How local health experts deal with COVID-19 in daily lives
This article was produced in partnership with the Institute for Public Service Reporting at the University of Memphis, a nonprofit newsroom specializing in investigative and explanatory journalism.
Local infectious disease experts are helping us all manage and mitigate the coronavirus pandemic.
But, like us, they also have to eat and shop and send their kids to school.
How are they managing their daily lives in the midst of COVID-19?
Do they work out? Eat out? Have people over for dinner? Would they send their kids back to school?
We asked seven local public health/infectious disease experts what sort of daily precautions they’re taking.
Dr. Martin A. Croce, senior vice president and CMO, Regional One Health; professor of surgery, UTHSC.
Dr. Kathleen Forbes, executive vice president, Methodist Le Bonheur Healthcare.
Dr. Cassandra Howard, chief medical officer, Methodist Germantown Le Bonheur Hospital.
Dr. Manoj Jain, infectious disease physician and consultant at Baptist Memorial Hospital and Methodist Hospitals in Memphis.
Dr. Jon McCullers, professor and chair of the Department of Pediatrics, University of Tennessee Health Science Center; pediatrician-in-chief, Le Bonheur Children’s Hospital.
Dr. Lilian Ogari, associate professor and chair of Biomedical Sciences, Baptist College of Health Sciences.
Dr. Stephen Threlkeld, medical director infectious disease, Baptist Memorial Health Care.
Here are their responses:
Q: When and where do you wear a mask?
CROCE: I wear a mask most of the time. The times that I don’t wear one are when I’m at home, when I’m alone in my office or when I’m playing golf. I try to be very particular about social distancing too.
FORBES: At work and anytime I leave the house for errands or meetings.
HOWARD: I wear my mask whenever I am out in public and at work. Hospital policy directs all employees to wear a mask unless in a private office space not shared with others.
JAIN: Almost all the time – in the hospital, at the grocery store and at the gas station. The only times I don’t wear a mask is at home, in the car and walking/exercising outside with my family.
McCULLERS: Anytime I am indoors around other people outside of my own house. I take it off in a private office. I take it off after I am seated at a table in a restaurant, then put it back on to leave.
OGARI: I wear my mask everywhere except in my house and when in my office. I do not interact with anyone while at work after daily routine temperature and symptom checks. I keep my office door closed.
THRELKELD: I wear a mask essentially any time I’m away from home and am inside or in close proximity to others. I don’t wear a mask if I’m alone outside walking the dog or in my office working alone. I put it on if someone comes in. I think it’s important, though, not to forget adequate distancing. As important as masks have turned out to be, there’s no adequate substitute for just not being in harm’s way in the first place.
Q: Besides family, do you allow anyone else inside your home, such as cleaners or service people for repairs?
CROCE: Yes. We take appropriate precautions, and believe in supporting the service industry.
FORBES: Not at this time.
HOWARD: My 95-year old grandfather lives in our home. We love him dearly and protect him by not allowing any visitors into our home. Our other adaptations have included suspending our cleaning service and sharing chores among the family, and restricting our exposure to environments/gatherings where we may come in contact with others who may transmit the virus (i.e. parties, parks) to limit the likelihood of bringing the virus into our home.
JAIN: Yes. but they must wear gloves and masks and keep 6 feet away from all of us.
McCULLERS: We allow house cleaners in while we are away or in another room with closed door. We allow our personal trainer in - she is very conscientious about her health and stays 6-12 feet away with no physical contact.
OGARI: I do not allow anyone besides family to my house.
THRELKELD: We have a person who helps with cleaning occasionally. She wears a mask, and the rest of the family clears out for a while around that time.
Q: Do you shop in grocery stores, or order online? Do you wash the items off or disinfect the outside of packages once you get home?
CROCE: I try not to! When we need an item or two, I will go, and wear a mask and keep my distance. After unloading, we wash our hands with soap and water.
FORBES: I shop at the grocery store every two weeks and try to go very early in the morning when it is less crowded. I wear a mask and gloves, practice social distancing and wash all produce when I bring it home.
HOWARD: Yes, I shop in our local grocery store. (No, Grandpa no longer accompanies me shopping, which he enjoys!) Yes, we wash all produce. We used to keep a can of Lysol by the door and disinfect packages but we have relaxed that process. Instead, we store items once home and thoroughly wash our hands.
JAIN: We go to the grocery store once a week and do our own bagging and checkout. Initially, we wiped all items thoroughly and disinfected the packages. Now that there is evidence that COVID-19 is not likely to be transmitted by fomites, we only wash the produce thoroughly.
McCULLERS: No washing/disinfecting.
OGARI: I go to the store once every other week. When I go to the store I put on my mask, take my own Clorox wipes to wipe off the cart and I maintain social distance. Once home, I wipe down everything with disinfecting wipes before putting them away and thoroughly clean my hands with warm water and soap.
THRELKELD: Unfortunately, I’m generally at the hospital from early a.m. till late p.m., so my wife handles all of the shopping. We are careful with hand hygiene after opening things but spend less time disinfecting bags and packages.
Q: Would you dine inside a restaurant? Outside? Do you get takeout?
CROCE: We have been to a restaurant once and ate inside. The tables were separated and the staff was wearing masks and gloves. We do order takeout.
FORBES: I have not dined out but we have ordered takeout that we pick up curbside.
HOWARD: I do not dine inside restaurants. I have dined outside on the patio while practicing social distancing. Yes, I am comfortable with takeout from facilities that demonstrate safe practices to include employees wearing masks and clean facilities.
JAIN: We would not dine inside a restaurant. The risk is high due to insufficient ventilation, proximity to the waiter and other guests, especially with widespread community transmission. Dining outdoors has a lower risk of covid transmission, yet we are avoiding this also. But we are actively supporting the restaurant industry and making sure to order takeout more often than usual.
McCULLERS: Takeout frequently, dining outside maybe once a week lately, inside rarely and only when I feel comfortable about the restaurant
OGARI: I prefer home-cooked food. Occasionally, I order takeout and do a curbside pick-up or have it delivered.
THRELKELD: We only really do takeout at the moment. I have very limited opportunity to go out during this time anyway, but I think anything inside with a larger group of people poses a risk. Certainly outside should pose a lower risk.
Q: Do you take any precautions with your mail or packages?
CROCE: No.
FORBES: No, but probably should.
HOWARD: Packages that arrive at our door are sprayed with a disinfectant and allowed to dry. After opening the package, I thoroughly wash my hands.
JAIN: In the initial stage of the pandemic, we use to wipe them with a disinfectant. Now, we just let them sit on the counter for a day or so and only open the essential ones initially.
McCULLERS: None.
OGARI: When I receive a package, I wipe it down with disinfecting wipe before I open and after I open, I wipe down the products. As for regular mail, I do not do anything special with them. I let them sit on a designated spot for a couple of days before I open them. I wash my hands thoroughly after bringing them in.
THRELKELD: Very little actually. Our mailbox probably cooks most virus in the several hours it often takes us to pick up the mail.
Q: Do you go to friends' homes for dinner, or have friends to your house, or see them in other ways?
CROCE: We have been to very good friends’ homes for dinner a few times. We eat outside.
FORBES: No, not at this time
HOWARD: I do not visit friends or relatives at their homes or invite anyone to my home (remember, my 95-year old grandfather lives with me). I often see my neighborhood friends while I’m out exercising or walking my dog at which time we may visit while maintaining safe, social distancing.
JAIN: We avoid getting together with groups of friends. We get together with only one family at a time and only those who are very careful on making and taking all the precautions. When we do meet, we sit outside, six feet apart.
McCULLERS: Zoom parties only (OK, one exception at a friend’s house where we mostly social distanced).
OGARI: The only person I visit is my brother and family who lives in town and is equally (probably more) careful as I am. I am in contact with friends and other family members who are out of town via phone, zoom chat, house party, etc.
THRELKELD: We’ve been to friends’ houses twice for dinner since this started. In each case it was one couple and we sat outside with avoidance of any shared items. Anything beyond that remains problematic at the moment, I think.
Q: What would you tell your kids or grandkids who wanted to join a protest march or go to a political rally?
CROCE: If they feel strongly enough to protest social injustice, I’d tell them to wear their mask (preferably N95) and keep their distance. And it should be outside.
FORBES: To speak up but to avoid crowds, practice safe social distancing and at all times wear a mask. If someone comes up to them without a mask on or is speaking to a group without a mask on, leave the area.
HOWARD: I appreciate and respect the freedom afforded to every American citizen. While exercising those rights, I would encourage everyone to wear a mask and maintain effective social distancing of six feet of more to reduce the risk of virus transmission. Personally, my children are not intentionally participating in large gatherings of any type out of an abundance of concern for the safety of their 95-year old great-grandfather.
JAIN: My son wanted to do this and I discouraged him at this time. The risks of transmission at large gatherings, especially indoor, are very high. A study at a church in Arkansas showed that one person spread infection to 35 people.
McCULLERS: They have joined the protests so aren’t visiting our house at present (we drop stuff on the porch as a go between). We insist they wear a mask and get tested for even minor symptoms.
OGARI: I would tell them to stay home. There are better ways to protest than going out to march in the middle of a pandemic where you cannot guarantee social distance and take necessary precaution.
THRELKELD: Both our son and daughter are very socially conscious, but I do tell them that viruses do not care about the intrinsic value of your activities. It’s important to try to practice adequate distancing, particularly in activities in which people are raising their voices and mask utilization may not be universal. Football crowds and marches look quite similar from the standpoint of a virus, even if widely separated in terms of ethical importance.
Q: Would you go work out at a gym? Swim in a pool? Run? Walk?
CROCE: We work out by appointment with a trainer — otherwise I’d never do any exercise! No other clients are present. We have gone on walks.
FORBES: I swim in my own backyard pool utilized only by my immediate family.
HOWARD: Even before COVID, I have always preferred running, walking and working out while outdoors. I do not feel comfortable frequenting gyms, pools or other establishments given the rates of infection in our area.
JAIN: I would avoid the gym at the present time. Running and walking at the gym are high risk because people will be breathing heavy and transmitting the virus. Also, recent evidence is showing the virus has airborne transmission in addition to droplet transmission. Hence 6 feet may not be sufficient in places such as gyms or places where people yell, shout, or sing.
McCULLERS: No to gym and pool. No problem walking or running in the neighborhood if uncrowded. We have been playing some tennis with good social distancing.
OGARI: I would not go work out at a gym or swim in a pool at this time. I walk in the park late in the evenings when the park is mostly empty. I have my mask with me in the event someone is also walking.
THRELKELD: I don’t use a gym at the moment. Adequate ventilation can be a key, so I would probably swim in an outdoor pool where adequate distancing can be maintained. Obviously outdoor runs and walks are ideal at the moment.
Q: Are you making routine trips to the doctor or dentist?
CROCE: I haven’t had to yet, but I will.
FORBES: Yes but practice appropriate precautions.
HOWARD: I have not needed to make any routine appointments for myself. I have taken family members to routine but necessary appointments for health maintenance.
JAIN: Yes, I would make a routine trip to the doctor. Lots of precautions are being taken. I would avoid a routine trip to the dentist.
McCULLERS: Deferring some for now (my wife had to go once, I skipped).
OGARI: Only the required visits that I am unable to do telehealth. I have a few coming up.
THRELKELD: I’ve had to be seen in a doctor’s office once, but I must confess I have otherwise avoided routine office visits. But I’m a better doctor than patient!
Q: If you had young kids, would you send them back to school in the fall?
CROCE: Not without a reasonable plan to protect the children and teachers.
FORBES: I would not at this time but not everyone has the ability to tend to their kid’s education remotely so it has to be an individual choice. They must learn good hand hygiene, manage acute illnesses, and ensure social distancing in the classroom while wearing a mask at all times.
HOWARD: I have a daughter in secondary school. Yes, I am comfortable supporting her safe return to school as long as appropriate precautions are in place. Appropriate precautions should include: Screening of all entrants to the building; Wearing of face masks; Effective social distancing inside (classes & lunch) and outside (before & after school socializing, and sports practices); Frequent cleaning of shared spaces; Adherence to the local Health Department and government recommendations.
JAIN: At present I am concerned about the rising case numbers. I would want greater levels of precautions such as covid testing of teachers and selected schools with low-cost “pooled testing” with a simple nasal swab once every 2-4 weeks. We need to be doing more asymptomatic testing in the workplace and the school.
McCULLERS: Yes.
OGARI: I have a 7-year-old I would send back to school, if the school takes all the necessary precautions to protect my child - maintaining social distancing everywhere in the school, disinfection of classrooms and all common areas, strong mask policy, etc.
THRELKELD: That would depend on a combination of the current infection rate in the community and the precautions and plans the school had set up, including what to do about the cases that would inevitably occur despite our best efforts to prevent them.
Q: Have you been tested for the coronavirus?
CROCE: Twice. Negative both times (knock on wood!). We have routine testing at Regional One Health to keep out patients and staff as safe as possible.
FORBES: No.
HOWARD: No, I have not met testing criteria.
JAIN: Yes I have been tested with the nasal swab which is a PCR test and tells me if I have an active infection. Also I have been tested with a blood test which is an antibody test and tells me if I have had an infection in the past. Both were negative.
McCULLERS: No.
OGARI: No.
THRELKELD: I’ve had antibody screens as part of routine surveillance maneuvers but thankfully have not had any symptoms to date.
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Topics
Jon McCullers Lillian Ogari Stephen Threlkeld Manoj Jain Martin Croce Kathleen Forbes Cassandra HowardDavid Waters
David Waters is Distinguished Journalist in Residence and assistant director of the Institute for Public Service Reporting at the University of Memphis.
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