>> FOR MORE ON COVID-19 IN
WISCONSIN AND FROM "HERE AND
NOW," VISIT PBSWHICH.ORG STLI
NEWS.
EVEN AS WE TRY TO SLOW ITS
SPREAD.
WE HAVE MEDICAL QUESTIONS NOW
FOR STATE EPIDEMIOLOGIST
DR. RYAN WESTERGAARD.
HE ALSO JOINS US BY SKYPE.
DR. WESTERGAARD, THANK YOU VERY
MUCH FOR JOINING US.
>> THANK YOU FOR INVITING ME.
>> WE KNEW THERE WOULD BE
DEATHS, AS THE NUMBERS OF PEOPLE
TESTING POSITIVE FOR COVID-19
CONTINUE TO RISE, BUT WHAT
SHOULD WE STEEL FOR IN TERMS OF
MORE?
>> I THINK THE PICTURE IS
CONCERNING RIGHT NOW BECAUSE I
THINK WHAT WE'VE SEEN IN THE
DATA BOTH THIS WEEK IN WISCONSIN
AND NATIONALLY IS THAT WE REALLY
SEEM TO BE AT AN ACCELERATION
PHASE OF THE EPIDEMIC.
WHERE WE'RE SEEING THE NUMBER OF
CASES INCREASE DAY BY DAY, AND
WITH THAT, WE KNOW THERE'S A
SUBSET OF PEOPLE WITH SEVERE
DISEASE OF ALL THE PEOPLE THAT
GET DIAGNOSED SO I THINK WE CAN
EXPECT INCREASED NUMBERS OF
DEATHS.
I THINK THE THINGS WE'RE DOING
TO MITIGATE THE SPREAD OF THE
VIRUS IN COMMUNITY IS GOING TO
DETERMINE HOW MANY, BUT
CERTAINLY WE'RE GOING TO SEE
MORE IN THE COMING WEEKS.
>> PEOPLE ARE, OF COURSE, VERY
AFRAID, AND WE HEAR CONFLICTING
INFORMATION, BUT OF THE MOST AT
RISK POPULATION, WHAT SHOULD THE
ELDERLY AND THOSE WITH
UNDERLYING CONDITIONS BE DOING
RIGHT NOW?
>> I THINK IT'S FOR EVERYONE BUT
PARTICULARLY FOR PEOPLE WHO ARE
MEDICALLY VULNERABLE OR FRAGILE
IS TO STAY HOME AND PREVENT
CONTACT WITH OTHER PEOPLE.
IT'S NOT THE KIND OF
RECOMMENDATION WE LIKE GIVING
PEOPLE, BUT AT THIS MOMENT, WITH
A VERY CONTAGIOUS VIRUS
CIRCULATING IN THE COMMUNITY,
THE BEST STRATEGY WE HAVE TO
PREVENT INFECTION IS FOR
EVERYONE TO STAY IN PLACE, AND
ALSO WHEN YOU ARE OUT IN PUBLIC,
FOR DOING ESSENTIAL THINGS, BE
VERY VIGILANT ABOUT HYGIENE AND
SANITIZING SURFACES.
THINGS THAT WE ALL KNOW PREVENT
THE SPREAD OF GERMS OUT IN
PUBLIC.
>> WE NOW HEAR THAT YOUNGER
PEOPLE ARE ALSO VERY MUCH AT
RISK.
HAS THAT MESSAGING CHANGED?
>> WELL, IT HASN'T CHANGED IN
THAT WE'VE KNOWN FROM THE
BEGINNING OF THE EPIDEMIC IN
CHINA THAT YOUNG PEOPLE HAVE
DEVELOPED SEVERE ILLNESS AND
SOME HAVE DIED.
THE RISK, MEANING THE PERCENTAGE
OF PEOPLE WHO HAVE SEVERE
ILLNESSES IN AN UNDER 50 OR
UNDER 40 AGE GROUP IS QUITE A
BIT LOWER.
HERE IN THE U.S., THE DATA THAT
WE'VE SEEN IN THE PAST WEEK
LOOKING AT THE FIRST SERIES OF
HOSPITALIZED PATIENTS WAS THAT
THE MORTALITY RATE FOR PEOPLE
UNDER AGE 50 WAS LOWER, 1% OR
LESS, WHERE PEOPLE IN THEIR
80s, IT WAS AS HIGH AS 10%.
SO ALL PEOPLE ARE AT RISK OF
BECOMING INFECTED WITH THE
VIRUS.
THE RISK OF HAVING SEVERE
COMPLICATIONS WHEN SOMEONE IS
INFECTED VARIES QUITE A BIT BY
AGE.
BUT I THINK THE RISK -- THE
MESSAGE FOR EVERYONE IS THAT IF
NO ONE IS -- NO ONE IS IMMUNE TO
THIS VIRUS, EVERYONE CAN BE
INFECTED AND EVERYONE HAS THE
RISK OF GETTING QUITE SICK.
>> WITH YOU VIEWER ONE VIEWER ASKS, I WORK AT A
TARGET STORE.
SHOULD I BE TAKING A SHOWER AND
CHANGING MY CLOTHES AS SOON AS I
GET HOME?
>> I DON'T THINK SO.
I THINK THE MOST IMPORTANT
MESSAGE IS COMES FROM HOW WE
KNOW THESE RES PRY TRI VIRUSES
GET SPREAD AND THAT'S THROUGH
RESPIRATORY DROPLETS, SO COUGHS
AND SNEEZES BUT ALSO TOUCHING
CONTAMINATED SERVICES.
PEOPLE IN PUBLIC, THE MOST
IMPORTANT THING RIGHT NOW IS
WHAT WE'RE REFERRING TO AS
SOCIAL DISTANCING, SO KEEPING AT
LEAST 6 FEET OF SEPARATION FROM
OTHER PEOPLE.
THE OTHER THING THAT'S VERY
IMPORTANT, AND I WOULD SAY
PARTICULARLY IMPORTANT FOR
VIEWERS WHO WORK IN PUBLIC
SETTINGS, IS HAND HYGIENE.
SO HAND WASHING WITH HOT WATER,
ALCOHOL-BASED HAND SANITIZER,
THE MORE THE BETTER.
SO THOSE ARE THE REALLY HIGHEST
IMPACT STRATEGIES THAT EVERYONE
SHOULD IMPLEMENT IF YOU HAVE TO
BE OUT IN PUBLIC.
>> SO IS IT SAFE TO GO TO THE
GROCERY STORE OR PICK UP
TAKEOUT?
>> YES, I THINK IT'S SAFE TO DO
THAT IF PEOPLE PAY ATTENTION TO
THE INFECTION PREVENTION THINGS
THAT WE'RE TALKING ABOUT AND
WE'RE KNOWING ABOUT.
OVERALL, THE RESTRICTIONS ON
GATHERING ARE REALLY TO REDUCE
THE PROBABILITY OF GETTING IN
CONTACT WITH THE VIRUS TO AS LOW
AS IT POSSIBLY CAN TO SLOW THE
SPREAD IN THE COMMUNITIES.
CERTAINLY PEOPLE NEED TO GET
THEIR BASIC NEEDS MET, IF PEOPLE
NEED TO BE OUT IN PUBLIC, NEED
TO GET FOOD.
SO THERE'S RISK TO BEING OUT IN
THE COMMUNITY OF INFECTIOUS
DISEASE SPREADING, BUT WE STILL
ENCOURAGE PEOPLE TO MAKE SURE
THAT THEY'RE GETTING ALL OF
THEIR NEEDS MET AND DOING THINGS
LIKE GOING TO THE GROCERY STORE.
>> EVEN WITH HAND WASHING AND
CLEANING AND DISTANCING, SHOULD
WE ALL JUST ASSUME THAT MOST OF
US WILL BE INFECTED WITH THIS?
>> WELL, I THINK THE ANSWER TO
THAT REALLY DEPENDS ON HOW WELL
WE EXECUTE THE TYPES OF THINGS
THAT WE'RE RECOMMENDING.
IT'S CERTAINLY NOT A FOREGONE
CONCLUSION THAT MOST OF US WILL
BECOME INFECTED, BUT THE VIRUS
IS CONTAGIOUS ENOUGH THAT IF WE
DID NOTHING, THE POSSIBILITY OF
THE MAJORITY OF PEOPLE WOULD
BECOME EXPOSED AND INFECTED BUT
WE REALLY BELIEVE IF WE DO THESE
RESTRICTIONS ON GATHERING, WE
FOCUS ON HAND HYGIENE DURING
THIS PERIOD OF THE EPIDEMIC
WHERE IT'S STARTING TO SPREAD IN
COMMUNITIES, WE CAN KEEP THAT AS
LOW AS POSSIBLE.
SO IT'S REALLY UP TO US ON HOW
WELL WE KEEP THESE LESSONS
AND -- HEED THESE LESSONS.
>> DO WE HAVE ENOUGH ICU BEDS IN
WISCONSIN?
>> WE DO.
THAT'S SOMETHING WE'RE ACTIVELY
MONITORING.
WE'RE IN COMMUNICATION HERE AT
THE DIVISION OF PUBLIC HEALTH
WITH HOSPITALS AROUND THE REGION
TO KNOW WHAT THEIR CAPACITY IS
UNDER NORMAL CIRCUMSTANCES AND
WHAT THEIR SURGE CAPACITY IS.
SO WE HAVE A HANDLE ON THOSE
NUMBERS AND WE'RE TRYING TO KEEP
IT UPDATED IN REALTIME.
I WOULD SAY THAT THE BETTER THAT
BECOMES, WHETHER WE PUT A STRAIN
ON THOSE RESOURCES, AGAIN,
REALLY DEPENDS ON HOW WELL WE
EXECUTE THESE PUBLIC HEALTH
INTERVENTIONS.
>> ANOTHER VIEWER ASKS IF
VENTILATORS GET TO THE CRITICAL
SUPPLY LEVEL, HOW WILL IT BE
DETERMINED WHO GETS TO USE ONE?
>> AGAIN, I'LL SAY AGAIN THE
MOST IMPORTANT RESPONSE TO THAT
QUESTION IS WHETHER WE GET TO
THAT POINT, REALLY DEPENDS ON
HOW WELL WE CONTROL THE SPREAD
OF THE VIRUS.
AND THAT'S SOMETHING THAT'S IN
OUR YOAL.
CONTROL.
WE HAVE A FINITE NUMBER OF
VENTILATORS IN THE STATE.
THERETHEY ARE MANUFACTURING MORE AND
THERE'S ALSO STRATEGIES THAT
HEALTH SYSTEMS ARE DOING TO FREE
UP MORE VENTILATORS, FOR
EXAMPLE, CANCELING ELECTIVE
SURGES IN OUTPATIENT SETTINGS SO
WE HAVE MORE.
SO ALL OF WHAT WE'RE DOING WHEN
WE TALK ABOUT STOPPING THE
SPREAD IN THE COMMUNITY, IT'S
ALL AIMED AT THIS HEALTH SYSTEM
CAPACITY QUESTION, SO WE WANT TO
AVOID HAVING TO MAKE THOSE
REALLY CHALLENGING DECISIONS
ABOUT WHO GETS A VENTILATOR AND
WHO DOESN'T.
NOW THAT IS POSSIBLE, THOSE
STRATEGIES, WE REALLY TRY TO
FOCUS ON DOING THINGS THAT ARE
EQUITABLE AND TRANSPARENT AND
HAVING GUIDELINES THAT EVERYBODY
CAN FOLLOW AND AGREE TO, SO SOME
OF THE CONSIDERATIONS ARE SORT
OF HOW MUCH BENEFIT CAN COME
FROM THE VENTILATOR USE, MEANING
PEOPLE THAT ARE HIGHLY LIKELY TO
RECOVER WILL BE OFFERED
VENTILATORS.
PEOPLE WHO ARE MORE GRAVELY ILL
MIGHT BE GIVEN A SHORT-TERM OF A
VENTILATOR TO SEE IF THEY
RESPOND AND IN SOME CASES WE MAY
NEED TO REALLY FOCUS MORE ON
PALLIATIVE CARE FOR PATIENTS
THAT DON'T SEEM TO BE
RESPONDING.
SO THERE ARE DECISIONS THAT WE
MAKE ALL THE TIME IN ICU CARE,
AND WE'LL JUST HAVE TO BE VERY
DELIBERATE AND VERY OPEN ABOUT
IF WE GET TO THAT.
BUT I THINK THE MOST IMPORTANT
PRIORITY IS THAT WE'RE DOING
EVERYTHING WE POSSIBLY CAN TO
PRESERVE OUR HEALTH SYSTEM
CAPACITY TO PROVIDE ICU-LEVEL
CARE TO EVERYONE WHO NEEDS IT,
AND HOPEFULLY WE'LL BE FINE IN
THAT REGARD.
>> WE KNOW WE ALSO HAVE A
SHORTAGE OF PROTECTIVE GEAR LIKE
MASKS FOR HEALTHCARE WORKERS.
ONE PARAMEDIC SAID IF IT COMES
TO THAT, THEY WILL USE SCARVES
OR SHEETS AND CUT THEM UP AND
MAKE MASKS OUT OF THEM.
HOW CLOSE ARE TO HAVING TO DO
THAT?
>> WELL, THE SHORTAGE OF THE
PERSONAL PROTECTIVE EQUIPMENT IS
REALLY A BIG CONCERN.
WE'RE APPROACHING ALL OF OUR
HEALTH SYSTEMS AND OTHER
PARTNERS LIKE PRE-HOSPITAL CARE
AND EMS TO TAKE INVENTORY AND
LET US KNOW HOW MANY DAYS OR
WEEKS SUPPLY THEY HAVE.
WE JUST RECEIVED SHIPMENT FROM
THE FEDERAL STRATEGIC NATIONAL
STOCKPILE AND HAVE BEEN ABLE TO SUPPLIES TO
PLACES THAT NEED IT.
AND WE'RE ACTUALLY PRIORITIZING
AREAS THAT ARE REALLY HIGH
CRITICALLY NEED, LIKE FIRST
RESPONDERS AND LOCAL EMS.
SO WE'RE PREPARING FOR THIS,
WE'RE TRYING TO MAKE THE BEST
USE OF ALL AVAILABLE RESOURCES
WE HAVE AND GIVING PEOPLE ADVICE
ABOUT SORT OF THE BEST
STRATEGIES TO CONSERVE AND MAKE
USE OF THESE RESOURCES WISELY,
BUT IT'S SOMETHING THAT WE'RE
REALLY FOLLOWING CLOSELY.
>> IS THERE MORE M COULDING FROM
THAT STRATEGIC STOCKPILE?
>> I THINK THAT'S STILL TO BE
DETERMINED.
THE WISCONSIN STATE ALSO HAS A
STOCKPILE OF A LARGE NUMBER OF
MASKS THAT WE'RE ALLOCATING, SO
WE'RE TRYING TO BE THE BEST
STEWARDS OF THOSE RESOURCES THAT
WE CAN.
AT THE SAME TIME, ENCOURAGING
OTHER AREAS OF THE SUPPLY CHAIN
AND INCREASING MANUFACTURING TO
MAKE SURE THAT WE HAVE PERSONAL
PROTECTIVE GEAR.
>> NOW WISCONSIN HAS RAMPED UP
ITS TESTING BUT YOU WROTE IN A
MEMO THIS WEEK THAT ONLY THE
MOST CRITICAL PATIENTS CAN BE
TESTED.
WHY?
>> WELL, THE WAY THAT WE FRAMED
IT WAS THAT WE NEED TO
PRIORITIZE TESTING FOR PATIENTS
FOR WHO IT'S MOST IMPORTANT TO
KNOW QUICKLY.
AND THAT REALLY COMES TO
HOSPITALIZED PATIENTS.
THERE'S A COUPLE REASONS FOR
THAT.
SPREADING THE VIRUS INSIDE
HOSPITALS, BOTH TO HEALTHCARE
WORKERS AND OTHER PATIENTS, IS
REALLY ONE OF THE MOST IMPORTANT
THINGS WE WANT TO TRY TO
PREVENT.
SO WE WANT TO MAKE SURE THAT WE
KNOW THOSE ANSWERS TO THOSE
QUESTIONS OF WHO HAS COVID-19 IN
THE HOSPITAL OR OTHER HEALTHCARE
SETTINGS AS URGENTLY AS
POSSIBLE.
SO IF WE HAVE TO MAKE CHOICES
ABOUT WHAT TESTS GET DONE
QUICKLY, IF WE HAVE A LONGER
TURNAROUND TIME, WE NEED TO
PRIORITIZE THOSE.
NOW THE OTHER REASON IS THAT A
LOT OF PEOPLE WITH MILD SYMPTOMS
OF COVID-19 DON'T REALLY REQUIRE
MEDICAL CARE AT ALL, AND RIGHT
NOW SINCE OUR RECOMMENDATION FOR
EVERYONE IN THE POPULATION,
WHETHER YOU HAVE A MILD COLD OR
YOU HAVE INFLUENZA, IS TO STAY
AT HOME, RECOVER AT HOME, AND
PROTECT THOSE AROUND YOU FROM
POTENTIALLY BECOMING INFECTED.
KNOWING THAT RESULT OF A
COVID-19 TEST ISN'T AS IMPORTANT
FOR EVERYONE.
IN FACT, FROM AN INFECTION
CONTROL PERSPECTIVE, THE
ADVANTAGE IS BEING ABLE TO
SUPPORT PEOPLE REMOTELY, NOT
HAVE PEOPLE COME IN AND GET
TESTED IN A HEALTHCARE SETTING.
SO IT'S ANOTHER STRATEGY WE'RE
USING TO TRY TO PRESERVE
HEALTHCARE RESOURCES.
WHEN PEOPLE THAT ARE YOUNG HAVE
MILD ILLNESS, EVEN IF THEY HAVE
COVID-19, OUR MESSAGE MOST
PEOPLE ARE ABLE TO RECOVER, CALL
US IF YOU HAVE CONCERNING
SYMPTOM BY ANY MEANS BUT YOU
DON'T NECESSARILY NEED A TEST.
>> EXCUSE ME, DOCTOR, WITH JUST
ABOUT A MINUTE LEFT, IN A LETTER
TO THE FDA, WISCONSIN
CONGRESSIONAL DELEGATION
DESCRIBED EXTREME CHALLENGES IN
HOSPITALS ACROSS THE STATE AND
GETTING REAGENTS AND EVEN SWABS
TO CONDUCT THE TEST.
HOW LONG DOES WISCONSIN HAVE
BEFORE IT RUNS OUT OF WHAT IT
NEEDS TO COMPLETE THE TESTING?
>> WE'RE IN CONVERSATION NEARLY
DAILY WITH OUR LABORATORY
PARTNERS.
WE HAVE TWO PUBLIC HEALTH LABS
IN WISCONSIN, IN MADISON AND
MILWAUKEE -- THEY HAVE BEEN VERY
OPEN AND COLLABORATIVE IN TERMS
OF TAKING INVENTORY ON AN
ONGOING BASIS OF HOW MANY
INGREDIENTS OR REAGENTS THEY
HAVE TO D TESTS AND ARE
ACTUALLY SHARING, WHEN
NECESSARY, TO MAKE SURE THAT
THEY HAVE ENOUGH SUPPLIES.
SO WE ARE NOT IN A POSITION THAT
WE ARE ONE TO RUN OUT AND NOT BE
ABLE TO DO THE TESTING THAT WE
NEED RIGHT NOW, BUT WE'RE
ACTIVELY LOOKING AT THAT.
>> ALL RIGHT, DR. RYAN
WESTERGAARD, THANK YOU, THANK
YOU VERY MUCH FOR YOUR TIME.
>> THANK YOU.
>> FOR ADDITIONAL REPORTING ON
COVID-19, GO TO OUR PARTNER
WEBSITE AT WIS CON TEXT.ORG.