059: SPECIAL COVID-19 RELEASE – The Truth About COVID-19 with Dr. Krys Johnson, Epidemiologist

Want the TRUTH about COVID-19?  Listen to this episode of the Self Made Strategies Podcast

This episode is a special release meant to help flatten the COVID-19 curve in two ways: 

First, the main message of this episode is to follow the advice of your local government as well as that of Dr. Krys Johnson, an Epidemiologist who also worked in Polk County, Florida, during the Zika crisis. Secondly, we are trying to help flatten the curve of current COVID-19 pandemic MISinformation, to ensure that you are getting the true facts. 

ABOUT Krys Johnson

Krys Johnson joined Temple University in fall 2019 as an assistant professor of instruction in the Department of Epidemiology and Biostatistics. She received her PhD in public health with a concentration in epidemiology from the College of Public Health at the University of South Florida in Tampa, Florida. She earned her undergraduate degree in health education and promotion and her master of public health in epidemiology at Georgia Southern University in Statesboro, Georgia. She interned at the Georgia Department of Public Health and then served as an Emerging Infectious Disease Fellow at the Florida Department of Health, stationed in Polk County from July 2015 to August 2016, during the height of the Zika outbreak.

Dr. Johnson’s research interests are in mitigating health disparities through community-based participatory research and culturally appropriate behavioral interventions. Her teaching goal is to ensure that students understand the practical applications of epidemiology and biostatistics and can critically review news or journal articles. She seeks to motivate students to realize their own potential and to use that potential to positively impact the world around them.

SHOW AGENDA

On today’s episode we will:
• Ask Dr. Johnson for the factual information (the real facts) that we should know concerning COVID-19
• Go through several statements, which have been going around the internet, concerning COVID-19 and set the record straight (these statements were also covered by factcheck.org in their recent interview of Dr. Johnson, which can be found here: https://www.factcheck.org/2020/03/viral-social-media-posts-offer-false-coronavirus-tips/?sf119120963=1)
• Discuss several recent articles covering the Imperial College of London’s report entitled “Impact of non-pharmaceutical interventions (NPIs) to reduce COVID-19 mortality and healthcare demand” and get Dr. Krys’ opinion on the report

WHAT YOU WILL HEAR ON THIS EPISODE:

• The real factual information about COVID-19 (and why the false statements you are reading on the internet are untrue)
• Why Dr. Johnson believes the measures we are currently taking are not enough
• Dr. Johnson’s advise for protecting yourself and your loved ones
• How we can improve our responsiveness to COVID-19 by following Taiwan’s lead
• What we can expect in the coming weeks
• And so much more!

PRODUCTION CREDITS:

This Self Made Strategies Podcast is a SoftStix Productions LLC jawn.  This episode was produced, edited, and hosted by Tony Lopes, REMOTELY (because we are in COVID-19 isolation) in Philadelphia.  The Self Made Strategies Podcast is sponsored by Lopes Law LLC (www.LopesLawLLC.com).

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HERE IS THE TRANSCRIPT FOR EPISODE 059 OF THE SELF MADE STRATEGIES PODCAST:

Tony Lopes, Esq. – Self Made Strategies & Lopes Law LLC: [00:00:21] Hey everyone, this is Tony Lopes, host of the self-made strategies podcast, welcoming you to a special COVID-19 release, but don’t forget to go hit subscribe, and also drop us a review wherever you listen to podcasts. Thanks very much. We really appreciate you listening and we hope you enjoy the show.

Welcome to a brand new special release COVID-19 episode of the self-made strategies podcast. I am your host Tony Lopes, and with me today is Dr. Krys Johnson. Hey, Krys, how are you? Yeah. Great. Thank you for being on the show. Obviously Krys is coming in remotely as we are all still staying inside. Krys is an epidemiologist with temple university.

She teaches at temple. That’s kind of how we met. Krys was recently quoted in factcheck.org article entitled viral social media posts offering false coronavirus tips. So Krys is here as in her role as an expert. Epidemiologist. To demystify all of the false and misleading information that’s going across the internet and on social media, with respect to COVID-19.

Krys Johnson joined temple university in fall of 2019 as an assistant professor of instruction in the department of epidemiology and biostatistics. She received her PhD in public health with a concentration in epidemiology from the college of public health at the university of South Florida in Tampa.

She earned her undergrad degree in health education and promotion and her master of public health in epidemiology at Georgia Southern university in Statesboro, Georgia. She interned at the Georgia department of public health and then served as an emerging infectious disease fellow at the Florida department of health.

Stationed in Polk County from July of 2015 to August of 2016 right. During the height of the Zika outbreak, Dr. Johnson’s research interests are in mitigating health disparities through community based participatory research and culturally appropriate behavioral interventions. Krys, welcome to the show.

Why don’t we talk a little bit about your. Time in Florida, in Polk County. You were down there during the Zika outbreak. First of all, tell us a little bit about your experience down in Florida during that time period. The craziness that was going on with that, and that was a bit difficult to control, I’m sure.

And then we’ll talk a little bit about the similarities between Zika and COVID-19.

Dr. Krys Johnson: [00:02:58] So I’m actually gonna back us up just a little bit before that. Um, the funding that I was actually hired on, and Florida was a bowl of funding, so it was emergency Ebola funding for us to be able to monitor people who, of course in that area had come to Walt Disney world, Busch gardens, things like that, um, and were from other countries or needed to be monitored for their fevers.

But by the time they operationalize that funding, there weren’t that many people that were coming in from the Ebola affected areas. So. I had about two months of on the job training, and then immediately Zika started happening, so we first heard about it in Brazil and then it got into the Caribbean, and then we knew that Florida, it was always going to end up having Zika virus because mosquitoes are everywhere.

They could be the state bird in Florida and. Actually Florida fun fact, um, is one of the only places in the United States where Dingo fever occurs every year with another mosquito borne disease. Yeah. It’s usually in the keys because people collect rainwater. So we were used to dealing with mosquito borne illness.

Um, Lee County, Florida actually has some of the best mosquito control, um, specialists that you’ll ever meet. But, um, so during that time it was kind of like what we’re dealing with here. There was this new mosquito borne illness, and we didn’t really know how it was transmitted or what it was going to do to people.

Uh, we all remember the microcephaly associations there. So not only were we scared, um, for people coming back, but. There were also children, um, and yet to be born children that were being negatively impacted by this. Um, what we did in that case was because Zika is in the same family as things like yellow fever, we just kind of took what we knew about yellow fever and proceeded, like those were the things that were true until we learned more about Zika.

So actually, Polk County was the County that had the very first sexually transmitted case of Zika virus in the state of Florida. Um, so we contributed to the CDC guidelines, figuring out how long Zika virus can stay in seminal fluid. I luckily was not the person taking the samples. We had some heroic people in our disease control division that were going out to get their samples.

Uh, our mosquito control people were also very, um. Systematic in the way that they approach this. So we still, um, here in Pennsylvania we have, whenever diseases are reported, we make sure not to give too much descriptive information. The same was true there. We would give mosquito control. A five mile radius of where the case had been tested positive so they can spray in their neighborhood and make sure that there would be no mosquitoes that could transmit the disease in their neighborhood.

Um, and so. We worked a lot with emergency preparedness, mosquito control and disease testing site ends up public health laboratories in Florida to contain speak of virus, to make sure that it wouldn’t become endemic in our mosquitoes like West Nile virus has become, and it didn’t. It just means that that disease always occurs in the population.

So like common cold is something that’s endemic. In our country.

Tony Lopes, Esq. – Self Made Strategies & Lopes Law LLC: [00:06:25] And so I can already see the similarities and hopefully the listeners can see the similarities between Zika and you pointed some of them out with COVID-19 because it’s a novel virus. We’re using a lot of prior research into other similar viruses to make decisions and to statistically kind of plot out what the potential damage could be from all of this.

But we’re kind of working in the blind. Correct,

Dr. Krys Johnson: [00:06:50] exactly. So I didn’t want to get ahead of myself. Whenever I was talking about Zika. When Zika virus, we did not know that it was going to be sexually transmitted. That was something that was unprecedented and other mosquito borne illnesses. So that was something that we kind of had to pivot as public health professionals and all of a sudden start in addition to telling people to wear mosquito repellent.

Also like be very cognizant. Whenever your sexual partner comes home from an effected area or you’re in an effected area. And we think kind of the same thing, not the sexual transmission necessarily, but with this Corona virus. Um, other Corona viruses haven’t been able to be sustained in the air for extended time periods.

It’s typically been respiratory droplets, which means someone sneezes near you if someone Costes near you and they’re not covering their cough or sneeze and not coughing or sneezing into their elbow. Well, there’s actually evidence out there to show that these viral particles can linger in the air, and there’s different estimates, um, from 34 minutes to a couple of hours.

And that’s something that’s a little bit different that we’ve also had to kind of pivot and account for. So instead of what, uh, in the hospital, we call droplet precautions, which is just making sure that no a person. Using and coughing droplets can’t get into our system. We also have to account for that potential airborne spread, which is why there was more high tech in 95 math are more in demand for hospitals right now.

Tony Lopes, Esq. – Self Made Strategies & Lopes Law LLC: [00:08:22] Right. And those  masks, by the way, are not the traditional masks that are just the, the white masks that you might use at home for, you know, to prevent dust particles. They actually have that built in fan. Um, that allows for circulation of air. Is that correct?

Dr. Krys Johnson: [00:08:40] Yeah. Think whenever. People in public. We just think about math is kind of the surgical masks.

So those are the ones that would work for droplets or costumes, and they just kind of keep things from getting in your mouth and nose. But with the end 95 ones, they actually have that mask, that fan and filter too. The teeniest tiniest little particles and prevent them from coming into your math. Um, so there are a lot more effective at that than just the surgical mask that we normally think of.

So what about,

Tony Lopes, Esq. – Self Made Strategies & Lopes Law LLC: [00:09:08] there were some articles and some posts that have been popping up, and I know everyone’s trying to help with the shortage of available PPE, personal protection equipment that doctors and hospitals currently need, medical professionals currently need, who are treating or testing for COVID-19.

What about homemade masks? Multilayer cotton fabric made masks. There are a lot of posts and a lot of articles that went around the internet this weekend. And my wife, for example, being a fashion designer as well, did talk about, we were having a discussion internally at the house, you know, is this effective?

Should we reach out and see if we can help? Are those helpful or are they literally a last resort?

Dr. Krys Johnson: [00:09:50] I would say that they are literally a last resort because even if you look at those, I actually shared one of those articles. It was backed by some, um, some studies, but even looking at those, a surgical mask is still much better than those cotton masks.

So ideally we want our medical professionals to have in 95 after that, surgical masks are better than most things that they could have. But in the absence of anything else, if you’ve probably seen that news has started discussing the fact that medical professionals are now being advised to use bandanas or scarves to cover their mouth and absence of math, right?

Double layered cloth type masks are actually better than using a scarf or a bandana, but they still should not be chosen over any medical grade mask of any sorts.

Tony Lopes, Esq. – Self Made Strategies & Lopes Law LLC: [00:10:46] Right. But given that resources are limited, and for example, there was an article that circulated, I think today we’re recording this Monday, March 23rd of 2020 there was an article that’s been going around today that New York may be out of supplies within the next week or so.

Obviously, we don’t know if that’s accurate or not. Given that supplies run out, you’re saying that a multilayered cotton mask, and I’m assuming more layers the better. So if you have four layers of cotton that would be better than two layers, et cetera, or no, uh,

Dr. Krys Johnson: [00:11:14] I wouldn’t necessarily go that far because you also want to make sure that the math is breathable, because if it keeps moisture in, then it actually can foster bacteria.

So I would say that you would want to go with a more lightweight kind of fabric. And the article that I. Saw this weekend had, um, it was like comparing the differences between using t-shirt, material, pillowcase material, um, dish towel material, and it kind of went through to see which ones did the best and of those dish towels did the best, um, in filtering out.

Um, bacterial and viral particles, but it was just kind of comparing what household cotton based goods could be used to create this mass if you’re going to, yes. So if you’re going to create math, um, because I would definitely rather our health professionals have that than nothing at all. Absolutely. Um, so I commend to everyone who is creating those masks themselves and providing them to health care professionals to try and protect them.

And then try and find the studies that show what type of material is gonna work best. I know there’s a couple of the fabrics, um, source that are also donating materials to people who are willing to create masks. So also check that out.

Tony Lopes, Esq. – Self Made Strategies & Lopes Law LLC: [00:12:34] Right? Exactly. So Jo ann.com and joanne.com is in no way affiliated with this podcast, but there was a post that went out and they do have a website set up for this joanne.com/make.

Hyphen to hyphen give hyphen response has information about how you can join Joanne’s fabric stores into helping support medical personnel. So they’re sort of at the forefront making an initiative to make some of these masks at home. There’s other articles also popping up with some designs that you can download to help start making these masks, but the best might be.

To contact Joanne’s and see how you can get involved because they’re making a big grassroots, uh, campaign that might be able to actually make an impact. And I’m sure that they have some connections directly with the hospitals rather than just making masks at home and then trying to deliver them yourself.

Now switching gears to the article that you did. With factcheck.org we’ll go through some of these claims that have been made over the internet over the last few days and weeks, and we’ll let you comment on the truthfulness or the accuracy of some of these claims, if that’s okay. Great. So claim number one is that if you take a deep breath and hold your breath for more than 10 seconds, if you complete that successfully without coughing, without discomfort, without stiffness or tightness, cetera.

It proves that there is no fibrosis in the lungs, basically indicating no infection.

Dr. Krys Johnson: [00:14:07] So this is completely untrue. Um, because there are some people who don’t have infection at all that can’t do that because they have, um, CRPD or other breathing complications like asthma. Um, also just because you can manage to hold your breath for 10 seconds, that’s actually not that, not that long.

And so that’s definitely not a, let’s say, a testing method to say that you do not have current a virus.

Tony Lopes, Esq. – Self Made Strategies & Lopes Law LLC: [00:14:31] Right? Exactly. Not exactly found in the medical textbooks, I would say. Right.

Okay. The next claim is quote, if you have a runny nose and spot them, you have a common cold. Coronavirus pneumonia is a dry cough with no runny nose.

Dr. Krys Johnson: [00:14:50] So this I think, actually started out of people trying to be helpful because initially, and for most people, a cost with current of ours is dry. But there are also people who have runny noses and they’re also people who have productive cough, particularly once they start taking something for chest congestion.

So just because you have a wet cough or your running nose doesn’t rule out the possibility of having Corona virus.

Tony Lopes, Esq. – Self Made Strategies & Lopes Law LLC: [00:15:15] Right? Exactly. The next claim is that everyone should ensure your mouth and throat are moist, never dry. Take a few sips of water every 15 minutes at the least. Why? Even if the virus gets into your mouth, drinking water or other liquids will wash them down through your throat.

And into the stomach. Once it gets to your stomach, your stomach acid will kill all of the virus.

Dr. Krys Johnson: [00:15:38] So this is probably my favorite because it’s the most absurd. Mmm. Just because you’re drinking water does not mean that you’re washing the virus out of your system because the virus is still going to be in your mucosal passages.

So in your nose, um, in your throat and things like that. Um, it is true that if you ingest the virus, your stomach acid will, Mmm. Neutralize it. But. If you’re already in your music pathways, then you’re still going to be impacted,

Tony Lopes, Esq. – Self Made Strategies & Lopes Law LLC: [00:16:13] right, because it’s got a pass through your throat and through your mouth and other mucus membranes to get to the stomach to begin with.

So the likelihood of any version of this being true is highly unlikely. Correct.

Dr. Krys Johnson: [00:16:27] Highly unlikely. Some of the viral particles,

Tony Lopes, Esq. – Self Made Strategies & Lopes Law LLC: [00:16:33] and there’s a version of this that’s been going around and maybe there’ve been multiple versions, but I’ve seen at least one other one where they talk about gargling with a variety of different solutions. One of those being, if you drink lots of water and gargle with. Uh, vinegar that that might kill the virus also untrue.

Correct.

The next claim is that this new virus is not heat resistant and will be killed by a temperature of just 26 to 27 degrees Celsius. And that’s somewhere in the ballpark of 65 plus 70 plus Fahrenheit.

Dr. Krys Johnson: [00:17:12] So just by the nature of knowing that it lives within our bodies, which is about 37 degrees Celsius, 35 or 37 degrees Celsius, we already know that this claim is untrue.

So this kind of led to the other rumor that’s going around saying that once it becomes summertime that. The virus will disappear. So we have no idea whether that’s actually going to happen. And in fact, people are probably going to be in more close quarters with air conditioning whenever it gets hotter outside.

So we may actually see more transmission. So the virus is, there’s no evidence that increased heat will actually kill this virus.

Tony Lopes, Esq. – Self Made Strategies & Lopes Law LLC: [00:17:52] Right? Exactly. Okay. Now let’s talk about the New York times article that was released, I believe on March six March 17th. And that article is called behind the virus report that jarred the U S and the U K to action.

The report that the article is referencing is from the Imperial college of London, and that report was released on the 16th of March of 2020 and that report is called the impact of non-pharmaceutical interventions to reduce COVID-19 mortality and healthcare demand. And essentially that report, and you’ll correct me if I’m wrong, because you’re the expert.

Essentially that report is discussing these alternative methods like quarantine, like quarantine of individuals that are of higher risk, like, um, closing of universities and schools, et cetera. So in other words, again, non-pharmaceutical interventions. And we want to be clear also, that these things do not necessarily exist in a vacuum.

Just because we’re utilizing some of these non-pharmaceutical interventions, which many governments all over the world at this point are you utilizing? It doesn’t necessarily mean that they’re not trying. Or seeking out pharmaceutical interventions to work in tandem with these things. But this report is specific to those non-pharmaceutical interventions.

So with regard to that article, what’s your opinion overall?

Dr. Krys Johnson: [00:19:23] Um, with, I’m going to go ahead and just get to the Imperial London articles, like get to the source. Um, so I. I think that that article does a good job of examining kind of the worst case scenario. And I think that’s something that we should be cognizant of as public health professionals and the public at large.

So they’re saying, you know, if we do absolutely nothing, we’re going to see a ton of people get sick. Our hospitals are not going to be able to take care of people in a lot more. People are going to die then need to. And so they did is looked at what happens if we just do the social distance thing? What happens if we just closed down schools?

And what happens if we combine some of these efforts and you can kind of see the different levels of. People who are sick and people who need to be hospitalized and need to be in ICU can get stretched over this longer period. So that leads to one point that I’ve heard people make it. Oh, well then that’s just going to make this last longer.

Let’s get it over with. Well, making it last longer means that our health care facility, they’re actually able to take care of. Healthcare professionals and also take care of the people who come in and need intensive intervention. Um, so, uh, what we keep hearing, flattening the curve and all of these efforts are social justice, social distancing measures, which just means things that keep us from being in close contact with other people.

And right each. Intervention that we do closing down schools, asking people to work remotely, shutting down public transportation, um, asking people to quarantine themselves and isolating people who test positive. All of those are individual interventions that can flatten that curve and make our health care.

Facilities, more able to better take care of people and to better take care of healthcare professionals. Yes. Um, so I think, uh, that was authored by 30 different epidemiologists, and they looked at the UK, uh, as well as the United States, and they were just. It was kind of getting out there. This is what each one of these things can do, and this is what we can do if we really have intensive and what they call extreme measures put into place to reduce.

Tony Lopes, Esq. – Self Made Strategies & Lopes Law LLC: [00:21:43] So that leads us into fast company’s response to that article, which was published by fast company on. March 19th of 2020 entitled, a horrifying report says flattening the curve may not be enough, but there are reasons that it might be wrong. And the fast company article essentially talks about, um, now that first of all, the Imperial college of London’s study was not peer reviewed.

But to your point. 30 or so epidemiologists participated in that study to begin with, and yes, they are viewing things from a worst case scenario, but quite frankly, viewing them from a worst case scenario might be important right now because there are many in the public who still think this is not a big deal, and you pointed out very astutely that a lot of this is a safety measure to buy time for our healthcare industry globally.

To react to this and the fact that there’s a shortage of resources throughout not only the United States, but in other countries across the world. And this may be the first time globally that we as an entire planet have to deal with. A crisis of this nature and therefore aren’t able to rely on other countries for aid.

Is that correct?

Dr. Krys Johnson: [00:23:02] Right. Yeah. Um, so the last time we saw anything like this was the 1918 flu and we weren’t in a place then to be able to quickly get supplies from one place to another. We didn’t have rapid testing like we do now. So we’re looking at a completely different type of pandemic ban. The 1918 flu, which we often hear this compared to.

Yeah, the effects of this disease has similar ones to the 1918 pandemic. If we don’t start implementing some of these social distancing measures. So, um,  article behind the horrifying report, um. It kind of tries to alleviate some of the panic that resulted from the Imperial college of London article in saying, well, this is only if we haven’t done all of these measures or we’re not doing, like you said, um,

Other pharmaceutical interventions in tandem. So that includes taking antibody serum from people who survived and giving it to people who are infected or exposed to try and give them an immune Zeus. I’m coming up with a vaccine coming up with antivirals that will help us fight off the disease. So, Mmm.

None of those things were taken into account in the article. But I think it’s very important to go ahead and exclude those because. Doing antibiotics. Antibody serum infusions takes time and it takes resources. The vaccine is now isn’t available yet and may not be yet for 18 months. And the antiretrovirals, there’s still a lot of skepticism going around about what would actually be effective in that.

And trying to make sure that we’re not rushing things through the FDA process and actually harming people more than we’re helping them.

Tony Lopes, Esq. – Self Made Strategies & Lopes Law LLC: [00:24:54] Right. That’s a great point, because we do need some time in that 18 month development phase for clinical trials and clinical studies to make sure that we don’t make a mistake and to your point, create something that while it may prevent this virus, could be harmful to humans as a whole.

Correct.

Dr. Krys Johnson: [00:25:12] Right. So there are a couple of combination of drugs that have been discussed so far that actually if they’re taking in the wrong quantity, can call it heart attacks or other cardiac, uh, episodes. And so we want to make sure that we’re not causing heart attacks in our efforts to reduce this ex Corona virus.

Um, that said, I think it’s, it’s really important for us to kind of see this worst case scenario as from the Imperial college of London, because that, that is what it looks like if we don’t have a strong national response. And right now we don’t have that. Right now, we have States like New York, California, Pennsylvania, and I believe five others that have these shutdown orders.

But the two States that I’ve lived in previously, Georgia and Florida, where most of the people that I know and love are those States have yet to shut down themselves. So whenever we still don’t have this blanket nationwide order. That imposing social, social distancing and shutting down non essential services, then we’re making it much more likely that we’re going to be in that worst case scenario.

And the fact that we don’t have enough Mmm. Protective equipment for our healthcare professionals continues to put us closer to that worst case scenario. Then towards, um, the reaction to that report, they said, Oh, well, it’s not that bad. It can definitely  not that bad. If we impose that social distant thing while at the same time working towards making antibody serum vaccine and , um, some sort of pharmaceutical treatments available to people at large.

But right now we don’t even have the appropriate testing across the nation to see how many people are actually insecticide. Coronavirus.

Tony Lopes, Esq. – Self Made Strategies & Lopes Law LLC: [00:27:00] Right. And now let’s talk a little bit about some of the countries that have responded very well to this, and one of those being Taiwan, if I’m not mistaken. Right.

Okay. Yeah. So let’s talk about their response as a whole. So they, they actually started reacting to this back in December of 2019 correct?

Dr. Krys Johnson: [00:27:25] That is correct. Um, they were ahead of even China in addressing this. And it seems like they, um, kind of took notes from the SARS outbreak in early two thousands.  and, um, made a lot of lessons learned.

So they quickly shut down travel and were testing and isolating people and quarantining people who were contacts, people who tested positive from Corona virus. So they. Um, reacted very quickly and have continued to maintain, um, pretty stringent monitoring policies to keep very low levels of positives in our country.

Right.

Tony Lopes, Esq. – Self Made Strategies & Lopes Law LLC: [00:28:04] Rather fascinating. And even South Korea, I think, if I’m not mistaken, has also now started to see a trend in actually flattening the curve and seeing their numbers decrease. And that’s in large part because they’re now adapting in a similar fashion to Taiwan and Singapore, which is also Singapore is also reacted fairly well to this.

Correct.

Dr. Krys Johnson: [00:28:27] Yes. Yes. So all of those, um, have reacted very well. I think Taiwan and Singapore were a little more proactive, whereas South Korea ended up being more reactive. But once they realized the, um, potential consequences and how quickly it was spreading, they did a good job in shutting down. What they could, um, identifying people with fevers, testing them for Corona virus or flu and quarantining people so that they wouldn’t be, um, infecting other people.

China also did a really good job. Um, they, as a result of the SARS epidemic in the early two thousands, again, had created these fever clinics, which are actually, Mmm. Separate entities.  Oh, hospitals. They’re kind of near the emergency department, but not in them. So people wouldn’t contaminate people in the emergency department and Mmm.

People who had a fever would be sent there. They would stay until they were tested with for flu and Karuna virus and any other respiratory tests. If their tests were not going to come back that day, they were sent to a quarantine hotel, and if they got ed tests positive for crowing virus, they were sent to a quarantine hotel so that they could not transmit it to their families.

Because in China, about 80% of positive cases were transmitted within the household. So it was because of people going home with the virus and getting everyone else sick that it kept transmitting. So once they removed that, Mmm. Method of transmission. Um, China was able to really dramatically reduce their cases.

And I think it’s also important to say, uh, to note that those countries seem to have had a nationwide effort to address. The epidemic, and to really kind of push resources out to health care facilities and create new healthcare facilities just for this purpose. Um, we’ve seen States like Washington state kind of moved towards the quarantine hotel, acquiring hotels and motels to be able to remove people from their families and keep them there until they’re no longer infectious.

But that’s not something that’s a national response. And again, this lack of one cohesive. Response to call the epidemic is really going to make it harder to flatten that curve and to reduce the deaths. That could very well happen because of this epidemic.

Tony Lopes, Esq. – Self Made Strategies & Lopes Law LLC: [00:30:51] Right, and so let’s talk about that because there is also a lot of misinformation in the context that started early on with this and in part, we’re not blaming anyone for the myth.

A lot of this misinformation, as you said, a lot of it came from a good place. A lot of it came from trying to understand. What is a novel virus in the context of prior experience and not realizing that we didn’t really have any valid prior experience to go on. Aside from as some of these articles that we’ve mentioned and the study mentions, we’re essentially right now using the 1918 influenza playbook on this, correct.

Dr. Krys Johnson: [00:31:30] Yes.

Tony Lopes, Esq. – Self Made Strategies & Lopes Law LLC: [00:31:31] So, so looking at that, one of the things that that started early on and maybe has dissipated a little bit, but you hear it trickling around still, is that this is no worse than the flu than the regular flu generally kills more people per year. And generally speaking. First of all, that’s probably untrue at this point to begin with.

But second of all, you’re looking at something that we have a lot of data for the common flu, right? Versus a novel virus. So can you talk a little bit about, first of all, whether or not that’s an accurate statement to begin with, what the similarities or dissimilarities are with the regular influenza that we face on an annual basis, et cetera, with respect to COVID-19.

Dr. Krys Johnson: [00:32:20] Actually as public health professionals, whenever we were first starting to talk about Corona virus here in the U S in January, um, actually my first video about coronavirus, I compared it to the flu and not in its severity because it actually is, it can be much more severe in the flu. For most people.

It’s usually about for the flu. About two. Uh, 200th of a percent of people, um, who contract the flu die from it. Now in the U S because of how many people we have, that’s still 20 to 30,000 people per year. So that’s why we were trying to put it in perspective for people. And also because the current a virus is spread in much the same way as the flu with those respiratory droplets and things like that.

So we could still talk about the same preventive measures. Wash your hands, make sure you’re covering your costs and sneezes, sanitize your hands, um, stay home if you’re sick, all of those things still applies. But the more information that we got out of China and South Korea and now Italy, um, the more we’ve come to know how serious this disease is.

So initially we heard that young people were not having severe reactions. Later we found out the severe reaction could be, or a mild reaction could be anything from no symptoms to what is called mild pneumonia. And I don’t call mild pneumonia a mild disease. So  had all of this information for young adults saying, Oh, you’ll be fine, but pneumonia isn’t fine.

So now we’re saying a lot more younger people, um, people below the age of 50, who are getting these really, um, intense reactions to coronavirus and are still needing medical intervention. Mmm. The  other things about that is, I talked about how often people die of the flu. Um, this is at least 30 times more deadly then the blue, and that is based off of the estimate coming out of South Korea where they did blanket testing, so they knew, Mmm.

They tested as many people as they could to come up with a good idea of the number of people who actually had Corona virus, and then the people who’ve died of Corona virus to tell us it’s about 0.65 Mmm. Case fatality rates. So yeah, again, that’s not three times the rate of. The flu, and if we think about that, I already said about  20 to 30,000 people die of the flu every year, okay?

If we multiply that by 30 times, that’s 600,000 people die.  in the United States of Corona virus, it’s the same number of people get infected with the flu. Issue with that is we have a flu vaccine, and we have people who, because they’ve had saloons in recent years, have immunity to the flu. So the number of people who are actually susceptible to or likely to develop the flu is much smaller than the number of people who are susceptible to coronavirus because this was.

This is a novel virus to us, new to humans. None of us has an immunity to it. So that means that the vast majority of people in the United States are susceptible to it. And so if those come into contact with it, they’ll likely develop at least some symptoms.

Tony Lopes, Esq. – Self Made Strategies & Lopes Law LLC: [00:35:47] Right. Great point. And in part, what we’re, what we’re saying, I think at a 30,000 foot view, and you correct me if I’m wrong, please.

But basically what we’re saying is. We don’t have enough data to compare it to something like that. Because to your point, there’s a lot of treatment. There’s a lot of people with antibodies for the common flu, and not for this because it’s a novel virus. So it could really, to your point, at a 30 time kill rate, essentially could potentially kill a lot of people if we don’t take this seriously.

Dr. Krys Johnson: [00:36:20] Yeah, exactly. Yes. And that’s where the 2.2 million people potentially dying in the United States that came from the interior  college of London report. That’s where that could actually be the true story if we don’t get serious in reacting to this virus.

Tony Lopes, Esq. – Self Made Strategies & Lopes Law LLC: [00:36:37] Right. And another thing is if we don’t all stay inside and you keep going outside and interacting with people, you’re basically just putting us into a vicious.

Circular cycle, right? Because people keep going outside. They keep infecting others, they bring it back into the house. People are in the house in close quarters. Then the whole house gets infected. This all puts a strain on our healthcare system beyond all imaginable belief at this point, and just continues to spiral if we were all to just stay inside.

Would you say that that’s. The best thing that we could do for now to try to at least reduce this. And then in addition to widespread testing, we could probably get over this, this hump in. What’s your estimation in terms of time? If we were to just buckle down and stay inside,

Dr. Krys Johnson: [00:37:27] if everyone stayed inside, and let me clarify.

Stayed inside because some people have thought that having a house party. It’s staying inside and practicing social, different things, having friends and social distancing. I love my students. Um, but apparently there are still have been parties going on your campus. So, um, just because you’re staying inside doesn’t mean you’re practicing social distancing.

So you should only be interacting with the people who you live with and then keeping, um, even if you, you are still allowed to go outside for. Exercise that even with that, you should be maintaining six feet of distance between you and all of the other people that are outside. The only people you should be closer to are the people that you actually live with.

Um, so if we did that, if we practice social distance, things like how the CDC wants us to, uh, within . Probably eight weeks or less. We could see, um, uh, a stark decrease in the number of new cases. We would start seeing, seeing people who had to go into the ICU come out of the ICU and be able to be in regular hospital beds and start resolving some of those really severe reaction.

Mmm. But we would still have to take a lot of precautions in slowly reopening our economy and our country as we know it, to make sure that we didn’t immediately see a spike in those, uh, reactions. So that’s why some people, some articles have said that it’s not feasible to do that until we have a vaccine.

Um, I would argue it’s not necessarily feasible to expect people to stay inside for 18 months. So there’s gotta be, um, somewhere in between where we can still get some semblance of normalcy, get our economy at least creeping back towards, Mmm. A functioning economy for the , the workers that are now out of work.

Um, but also to maintain those low levels of infection and mixture. That we’re keeping them low enough that as people become infected, they’re still going to be able to get quality healthcare and our healthcare professionals are going to be able to protect themselves so they can help everyone else.

Tony Lopes, Esq. – Self Made Strategies & Lopes Law LLC: [00:39:45] Right. And part of that though, if we look at Taiwan as an example, going back to that is that Taiwan kept the price on. Masks for people to be able to afford them throughout the public at large. So if we did something like that, capping the cost of masks to begin with, reducing for example, and some supermarket chains and some stores have begun now issuing limits on things that you’re buying.

But for the life of me, I can’t understand why of all things, toilet papers being hoarded. But that being said, um. It’s a bit like those measures can be added onto this to really support getting beyond this. Correct. So for example, if we stayed in doors, yeah. If we stayed indoors for, to your point, somewhere up to.

Eight weeks or so, roughly, maybe less. If we all actually listened to the government and stayed indoors, we could get past this. Then in combination with returning to normal life, but using masks in public and, um, trying to practice unnecessary, you know, social distancing as much as possible, we could get back to some form of normalcy until we have enough time to develop a proper vaccine.

Correct.

Dr. Krys Johnson: [00:41:06] Right? Like you said before, you think things in tandem together to kind of reduce the likelihood of seeing a spike in cases as we start opening up our country again.

Tony Lopes, Esq. – Self Made Strategies & Lopes Law LLC: [00:41:20] Right. Exactly.

Dr. Krys Johnson: [00:41:24] I think the big issue with the masks right now though, is, um, because our healthcare workers right now can’t even get enough. It might actually take those eight weeks for there to be enough for all of us as citizens to be able to have them once they make sure that the healthcare professionals have them.

Taking

Tony Lopes, Esq. – Self Made Strategies & Lopes Law LLC: [00:41:41] a step back, let’s talk about why the shortage of respirators in hospitals and shortage of available intensive care unit beds is such an issue related to COVID-19 because I think that’s also. Intertwined with this misunderstanding of the need for medical resources. And that is we do not have enough beds if there’s a huge spike in necessity for people to get intensive care treatment.

And part of the reason that they need intensive care treatment related to COVID-19 is that it can turn into a lower respiratory infection. Correct?

Right, exactly. So can you explain. First of all, what that is and the potential severity, and then relate that to the shortage and resources so that hopefully people can really see clearly why this is such a major issue.

Dr. Krys Johnson: [00:42:39] Right. So, all right, I’ll start with the numbers. So there are about 370 million people in the U S there are about a million hospital beds, but only about 42,000 of those are for intensive care.

So that’s how many we have for people who are going to need ventilators or things that are actually life sustaining. Yeah. The people who are most at risk for Corona virus are the people who are more likely to develop that lower respiratory disease that actually stops their loans from being able to get enough oxygen to the rest of their body.

If that persists long enough, it happens long enough without a person being on a ventilator and getting the care they need to kind of get fluid out of their lungs and get the oxygen into their body, it can turn into sepsis. And sepsis is basically a bacterial infection that goes throughout your bloodstream, so it infects your entire body and it can very easily kill you.

So this is a virus that can actually weed too, a bacterial illness that can also kill you. Okay. But it’s. So the whole thing with flattening the curve is making sure that those 42,000 intensive care beds are enough to take care of the people who have those severe reactions. So if we slow down the spread of disease and we decrease the number of people who are sick at any one time, and therefore decrease the number of people who need those beds, hopefully two then number of people or the number of beds that are available, or even less, to make sure that we have.

I see that for people who have complications of other diseases because coronavirus isn’t happening in a vacuum, flu is still occurring. Um, so that can still lead to people needing to be on respirators. Um, because of that shortage in, because, um, ventilators and respirators are very highly technical equipment.

And so we’re seeing. We’ve heard general motors and other companies are moving towards creating ventilators, but it’s not something that those industries were created to make. It’s not something those factories were built to make. So we have this lag time between. Um, whenever they say that they’re gonna start producing that, and then the amount of time it actually takes to prepare them to create those machines and then actually getting those machines created and in to the hospitals that need them.

So we think governor Cuomo of, uh, the work. Asking all facilities that are no longer seeing patients, to have ventilators, to make sure that they’re getting them to hospitals. That’s going to help a little bit in the time between whenever those factories are working towards creating the ventilators and whenever they can actually get them.

So we as the American public, what we can do. Two, hello? Everyone at large is practice that social, distant thing and make sure that we’re doing everything we can not to get infect there ourselves so we don’t end up taking up one of those beds. That could be. Used for somebody who might not otherwise survive the disease.

Um, so like our grandmothers or people who have kidney disease or heart disease or otherwise immunocompromised. So making sure that we are saying healthy so that people who are going to get sick have the opportunity to live through this.

Tony Lopes, Esq. – Self Made Strategies & Lopes Law LLC: [00:46:01] Right. And the dark side of that, if we don’t adhere to those.

Suggestions or mandates in a lot of cases being made by the government is that there will be a shortage of materials and embeds. There will be tough decisions like are being made in Italy right now, and in some places across the world where doctors have to start deciding who to give those beds to, and we don’t want it to come to that because a, it puts a major strain psychologically on the medical staff that’s already being overworked and under an

an ordinate amount of stress. And then in addition, really just puts us in a bad place societaly where you have to start making decisions about who’s getting what bed and who’s getting what treatment. So. Just to wrap all of this up really nicely. Your advices, and correct me if I’m wrong, we should all just stay inside.

Listen to the government, stop having house parties. Stop getting together with friends and family unnecessarily. If you have to treat someone, still practice social distancing. If they’re sick, make sure that you cover your mouth with. A mask potentially, but if you don’t have a mask than a bandana or a scarf of some sort should be used to cover your face.

You should use protective eyewear. If you’re treating someone in gloves, try not to touch your face. Wash your hands frequently. Is there anything else I’m missing?

Dr. Krys Johnson: [00:47:23] Make sure you’re walking, washing your hands for the full 20 to 30 seconds. I don’t see through the happy birthday song and make sure that you’re even starving under your fingernails because some of us unknowingly will chew on our nails, and that’s where the virus and bacterial particles can hide.

I think the best rule of thumb is to go ahead and pretend that you are already infected and you’re trying to prevent yourself from infecting other people because that makes it work a little bit better. Psychologically, you’re not afraid of becoming infected yourself. You’re. Acting proactively. Yeah. To prevent other people from becoming infected by you.

Tony Lopes, Esq. – Self Made Strategies & Lopes Law LLC: [00:47:57] Wonderful advice for us all. Thank you so much, Dr. Krys Johnson for joining us today and giving us all of this information and most importantly, for getting rid of a lot of flattening the curve on disinformation and misinformation about COVID-19. Is there any way that people can reach out to you if they want to get in contact with you or if they have questions and do you have social media handles that people can follow?

Dr. Krys Johnson: [00:48:24] Oh, so you can find me with a quick Google search. I’m at Temple University. That’s where my email will be, and I am on Twitter quite frequently.

And I would be happy to answer any questions that people have via Twitter.

Tony Lopes, Esq. – Self Made Strategies & Lopes Law LLC: [00:48:44] Awesome. Thank you so much for your time. We really appreciate it.