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Transcript of JoCo on the Go podcast 07/15/2020

Theresa Freed [00:00:00] On this episode, hear from Johnson County public health officials about when, where and how you should wear masks to protect the community and stop the spread of COVID-19. Also, what's the outlook for a vaccine? And find out why spread among young people is increasing and a recent category of people added to the at risk for complications list.

Announcer [00:00:18] Whether you live in or just love Johnson County, Kansas, JoCo on the Go has everything Johnson County. Here's what's happening and what's coming up in the community. You call home.

Theresa Freed [00:00:32] Thanks for joining us for JoCo on the Go, I'm your host Theresa Freed at Johnson County resident and employee of Johnson County Government. On July 2nd, the Johnson County Board of County Commissioners voted in support of the governor's executive order requiring masks in public settings. The more than two and a half hour discussion before the vote included public comment and also comments from Johnson County Department of Health and Environment Director Dr. Sanmi Areola and local health officer, Dr Joseph LeMaster. We welcome both of them today to share details of the mask mandate and more on efforts to contain the spread of the disease. We'll start with Dr. Areola. Can you talk about the number of cases increasing and where we're at with testing?

Dr. Sanmi Areola [00:01:13] Our number of cases is increasing. We have gone from less than 20 cases per day a few weeks ago to about 22 cases per day to a week later, 40 cases per day and a week after that to over 60 cases per day and now to a hundred cases per day. The virus is clearly circulating. We opened things up and there's a lot of activities, more activity than we had two months ago. It is very important for us to continue to work together to contain the spread of this virus. The more spread that we have the more likely that people who are vulnerable are going to be exposed to this virus and the more likely that we'll have deaths and other more serious consequences. It is also true that the more exposed the younger population are, the more we're going to see some of the more serious effects, also even in the younger population. And so wearing a mask is very important. I am very appreciative of the approval of the mandate by the Board of County Commissioners. It's one of the really effective tools that's available to us. And if we get more of us, 80, 90, 95 percent of us to wear a mask, we stand a very good chance of successfully containing the spread of this virus. Now, I know that we just had the July 4th weekend and there are pictures of people who are not wearing masks or social distancing. I do want, again, to appeal to our sense of responsibility to the community, as well as a personal responsibility to understand that while I may not be susceptible to the most serious effects, my neighbor could. My mom could. My dad could, my Aunt could and so it is very important for us to continue to physical distance and to wear masks. And opening up of things, opening up of long term care facilities, opening up of schools very, very much depend on the level of common transmission.

Theresa Freed [00:03:40] A lot of parents are weighing the decision to let their children go back to school this fall. Thoughts on that?

Dr. Sanmi Areola [00:03:45] We want our children to be in school. They need to learn. They need the social interaction. If we have the virus spreading wide, that's going to potentially impact that. So we need to keep in mind all of the potential consequences of the actions that we take. Again, thank you for supporting our efforts to contain the spread of this virus.

Theresa Freed [00:04:08] And Dr. LeMaster, can you address where masks are required now?

Dr. Joseph LeMaster [00:04:11] The mask use order that has been put out by Governor Kelly. Executive Order 20-52, which has been confirmed by the Johnson County Board of Commissioners, has a number of different stipulations for how we wear masks and how the general public would conform with that order. So if you're in an inside public space, that means a space that other people can come into or go out of. Then if you're inside that public space, then the expectation is that everyone who is in a meeting in there will wear a mask. There are some sorts of indoor spaces, let's say your private office, that no one comes into but you. And it is and you alone are alone in there. There is. An exception in the governor's order, which says that when you're in that private space, which is not one that other customers could come into or other people that you work with can come into, then you don't have to wear a mask in that space. We'd still recommend you be ready in case somebody does end up coming in there, because if another member of your staff or a member of the public come into that space, then you'd be required to wear the mask in that space. The order requires if you are an employee in a business that is frequented to or visited by members of the public, that you're required to wear a mask when you're in a space that is visited by the members of the public, even if there are no members of the public present at the time. It goes on to say that obviously when there are members of the public there, you would be required to wear a mask during that time while they're there. If you're in any enclosed area or other space where you're going to be with other people but cannot maintain six feet of distance. The order would require you to be wearing a mask in that situation too. The order specifically mentions businesses that in which meat or other types of food are being prepared or packaged for sale or distribution. All those places are required, required to wear masks at all times. So what about in a restaurant or other area where people go to eat and drink? The order specifies that in that situation, while you are eating or drinking, it's not necessary to wear a mask. However, you should be seated from other people who are with whom you do not reside at least six foot distance from those people. So this means that if you were coming into a restaurant, you should arrive wearing a mask. Be seated wearing a mask. Keep that mask on until it is time for you to begin eating and drinking. And then after you finish eating and drinking, when you're getting ready to leave, putting the mask back on as you leave. So what about athletes participating in any kind of a sports activity together? The order specifies that in that situation, then the athletes would be exempted, provided that they're able to maintain six foot of distance from other people while they are doing the the activity. It does not make any exceptions for people who are engaged in sports activities where it would be impossible for them to engage in that activity and maintain six foot of distance from other people. So there would be other types of sports where that might be possible, where people were participating in a joint sports activity, where they're only for a moment or incidentally, going to be closer to another person. Very briefly. And the order specifies in that situation that that, too, is OK without a mask. So what about things like pools and other kinds of activities? We've said, as we've said before, the danger in the pool is not in the water or under the water. There's plenty of chemicals there to prevent spread between people that are under the water. It's it's where people are crowded together, either at poolside or at a bar or at an area where they are very closely sitting next to each other, not wearing masks, maybe not eating or drinking in that situation, crowded into a situation, talking with other people or sharing that same space. And there's not adequate space between them in that in that pool. So those are sort of situations that we would say are outside of what the order is requiring.

Theresa Freed [00:08:39] There are some exceptions to the mask mandate. Can you talk about those?

Dr. Joseph LeMaster [00:08:43] Well, first off, the order has an exception for children who are under five and specifically says that children under two should not wear a mask because of the risk of suffocation. There are some people who have a medical condition or a mental condition which could make them at increased risk of either suffocation or some other sorts of making their disease worse. And the order to specifies in that situation that those sorts of people with those medical conditions do not need to wear a mask. So the order also exempts people who are hard of hearing or who are deaf, who are using lip reading for communication with other people in the situation where they would need to do that. The order also exempts people who are working on a job where the physical act of wearing a mask could be a safety risk. One could imagine this in certain types of machinery operators where the potential of the mask of wearing the mask could cause some kind of interaction with the machinery. But there are these are specific under federal, local or state regulations. So this is not just something that you would imagine to be a. A safety risk, but something that's actually specific, specified in the regulations. The order also exempts people who are obtaining a service of some sort for whom temporarily removing the mask is required in order for them to obtain that service. I guess a great example of that would be if you were at the dentist and you have to remove the mask in order to receive the service from the dentist. That would be an example. That's a health care example. But there could be other situations and other sorts of interactions where you're obtaining a service, where it would be necessary for you to remove the mask, to receive the service.

Theresa Freed [00:10:33] As far as enforcement goes, we want to remind people to call the district attorney's office at 913-715-3003. That's the consumer fraud hotline. You should not call 911 if you have concerns about businesses or individuals not adhering to the governor's mask mandate. So we're seeing lots of cloth masks out there early in the pandemic. There was some conflicting information about the effectiveness of these masks. Can you talk about the protection they provide along with other types of masks?

Dr. Joseph LeMaster [00:11:03] An N95 mask, this is a mask. Sometimes you'll see it, people wearing them. They're the sort of mask that you wear if you're working around wood or a high amount of dust. You know, sometimes people you used to see people wearing this who were working in workshops. These fit very tightly around the face and they have the added advantage that they protect the person wearing them because they they eliminate air coming in and out around the side of the mask. All the air has to come in and out through the mask. They do. There are certain types of ninety five mask that have an exhalation valve. We don't recommend the use of those. Those actually protect the person wearing it, but not the people that they're with because the exhalation allows all of their breath to go out through the valve. Then there are surgical masks. You'll see these worn in clinics and health care systems. There's good evidence that these work quite well. There have multiple layers of protection. So our surgical staff and all of the health care staff in the hospitals are wearing these. If patients come without a mask, we give a patient to wear these. This is the sort of mask that is a disposable mask. You want to make sure that it's tight down around your nose. It is not effective. If it pulls down and your nose is sticking out and you're breathing out through your nose, then all the breath is coming out here. Remember that these masks are not tight enough around your face that they are protecting you the wearer, they are rather protecting the other person who you are in contact with. Cloth masks. So cloth masks should be 2-ayered. You can make these easily by to have a tight place around your nose by putting a bread stay inside of the the the mask. These are washable masks so they can go after you have worn them one day and been out in the community with them. Your hands have touched the outsides of them. You want to put those through the wash in some way to disinfect them. They could be disinfected in any through any standard type of a wash cycle. I would recommend using hot water. If you have soap, that will include bleach. That's great. But it's not necessary. Just as when your hands are washed for 20 seconds. When these mask go through a wash cycle, they're clean as well.

Theresa Freed [00:13:31] Are face shields is a good alternative? Or who should be using those and how?

Dr. Joseph LeMaster [00:13:34] Much of the guidance that we have in place are based on large groups of studies that have been summarized into something called systematic reviews that give us the the overwhelming amount of evidence pushing us towards whether a particular type of protective device has an effect to reduce transmission. Most of the studies that we are looking at have been focused on masks and social distancing. Other measures, we are using face shield specifically in health care situations as an extra layer of personal protective equipment, PPE over and above masks. When our health care staff are any higher risk situation. So, for instance, if they're doing testing for a patient who's suspected to have COVID, then they're wearing a face shield, a plastic face shield over over a mask, in addition. Every piece of protective equipment that we use reduces the risk of transmission. However, what we encourage people to do is to think about what they can do to reduce the risk of transmitting unintentionally to other people. If you happen to have the infection and don't know you have it if you are asymptomatic. Then you don't want to transmit that to your loved ones, friends or colleagues wearing a face shield keeps the whole of your face open for any kind of your breath to circulate out along the side and stops any kind of of of circulation of that nature. Wearing a mask reduces that some more. There are some types of mask who reduce that, reduce it much more. We encourage you to think about those additional types of things that you can do to reduce your risk further. For instance, in The Lancet article, which showed that the wearing of masks in health care settings and outside settings greatly reduces the transmission of COVID, it also showed that having an additional amount of distance between people also reduced transmission. So there's a great drop between zero and one meter apart and between one meter and two meter apart that even drops further. Less drop off after you get beyond two meters to three meters. So we know that there's good evidence for social distancing, for staying six feet apart from other people. That will reduce your transmission to other people. But we recommend that these things be done together. So wearing masks. Plus, keeping that social distancing increases the effectiveness of what you're trying to do to prevent transmission. We aren't trying to recommend that people do less or only the absolute required minimum. The idea is, how can you, as a socially responsible, compassionate friend of others and resident of this county? How can you do all you can to reduce the risk to your neighbors, friends and family members of getting this horrible disease? So the question comes up. Can I wear a face shield instead of the mask? So if you go back to the executive order 20-52, it specifically lays out what is a face covering or mask which is acceptable. Face shields are not described in that order or in that set of recommendations. Therefore, we do not recommend that they be used instead of and they don't satisfy the requirement of the executive order.

Theresa Freed [00:17:37] And pregnant women have been added to the list of those who are at risk. Why is that?

Dr. Joseph LeMaster [00:17:41] So we've recently learned some new data about coronavirus in pregnancy. What we are now finding is that there is an increased risk of bad outcomes in pregnancy, in particular, pre term births, which so very early deliveries which can occur in people who are pregnant, who get coronavirus. So what are some of the actions that you can take? First off, don't put yourself in situations if you're pregnant or think you might be pregnant or are trying to get pregnant where you are at increased risk of catching coronavirus. This is not a time, if you are pregnant, to be out mixing around in a large group of people that are not wearing masks. So minimize your risk as much as you can. Do continue to keep your prenatal visits and get all the kind of care that you need while you're pregnant. We don't ask that you not come to the clinics where we're providing care. You need to get that prenatal care if you have an emergency dial 911 or go to an emergency care center, they're all able to take whatever precautions they need to to reduce your your infection risk. Those are not the places where you are at increased risk. If you need care, get care. But do all you can to protect yourself and your baby during this time from unnecessary exposure.

Theresa Freed [00:19:06] Can you talk about what's happening with the development of a vaccine?

Dr. Joseph LeMaster [00:19:09] We know that from this number of different vaccine trials that are going on, the likelihood of a successful vaccine is very high. What we don't know and there is some concern about is because this is a coronavirus, immunity even when it has been provided by the vaccine may not be long lasting. It may be enough to get us, for instance, through one flu season, a little bit like the flu vaccines are maybe even a little shorter in terms of the protection of the immunity. So we're not sure whether the vaccine is gonna do the whole job. It's much more important right now that we focus on trying to protect our vulnerable populations by following the social distancing recommendations and laws where they exist in order to reduce the likelihood that many, many people will become infected.

Theresa Freed [00:20:01] We've talked about masks, but we just lastly want to touch on the importance of hand hygiene, too.

Dr. Joseph LeMaster [00:20:06] So if you're going to use hand sanitizer rather than soap and water, we still recommend the use of good old fashioned soap and water for 20 seconds. That's probably the best way to clean your hands. But if you're in a situation where you need to use hand sanitizer, make sure you're using hand sanitizer that contains at least 60 percent, either ethanol or isopropyl alcohol. This is the minimum amount that the CDC has found to be effective to kill the virus. Not all of those types of hands, handmade or homemade sanitizers, are good for your skin. There are some recommended components that will keep your skin from getting dried out. Those are important to do. At various times, sanitizer is more available than less. People have a tendency to buy up, sanitizer. All we want to really say at this point is sanitizer is something that you should use when you're in a situation where you cannot wash your hands. We'd still recommend the washing of hands with soap and water before you eat or touch your face. As the first line of defense.

Theresa Freed [00:21:12] For more information about COVID-19, visit our Web site at jocogov.org/coronavirus. Thanks for listening.

Announcer [00:21:19] You just heard JoCo on the Go. Join us next time for more everything Johnson County. Have a topic you want to discuss? We want to hear from you. Follow us on Facebook and Twitter at JoCoGov, For more on this podcast, visit jocogov.org/podcast. Thanks for listening.