COVID-19 and the holiday season with Theresa Brennan, MD

• We’re in a tough situation as case numbers continue to go up.
• UI Hospitals & Clinics has over 90 COVID-19 patients in the hospital.
• We’re communicating with other hospitals in Iowa. They are all very busy, nearly full, or entirely full.
• Almost 1,400 people in Iowa are in the hospital, with nearly 300 of those patients in intensive care units (ICUs).
• The capacity of Iowa’s health care system is being stressed by the prevalence of COVID-19 in our communities.
• Every Iowan is at risk for exposure to the virus.

• We should all respect the virus rather than fear it. Know the impact it can have on you, your family, and your community. Use these resources to respect and stop it.
• Many have gotten complacent, so we all have the opportunity to be better at stopping the spread.
• Everyone is tired of hearing about COVID-19. Between health care, schooling, the economy, and the rest, there is a lot of fatigue around the pandemic between the general public and health care workers.
• Everyone misses their loved ones immensely. So even though social distancing is the most effective way to stop the virus, we are having a harder time practicing it.
• We’re becoming accustomed to COVID-19. Because of that, we aren’t being as effective at preventing its spread. This is why the number of cases continues to rise.

Please follow these steps to stop the spread of COVID-19

Take care of your mental health during this time

• Our staff are facing things they have never faced before and are doing amazing things.
• All health care systems, including us, are evaluating the ways we deliver care to make sure we are prepared to handle what lies ahead.
• We are ready to respond as the needs arise.

• Our ability to do surgeries, even essential ones, is at risk because of the need for hospital beds. Many hospitals have already decreased elective surgeries for this reason.
• If the prevalence of the virus continues to go up, larger statewide shutdowns outside of health care are also possible.

• Avoid gathering in person with anyone outside of your household.
• Interacting with those you live with is safer.
• Using technology, like FaceTime, Zoom, and other video chat platforms, to connect with those you don’t live with is safe. Connecting this way is good for your mental health.
• Getting outside is safe, with the right precautions. If you will be within six feet of someone outside your household, you should wear mask.
• When wanting to dine out, choose takeout from your favorite local restaurant instead of eating inside the restaurant.

Are outdoor gatherings safe?

• Outdoors is better than indoors, partially due to the air circulation.
  • Keep gatherings as small as possible
  • Stay six feet away from those you do not live with
  • Wear a mask
  • Avoid sharing food and beverages

• Holidays are going to need to be very different this year.
• Avoid large, indoor, in-person gatherings, especially gatherings with eating involved.
  • This will be difficult, especially if you live alone, but is important in order to stop COVID-19 from impacting us further.
• If attending an outdoor gathering, wear a mask, and avoid sharing food or drink with others.
• See loved ones you can’t safely get together with using an online platform like FaceTime or Zoom.
  • This year may even have a silver lining because no family member has to be left out due to distance. See everyone virtually and connect.
• Consider starting a new tradition that you can look back on and celebrate the creative ways you were able to bond in during this moment.
• Seek the good in this moment whenever you can. There is a lot to be sad or angry about, but there is also a lot of good in the world. Spend this holiday season trying to focus on those bright spots and positives.

• We believe a vaccine is on the horizon, but there is no official timeline.
• There are two leaders, Pfizer and Moderna, that have shared preliminary data about their vaccines.
• Both vaccines require two doses in order to be effective against COVID-19.
• The Food and Drug Administration (FDA) will review that data to make sure that it is sound and trustworthy.
• It is important for us to continue to follow safety standards, because once approved, a vaccine will not be available widely for a period of time.

Please follow these steps to stop the spread of COVID-19

When it’s available, will you be getting the COVID-19 vaccine?

• Yes, there is no question I will be getting the vaccine if the reported safety data shows it to be safe.  We have heard that both of those that are under review from the FDA are highly effective.
• I trust that researchers have done their work to make sure it is safe and our team will also review the data.
• I also know that the FDA will verify its safety.
• The average vaccine goes through a trial of 6,000 to 10,000 people to ensure it is safe and effective. These vaccines trials have been far more than that, and this trial was more aggressive about including a more diverse group of participants.

• People who have had COVID-19 are no longer considered contagious when they have gone at least 10 days without a fever or any other symptoms.
• It is possible that a person can be reinfected with COVID-19, so being recovered does not mean you are immune.  This likelihood of reinfection appears to be rare, but it has occurred. 
• For those that do show immunity, we are still not sure how long that immunity lasts.
• Once they are recovered, it is still important to follow safety precautions by wearing a mask, maintaining at least a six-foot distance, and washing your hands.

• Yes, the data shows us that wearing a mask is better at preventing the spread of the virus than not wearing a mask.
• Many people who are infected can pinpoint the moment they contracted the virus and were not wearing a mask.
• It is much more uncommon to find that someone contracted the virus while wearing a mask.  It is more likely that one had close contact with someone who was not symptomatic while one or both were not wearing a mask.
• Masks stop small droplets from traveling out of your body into another person through breathing, coughing, speaking, etc. COVID-19 spreads through these droplets, so the masks disrupt that.
• Wearing a mask is just as important as something like wearing a seatbelt and driving the speed limit when you drive a car. The more people do it, the safer you and others around you will be.

• Bed count refers to and is impacted by many things:
  • Type of patient (pediatric or adult)
  • Providers available to care for patients
  • How sick a patient is or what level of care do they require?
• When health care organizations look at bed count, they look at beds by type based on those factors.
• A hospital may have beds open, just not the right ones needed for any given patient.
• During COVID-19, many Iowa hospitals have had full ICUs. We are also seeing more hospital admissions overall and more pediatric cases, as well. The more that continues, the fewer beds will be available, which is why we’re watching these numbers so closely.

• Risk is a spectrum. It isn’t like a light switch that you turn on or off. You are at risk for having poor outcomes with COVID-19 even if you are not a part of these groups.
• Groups that have a higher risk of poor outcomes include:
  • Advanced age
  • Obesity
  • Diabetes
  • Heart disease
  • Lung disease
  • High blood pressure
  • Individuals taking medications that suppress their immune system
• At UI Hospitals & Clinics, we’ve most commonly seen people with advanced age, people with diabetes, and people who are obese needing to be in the hospital for treatment for COVID-19.

• Always reach out to your health care provider with this question.
• If you have a new or worsening condition that is not routine, you should absolutely receive medical care for it. Even something like a mammogram is still important to get right now, particularly if you’re at high risk for breast cancer or have just found a lump.
• Your provider may recommend changing the way you receive care and see you via telehealth instead. They may also recommend postponing, which is why it is important to ask them directly.
• If they do request to delay your appointment, it is likely due to the need for providers to focus on assisting with care for COVID-19 patients. Hospitals and clinics around the state, including ours, have great safety measures in safe to ensure that COVID-19 does not spread within health care facilities.