolutely, I’d be in favor of all that. I think maintaining social contact with our friends and family is vital right now. So it’s just kind of keeping those boundaries, right? Like those five foot, six foot, like he was saying. Trying to get together but not too large of a group, not too close.

Brad Means: You touched on this at the beginning of the interview, I’m getting more specific now. How do we know when it’s time to maybe give you a call and say, look, I’ve tried everything I can, I feel like my child’s slipping, and we do bring a pro in?

Dr. Dale Peeples: Yeah. So with psychiatry, when we’re talking about kind of different problems people can have, we do think about adjustment issues where people are really having trouble just in the face of a crisis, and when that crisis goes away, the problem goes away. Now the issue here is we’re not quite sure when this problem is gonna go away. So I’d suggest, well, if you’re seeing symptoms of anxiety or depression and it seems to be dragging on two weeks or more, that might be a reasonable time to think about turning to someone to talk to. If you’re seeing symptoms get to the point where it’s raising safety concerns, where people are having thoughts about hurting themselves or they’re getting physically aggressive, obviously those would be times to seek immediate help.

Brad Means: Have you ever seen anything like this or studied anything like this, as far as a gloom and doom type era that we’re going through?

Dr. Dale Peeples: Hm, I don’t know. I remember around the year 2000 we had a big panic with Y2K but it seemed–

Brad Means: We did.

Dr. Dale Peeples: Seemed to kind of have a little bit more of a positive-

Brad Means: Right.

Dr. Dale Peeples: Feel to it as well.

Brad Means: It did, yeah, we can–

Dr. Dale Peeples: Not quite as pessimistic, yeah.

Brad Means: No, not quite as pessimistic and even you go back to darker times, you go back to 2000– You can go back to September 11th. But it seemed, looking back, to have a beginning, a middle, and an end. Might we, I guess this is sort of my attempt to get some optimism in this interview, is might we look back on the coronavirus pandemic and say, oh, okay, I see where it started, I see where it ended, we did get through that together. That is kinda how history’s gonna treat it, right?

Dr. Dale Peeples: Oh, I think so, yeah. We don’t see the end right now but it’s definitely out there. This is something that we will beat.

Brad Means: We will beat it. What about the longterm impact of anxiety and stress? And let’s say this does have a lifespan of, as the experts say, three to six months?

Dr. Dale Peeples: Yeah.

Brad Means: Is it possible for that to scar a person, a child, for life?

Dr. Dale Peeples: We know individuals with preexisting mental health issues are at greater risk, so if you already have trouble with anxiety or depression this can obviously magnify it and make it a little bit harder to recover from. However, most people do come out on the other side of these sort of things without problems, without issues. We might be looking at having to deal with some longer-term consequences if individuals experience furloughs or unemployment as a result of this. Obviously that could bring on a whole bunch of different stressors for families to face.

Brad Means: Well, so many questions and you have tackled them all, as you always do, Dr. Peeples. I know we’ll turn to you again. Thanks for being one of the folks that gets us through this.

Dr. Dale Peeples: Absolutely, happy to be here.

Brad Means: Dr. Dale Peeples, Medical College of Georgia at Augusta University, helping us maintain mental health during this pandemic.

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The Means Report first aired in January of 2009 offering coverage that you cannot get from a daily newscast. Forget about quick soundbytes -- we deliver an in-depth perspective on the biggest stories. If they are making news on the local or national level, you will find them on the set of The Means Report. Hosted by WJBF NewsChannel 6 anchor, Brad Means, The Means Report covers the topics impacting your life, your town, your state, and your future.

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