During difficult times like these, many of us have a tons of questions.
Thankfully, there are highly intelligent people out there who have their finger on the pulse of all of this. I am certainly not one of them. However, Dr. Dan Grove, MD is.
He is both a doctor on the front lines and, unfortunately, a patient now as well. He is on the mend, getting over COVID-19, and here to help us better understand our new normal.
Here are some answers he gives us to two crucial questions. (They come from his blog My Covid Journey.)
Are package deliveries safe?
Dr. Grove reveals the following:
“Since this saga started about 2 weeks ago, I have received countless questions about issues relating to the coronavirus. I am not an expert on infectious diseases nor do I claim to be an expert on this virus in particular. I’m not really giving you any information that you can’t get from another source. So why am I doing this you may ask. The answer is that people have been asking me tons of questions. Because of how this virus is scaring everyone, people want a bit more of a personal explanation of what’s happening to ease anxieties. I’d imagine most doctors have had to take on this role of surrogate expert. In a way, this is a main part of our job. People are feeling overwhelmed by the quantity and nebulousness of the information and want someone to explain things to them in laymen’s terms. That’s what I’m trying to do. It is my sincerest hope that it helps.
One of the questions I have been hearing a lot recently is about the safety of package and take out food deliveries. With fewer people going to the store, many are turning to Amazon and the like to fill their house with all the stuff that occupies our space and time in the internet age. As the comedian George Carlin has said, “A house is a place to put your stuff, while you go out and get more stuff”. In this case we’re not going out to get the stuff, but the message is the same.
All this stuff is coming to us having passed through the hands of multiple individuals raising concerns about transmission of the virus. To review, the main ways the virus is transmitted is by large droplets in the air getting on you. This is only an issue if you are within 6 feet of someone who is infected and is prevented by social distancing. The other main way it’s transmitted is by the fomite-to face route ( to review that read my previous post How is the coronavirus transmitted). A package would be via the fomite-to-face route.
This issue with Amazon and other delivery companies turns out to be a serious problem. The Daily Mail reported that Amazon workers had tested positive at 10 separate US warehouses. Since their packages are going out far and wide, the virus could be spread easily. Now before you panic and burn the packages, take a breath, put down the blow torch, and read further.
The virus lives for different periods of time on different surface types. A correspondence in the New England Journal of Medicine (you can access it here) discussed data on the survival rates depending on the type of surface it was found. The virus was viable for up to 72 hours on stainless steel and plastic which are the biggest concern, think door and appliance handles. On cardboard, however, there was no viable virus measured after 24 hours.
This means that you can still get packages from Amazon. It also means you can get your take out food and stuff from the stores as well you should just take the following steps:
- When you get the package from Amazon, take it out of the box and throw the box out.
- If you need the item immediately, disinfect it before opening it.
- If not, you can leave it for 24 hours and then open it.
- For food containers, take the food out of the packaging and throw the packaging away.
- Wash your hands before you eat (you should do this anyways).
This is all good news. Those Amazon packages can be a life line of needed supply reinforcements in the battle against childhood boredom. Take out is also the main nutritional source for many young urban types as well so don’t worry if there’s only an old can of beer and a tupperware based science experiment in the fridge, you can have Door Dash tonight. Bon Appetit!”
Are you infected without knowing it?
Dr. Dan, who is right now quarantined in his basement and getting acquainted with the difference between drywall and sheetrock while blogging to help educate others answered this question by saying:
“One of the most challenging things with the COVID-19 pandemic is how rapidly information is changing. From one day to the next the recommendations seem to change making it almost impossible to keep up. At first this may seem like a flaw in the public health machine but often it is an unavoidable reality. The speed and extent of the spread of this virus is astonishing as you certainly have noticed. Decisions need to be made and interventions enacted on a global scale very quickly. This means that the decision makers have to decide what to do on the basis of imperfect and incomplete information. If they wait for more data to come in it may be too late. The downside is that the recommendations today may turn out to be wrong tomorrow as more research results come in.
Nowhere is that more evident than with the issue of asymptomatic spread and the recommendations for the general public to wear masks. Both the World Health Organization and the Centers for Disease Control and Prevention have repeatedly said that ordinary citizens do not need to wear masks unless they are sick and coughing. This recommendation was partially driven by a fear of shortages of protective equipment needed in hospitals but also by an incomplete understanding of the numbers of asymptomatic carriers and how important they were in the spread of disease. This information is what drove the CDC and WHO only to recommend sick people wear masks
The problem is that more recent data has come in that shows a higher number than previously thought are infected with the coronavirus but have no symptoms. They are then spreading the virus around without realizing it. If everyone were to wear a mask this unknowing spread would decrease. On the Diamond princess cruise ship 18% of patients never had symptoms but could spread disease. A more recent study in Iceland was most concerning. They tested 10K people regardless of symptoms. Of the patients who had contracted the virus, half were asymptomatic.
The CDC may change its recommendations and recommend everyone wear a mask. I think this is a good idea. Most people think that they are wearing a mask to protect themselves from being infected by someone else. In reality the masks are to protect someone else from being infected by them.
This data also underscores the huge importance of mass testing. Mass testing without regard to symptoms would identify people who have contracted the virus without realizing it and allow them to take appropriate isolation precautions. This would prevent them from unwittingly spreading the disease. Ramping up of testing has been a massive failure here in the United States (I documented my personal experience here). Countries who are testing more can be less strict about their social distancing and isolation restrictions because they can focus all these energies on those who are actually infected as opposed to a our approach which is like hunting in the dark with a machine gun. You’ll likely hit the target but a lot of other things will get shot up in the process.
If you can’t get access to masks when you go out, this does underscore the importance of strict adherence to social distancing and quarantine recommendations. You may be infected without symptoms putting people around you at risk without realizing.
Hopefully more testing will become available in the United States. Regardless of what the President says, we are not testing nearly enough people nearly fast enough and it’s fueling the fire. Until testing becomes available, it’s probably best to assume you are an asymptomatic carrier and take appropriate precautions. You can check this link out to find out how to make a mask for yourself.”
Stay safe out there!