On Friday afternoon, Aaron Carroll, MD, joined the conversation on the Indiana University Facebook page to do a live question and answer session about COVID-19, which was viewed by more than 12,000 people. Carroll is the host of the Healthcare Triage podcast, which is sponsored by the Precision Health Initiative and IU School of Medicine. In recent weeks, he has been featured as an expert on MSNBC, the New York Times and other national publications.
Question: If you could give people one piece of advice, what would you tell people to do to keep themselves and their families healthy?
Answer: Stay at home and away from other people as much as possible. At this point, we’re concerned that this has spread into the community so significantly that we can no longer do contact-tracing and find out who has it and try to isolate them, so we have to ask everyone to stay at home and distance themselves from each other so we don’t keep seeing this infection increase at an exponential rate. That kind of social distancing is really the only tool we have at the moment to flatten the curve, or slow the rate of infection. We need to do that, because otherwise we can overwhelm the healthcare system if too many people get sick at the same time. That’s what you’re seeing in New York, that’s what you’re seeing in Italy and Spain and a couple other countries, and we need to avoid that.
Q: Can you talk more about the comprehensive testing infrastructure and why it’s so important for our nation?
A: Everybody’s worried about tests right now and that we don’t have enough tests and they’re right, but almost all the tests we’re doing right now are for the healthcare system. We need them specifically for healthcare workers to make sure they’re not sick, and we need them for hospitalized patients so that we know how to triage them, and after that, it’s nice to be able to test people who are symptomatic to know if they’re infected, but at this point, everyone should be isolated. The infrastructure we’re going to need in the future is slightly different, because after we’ve been successful in suppressing this, then we’re going to need a testing scheme that can prevent this kind of widespread outbreak from happening again. The way we do that is we need to be able to test every single person who is symptomatic, and then if people turn out to be symptomatic, we have to do very sophisticated contact-tracing and isolation. We have to find out everyone who that infected person might have come in contact with and we have to get them to isolate as well and hopefully test them, and if any of them turn out to be positive, do the same thing again. That’s going to take a significant public health infrastructure. It’s going to take a fairly large number of quick tests. We don’t have those tests or that infrastructure yet, but those are some of the key components we’ve got to have in place before we can even think about reopening and head back to a more normal way of life.
Q: Where can you get COVID-19 testing in Indiana?
A: A number of places, but there is nowhere you can just go and say, “test me.” It’s really in the hands of the healthcare system. If you are sick, call your doctor and talk to them and determine if you’re someone who needs testing, and if they determine that you are, they will refer you to a testing facility. Some of them are even drive-through.
Q: How can you tell the difference between COVID-19, the common flu and seasonal allergies?
A: The symptoms are a little bit different. COVID-19 is usually characterized by fever, a dry cough and feeling really sick. Flu, on the other hand, is more of a general malaise and you may have a headache, but it’s similar so it may get confused. A common cold usually doesn’t get you sick. Rarely a fever, rarely a feeling of not being able to get out of bed and do anything, it’s usually more of a cough and runny nose, things like that. Runny nose is not as common with COVID-19. The bottom line is that it’s hard to make that distinction, which is why we need testing, especially between influenza and COVID-19.
Q: Is it safe to get carryout food from a restaurant?
A: In an ideal world, you wouldn’t go into the restaurant. You want to stay away from people. A lot of restaurants are doing curbside, where you drive up and you open your car door and put it in the backseat and you drive away, that would be ideal. If you have to go into the restaurant, it’s best if there aren’t many people there, if they have some mechanism to space people out or set up a time for you to pick it up, that’s more ideal as well. As much as possible, what we’re looking for is not to spend time around people, certainly within six feet of them, so going to a crowded restaurant to place an order, wait for it, hang out with people and then take it home, that’s not ideal. That’s not really social distancing. Delivery is even better because somebody could leave it at your door, you could prearrange the tip and payment, and then you don’t need to come in contact with any people directly.
Q: How can I keep my mental health from deteriorating while we’re on lockdown?
A: First of all, if we’re talking about significantly-diagnosed mental health, stay in contact with your healthcare providers. If we’re talking about the use of therapy, a lot of that can still be done over the phone or video, so you should check if you have a therapist or something like that, because you could still keep doing that. We keep calling this social distancing, but what we’re talking about is physical distancing. We don’t want to physically be near other people. We don’t need to socially remove ourselves though. Talking to people on the phone or through video is fine. We hang out with our friends on Zoom. There are games we can even play on Zoom. It’s important to still have social contact. It’s also important to keep yourself busy with hobbies and other interests. I’ve been doing a lot of cooking. Find other ways you can relax and take care of yourself. Also try to remain physically active as much as you can. Get outside, get that sunshine, hang out virtually with friends as much as possible, all of those are things you can do to really take care of yourself.