On April 1, 2020, Icilma “Dr. Icy” Fergus, M.D., a cardiologist an associate professor at Mount Sinai Medical Center in New York and past president of the Association of Black Cardiologists, hosted a coronavirus Q&A on Black Health Matters Facebook Live.
What follows is an edited version of that session.
Are you protected from coronavirus if you are younger than age 60?
Dr. Icilma Fergus: Unfortunately, we have seen a number of young individuals who have contracted the virus. This may occur even without an underlying condition; there is now some evidence to suggest that one possible etiology may be due to an overwhelming response of the immune system. Some may have underlying condition. So, you are not necessarily protected because you are young. Everyone should assume, at this point, that everyone is potentially infected and take the necessary precautions. Which, as we know, means social distancing at least six feet apart and, of course, general good hygiene. Hand washing, making sure surfaces are clean, surfaces are wiped down, etcetera.
How long does coronavirus last on surfaces?
The best data we have at this time, corroborated by recent research and experts like Dr. [Anthony] Fauci, is that the virus lasts in the air for about three hours. You may have heard about the choir of about 60 individuals who were practicing social distancing. Despite that, 45 people came down with the virus. At the time, even though they were practicing social distancing, when you’re singing, there is sort of a forceful exhalation. So, the actual particles could be disseminated and, in this case, aerosolized. Now we know the virus can be spread just in regular exhalation. This most likely one of the reasons why [so many members of the choir] came down with the virus. Nevertheless, the virus is stable for three hours in the air, four hours on copper surfaces, 24 hours on cardboard, two to three days on plastic and stainless steel. So, it can persist. It is very viable. But, again, if you practice safe, clean and well-done hygiene, it should be fine.
Should we wear gloves?
When wearing gloves, you still have to practice safe management and safe hygiene. If a contaminant gets onto the gloves, when the gloves are taken off incorrectly, or, if those gloves are used to touch different things, everything, including the hands, may subsequently become contaminated. You can either double glove when you are in areas you think may have high viral particle counts or change gloves. When changing, be sure you are not touching the tips or palms of the glove or the contaminated areas. Still practice good hygiene. Still use hand washing techniques with soap and water, preferably after taking gloves off, or use wipes if no soap and water [is available].I believe [experts say] gloves may not be that helpful is [because] people get a false sense of confidence when they’re wearing the gloves. They may end up doing things they ordinarily wouldn’t do with their hands, which could also put them at risk if they are not careful.
Should we wear masks?
Right now [April 1], the CDC is considering whether everyone should wear masks. My recommendation is just assume at this point that everyone is potentially infected. As a health–care provider, I am wearing a mask with my patients. But for those who definitely have an underlying condition or those who may be susceptible, they should wear a mask. If you are going to be going into a crowded area, then you should wear a mask. If you don’t have a mask, other types of covers could be used, like, a bandana or a scarf. This may not prevent you from getting the virus, but if there are droplets or heavy particles in the air, this can actually reduce the virus from getting in—or out if you are the infected person. So, (wearing a mask) is helpful. But if you have infected material on the outside of your mask and you touch it with your hands, you could carry the infection from one place to another. So you’re going to remove the mask as if the front were contaminated. Always assume something is contaminated because you never know.
Is there any information on whether or not you develop immunity after recovering from coronavirus?
As of right now, what we know is that people who have recovered have antibodies in their blood. And, in fact, what we are doing right now in the hospital is some of these individuals are giving their plasma. The plasma is being given to some of the sickest people with the thinking that the antibodies in the plasma can help heal and protect them. I don’t know if a new strain can afflict us just like with the flu once this current pandemic passes. But if a new strain comes, that is something we would obviously have to be concerned about and hope a vaccine would be protective.
Is coronavirus airborne?
We know it is aerosolized, so it is airborne and can be transmitted after a cough or even some people when they talk, due to droplets of saliva in the air. We just talked about the fact that there were 60 people in a choir who practiced social distancing and yet 45 of them came down with the virus. Therefore, it was aerosolized, and definitely it is in the air. And, as I mentioned, it can last for at least two to three hours in the air.
If you have tested positive but no longer have symptoms, what are the recommendations for when you can come out of self-isolation? Is it just the 14 days?
The virus’ infective capability in the body is believed to be about 14 days. The data is constantly being updated, but it is now believed that if after 14 days your symptoms are gone, if you no longer have fevers, none of the symptoms, and have tested negative twice within a 24-hour period, you may be presumed to be clear. We don’t know if there is a second curve to come in another season. I would say if you’re going to be working in a very [high–risk] environment, tests to determine that you are indeed negative [may be required].
Does it help to spray Lysol in your home?
That’s a good question. This virus is not alive but it has proteinaceous material that needs to connect to biologic material [to infect you]. If it is laying around or sitting in the air, and then it gets into your nose or mouth, then it’s going to start to replicate. Lysol is an antimicrobial, so if there are particles in the air, it will diminish those particles. It would be very helpful in terms of diminishing the number of particles in the air. But, again, you still have to practice all the safety guidelines.
Will rain wash away the virus?
Oh no. Actually, you can go to the World Health Organization [website]. There is information about how weather affects the virus. The virus is not affected by rain, cold weather or hot weather. Thus rain will not make a difference. This is not to be confused with seasons or climate, where there may be a correlation with a lot of virulent infections that happen, such as the flu that comes around in the fall. There is a prediction that there may be a second strain or second infection [of coronavirus] coming in the fall. It may be a slightly different version. With vaccines it is hoped we may be able to manage the coronavirus much like the flu, but we don’t know at this point. Hopefully, vaccines will be available by that time and can be used to combat the virus.
What should you do if you don’t have symptoms and have never been tested? Is it safe to go out?
There is already a very large number of people who have been affected—maybe as high as 50 percent—who may not even know they have the virus. So yes, it is important to worry about being infected by an asymptomatic person who is carrying the virus. Continue social distancing. As of right now, there is a lot of virus being transmitted from one person to the other. Until the Centers for Disease Control and Prevention, WHO and health public officials say it’s safe, I would say you have to assume the virus is still being spread. Currently testing is prioritized to those who have underlying conditions, those who are health–care providers on the front line, and those who have fevers and other symptoms. Unfortunately, not everybody is getting a test; maybe we will get there. There is also a test for antibodies to see if someone has been exposed to the virus, but [right now it is] mainly used in research and not yet widely available.
Why is coronavirus so prevalent in New York City?
First of all, New York is heavily populated. That’s one reason. And number two, there was a lot more testing done in New York City, so many people were detected. But mainly because of the heavy population, people congregating in areas such as Times Square, the subway system, the bus system. People weren’t necessarily, [a couple of months ago], practicing six-feet apart. So, of course, more people became infected. But I think other states are going to lag behind. They aren’t as densely populated. But we have not seen the peak yet, so it’s projected that the peak will go up for several more days before it goes down.
Can coronavirus be spread to and from pets?
At this point, they have not seen coronavirus in pets, like dogs and cats.* They aren’t transmitting it to people and people are not transmitting it to them. This question may be eluding to the fact that this virus is thought to be derived from bats, and there’s still research being done on that. But you don’t have to worry about getting it from pets.
*After this Facebook Live, a tiger at the Bronx Zoo contracted coronavirus, presumably from an infected worker at the zoo. The World Health Organization still considers human to human transmission the primary driver of coronavirus, but it now says it’s too early to say whether cats can transmit COVID-19 to humans.