An Infectious Disease Expert Answers Your COVID-19 Questions

The spread of COVID-19 has sparked fear and apprehension — and misinformation can elevate those emotions.

To help clear up some of those misconceptions and answer your questions about the new coronavirus, we turned to infectious disease specialist Dr. Susan Bleasdale, medical director of infection prevention and control at UI Health.

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Note: Some of Bleasdale’s answers, below, may have been edited for length and/or clarity.

Do you know if any patients recovered from COVID-19 have had lasting damage such as chronic kidney disease or heart disease? — Annette Moore (@amoore2171)

Bleasdale: There’s early indications from some of the cases in China that there are some people who have had long-lasting damage related to how severely ill they were. But I think it depends on the case and how severely ill these individuals are. People that end up in the ICU that are having problems with their kidneys may have some potential long-term damage. There also may be some long-term damage related to inflammation that happens to the heart as well. It depends on how severely ill they are as to whether or not they will recover and to what extent they will recover from the illness. 

If you are having so much of an inflammatory reaction it is causing damage to some of your organs it is variable as to whether those are going to completely recover or if you will recover with some impaired function.

If you contract COVID-19 and recover, can you get it again? — MaryAnn Sanfilipp Crotty

Bleasdale: It appears that when people have been exposed that they likely are (now) protected and have some immunity. That’s the way it appears. But this is still early on.

There was a case of, supposedly, a woman who had it and then had a negative test and then a positive test. It probably was during that interim time (when some of the tests were faulty) which meant that negative test was maybe falsely negative. It does appear that, hopefully, people will have some immunity and that’s our hope with social distancing. If we can prevent a flood of ongoing cases but we continue to have cases where we are seeing the numbers rise, hopefully that will give us some herd immunity so that when these social distancing measures are removed we will have some immunity in our communities and it won’t overwhelm our health care system when these measures are slowly removed.

Could someone have a COVID-19 infection and the flu? If so, how would that impact their symptoms? Would it be worse? Would they be sicker longer? Are these cases not tested/recorded? Per current testing guidelines if you test positive for the flu, you don’t get tested for COVID-19. — Debra Moebes

Bleasdale: Early on, the guidelines were that if you were positive for the flu you weren’t initially tested (for coronavirus). The thought was that if you had another likely diagnosis it would not be likely to be also COVID-19. But we do have data from the early cases in China and other countries before it came here — and in our own data internally — that there is co-infection with other respiratory viruses and with influenza. Whether or not there’s some cross-reaction between the tests and having the positives related to other respiratory viruses is not quite clear or if it is really, truly co-infection. These cases are being recorded and people are tracking this so we have some early data that there is co-infection in pediatrics we are seeing, I believe, out of China. And then here in the United States we have seen some small (number of cases being tracked) showing information around co-infection with other respiratory viruses.

Is it possible to clean some of the used PPE? For example, can the N95 masks be cleaned with steam or alcohol? Could the rubber gloves be washed in the same way? — Vince Calcina

Bleasdale: Gloves are probably a little bit harder for the standard gloves that we wear in health care but there are several things that many of us have been able to reuse and disinfect, for example, the goggles or eye shields. And just recently the FDA has given guidance on how to disinfect the N95 respirators that many people have been talking about that are in critical short supply. So that’s been helping us to reuse some of that equipment. Most often things that are non-porous like goggles or a face shield can be disinfected with alcohol mixtures. However you disinfect them, it has to not compromise of the equipment that you are using. Whatever you are doing you have to make sure that it still has the integrity to protect the health care worker.

What is the suggestion from physicians regarding best protocol for what fresh, raw veggies/fruit are safe to eat? Most produce staff do not wear gloves when stocking shelves. Should we use soap/water to wash lettuce, broccoli, peppers, etc. — Bobbie K (@BobbiefromIL)

Bleasdale: It does not appear to be spread by food contamination but it is important to take some precautions when shopping.  Wash your hands before and after shopping. Use the sanitizing wipes on the cart.  

Wash your produce vigorously under water and scrub, which is good practice for preventing any infections from fresh produce. It is not recommended to use soap as that might leave a residue that you would ingest. Again, it does not appear to be spread by contaminated food.  

Is how the coronavirus enters the human body significant to the severity of the disease? — Robert Kirsch

Bleasdale: There may be some association with how much virus enters at once and the severity of disease. If you have a smaller dose your might be able to overcome this without as severe an illness, but also, other medical conditions play a role in the severity of illness.  

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