Session 153: Q&A with Dr. Oni Blackstock

Published Apr 29, 2020, 7:00 AM

The Therapy for Black Girls Podcast is a weekly conversation with Dr. Joy Harden Bradford, a licensed Psychologist in Atlanta, Georgia, about all things mental health, personal development, and all the small decisions we can make to become the best possible versions of ourselves.

Dr. Oni Blackstock, the assistant commissioner for the Bureau of HIV/AIDS Prevention and Control for the NYC Health Department shared all the facts you need to know about what we currently know about COVID-19, tips on how to keep you and your loved ones safe, what vaccine development looks like for the virus, and how it would work once we have one.

 

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Kay Welcome to the Therapy for Black Girls Podcast, a weekly conversation about mental health, personal development, and all the small decisions we can make to become the best possible versions of ourselves. I'm your host, Dr Joy hard and Bradford, a licensed psychologist in Atlanta, Georgia. For more information or to find a therapist in your area, visit our website at Therapy for Black Girls dot com. While I hope you love listening to and learning from the podcast, it is not meant to be a substitute for relationship with a licensed mental health professional. Hey, y'all, thanks so much for joining me for session one of the Therapy for Black Girls podcast last week. Through the generous sponsorship and support of MADIQ, I was able to have a conversation with Dr Ony Blackstock, who is the Assistant Commissioner for the Bureau of HIV AIDS Prevention and Control for the New York City Health Department. Dr Blackstock has spent much of her career advocating for justice in medicine, and it's always so amazing at translating medical information so that it's digestible for everyone. She shared all the facts you need to know about what we currently know about COVID nineteen, tips on how to keep you and your loved one safe, and what vaccine development looks like for the virus and how it would work once we have one. This conversation originally took place on our Facebook page and it was so good that I wanted to make sure as many of you heard it as possible. Once you've listened, please be sure to share with your circles as well. Here's our conversation. I'm very happy that you all were able to join us this Thursday afternoon. UM. So those of you who have been following for some time, you know that this is typically our three for Thursday time. We have a very special guest with us returning special guests, UM Dr Ony black Sock. So i am Dr joy Harton Bradford. I am the like I'm a licensed psychologist and the founder of Therapy for Black Girls. And Dr Only black Stock is the Assistant Commissioner for the Bureau of h for Vesion in Control for the New York City Health Department. So welcome back, Dr black Side, thanks for having me. Dr Bradford, get to see you again, perfect perfect, I'm very happy to have you back. Janet's in the comments, saying that she follows you on Twitter loves you. So today Dr black Sock. The last time she joined us, we talked all about prep um, the medication that is used related to hi UM, and today she is joining us to talk about all of the facts that we need to know about COVID nineteen. So we know um how this is disproportionately unfortunately impacting our community. So we really wanted to make sure that we had a conversation with a physician who is doing the work on the front line UM to to kind of give us the factual information and to kind of get rid of any misconceptions that people are having. So really thankful to the medi q T for partnering with us again to sponsor this conversation with Dr black Sock. So Dr black Sock, and make sure you drop your questions in the comments. So Dr black Stock will be answering as many questions as you can, UM, so make sure you're dropping those in the comments. So, Dr black Stock, I want to first weekend by hearing UM, why is this virus so different than any other virus that we've experienced. So Dr Bradford said, this is UM a novel virus, so a new virus, brand new UM, identified in late December and will hunt China and since then has traveled across the globe. UM. This virus in particular seems UM more contagious than some of its predecessors UM, such as UM Stars and mirrors, which people may have heard of in the past. UM. And then also something that seems so unique about it is that people can have UH infection with UM the coronavirus and novel coronavirus and not have any symptoms or have very mild symptoms. And so because of that, people may be spreading it to others without knowing UM. The stars virus UM the first one from back I think in two thousand three I believe or thirteen that virus UM typically caused like very significant respiratory symptoms, so if someone was sick UM, they knew it UM. But with the novel coronavirus, there are people who may have no symptoms, are very mild symptoms with it and then can spread to others mmmmmmmmm. And something else that we are kind of learning is how it impacts people differently. And so you know, I think a lot of people have been shocked UM. And of course it is on a case by case basis, with that children are not seemingly as impacted UM, at least by the symptoms of the coronavirus. Can you talk a little bit about that, right, So, we are seeing UM much you know, worse outcomes UM as age increases, So particularly in older people in the population, we're seeing them being disproportionately impacted, hospitalized and dying from this new coronavirus infection and UM. The thought is that some of this has to do with sort of differences in the body's response to this new virus. So older people have a more vigorous response in terms of mounting UM and immune response UM so may have like a lot for instance, UM the lung involvement that we see when people have really UM much trouble breathing and the lungs full up with inflammatory cells UM, that is more likely to happen. And someone who is older UM than someone who was younger. So these differences and how people are responding by age seemed to be UM one of the reasons why we see it affecting older people more and UM younger people less got it. Got it. So, what are some of the main things that we can do down the black side to make sure that we are keeping ourselves safe and I love right. So if people have the ability to to definitely shelter in place. I know that not everyone has access to safe UM and warm shelter UM, but if you do, to definitely stay inside unless you need to go outside for essential items like food or there's like urgent medical care you need. Otherwise UM, please stay inside. People should probably only be going out every one to two weeks if they're able to. UM. We understand some people don't have that choice and are still having to work to support themselves, support their families. UM. For for those individuals who must leave UM the house frequently and are in like high contact UH professions recommendation is to UM you know when they are coming back home, really to if they can change their clothes before entering their homes UM and then to immediately shower if possible, because that can reduce the risk if there's anything like on their clothes or on their bodies that could be like the vibeer virus and then they could touch a contact surface and then so when in their home could touch it that could cause spread. So definitely changing one's clothes when one goes home, or just having a different set of clothes for work UM than for home. UM. Obviously hand hygiene for everyone, so washing your hands for twenty seconds with soap and water or using alcohol based UM sanitizer. UM. If you need to reach out to a physician or healthcare provider, seeing whether they have a telehealth option UM if you're if you're able to those are all UM really important as well. When you cough or you sneeze, make sure you're sneezing into a tissue or into the crook of your your arm like this, and not using your hands. Avoid shaking hands with people. You can do what kind of salute, elbows, whatever it is. Avoid um touching other people. Making sure you're disinfecting your home. Making sure also that you're taking care of yourself, that you're like eating well, that you're getting the sleep that you need. I noticed this is a very stressful time, so people may not be able to get the sleep that they need, but trying to really prioritize sleep. And then also part of health is really the social support that we have from our family and friends, So really trying to maintain maintaining those connections UM. But doing so virtually. And I'm part of the reason it sounds like that the recommendation so quickly was for people to shelter at home if they could, was because of how easy it seems for the virus despread. Correctly, yes, right, so right, and so that was another thing, right to add to add to the issue runs physical distancing or social distancing. And the whole idea is that so this virus is spread when someone coughs, sneezes, um, or um talks. It can be spread in terms of respiratory droplets and these little sort of droplets that include that have the virus in them, but they don't go further than than six ft. And so that is the reason why we want people to to um have a distance of at least six feet other people, because that way they won't be infected through droplets. UM. It's also spread by if someone you know, costs or sneezes, touches their nose, their face, whatever, and then touches the surface or touch is someone else, and then that person touches it and then touches them their face. So definitely avoid so physical distancing, which obviously an extension of the sheltering in place, but when you do go outside, maintaining at least six feet if you can, UM and avoiding touching your face. Also, I should add UM depending on what jurisdiction you live in in New York City and so the recommendation is for everyone if they are in places where they cannot maintain a six ft distance to where a face covering. The face covering does not necessarily prevent someone from acchore ring the novel coronavirus or COVID nineteen UM, it prevents them from passing it to someone else, kind of we set. A lot of people may not have any symptoms and maybe unknowingly transmitting it. So the face covering can help if you have coronavirus infection, may not know it helps you to prevent prevent you from passing it to others. Got it. So we have a question from Cynthia who says, what about black folks who are not exercising caution because they consider the virus a hoax? UM. So, I'm not sure how much you've heard about some of the misinformation around UM, the coronavirus being related to five g um, to the telephone, you know, systems and those kinds of things like what kinds of things would you say about that. Yeah, I definitely want to make space for you know, concerns around this virus being a hoax, because I think that UM, as black people in this country, we have obviously been been treating a way that would make a sort of question what we're hearing from sort of larger authority, and so I want to say like whole space for that and the fact that this is not a hoax. This is like a very real virus that is really causing UM much illness and death around the globe. UM. We no initially think there were also some suggestions that black people don't get coronavirus infections initially, UM, and I think that that had a lot to do with like we just didn't have access to testing for it, so that was why, and then people were saying it wasn't happening happening in Africa. I think also again and now we're seeing Africa being impacted and a lot of it is really about our people have access to testing. And initially, UM the criteria to be tested very early on, and this were very restrictive, so people had to have like travel to um Muhan, China and or Italy, and some other places that were being heavily impacted, and you know we are you know, many of us some do travel, but many of us don't travel, and so we would we would be limited UM by those UM really strict reteria criteria in terms of being able to get tested UM. Now test testing has opened up more, but we still have we still deal with some of the same same barriers. And obviously, you know, provider bias, concerns that maybe our symptoms aren't being treated, aren't being UM sort of considered serious when they are. We do know there are beliefs that medical providers have partular white medical providers that you know, black people may have a different threshold for pain UM, and we know that these UM biases really impact the care that people receive. So I want to acknowledge counter narratives and beliefs around that's potentially being a hoax UM and those beliefs with the fact that this is something that's very real, and we want to make sure that UM that black communities know this are doing what they can to stay safe, recognizing their lot to structural factors UM that make us very vulnerable to this. M H. Good, I appreciate you being able to hold spacebook both of those. That is a very real part of our history in this country for sure. Way, So you mentioned testing a little bit, and so I want to dive into that a little bit more because you said that like testing has opened up, UM, but we are also kind of seeing accounts on social media and even I've heard from like friends and colleagues UM that they may hand some symptoms but they try to call around to try to find a test and they're still kind of saying, you know, like oh they're not enough tests or you don't actually meet the threshold. So what kind of information would you share with us about testing? Right? So I would say, UM, just first becalling that everyone is UM listening or watching from different places throughout the country. So making sure you check with your local and state health department web page like web pages to see sort of what UM testing is available and what are sort of the threshold for testing where you live. UM. Just saying that I think also private providers maybe also doing something you know different in terms of like who they're testing and whatever. Is just putting that out there, UM. But because testing has been limited, it has been reserved UM at least where I AM in New York City for people who were present, who were sicker, who had more more chronic medical conditions like diabetes and high blood pressure, UM, people with very severe presentation, you know, very shorter breath. And so the priority has been to test those individuals UM because we want folks who have milder illness UM, if they're doing okay and they don't need medical help, we want them to stay home UM to isolate themselves um UM for a certain period of time after which they won't be able to pass it on to others UM and to do that and that's sort of the way that we had been addressing this issue around the shortage of tests. Now we're seeing increases in UM resources putting putting um for testing and so hopefully we'll see some of those barriers lesson UM. And I'm happy also to talk about like their different types of testing UM. There are two main types of testing people may have heard about sure so UM there's like there's like molecular or PCR testing and that testing is usually involving like a swab in up the nose UM and UM also in the nostrils sometime now in the saliva and sort of back in the throat UM. That testing is for if someone has an infection at that moment, So it's like, do I have coronavirus UM COVID nineteen right now, UM, and so that's what that test helps to identify it we call like acute infection UM. The reality is that none of these tests are a hundred percent accurate UM. So it is possible, depending on how the spestim most was taken or whatever, that someone who does have symptoms that are very consistent with COVID nineteen could test negative UM. And then it's also possible that you could have a false positive. So just to say that like, they're not a hundred percent accurate UM. But typically if someone test positive and they have symptoms consistent, we say that that is coronavirus UM COVID nineteen. There's also testing UM, antibody testing or sterologic testing UM, and that UM you make people may hear more and more about that, and that type of testing can help us determine if someone has been infected in the past UH with UM, with with the virus that causes COVID nineteen UM our body. When we're exposed to UM, a virus or bacteria UM can often mount UM an antibody response, and but sometimes it doesn't do that necessarily immediately. So that's why this test is not used for UM testing. Like a current infection, it can, but it takes time to develop anybody response. So that's why it can detect whether someone has had a previous infection. All that being said is there are many tests that are flooding the market now UM, and many of them have very questionable accuracy, and so we just want to make sure that people understand that many of these tests UM haven't necessarily been validated UM, and so it's possible, but someone can get UM a false positive, so saying that a test result that says they've been a supposed to coronavirus and they had it, and then people will think, oh, well now I have protection against and then they'll go out and do whatever they want to do UM. And then people who potentially have false negative tests as well. UM. So just to say that UM, there are more and more tests that are coming on the market and hopefully we will be able to UM, you know, have more widespread availability of these tests and have them be really accurate. God God, thank you for that. Dr black Sack and don't forget to be dropping your questions in the comments section. And for those of you joining us, please make sure that you're sharing this on your Facebook pages as well, so that we can get as many people getting goomation as possible. So we saw another question, UM, why are we having just as many cases in the warmer climates if he kills the virus? Okay, So it's it's actually not clear this is a new virus, Like we don't know whether he kills it or not. I think this is we're going to see, um what happens. UM. We know and people in Florida, I think are you know, and warm climates throughout the world are being impacted. So it's not completely clear whether this is going to have like a significant seasonal variation. UM. There is a thought that it is possible that by the summertime being might improve based on all the social distancing and physical UM and mitigation measures that are being taken. UM, but it's possible that it may come back again in the fall for a second wave along with the flu. So I suspect that, UM, I don't know if we'll be going back to normal any time soon. UM, And that as we see the clines in the number of cases and lower transmission of this virus. Um, we may say, like a relaxing of the physical distancing. So maybe people may return to work, but not everyone all at one time. Maybe it'll be staggered. People might have alternating schedules. We might see maybe more businesses opening up, but only allowing a smaller number of people inside. Um. So I think that might end up being our new normal, goad it. So let's talk a little bit about this new normal in like what kinds of things would need to be in place for us to be able to even gather again. And I know that one part of that is a vaccine, right, um tell us? Like where things stand with the vaccine and what would the vaccine even do? Right? Okay? So, um, there are I think like dozens of vaccine candidates that are in very early stages of development and investigation. I believe there are five vaccine candidates that are in clinical trials too, of which I believe are here in the United States. So, a vaccine basically prevents or reduces the risk of infection by a virus or bacteria, and it does so by sort of replicating the body's immune response to that virus or bacteria so that when the body actually does see it, it is ready to protect itself. UM. So just to say that there are lots of stages to vaccine development, and that typical vaccines take UM usually and I'm partly there's no typical but about ten to fifteen years for development. Obviously, things are going to be much more accelerated with UM a vaccine against COVID nineteen and the timeline that UM Dr Anthony Fauci from the and I H has put forward is about twelve to fifteen months. I have heard him say on the news that, UM, they think it's possible that there will be a vaccine available in the fall, probably for frontline workers, first responders, healthcare workers sort of more like piloting testing that, and then for the more general population if all things go as planned, UM by next spring. But this is like that would be like if everything went as planned, there were no issues. But people should know, you know, initially their test vaccines and know in animal models they have to see if they're safe, and they have to test them and learn and people who have you know, healthy people, Like there's just lots of different steps and the same thing for treatment as well. UM. There are lots of different their pre clinical stages UM, their phase one, two and three stays is of clinical trials UM. The thought is that there will probably be a treatment treatment UM that's approved before we have a vaccine UM. And there are a number of a number of dozens of treatments also that are being investigated. UM. The NAH on Tuesday came out with their UM treatment guidelines for COVID nineteen and as of now it is supplemental really supplemental oxygen and mechanical ventilatory supports really helping people to breathe as their body fights off this UM infection. UM. There are no FDA approved treatments for COVID nineteen. UM. There are people may have heard of, like chloroquine and hy hydroxy chloroquine UM and the panel at the National Institute of Health recommended that if these are used, that they should be used within context of a clinical trial because there was not enough evidence to use them outside of of a research UM setting. UM. So yeah, so a number of uh oh and then also the NH trial also said they actually recommended against using high doroxic chloroquine plus zetro miycin. This is what UM. The President had actually recommended UM as potential treatment. They're saying that the data that they have suggests that it's actually more does more harm than good. And then also UM callitro or lapinovie bratano are, which is an HIV medication which has had activity against other coronaviruses. They're also saying that that also the risks appear to outweigh the benefits. So those were two medications that they were saying definitely don't use hydroxic chloroquine alone and chloroquint could be used as well as rim dissevere another medication UM, but within the setting of clinical clinical trials. So can you explain to us how that window is going to be shortened? So if something typically takes ten to fifty is before, like, how how is it going to be possible for it to give you us so much quicker? Yeah, I think I suspect UM. It's a really good question. I don't know if like maybe the numbers of people that will be enrolled will be much larger. I have to say, I'm not sure how they're able to UM accelerate this. I do know that there are many people who are collaborating from all over the globe and I'm sure sort of sharing best practices and what they're learning. I'm sure sort of like putting everyone's brains together will help. And there may be differences and how recruitment is happening, how um the trials are being designed that would allow for them to be to be expedited. So for instance, like if you're able to like enroll a larger number of people, you have like more power to see whether there's a difference between different treatments. So that may be one way that they're they're doing this. And can you explain a little bit about a clinical trial, because there may be people who say, like, yes, me up, like I want to help. Um, you know, so how wouldn't we would like to participate in a clinical trial and easn't see Yeah, yeah, so they're different too, they're different stages at stages of clinical trials. UM. So Phase one are the clinical trials. Those are the first clinical trials that happen in human beings, and those are really testing for safety and they enroll like a very small number of people. UM. And then that goes all the way to phase three trials, which are really the trials around enrolling a large number of people, and those are looking at UM sort of how efficacious, how well does this treatment work, and also like how also looking more again at the time at safety, at different like side effects that people are having, and phase three is what's needed usually to get um FDA approval or a license to be able to market the medication UM SO, I think I suspect like I'm online and I maybe I can like look for resources afterwards, but there are probably opportunities to be to take part in in treatment trials. Treatment trials are likely going to be happening happening in hospital settings already, so if someone is hospital is hospital life, treatment will probably be for those folks who have very severe disease UM right now. And then for vaccine trials UM I can look and see if the ni H or any other entities have I'm sure there's stuff online so people can volunteer to be part of these trials UM. And then they're also a number of studies that are going on where and these are also related to um TO treatment. People who have had COVID nineteen like and can give their serum SO and having anybodies from that taken so that they can be also used as part clinical trials for for for treatment to see if they they can treat or protect people from from COVID nineteen. Got you? Okay? Okay? So justica for families that have hand a FAMI member and households has positive for COVID nineteen and have recovered and return to work, should extra precautions still be taken by the family members who have not contracted devirus in their time would to be advised for the family member who has to return to work to continue working? Okay? So with the family member who has to return to work, is that person UM had COVID or did not have COVID nineteen person tested positive has recovered and returned to work. Yeah? So yeah, So the there is UM data to suggest that most people who have on COVID nineteen UM probably stopped shedding virus, meaning they don't they can't pass it to other people, probably after eight days after symptom on set, after they start having symptoms. UM, and we had we used this like seven plus three type thing UM for most healthy people, Like if it's been seven days since the person started having symptoms, UM, it's been three days since they have not had a fever and they haven't been taking any title at all or or other fever reducing medication and their overall improving, then they can probably like they're not infectious and can probably conduct their business as usual. UM I was still safe for the people in the house who have not had COVID nineteen, Like obviously they're potentially at risk, but not of getting COVID nineteen from they're the people who are in the house with them. If that, if they have lab if they have lab confirmed um COVID, if it's been confirmed by a test um, and so they should take off all the precautions. I think everyone should just, you know, take all the precautions in terms of hand hygiene, the social physical distance, saying when you sneeze, use your elbow like all of that. Everyone should just continue doing that because we don't we don't know who, Because it's possible that the people in that house, because they were living with someone who had COVID nineteen, they actually may have had it already. We don't know, So it's just safe to act like we all could potentially have it, and just to protect ourselves and other people. Another question, can we realistically expect to travel out of the US this year. Oh, it's a good it's a good question. I I don't know. I don't think anyone can predict their few. Sure, I think everyone should try that if they can hunker down, stay put, because we are literally hiding from this virus, right We're like in our homes if we have we're fortunate to have a home that's safe and warm. UM. And I think that I think to the extent that we can to continue UM physical distancing UM. And this will also give us time and many jurisdictions to like ramp up other other initiatives, so like there's gonna be this in New York City. UM. A lot of resources put behind UM contact case investigation and contact tracing. So once we have many fewer cases, we can have disease detectives go out and if they and if someone has positive, they can go and talk with their contacts UM, the people who who have been in contact with them, they can put them potentially or make sure they isolate themselves. So then I'll be a much more magicable number of people that we can directly UM work with to ensure that they also are not passing UM the virus on UM to other people. UM will also hopefully there'll be a time to like develop a treatment, develop a vaccine. So I think we need to use these like non pharmaceutical interventions like the physical distancing until which time we have like robust treatment and vaccine available. So I think they'll probably be like a tightening and a listen listening and a tightening of the social of physical distancing. So I think, oh loosten, we might then see every crudescence or like an increase in cases, and then we'll have to tighten up again. And so it maybe like that for a while until we have vaccine intreatment not to black slide. I had also seen something I'm not sure, um where about you know, if you've contracted COVID nineteen, like the possibility of getting infected with this. So people were kind of thinking, like it's like the chicken pots right, like where you have it once and then you don't ever get it again. Can you talk a little bit about that. Do we know enough yet to know if you'll you'll be to give me infected? Right? So, typically with with many viruses, like once you've been exposed, you developed some level of immunity or protection to that virus. UM this is a new virus, so we really don't know. I think the thought is that there should be so we don't know if it's probably not full immunity but some partial immunity to it. UM that would protect people, But we also don't know you know, the level of protection and how long that lacks. So I think until we know, everyone should act like they have the potential to be would be infected again, and just use um whatever precautions are needed. Okay, so we have another question. Can I get it if I stand in my backyard for ten minutes? My grandmother is saying the outside and makes her nauseous. But I think her anxiety was getting to her. Okay, if you're standing in your backyard with nobody else or just with the people that you live with. Um, she's it is not it is not. It isn't would you say? I said, I'm thinking she's talking about yeah no, not no. And they're worried that the wind could like blow the virus. Well she said that her grandmother says that the outside air makes her nauseous. Okay, yeah, I think yeah, no, no, no, no, Actually, so like solitary like walking, exercising, standing, um while maintaining six ft from somebody else that you should definitely be safe. Got it? Okay? Another question, I heard that it impacts people differently based on blood type. Is this true or is this something being researched. Um? I heard that as well. I don't know the basis for it, and I don't know the data behind it, and probably UM their number of studies that are underway right now, we'll probably get more definitive information about that in the future. Okay. UM. Is it a myth that household pitts can get the virus? Yeah? Yeah, no, it's not a myth, so apparently UM, and I can probably post to your page. Dr Bradford, UM an info sheet from our health department in New York City about pets and COVID nineteen. But pets can like there are reports of cats, I believe, potentially dogs who have cats definitely who have gotten COVID nineteen. Um. We don't know if it can be passed the other way, like a pet could pass it to a human being. But human being um to pet? Um? Yes has been seen okay? And another question, how much care and caution should we take with things like groceries? Are packages from Amazon for example. Yeah, I know that's a really good question. UM. And I just heard something from the CDC about this. I think the thought that UM packages from supermarket being contaminated, it's it's beitely very unlikely and from the ability of the virus to live that long on on these various surfaces. UM. But I don't think it's unreasonable. And I do this too when I get my Amazon packages UM, like the boxes, I do let them sit for like twenty four hours, you know, I mean, or if you or if you do manipulate them or touch them, just making sure you use gloves UM, that that can be something that's helpful if you don't have time what it's set and then just washing your hands afterwards, or just you know, doing whatever you need to and just making sure you have the correct UM handing and hiking that you're washing your hands for twenty seconds with open water or using a m alcohol based sanitizer. MM hmm. Okay. So, so the UM information that have been circulating around, like having this whole separate staging area in your home, like we can bring your groceries in, you wipe it all down and do all of these things. You're saying that that is likely not necessary, right, and there's there have been no like case reports of people I'm getting COVID nineteen from their groceries. Okay, yeah, got it, got it. So I know in our community we have been talking a lot just about the anxiety related to things reopening. Um, you know, so what kinds of suggestions maybe would you have around um? And I think so much of it is still kind of up in the air because we don't even know like how things are gonna be reopening, you know, I think, and like there's gonna be a lifting of the gate, so to speak, and like we all are free to kind of roam a little bit more, um, you know, because the suggestions would you hand for people like in managing their anxiety about how these things are going to be reopening, right. So I think with this whole situation, it's like you know, and I'm sure you've probably seen this as a psychologist, Like the so that diagram was like the things that are in your sphere of control and those that are like outside your sphere of control. So like, you know, just continuing, you know, when you're going outside depending on the rules in jurisdiction, you know, face covering is the same thing, hand hygiene, physical distancing, just doing this just you know, just whatever you can do that's in your power to stay safe, you know, without you know, obviously this is very anxiety producing experience for many people. But there are things that that we can do and that we do have control over. So I would do those things, um and do what do what makes sense to you, like I, I, you know, obviously large gatherings, I would probably be very concerned about those. And I used suspect that we're are going to have very large gatherings for a while now, you know, stadiums builled with people hobably not I think, um, you know, there's so much uncertainty, and so we just kind of like have to really take it a day at a time. Got it? Okay? Is the CDC testing circulated air and busses, trains, grocery stores, elevators, nursing homes. Are they still focused on direct person to person content? Okay? So the data that we have again suggests that this is passed by UM droplets, like the droplets that someone's coughing, sneezing, talking, that UM in close proximity to you that could spread that way or usually by falling on a surface and someone touches them and touches their face. Um. There has been some some data to suggest that this is also airborne UM, and so I know some hospitals are taking also airborne precautions, meaning that like it can be it's all like in the air, no matter where you are, people can get it. But typically we have that. I believe the CDC hasn't focusing on UM this being acquired through droplets, so like close contact with with one another. Okay, another question I had missed, excluding the age factor, say two forty year olds are both exposed, why might one be very sick or even die and the other have no symptoms at all. Yeah, I think this is like the one million dollar or whatever, the six whatever the million dollar question is. It's like, um, you know, why do people have such different responses like you'll see um you know, I know, UM, a couple where they both had COVID nineteen and actually several and the one of one person the couple got definitely ill and the other person did not. And it's really about we don't know why. But again, as I said, it's about the bodies. How the body responds to seeing this new virus and people, and there's variability and how our body. It could be based on, um, you know what we've been exposed to in the past. You know, it could be related to sort of hereditary issues whatever it is. But like people respond very differently. We do know that when people are older, when they have other chronic conditions, that that increases the risk for severe illness. Okay, so that's wait right, So diabetes, high blood pressure, chronic lung disease, kidney disease, um heart disease, um cancers, all those seem to have some association with more severe disease. Okay. Another question, with the dearth of lifestyle and chlorods products, what's the best way to clean counters and floors or people can't get their hands on like the common cleaners, what might they be able to use? Oh, that's a question. And I think any like alcohol based I mean cleaner. I'll look at this, so I don't want to give people the wrong information. Um yeah, I believe like soap and water, any alcohol based um like cleaners should should work just fine. And I'm when people short of access to even those things right now. But I can take a note and see if the CDC has a link to alternative options. Got it, and please stay tuned to the page because if there's anything that we didn't answer here or Dr black Sack is additional resources, then we will um post those on the page as well. How about COVID and kidneys, does do you know much about how it's impacting kidneys and the impact on people with kidney disease? Um? I do know that as I mentioned that, so folks who do have renal disease seem to be at higher risk for more severe illness with COVID nineteen. And we are seeing that people even if they did not have like end stage renal kidney disease, are requiring like dialysis, are seeing their kidneys fail um while they're in effect that they're infected. So it could be that um, you know, people like as I mentioned, like diabetes, hypertension, all of those things like predisposed to kidney disease, and so having like the stress of the COVID nineteen disease is like an added stress on the body. And so there may be some level of susceptibility that people have any way to like worsting renal disease or severe renal disease. UM, so that may be UM related to it, but I don't have like specific data on it. Just just to say that kidney disease is a respective for severe illness, and then people are seeing in those a severe illness, worst thing, real disease. Shanil Um. The video she's asking is they're recording, so the video will be up on the Facebook page, is not gonna go anywhere, so you can be able to catch it. Um if you miss some of the beginnings. What about taking off your shoes on the inside after you go outside? Is that um a good suggestion? Yeah? But yeah, I think all these measures, you know, if it's like a low barrier thing that you mean, a low threshold thing that you can do, like take off your shoes, particularly for people who are in essential field who are having a lot of contact with people. UM. Yes, definitely taking off your shoes before you go inside would be helpful. That's recommendation for like healthcare workers and other folks who may be exposed. Okay, And another question is there correlation between COVID nineteen and people who had the food shot previously? So I am not aware of um any studies that have looked at this UM and just to my loud knowledge, they're they're different viruses, so I would suspect there is not an association, but I don't know. There's a lot that's unknown, and we should probably getting more answers as the months go along. Okay, okay, okay, okay. Great to see Allison um put the link for the CDC website that has more information I'm at around cleaning and disinfection. So thank you folks to see that. Yeah, it's great, thank you, Allison. Okay, So and you and I adapted blackstick. We're talking about this a little bit before we started UM recording. She saying, Tisi is saying, I'm hearing a bit about amputation being related to COVID. Can you speak a little bit to that, right, So it seems like UM, the virus causes lots of different UM like clinical manifestation. So we're seeing that it causes like a higher propensity or likelihood of having like blood clots UM. And again this is like all new information that people are seeing, and so UM blood clots can affect the blood flow to certain parts of the body, and so if someone is having blood clots related to COVID nineteen and it is affecting the blood float to the persnal parts of the of the body, for instance a leg um, and that area has been compromised in some way, then that would lead to a need for amputation. Mm hmm. Yeah. So it really is all about like what the clinical presentation looks like. Ye, many different ways. It seems exactly right, Like we were talking about the COVID nineteen toes, which seems to be like related potentially to like inflammation potentially in the blood vessels. And I think people, ever, again, all of this has new, and I think researchers are trying to like answer these questions and really understand all the different ways that thespius can present Yeah, and I do thinking that poses an interesting, um kind of predicament. Right, So let's say you start experiencing some symptoms, because this kind of looks so different. Um, you start experiencing some symptoms, some of which we've heard are related to COVID nineteen, but maybe some of which are not. What are some of the first steps, So should we try to like make a virtual telehealth appointment with our primary character actor, Like what if we have some of these symptoms we can't get a test, Like, what are some of the steps people should take? Yeah, No, I definitely think if someone has any concerns, they should regardless reach out to to their clinical provider and proffitably via a telehealth option. I mean, we do know that most people tend to present with like fever, cost um, shortness of breath, to people have sore throat. We talked about lots of taste and lots of lots of smell. Older people, um, like the very elderly can present with like disorientation and confusion or or or um maybe a fall like they may not necessarily have like a focal symptom like a cough, um, and so just to be aware of that. Um. Yeah, So I think there there are presentations that we know are like much more common. If someone has like something that like they're not they're worried about, I think it's very reasonable to reach out to a health care provider and are there certain symptoms that would indicate to you like this is absolutely the time where you need to go to a hospital. Yeah, right, So someone is having substantial difficulty breathing, um, that would be an indication of you. If someone is seeing like bluish, like tinge or purple, and maybe manifests differently on us who are darker brown colored, UM are seeing in your palms, you can see bluish color UM. When the oxygen level gets low, definitely an indicator UM to get help. If you're having a persistent chest pain, definitely get help. One thing that we're seeing that's like very unique to this byrus is that people can look normal, can look normal, not in any distress, and have very low oxygen levels UM and then suddenly deteriorate UM. And so that's why I'm saying, just like looking for other indicators of low oxin level like the bluish color in the hands UM. And if people are feeling short of breath like definitely, UM, get urgent help or emergent help. And then me, it looks like one more question, what are the numbers for those who are being diagnosed with COVID nineteen and who have diabetes in terms of the survival rate? Do you know those numbers? Yeah, I don't know those numbers offhand. UM. Just that UM diabetes is increases the risk that someone will be hospitalized and and die from COVID nineteen. So that's what we do now. So I would suspect. And when we were looking at studies of people who have been hospitalized or died from COVID nineteen, we are seeing high prevalence of diabetes. Okay, So a couple more questions, Yes, we have a few more minutes, So get those last many questions in UM are they're currently more than one strain known? So I was reading that UM, this virus UM mutates or changes very slowly UM, and so there are multiple strains of it, but I don't but not like I don't think, like tons of it. And they're also not seeing it change in terms of it's like you say, virulence or sort of how you know, deadly or powerful it is. We're not seeing those changes like some other viruses UM that can change much more rapidly. UM. So yeah, so as of now, UM not tons of variation, And it doesn't seem like the the virulence or the deadly nature of it is also changing very much. Got it? Okay? So Naomi has a bit of a different question. She's a myth student who's been dismissed from rotations as a part of the health systems policy to mitigate transmission by removing being all mad students from clinical care. I want to stay in tune with all that's going on, but it's a bit overwhelming, especially with the shock of getting removed from clerkships in a pandemic. What would you say are key things to stay abreast of during to stay abreast of during this time? How can we best use this time to learn for the future, given that this will probably not be the last pandemic we encounter. Yeah, that's a great question, and I'm sure it's like a very challenging time being removed from your clerkships and UM and and wanting to be help of help UM and not always being able to directly help UM. I think you know, I think you know. I think learning as much about this virus as possible. Literally, there is new information every day. UM. There's a lot of information and the clinical um the research literature, but there's a lot around like equity issues as well, And so I think what might be interesting is to figure out like how if Naomi is interested in terms of like one really wonderful I think side effect of this is that we're in mutual aid like communities coming together really to support one another and support the most vulnerable. So UM, I think there are ways to like to help there if it means like seeing if they're vulnerable members of her community that need help with getting groceries or getting their medications or whatever, it is like helping to go in some of those gaps and be like a safety net for people who um, you know, maybe um much more vulnerable to this disease and others. M hm, do more questions? Do we know which hospitals have clinical trials for hydropsy chloroquine now that the preliminary results show increased death, is it's still ethical to keep testing in high minority areas like New York City. Yeah, I was saying that the the NIH had recommended save for chloroquine or a joxy chloroquine if anyone, that people only receive it within the context of a clinical trial. And I believe someone I saw had posted in the chat linked to the clinical Trials dot go website. So thank you to whoever whoever did that, because that will have um a list of the most the most up to date list of clinical trials that are happening with respect to hydrae xoxy chloroquin and other agents that are being looked at for COVID nineteen treatment. Okay, and then one final question. Would the blue color be consistent across all extremities at the same time, how would you distinguish that from rainw disease? So the blue color would be like um in your hands, like all of your hands and potentially your lips. Um rain noodes is typically the It's like a causes um the arteries to to constrict, so tend people tend actually I think, lose color and the tips of their fingers and it causes pain. So I would say that's like the difference that it causes pain and NAL's in nuts. It can be painful and it causes like I believe it because it affects the blood flow, it would be more like, uh, it wouldn't be blue. It might be like white, like a light color because it's like no blood flow. Whereas when you are called cyanotic, when the oxygen levels are low, oxygen the blood is still getting everywhere, it's just the level of oxygen is low. And so what that comes off as is that um. For people who are darker skin colors, we would see like a blueish hue to our our palms and maybe like our lips. People who have lighter color might actually see their more of their skin being blue perfect. Well, thank you so much for all of this incredible information, Dr black Zack. I really appreciate you sharing with that community today. You people where they can find you online if they want to stay connected to what you've been doing. Sure, I post a lot on Twitter, so um my Twitter handle is at d r O and I b E at dr on e B. We'll share that for having me Dr Bradford desolutely We'll share all of that in the comments as well. Thank you again to men i Q for sponsoring this conversation. I really appreciate making this happen for our community. Like I said, the video will be saying here on Facebook so you can catch it. Please share with all of your circles so that they can get this incredible information from Dr black Stock. Um. I hope that you all have an incredible rest of your day in a great weekend, and we will see you all next Thursday. Take care, stay safe, by bye everyone, By Dr Bradford Bye. I'm so thankful for the work that Dr black Stock and so many other incredible healthcare professionals are doing. Please remember to share this episode in your circles and on Twitter or in your I G stories so that as many people have the information as possible. Remember that if you're looking for a virtual therapist in your state, check out our therapist directory at Therapy for Black Girls dot com slash directory. And if you want to continue digging into this topic and meet some other systerms in your area, come on over and join us in the Yellow Couch Collective, where we take a deeper dive into the topics from the podcast and just about everything else. You can join us at Therapy for Black Girls dot com slash y c C. Thank you all so much for joining me again this week. I look forward to continuing this conversation with you all real soon. Take it care

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