Elon Answers: Distancing aids safety while shopping

This is part of a series of articles featuring responses by Elon University faculty members to questions about the novel coronavirus 2019 (COVID-19) submitted by Alamance County community members.

Is it better to go to an outdoor farmer’s market than to go to the grocery store?

Dave Gammon, professor of biology

It depends. Your chance of being infected with COVID-19 depends mostly on how many people you will encounter at the farmer’s market compared to the grocery store, and how physically close you will get to them. The novel coronavirus spreads mostly through small droplets in our breath and through physical contact, which is why staying six feet away keeps us safe. Regardless of where you purchase food, you should avoid the busiest days and times for shopping. You can also wear a well-fitting mask to reduce the risk of breathing in virus particles.

Shopping outdoors is perhaps a little safer than shopping indoors, but crowd size matters more. Other risk factors include how many surfaces will be touched by several people, and how many people have handled the food before you purchase it.

Is it true that food delivery is safer than going to the grocery store?

At this time food delivery is safer than shopping inside a grocery store. This is because you will encounter more people inside the grocery store than through food delivery. For most people, it is still safe to shop in a grocery store. It’s a good idea to distance yourself from other people while in the store, wear a mask, and use hand sanitizer after touching things that may be contaminated, like the keypad at the checkout counter. People in high risk groups like older adults and those with existing chronic health conditions are advised to use no contact services like food delivery.

When purchasing food that may have been handled by other customers what’s the best way to avoid an infection?

Maintaining social distance is by far the most important thing you can do to avoid infection. It might be possible to get infected from food handled by other customers, but that risk is small. Coronavirus can remain viable outside the body, but most of the virus will die within a few hours, and there is still no hard evidence the disease actually gets passed on through shared surfaces.

If you purchase food inside packaging, simply using clean hands to remove the food from the packaging should protect you. If the food itself was handled, like fresh produce, then washing the food off in plain water should be adequate to remove any virus particles. If the food cannot be washed, then leaving it alone for a couple of days will likely keep you safe.

Will you automatically get the disease if you get the virus?

If you get the virus inside of you then by definition you have COVID-19. This does not mean getting the virus will immediately make you feel sick, however. Two concepts known as presymptomatic and asymptomatic infection make it almost impossible for us to eradicate COVID-19 completely.

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Presymptomatic means you are infected but do not yet show symptoms. It takes five days on average for you to start showing symptoms after you first pick up the virus. Unfortunately, you will be highly contagious for at least a couple of days before you start to show symptoms. Data from Singapore and China show about 1 out of 10 people with COVID-19 picked up the disease from a presymptomatic person.

Asymptomatic means you are infected but never feel sick or show symptoms of illness. Asymptomatic people are also contagious for at least a couple of weeks. Dr. Robert Redfield, director of the Centers for Disease Control and Prevention, estimates one in four COVID-19 infections is asymptomatic. He bases this estimate on limited data from small populations in Iceland and other places.

We cannot know how many cases there are of asymptomatic infection until we can do more widespread testing for COVID-19. In North Carolina tests are normally performed only on people who already feel sick or who have had known recent contact with an infected person. A study published April 13 in the New England Journal of Medicine suggests asymptomatic infections might be much more common. In this study two New York City hospitals routinely tested women for COVID-19 who were about to deliver a baby. Twenty-nine women were infected, and most of them never developed symptoms.

In other words, many Americans are infected and do not even know it. That is why COVID-19 has spread so rapidly. That is why all Americans are being asked right now to practice social distancing. That is why quickly developing a COVID-19 vaccine is critical. And that is why it is so difficult to know when and how to re-open the economy.

Is it true that coronavirus is SARS 2.0?

This is somewhat true. The COVID-19 virus and the virus that caused the SARS epidemic in 2002 are biologically related. A third virus known as MERS (Middle Eastern Respiratory Syndrome) from 2008 is also very closely related. All three belong to a group of coronaviruses that cause respiratory illness in humans. Under the microscope, each coronavirus looks like a tiny ball with several spikes poking out, but the three types of virus have slightly different genetic sequences. The official name of the COVID-19 virus is SARS-CoV-2, which stands for Severe Acute Respiratory Syndrome coronavirus 2.

Can you explain the difference between a virus, bacteria, disease and condition?

Viruses and bacteria are two different kinds of organisms. Bacteria are made of cells, but viruses are much smaller. If your fist represents one bacterial cell, then a virus is represented by the top knuckle of your pinky finger. A virus consists of a short segment of genetic material surrounded by a few protein molecules. Viruses can only survive inside the body of a host.

Most infections are caused by either a virus or a bacterium. Drugs that work against viruses do not work against bacteria, and vice versa. COVID-19 is caused by a virus, so antibiotics and other drugs designed to attack bacteria cells do not work against it.

Generally speaking, a disease is a health problem that can be cured or treated. A condition is any abnormal state of health. Conditions are a broader collection of health problems that include diseases, but also include things like injuries, allergies, and mental health.

Although anyone can get COVID-19 disease, some people with pre-existing conditions are under greater risk of severe illness, possibly leading to hospitalization and death. These conditions include:

  • Senior citizens or people who live in a nursing home;
  • Respiratory problems such as asthma or chronic lung disease;
  • Severe obesity;
  • Impaired immune system; and
  • People with other serious health conditions, such as diabetes, heart problems, liver disease, or chronic kidney disease and undergoing dialysis

I imagine COVID-19 could spread rampantly in detainment centers, refugee camps, and jails. Is anything being done to curb the spread in populations such as these where many individuals are living close together in conditions which are subpar?

In the early stages of the pandemic, many refugee camps and prisons were protected by their lack of exposure to travelers who visited China, which is where COVID-19 originated. Pockets of the disease are now emerging throughout every country due to transmission of COVID-19 within communities. Crowded populations everywhere are at a higher risk because of the close living conditions.

Two million people live in American prisons and indoor detainment centers. Conditions in these facilities are often crowded, placing people at more risk of exposure if anyone in the population becomes infected.

Because of the close conditions, the coronavirus is likely to spread easily, which will result in high rates of infection. We already see evidence of this at a federal prison in Butner, N.C., where 62 inmates tested positive for COVID-19. Chicago’s Cook County Jail reported 251 infected prisoners and 150 infected employees.

Steps are being taken to curb the spread of COVID-19 within prisons. For example, visitation by lawyers, family members, and other outside traffic has been limited at most facilities. Some low-risk prisoners were released early. Many facilities also disinfect shared surfaces, provide additional hand sanitizer and masks, and now waive copayments for medical treatment of inmates.

We have less information about the current state of infection in refugee camps because these camps are generally located far from the microphones and pens of journalists and other interested outsiders. We do know access to health care is extremely limited in these camps. Sometimes several thousand refugees share a single doctor.

Early in April, 20 residents of a refugee camp in Greece tested positive for COVID-19, leading public officials to quarantine the entire camp. More camps worldwide will probably be quarantined in the coming weeks as COVID-19 spreads.

Residents within these camps will need to isolate infected individuals, but this is a daunting challenge for at least two reasons. First, many infected individuals are never identified, due to a lack of testing and to the presence of infected individuals who lack symptoms but are nevertheless contagious. Second, the cramped quarters within refugee camps make isolation of any individual difficult.

The number of infections in both prisons and refugee camps will likely exceed whatever gets documented. Many prison facilities in the United States no longer test for COVID-19 because of limited test supplies. It will probably be months before we develop a clear understanding of how the pandemic affects detainment centers, prisons, and refugee camps.

Dave Gammon is a professor of biology at Elon University. Reach him at dgammon@elon.edu.

To submit a question to our team of scientists, visit tinyurl.com/eloncovid19, email us at eloncovid19@gmail.com, or use social media with hashtag #eloncovid19. Answers will be published as available in the Times-News, at www.thetimesnews.com, and on Today at Elon.