United States, China, Dr Padillia discussed on Short Wave
You're listening to shortwave from NPR. The new corona virus is on the move from China to Europe here in Italy at this point the country has been divided into three different areas. There is the red zone the yellow zone and then the rest of Italy and the United States Washington state remains the center of attention as Karuna. Virus SPREADS QUICKLY RESEARCHERS. Say The virus may have been circulated in the area for weeks. Undetected and more cases are likely in New York. Experts warn the virus will spread their cases. Keep popping up and when they do. Some governments are responding with one of the most powerful tools they have quarantines doctor. He'd Padillia knows a thing or two about quarantine. You are a person not only under investigation for potentially developing a disease. But you are a person who's trustworthiness is. Now come into question you know. Will you follow the rules? And You keep them safe from you. She's an infectious disease. Specialist was quarantine twice after returning home from Sierra Leone during the Ebola outbreak there in two thousand fourteen sudden. Change that you see in people's faces it's like you are a human but all of a sudden you become a threat to them today in the show. We'll talk about what? Corentin actually gives why this virus is so good at reading it and what steps the United States might have to take to contain the novel Corona Virus. Dr Padillia is the medical director of Special Pathogens Unit at Boston University. And so she's been paying close attention to this latest outbreak of the novel. Corona virus and the efforts to stop it. I it's important to understand why this virus is hard to contain a lot of the symptoms. It causes are the same as what people experience when they get the cold or the flu on top of that. There's some evidence that people can transmit the virus before they have symptoms and perhaps even after they feel better and even if that doesn't happen often. It's still a problem when you're trying to track an outbreak. Because if you don't have symptoms you're not gonNA come to care and if not gonNA COME TO CARE. We won't know that you're sick and hence be able to do contact tracing which is basically looking for anybody else you may have been in contact with. We didn't really have a test for this virus until February and initially in the states. We were only testing people who had traveled to places with outbreaks or people who had been in contact with somebody who had the disease now. Public Health officials have expanded. Who can be tested? Which is why all these new cases are making the news. Yes I think that's playing a major role in the identification of some of the cases and I also think that's going to lead to new cases being diagnosed during this week in the United States though just to be clear Dr W. says that doesn't necessarily mean there's a big spike in the number of people who are sick. We're probably just identifying more people because we're testing more people. In when these cases appear local governments are taking action in King County Washington. The government is buying an entire motel to use for quarantines. But what is quarantine so quarantining Is the is the practice by which we separate those that we think may have had exposure to a disease of interest from the rest of the community and the reason to do that is because if they develop symptoms We want them to be separate at that point from other. So they don't transmit that disease to others. Gotcha Gotcha so individual quarantine obviously is a very different thing than mass quarantine which is trying to quarantine huge groups of people Tell me a little bit about that. There are temporizing measure rate. I mean if you have bleeding in your leg you can cut off your circulation to stop leading but that's just a temporizing measure Until you can figure out how to fix what's going on and it's the same thing with Corentin I think it works early on If you can sort of separate people in in a smaller outbreak becomes much more difficult as the outbreak of the epidemic becomes bigger. Because now you're talking about a bigger group of people. Can you talk to me about some of the costs of quarantine? Because you know. They're not all economic right. There are psychological and social tolls on a person were a community. Yeah I I'm glad you brought that up. But I mean I think even before I start with the sociological aspects in the psychological aspects. I mean let's just talk about the logistic aspects of it. The cost is a big thing because you now have a huge number of people. It's not just the direct cost of putting somebody in quarantine but you are taking them. If they are a working adult you are taking them out of the workforce. And if you do that for massive number of people you are basically halting entire economic sectors But then there is the logistics cost on the aspect of it. Which is if you quarantine people. There needs to be a plan to basically feed them. You know engineered to get medications that they need if they get sick. So there's that element and then then. There is the sociological and psychological aspects. In the stigma. 'cause what you're being told that you are potentially a threat to society and so there's the figuring out the logistics of how do you have you sort of survive you know within? Cro- close quarters alone for long periods of time and the second is the loneliness of it you know I remember for being. Thank you know I for both of my sense of quarantine. I was desperate for company NUMB. And so of course we recognize the importance of separating folks who may be at high risk of potentially developing disease. You know you have to take into account. What else is going on in their life. And what kind of support. They need psychological support that they need as they go through with it. What are some of the steps that we might see the? Us government take before or instead of quarantine so asides from having more information out there. I think some of the steps that you might see public health Officials do is cancelling delaying large events. Such as sports games or or concerts or conferences In areas where there is sustained number of cases The other steps that public health officials may take is is really encouraging if they have symptoms of their if they're worried about it to contact their healthcare providers or if they're in a state that has a dedicated hotline to really sort of go through whether or not they should come to care. Actually stay at home. You're healthy person has symptoms. I think the best strategies for you to stay at home until you get better rather than go to work or go to the hospital so I've also heard people talking about school closings which I think could be really tough especially on parents who may be can't take time off to stay home with their kids right. Yeah I think that for every step that we take the public health realm There's going to be consideration of how we can. We are going to mitigate the impact of those steps on people and that's what helps us ensure that there is adherence to recommendations right. An so school closings are are an excellent example. Because you're not only asking that student to stay home but you're asking that parents to stay home from work may or may not have the job security to be able to do that so thinking through how you support parents who are going through that in a district where we've closed. The school is GonNa Be Important. Right Right Okay. So as a person who works in infectious disease who works in hospitals has experienced quarantine themselves. Do you think the United States is prepared to quarantine large groups of people? I think we need a little bit of work on that. Whol actually has a wonderful guy that they released poor countries as they're thinking about mass quarantines and one of the things that I talk about this importance of community engagement and outreach to really explain to a wide as being done and the importance of it if it is being pursued and so if we are going to do it aside from the Logistics Readiness. I think one of the things to think about that the US may have to do is massive amounts of community outreach to ensure that people understand or sections of communities understand why this is being done. The other part of this is we have to see aside some quarantines if they are perceived we have to invest in behavior change and community engagement because that is more sustainable and probably in the end. What's going to help? Stop the epidemic. Yeah so I guess one of my questions is if we got to a point where we needed to do you know big quarantines in the United States would it really be effective here versus a place like China which obviously has a different government setup? I think whether or not The mask oranges United States. Work are it's dependent on a few different factors right. Anything can work if you throw enough. Resources added if you're not willing to put enough manpower to make sure that you know something goes. According to plan. Then the question becomes is that the most effective way of spending resources but regardless of whether or not we pursue quarantine. I think the important thing to know is what makes quarantine effective in certain communities I. It's not as the amount of effort you put into engagement without community and the people that you are quarantining education about why that's being done and ensuring people that there needs both economic logistic and ability to survive while in quarantine or Matt. Yeah so I know there's been some back and forth about whether or not Corentin has been successful or not in in this case whether or not global efforts have helped slow the virus at all or have been a waste of resources. How do you see that I think majority of the attention been on China on whether or not the very strict restrictions that they placed in travel and quarantining entire cities? Actually help As I mentioned earlier I think quarantine is always a balanced between individual taking away an individual's freedom versus the potential benefits. That you might get from taking such a step despite my own unease with with massive quarantines you know. I do think that there are people who would say that this roic efforts you really call it a sacrifice on on the part of the Chinese people because they didn't stick with that strict quarantine orders they were given by their government It did bias time. It didn't stop it nor do I think at that point would have been effective in stopping it Did it by as potentially more time to prepare here and everywhere else and I think it probably did but at what cost and did we more importantly did we take advantage of that time. Dr. He'd Padillia is an infectious disease. Physician and the medical director of the Special Pathogens Unit. At Boston University you've been listening to shortwave from NPR. Today's episode was produced by Rebecca Ramirez. With engineering. Help from Josephine Neo. Nai It was edited by Jeff. Brumfield in fact checked by Emily. Von I'm your host Mattie Safai Cenex.