This is an edited transcript of an interview on Wednesday, Oct. 20 with Dr. Richard A. Bunio, Cherokee Indian Hospital Authority executive clinical director, about current COVID-19. Chris McCoy, Director of Communications is the host. It is aired via Cherokee Cablevision Channel 28, livestreamed by Communications (replays online may be seen at several tribal social media pages).
Most of the little clusters that we have found are related to gathering and I think it is worth talking about what we mean by that. What is a gathering?
A gathering is anytime you are getting a group of people together that are not in your immediate circle or your immediate household. This is where we know the virus can spread really easily and really fast. Things like cookouts, birthday parties, weddings, funerals, any group of people that don’t live together. And its particularly dangerous when they are inside. There is no good air circulation inside so the virus can spread quicker. It’s worse if you are not social distancing. If you are inside and you don’t have enough room to put six feet between you and the other person, that is particularly bad. And if you don’t wear a mask and unfortunately we are seeing this in the community.
People are tired. They want to see their friends and families. I understand that but that is why this virus is now surging. It’s a little bit out of control right now.
You can have a family come visit another family and they can stay outside, and they don’t have to social distance within their own family. They live with those people. You can have one family stay six feet away from the other family (outside) and you can have a visit. You have got to just follow the three W’s. You have got to wear your mask, wait, and you’ve got to stay six feet apart. And you’ve got to wash your hands.
One of the things we have seen at these cookouts (not taking precautions in food preparation and serving), and we need to talk about Thanksgiving. If you set up a buffet were people serve themselves and everybody is touching the same serving utensils, that is a potential area of spread. It’s much safer to either have one person prepare the plate, they wash their hands and wear gloves and mask, prepare plates for other people to pick up and go and eat further away from other people or within their household group. So it is a risk when you set up buffet style and one person takes a scoop of potato salad and the next person uses that same spoon.
The CDC (Center for Disease Control) has come out with what is the safest and what is moderate risk and what is high risk. The safest is that you have Thanksgiving with your household. Its an opportunity to get together with your own family, your together all the time, you have a nice meal, you don’t have to wear masks. You don’t have to social distance, because you are already near each other. An alternative is doing it virtually in some way. You have your meal, and you have a call with friends or family.
One other thing to remember, Black Friday comes after Thanksgiving, a big, big shopping day. Do your shopping online. Do not go to these large crowds where they are trying to get this discounted TV. We ask you to wear a mask when you cannot keep your distance. If you ask me, distance trumps mask wearing, which trumps hand washing. So, if you can keep your distance that is the best prevention. You wear the mask when you can’t. When you are at WalMart, you can’t control when someone is going to come down that aisle and be within six feet of you. You wear the mask when you can’t, but social distancing is the most important. And that is what the public health goes by. If you are wearing a mask and you didn’t social distance, and that person ended up positive, you are still going to have to quarantine. (The masks) are good, they help prevent you from getting sick, but they are not 100 percent.
I feel like we are doing a little better on the contact tracing reporting. We have over 300 people who are supposed to be in quarantine. These are people who are identified as contacts. How can you avoid getting in quarantine? Don’t put yourself in a situation where you might be a contact. Back to Thanksgiving, what we have described (following the CDC recommendations), you are pretty safe. If a family member in your immediate circle gets it, your stuck. You are going to have to stay together for 14 days.
The second-best option for Thanksgiving is to hold it outdoors. There is a lot more airflow. It’s a lot safer. Be outdoors and do social distancing. Have only one person prepare the plates and serve people.
Worst option is crowded spaces, where you can’t social distance and if people are not wearing their masks, particularly indoors. And that is where a lot of the current large spike is coming from, events where multiple families are gathering.
We understand things like a funeral. There are safer ways to do that, to pay your respects, graveside service, outdoors, social distancing, wearing a mask. Again, it just all goes back to those three W’s. We understand that that is a difficult time for those families and they really feel the need to support each other. It’s really tough. This virus is hurting people in a lot of different ways.
We are seeing more people get the virus, so we are seeing more people who have different symptoms and prolonged symptoms. There are a lot of people, particularly in this young age group, I think that they think they can get the infection and they will be okay. There are two problems with that line of reasoning. First of all, it is not true. There are a lot of young people who end up with this fogginess and fatigue and ongoing symptoms. And second, we are now seeing an increasing number of cases where people have caught the virus, recover, and they catch it again. And it is not necessarily that the second infection is easier. We think that people have a little bit of immunity (after recovering from the virus). We catch colds every year. We have never developed an immunity to other coronaviruses. The idea that we can get this “herd immunity” is not really solid. Herd immunity is the idea that enough people will be immune to a virus so that the rest of the community won’t catch it. The only diseases that we have developed an effective herd immunity for are the ones we have vaccines for. We never developed any sort of herd immunity to measles or mumps until we had a vaccine.
I want people to be cautious. The strategy of catching the disease in the hope that it will give you more freedom and immunity, that is just not backed up by science. Some people take a chance, and they go to a gathering. People have done that and have gotten away with it. But our test positivity rate is ten percent. So if there is more than ten people at the gathering, chances are one of them has it. It may be an asymptomatic spreader or someone a couple of days before they show symptoms, which really brings us to another important point: for Thanksgiving gatherings, if you are sick, stay home. I hate to say it, but if you think you have allergies, there is no way to distinguish allergies from COVID-19 unless you have a COVID test. If you have any kind of symptoms, loss of taste, smell, cough, runny nose, fatigue stay home. The message is-if you are sick, don’t go to a gathering.
There is a survey out in the community that I encourage everybody to take. It is going to help us understand what attitudes toward the virus are and particularly to the vaccine. We don’t know when it will be out, but when it comes out, we want to know how many people are going to take it right away. Obviously, we are not going to force anybody to take the vaccine, but we are planning to give as many people the vaccine as want it. We want to know how many are going to take it. Some people are really confident and say give it to me right away and there are others who go “well, it has been kind of rushed a little bit. I know that. My feeling is that it is being rushed politically but the science is still pretty solid. If the vaccine comes out, we believe it will be safe. Having said that, we don’t have the years and years of experience with this one that we do with the flu shot. By the way, we have been seeing a real good response to the flu shots. Do that. Get your flu shot. Here is the best reason to get your flu shot; you don’t want to get the flu, because if you get the flu you might think you have COVID, and then we have to stick that swab up your nose, which is not terrible but its not comfortable. You want to avoid getting sick and the flu shot is the best way to avoid getting the flu and then having to go through all of that. Wondering “is it COVID or isn’t it”. It is still early to see any cases of the flu. This spike in COVID came a little earlier than I thought it would. Again, I am just appealing to the community, get your flu shot.
Public health is working extremely hard and I’ve got to say to the community we cannot test and contact trace our way out of this. Everybody has to do their part. People have to stop putting themselves into the position of catching it. For a little while, at least till we have a vaccine and then we will reassess things. Our sense is that our elders are doing that. The biggest spike is in this younger age group. It is really tough for a grandparent not to hug a grandchild or spend time with someone that they love. So don’t put them in that position. Don’t put yourself at risk where you could be spreading the virus to an elder.