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Have a question about coronavirus, also known as COVID-19?

We will ask the experts.

Send questions to tribdem@tribdem.com.

A reader of The Tribune-Democrat asked:

After much concentration with social distancing and staying at home I inadvertently drank from a soda my granddaughter had been drinking from. She is from a family of four with no apparent symptoms. I am 70 years old with Type 2 diabetes. Is there testing we should have done following this incident or any additional measures? Im nervous that after all my efforts the past 2 1/2 months that I will contract the virus.

The answer:

I congratulate you on all your efforts and safe practices. In my opinion, no testing is indicated unless you develop any symptoms or fever, and no additional measures are needed.

I believe your risk is very low concerning the one incident which you described, and I would not worry. I do recommend that you continue social distancing, good hand washing hygiene, and wearing a face mask. Youre doing a great job!

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

My employer has required me to havetwo negative tests before returning to work. How long do I have to wait after my first negative test before I can get my second test?

The answer:

The CDC has placed guidelines concerning returning to work after recovery from COVID-19.

These guidelines state that an individual should havetwo consecutive negative results of an FDA-approved COVID-19 molecular assay for detection of SARS-CoV-2 RNA from at least two consecutive respiratory specimens collected greater than 24 hours apart.

Therefore, the least amount of time between testing that can occur is 25 hours.

It is important to point out that an individual must havetwo consecutive negative tests, and results for these tests can take several days to be returned to the individual.

Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

I am a personal trainer who has had an 89-year-old client request that I come to her home to train her. Besides being a trainer, I also have a part-time job at a regional airport near my home where I handle bagsand check in passengers, as well as cleaning the plane. I am very careful when I work about wearing a mask, gloves, using social distancing and washing my hands. Is it safe for my client if I train her?

The answer:

Im glad that you are using personal protective equipment (PPE) and practicing good hand-washing hygiene. The question of risk exposure for an 89-year-old individual is not insignificant, even though you are taking appropriate precautions.

In the United States, the highest incidence of severe outcomes with COVID-19 were in patients older than 85. Therefore, visitors other than caregivers are not recommended.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

I am 75 and have Post Polio Syndrome, chronic bronchitis and shingles. My husband is going back to work at an auto glass manufacturer. How can I isolate in my home? We also have three dogs. Could they carry the virus to me if he gets sick?

The answer:

Self-isolate in a private room and use a private bathroom, if possible. Wear a mask when you enter general living areas. Follow other Pennsylvania Department of Health and CDC recommendations and precautions including good hand-washing hygiene and frequently clean with a sanitizer common surfaces you may both touch.

CDC is aware of a small number of pets worldwide, including cats and dogs, reported to be infected with the virus that causes COVID-19, mostly after close contact with people with COVID-19. Based on the limited information available to date, the risk of animals spreading COVID-19 to people is considered to be low.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

I have symptoms of COVID-19 and am scheduled to do my test this morning. It will taketwo days to get results. Is it safe to use my inhaler and nasal spray? And if my test is positive, is it safe to use my inhaler and nasal spray?

The answer:

Im not aware of any inhaler and/or nasal spray contraindications with SARS-CoV-2 (COVID-19). I recommend that you follow-up with your primary care physician.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

If the virus has a very short life in/on non-living environments, why is it so important to deep clean spaces that have been vacated for several months?

Wouldnt routine cleaning suffice before the space is occupied again?

The answer:

Cleaning spaces that have been vacant for several months with a deep cleaning is a good idea in general. Many microbes could be present on these surfaces (Staphyloccous and Streptococcus species for example).

There have been news stories circulating that the CDC has changed their guidelines on how SARS CoV-2 spreads. This is untrue. The CDC merely placed the contaminated surfaces under a subcategory stating that the virus does not easily spread via contaminated surfaces. Both the old and new versions of the recommendations state that it is known that the virus can survive on contaminated surfaces for hours to days depending on the surface.

The best way to reduce risk of infection is to wash your hands regularly and clean surfaces with soap and water followed by a disinfectant.

Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

My husband had COVID-19 symptoms, a sore throat,and because he is 63 years old, we wanted to check to see if he is OK. His results came back positive and he is on a 14-day quarantine. We have now all been tested in the family. So far my youngest daughters results came back negative. Should she move out to be safe?

The answer:

I am assuming the test that all of you received was the genome test. If your husband was positive for the genome, that is indicative of an active infection. This means he is contagious. He needs to quarantine himself and limit the exposure to other family members. It is recommended that high-touch surfaces be cleaned multiple times a day as well.

It is prudent for your daughter (and any other family member who tested negative) to self-isolate in a separate part of the home. Since she is currently living in your home and your husband tested positive, there may have been exposure to SARS CoV-2 since the testing. Testing gives us a snapshot of what is occurring, and since you are all in the same household, there could have been exposure after testing.

If she has a place to go to for 14 days where she is not risking exposure to others, you may want to consider having her go there.

Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

If I pick up the virus from someone at noon, how soon do I start infecting others?

The answer:

A small number of studies suggest that some people can be contagious during the incubation period, the time between exposure to the virus and the onset of symptoms. The incubation period for SARS-CoV-2 (also known as the COVID-19 virus) is estimated to be between two and 14 days, with a median of five to seven days (possibly longer in children). Greater than 95% of patients develop symptoms within 10-12 days of infection.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

My ex and I have shared custody. She just called to say shes in quarantine waiting for COVID-19 test results. I have the children now, but she had them last week before her quarantine.

Do we need to quarantine now until we hear her results? From a concerned father.

The answer:

Yes, self-isolate to your home while you wait for her results. Whoever else lives in your home should also stay at home. Close contacts are people who have been withinsix feet of you for a period of 10 minutes or more. If you or the children develop symptoms, notify your health-care provider for instructions and testing.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

How can I keep COVID-19 from spreading in my home once I turn on my whole-house air conditioning? My husband works and I am doing my best to isolate him in his room and a bathroom across the hall.

The answer:

There have been two studies that show the airborne droplets containing SARS-CoV2 can spread farther than six feet when the airflow in a room is increased (either from an air conditioner or a heating system). These systems often draw air in from a room and cool it, sending the cool air throughout the home and the heat outside. This type of system has the potential to circulate the virus in a home if someone is infected.

A study out of the University of Oregon together with the University of California-Davis says the best way to reduce the spread of the virus and still ventilate a room is to open a window. Opening a window in the home will reduce the possible virus concentration by increasing the concentration of air from the outside.

If you cant open the window (allergies, asthma, 95-degree heat) and there is concern that someone in the home is infected (showing symptoms, asymptomatic or exposed), you could block the intake vent in the room(s) that individual is isolating in.

Duct tape can cover the vent and help to reduce the spread of the virus through the home.

Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

Is there a COVID-19 test my 3-year-old grandson can take that would allow him to stay with us for a day or two if he tests negative? I am 71, and would do anything to see him again.

The answer:

Molecular (Polymerase Chain Reaction PCR) swab test detects RNA from SARS-CoV-2, also known as the COVID-19 virus. If the PCR is positive, the patient is considered infected with the COVID-19 virus and presumed to be contagious.

You mention testing your grandson, but also consider testing the grandparents as well. However, it is important to emphasize that a negative PCR does not exclude COVID-19.

Also, realize that the mean incubation period for COVID-19 is five days, and the range can be two to 14 days. This means that a negative result does not rule out infection.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

If a persons antibody IgGand IgM came back positive, are they able to spread the virus because of the IGM result?

The answer:

Testing shows us a snapshot of what is happening with a person andhis/her course of disease. The two types of antibody tests are looking for a particular type of immune response.

When we are exposed to a pathogenic microbe, our immune system has two ways to defeat it.

The first is called the innate response. This response is encoded in our DNA as a human.

It is nearly the same for all of us (with minor differences). This response causes inflammation. It is non-specific and only reacts to each pathogen based on its particular type.

For example, all bacteria are treated the same. It cannot distinguish Streptococcus pyogenes from Staphylococcus aureus. It doesnt distinguish an adenovirus from the Ebola virus.

Most of the time, this innate response kills the invading microbe. When it doesnt, that is when we see symptoms of a disease.

When the innate response cant destroy all of the microbes, then we see the adaptive response.

The adaptive response is specific. This response is different in every individual.

We have a complex immune genetic system to take gene segments and piece them together to create an entirely new gene. Its called somatic recombination. Our germline DNA is pieced together to give us a new never before seen gene to fight a specific pathogen.

That gene is then turned into a protein and made into an antibody for the specific pathogen.

The first antibody made when fighting that response is IgM. If this is found in a test, it indicates the person is in the early stages of the specific response to the virus. IgG is made later, about 14 days into the infection, in the specific response and is often the antibody that allows our immune response to remember the infection (it is made for a few months to years afteran infection).

If a person tests positive for IgG, thatwould suggest theindividual was infected sometime in the past. Ifhe or she is symptomatic, theperson would still be able to transmit the SARS CoV-2 to others, but in most cases the IgG test would be positive after the disease has run its course.

Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

If a person had COVID-19 in the past, lets say in February, and takes the testagain in May, is the test going to show negative? In other words you could have hadcoronavirus in the past and it would test negative now?

So, the only way to find out if you had it in the past would be the antibody test, correct?

The answer:

Great questions, and it all comes back to testing and more frequent testing. Theres some very recent positive data out of South Korea which Ill discuss below.

Your questions refer to the different types of tests. One test is the molecular swab (Polymerase Chain Reaction PCR), which detects genetic RNA from SARS-CoV-2, also known as the COVID-19 virus. The other test is a blood IgG antibody, which determines if someone was previously infected, or was recently exposed to the virus 10-21 days ago.

If you had COVID-19 infection in February, the PCR swab test would probably be negative now, and the blood IgG antibody test would probably be positive (indicating prior infection). Recent data out of South Korea suggest that if the repeat PCR swab test is positive, that may be detecting dead virus, rather than indicating reinfection. And the positive IgG antibodies may provide some protection.

Because the pandemic is only a few months old, there is no data on long-term immune response.

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Experts answer your COVID-19 questions: 'Is there testing we should have done when drinking from my granddaughter's soda or any additional measures?'...

This entry was posted on June 4, 2020 at 10:47 am and is filed under Genetic medicine. You can follow any responses to this entry through the RSS 2.0 feed. Both comments and pings are currently closed. |