Your coronavirus questions answered

Dr. James Hinrichs

By Dr. James Hinrichs

Editor’s note: This column by Dr. James Hinrichs was made possible thanks to the generosity of Dr. Jonathan Root, Dr. Norman Druck and Galia Movitz. 

Thank you for your kind responses to my article last month in the Jewish Light on COVID-19. The situation has clearly evolved since my last column, and I would like to respond, as well as I can, to some of the questions that have come forth from Light readers. Should you have additional questions that you would like me to address, please email [email protected] (include “coronavirus question” in the subject line). 

Question: After grocery shopping, is it necessary to wipe down all my groceries before bringing them into the house? And which is safer, paper or plastic? 

Answer: The research on the ability of this coronavirus to persist and be infectious on inanimate objects is still not complete. At present, the New England Journal of Medicine reported on a National Institutes of Health study on this matter, noting that plastic and metal surfaces could have detectable virus on their surfaces for up to 72 hours, but at very low quantities.  

Paper and cardboard can hold virus for shorter periods of time. The key fact on these studies is that we do not know how long this virus is actually capable of causing infection if transferred from the hands to the mouth or eyes. I have heard of people leaving their groceries out for three days, but that leads to all sorts of problems, such as spoilage. 

I would instead recommend using hand sanitizer frequently while shopping in grocery stores, definitely unpacking at home after washing hands thoroughly, then washing hands thoroughly when finished storing. 

As always, any food preparation should be preceded by good hand-washing and with post-preparation hand-washing. 

Try to avoid, if possible, touching your face or eyes during the food preparation or storage or while shopping. Masking is now becoming a general recommendation when out shopping, even if not close to other shoppers.

Should I wash the clothes I wore to the grocery store as soon as I come home?  

Unless there was clear soilage while in the grocery store, or you had to balance products against your clothes, I would think that the above recommendations on hand-washing are sufficient.  

Again, there is no definitive information about how much virus is present on these objects and even whether it can be transmitted as infections. I do think that use of cotton masks, bandanas or scarves over the nose and mouth while shopping should be strongly encouraged, as the aisle you are shopping in may have had some droplets still present if someone who is contagious was coughing a short time before.  

The mask protects you but, importantly, protects others that are within 6 to 8 feet of you if you are carrying the infection and are asymptomatic. If you feel self-conscious about doing this, remember that you are protecting others as well as yourself.

I’d like to plan a summer vacation for late July. Do you think it will be safe to travel by airplane by then?

The situation is too unclear at present to plan a lot of traveling, particularly international. It is possible that countries, when they relax current restrictions, will have a resurgence of infections and become unsafe again. In addition, countries in the Southern Hemisphere may have a significant number of cases during their winter, affecting Northern Hemisphere countries.

I heard that once things “reopen” they will likely do so in a tiered system. Can you explain what that might look like?

From what I understand, various nonessential workers may be allowed to return to work if the number of active cases falls dramatically. It is also possible that antibody testing will be available as this occurs so that there can be information on what percentage of the population is presumably immune and may be less likely to transmit or acquire a new infection.  

When this occurs, there will also have to be a concerted effort to quickly test anyone who appears to have coronavirus infection and then get that patient home and use contact tracing very aggressively to ensure the number of secondary cases is minimal. This requires a much faster turnaround time than we currently are experiencing (seven to 10 days) for outpatient testing. 

I was in Spain in November. Not long after, I came down with a terrible cough and some body aches. The cough was like nothing I ever had before – superdry, almost like I was gagging. It took a while to get rid of. I am now wondering whether it’s possible that I have the antibodies in my system. Is that possible and, if I do, does that mean I won’t get the coronavirus now?  

It is unclear as to how much coronavirus infection was in Spain in November, as the infection was just blossoming in China later that month and in December. It is more likely that you had influenza or another respiratory virus. When antibody testing becomes available, you could be tested at that time and determine whether this was coronavirus, but I would assume until then that you are not immune and can certainly get this current viral infection. Stay safe!

Can you get coronavirus more than once? Or once you get it,  are you immune?  

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, has addressed this several times. His presumption is that you will likely be immune to subsequent infection in the near term, but how long lasting that immunity will be requires further research and testing.

Is it likely that coronavirus will return with a vengeance in late fall?  

If this virus is a respiratory infection that mimics the spread of influenza, as most experts are predicting, then we will see a resurgence in the fall and in the winter. The hope is that we may have more effective treatments by then, will be quicker to isolate and investigate contacts of infected individuals and be prepared to enact social distancing at the earliest sign of its return. 

The degree of the epidemic at that time will depend on how much “herd immunity” exists in our communities, as it may require that 80 percent of the community has been infected before, thus not allowing for much more spread of the virus if it returns.  

I think these numbers are unlikely, so we will need to depend on the measures listed, as well as the eventual development of a vaccine, likely not until next year. This is a “long haul” situation, and our world has changed because of it.  

Keep safe!

Dr. James Hinrichs is board certified in infectious disease and medical microbiology and practices part-time in telemedicine. He is also involved in an HIV clinic serving North St. Louis County and St. Charles County and serves as Medical Director for Doorways, a nonprofit organization providing housing for HIV homeless clients. As such, he has been involved in helping the organization with its coronavirus planning and in training nursing staff at the residential facility, which takes care of sicker HIV patients needing ongoing nursing care.