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As second wave of COVID-19 roils Illinois, here are 5 updated ways doctors say you can stay healthy

Chicago Tribune - 10/21/2020

In recent days, Mayor Lori Lightfoot and Gov. J.B. Pritzker have issued stark warnings about rising COVID-19 rates, cautioning people to stay on guard and refrain from gathering in large groups as a new wave of the pandemic hits Illinois and much of the country.

Illinois officials Tuesday announced it’s time to revert to earlier lockdown levels in parts of the state. Now, even the most responsible residents who’ve sacrificed all year could face their breaking point as the holidays near and Chicagoans face a long, cold, dreary winter.

The end result for many is complacency, said Dr. Emily Landon, an epidemiologist at the University of Chicago Medical Center. For Illinois alone, this uptick in cases could be considered a second wave. But for the country, this is more like the third wave -- first were the urban centers, including Chicago, in spring, and second was the Sun Belt in summer.

“The bottom line is cases are going up and it seems to be looking pretty serious this time,” Landon said.

A lot of the advice about how to protect yourself against the virus has evolved since the state opened up in the spring -- just Wednesday, the CDC updated its guidance on contact tracing and the definition of “close contact” with someone with coronavirus. For those feeling a new urgency about COVID-19, here’s the most recent guidance from Chicago-area doctors and the U.S. Centers for Disease Control and Prevention on how to protect yourself as COVID-19 cases surge.

1. Do you really still need to wear a mask?

The short answer is yes, experts say.

COVID-19 has led to the death of nearly 220,000 Americans. About 40 million people worldwide, including 8 million Americans, have survived the disease. Those numbers represent the patchwork response from states or regions, versus a single unified strategy, said Dr. Michelle Prickett, an associate professor of medicine at Northwestern University’s Feinberg School of Medicine.

“Universal masking is 85% effective,” Prickett said. “But everybody has to do it. You can’t approach it as ‘It’s somebody else’s problem and they’ll take care of me.’ ”

As the pandemic has worn on, Prickett’s patients have told her they feel they have to make a risk calculation whenever they leave home. The solution is simple: Wear a mask every time you leave your home. Unless someone in the home is sick or quarantining or people who don’t live there come into your house often, home should be a safe zone where masks aren’t necessary.

“Your risk is less walking down the street than it is indoors, it’s about a twentyfold decrease outside versus inside, we know that. But it’s not zero,” she said.

Fatigue about protection is one big reason cases are spiking again.

“Getting through this is a team effort. It’s every little decision everyone in the community makes,” Prickett said..

“We need to treat this like no shoes, no shirt -- no mask -- no service,” she said.

2. When should you social distance, and is 6 feet enough?

While interacting with others, the “farther apart, the better,” according to a guide from the Infectious Diseases Society of America, and the CDC has consistently recommended at least six feet of distance.

When social distancing is not possible, like on public transportation, the physicians group said masks are especially important.

Social distancing, coupled with masking, is the best guard against the virus, said Dr. Susan Casey Bleasdale, an infectious disease physician and associate professor at the UIC College of Medicine.

“I think it’s an important thing to highlight that it’s not an either/or but both,” she said.

Doctors have also emphasized that the amount of time in contact with someone else affects transmission, so reducing the length of a social interaction can help, and experts still recommend avoiding indoor spaces with groups of people when possible.

“The more you distance the better off you are,” Prickett said.

3. Is wiping down surfaces still necessary?

COVID-19 spreads less commonly through contact with contaminated surfaces, according to the CDC, although the agency still recommends regularly disinfecting frequently used surfaces.

“It is possible that a person could get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or eyes,” according to CDC guidance.

But we know now that transmission through surfaces is not the primary way the virus spreads.

Instead, the virus often spreads through close contact with other people. People are generally exposed through inhaling respiratory droplets produced by infected people when they cough, sneeze, sing, talk and breathe.

Still, Dr. Michael Lin, an infectious disease specialist and associate professor at Rush Medical College, said people should regularly disinfect common surfaces like doorknobs and kitchen countertops. Wiping down surfaces you might touch just before eating is a good idea, Prickett said.

At the grocery store, it’s a good idea to wipe down the shared carts, but it is probably not necessary to wipe down every individual item when you arrive home, he said.

4. Does hand-washing really make such a difference?

Frequent hand-washing is still one of the best ways to prevent coming down with the virus, experts said. If for some reason you can’t or won’t adhere to other best practices, consistently washing your hands still should help reduce spread.

Hand-washing makes disinfecting surfaces less of an issue, Lin said.

“If one is able to do hand hygiene routinely, you don’t need to wipe down groceries and do extraordinary things,” Lin said.

Bleasdale said washing hands every time you get home is a good habit to stick with. She keeps hand sanitizer in her car and uses it whenever she returns to her vehicle.

“More often is better,” she said..

“Hand-washing is absolutely one of our best defenses,” Prickett said. “And it’s by far one of the easiest. ... People will let their guard down and that’s part of the increase we’re seeing in community spread.”

5. When or how often should you get tested?

The kinds of tests and their availability has evolved throughout the pandemic, as have best practices on testing. During the summer, the CDC revised its guidance on when people should consult with a doctor or be tested. Formerly, a person who tested positive was to be tested a second time to see if they were still contagious, but that’s no longer the protocol.

“We did move toward a symptom-based, time-based algorithm for returning to work,” Prickett said.

Coronavirus has a long incubation time. While with the flu you may want to think about what you were doing a day or two before you noticed symptoms, with COVID-19 you need to consider what you were doing a week before symptoms, which often begin with a fever, Prickett said. That has affected contact tracing because people don’t always remember every interaction so far back.

It’s also possible to have a negative test if you are tested too early, she said.

“It’s kind of like a pregnancy test, that’s a fair comparison. Just like it’s possible to test too soon and get a negative result when you’re pregnant, it’s possible to test too early for this,” she said.

With exposure to someone with COVID-19, someone should quarantine and see how they feel. If no symptoms appear, they should get tested after five days. If they have symptoms, they should call a doctor and follow recommendations about whether and when to test.

Without a known exposure but with symptoms, a person should follow the advice of their doctor. Those who test positive for COVID-19 will most likely be told they are considered no longer contagious if they don’t have respiratory symptoms or a fever 10 days after get symptoms or test positive, she said.

kdouglas@chicagotribune.com

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