Answered by Dr. David Aronoff
Questions were posed by the Tennessee Business Roundtable and member executives.
Answers were provided by Dr. David Aronoff, VUMC.
Q1: Does age play a role in someone being asymptomatic for COVID-19?
A1: Yes; younger people are less likely to have symptoms than are older adults.
Q2: Please comment on best practices for childcare options, as that is so cirtical for employees with children.
A2: This is not a simple one.
Daycare facilities may be open but they are likely reducing capacity. The CDC has some guidance for operating a daycare facility during COVID-19.
Businesses may need to be creative about childcare options, supplementing expenses for home care of children for example.
Fostering more work-from-home options with flexible hours might help too.
Q3: What are your views about whether schools and colleges can open and operate safely with the amount of COVID currently in our state and country?
A3: This is a moving target.
In-person classes might be very difficult when disease activity is high (>10 new cases per 100,000 persons per day, for example), and/or [is] on-the-rise.
Virtual classes, selective in-person classes for students who truly need in-class education, protecting vulnerable teachers and staff, etc., are going to be important.
The way Tennessee is heading [may not indicate likelihood of] in-person classes in August.
Q4: How does COVID-19 “end”? A vaccine, virus mutation, herd immunity?
A4: All of the above are possibilities, but likely, [a] vaccine will be needed.
So far, < 10% of Tennessee’s population has been infected; around 1% of the state population has had confirmed COVID-19. True herd immunity from natural infection requires a majority of the population to have been infected AND immune.
We still do not know how durable immunity is following infection.
Effective oral drugs to treat or prevent serious COVID-19 infections might be here before anything else.
Q5: Do we have data on age and COVID-19 infections over time?
A5: Age over 60 is a major risk factor fr doing badley, and over 80 years of age is really tough going.
Q6: Is there a lag in COVID-19 test reporting? My son waited eight days for results.
A6: The TAT (turnaround time) for tests can be several days. This has a lot to do with resources being limited due to high demand. The tests do not take long to perform, but if [test-processing] supplies are low, TAT can take a while. As the number of cases has increased across the country, we unfortunately have seen [prolonged] laboratory TATs.
We encourage people to stay home after they are tested: If they are symptomatic, this is a must; if they are asymptomatic, this is strongly encouraged.
Q7: Are there any data points on types of masks that are most effective? Do masks actually stop molecules from transmitting, or just lessen the volume/velocity of transmission?
A7: Cloth masks absolutely prevent a cloud of infectious respiratory droplets from creating their usual cloud around the mask wearer. They protect others from the mask wearer.
This NPR report is a good one on that subject.
The data absolutely support mask-wearing. Observational studies during COVID-19:
* SARS-CoV-2 Infections and Serologic Responses from a Sample of U.S. Navy
Service Members — USS Theodore Roosevelt, April 2020
* Absence of Apparent Transmission of SARS-CoV-2 from Two Stylists After
Exposure at a Hair Salon with a Universal Face Covering Policy — Springfield,
Missouri, May 2020
Q8: How can we share some best practices from larger companies that are executing anti-virus efforts at a high/advanced level?
A8: You might want to create peer groups of similar businesses to share best practices.
Q9: With limited contact tracing resources and increasing cases, local health departments seem to be broadly instructing potentially exposed individuals to quarantine for 2 weeks. Having large numbers of employees out as a precaution has the potential to severely impact the ability for essential businesses to continue operations. At the same time, a workplace exposure would also have a similar impact. What should employers do to mitigate staffing shortages?
A9: Public health acknowledges the essential role of some workers, and therefore allows them to continue working even after being identified as a “contact” to a case of COVID-19.
If an essential employee was possibly exposed, that employee should work from home if possible for 14 days from the day of exposure.
If an essential employee must work on-site, applicable guidance from the department of health concerning exposed or infected employees must be adhered to, and safety measures must be implemented, including (but not limited to):
* Be masked at all times.
* Be separated from others by 6 feet or more to the degree possible.
* Be closely monitored for any symptoms or illness.
* Practice strict hand hygiene.
Q10: What’s the cumulative effect of adopting/promoting multiple anti-corona virus measures (e.g., masks, distancing, hand hygiene, etc.) concurrently? Do they work together to combat corona virus spread more than each practice does individually?
A10: YES, YES, YES:
Distance is the most vital; then
Blocking the virus (plexiglass, walls, masks); then
There is no single “magic bullet” against COVID-19; all of the above measures are extremely important.
Q11: In the overall fight against coronavirus, how much would it help if employers were to actively support/facilitate mass testing for their employee populations?
A11: Not a ton, unless it were part of a specific broader government health effort.
We recommend testing symptomatic people, and also exposed asymptomatic people, probably at day 5-8 following exposure, assuming they’re still asymptomatic.
But beyond the above, it’s best to avoid getting into the testing business unless its needed.
We also want to reiterate that if an employee tests positive, there is no requirement for a negative test before that employee can return to work. We encourage use of the CDC’s symptom-based strategy for ending isolation. Persons recovering from COVID-19 illness should be isolated for at least 10 days after illness onset, and for at least 3 days after illness recovery; more here: https://www.cdc.gov/coronavirus/2019-ncov/community/strategy-discontinue-isolation.html.
Q12: When the virus spreads to levels which indicate “community spread” or a “cluster” within a company environment, what are the implications and consequences?
A12: The direct implications could be illness or death for employees, customers, and/or their families or housemates.
We know that a healthy community is the best way to support a healthy economy. To the degree that we can all work together to decrease disease transmission, it will help our businesses thrive.
COVID-19 12 Q&A by TN Doctors
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