Facebook Live 4/17- Answers

A lot has happened since Monday, and I’ve been doing a lot of researching, looking at everything that’s out there. Being data driven, I’m happy to say that we have a lot more data and information to reference as we look to moving forward.

The UVA data came up this week, and it was very persuasive that the curve is going to be much later than anticipated. I’ve been reviewing the UVA data, and the Washington State data, and both have moved back the peak day for Virginia to April 27th. The peak appears low, and we have the capacity to handle it.

The President and the federal government’s recommendations for reopening have come out, and I have gone through that data as well. I will provide the slideshow on Facebook that was provided to all legislators by the federal government.

Here is my analysis:

We needed to have aggressive action to make sure we got ahead of the curve. We needed to make sure our supply chains were adequate to meet capacity, and to reduce overall capacity needed by preventing vulnerable people from becoming ill. Additionally, we needed enough data to make well thought out decisions moving forward. What we have done has worked, but the question is, what parts of our actions have influenced the reduced levels of illness, and which practices should be kept up as we move toward reopening?

The UVA data talks about pauses and a slowing of the spread of the virus. The way I read this data, we are going to have some ongoing issues with cases of COVID, and even deaths, for a longer period of time. However, we should have capacity in our hospitals and supply chains to accommodate this. What the data doesn’t outline is whether there are specialized populations among us that need to stay quarantined because the risk for them is so great. This is a question of age, and in my opinion, the answer is yes, absolutely. Not everyone needs to take the same precautions as vulnerable populations. The risk is amongst the 65+ population, as well as some in the 55+ population. Older people will probably need to stay quarantined.

This is exactly what the federal government is suggesting in it’s reopening plan. I think this means that when we’re in public, we’re going to have to wear masks, and we’re going to have to reduce the number of people in gatherings.

As a review: wearing a mask protects other people from you. Washing your hands and washing surfaces protects you from the virus.

Update on Canterbury: we’re up to 49 deaths.

We’re over 200 deaths in Virginia now, 1,221 people hospitalized. We’ve had 1,110 people discharged. There is a lot of great science out there, and those who are trying everything to find solutions.

What does the federal government propose we do to get back to work?

Benchmarks, or gateways, have to be reached before a state can properly go back to work. If a state is on the downslope of the spike and there is capacity at hospitals, then people can go back to work using a three-step approach. This can be done on a state-by-state basis, or on a county by county basis in Virginia.

Question 1:

Where is Virginia in terms of the criteria for moving into phase 1 of reopening?


Based on what we’re seeing out of the Washington State data and the UVA data, we are not on the downslope of our spike yet, and we may have another 10 days before we get to that point. Looking at Virginia as a whole, we’re not there, but some individual counties in Virginia might be getting to that point.

Question 2:

Do we think Virginia will be ready to enter phase 1 by May 8th?


I hope so, I think we can take precautions and continue what we’re doing. I will be fighting to go back, and I know that the May 8th deadline was a setback for many.

Question 3:

What are the metrics for Virginia?


I will provide all the data and metrics that I am looking at, and much of the data on age has been peer-reviewed, which is important.

Question 4:

Will the Governor follow the federal guidelines for opening up America? The most cases seem to be in northern Virginia, could we open the rest of the state besides northern Virginia?


Our hotspots seem to be in nursing homes with older individuals. We will have to maintain strict practices with the older populations. Northern Virginia, Richmond and Tidewater seem to be our hotspots other than nursing homes. I hope to look at that on a case by case basis. We now have the governor’s amendments to look at when we reconvence on Wednesday. We will only be discussing what he has in the amendments. We are moving out of a space of absolute resolve to prevent people from dying, but if we continue in this way, we will put our economy in jeopardy without much benefit from protecting people from the virus. I do believe we may be tipping into a bit of overreach, and our Constitution may be at risk if we stay too strict for too long. At reconvene, we can request a special session; we can make requests, but we have to go into session to make those asks.

Question 5:

Could COVID become airselized by someone who is vaping and infected? I’m wondering if they can spread live virus and then it settles on surfaces or others nearby.


Yes, but that is true of someone breathing. It is possible, but the same thing can happen to someone who is speaking. It is recommended that if you are out in public, wear a mask.

Question 6:

How do you wear a mask and not have it fog up on your glasses?


The key to wearing a mask and not having it fog up is you have to kink it around your nose. When you put it on and make a seal around your nose, the hot air can’t travel up and fog up your glasses. This is harder with a homemade mask because they might not have metal in them. It’s all about sealing around your nose.

Question 7:

How can we open up the economy without universal antibody tests, if so many people are asymptomatic, how can we go back to work without universal testing?


I think we have to use universal precautions. This has been in medicine for a long time because we don’t know who is carrying the virus and who isn’t. Antibody testing is valuable, but I don’t see how we prove that someone without a mask has the antibodies.

Question 8:

Have you done any research on Actemra against COVID?


I have not done any research, I’d have to look more into it. I will look into it.

Question 9:

What if the high risk populations need to go out for medical care?


I think we can work on that. There is telemedicine, which I am doing now. Telemedicine has been revolutionized in this process. Anything that a doctor doesn’t have to put their hands on a patient for, can be done through telemedicine. Most doctor visits for older people can be done at their home. This depends on how high risk someone is.

Question 10:

What are your thoughts on treating with high doses of vitamins A, C, D, iodine and nebulizing peroxide? I’ve heard great results.


I don’t know, I’d have to look at the studies. I know that infusions of vitamin C can significantly reduce death rates for sepsis. I know that makes a difference, I’ve seen studies on taking supplements for vitamins A and D, and I think that’s great too.

Next week we’ll look more at the slides, and why I’ve drawn the conclusions I have. I’ll talk a bit more about recovene, and what those amendments look like.

Thank you so much, keep the questions coming. My job as a doctor is to act as a conduit for my patients to give them information so they can make good decisions. I have the responsibility of making good decisions for my district and my state as well, and I will continue to do that.