Western experts field your questions on COVID-19

Western continues its special COVID-19 webcast series next week when Maxwell Smith, Faculty of Health Sciences, and Prachi Srivastava, Faculty of Education. answer your questions on the ethics, education and social impact of COVID-19 from 12-1 p.m. Wednesday, April 15. Click here to visit the Western Alumni page for details.

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On Monday, Western researchers Eric Arts and Greta Bauer took part in a special webcast to answer questions from the community regarding COVID-19, including ones pertaining to testing strategies, physical distancing, disease transmission, understanding key statistics and an update on the vaccine being developed at Western. The event was hosted by Sarah Dawson, Western Alumni Career Coach.

Sarah Dawson: Good afternoon and welcome to today’s webcast on the COVID-19 global pandemic. I’m Sarah Dawson from Western Alumni. We’re joined today by two of Western’s leading experts: Eric Arts and Greta Bauer.

Eric Arts, BSc’86, is the Canada Research Chair in HIV Pathogenesis and Viral Control and serves as a Professor at Western’s Schulich School of Medicine & Dentistry. Eric and his collaborators are rapidly mobilizing their efforts to establish and test an effective COVID-19 vaccine at Western’s state-of-the-art ImPaKT facility.

Greta Bauer is also a professor at Western’s Schulich School of Medicine & Dentistry. Her understanding and analysis of key statistics about disease progression, population hotspots and social distancing have placed her perfectly at the epicentre of the things we are thinking about so much lately.

Greta and Eric, thanks for joining us today. We’re so glad to have you. Let’s get started.

Eric Arts: I’ll just give the research perspective and how we need to interact and how we’ve been interacting with the public and also with our health-care professionals to respond as quickly as possible.

In one aspect, we have probably the largest concentration of vaccine development that there’s ever been in the world at any given time, and this is also true for new drug development that might combat this coronavirus.

But there’s also a lot of other aspects that the research labs are engaged with. Just five minutes before this call, we were rapidly discussing how we might deploy ways of sterilizing PPE (personal protective equipment) and testing whether that sterilization can happen by doing some work in a facility like our ImPaKT facility to try to see if we can re-use PPE effectively without destroying its content.

And then we’re also trying to work with public policy makers and in epidemiology in some ways, which is Greta’s area, to try to understand better how this virus is spread and how it passes from person to person and what types of mitigation we could use that might be more effective than what we’re using right now.

Sarah Dawson: Thank you very much. Eric, you mentioned the ImPaKT facility. I’m wondering if you could share with us what makes it unique to work in that environment and how that’s special to Western.

Eric Arts:

Some people have heard about it through the news and, of course, at Western we’ve heard about it for a few years now because it takes so long to get a facility like this up and running. It’s a large, multi-million-dollar facility and it needed to be certified by the Public Health Agency of Canada.

And all of this fortuitously came online just a couple of weeks before this epidemic really broke. So now we have basically a fully operational facility to respond. And the facility is unique because not only can we do work with the virus that causes COVID-19, but we can also do more ground-breaking studies that people haven’t been able to do effectively in the past with pathogens, and that is to understand how the virus is rapidly causing disease and how the vaccine might be very effective, by looking within a body, within an animal model or a human in some ways, and not have to rely on things we call biomarkers, which are essentially less effective.

So, we use high-resolution medical imaging to understand how we respond and that’s fairly non-invasive and it could be used very effectively. And just give you an example:

In China when they were doing diagnostics for COVID-19, they were giving everyone a CT scan in addition mucosal testing to rapidly diagnose COVID-19. That’s not something we’re doing here, but it’s something that they were very effective in implementing, so imaging will be a big part of how we respond.

Sarah Dawson: Are Canadian researchers and health officials collaborating in any way with colleagues around the world to make progress on this?

Greta Bauer: Canada is an immensely collaborative place and I’m really appreciating that right now especially when talking to colleagues in some other parts of the world.

It was a pretty quick job to link together people, identify areas of expertise that were needed on this. Because it’s really an ‘all-hands-on-deck / everybody-on-board’ kind of thing. So, communication networks have been set up that include not just researchers in universities but industry, public health, Indigenous leaders, community organizations, all the public health infrastructure.

And I should add here that largely as a result of SARS after 2003, Canada did a lot of work building public-health infrastructure that didn’t exist. So, all those degrees in public health, organizations like Public Health Agency of Canada, the fact that we have somebody in Dr. Theresa Tam’s position speaking as one person. That was all based on what went wrong earlier during SARS.

So, we’re actually in a very good place. And then, of course, there’s communication internationally.

I don’t know if you have things to add to that Eric.

Eric Arts: I’ll just speak to the London response and it’s been really remarkable. I mean, from Dr. Doug Fraser, who is working tirelessly to try to get samples from patients that we can understand and analyze to Dr. Silverman, who runs Infectious Diseases in the city, who is working tirelessly, taking care of patients. And then we’re getting constant emails from these individuals in response to various hospital officials, people in clinical microbiology. I’ve never seen so much of an exchange.

And with our team, with Steve Barr and Ryan Troyer and with Dr. Yong Kang, who’s really involved in the development of the vaccine and many researchers here. It’s kind of nice to see that we’re responding and then the interaction goes beyond that, too.

I’ve been working a lot with engineers and the Faculty of Engineering in developing devices that we can test or things like aerosolization of the virus to understand how it’s transmitted, and then I’m working with the tool-and-die shop in Windsor, CenterLine, that are constructing these devices that we need and all of this is happening in days, not even weeks. And it’s remarkable because normally this stuff takes months to years to really implement. Full on, it’s really quite interesting and in some ways, it provides us with some kind of reassurance that something is being done.

Sarah Dawson: You spoke about the masks and that brings a rise to a really popular question that we’ve been fielding about spreading and preventing, and so I’m wondering, Greta for you, since the early days you have been saying that every case prevented now is multiple cases prevented in the future. Can you explain what that means in terms of the exponential growth? And then I’ll get into asking both of you some questions about masks and keeping it contained.

Greta Bauer: I think what was hard to communicate publicly, as the alarm that epidemiologists were experiencing watching this develop not only with regard to what was happening initially in China, but once we had evidence of community spread, it takes it to a very different level in terms of our ability to contain an epidemic.

So, with SARS for example, we were able to contain the case identification and contact tracing, which we’re quite good at. But because transmission can happen earlier with this, this was not the case. And once it’s out in the community, it’s spreading exponentially, which is, you’ve seen those charts that just go up at the one end or thrown a log scale, you see them going straight. It’s actually effectively the same thing. You have to look really carefully at that axis whether it’s going from 100 to 200 to 300 or 100 to 1,000 to 10,000 to 100,000.

But what we’re looking at, you’ve probably been hearing a lot about doubling time, is that effectively as something’s transmitted at doubles, and so something that appears very small, can grow exceedingly rapidly.

So, people who were tracking this is understood this, saw those early numbers that still in many cases looked low to the public and were able to model or to envision what would happen with the exponential growth. And we were starting with a doubling time of about every three days.

Now, fortunately, an epidemic will not double forever. You probably realize that that would exceed the population at some point.

It will start to come down for a variety of reasons, and those can include population immunity due to past infection, if in fact that is what happens, or due to a vaccine, hopefully which is our best, safest way to gain immunity for the majority of people. Or it can happen because it’s not spreading as fast or as far because we’re doing things like physical distancing where when somebody becomes infected it’s just not possible for it to extend to that many people, so that’s kind of the early course that we’re at. We’re really on an exponential growth trajectory.

We’re going to try to slow that down, so we’ll still be seeing new cases, but fewer new cases and then eventually fewer hospitalizations and fewer deaths, because those follow with the time lag.

Sarah Dawson: A lot of people are interested in understanding the value of a homemade mask. As we know there are shortages of masks and our governments and industries are working on trying to fix that and it’s amazing to see Western trying to make a difference there, too.

Do homemade masks make a difference? And when people do have to go out into the public for groceries and whatnot, do the plexiglass screens make a difference? How are those things helping or not helping in our communities?

Eric Arts

Eric Arts is director of the ImPaKT, a new facility at Western’s Schulich School of Medicine and Dentistry where pathogens can be imaged in real time.

Eric Arts: In my household right now, this is a constant debate. My in-laws are staying with me and my wife and my kids, we’re constantly debating the value of masks. I’ll give a shout out to Sue and John Walker, my in-laws, who make it possible that I can be working all the time because they’re preparing all my food and everything like that.

I think with masks, the trouble we have right now is that we don’t have enough masks for the people that are on the front lines. And whether that be police officers, whether that be EMS workers and people in hospitals, anyone who might have contact with patients, they should be provided PPE and we should try your best to get that to those individuals.

Now within the community and wearing masks, I, for one, think it’s effective. And the reason why is not necessarily in protection of you from COVID-19 from someone else who may not be wearing a mask for example, although there is a part of that. And it’s been shown that the aerosolization of the virus can actually stay in particles and survive for sometimes a minute or two minutes suspended in air. So, if someone had coughed and you walk through that airspace, especially in in a crowded grocery store, that can be problematic.

Although I think that that’s less of the problem as to why you wear a mask, and that is because there’s a lot of asymptomatic people walking around that have no idea that they’re infected, and in those cases it’s been already shown that they are responsible for transmissions.

I think that that’s where some kind of protective facing will reduce potential transmissions. But this has to be done, not piece meal. It’s got to be done with the entire population when they’re out in public, and that’s what China did and that’s what a lot of countries have done in Asia. And I think it does show some effectiveness, although we don’t know, and we will not know the answers to these questions until possibly long after this epidemic is over. Because to analyze the data and to do real research studies on it is going to take time.

But just from a practical point of view, it just makes sense to cover your mouth and your nose when you’re in public because, again, it prevents you from getting infected but it could prevent other people from being infected.

And I think we’re going to see that coming out more and more. We can develop homemade masks, and everyone can be involved in creating them effectively. Even any type of surface that you would breathe through probably would provide some level of protection. Although honestly, some things are better than others and we should have that out on the web and tell people how to construct them.

Greta Bauer: I just wanted to add a couple of things to that and that’s just to make sure that you’re doing it safely. I also support non-medical masks for the public. Remember though that when you come back in, that mask has to be considered contaminated and should go immediately in the laundry.

And also if you have a poor fitting mask that you’ve designed, or a scarf or a tie, you’re adjusting it all the time and then you’re touching it, you’re contaminating your fingers, you’re touching your eyes, you’re potentially spreading it.

So, learn how to use it properly and treat it properly and then I’ll just also flag that there’s some advice on the Internet for different filtering materials that you can insert. And there are some nice models of masks where you can actually put in an insert although there are warnings out there from some of the companies about using furnace filter materials, for example, that point to issues with fiberglass and small bits of glass that you could be inhaling.

So if you’re going to do it, just make sure you’re doing it safely, that you’re cleaning it immediately after use, that you’re not cross contaminating and that you’re not using a kind of filter material that’s going to cause harm to your own home.

Sarah Dawson: Can we think about how long it lasts? Eric, you mentioned that it can stay in the air, but do we know how long it can stay on a surface? We hear clean your surfaces frequently and as you’re touching your protective wear. There was the idea that you might be overly confident then that you protected yourself, when in fact are spreading it, without realizing it, onto different surfaces. What’s the lifespan that the virus can stay on a hard surface?

Eric Arts: So, just to adjust the first part and get back to what Greta said, for myself when I work in the lab and I’m in a Level 3 facility or Level 2 possibly, I’ve learned not to touch my face because I have gloves on, they might be contaminated. But for most people that’s a really hard thing for them to understand. And it’s something you do, unconsciously and that makes it difficult, so that’s the first thing. And touching your face is probably one of the major methods of transmission if you touch a surface.

So now surfaces, they’re not all created equal, and that’s one thing we’re just starting to do studies on as a team, to test the viability, how long the virus lives on different surfaces. But it’s somewhat understood that if the surface is anything porous or that can absorb water, like cardboard or paper, the virus is not going to live very long. Because pretty well, the virus can dehydrate and when it dehydrates it’ll be dead. But on surfaces like a hard plastic, metal, countertops, etc., the virus probably will survive much longer because there’s nothing on those surfaces that really absorb water.

That’s the understanding, so if you’re touching things like handles or touching surfaces in grocery stores, it’s good to constantly wash your hands and clean and try to avoid touching your face.

If you wear gloves, just remember that the gloves are only effective if you don’t touch your face, and you should remove those gloves after you visit a place like a grocery store, because they are no good to you after that.

That’s a general understanding that’s been told to many people all around, but it’s a really hard thing to understand in the context of why it works, and so that’s why I share the information.

Sarah Dawson: Thinking about developing a vaccine, new and emerging technologies or creating a drug that could treat people who are infected, how do all of these things fit into the landscape that we’re living in right now? And is there a timeline on which one of those aspects might be more effective sooner than later? How does that all fit together for us?

Eric Arts: So I’ll start off. And then I’ll let Greta discuss more of the timelines and how acceleration is more difficult than people think.

We are asked to do an incredibly monumental task, researchers around the world. And what we really need is people working really hard and really fast on this to try to discover potential therapeutics, drugs and vaccines. We have templates for these types of drugs and vaccines, but in normal courses of time we would take months, if not years, to really develop these drugs and vaccines.

You know one thing is and I say this because it’s a lesson that we need to learn as a public, as researchers, and as governments, is that no more can we pull the plug on this kind of work that we’re doing. Like we did after SARS and after MERS, which is another coronavirus that caused an epidemic. And if this happens after this COVID-19 epidemic, I’m going to quit. Because we need to continue to invest. This has happened three times in the last 15 years and we need to stop turning off the taps when we’re done with an epidemic. And we will be done with this epidemic. This we will survive. This will end. And the worst thing would be to stop investing into this research.

But saying that, we are tasked with something really difficult. We have to drop everything we’re doing and focus on this solely and right now, it’s really hard to operate in a University that’s shut down. It’s not fully shut down, OK, but we’re probably some of the only people working right now in laboratories. I’m in my office right now and I’m coming in every day. There’s no one here, so that’s fine.

But we need to work very hard in developing vaccines, and fortunately Dr. Yong Kang had a vaccine that he was already testing for MERS and he’s now adapting that for this current coronavirus. So, I want to say it’s a pretty easy plug and play if you will.

We’re taking out the parts of MERS, which is a coronavirus that caused an epidemic a few years ago, and we’re putting in SARS CoV-2 or the virus that causes COVID-19. And then will be rapidly testing it. Steve Barr is developing pathogenesis models for the virus to test in his vaccine approach, and Ryan Troyer is working on a system to rapidly screen for drugs and the effectiveness of this vaccine. So, all of this is coming together.

None of us were doing coronavirus research prior to a month ago and suddenly we have to become coronavirus experts. We’re virologists so we can do it. But it’s still a challenge. But once we get these things, people think, “Well that’s it. Now we can put it into people.” And that’s where maybe Greta can speak to this more.

Greta Bauer: So timeline-wise, a vaccine is probably going to be one of the last things that we get because there is phase one trials which are basic safety testing and dosing. And then you have to scale up because it’s very possible for something that has activity against a virus to not function as a vaccine and even to harm people. So, it’s not like we can just go forward and say, “well this will help, or it won’t,” it could actually harm people.

There are parts that are moving faster, treatment research is moving fast with regard to re-purposing existing treatments for other conditions. Some of this unfortunately has been overhyped in the press.

I think most people have probably heard about hydroxychloroquine and azithromycin as a combination treatment based on one really poor, initial study. And you don’t have to be an epidemiologist to understand that if a study starts with 26 patients on the treatment and 16 controls and they only analyze 20 of them but there are concerns about what happened to the other six. They didn’t complete the treatment because one died, three progressed and were sent to the intensive care unit and the others were not clear.

So, you get this stuff in the press about “this is a cure.” Well, it’s not.

People took it, some died, some ended up in the ICU, some did better. And the subsequent studies, not surprisingly out of China in new data out of France, show no effect.

But we do have a range of existing drugs and we know enough about the mechanisms of viruses to have a good idea what drugs might plausibly have an effect, and they’re already approved, we know a lot about the safety.

So the best option will be if we can come up with something that already exists, is already approved, we already have safety data on, then we don’t have to go through the whole long process that vaccines will have to go through with initial safety testing.

And if we don’t find something from existing drugs, then it’s going to be a much larger process of developing things that target things that are really specific about this virus. So, trials are underway now and there’s some that are scheduled to wrap up in early April.

There’s going to be a lot of data coming out on treatments in the near future, so that’s very good projections. You’ve been seeing a lot of the Province of Ontario’s release and other provinces. Well, federal government people are put under a lot of pressure, but they’ve got different challenges because of different testing criteria in different provinces, in different case definitions for confirmed cases. It’s a lot harder to put together projections federally when you’re dealing with different contingencies in the data across all the provinces and territories.

So, we’ve been seeing that kind of research that is really about taking plausible estimates and modeling what could happen: best case, worst case, realistic range of scenarios, what happens under different interventions.

We saw from Ontario, the projection that without interventions we would be looking at about 100,000 deaths. That’s definitely within the plausible range, I don’t think that’s a worst-case scenario. If we went up to 70 per cent infected, potentially higher case fatality rate, it would be a lot more than that, but I think that’s plausible. The good news is that projections say that we can reduce that by 85-97 per cent through the kind of interventions that were taking.

Starting with the really hard work everybody is doing right now on physical distancing. It’s been really challenging. People have had to move mountains to change systems to change everything that we’re doing and to do the emotionally hard work of just staying home. And so, the earliest research we see is that kind of thing.

And then we’ll move into treatments. We already have, I think over 200 different tests that have been developed, either for the virus itself or for antibodies in response to the virus. How well those perform, which ones might be useful in different contexts and what can be rolled out quickly is a big challenge. But in addition to effective treatments that stop the development of severe disease, which is what we’re trying to do right? Many people get sick and then often in the second week of symptoms there is something else that happens that causes a severe disease development, difficulties breathing, hospitalization, and ultimately for some number of people, death.

I think another thing that could be a game-changer is just rapid testing. Because when we look at how we’re going to move out of physical distancing, it’s going to be either through the development of natural immunity, and we don’t know yet whether there’s long term immunity to this infection, it’s going to be through a vaccine which will take a while and we’re going to be aided if we have rapid tests that can detect the antibodies. And if in fact it does indicate immunity, then people can start to move out into playing different roles in society that don’t require social distancing.

So that’s kind of the timeline. Hopefully we can learn more about immunity. We can get people into different roles. We can have drugs that prevent severe disease and death, amongst people who are infected and ultimately what we want is a vaccine because that’s how we want to reach population immunity. It’s going to be the safest way with an effective vaccine.

Sarah Dawson: So let’s talk a little bit about physical distancing, because as you probably are experiencing even yourselves, this is one of the trickiest things that all of us are encountering right now. We are away from our family, our friends, our schools, our communities in a lot of ways, and so there’s a lot of questions and a lot of concerns about how long the human spirit can continue to thrive with social distancing. And so, we’re hearing “stay at home, only go out when you have to” and that’s obviously a very clear message from both of you.

That being said, what are the considerations that people should keep in mind as they’re navigating their own personal decisions for themselves and for their families around when to go out and how to go out and who to be around? Can you give us give us some ideas around that?

Eric Arts: It’s evolving and changing as the epidemic has gone on and it will continue to do that. I mean, we’re seeing more and more tight restrictions, which is, I think, essential. You know this weekend I was quite upset going to the Home Depot, Rexall, Sobeys parking lot and seeing it almost completely full and that to me was disturbing.

People have to realize that you really need to practice this and it’s not necessary that you get your gardens ready. And if you do, get your gardens ready, you don’t need to go to Home Depot to do that; you can basically order curbside.

Anyways, there’s a lot of things that we need to do more in preventing these interactions. But we’re doing a really good job otherwise, I would say. I mean, that was just one thing I saw that I was disappointed in, but I think that everyone has a pretty good spirit right now, and people are interacting and I’m not a psychologist, and I can’t really speak to how long people can handle this, but I think when we look at what’s happened in the world wars and much more worse situations than what we’re facing now, believe it or not, the human spirit is very resilient and people will manage and in fact I find people a whole lot more friendly these days.

You know, I’m talking to people and neighbours from a distance that I’ve never talked to before, and I think that’s refreshing. I have Zoom parties with friends where we all grab a beer and I haven’t talked to these friends in months, sometimes years and so I think there are benefits to what we’re experiencing and you can do these types of things, so I think we’ll be okay.

I mean, financially, I think that’s a bigger issue and I can’t speak to that, but the government has made concessions that will hopefully help the populous.

Greta Bauer: I think we’re going to do this because we have to do it. We don’t really have a choice. We know that the physical distancing works and it’s all we have at this point. Whether that’s going to be good for people’s health is an open question, and I think some of it depends on the home situation that they’re in.

So in addition to the financial supports that need to be put into place, we also need intensive social focusing on food supply chains and on domestic violence and child safety, because for some people this has meant being locked in a home with abusers, right?

I haven’t left my house, other than to go in the yard, for three weeks because I was traveling and I was post-travel quarantine and developed symptoms and got COVID-tested, and thankfully that was negative, but here I am. My lab, unlike Eric, involves computers and a lot of software, and I already had that set up so I’m good to go from home.

But in terms of what this means, we don’t know exactly how we get out of this. We have different ideas and the science is evolving so rapidly that this is going to look really different in a month. But we do have to be prepared to do this for as long as we need to, and so we need to set up the systems to make that work, to keep people safe, to keep people fed and to support them in terms of their mental health.

And keep in mind that even as we let up on these going forward, we’re still going to be in a situation where everybody has to be prepared to go away for two weeks and self-isolate if there’s an eruption of an infection, if they are exposed to somebody. And so, setting that up requires that we have that kind of social and economic stability, because this really makes clear, and it’s always been true, how much our health and well-being really is interdependent with everybody else’s.

Sarah Dawson: Thanks, we have loads of questions coming in, so this would be a good time to segue to some rapid-fire questions from those who’ve tuned in today. So, Dave Lee asks “What sites do you recommend that have both accurate, timely data and comparisons to other jurisdictions in Canada and the rest of the world?”

Greta Bauer: We might be bad people to ask, as we probably read things that many people couldn’t read. Or wouldn’t read. The public National Library of Medicine in the U.S. has put together LitCovid, it’s an open index of scientific literature. I read that, everybody can read that, but it’s not exactly written for the public and I go to the Johns Hopkins site. Eric, what are you reading?

Eric Arts: I go to the Hopkins site. I actually go to world meters too because they’re pretty good at updating the number of cases. I guess it’s the way you look at these sites too, and you know, looking at the cumulative total is misleading in some ways and you really want to look at the daily case rates that exist in different countries to really understand what’s happening. And to realize that it fluctuates a lot with the amount of testing that is done. But that’s where I keep the closest eye on, to see what’s going on.

And the other thing is, for me personally I am laser focused on what’s happening or what potentially could happen in sub-Saharan Africa. And for me that is a telltale sign as to what potentially could happen in the summer when we hit warmer climates with higher humidity.

So to add a little silver lining to what’s going on is, despite what people think, there are pretty good networks for testing in a lot of sub-Saharan African countries because of the widespread testing of HIV and for treatment networks, etc. And what we’re seeing, there is very, very slow transmission and well, for some reason we’re not seeing large epidemics emerging in these sorts of tropical zones.

I take some solace in that if you’re looking at what’s going on, you might want to look across the world at what’s going on to really get an understanding. And this is really, so far, surprisingly, a more northern disease. Although it has obviously affected Brazil and a lot of South American countries, and a lot of people have emerging data as to why that might be happening.

So, you have to look at it as a whole and not just the number of deaths which is a lagging indicator of the number of new infections occurring.

Greta Bauer is a professor at Western’s Schulich School of Medicine and Dentistry. Her understanding and analysis of key statistics about disease progression, population hotspots and social distancing have placed her perfectly at the epicentre of the COVID-19 pandemic.

Greta Bauer: I’d like to add that the person may have been asking also about like public-health recommendations in data and not just tracking the epidemic we’re talking about. Our public-health organizations, provincial and federal, they’re doing a really good job with this. I know it can be frustrating when recommendations change, but remember up until a few months ago, we didn’t even know what this pathogen was.

And as we learn more, these recommendations change. I just ask people to be patient and to not be frustrated or not to think that things were being misrepresented. It really is the speed at which knowledge is moving and I would like to see people pay attention to what’s coming out of public health because they’re trying to communicate that calmly and in real time to the public.

Sarah Dawson: What do researchers think about anti-malaria medication currently being used in New York?

Greta Bauer: That’s the one that I was already talking about with the hydroxychloroquine. Not very promising. It’s not looking good.

Eric Arts: I don’t think it is an effective treatment. You know what you’re seeing a lot in the media, and the public should realize this, is we have publications that come out in the scientific literature that are peer reviewed. Meaning that people like Great and I and other scientists review these papers and check for their validity and then they’re published in journals.

And usually you can trust those articles a little bit more than what’s happening today and what the media is picking up. So, we have this ability, just recently before an article is published, to put it into what we call bio archives. And this has not been peer reviewed.

Researchers are adding more recent results, but they haven’t been peer reviewed in a lot of times, aren’t properly controlled, or we make mistakes, and that’s where the problem lies. Because the press now is picking up on these articles and we have to work hard to say, “This has not been peer reviewed, this has not been tested effectively, we don’t know if this is correct or not, the numbers are too small.”

There are so many aspects that exist in what we call bio archives that is unfortunately releasing a lot of misinformation into the public and journalists don’t even know that that’s misinformation.

We are challenged with this right now and it’s kind of a weird circumstance that it’s happened at the same time at this epidemic. But again, just like Greta said, we need to trust public health officials and people that are in government and in charge and people that can provide you a filter in some ways to understand what’s really going on.

Sarah Dawson: A question from Jeff, who submitted from Instagram, and wants to know “what’s the safest way for me to bring groceries and supplies to my elderly parents?”

Eric Arts: There’s so much in that question. Spraying things with disinfectant, if you got a good misty spray, you’re probably fine. If you want to wipe it down on top of it, that’s also fine.

Again, remember that if it’s on a cardboard or paper surface, the virus is not going to survive very long from what we understand, but it’s still probably good precaution to spray things off. Of course, be careful, because if your food is exposed, you don’t really want to do that.

And if you need to, just wear a pair of gloves to unpack the groceries and throw away the bag. You have to have trust in the person who’s packing the groceries, if you’re doing curbside pickup, that they’re doing it with gloves, and almost everybody is and those are the types of things that are just good precautions.

And if you have some gloves, you can wear them. You know, if you have latex gloves, great. If you have winter gloves that you can throw in the wash, then wear those. There are a lot of options that you can use, just remember try to avoid touching the outside of things that you might come in contact with.

But these are extreme precautions. For the most part, the surfaces of groceries that you buy in the bags aren’t going to be a major source of potential infection, and these are pretty simple mitigating ways of dealing with it that you can manage.

Greta, you think that’s reasonable?

Greta Bauer: That’s reasonable. Also keep in mind that when you hear about how long the virus can survive, it’s going to be very small amounts of virus at the end of that. If you hear about detecting virus on a cruise ship 17 days later, we can detect things that are really are not in the amount that’s going to cause that’s going to infect you, and in fact, the half- life of the virus can be fairly short.

So even if you leave something, you leave it sitting there for hours first, you’re going to have a reduced amount of virus on it if there was virus at all.

Just do the best that you can. If it were spreading through food readily, the epidemic would look really different than it is. In fact, we don’t have any documented cases of flu transmission through food that I’ve heard of, at least at this point in any way. So that’s really just about us being extra precautious, wipe things down to the extent that you can and then afterward wash your hands. And wash them well.

Everybody’s got the message that you need to wash them for a while. You know scrub them down really well and you’re good. You don’t need the gloves if you don’t touch your hands to things and then you scrub them down afterwards, right?

Eric Arts: Let me emphasize that too, because I probably wasn’t thinking about how to really answer the question. Exactly what Greta said, if you’re touching this material and you just avoid touching your face and you wash your hands rigorously afterwards, you’re fine, you’re not going to get the virus from touching the surface.

It’s only in circumstances where you’re getting it from a source where you don’t know who’s been in contact with that source, I suppose. And we’re talking immediate contact if it’s been sitting around for hours, you don’t really need to worry about it. Just wash your hands.

Greta Bauer: We didn’t actually answer a question earlier. Somebody had about plexiglass at the grocery store, so I’ll just add in here. Don’t touch that. That’s a good barrier between the customer and the person who is working there and then it’s going to catch droplets. If you’re a customer coming up, that partition is covered with the droplets of all the customers that have just come through there unless it’s being wiped down between each and every customer, and so be cautious.

Be cautious of that part of the grocery-getting for the parents or grandparents, you want to think about the purchasing aspects. Think about the transit aspects, how you’re getting it there safely. And then what we’re talking about which is what happens when it gets there.

Eric Arts: And bag your own groceries. Almost every place now you’re bagging your own groceries but do that because you know what you touch. The person that is serving you might want to be very helpful, but just say, “No, I got it” and that’s probably a better way to deal with it.

Sarah Dawson: We’ve got a couple of questions here that I’d like to get to before we have to sign off – one is that National Geographic reported yesterday that a tiger in New York City Zoo has contracted the virus. Is this true? And if so, is there a heightened concern that the virus can spread through the animal kingdom and what’s the impact to humans?

Eric Arts: This is true, I believe it is true. This virus can spread into different animal species and cause differential disease. So, some animals might be relatively immune to the pathogenesis of the virus and some animals are just completely immune to the virus and then some animals will develop disease. There’s emerging data that cats potentially could develop the disease, but that’s really preliminary.

Don’t worry about your domestic cats, they don’t mean to say it that way.

But we have to realize that the whole reason why we’re getting these diseases is our encroachment on wildlife, and this is a major reason for each of these coronavirus outbreaks, and a lot of other diseases that don’t always get attention. Even HIV, you know it jumped into the human population from chimpanzees, probably at the turn of the century in the early 1900s. And it is largely because we get diseases from animals, even when we domesticated livestock 10,000 years ago.

We succumbed to a lot of diseases that we know about today and eventually we developed immunity, which was sort of herd immunity that we’re discussing (potentially that we could develop to this coronavirus, hopefully will have vaccine before that emerges).

But it’s this contact with wild animals that has really been responsible for these epidemics and that’s another thing that a lot of people are studying, us included, is that we should be better prepared for this. We can sample these wild animals noninvasively collecting their poop and testing that feces for potential viruses that might jump into humans; even developing vaccines before they jump into humans is a potential for the future.

Because this is not going to get better. This is going to get worse in terms of new infections spreading because we’re just encroaching on their territories more and more and more, and this is really one health perspective that we really need to be paying attention to. It’s not only us getting viruses and bacteria and other parasites from animals, but it’s going the other way too. We are infecting animals, the great apes, in the Congo basin, in the jungle, are being infected by humans, and they get cases of influenza, and they die because of us, so it goes both ways.

Sarah Dawson: Alright, one last question. Greta, I’m going to send it over to you and get your thoughts on this. Andrew writes “What are your expectations for the outcome in Sweden as compared to other countries given their decision not to enforce any sort of lock down or intensive physical distancing?”

Greta Bauer: We’re going to be following that closely. We’ve seen different countries take different approaches, right? Japan has also not really locked things down, but they’re doing a much lower level of testing, so it’s hard to know what’s happening there. And South Korea has stayed quite functional, but with a very high level of testing.

Sweden has stated that their policy really doesn’t allow them, that it is built on trust, and that they’re making recommendations. So, the first question is going to be how much social distancing actually happens in Sweden? We measure that because even if it’s voluntary, even if the government’s not putting the same measures in place, people are still social distancing.

It’s going to depend largely on what people do there with their behavior. Because it’s ultimately, whether there’s a policy that mandates it, makes it illegal to gather, “this strongly recommends” etc., what’s really going to matter is the extent to which people are separate.

And we did not yet understand the ways that that may be influencing the trajectory in different countries beyond intentional physical distancing. So, is the reason that it moved so far and fast in Italy because people greet each other with hugs and kisses versus keeping more of a distance? And we know that culturally our sense of physical space is really different, the ways that we come into each other space and contact each other for greeting, whether it’s a bow or a handshake or a kiss, is really different.

Before we even start talking about the moves that people are making toward physical distancing, you know as well the households that people live in are different, so again, if we’re staying home in larger groups, in smaller groups, and that’s going to impact the secondary spread as well. If one person brings that into a household, is it going to one other person? Is it going to nine other people? It’s going to really impact the overall shape.

So, it’s going to depend on those same factors regarding how people cluster together, how they separate, and the ways that they come into contact with each other, so I don’t have a clear projection. I’m kind of curious myself to see where this goes.

And in the end when all is said and done and we can look back on this, I think there’s going to be some really interesting research into what factors shaped really different trajectories for different countries, states, provinces, jurisdictions, in the course of this, because we’re seeing really different approaches in different places.

Sarah Dawson: If you had a crystal ball Eric and Greta and you could predict the future, how long do you think we’re going to be distancing ourselves from one another?

Eric Arts: I hope the governments will maintain this policy until we see a clear drop on the other side of the curve and to the point where we have very minimal transmissions. Because really what we’re talking about is concern for the elderly. And that’s where I’m most concerned that if we lift those restrictions too quickly, we might run into some issues.

I do believe that we’re going to see a reduction in the summer. I see more and more data suggesting that this is going to work a little bit like influenza. But saying that, most of us suspected it will have a second wave and the second wave will hit sort of fall when temperatures get cooler. And with that we might see another epidemic emerging, hopefully less dramatic than the first one. And that’s why when we talk about vaccine development and even drug development, there’s very little we can do for this first wave and hopefully we will have some things in place that can mitigate the second wave.

And again, it will be key to see what will happen in the southern countries in the southern hemisphere. If they start developing large epidemics, let’s say in the southern parts of Argentina and Chile, South Africa, as they approach winter then we know it will be switching back and forth and then we will have to continue to implement travel restrictions until this all sort of calms down.

But things will get better. We will start seeing people able to interact. And with new rapid testing, we will be able to test ourselves much more frequently, and that will be a telltale sign as to how we can interact, right? So, it’s a different dynamic that we’re dealing with and how we go around and socialize, but I think it’ll get better.

Sarah Dawson: Greta, any last-minute comments?

Greta Bauer: Just the crystal ball aspect of things, if we go back to our last real comparator, the 1918-19 influenza pandemic. Remember that that took almost two years to resolve and it came in three waves: the spring of 1918, again in the fall and in the winter of 1919.

And what we’re doing now with this is the equivalent of that first kind of wave, and right now our tool is physical distancing as we’re changing over policies and learning more about this. I’m hoping that when the second wave hits, we have rapid testing in place, we’re able to know more about immunity, and so we’re able to move in a situation where we’re able to be together in small groups, to meet in person, re-establish some of that, and again with anybody who’s potentially exposed being supported in being able to step back into self-isolation for a couple of week because we’re still going to be grappling with this.

My hope is that through vaccines we can avoid that third wave pretty much entirely and gain immunity through vaccines in advance of that because it is a really different time.

Remember when that outbreak happened too, you know that people die from influenza, not as directly as with COVID, they died from bacterial pneumonias that would follow afterward, and that was in a pre-antibiotic era, so you know any treatment that we have now is going to look much better than that.

In some ways, this is kind of the really hard point. And I don’t mean to belittle the other points because it’s going to be hard in very different ways throughout this, but this is where we’re being able to act or being told we have to act in ways that may seem extreme at a very early point and we don’t see all of the effects of either our efforts or we don’t see the worst of the pandemic to justify it. And we don’t have a lot of information yet, so we don’t really clearly see our way out of it. But that’s going to become more clear as we go on.

So, I just want people to be left with the idea that we’re not going to be in this version of social distancing forever. It’s going to change as knowledge changes, and as the pandemic progresses.

Sarah Dawson: Thank you both for your time today, we have breached the 1p.m. cutoff. I am sensitive that people may have things that they need to get back to and you both have really important work to continue on. So, thank you so much for your time. You shared a tremendous amount of information with us and we wish you both health and safety and so stay well during the next few weeks.

Greta Bauer: Thanks to everybody who joined us today.

Eric Arts: Yes. Stay safe.