For many parts of the United States, allergy season is in full swing. During the COVID-19 pandemic, some symptoms of allergies might be confused as being similar to those of the coronavirus. Emory University School of Medicine at Grady Health System in Atlanta hosted an online discussion with regional and national reporters to address some of the confusion, as well as concerns over the coronavirus such as social distancing and the safety of take out food.
Epidemiologist Carlos del Rio, MD, executive associate dean at the school, fielded the questions.
Questions and answers have been edited for length and clarity.
Q: How do I know the difference between allergy symptoms and COVID-19
del Rio: In allergies, you are going to have a lot of itching in your eyes and you’re going to have a lot of scratching in your throat. You will also have maybe some cough occasionally. The bronchospasm, you know that feeling when you feel your chest is tight, is very characteristic of allergies.
An important thing to tell everybody is you don’t get a fever with allergies.
One thing that we’re learning with COVID is some manifestations. Clearly fever and a feeling that I have viral symptoms is very characteristic. The cough is not actually something that comes up right away. But the one thing that we’re seeing in about 30% of the people and presenting, even before they present is actually loss of smell and loss of taste, so I tell people in the morning if you wake up, you take your temperature and you don’t have a fever, you feel good and you can smell the coffee. You’re good to go. You don’t have COVID.
Note: Emory has developed a virus checker to check symptoms. It’s available in English, Spanish and Portuguese.
Q: What is modeling and how is it being used?
del Rio: In epidemiology, modeling is a tool that is used to try and predict the future, with the best available evidence and the best available data. It is done to help predict what responses are needed on both the local and the national and I would say the global level. The models differ depending on the input as you put the numbers of patients you are seeing. You have to rely on the best available input. Or guestimate. There’s a group in Seattle, the Institute for Healthcare Metrics and Evaluation are some of the most robust in the world. You can go state by state and get imprints and direction.
Q: Are you seeing evidence in any of the states that the social distancing measures are working?
del Rio: If you evaluate the data, the Institute for Healthcare Metrics and Evaluation’s data, California was a state that enacted Stay at Home on, March 18th. They enacted closed schools on March 18th and they closed nonessential services March 18th. And in California, they predict the peak of the epidemic will be April 24. They predict that California is going to have zero bed shortages and California will have only a 299 ICU bed shortage.
When you look in the same place at the Georgia data, there’s a big contrast. In Georgia, with Georgia not having implemented a stay at home or that essential services be closed, Georgia, the peak of the epidemic which will be April 21st, is predicting a shortage of 2,114 beds and a shortage of 977 ICU beds. So again, the states who have done this and did it on time, will not have as shortage of beds. It’s not great data, but I think it’s pretty good data that some of those measures are working
Q: Do you see any evidence that anything is reducing the spread of COVID-19?
del Rio: All of these measures don’t necessarily limit the spread right away. The best thing we can see is a flattening of the curve. What we want to see limiting the peak. You don’t want to see a ton of patients coming into hospitals all of a sudden. If I tell you that you’re going to have 30 admissions of COVID today to the hospital, you will overwhelm the hospital. If I tell you that you’re going to get 30 admissions of COVID over 7 days, it’s going to be ok. What we need the measure to do is not necessarily limit the spread but spread out the number of patients that come to the hospitals.
Q: Do you believe quarantine and social distancing will be our new normal?
del Rio: My phrase is, let’s erase April from our calendars. If we’re able to hunker down in April and in meanwhile let’s increase testing significantly, continue our clinical trials and make sure our hospitals have the supplies we need. I think by early May we will be fine. But we have to do those things. Especially the testing is necessary because we have to have the information we need. Because as (White House Coronavirus Task Force member) Dr. Birx has said, 40% of the country doesn’t have cases. Now, do they not have cases because they haven’t tested or do they really don’t have cases?
Q: Why is testing so far behind?
del Rio: The biggest challenge we have across the state and across the country is actually an issue of reagents. We don’t have enough swabs to get samples from noses. We don’t have reagents to prepare the specimens. And also, we don’t have enough machines. I’ll give you an example. Here at Grady, we have a machine that could run -- I think it’s 90 tests in 8 hours. That means if you ran the machine 24 hours a day, that would be 270 tests. That’s your limit of capacity, right? We��ve ordered new machines, but until you get the machines you can’t do more testing because you are simply limited by your machines. Everybody has their issues.
Q: Is it safe to get to-go orders from restaurants right now?
del Rio: Yes, it is. What they are doing here is perfect. You call a restaurant and you pay through Postmates, Uber or give your credit card and then you pick it up in a way there is no human interaction. If you have delivery to your house, they deliver and leave the stuff at the front door. They ring the bell and when the person walks away, you get out, you grab the food, you take it inside. You wash your hands. Then you take the food, you pass it to a plate that you have in the house with utensils. You wash your hands. You wash the utensils. You’re good to go. There’s no risk from food. There’s no risk from containers as long as you wash your hands and don’t touch your face. So yes, I personally believe it is safe and I am doing it myself. We have to support our restaurant industry, right? We all want them to survive
Q: What will be the answer to the pandemic?
del Rio: Clinical science and research are going to be the answer to this epidemic. Public health is going to buy us the time and is going to limit the spread. Clinical research is going to get us the answer in both treatment and vaccine. That’s why it is so important that during an epidemic we do research.
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