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Fayetteville public health officer answers covid questions

by Stacy Ryburn | October 21, 2020 at 7:00 a.m.
Covid Questions with Dr. Sharkey

FAYETTEVILLE -- The Northwest Arkansas Democrat-Gazette has launched an online resource for readers to ask questions about covid-19 and its impact on the region.

Dr. Marti Sharkey, Fayetteville's public health officer, was tapped to answer questions. Sharkey is a pediatrician with a background in infectious disease. She reports to the city Board of Health, which advises city officials on matters related to the health and well-being of residents.

The newspaper will post periodic updates with Sharkey's answers to readers' questions.

To ask a question, visit Questions should be limited to topics related to the pandemic. Only those questions will be answered.

Watch the video here:

Below is a transcript of the video.

NWA Democrat-Gazette: Dr. Sharkey, If you could just tell us a little bit about yourself that'd be great.

SHARKEY: My name is Marti Sharkey, and I am the city health officer for Fayetteville. I was nominated by the mayor and the Board of Health and voted into office, technically, by the City Council back in July. I have a background in vaccine research and infectious diseases, as well as a master of public health.

I was born and raised here in Fayetteville. I left for college and medical school, did my pediatric residency at Johns Hopkins in Baltimore, and now I've been back here in Fayetteville practicing medicine for going on 20 years.

I answer to the Board of Health, but my role really is as liaison and educator to get information to the people who need it in order to make the best decisions possible. That includes the mayor on down to everyday citizens.

NWADG: We have a plethora of questions from our readers touching on different aspects of this pandemic and how it relates to our region. We'll just go down the list.

QUESTION: "Are we to wear a mask and socially distance?" This person mentioned how they go to the grocery store, for instance, and they'll see people wearing masks, but they're not 6 feet apart. So the question is, is it an either/or situation or is it both?

SHARKEY: It is not an either/or, it is a both. Both are equally important.

Wearing a mask and maintaining a distance of at least 6 feet from one another is really critical to decrease the transmission of SARS-CoV-2, and that is the virus that causes covid.

It is considered to be a contact by the Centers for Disease Control if you are within 6 feet of a person for more than 15 minutes, regardless of whether or not you are wearing a mask.

The reader mentioned the grocery store scenario. If you and the person you're in the aisle with are both wearing a mask, and just walk past each other in the aisle, the risk of transmission in that scenario is very minimal. It's not zero. The only way for it to be zero is if we're sealed up and cocooned in our homes. But that scenario is fairly safe.

Again, the risk is not zero. You don't want to stand next to somebody and chat with them, like when you run into your neighbor at the grocery store. Those days are not happening at the moment.

So, 6 feet with a mask, that is ideal. Try to limit your interactions to as brief as possible. If you cannot maintain that 6 feet, the best way to interact with each other is outdoors, socially distanced at least 6 feet, preferably with masks on to really decrease the transmission.

QUESTION: "I've heard people saying that if you have had the virus once that you won't get it again or you're immune to it. Is that true?"

SHARKEY: Unfortunately, that doesn't appear to be true. As we are learning about this virus and time goes on, what we are seeing is some individuals have been infected a second time.

There was a report of two individuals in India who had covid back in April and then tested positive again. It just so happened they had viral isolates at both of these times the individuals tested positive, and they were two different strains.

So there is documentation of people getting infected a second time, and we know it was not a persistent positive test. It was actually a new infection in these cases.

What we also are seeing is the antibody levels drop fairly quickly after people have been infected with SARS-CoV-2 -- about three months after their illness. The good news on this is that in persons we've seen second infections with, the second infections have been milder or asymptomatic. So there does seem to be some immunity to the virus if you get infected a second time around, but it is not 100% immunity. Over time, the antibody levels do wane and do seem to be able to get the virus a second time.

NWADG: So this isn't like mumps or anything like that, where you typically get it once, or mono?

SHARKEY: It is not chickenpox or mono or any of those. This is something you can get at least twice. Six months from now, we may be saying three times. That's something as time goes on we're going to learn. And we are learning.

QUESTION: "Can you catch covid via your eyes?"

SHARKEY: Yes. It is believed you can catch SARS-CoV-2, the virus that causes covid-19, through your eyes. The reason this is believed is that the cells on the surface of the eyes express the ACE2 receptor, which is the receptor that the spike protein of the coronavirus attaches to to infect cells.

Now, we have not done a study where we've actively tried to infect people with SARS-CoV-2 in that way, obviously. But, in theory, that is a possibility.

In addition, the coronavirus has been isolated in peoples' tears who are infected with it. So not only could you catch it through your eyes, you could potentially spread it through your tears. Therefore, that is the recommendation -- to avoid touching your eyes as much as possible, and for health care workers to wear protective eyewear as part of their personal protective equipment.

NWADG: So is it a good idea for someone who's not in health care, in addition to wearing the mask, to also wear protective eyewear when they go out to the grocery store or anything like that?

SHARKEY: It's not going to hurt. It's only going to help.

That comes down to, do we need to worry more about people who wear contact lenses and are messing with their eyes more? Are they more prone to it? I think there are going to be some studies coming out looking at that aspect eventually.

QUESTION: "How effective will or could a vaccine be?"

SHARKEY: We will not know how effective any of the vaccines currently being developed will be until they have completed the Phase III trials. That is when vaccine efficacy is evaluated in vaccine research, it's in the third phase of the trial. During Phase III, that is when the vaccine is given to tens of thousands of individuals.

When we talk about vaccine efficacy, we're talking about, does the vaccine prevent disease? Does it prevent infection with the virus altogether? Or does it just prevent symptomatic infections? What sort of antibody levels does it produce, and how long do those antibodies then stick around for? So there are a lot of components to how effective a vaccine is. Those are what Phase III trials look at.

Both the Federal Drug Administration and the World Health Organization have stated they will only approve a vaccine that is at least 50% effective and induces immunity for at least six months. That's not going to be our ideal vaccine candidate, but that's the minimum bar they have set to approve a vaccine.

QUESTION: "At what point does isolating residents in a long-term care facility from covid become detrimental to their mental and physical health?"

SHARKEY: Right now we are faced with the heart-wrenching tension between protecting the medically fragile, older adults from the virus and cutting them off from outside support and connections vital to their overall well-being.

Data on the mental health effects of the lockdown are scant. However, more than 70,000 long-term residents and staff have died from covid, and that accounts for four out of 10 deaths that we've had during the pandemic of covid-19.

Some states, including Minnesota, have now added some things to their death certificates listing social isolation and failure to thrive as reasons for some of their deaths during the pandemic, which is just, again, heart-wrenching and heartbreaking. Facilities are working hard to overcome this problem.

Arkansas recently changed its guidelines regarding visitations to nursing homes. At first, for several months, there was absolutely no visitation. Starting July 1, if a facility had no cases of covid-19 in the elderly or their caregivers or staff for 28 days, then visitors were allowed in. We recently shortened that time to 14 days and also put in exception that if a member of a facility was struggling with adjustments, loneliness and illness, then a family member could be let in to provide them support.

It's absolutely heartbreaking what we've seen happen in our nursing homes as far as the deaths from covid-19 and also the mental health aspect of it. Time's going to tell whether, in retrospect, we think what we've done was worth it to save the lives that we did. And even despite what we did, we still have lost so many. And we're going to lose more, unfortunately.

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Stacy Ryburn can be reached by email at [email protected] or on Twitter @stacyryburn.


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