Q and A with Dr. Maldonado COVID-19 Census and Ventilator Use

There are mixed feelings about re-opening states and whether it is too soon. However, many businesses—including hospitals—are suffering financially. Now that we are two months in, is it possible for COVID-19 and the economy to co-exist without doing further harm?

COVID-19 will not just disappear and we have to learn to live with it. Our lives will not be the same for a while, probably until a vaccine is available or until the majority of people have developed immunity. That will easily take another year and we cannot stay in quarantine that long. Cases will continue to occur. Reopening the country is necessary. We needed to buy time and flattening the curve helped us with that. Today, we feel better with our ability to test people, we understand the disease better and understand treatment strategies, we have enough beds, and we are trying to keep up with our supplies of personal protective equipment. We must understand that we still do not have a specific antiviral therapy that is proven and accessible to everyone. Many treatments are being studied and hopefully soon, we will know which ones really work and will be accessible to hospitals and physicians, so we can treat our patients. I expect that to continue to improve in the next few months.

Indications are that people are taking the 6-foot distancing rule fairly serious, washing their hands better than before and using disinfectants at home and work. Masks don’t seem to be taken as seriously. Do cloth masks really help?

Any barrier that protects your face will be better than nothing. Covering eyes with glasses or face shields, and mouth and nose with masks, are physical barriers to droplets that contain the virus. They are better than not having anything. The way we protect ourselves in the hospitals is exactly that way—we wear face shields and masks, and practice hand hygiene obsessively. They are not 100 percent perfect, but help. If I told you that by wearing eye protection and a cloth face mask decreases your chances of getting COVID by 50 percent, wouldn't you do it? If you add that to social distancing and hand hygiene, then your chances are even lower by combining methods of prevention. It is just good common sense. The more people who wear a mask in a store, the less chance that someone will get infected.

People are starting to talk about church services in person, summer parties, and football and school in the fall. Is any of that reasonable?

Life will not be the same it was three months ago. Churches are the perfect example: church services like we had before COVID represent a danger because of high chances of transmission. Services will need to have less attendance—50 percent or even less so as to have protective social distance. Wearing masks AND eye protection like safety glasses or face shield will help reduce transmission as well as the ability to perform hand hygiene with sanitizers. We had several patients who unfortunately got COVID-19 at church services and several of them died. The same situation will happen if we do not make changes.

Another important aspect is for those that are more vulnerable: the elderly and those with comorbidities are the ones that are at higher risk of severe disease and death. They have to understand everything they do has a consequence. If I told you that your chances to die from COVID-19 is 20 percent because of your age and comorbidities, would you take chances? We all have a personal responsibility now that the country is reopening. The decisions we all make will have an impact on our lives and the lives of others.

Any large gathering will bring new cases and subsequently cause deaths. I would not be surprised to see sporting events in empty stadiums or arenas. Some colleges want to reopen, and so it is all about balancing between decreasing chances of transmission and preventing people who are at risk of severe disease to take chances. So far, COVID-19 has largely spared children and young people, but the question is if any of these healthy young individuals have someone at home with risk factors. That needs to be discussed and having a plan to decrease those risks.

We have to learn from other places and avoid making the same mistakes. In countries where people are ignoring social distancing and shelter-in-place orders, they are about to lift the restriction and as a result of people simply not listening, those places basically are accepting the concept of "natural selection." That will bring the number of fatalities very high and is quite sad to see. We can always do better and it starts with our own personal decisions. When restrictions are lifted, if we pretend nothing is going on, we will overwhelm our hospital in a very short time. We depend on every person in our community to participate in the safety measures that have been outlined so the curve stays flat and we can have a life that is a little close to normal.