Beth Israel doctor responds to CDC guidance changes

WCVB – September 21, 2020

Sharon Wright, MD (Infectious Disease, BIDMC) discusses changes in guidance from the CDC about how COVID-19 can be transmitted.  

Transcript

MINUTES. EMILY: A MAJOR CHANGE IN SOME GUIDANCE FROM THE CDC ABOUT HOW CORONAVIRUS CAN BE TRANSMITTED. HERE TO TALK IT THROUGH WITH US DR. SHARON WRIGHT, SENIOR MEDICAL DIRECTOR OF INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY AT BETH ISRAEL DEACONESS MEDICAL CENTER. GOOD TO SEE YOU. RECENTLY, THE AGENCY SAID SAID CORONAVIRUS COULD BE TRANSMITTED IN THE AIR. THAT’S AFTER SEVERAL STUDIES SHOWED RESPIRATORY DROPLETS FR A COUGH OR SNEEZE, EVEN TALKING, COULD INFECT ANOTHER PERSON IN CLOSE CONTACT. NOW, THE CDC REVERSED THAT. WHAT DO WE KNOW ABOUT THAT SHIFT? >> IT’S HARD TO KNOW WHAT CAUSED THE CDC TO RETRACT THAT DOCUMENT THAT WAS NOT READY YET, BUT I THINK WE SHOULD KEEP IN MIND IT IS NOT JUST ONE OR THE OTHER, BUT A CONTINUUM. WE KNOW THAT COVID IS LARGELY TRANSMITTED SIMILAR TO INFLUENZA BY LARGE RESPIRATORY DROPLETS. CERTAIN SITUATIONS IT HAS BEEN TRUE. WHEN YOU HAVE VERY CLOSE AND UNPROTECTED CONTACT WITHOUT A MASK ON IN IN CLOSED SETTINGS WITH LIMITED VENTILATION IN SMALL SPACES. ESPECIALLY THAT YOU CAN HAVE DROPLETS HANG IN THE AIR LONGER. IT’S NOT NECESSARILY TRULY AIRBORNE LIKE MEASLES OR TUBERCULOSIS, BUT THERE CAN BE A RANGE OF WAYS. EMILY: I THINK THE PART THAT’S TOUGH FOR PEOPLE IS IT’S NOT THE FIRST TIME IT’S HAPPENED WITH THE CDC SAYING ONE THING AND THEN CHANGES. IS AN UNUSUAL FOR THE AGENCY TO GO BACK AND FORTH LIKE THIS? >> I THINK THERE ARE PROBABLY TWO THINGS GOING ON. ONE IS THAT WE HAVE NEVER SEEN SO MUCH SCIENCE COME OUT SO QUICKLY. THERE IS OVER 50,000 PAPERS THAT HAVE BEEN PUBLISHED SINCE THE BEGINNING OF THE PANDEMIC. THERE IS A LOT TO EVALUATE AND LOOK AT THE SCIENCE. I THINK EVEN BACK DURING H1N1, RESPIRATORS WERE RECOMMENDED AND THE CDC EVENTUALLY MOVED OVER TO SURGICAL MASKS. THAT’S PROBABLY PART OF IT. AND THEN FOR REASONS THAT ARE NOT ENTIRELY CLEAR TO ME, WE ARE NOT LETTING THE CDC LEAD THE COUNTRY AND THE WORLD TE WAY IT USUALLY DOES. EMILY: BOTTOM LINE, CORONAVIRUS IS ON A CONTINUUM, BUT THERE CAN BE AIRBORNE TRANSMISSION? >> I THINK IT’S SEMANTICS. WHETHER YOU STAY A TRULY AIRBORNE GORGEOUS DROPLETS LIKE SPRAY FROM A COUGH OR SNEEZE I CAN HANG IN THE AIR A LITTLE BIT LONGER UNDER CERTAIN CONDITIONS WHEN YOU’RE IN YOUR RANGE. BUT NOT SOMETHING THAT IS TRULY AIRBORNE THAT WILL MOST LIKELY TRAVEL ALL AROUND THE CORNER. EMILY: THE DISTINCTION IS IMPORTANT. THANK YOU FOR THE CLARITY. U.S. IS HITTING THIS PRETTY GLIMPSED — PRETTY GRIM MILESTONE. 200,000 DEATHS TIED TO COVID-19. IN MASSACHUSETTS, WE RECENTLY SURPASSED 9,000 DEATHS. WHAT ARE THE DETAILS BEYOND THE NUMBERS? ARE THERE ANY COMMON TRAITS AMONG THOSE WHO HAVE DIED, AND HAS THAT CHANGED AT ALL BETWEEN MARCH AND NOW? >> ACROSS THE COUNTRY WE ARE SEEING SIMILAR RISK FACTORS. CERTAINLY PATIENTS OVER THE AGE OF 65. PERSONS WITH VARIOUS ILLNESSES, ESPECIALLY CHRONIC ILLNESSES ARE AT HIGHER RISK. IN THE BEGINNING OF THE PANDEMIC, ESPECIALLY IN MASSACHUSETTS WE SAW A FOCUS ON THE ELDERLY AND NURSING HOMES. BUT NOW WE HAVE BEEN ABLE TO CREATE PREVENTATIVE MEASURES. ESPECIALLY TESTING IN THE SETTINGS AND WE HAVE BEEN ABLE TO REVERSE THAT A LITTLE BIT. BUT THOSE GROUPS ARE AT THE MOST RISK STILL. WE ARE SEEING IN THOSE UNDER 65 THAT THOSE POPULATIONS ARE AT RISK. AND OH MASSACHUSETTS AND OTHER PARTS OF THE COUNTRY ARE WORKING HARD TO TRY TO COMBAT THAT. EM