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How SC health experts protect their families from COVID-19

Island Packet - 8/8/2020

Aug. 8--It's hard to wade through the deluge of coronavirus safety tips in South Carolina.

To help residents and tourists along the coast better navigate the crisis, The Island Packet and Beaufort Gazette asked five Palmetto State health experts to explain how they keep themselves and their own families safe.

Here's what they had to say:

Questions & answers

Q: Do you ever wear gloves in public?

Dr. Joan Duwve, director of public health at the S.C. Department of Health and Environmental Control: No. Gloves, like hands, can be contaminated by touching surfaces. I avoid touching surfaces, if possible. If I have to touch something, I use hand sanitizer immediately afterward.

Dr. Michael Sweat, director of the Medical University of South Carolina's Center for Global Health and director of the COVID-19 Epidemiology Intelligence Project: I do not use gloves for protection. I think frequent hand washing is better. Gloves do not protect you unless you change them frequently, and you can still touch your face and contaminate yourself.

Dr. Gerald Harmon, family medicine physician and vice president of medical affairs at Tidelands Health, in Horry and Georgetown counties: No, I don't. We don't really have a need to wear them in public. As long as you wash your hands, it doesn't really make a difference.

Dr. Kathleen Cartmell, public health professor at Clemson University: I never wear gloves in public. Instead I use hand sanitizer every time I go in and out of a public establishment. I also go home and wash my hands with warm soapy water after I've been out.

Russell Baxley, president and CEO of Beaufort Memorial Hospital: No. I do practice good hand hygiene and carry sanitizer with me.

Q: Do you wear a mask or face shield? Is one better than the other?

Duwve: I wear a mask and eye covering (glasses) when I'm in an enclosed space with other people and when I'm outside with others and not able to maintain at least six feet of social distancing.

Sweat: I wear a mask routinely, but not a face shield. Face shields are useful protection, but it is not either/or. If you use a face shield, you should also be wearing a mask. It is not very feasible to wear a face shield for most people.

Harmon: I wear a mask when I'm out in public, either a surgical or cloth mask. I only wear a face shield in the medical environment when I'm testing, treating or evaluating COVID-19 patients or suspected COVID-19 patients.

Cartmell: I always wear a mask when I'm out in public, at grocery stores, in pharmacies, at the vet. Personally, I don't see a benefit of wearing a face shield over a mask. A mask is designed to cover your nose and mouth, which is what is important on an everyday basis.

Baxley: Yes, I wear a mask whenever I go out in public. I believe they both provide benefits.

Q: Do you get takeout or eat in-person at restaurants? Outside or inside?

Duwve: I rarely get takeout food because my husband loves to cook.

Sweat: Occasionally I will get takeout to bring home. I would not eat inside a restaurant at this time.

Harmon: Yes, I'll get takeout or eat at a restaurant. We typically sit inside -- it's so hot outside right now. Of course, the tables are spaced out, and we practice social distancing. I also wear a mask walking through the restaurant to our table and wear it when ordering. It's impossible to wear while eating, of course, but I'll put it back on after finishing the meal and wear it as we leave.

Cartmell: We haven't eaten in a restaurant since the COVID-19 situation started. We do take out once or twice a week.

Baxley: We have cut back significantly on dining out, but when we do, we dine outside. We have supported local restaurants by ordering takeout.

Q: Do you go grocery shopping in person? Why or why not?

Duwve: I do go grocery shopping in person, but I choose my stores based on whether their employees wear masks that cover their nose and mouth, if they are crowded, and how many of their customers wear masks. I try to go very early in the morning.

Sweat: Yes, I go grocery shopping in person. Where I live there is no food delivery option, but if there were I would use that.

Harmon: I didn't go before COVID-19 and I'm not planning on going now. If I went to a grocery store, I'd wear a mask and practice social distancing. I do wear a mask in the 7-Eleven or other convenience stores.

Cartmell: At this point we still get groceries in person, using precautions. More and more friends though are shopping online to minimize risk.

Baxley: Yes, with a mask.

Q: What businesses or gatherings do you try to avoid?

Duwve: I don't really go anywhere that isn't necessary. Right now, the fewer people I'm in direct contact with, the less chance I have of coming into contact with someone who has COVID-19.

Sweat: All of them. We currently have approximately 34 infections per 100,000 people in Charleston per day (as of Aug. 4). That means that there is a very large number of people carrying the virus. Most of these people do not know they have it and probably have mild or no symptoms. Every visit to a business or gathering is a risk.

Harmon: I don't. I'm not afraid or avoiding any particular type of business. There have been no gatherings I could have gone to, so I'm not missing any gathering because they haven't been held.

Cartmell: By far I have seen the biggest crowds at large home improvement and chain stores. I see some people practicing precautions, but there are so many people who aren't paying any attention to social distancing or wearing a mask. It honestly scares me.

Baxley: Most gatherings I avoid outside of work. At work, we do meet, but in small groups that are distanced and all are wearing masks. We do try to virtually meet as much as possible.

Q: Would you go to the beach with your family and if yes, what precautions would you take when there?

Duwve: I would go to a quiet beach and find a place to sit away from crowds. I burn easily, so I would walk early in the morning and swim before the crowds showed up. I would take enough food and drink for the duration and if I were going to stay, I'd find a rental so I could prepare my own meals, or get carry out.

Sweat: Yes, I go to the beach on occasion. I wear a mask and stay 10 feet away from others. It is outside so the risk is minimized.

Harmon: Yes, I would. Yes, I have. And yes, I take precautions. We live across the street from the beach, so we go at a less crowded time. And we always keep 12-feet social distance from others -- more than the usual six feet with the additional space on the beach.

Cartmell: I would only go to the beach if there weren't a lot of people on the beach. Right now, though, that's not possible, so I'd avoid beaches.

Baxley: Yes, so long as we could socially distance. If the beach was too crowded, we would turn around.

Q: Would you go to a gym? Why or why not? Do you run or walk outside?

Duwve: I don't typically go to gyms but did attend a few yoga sessions at a gym before COVID-19. The room was large with high ceilings and good air flow and everyone was spaced out. If I did go back to yoga, I would be sure to wear a mask.

Sweat: I personally absolutely would not go to a gym. It is inside, which is more risky. People are working out and breathing hard, which amplifies the risk.

Harmon: I would go without any reservations. I would wear a mask during a class with others. I'd bring my own towel, and shower before and after but not at the gym. I enjoy running, walking and biking outside. I don't wear a mask while I'm doing these activities, but I always have one with me so I can put it on if someone stops me to chat.

Cartmell: I definitely go for walks outside a lot. Fresh air is incredibly protective because virus particles are able to diffuse easily through the air.

Baxley: Yes, I go to a gym, but I mask and I do run outside. Physical fitness is important to stay healthy pre-pandemic and during a pandemic. It is an important part of my life.

Q: Would you go to a bar or club?

Duwve: No.

Sweat: Red alert on this one! No way would I go to a bar or club. These are by far the most risky places a person could visit. The noise level forces people to speak loudly and that dramatically increases transmission. It also forces people to stand close together. People also relax their distancing due to drinking alcohol. Bars and clubs should be closed now if we want to get over this epidemic.

Harmon: No, I don't go to bars. I haven't been to a bar in years. No reason to go.

Cartmell: Nope, no way!

Baxley: No.

Q: Would you hike, kayak or participate in other outdoor activities?

Duwve: Yes.

Sweat: Yes, but I would wear a mask if people were around.

Harmon: Absolutely. I would go on a hike while social distancing. A kayak -- certainly. I think you can do these things without a lot of restrictions.

Cartmell: We've tried going hiking to see waterfalls, but when we got there, there were so many people going onto the trails we turned back. Hiking would definitely be OK, though, if you can find places that aren't crowded.

Baxley: Yes.

Q: If you were staying at a short-term rental, what would you do to minimize COVID-19 risks?

Duwve: I would clean the frequently touched surfaces before I unpacked. I always travel with my own pillow -- but that would be the one object I wouldn't want to share with someone else!

Sweat: Wipe down the surfaces with disinfectant when I arrived. Most transmission is occurring from droplets and maybe aerosols coming from being close to people, especially when indoors. Getting COVID-19 from surfaces is less common. But I would still take the time to wipe down surfaces.

Harmon: What you are thinking about is decontamination. The science doesn't say we catch it that way. The interpersonal interactions are your highest risk. It's person-to-person, not person-to-chair. I would get it from the germs in the air. So, watch interactions with personnel, make sure they are wearing masks and keep that six feet of social distance. I might even leave the room while they are cleaning it if they showed up while we were in the room.

Cartmell: My mom had to stay at a hotel recently and she's older. I told her to take her own pillow, avoid contact with the bedspread because sheets are changed between guests, but bedspreads are not. I also advised her to clean surfaces with wipes such as around the sink area and on the bedside table she was using.

Baxley: I would wipe down high-touch surfaces, but have avoided travel where we must stay overnight at a hotel or rental.

Q: If you had kids, would you send them to in-person classes at school this year?

Duwve: I do have kids -- they are older and in a university setting. Both of their schools are offering classes remotely. So much about the decision to attend in-person really depends on the family situation and how much disease is circulating in the community. A family that has elderly grandparents living with them may not feel they can risk sending a child to school where they could get infected unknowingly. It's also important to consider the risk to teachers and the impact on a child should they lose a teacher to COVID-19. If we all rally and wear our masks, I am hopeful that disease levels will fall to a level that everyone can get back to school and work safely.

Sweat: No. The rates of infection and transmission are too high now for that.

Harmon: Right now, I'd say I'd do what the county is doing. It has risk levels -- low, moderate, high -- and courses of action for each, similar to hurricane warnings. If we were at the low level, I would allow my grandkids to attend.

Cartmell: Fortunately our son just graduated and he is going to take a gap year. Decisions about going back to school are going to be hard for people. Thinking about things from the perspective of preventing COVID-19, I would strongly prefer not to send my child into a classroom. However, I know there are also a lot of risks when kids aren't in school and not all families have the resources to teach online.

Baxley: No, but each situation is different and we would be in a position, with a stay-at-home mom, where we would not have to send our children to school. That said, if we were not in this situation, I would send them to school and do believe the schools have tried to take the necessary precautions and followed recommendations by (the Centers for Disease Control and Prevention).

Q: Should South Carolinians expect another surge this fall? When would that materialize?

Duwve: Not if we continue to do the things we know work. Wear a mask, maintain a safe physical distance from others, avoid crowded spaces indoors and out and work with public health officials in your community if they call you about a positive test or an exposure to someone else who tested positive. In fact, if we do these things, and get a flu shot, we could have a very mild influenza season as well.

Sweat: Well, we are actually having a surge right now, but I do worry that it will get worse in the fall. Especially so when the weather cools and people get together in poorly ventilated indoor spaces, when schools open, and when universities open. Universities worry me a lot. These students are young adults who will be in settings that are tailor made for outbreaks.

Harmon: What we have now and should continue to expect is ongoing transmission of the virus. The mitigation strategies -- wearing a face mask, practicing social distancing, avoiding large gatherings, washing hands -- have stabilized the spread where we are.

Cartmell: It seems like we are just having one big surge that continues to grow larger and larger. The virus is spreading so quickly now that cases are multiplying, as each person who gets infected is passing the virus to multiple people. This is what we need to avoid.

Baxley: Hard to say: Schools opening would create potential for a surge if not done right.

Q: How has tourism contributed to coronavirus spread in coastal counties?

Duwve: Whenever large groups of people get together and don't distance themselves from each other and wear a mask, coronavirus will spread. We have certainly experienced that first-hand in South Carolina.

Sweat: It is difficult to know for sure, but I suspect that it has helped to fuel the increased growth of the COVID-19 epidemic. It adds to crowding in the area. Being a tourist by definition selects for people less worried about COVID-19, as I think those most worried are laying low and staying home. Tourists staying in hotels also need to go out to eat and are probably more likely to visit bars. Having said that, I suspect that tourism may be less of a concern than people think, as there is plenty of risk behavior by locals.

Harmon: It has been an accelerant. It is not the entire cause. There's also been community spread from parties, people not wearing face masks or not practicing social distancing.

Cartmell: At this point, the tourists are taking risks coming here because our infection rates are so high.

Baxley: Undetermined -- you would believe however that it would contribute to an increase in spread.

Q: What else should residents and tourists keep in mind as the pandemic continues this summer?

Duwve: Outdoors is best (make sure to wear sun protection), maintain at least six feet of distance from others and wear your mask anytime you are indoors and if you can't stay physically distanced from others while outdoors.

Sweat: One message I want to stress -- we have all been told three key things that reduce risk: 1. Outside is better than inside 2. Wear a mask and 3. Keep your distance from people. However, these are not mutually exclusive. You need to do all at the same time when possible. If you are outside, still wear a mask and keep your distance. If you are inside and wearing a mask, you absolutely still need to keep your distance. Somehow, many people seem to think that just practicing one of these is enough -- it is not. Do them all.

Harmon: Keep your foot on the gas. Don't let up. This is an endurance race right now. We can't make a pit stop.

Cartmell: Please be safe and take care of yourself and your community right now. It's the only way we are going to get the virus under control.

Baxley: Follow the rules.

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