Ask The Newsroom: COVID-19 Q&A With Local Public Health Officials And Medical Doctors

If you have a question about COVID-19, you can submit it to Illinois Newsroom through our “Ask The Newsroom” site.

The following is a transcript of the event. The panel discussion has been lightly edited and condensed for clarity.

Our panelists tonight span three counties in east-central Illinois. We have three public health administrators:

• Brandi Binkley is with the Macon County Health Department
• Julie Pryde is with the Champaign-Urbana Public Health District
• Doug Toole is with the Vermilion Health Department

We also have three medical doctors joining us.

• Dr. Ted Clark is chief medical officer of Decatur Memorial Hospital -- in Macon County
• Dr. Robert Healy is chief quality officer at Carle -- based in Champaign County
• Dr. Janet Jokela is the acting regional dean of the U of I college of medicine Urbana campus

This is a very difficult time for many people, and we know there are a lot of questions and perhaps a lot of conflicting information online. We hope tonight’s discussion will help provide some clarity and get some of your questions answered with the local experts we have with us.

Status updates

Christine Herman: To start, I'd like to check in with each of the local public health administrators. How are things looking regarding the COVID-19 pandemic in your county?

Julie Pryde: We're up to about 6700 tests done (in Champaign County, as of May 14) and we have a total of 333 cases, and 153 of those are active. So we have 153 people in isolation, and well over 500 in quarantine at this time. The good thing is we only have three that are hospitalized, and we have had since the start of the pandemic, a total of seven deaths.

Brandi Binkley: As of today (May 14), around 3 pm, we had 158 confirmed cases of COVID-19 (in Macon County). We are giving an update on Mondays and Fridays to our community as far as how many total tests have been done. On Monday it was a little bit over 1400. 

We have had 51 people that have been released from isolation, 85 are currently on home isolation. Of course, there are more that are quarantined, six are hospitalized, and unfortunately we have had 16 of our residents with COVID-19 pass away. We are currently managing some outbreaks. We are very grateful for our health department team and also all of our community partners that have been so strong in this COVID-19 preparedness and response effort.

Doug Toole: We're doing alright, Vermilion County is the smallest of the three health departments we've got represented tonight. We only have about 75,000 residents in our entire county. We've done about 1300 tests total. Of those, we've had 32 test positive, one of those 32 has passed away, unfortunately. More than half the folks who have tested positive and released from isolation, only 14 of them are still being home-isolated, none hospitalized at this time. And I've been kind of curious watching the results come in, about half the positive cases we've had have been people under the age of 30.

Christine Herman: Any idea why that's the case?

Doug Toole: Not really sure. Ours is a county that kind of skews older, so it's odd that a higher percentage of young people are testing positive. But the ones with the more serious symptoms tend to be older.

Christine Herman: And let's do a check in with the hospitals. Dr. Ted Clark, you are at Decatur Memorial Hospital. How are things looking over there?

Dr. Ted Clark: Well, the last two months have been very busy. As we instituted social distancing, we worked with the policies and procedures to take care of the COVID patients. On the inpatient side at DMH, we have had 270 persons under investigation. We've had 47 COVID-positive patients. We've had, unfortunately, eight deaths, it's a very severe illness. And we've had 39 recoveries. 

So we certainly have done it, we know how to do it, we know how to take care of COVID. Our current planning right now is around how we live with COVID, as we expand into this new world where we're living with it over a longer period of time, but not necessarily worried about major surges. We've got the processes in place to protect our patients, to protect our healthcare workers. 

On a slightly different note, I ‘ve been very impressed and I'm very grateful to our communities that have taken this very seriously and done what needed to be done to flatten the curve here to save our region from a dangerous spike that would overwhelm our local healthcare resources. And I hope that as we move forward with releasing or relaxing some of our social isolation, I hope that everyone keeps in mind the importance of maintaining social distancing. So we don't find ourselves in an epidemic stage again.

Christine Herman: And Dr. Robert Healy, you're with Carle, which is based in Urbana, but you've got locations all throughout central and downstate, Illinois. How are things going with the Carle Health System?

Dr. Robert Healy: Well, similar DMH, a few months ago, we were struggling to prepare for a large surge that luckily never came. And I think our communities are similar because, here as well, people have been really good at sheltering in place and maintaining social distancing, and now wearing masks. We've been able to bend the curve, like you said, Dr. Clark. 

It's been amazing to see the system throughout and our employees and our staff and visitors all kind of going along with this new reality of, you know, coming through to certain doors in the hospital, having questions being asked and screening for whether people are symptomatic or not, keeping an eye out for people who are sick and getting them to the right place. 

Luckily, right now, we're pretty much in a lull. We have three (COVID-19) patients in the hospital, and that's the lowest we've had since this began. And we're ready if there's more, we think there will be a time when there's another surge and we're preparing for that. But we're ready now, and as was mentioned, it's the new normal now, we're going to exist with COVID, just like we've existed with influenza for many years, and we'll see ups and downs and we'll adjust to it.

Christine Herman: And Dr. Jokela, as the Dean of the U of I College of Medicine Urbana campus, how are things going with you and with your students?

Dr. Janet Jokela: Thank you so much, Christine, and thank you so much for the opportunity to be here tonight with everybody. We're really blessed to have wonderful colleagues here in Champaign-Urbana, and I just can't speak highly enough for our community and the work that's been done to kind of bend the curve, flatten the curve, and maybe stretch out the curve a little bit to alleviate, you know, potential, you know, real problems inside the hospitals. 

Our students are getting ready to enter back into the clinical space. So we're excited for them, and they're excited as well. And we've been doing a lot of remote distance-learning and we really commend our faculty for stepping up and helping to organize all that and deliver that curriculum. And I think in the broader picture with the U of I campus, both in Champaign-Urbana, also Chicago, there's a lot of, you know, really important discussions taking place around: How do we do this? How do we bring back students? And how do we do what we do safely and in a way that is beneficial and is really representative of the excellence that defines the U of I.

COVID-19 immunity

Christine Herman: Let's dive right into questions. Rosa wants to know: "What information do we have on immunity of COVID-19 once someone has had it?" Dr. Healy, what do we know about immunity against COVID-19 once someone has already contracted the illness?

Dr. Robert Healy: Well, we're able to do testing now and find out if someone has antibodies, and there's different types of antibodies but some will show that you have been exposed to COVID in the past. And we're actually doing that on patients that need that test, which is actually very few. 

More importantly, we're studying or we're looking at our employees. And we started with the high-risk employees, meaning the people that were at the front lines in the emergency department, and we're going through to test anyone that wants to be tested eventually for these antibodies. 

So that's the facts, now, what does that mean? Really what it means is if you have a positive antibody (test) it means you've been exposed to COVID. That's all we know right now. We can't say anything more than that. What we very much hope is that having antibodies will prove to give you some immunity, at least for a number of months, hopefully years, it'd be wonderful if it was lifelong. From things that we know from science for other (coronaviruses), the kind that cause the common cold, that immunity wave wanes off after a few months to a year or two, so that might be what we're dealing with from COVID. But anything we say about COVID, we have to acknowledge that this is a very unique virus. And we just don't have the science yet to say what an antibody level will mean to you.

COVID-19 case counts

Christine Herman: The second part of Rosa's question is: "How accurate are the numbers for current cases?" Julie, we've increased the level of testing both locally and across the state over the course of this pandemic, but we still are hearing all the time that there's not enough testing. Do we know what the reality is in terms of how many people have contracted COVID-19?

Julie Pryde: We believe that there's at least 10 times as many people that have been infected with this (than reflected in current case counts). You know, it's all kind of a guessing game at this point, until we get the antibody testing widespread. At the beginning, of course, almost no one could get tested and then as it's expanded out the testing gets wider, but everybody who had been sick all those months (early on), we just don't we just don't know.

Social Distancing Concerns

Christine Herman: Jessica wants to know: "How can I help my family understand the importance of social distancing and other CDC guidelines? I understand the importance of them for myself, but it is very concerning to see those I love disregarding the guidelines, I am not sure what I can do besides just sharing factual information with them." Brandi, I wonder if you can chime in with any advice you might have for Jessica?

Brandi Binkley: Yes, definitely. I think this is a struggle for all of us in public health and in the healthcare field right now, especially because we're really trying so hard every day to get people to take these proactive measures like social distancing, to try to prevent that spread of illness. So I think facts can always be very, very helpful, but if that is not impacting your family the way that you would hope for it to, you know, maybe giving the emotional or personal side of it. 

Your family may feel like they are not at risk of having COVID-19, but maybe you are more at risk, or maybe you go and you're around people at work, or you're around other people that are in the vulnerable populations, and you don't want to put them at risk. So, by them not making the choice to social distance or to do things safely with you, as we start moving forward and we're able to be around more people in a safe way, you know, they have to understand that they're not just putting themselves at risk, but anybody else that they would come into contact with, and then anyone that you could spread it to. 

So, I think that's something I may be facing with my own extended family, having to explain to them why it's not just about those of us that might be together in a room, but everyone else with whom we may come into contact. And also it's really important for us all to lead by example, and I know, you know, everybody tonight is doing that, but it's important that you know, it's a culture change, that we're all doing these things and making it, you know, something that's normal and comfortable and we're stressing the importance of this everyone that we love that we work with and that we have contact with.

Enforcement issues

Christine Herman: We got several questions about enforcement issues, mostly about enforcement of the use of masks. Angela wrote in to ask: "Can County Health Department officials enforce the governor's order? For instance, can they enforce facemasks in retail stores that aren't enforcing it? Do you have a local lever like a fine or forcing closure, the same way you are able to force compliance with food safety guidelines at restaurants?" Doug, what is the local health department able to do or perhaps not able to do when it comes to enforcement, and what advice would you have for someone who's concerned about lack of enforcement?

Doug Toole: It's a really good question. Maybe equating an employee or customer not wearing a mask to some violation of the food code that could make people sick isn't really a fair way of looking at it. The Illinois food code, and now the FDA food code that we're using, is written into law. It's been established for a long time, it's got the backing of state agencies and a lot of history behind it. 

With the executive orders, it's more of a temporary thing that's in place right now. So, while we are getting calls from people complaining that I'm going to a retail store or a fast food place, and maybe all the employees aren't masked. Or is asking like, well, what other steps did they take, is there now a plastic barrier between the employees and the people coming into the store? Are they limiting the number of people coming in the store to make it easier to social distance? You know, what other steps besides masks and gloves maybe are they using to make that happen? 

But for customers who are in a place and they're concerned that the sign may say all customers must wear masks, and they're seeing people who aren't, talk to the managers about that? If you're upset about it, that's where the change happens. And it's important for them to know that you may take your business elsewhere if they're not complying with these things, if they're not taking this seriously.

Guidance on masks

Christine Herman: David wrote in to ask: "Can people be instructed on how to wear a mask?" Dr. Jokela, can you offer some general guidance on how to properly wear a mask, put it on, take it off? And where would you place people for guidance?

Dr. Janet Jokela: Sure, I'd be happy to. In terms of wearing a mask, there's a number of different kinds of masks out there and for the general community right now, because of the shortages in the hospital, the cloth face masks would be the ones that we'd be recommending. This helps preserve the surgical masks and N95 masks for use in the hospital where they're known or suspected COVID patients. 

So with the cloth face masks, first of all, there are directions on the CDC's website for how to make those. With the masks, you want to make sure that they would cover your nose and your mouth, just covering the mouth isn't enough. And then there would typically be little elastic loops or little ties that you could either slip behind your ears or tie behind your head.

Christine Herman: The CDC website also offers tips there for how to create your own homemade cloth masks from materials you may have at home. So that can be a useful website for people to check out. 

Contact tracing

We got a few questions also about contact tracing. Before I get to those, I would like to have one of the public health officials explain what contact tracing is and why it's important. Julie, can you start us off?

Julie Pryde: Sure. First of all, contact tracing is nothing new. It is, it's suddenly, you know, the star of the show out there, and everyone's talking about it. But public health departments all over the world do contact tracing every single day. There are reportable diseases, and when the health department gets a reportable disease, then we basically have different algorithms and different things we do for each type of disease. 

So with COVID, when we get a COVID positive, public health is notified by the laboratory or the clinic. And then we call the positive case and we interview them to find out: Where do you work? Who have you been in contact with, and we hope the answer is no one because I'm not supposed to be, but that's rarely the case. But ideally, you know, other than people at your worksite or people in in your home, we hope that there are no other contacts. 

What we do is try to get them to be really honest with us. So we put that person in isolation, and then we contact all of the people that they may have been in contact with. And then we offer them testing and then put them in quarantine either pending test results or until the their incubation period is over. And that's pretty much what it what it boils down to. 

It gets a little trickier when you can't just do something on the phone, where you have to go out and actually find people and things like that. But I think that, with this, people are understanding that it's important and that it's a good thing to tell people who you may have been in contact with to give them a chance to get tested and that helps us shrink it down more and more. And then, during that, if you get a positive test result, then of course you start that process all over and then it just keeps going from there.

Christine Herman: Robin wrote in and she referenced the time that Governor Pritzker earlier this month said that he'd be launching a $40 million contact tracing program. Has that help trickled down to your local departments? Brandi, has that support come available through the state? Or how are you managing otherwise?

Brandi Binkley: We're still waiting on some more information (about) that entire process, as far as what Governor Pritzker had been discussing and what Dr. Ezike had discussed. As far as this new funding, we do not have that yet. We're still waiting on additional guidance. 

However, as far as for us at the Macon County Health Department, we have people that regularly complete contact tracing activities whenever there is some kind of communicable disease. So we already have that in place. We also had people cross-trained as soon as we started seeing this as an issue that was going to grow much larger more quickly. We did have additional people trained and then we have other divisions within our health department that do have nurses that are ready to be called in for backup. 

That being said, to try to kind of advocate for other health departments, not all health departments have, you know, as many nurses as we do, or as many people and if there is a large spike in this, we may not end up having enough people. So we will need additional support, and we may not know exactly what that looks like now, as far as how many people we would need. 

And I will tell you, just overall, you know, public health is underfunded, and so when you get to something like this, this stretches you thinner than thin and it's very difficult to try to staff everything, all of the regular essential life-saving services that public health provides, plus also respond to a pandemic. It's very difficult, it's trying, 

I think all the health departments that we have been communicating with have done an excellent job of stepping up to the plate and doing everything that they can, but I do think it's important for people to realize when they take the measures, like social distancing, cloth face coverings, sheltering in place that makes us and the hospitals, etc., be able to manage this in a better way to actually try to prevent more spread of illness and death. Because if we get these huge surges, it's very difficult for health departments to manage that as well.

Christine Herman: We've got one more on contact tracing before we move on to a couple medical questions that have come in. This one's specifically for Julie: What is Champaign Urbana Public Health District's opinion on the use of phone apps compared to human contact tracing? So I'm guessing this is talking about using people's GPS cell phone data to track where they are and if they may have been exposed to someone who has had a confirmed COVID-19 case?

Julie Pryde: Okay, well, first and foremost, I'm a Boomer. So that's a little above my my skill level how that works. But what we do ask people is to go ahead and look at their own cell phone. And you know, we carry so much data with us right now, and we've even done that with foodborne outbreaks, we'll say, hey, you look back and see where you've been where you've been spending money. And that helps to jog people's memory. So we really ask the people to use it themselves to help give us the information. 

But there are some really, really neat things coming up, all kinds of apps, all kinds of innovation is coming out of this pandemic, which of course always happens in pandemics. So we are eager to see what some of these are. I can see them being a voluntary thing, like an app that somebody puts on their phone. 

The other stuff that we get is more like metadata. So it's de-identified, we just use it to see (things like): more people are moving out into the parks, less people are in retail, that type of stuff. And so we use it like that. But essentially how we're using that information right now is just asking people to kind of use their own data to look back and see how things are going and where they've been.

More questions about antibodies & testing

Christine Herman: Dr. Clark, Judith wants to know: "Have doctors found out anything about the asymptomatic positive cases of COVID-19? Do those people who had COVID-19 but never showed symptoms, do they have antibodies? Are theirs different from those who got sick? Do they carry the active virus for the same length of time that sick people do?"

Dr. Ted Clark: Those are a lot of the great questions that we are trying to answer. Until we really know more about how exactly this virus behaves, there really is no clear answer on this. 

A lot of this goes back to what Dr. Healy said. Yes, we can test people, we can identify the antibodies to say you've been exposed. What we don't know is, one, how long you're contagious, two, how long, or if you have long-term immunity to the virus after that point. Those are just unfortunately questions we don't have answers to. We can extrapolate based on what we know from other coronaviruses from the flu epidemics that come through every year, but ultimately, there's still a lot of question marks.

Christine Herman: Dr. Healy, Steve wants to know: "What resources exist in Champaign-Urbana for Carle and Christie Clinic members to obtain antibody tests under their health insurance?"

Dr. Robert Healy: Well, whenever I think about a question that involves health insurance, I think what's going to cost me? The antibody tests, just like the RNA test or the nasal swab, is no cost to the patient. That's part of the CARES act. You could talk to your primary care doctor and ask them about antibodies, but really, there's not much use for them right now. 

If you're curious, you had that weird illness a month ago or two months ago, and you don't know, you never were tested, you don't know what it was, you might get an answer that, hey, you were exposed to COVID. It really doesn't and shouldn't change what you do right now, though. It wouldn't change the your behavior, it wouldn't change you wearing a mask, for instance, or it wouldn't allow you to go closer to someone than six feet and keep all those those rules in place. 

So if someone's interested, they can sign up their primary care doctor, but most likely they're going to hear, yeah, we could do it, but you probably don't need it. And let's leave it to the scientists for now.

Christine Herman: Dr. Clark, did you have something to add to that?

Dr. Ted Clark: Yeah, I mean, it's a larger point to what Dr. Healey's making. You'll see in the popular news media or you'll see press releases from various testing companies that they have some breakthrough that's going to revolutionize or do this or do that. But where we are, those of us in healthcare, we have to find a way to translate that into something that actually benefits patients, something that actually benefits our populations. So, so far antibody testing, while there may be some benefit, if we had large-scale, massive antibody testing and could use that for epidemiological purposes, there may be some benefit there. But for the individual patient, most of this stuff is not helpful.

Christine Herman: Dr. Jokela, did you have any thoughts about antibody testing as well?

Dr. Janet Jokela: Sure, thanks, Christine. And there are really good points that everybody is bringing up. And the whole (question about) asymptomatic infected population is really interesting. As Dr. Clark had mentioned, there's a lot of work being done and looking at that. 

People might have heard about the Theodore Roosevelt aircraft carrier, when all those sailors on that aircraft carrier were tested, a large number of them turned out to be asymptomatically infected. And there was no idea that that had happened. Same thing in a homeless shelter in Boston, the tests were done -- and these were the PCR tests that were done on these patients -- and there were a number of asymptomatically infected persons living there in this homeless shelter. 

So, I think as Julie had mentioned earlier, for every case that's diagnosed, the presumption is there may be at least 10 other asymptomatically infected persons out there that we don't know about yet. So antibody testing, right now, you know, so hard to say what it means. I do think, as Dr. Clark was just saying, on an epidemiologic basis, it will give us a sense of perhaps what's going on. What it means for that individual, if they're protected or anything else as Dr. Healy said, we just don't know yet. So there's a lot of work being done, investigations being done looking at that.

Christine Herman: And I've also learned that even if antibody tests have something like a 95% accuracy, and COVID-19 is low prevalence in the general population, it actually returns back potentially, you know, half or more false positives, or there's a large error that can result which is also a little bit concerning, right? I've seen estimates that, in the U.S., we're anywhere from a 5% to a 15% infection rate, which can affect how we interpret the results of these antibody tests. Dr. Healy, did you have any other thoughts you wanted to share about that as well?

Dr. Robert Healy: Yeah. It's a very important topic, and so much is unknown. I guess, two things. One, as a primary care doctor, I wouldn't want every patient calling me and saying they want antibody testing. 

But I think what they're really the most useful for is (studies like) a recent one that came out of Indiana. They did an epidemiological study of Indiana, they tested some thousands of conditions, sampling from all over the state and they found that probably about 2.8% of people in Indiana had been infected. And they did some extrapolation from that. And they found out... probably for every person who is infected that we know of, there's probably 10 or 11, that haven't shown up (in testing) or that don't have symptoms. 

So, really the antibody testing, I think, is going to be critical for: What does our community look like right now? What does our state look like? What does our country look like? And then, if it's shown that it's protective, that'll be really helpful for individual patients.

Possible spikes as economy reopens

Christine Herman: We got several variations of this question about potential spikes coming in the future. So Connie asks: "Do you think there could be another spike in cases this fall?" Doug, your thoughts on that? What do we know about the possibility that even if we've flattened the curve now, that as we begin to reopen different parts of the economy, and try to return certain parts of life back to normal, that this could resurge?

Doug Toole: Of course, it's impossible to say, but as we've looked at pandemics in the past, they do tend to come in waves. So just because we're in a bad spot now and maybe plateauing or coming out of it doesn't mean it's not going to recur at some point. In the past, that's how these sort of things work, unfortunately.

Christine Herman: And related to that, we got an anonymous question from someone who just wants to know: What recommendations do you have as states begin to reopen? And maybe we can localize that to say, you know, Governor Pritzker has said that potentially as early as May 29, we'll move into Phase Three of the Restore Illinois plan, that would allow certain other currently non-essential businesses to open but with limits and still having social distancing involved. As we approach this kind of change to a partial reopening, what advice do you have for people, Julie, who want to make sure they're still taking appropriate precautions?

Julie Pryde: First and foremost, just because something is allowed to open doesn't mean that you have to go there. So everybody needs to make that determination for themselves. And certain places, it's going to take a while for places to get, you know, their procedures down. 

And if I were somewhere that was open, I don't care what it was, and there was starting to be crowding, I would get away from it. You just have to, you know, don't stand there and complain about it or anything, just get away from it because that's first and foremost is your health. 

But there aren't going to be a lot of things opening when we get to Phase Three, but it will be things like salons and things like that will open, and they will be able to do things safely there. So, just because something's open does not mean you know, you need to go there. And like I said, if you go there and they're not doing it right, don't go there.

Christine Herman: Dr. Clark, your thoughts on that as well?

Dr. Ted Clark: I think it's also important for people to take their own personal risk into account, what their risk is if they are exposed to COVID-19, meaning folks over 60 or 65 years old are higher risk, diabetes, hypertension, obesity, these are all risk factors for more severe COVID illness. 

And beyond that, you have to take into account who you're going to come into contact with. So if you're, you know, 20 years old, you're young, you're healthy, you want to get out and about, you can but you also, you know, to a reasonable degree, you still want to take reasonable measures to protect yourself. But more importantly, you want to think about who you're going to expose yourself to, if you're going to go to church, or if you're going to come into contact with folks who may be in a higher risk category. So you don't want to be a disease vector for someone else's critical illness even if you feel invincible. 

Everyone has to take their own situation into account and, you know, certainly the social distancing should still apply. Certainly, the masking should still apply. And back to the question about spikes. Yes, we expect that as we relax social distancing, there will absolutely be spikes. 

What we're trying to avoid are spikes that overwhelm our local health care resources. And again, our hospitals are prepared. But if we get out of control, if we get to that logarithmic growth again, and we're running away with it, then we will overwhelm our healthcare resources. And then we may have to draw back at that point.

Julie Pryde: And we have to remember that, you know, fall and winter is a time where there are a lot of respiratory viruses going around anyway, in children and the elderly. So anything that's vaccine preventable, people need to really make sure that your shots are up-to-date and that you have your flu shot and if you need one, you have your pneumonia shot, because everything like that will compound the hospital's and the healthcare system's burden.

Access to childcare

Christine Herman: We got a question about child care from Jamie, who's saying that she is currently a non essential worker but if the state moves into Phase Three, she will be called back into work, but she doesn't have a place to send her child because her daycare has been closed except for essential workers. Brandi, are you aware of what will happen with childcare moving forward as we reopen? And specifically, I guess, moving into Phase Three potentially as early as May 29, do we know what will happen with childcare?

Brandi Binkley: Well, there are some allowances that can be made if IDPH guidance is followed. So what I would encourage this person to do is, you know, check to see if their daycare would be one that would be opened. If, at that time, she is determined to be an essential worker, there are daycares that are currently open, serving essential workers and their families. 

Another option is even as we move forward in these phases, the whole entire plan is encouraging workplaces to allow telework, if at all possible. So if you have somebody that is in a vulnerable population and can work remotely, I have been strongly encouraging and will continue to do so, any workplaces to keep those employees working home if they can, or to do so as much as possible. 

And then of course, there is also the (CARES) act that does provide some time off for families if they do not have any childcare, so I encourage you to look into that as well. I think there's a few different options. I know it's scary because things can't open if employees cannot come work, employees can't go to work if their daycares aren't open. So I think there's some different options. Definitely check into those. I know Macon County has put out a lot of information regarding the resources that are available. So if you can't find those anywhere else, please always feel comfortable to reach out to us and we'd be happy to help you.

Telemedicine & COVID-19

Christine Herman: We got a question from Rebecca, who wants to know a little bit more about telemedicine: "How has telemedicine changed over these last few months? Can I get all of my prescriptions refilled now without going to a doctor's office?" Dr. Healy, is that something that Carle is dealing with right now?

Dr. Robert Healy: Well, yes, and actually, I personally had an appointment with one of my doctors, that was telemedicine. It was great. I was in my office, we video'ed together. I didn't have to walk all the way to the office and sit and wait. So I think one thing is it's very convenient. But there's places for it. If someone needs to see something really close up on you, look at your throat or your ears or listen to your lungs, your heart, it's a little trickier to do it by telemedicine, although there's some technology to do that. 

One statistic at Carle: before, in a typical month, we would have 46 telemedicine visits. And in April, it's something like 20,000. So, many, many visits are being done by telemedicine or virtually, and the reason is because we didn't want people to come in. Now, we're open, we're more able to take people and safely care for them in our offices in the hospital, but I think there will still be a subset of, like I said, I'm in primary care. A lot of my business could be, on a follow-up visit, I just want to talk to you and see how are you doing? How's this medicine affecting you? Are you better? Are you worse? A lot of that can be done by phone or video conference.

SARS-CoV2 versus SARS

Christine Herman: And we got a question from Victor about how COVID-19 is related to SARS. He said he heard on TV somewhere that COVID-19 is very similar to SARS and that the treatment from SARS can be used to treat COVID-19, and he wanted to hear the experts weigh in on this. Dr. Jokela, what do we know about how this novel coronavirus compares with previous coronaviruses that have infected humans?

Dr. Janet Jokela: It's sort of like they're cousins, so they're in the same virus family, but the new coronavirus, the SARS-CoV2 virus responsible for this COVID-19 pandemic, is distinct and a new virus. The coronavirus family, those viruses are commonly found in animals, there are a lot more animal coronaviruses than there are human coronaviruses. There are four that have that commonly cause a common cold. And then the SARS virus from years back, that was a coronavirus that jumped from animals to humans. 

And so similarly, with this COVID-19 related coronavirus SARS-CoV2, the presumption is that it also jumped from some animal to humans and presumably bats are the origin, very similar to the other coronaviruses. So it's like they're cousins. They're distinct, and there's no effective treatment right now. There are some trials going on with various medications and things but certainly there's no cure, and there's no really great treatment at the moment.

Public health services

Christine Herman: I want to shift back to public health just for a moment. Brandi, Melissa has a question. She wants to know if the Macon County Health Department will reopen to the public for services. And what would be the timeline for that?

Brandi Binkley: Well, the health department has actually been available for services throughout the response to this pandemic. Because of the risk associated with some of our services, we did have to either drastically limit those or suspend them temporarily. Certainly call the health department. Let us know if there's something that you need that we're not able to provide or that you haven't been able to access. 

But we've definitely done everything that we can to still provide all of those essential services. We're just doing them in different ways, in order to limit the risk of exposure for our staff, and also our clients. So some of our services have been changed to appointment only, some of them have been changed to virtual or over the phone. Some have been converted to curbside services. So we've gotten very creative in order to limit the number of people physically coming into our building. But we're certainly still open and providing services on a very comprehensive basis throughout this time.

Routine dental care resuming

Christine Herman: We got a question about dental care. Some dental offices are planning to open as early as May 11th. Kelsey says, "Do you think that is wise, since barbers and salons are being told to stay closed?" Julie, can you weigh in on this question?

Julie Pryde: The risk there is to the dentist or the hygienist and the assistant and the people that are in the room because dental procedures cause aerosolization. So that would push the virus up into the air. 

But the difference between, let's say, a salon and a dental office, dental care is health care. People need to have dental care, and you know, as lovely as it is not having a haircut as evidenced by me, it's not a health concern. So the dentists need to get open as fast as they can safely. 

Salons are set to open in Phase Three, which the way our region is going, will be at the end of the month or the beginning of the next month. So that's pretty much the difference. But what's going to be the limiting factor for dental offices is: Do they have enough of the personal protective equipment to do it safely? And right now, there's still a shortage. So the dentists are going to need assistance, just like everyone else, getting that personal protective equipment.

Christine Herman: Doug, is there anything else you would add to that when it comes to dentist offices in Vermillion County, trying to figure out whether and how to reopen safely and resume routine dental care?

Doug Toole: I think Julie covered it very well. I imagine it's going to start with an appointment-only basis for those with the most severe need to get into see the dentist. And we’ll start to move back into the routine stuff later.

Christine Herman: And Dr. Healy, as a primary care doctor, do you advise people to call if they're concerned or have questions about as they're trying to weigh the risks versus benefits of going in for a dental procedure? And how would you walk people through that process of figuring that out?

Dr. Robert Healy: Your primary care doctor, knowing you, will be able to talk to you about what your health risks are. And similar to what we talked about with going out into a group of 10 and more as we go further down the path to getting back to normal, I think it's important to know what your own risks are. 

So your provider can tell you, if you have diabetes, if you have bad lung disease, or heart disease, etc., they can talk to you about the possible risks. Really, what it comes down to is how bad is a dental problem and how much is it affecting your life and your health? If there's an infection, you know, that's going to be really important to deal with, or an impacted tooth that has to come out, whereas we're all for dental care and dental cleaning, but that can wait for right now. Yeah.

Elective medical procedures

Christine Herman: Dr. Clark, are you having similar conversations with patients who are wondering about non-emergency medical procedures and whether they should come in for those as well?

Dr. Ted Clark: That's something that we've really been working on over the last two to three weeks, in terms of how to take care of our routine health issues in the age of COVID. And it's really about living with COVID, knowing that we were prepared for an epidemic or a spike, but we also have to have business as usual. 

Importantly, cancer screening is a great example. We'll identify 20 cancers a month through our cancer screening programs, and those have been closed out for two months. And so as we open those back up, we're counseling the patients on, yes, we're doing everything we can to protect you so you can get in and get this very important service done. 

Extend that into elective procedures. If people need an orthopedic procedure, if they're suffering if they're in pain, we're again putting the processes in place through guidance, coming from the IDPH, to get these folks in and to get these procedures done. But we are having a lot of conversations around: Is this safe? Is this the right thing to do right now? And again, it's just the slow stepwise opening of getting back to the new normal, and doing it carefully and doing it in such a way that if we do notice that there is an issue, or a spike, we can draw back if necessary.

Employer obligations

Christine Herman: Jay wants to know: "If multiple people at a job become ill with COVID-like symptoms, does the employer have an obligation to inform the employees?" Brandi, I know that there are guidelines for places like nursing homes and long-term care facilities, does the same thing apply to other employers as well?

Brandi Binkley: When we become notified of a positive case, and we conduct that contact tracing that we talked about earlier, we do contact that person, that is the positive confirmed case, and we asked them where they work. At that time, if it's determined that there would been a risk of exposure to the workplace, then we do contact the workplace, and we do speak with someone that would be, you know, administration, a manager, an occupational nurse, and inform them of whom the person is so that we can determine, you know, what shifts have they worked? Have they completed home visits? Who has been in contact with them? 

At that point, the employer is to notify the employees, but to do so with confidentiality. So they would notify the employees and say, you know, you may have been exposed to someone with COVID-19, you would not share the name with everybody in that place of employment. 

And I think that's a really important point. We've been asked, and we've seen a lot on social media about, why aren't you telling us everywhere that it is? Why aren't you giving us two people's names or their address, etc.? And it's very important that we maintain the privacy and safety of these people that are diagnosed with any communicable disease, including COVID-19. You know, things like privacy, safety, stigmatization that go with communicable disease, it's very important that we maintain that privacy. 

So it's something that health departments do all the time when there's communicable diseases. And that is what we are committed to doing ,to protecting that. So there is communication that occurs but a lot of it is very confidential. But we do have guidance that we do follow from IDPH that guides what we tell, when, and how that process should occur.

Christine Herman: Related to outbreaks at at work sites, Andrea wants to know: "Are all the cases in the count for Rantoul Foods included in the count for Champaign County?" Or do some of those cases live in other counties? Julie?

Julie Pryde: The cases are reported in the county that you live in. So if there were people working at Rantoul Foods who lived in another county, they would be counted in that county's cases.