See, and the university of chicago has about 100 patients admitted on average every day with coronavirus. We are doing just fine. Ppere stretched with our but have enough to get us through this time now. We prepared for the surge of patients and are prepared should the numbers get higher. The stayathome order in illinois is making a difference. See it helping to us flatten out the curve, and a steady run in the hospital to be able to manage those patients. We have a lot of critically ill patients across the state of illinois, and you have seen the demographics that suggest illinois and chicago, the demographic is affecting our africanamerican population a lot more than some of our white neighborhoods. Takee doing our best to care of them and provide outstanding care. I think you wanted to know when this will all end, and that is the question of the day. One important thing for people to understand is the point of flattening the curve so we can spread out the infection. That does not mean we will be able to shut it down completely. We are still having contact with other people. There are still opportunities for spread, just fewer of them with these stayathome orders. It will take a while before we are able to get back to the containment strategy, the Public Health containment strategy we had at the beginning to get us out of this. We need to contain the virus. Host phone numbers on the bottom of the screen for our guest. Eastern and central time zones, 202 7488000. Mountain and pacific, 202 7488001. A third line just for medical professionals, 202 7488002. Dr. Landon is an associate professor of medicine at the university of chicago. Typically, how long are people in the hospital when they come in for a coronavirus case . How is the rate of recovery going . Guest the most important thing is about 80 of people will be sick for about a week and will never need to be in the hospital. 15 t 20 of people, maybe get worse. Get worse in the beginning but the majority get worse in the second week and that is when they end up in the hospital needing things like oxygen and fluid and supportive care, to be monitored closely. Of those, a portion will go on to need intensive care, a ventilator or lifesupport measures. If a patient comes in just needing oxygen, often times we that andhem through out in less than a week, and then they are on the mend and doing better. Those who go on to have intensive care needs are often in the hospital for another week or two. We are seeing a good rate of recovery. We are able to get a lot of our patients off the ventilator and are seeing fewer people died that we put on ventilators then were reported from other countries, and we are really proud of that. There is still a long time to go, as you might imagine. The ventilated patients that are critically ill lag behind because it takes a few weeks, maybe four weeks from being exposed to someone to being so sick that you need a ventilator. There are certainly plenty more patients that will come our way and we are doing our very best. I work with some of the best doctors in the world. These people are amazing and they have the best strategies to try and get people through this. Not just our doctors but doctors across the country have found that turning over, laying on your stomach can make your breathing better because of the dynamics of the oxygen and the blood flow in the lungs. One thing they are doing for patients is they give them oxygen and asking them to lay on their stomach. That is able to keep a few patients also ventilators. This is not a strategy i would recommend doing at home. If you are short of breath, you should go to the hospital where we can keep an eye on you, but Little Things like that can make a big difference. I am so proud of our medical team for the work they are doing , and what an amazing job they are doing. Host we are going to go for calls for dr. Emily landon. Eric is calling from rome, georgia. Caller dont you think that we need a Health Care System for all . In adequateas shown and capitalism has failed. We have went to a socialized system. The money is being spent and because this system is done for profit, not for people, Bernie Sanders has been saying unless everybody has health care this will continue to spread because there are people that are homeless, people that will not get checked. A time tohis be socialize the Health Care System so everyone, because Homeless People continue to go in the Grocery Stores and walk around with this disease, and that is the only way you will be able to kill the disease . The great depression, 2008, and now, and the money is being put in the socialized system, but the Health Care System is not being expended. Host thank you for calling. Landon,ar from dr. Talking about the Economic System and Public Health care. Guest i am not an expert in the Economic System, but i will tell you we are taking care of anyone that comes through our doors and i am painfully aware of the fact that it can be a disincentive to go to the doctor if people feel like they have to pay for it. We are working with everyone at the university of chicago to provide care to matter what your level of need is for economic ability to pay is or economic ability to pay is. This is a difficult time and we need to Work Together to get through this, and then maybe there are changes we can make. We can decide this as a nation together, we can vote, and we can change. I can hear the desperation in erics voice and i know there are so many people who feel the same way. Just know that we as medical care providers are here to take care of you no matter what. There is a lot to figure out, but we can work with you to figure it out after the fact. If you are sick now and need help, we will help you now. Host the headline from the the mayorimes will be cautious before lifting the stayathome order and it will depend on the amount of Testing Available, and people should have a level of confidence about whether or not they are infected. What about testing . Guest testing is so important. We are having even more Testing Available at the university of chicago, but we have cobbled together a system to meet the need in our community and we still need to do more. We have three or four different platforms we use in our hospital , but the supply chains for the reagents is getting a lot better. We are able to test most of the people that need to be tested, however what Lori Lightfoot is saying is true and had a lot to do with what the last caller was saying. We need more than just a health system, we need a Public Health system. In chicago, we need really good Public Health that is able to provide testing and containment strategies like helping get people quarantined in a targeted fashion instead of having every Single Person stay home. We can get targeted people to stay home and cocoon those that are sick and provide them what they need and testing, but it starts with knowing who is sick and who is not sick. The best thing we can do is have widespread testing, the availability to test everyone we need. The tests are good and can tell is who is sick now and who was sick so who is now immune. The tests that measure if you are sick, that look for the actual virus in your nasopharyngeal, or knows and back of your mouth nose and back of your mouth swab, and we need to look for antibodies to know if your body has seen the disease so if we were not able to test you before, we can look at your history and tell us whether or not you saw the virus or had the virus, and we will have a better idea about what is happening in our population and when it will be safe to cut back on these measures. Ruth from pennsylvania for dr. Emily landon. Caller thank you, doctor, for what you do. I heard that somebody from russia was saying the way they are handling this virus, they found it does not live in an alkaline environment which means we might be able to control our by controlling our diet. I dont know. I think people who live on hamburgers and soda might be on a higher risk of not surviving. If this thought has anything to i, it might be anecdotal, but put it out there because it sounds like it might make some sense because we dont know who is living and who is dying once they contacted. Guest your question has a complex answer. Inside our bodies is our blood and organs and tissues. Our body has a number of systems to maintain the ph or alkalinity or acidity of our body at a constant level. You can eat as much as it is you want and it will not change what your ph is in your tissue. Alkaline,t as much drink as much Alkaline Water as you can find, and the alkalinity of your blood and tissues will not change. We only see those things change when the body gets really sick that it cannot manage it and at that point we are giving fluids to keep the body in balance because our bodies do not work well at any ph other than a tightly held range. If this is true, it would be helpful to control the virus on surfaces and the environment, but inside the human body we have to live with a ph of 7. 4 or else we will not survive. No changing of the ph inside the human virus body will help fight this virus, but the better our nutrition is, some vitamins do make a difference and there is preliminary evidence about that. Eating a healthy diet, getting lots of exercise and plenty of rest. There is plenty of evidence that enough sleep can prevent illness. We need to do better with our diet, exercise, and sleep, and Mental Health. Being stuck at home for long periods of time can be hard. I work at home and i worked to arrange things. I do not see frontline patients because i myself am immunocompromised, so this is my work too. That Mental Health piece is not insignificant. We all need to make sure we are doing our best. Host karen is in clayton, indiana. Caller hello, and thank you so much for bringing up the idea of Public Health system. That is comprehensive. I worked for the Health Department in indiana for a long time and my question is this how are the chicago hospitals, the mayor and the governor utilizing your Rural Health Hospitals . I believe the Rural Health Hospitals are all kind of floundering at this point with regulations and lack of equipment, but this would be an opportunity to shore those up for the hundreds of thousands of people in rural areas. Host thank you for caller. Calling. A couple of callers calling about rural hospitals. Guest it is tough for us to keep up with the rules and regulations and instructions coming out of all of the literature being made, and this is not because people are trying to make it difficult. This is because we are learning about the virus and doing it in realtime. Any time we have a substantial preponderance of the evidence that says we need to change something, we need to make that right away, and good in a can be smaller for rural hospitals to keep up. We are making our policies and procedures available to anyone who needs them. We have heard from colleagues and friends and we are sharing with cities across hospitals across chicago, a number of us are involved in citywide and statewide organizations to make sure everyone is getting the help they need. Your work in indiana Public Health is valuable. We cannot discount how valuable our local, state, and federal Health Departments have been. They have been providing the links to the Rural Communities and larger communities to meet this challenge. Friends and colleagues in the Public Health department in our local Chicago Department of health every day. It is tough for all of us to get the ppe and ventilators we need and the help we need, the doctors and nurses that we need, but no one is struggling more than rural health. I understand that. We are doing our best to make sure make our advice available. I have family in Rural Communities in illinois, and i know what great things these systems can do to help out, and how hard they work and how difficult it is for them. All i can do is send them my help and encourage more public help. We all can see the need for stronger, more robust Public Health department. It is essential to our safety and health. Host a text from robert in california should hospitals invest in uv lighting because it kills the coronavirus . Is that true . Guest uv lights to kill coronavirus. We have had these fancy uv robots for some time. We put them into a room when the patient is leaving the hospital and we need to do what we call a terminal clean on their room. It gets completely cleaned with bleach and then we put these ub uv robots in they dont look like humans, they are just lighting structures. We put one in the room, one in the bathroom, close the blinds, and set them to shine a light people have said sunlight is the best disinfectant and this is the inside the hospital version of that we shine a light on all these different surfaces in the room and that does help kill off extra germs. There is evidence at works for coronavirus. If your hospital does not have one of these systems, it can take a long time to arrange. , andare not inexpensive bleach and regular disinfectant kill coronavirus too, so it is not essential, but certainly if it is part of your longterm cleaning plan, we like it and use it for specific circumstances, not for every single patient but when we need it, and we are using it for coronavirus. In some of our procedural areas, Health Care Workers are wearing for procedures that are pretty low risk, but because they have these aerosol generation things happening during the procedure, even if the patient is not known to have covid or symptoms of covid, there is a risk and we want them to wear their n95. We do not have a ton of supply and we are trying hard to not have them reused so we disinfect them and we use uv light. Our colleagues at the university of nebraska came up with this plan and our colleagues at Argonne National lab, we are working with them. They helped us to work on calculating exactly how much be,t, how close it needs to and after you use your mask for a procedure you turn it back in with your name on it and they put it in a little shelf like lightto hold it up to the , and we blast them with uv light long enough that we know it will penetrate and kill off coronavirus on both sides of the mask, and return them to the same user. That can be effective in making sure they are not contaminated. It is not a fabulous plan if you have used those and a highly patients withith known covid, and we have not done that, but we are doing it in some procedure areas. Ast dr. Emily landon is chief Infectious Disease epidemiologist at the university of chicago, a medical agree from University School of medicine. On the phone, we have jackie. Caller i am 71 and i have asthma, but the questions i have, i dont think it relates to my circumstances. What is to prevent somebody from being tested in the morning and being free, and then later that day they catch it, or the next day they catch it, or the person that is having their temperature taken to go to work and they have no symptoms, but they say you dont have to have symptoms to pass on the virus, and it seems like the only thing that really makes sense to me from listening to all of this is that people get a test and they are they goee, and then into a section of society where everybody is virusfree and that is the only way you can truly be safe. Otherwise, you have to keep taking precautions. Super jackie, you are up early in santa clara, california , and you should consider a second career in Public Health. You have great thoughts. It is important to note that especially when we test asymptomatic individuals, it does not give us any guarantee about tomorrow or later today. The tests are not that great in asymptomatic individuals. I know you hear about this or that person being exposed and tested negative. That does not tell us anything about whether they will be positive tomorrow, and we dont know. Temperature taking methods are great for if you, for example, we ask Health Care Workers to take their temperature twice a day because if you are starting to see a fever, that can give you a heads up that things might be happening, but it is not the only thing. We should not assume because somebody does not have a fever they are completely fine. Plenty of people have had coronavirus and covid19 and did not have any fever. We have had some people whose only symptom is a little bit of congestion and not being able to smell or taste, so we need to be thoughtful about what we are feeling. Now, i want to get into this issue of the mask because it makes a big difference. Fabric masks are being recommended at the cdc and we are using them at the university, not so much because they will protect you from people with coronavirus but because you can contract it before you get sick. I do not have a crystal ball to know who will be sick in two days, but a couple days before you get sick you can transmit coronavirus in the respiratory droplets when you sneeze or talk. Right now, mine are in my living room and i am in a safe place because only my son and i will have contact. I ami leave the house, if going to get sick in the next couple of days and i wear a mask , that keeps my respiratory droplets inside my mask. Unless i am sneezing or coughing, it will do really good. The respiratory droplets off my fingers and that means they will not be carrying respiratory droplets onto the other things i am touching, which will help in Public Transportation and grocery store. It would be great if we could all wear surgical masks, but there are not enough of them and we have to save them for medical workers. Those masks are best used by them. Fabric masks are the way to go. We made a bunch of them at my house. Masks and i made some with leftover fabric and old clothes. Sort of iron it together and use hair ties as the ear holes. I got information on a number of different websites and we were able to make those, and that is the answer we are looking for right now. There is really something important to say about who is sick and who is not sick. Host 15 more minutes left with our guest, dr. Emily landon. I meant to ask about the cook county jail. Chicagos jail is now the top u. S. Hotspot as the virus spreads behind bars. What is being done about it . Guest i am not on the inside of what is being happening, but i can only imagine what it is like. I have seen the numbers and talked to people involved, and it is a tragedy. It is just not the ability to keep people separated. It is different than a nursing home outbreak, like we saw some homes in washington, incidentally being propagated and we are having that same experience in Nursing Homes across america. They are doing an amazing job trying to control this virus and keep it out of these Nursing Homes, but it is such an incredibly high risk population. My heart goes out to all of our loved ones in these places, and it is hard because you cannot visit them and this sort of thing, but those rules are really important. Many of them are doing a heroic job trying to protect their patients, but the same thing is true inside the jails. People are living close together. I am not a Public Policy guru and, i am a health person, from a health standpoint i think we need to do more. I would like to see more masks, but i know the people working on this problem inside the jail are doing everything they can, and to be honest, those numbers could be a lot higher if it were not for some of the amazing work happening with my colleagues in Public Health. As awful as it is, i want to try and look at the bright side that they are doing something, and everyone should know that every time you hear about one of these horrible outbreak situations, that everyone is doing their best. We need to keep in mind, no matter how divided we are as a nation and as a people and whether we agree on this or that policy of doing things, everyone is in this together, and we are doing, Health Care Workers, economists, policymakers are all doing our best to try to get through this unbelievable situation. It is truly historic what we are experiencing here together. I have had the opportunity to talk to people i never get to talk to, people in different walks of life, people in different parts of community and society that i would otherwise never have a chance to get to know, and that has been a real silverlining. It is a thin Silver Lining for many of us. You should know that we are working together and some of the connections and contacts we had will make us better as we go forward into the future. From we have a caller montana. Caller i would like to address the question of the test. Any listeners can go to the seas read whatwebsite and this pcr test can and cannot accomplish. It says if you test positive for this virus, it is the case that you have an infection with it but it does not mean that this is the cause of your illness. It also does not mean that you do not have the flu or some other bacterial infection or Something Else causing you to be ill. It also says if you test negative, that does not mean you do not have the virus. Clinical information must be taken to figure out whether or not you really do, so that means you could test negative but have the flu, go into the hospital, but your son just got back from wuhan, china, so we are going to write this down as a covid infection. The healthinister of ministry in italy has admitted that italy has been very generous and what they are calling covid. Basically, that is what you are doing here. People who have pneumonia and flulike symptoms and this, that, and the other, you are calling it covid, and if you look at the numbers, they are not great from a fear point. In a normal flu system season , 60,000 people die and in 2019, 70,000 people died, not counting your copd and respiratory deaths. This is a big scam being played on us and bill gates and others are behind it. Epidemiologists need to go through these charts. Back in 1984, fauci and others went off the map and changed virology forever. In the old days you isolated a virus and you had antibodies and that meant you had encountered it and were not likely to get it again. Host thank you for your points. You can respond to any part of that. Guest you are making important points. This medical test is not perfect. No test is perfect. We need to take clinical consideration and account with every test we do. We can say yesay or no, black and white for every diagnosis, but it is not like that. The diagnosis in the United States requires a positive test and a positive test means you have covid. Whether or not you died because of covid or with covid those are Different Things are very different. What goes on to a death certificate is based on what the physician or medical examiner thinks resulted in the death of the patient, and covid has been an important indicator. So many people want to compare apples to oranges and say we have so many deaths from the flu each year and that is why we should not worry about this. We have got to stop this thinking. The math is real. If we do not social distance, we will not be able to control this virus and we will have thousands and thousands of people dying in what i call preventable mortality. These are people who would survive covid and we can have a 1 , 2 mortality rate if everyone can get the care they need. If we have too many people sick at the same time, we will not be able to provide the medical care and people will die waiting for medical care. The difference between the flu and covid is every year, many people are immune to the flu because you see the flu every year and some of them are the same. Every year, 20 are immune of experiences before. We also have good antivirals which help us take patients who are high risk and keep them out of the hospital. You can use it to prevent outbreaks and places like Nursing Homes. We do nothas things have in coronavirus. Social distancing, our huge flu outbreak went to zero. Maybe one case a week. This is very different from flu. Flu left to run rampant in our community is held back by immunity, vaccine, and antiviral. When coronavirus runs rampant it is not held back in our medical systems do not have any slack. We have only enough beds as we need. It is expensive to run medical care in the United States. We dont have a bunch of extra beds. I know some of you have had the experience of waiting for a bed or having to stay in an emergency room, and that is without a pandemic. ,e do not have extra facilities physicians, ppes, anything to take care of the extra people that would get sick in a pandemic, and the only option that leaves us with you because of the way things have been set up is to stay home. I know you want to look at this and say it is not bad. Please, lets not make it bad. That is what our Mental Health, what we want to do as humans, say, this is not bad. We want to look at the silverlining. We want to be optimistic, but i do not want people to die. Host mckeesport, pennsylvania, richard. Ler i am just wondering and this is a common sense question and i would expect a common sense answer first of all, leaders forgot to read the book about leadership 101. You lead by example. What i dont understand, and every viewer will agree with me, why on television, especially when the president is on the air every day, including you, beginningy in the now, why did they not lead by example with social distancing . These people on that little stage that the president stands at the podium on were Standing Shoulder to shoulder just to get there mug on a screen. Why they were not practicing leadership by separating themselves, they are shoving it down everybodys throat to keep six feet away from everybody and they werent doing that on television. Host thanks for calling. What do you make in the general sense of the leadership and the federal government, and from the state government, beginning with folks in illinois in springfield, chicago, and elsewhere . Guest i want to tell richard, you are preaching to the choir. I have been saying the same thing since the beginning and you can ask anyone in my hospital. The first thing i said is we need to be separated. No one can share offices, no one in the same room. I am reticent to answer your question about the federal government response because i am a hospital epidemiologists, and i want to say that everybody is doing their best, but i do want to make a comment about this social distancing piece because it is really important. The most important thing i can say is we need to lead by example. We need to stay six feet apart. I am in my living room because i do not need to be in my office at work answering these questions so i am out because that is the safest thing. Essentialmportant for workplaces to find a way to make it safer for their essential workers to be there. In the hospital, we have to keep having a hospital. We are not doing business as usual. We are doing business better and safer, meaning we are wearing ppe not just when we are next to patients, but we are using fabric masks to protect other Health Care Workers in case someone gets sick. We are doing social distancing. People do rounds the way i am doing with you. Instead of everyone going into a room together, we have one doctor go in the room and everyone meets via videoconference and discusses what to do about the patient instead of having everybody in there. Some of our teams have one person who goes in at rounds, local on the floor and goes in and examines the patients, and they report everything that is going on so they can get the insight and help they need from the experts and clinicians without them having to be at the bedside, because we never want people to be less than six feet apart. We removed computers and workstations. We took chairs out of waiting areas. We made it impossible for people to congregate. Saying,roving monitors get on the phone, talk that way. When we started doing that, Health Care Workers stopped getting sick. We had a number that were sick very early on in this pandemic and we have been testing them to make sure we do not have covid positive nurses getting treating our patients. These were not providers seeing or taking care of our covid patients. They were catching it from outside the hospital and spreading it to people in their area in workrooms, when they were congregating for lunch, so we closed all the seating at the cafeteria. Everything is mobile and take out. Sick healthcell care workers has plummeted between social distancing at home and at work. We are keeping people and patients safe, meaning patients that come in with covid and without. We are providing the care for anything. Becauseble to do that we know our Health Care Workers are safe because we are practicing what we preach with social distancing. Everybody needs to be doing that in our Grocery Stores and our essential businesses because everyone deserves to be protected, even people who have to go to work. Host we know you have to leave in about a minute. Final thoughts on what you will be looking for in the numbers in the days and weeks ahead. Guest it is so important that we have a good plan for how to get out of this, and that will include social distancing measures. I am working closely with premier economists at the university of chicago to help figure out ways to be more nuanced about how we start things again so that places at the lowest risk for creating bad health incomes but the highest benefit for the economy can be restarted earlier and we can do it safely with a good Public Health containment strategy on the back and. End. We will learn new things and blaze new trails, and together we will figure out a way to get through this unbelievably historic and difficult time. My heart goes out to all of you suffering from medical illness and suffering from the similarly bad economic losses that are happening to people. I understand. You need life support in the same way our medical patients need life support, and i strongly encourage everyone to Work Together to provide the Economic Life support everyone needs. My heart goes out to you. The last thing i want to say is a heartfelt and absolutely genuine, from the bottom of my heart, gratitude and thank you to all of the Health Care Workers out there and all of the Public Health officials working. I am right there with you. It is hard work. You on the front lines wearing uncomfortable masks, uncomfortable ppes, with sick i amnts, we are with you, with you, and thank you for everything you do because you are getting us through this. Host