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Dr. Martin Blaser Answers Coronavirus Questions From Twitter

Dr. Martin Blaser, MD, uses the power of Twitter to answer the internet's questions about the coronavirus. When should we expect to see mutations? Does COVID-19 have a lifespan? Is coronavirus the 0.01% that soaps and sanitizers can't kill? Dr. Blaser is a professor of medicine and infectious diseases at Rutgers University and chair of the Human Microbiome.

Released on 03/21/2020

Transcript

Hello, my name is Martin Blaser.

I'm a professor of medicine and infectious diseases

at Rutgers University,

and this is Virus Support.

[upbeat music]

I'm in my home in New Jersey.

The filming crews are not here

because they're in self-isolation,

and so I'm all by myself.

Does normal kitchen cleaner work to clean a virus

off a surface or should I be looking

to use something more hardcore?

The good news is that the virus is susceptible

to many different kinds of cleaners,

whether it's soap and water or alcohol

that's in Purell and other products,

kitchen cleansers, Clorox, or various chlorine compounds.

Cleaning things off, even with soap and water

will do a terrific job.

In a pinch, you can use vodka.

Given that many people have had COVID-19 without knowing it,

is there a way to test whether people had it?

The virus that lasts in a person for some number of days

or perhaps weeks, and then it's gone.

After a few weeks, there will be no way

to detect the virus itself,

but one can detect the antibody response to the virus,

and laboratories, including our labs at Rutgers,

are developing antibody assays.

So, we will be able to tell who's had the infection.

We generally believe that everyone who's had the infection

is now immune, so that they will never get it again.

If we're washing hands when we come home from outside,

shouldn't we be washing clothes too?

I'm not aware of evidence that the virus

ever has been transmitted from clothing,

and I think if it occurs, it's very infrequent.

You perhaps can lower the risk from clothing

by not shaking it in the air.

That might dislodge the virus.

Clothing turns out to be very sticky for viruses,

so if a virus gets to the clothing,

it'll probably stay there unless you dislodge it.

What actually happens when you get coronavirus?

So, it's like getting any kind of infection

or any kind of viral infection.

When the virus comes into your body,

it starts to multiply.

And it keeps multiplying until your immunity

is able to eliminate it.

Some people never have any symptoms whatsoever.

Some people have mild symptoms,

and some people get more severely ill.

So there's a lot of variations,

and that's something very important

for the public to understand.

Probably most of the coronavirus infections that occur

will either have no symptoms or have very mild symptoms.

In a place like the United States,

maybe 100 million people will get it

in the next some months.

So even if severe infection is uncommon,

those numbers add up.

Weren't we warned last year that people

were using too much hand sanitizer

and the result would be super germs?

Should we use it or not use it?

Should we limit how many times we use it in a day?

In normal times, when you don't have a lethal virus

that's circulating, you shouldn't wash your hands too much

because you're washing off good germs

that help protect you against bad germs.

Our body is full of germs.

We call that the human microbiome.

Those are the bacteria that live in and on our body,

and we live with these germs all of our life.

We've inherited many of them from our mother,

and she inherited it from her mother,

and it goes on for thousands of years.

These are ancestral organisms.

They help us fight infections.

They help us digest our food.

At present, we have a lethal virus that's circulating.

We need to wash our hands as often as necessary

after we have contact that put us at risk.

So, the two really aren't contradictory.

It's all based on the context of what's circulating.

How do we handle grocery checkout with this virus spreading?

We tap screens, touch products, pick over produce,

grab freezer handles, grasp grocery cart handles,

punch credit card keyboards.

So, we're using our hands all the time,

and when we're in a public place,

every time we touch something,

we have the chance of picking up the virus.

The good news is that the virus doesn't go through our skin,

but from the hands, it can go to our face,

and that's where it's risky.

So, after you have these exposures in a grocery store

or elsewhere, you should use a hand sanitizer.

The alternative is to wear gloves in public places

where you're gonna be using your hands.

And the good news for that is that you can wash your gloves

with soap and water and reuse them many times.

I know you're probably lying to me,

but is only one strain going around?

When should we begin to expect mutations?

So, at this point, there are two major clusters.

There's the original cluster from China,

from which all strains are descended,

and then there's a cluster that has been present in Europe,

which is a variant of that.

At this point, most if not all the strains in the U.S.

are related to that original Chinese strain.

But this is an active area.

I wouldn't be surprised if some of those European strains

come to the U.S., emerge in the U.S. as well.

How many tests are available in the United States?

I think everybody knows that we've had a real problem

got enough tests up and operating,

and although the number of tests is coming up all the time,

it's only a fraction of what we really need.

We have a need for millions,

if not tens of millions of tests

because just about everybody I know

wants to know what's their status,

and especially if they have any symptoms at all

of cough or fever or sore throat or shortness of breath.

Shouldn't we start nationally calling out

to all recently retired but able doctors, nurses,

first responders, EMTs,

and pull them into emergency training to help support

our hospital staffs during the crisis?

Older people are at more risk for severe manifestations

of the infection if they get it.

So, we're putting our people on the front line

who are at high risk.

Nevertheless, you can think about this as a war.

We're at war with this virus,

and there are people all the time

who volunteer to help in wars for a good cause.

So I don't think though, we should require

any retired people to do this because they do have danger,

but if people volunteer and they protect themselves

and they're aware of the risk, I would welcome their help.

I get food deliveries.

How long does the coronavirus stay on plastic bags?

Wear gloves when you're taking things

out of the plastic bags,

and then throw the bags away.

If you touch the plastic bags,

wash your hands with soap and water.

Then your risk should be zero.

I have a hypothesis.

Countries closer to the equator have very low

confirmed cases of coronavirus.

What if the heat from the sun

minimizes the rate of the spread?

It may be that living in warm climates

will decrease how much virus infection there is.

The virus has come to parts of the world where it is warm,

so it's not that there's no coronavirus,

but it's possible that the spread will be less.

And that's why when warm weather comes,

that may be one of the reasons

why in temperate parts of the world,

viral infections go down.

The flu comes once or twice year, then goes away.

Corona is contact with any person infected.

Right, so my question is this.

Can you keep getting corona every time you fight it off,

and then getting it again whenever

you're around another infected person?

If you get one particular viral type,

in general, you're immune

for the rest of your life to that type.

But new types keep emerging.

So this one, SARS-CoV-2, that's a brand new virus.

It's never been present in humans before.

That's one of the reasons that it's so infectious

because no one has any immunity to this virus

until they acquire it.

What we can predict,

if this virus is like all other viruses,

and we think that it is,

if someone becomes infected,

they will never get this virus again.

Now, if one or two years from now,

a variant of this virus emerges,

that is significantly different than the first one,

then they could get that one.

That's a little like what happens with flu.

Whether this corona will lead

to a whole cycle like influenza does,

or whether this is a one time event, nobody knows.

What if you have a cold or regular seasonal flu.

Can you get the coronavirus on top?

If so, as your immune system is already stressed,

does that put you in the vulnerable category?

Can't find any info on this.

When you have a viral infection,

your immune responses are all revved up.

So, usually you do not get a second viral infection.

If you have the flu, and coronavirus lands on you,

probably your revved up immune system will eliminate it.

Now, we don't know that for sure,

but that's based on our general understanding

of infectious diseases.

Does the coronavirus have a lifespan,

or will it be seasonal?

The virus like the coronavirus will keep spreading to people

until it runs out of somebody to go to.

That's why social isolation and quarantine is so effective.

We wanna have as many dead-end infections as possible.

The virus will keep spreading if somebody has the virus

and they're in contact to someone who is susceptible,

that is not immune.

So, one of the ways that epidemics end

is that over time,

the level of immunity in the population builds up.

Generally, epidemics end when 50 to 70% of the population

become immune to the virus.

That's for a virus like influenza,

and that's what we would expect for here.

Another way that we can increase immunity

is to develop a safe and effective vaccine.

The problem is testing the vaccine

because you have to test it to make sure that it's safe.

With vaccines, there is the possibility of side effects,

and there's also the possibility

that they will make an infection worse

instead of making it better.

And for certain respiratory virus infections,

like the influenza, there's a definite season.

It comes in the autumn, it's there in the winter,

it dies down in the spring.

It's generally at very low levels in the summer,

and then it comes back in the fall.

So, we're hoping that good weather will slow this down,

but then it could come back in the fall

just like other viruses do,

but at least that might give us an extra six months

to develop effective treatments

or maybe an effective vaccine.

I usually wash clothes in cold water.

During coronavirus outbreaks, does washing, including coats,

in hot water help alleviate spread of the virus?

In general, washing is gonna eliminate the virus.

There's a big dilution factor with water.

Any detergent lowers the virus.

Any use of bleach will eliminate the virus.

So all these things together pretty much make laundry

free from virus transmission.

So people that get the coronavirus and recover,

how long does that last?

Anybody know?

One factor about this virus is that the clinical course

is extremely variable.

That ranges from people having no symptoms at all,

and many young children are infected with the virus.

They have no symptoms, but they can spread it.

The people who have mild illness

that lasts three days or a week

and some people are sick enough to be hospitalized,

go to the ICU, and some people die as well.

So, there's tremendous variability.

If you get the virus and you recover,

you should be immune.

You will never get the virus again.

Then, if somebody's sick,

you can help take care of that person

because you're not gonna become infected.

So, I'm assuming coronavirus is the 0.01%

that soaps, sanitizers, and disinfectants can't kill?

This coronavirus is very susceptible

to soaps and sanitizers if they're used.

If they're not used, then the virus can transmit.

The important take-home message is that if people

use soap and water or hand sanitizer

after their hands get exposed,

they will be largely protected.

Any doctors that know how coronavirus spreads?

Is washing and drying your hands with surgical gloves on

a good strategy or was that a serial killer at the airport?

If you wear gloves, you will be protected from the virus.

If you wanna reuse the gloves,

just wash them with soap and water and dry them off,

and then you can use them again.

I'm not sure what you mean by serial killer at the airport.

I'm not aware of any unusual events.

This guy just bought $300 worth of toilet paper.

Am I missing something?

Is the coronavirus going to have us all living

in the bathroom?

Why is toilet paper more important than food?

Why are you not buying stuff to keep you alive?

Why do I not know the secrets?

This happens before hurricanes as well.

People start hoarding things.

They're afraid they're gonna run out.

And somehow people got the idea that toilet paper

was in short supply.

So, it's gone from the supermarket shelves everywhere

'cause nobody wants to run out of toilet paper.

I don't think there's anything special about this.

It's just people panicking and their fear

and their hoarding behavior.

So does corona not spread through the air?

We know that the most important route of spreading it

is through droplets.

The viral particles in the droplets

that somebody is coughing or sneezing,

but we also know that it can be spread

from people who aren't coughing or sneezing.

They have no apparent symptoms.

So there is some airborne transmission.

It's probably worse in small spaces

like classrooms or elevators and the like.

So, it occurs and that's why

social distancing is so important.

Is there any app yet which connects people

who are self-isolating over the coronavirus

and have time on their hands and good wifi

with charities or individuals who have jobs that need doing?

And if not, can someone please build one?

I think that's a great idea.

When you have a calamity like this,

there are all kinds of new opportunities.

Necessity is the mother of invention,

and probably in this terrible calamity,

there will be some good that comes out of it.

I've been an infectious disease specialist

for more than 40 years.

This is unprecedented in my career,

and I think it's really unprecedented in the last century.

We have to go back to the very terrible outbreak of flu

around the world in 1918, 1919,

to see something of this scale and consequence.

Social distancing, isolation, quarantining,

these are all very important.

Starring: Dr. Martin Blaser

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