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Dr. Rai talks coronavirus peak and how we get back to ‘normal’

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Dr. Rai talks coronavirus peak and how we get back to 'normal'

GREEN BAY, Wis. (WBAY) – Wisconsin was on track to reach its coronavirus peak on Sunday, but we’re still waiting to see if it happened.

Prevea Health President and CEO Dr. Ashok Rai joined us on Action 2 News This Morning to explain what the peak is and when we’ll know if we’ve hit it.

DID WE HIT A PEAK?

“That peak date that everybody’s referring to from the University of Washington is really our peak resource utilization, technically when we should be seeing the most people in the hospital using resources. And it’s hard to know if that’s going to be our peak or not. Did we see an increase over the last few days of more people in the hospital? Yes, slightly, at least in Brown County. Overall in the state we’re still gathering data. And then it’s also looking at the death rate and did we hit our peak there? And it’s hard to know if it’s a peak until we come down the other side of it. The next couple of weeks are going to be extremely important for us as we talk about how do you reopen society, how do you reopen the economy. We’re going to need to see that be our peak and a continual decline. That only works if people continue to stay safe at home and the other practices that we’ve recommended,” says Dr. Rai.

“It’s important to remember that there’s a long incubation time for COVID-19. In other words, you get exposed to it, you don’t get the disease that day, or you don’t get the symptoms of the disease of the virus that day. It can be anywhere between five-to-14 days. So for the election, maybe we’ll start to see a bump up in cases. We really hope not this week. We hope everybody self isolated right after the election. Same thing with Easter. If everybody stayed safe at home we should not see an effect. We know a couple of people were out and about, so hopefully that’s limited exposure,” says Dr. Rai.

“So it’s really it’s about five-to-14 days from the event that we start to look for if there’s going to be a response to it. That response will be an increase in the number of cases, which we really hope we don’t see.”

GETTING BACK TO BUSINESS

“Like a lot of things in production and economy, it’s a lot easier to turn something off than it is to turn something on. It’s going to be extremely gradual. There are a lot of things that are important to have in place to get back to work, get back to our normal lives. Normal’s not going to be normal for awhile. For example, we need to have better testing. We’re working on that every day. When we can test more people, we can isolate people who are positive for a short period of time and allow the rest of the economy, the rest of society, to get back to some sort of sense of normalcy. We may be considering continuing physical barriers for awhile, to prevent that spread without symptoms, such as masking. That’s going to be important going forward. We need to be able to symptom check people that come into work. So a lot of employers have to figure out how do you get 500, 2,000 people into a building while still checking their symptoms, including checking their fevers. Those are things that people need to be able to plan for. The important thing about getting back to work is being able to identify at-risk people, at-risk populations that maybe have COVID-19 and isolate them as quickly as possible rather than isolating all of society. For that to happen, once again, you need testing, you need symptom checking. It’s a process and it’s not one you just turn on right away,” says Dr. Rai.

“We’re concerned about people moving too quickly and having a very large number of cases rise to the point that they get so large that the only way to shut it down is to shut everything down again. Remember, we’re going to continue to see cases. We want to pull back in certain areas, or pull certain pepole back for short periods of time, and then continue on with society. But if we just kind of let it all go, we’ll likely see a very large surge and we’re right back to the end of February, beginning of March where we have to shut it all down. That’s what we’re trying to prevent.”

REOPENING THE UNITED STATES

“Everybody thinks that getting back to normal is just getting back to normal, and that’s not true. Getting back to normal is going to be a very different kind of normal. And it has to be done very carefully. These next two weeks are critical. These next two weeks, there’s no chance for complacency. There’s no time for it. Any complacency for this time will probably just reset our clock back to late February, early March where we have to lock down again. And that’s not what we want. So to avoid that, people need to maintain their social distance. Wear a mask if you really have to go out to prevent that spread of germs of a person without systems. And really the one thing we’re always going to be doing is washing our hands. And making sure we’re doing that and not touching our nose or our mouth. If we lay up on any of those categories or we start opening up businesses too early, we could really rewind the clock, and that would be awful,” says Dr. Rai.

TEMPERATURE CHECKS

“Anything is possible right now. If you look at other countries that have done this, you can’t fly without a temperature check. There could be industries where they’re measuring temperatures. I think every industry’s going to ask you questions or have signs posted. If you have these symptoms, turn around, go home, call your physician, do a virtual visit. There’s going to be different varying degrees to that. From the employer’s side, I can see a lot of things that are either employer instructed or even local governments telling employers what they have to do to get back to work,” says Dr. Rai.

“As far as checking customers, I think symptom screening, signage, and like I said, certain industries such as airlines, measure temperatures.”

PPE SUPPLIES

“We share our information every day, and as I look at our own partner hospitals at HSHS and what our other hospitals locally have shared with us, is we’re adequate as it stands today. For our current volume of patients, we have what we need to take care of them. We have what we need if we have a small surge and we have more coming, so that’s a very good sign for today. For that to continue, we need to continue to see that peak come down,” says Dr. Rai.

VISIT https://www.wha.org/COVID-19 to track supplies in Wisconsin.

ANTIBODY TESTING

“At this point, the antibody tests that are being produced, they’re somewhat being mass produced around the world. Some are working and some obvoiusly are not working. And we’ve seen that in certain parts of the world. The types of antibody tests that are being talked about these days–I think you’ll see it on TV–a prick of your finger, a small drop of blood to see if you have the disease or maybe if you’ve had the disease. That has a purpose, and when we start talking about getting back to normal or starting to understand immunity throughout the society, but it’s not like a magic bullet. We have to be very careful about these tests. They are reliable if they are done right. We have to make sure we’re doing them right and we have the right tests. Some of the tests we’ve seen being produced around the world aren’t working very well. So we have to be very careful about that. We’re evaluating that here in Brown County. We’re actually testing some of those tests here. And hopefully we’ll start to be able to use them in a limited manner where it makes sense,” says Dr. Rai.

VACCINES

“If we maintain social distancing for a little while longer, and really get us to a point where we’re starting to see the disease but we can isolate with it and health care can take care of the sickest who get it, that’s the really important part. Flattening that curve below that threshold is important and how long you can maintain that until a vaccine is developed. Overall, the ideal state most obviously is a vaccine where we can have a large percentage of the population be immune and then not have to worry about this anymore. Until then, we have to be really cognizant about our normal isn’t going to be normal. That we have to keep the number of cases at a certain low level, and we have to be able to isolate people who are diagnosed very quickly,” says Dr. Rai.

DID WE ACT QUICKLY ENOUGH?

“I think we see examples of that around the country. We see examples of that in New York. It would be very ugly. We would be seeing a lot more deaths in Wisconsin if we had not done what we had done. The disease is there. The only way you can control a pandemic is social distancing when you’re talking about a virus of this kind. By doing that social distancing, we made sure our cases stayed below a number that didn’t overwhelm the health care system. What happened in New York is the cases shot up, overwhelmed the health care system and you kind of had a societal collapse over a short period of time. We avoided that for now. If we were to take our foot off the pedal right now and just decided to go out and ignore it, that would be harmful,” says Dr. Rai.

MASKING

“The number one thing is if you’re having symptoms, you should not be wearing a mask because you should not be going outside. You should be staying home. So technically, everybody who is out there wearing a mask is somebody who doesn’t have symptoms and is trying to prevent that spread from person to person going forward,” says Dr. Rai.

“So as we go forward, we have to get rid of that stigma that a mask means sick. A mask means healthy and trying not to spread a virus that can make you sick. That’s a mindset shift that we need in our society–not only in Brown County, but across the United States right now, like other countries have done.”

CLEANING YOUR HOME

“Everybody does the standard, I’m going to do my counter tops, I’m going to do my bathrooms. But understand it’s going to be everything you touch. And I don’t think people are focusing enough on the handles on your doors, or your remote controls. Or things that are always being touched, especially when you come in the house and you haven’t had a chance to wash your hands completely yet. It’s getting everything clean in the house. Those entry points are very important. Door handles are a must. Those are things I think sometimes people overlook. Becaues when we talk about cleaning we think about traditional cleaning, which is usually counter tops and bathrooms. Just think about what you touch a lot and make sure it is clean,” says Dr. Rai.

ORGAN DONATIONS

“Right now if a death is due to COVID-19, as we’re starting to see, it’s an auto out per the current recommendations. We’re learning every day. And that’s going to be evolving recommendations. But as we read today and yesterday on this situation, right now, if someone dies of COVID-19 they can’t donate. That’s likely going to change over time, but as it stands today, no.”

TELEMEDICINE

“We had a lot of restrictions on us around telemedicine prior to COVID-19 and those were lifted. We told you not to come to us for things that are not urgent, but there’s a lot of things we need to see you for, such as your blood pressure checks, monitoring your diabetes. You can give us your blood sugars during televisit. You can measure your blood pressure at home and we can walk you through what needs to change,” says Dr. Rai.

“There’s a lot that can be done with telemedicine. It’s a very powerful tool. It’s one that the federal government was trying to evaluate if it should be a part of regular health care society. I think we’ve proven over the past few weeks how well it works, and hopefully we’ll continue to see the federal government allow us to do that. These visits are extremely popular. We’ve had a couple of patients saying, ‘Hey, can I do this all the time now?’ And that’s something we’d like to say yes to long term.”

DOCTORS CATCHING UP

“I think all three hospital systems locally are working through that very quickly. Number one we want to make sure everyone’s safe. So it isn’t as much about how can we get through that backlog, but making sure that we’re getting through that backlog safely. Do we have the policies and the procedures in the hospitals and the clinics to evaluate you before you even get in there to make sure you’re safe? And then once you get there, to make sure it is safe as possible. And then there are strategies there to say how can we schedule this? What are the priorities to make sure everyone gets the health care we need? We’re all working towards that right now,” says Dr. Rai.



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