11 Reminders from the Erie County Public Health Department on COVID-19

Department of Health

Melissa C. Lyon, MPH Public Health Director, Erie County, Pennsylvania

Since the COVID-19 outbreak hit locally in March, we saw many communities in the United States have a high rate of cases. In Erie, Pennsylvania, the virus had a slower community impact. However, the district has experienced spikes, with over 2,352 cases and 55 deaths at the time of this writing. Erie County Officials have cautioned the community to take precautions still as they go about their day-to-day life. 

Melissa C. Lyon, MPH, spearheads Erie County Department of Health as the Public Health Director, and it's COVID-19 response. She is a former Agroforestry Extension Agent for the United States Peace Corps in Cameroon, West African. She has memberships in the National Association of City and County Health Officials, the American Public Health Association, and the Public Health Accreditation Board. 

Simonique Dietz: What is COVID exactly? 

Melissa Lyon: COVID-19 is a virus that resembles viruses we've seen in the community and the world, such as MERS and SARS. Both of those were in other parts of the world. And this is what they call SARS-CoV-2. I think it's essential that I tell you that because it indicates that while it's a novel virus, we've not seen this virus before. But it resembles viruses we've seen in the world before.

SD: How would you know if someone has it?

ML: The most effective way to know someone has COVID-19 is through a laboratory test. They may have symptoms before receiving their laboratory test. And those symptoms could be low-grade fever, congestion, a cough, runny nose, sore throat, and loss of taste or smell. Sometimes, there's been reports of headaches, nausea, fatigue, muscle fatigue, muscle soreness, and those who are always recommended for COVID testing. We also have people that can be COVID-19 positive and have no symptoms or mild symptoms, which is what makes this virus incredibly tricky as I refer to it. And it transmits easily because if you don't know you're sick, you wouldn't know to do your regular activities or not. So, you would be out in the community, not knowing that you're spreading the virus.

SD: How does it start in the body?

ML: So, it has to enter the body through inhalation. That's either inhaling through your nose or your mouth and then it goes into the lungs. And then the same way as the virus is replicating in the body. After you have exhaled the virus, the next person will inhale it, and then the process repeats itself from person to person.

It's human to human interaction or contact, and that typically is within six feet or more. During talking, speaking to one another, being in close contact, hugging, kissing, all of those things where you would exchange either air – or in if you're kissing, that example would be saliva. So it's human to human contact. Primarily, we have heard of some instances where you can contract it by touching contaminated surfaces. But that is more that's less frequent than human to human contact.

SD: What type of mask would you advise people to wear because not all of them work the same?

ML: Ideally, any type of face covering is better than no face covering. I want everyone to know, any kind of face covering is better than no face covering. Medical grade face coverings have been reserved for those in the healthcare industry, such as N95, medical-grade, or regular surgical masks. However, those are some of the more effective materials to ensure that either you're not spreading the virus or not inhaling the virus. And then if you have to go to a cloth mask, we recommend two-ply. Sometimes those are also designed that you can put a filter in there. There's a lot of sophistication around the cloth masks but making sure they're two-ply is most useful for a cloth mask.

SD: What are some telltale signs?

ML: So, one of the telltale signs is the most commonly reported signs and symptoms: headaches, sore throat, coughing, congestion, and difficulty breathing. Any relation to respiratory distress or respiratory symptom is what we're typically having reported. Another more common one is the loss of taste and or smell. So that one as well has been favorably reported. It's interesting because even with, let's say, this is allergy season, or goldenrod has been putting out a lot of pollen and people are allergic to goldenrod, or other types of pollens, those symptoms are very similar to COVID-19. So sometimes people think, Oh, this must be my allergies, when in reality, they may have COVID-19. So, any symptom that would seem respiratory should be seen by a medical provider as soon as possible.

We've had a lot of people say; I just thought it was my allergies. And yeah, and what would what will happen is they end up getting sicker. You know, like they're there, they'll get congested, or they'll have difficulty breathing. And then they seek medical attention, but they've already been symptomatic many days before that. And it's unfortunate, so we're trying to get people tested even with the slightest symptoms. 

 SD: Even after recovery, are there any long-term effects that we should be aware of?

 ML: The long-term effects of COVID-19 are still being discovered. As more and more people recover, and then we're gathering that information. Some things often reported is a prolonged, persistent cough that doesn't go away. They still have difficulty breathing; they still have fatigue, residual headaches. And then this other piece they've been talking about is confusion like the brain remains confused beyond their infectious period. So, there are symptoms. Sorry, there are long term effects of COVID-19. I suspect we don't even understand all of them yet. We're still learning. The individual's health has driven each one of those scenarios before becoming sick. Or their age, and the amount of exposure that they've had. We are still learning so much about COVID-19. In my opinion, we only know a small portion of what this virus is doing to us as a community. 

 SD: Who's more at risk?

 ML: So those that are the people that are at the highest risk of COVID-19 are those that are over 65. Those who may have an immune-compromised or already immune system compromised, someone with another underlying illness, may have diabetes or have cardiovascular issues. They may be a smoker; those individuals tend to have higher risks than younger, healthy people.

We would say that the population at the most significant risk right now is 65 or older, who also live in a congregate care setting. So, when the elderly live in a congregate care setting, the disease can rapidly move through a facility. So that puts them at significant risk. Individuals with underlying health conditions or illnesses such as diabetes, high blood pressure, cardiovascular disease, circulatory disorders, and anyone struggling with other health issues are at greater risk. Also, I would say those who are the youngest of age don't have a significantly developed immune system, children under one's age.

SD: How does transmission happen?

ML: That's an excellent question on how transmission happens. And it's a little bit complex in its explanation. We would call it the dose of virus that you receive, right. So, the longer you are with someone that's COVID-19, so the longer you are near them, so there are 15 minutes, then there's half-hour than one hour or two hours. And the more time you spend with that person, the more likely you're going to have a higher dose of the virus. And so that's why we say 15 minutes or more, you become a close contact to unknown positive because we figure 15 minutes of exposure, you've had a dose, a large enough amount of virus that you become positive that that's the definition. It's a little bit of science behind it. But that's how we decide that. 

And that's why we say indoor settings are more dangerous than outdoor environments. For example, you and I will spend half an hour together or more, but we're outside. The likelihood of the virus being like pushed out into the air will result in a better outcome, say you or I became positive, you would still be a contact of mine, or I would be a contact of yours. But us getting sick is very unlikely because we were outdoors, and it's very windy. 

SD: Do you think we'll open up entirely soon? 

ML: There's the zinger, right. Um, I think it will be a significant amount of time before we're able to be fully open and fully functioning like we had been pre COVID 19 pandemic. I'm not sure that we will ever go back to life before COVID-19. I think you're going to see some residual behaviors that may last awhile. Some people may choose to wear masks in specific settings for an extended time. I think you'll see people sanitizing more regularly, their shopping carts, you know, the gas pump handles, things like that. Once the vaccine becomes FDA fully approved, and people start receiving the vaccine, we'll begin to see things change as far as recommendations on how people can start to feel more confident and safer that the virus in the community is dissipating or declining. 

SD: What's your take on the vaccine? 

ML: The FDA must do a full approval of the vaccine before we offer it to the broader general population. We must understand any side effects of the vaccine to educate people to make the best-informed decision properly. I completely understand people being concerned that there will be what's called the emergency youth authorization. And that does not go through a full FDA approval process. And I understand people being hesitant to want to take that vaccine. So, it's so important that we're patient. We keep doing the same things we're doing wearing mass social distancing, hygiene, not gathering in large crowds until a vaccine becomes available. That's fully FDA approved.

SD: How does the billing process work? 

ML: I don't know enough about the billing process to answer that. Comprehensively. I can tell you that various Erie County locations are offering free or low-cost testing. The community centers right now Booker T. Washington, the Martin Luther King Center, and the JFK Quality of Life Center provide free testing. One is Tuesday, one's Wednesday, and one is Thursday. I can get you that flyer if that's helpful. So those are, those are no cost. And in fact, those that are asymptomatic are eligible for testing. So that's a great resource. They're charging insurances if you have insurance, and then I know that some others have like a sliding fee scale or minimal charge, such as Community Health Net some other options. It all depends on the testing center and insurance status. Billing is never an easy topic to explain.

Simonique Dietz is a student intern of the Erie Reader. She can be reached at Simonique@ErieReader.com, or you can follow her on Instagram @dietz_digital_pro.