Episode 3 - Dr. Perez, Epidemiologist

Welcome to the City of Plantation's Podcast. In this Episode, Dr. Perez, Epidemiologist at Westside Regional Hospital and Deputy Chief Gordon, discuss COVID-19 and important information related to the Coronavirus Pandemic. This Podcast is aimed at keeping the residents of Plantation informed regarding how the City and its various Departments are responding to the COVID-19 Pandemic. Please subscribe to this podcast, as we will be producing new episodes on a regular basis.

Speaker: Dr. Perez, Epidemiologist
Host: Deputy Chief Joel Gordon, PIO
Production: Division Chief Ezra Lubow
Music: Oakwood Station - Summer Breeze Memories
Cover Art: The City of Plantation

Speaker 1 (00:00):

Hello plantation. Welcome to the city of plantations podcast. I'm dr J formerly with plantation information radio. Thank you for tuning in. We hope the information provided within the episodes of this podcast helped keep you your family and your friends safe during this pandemic. Today we are pleased to have with us Dr. Daniel Perez, a specialist in infectious disease at Westside regional medical center. As an epidemiologist. Dr. Perez spends his days often nights and now of course weekends dealing with infectious diseases. Unquestionably, Dr. Perez is currently overwhelmed in dealing with the Corona virus outbreak. However, he has graciously agreed to spend some time on his day off with us to speak about coven 19 and its impact on plantation residents. So Dr. Perez, first of all, welcome and thank you for joining us. Thank you for having me. You know, and let me, let me start by just thanking you, your staff and all the healthcare providers out there for really putting themselves in harm's way to try and protect the citizens, not just the plantation, but really globally. So let's dive right into this if we can. What we'd like is if you can just kind of give us an overview of what is coven 19, what is coronavirus, what does it mean, what is it all about? Um, you know, what's happening globally around the world and then maybe focusing in on what's happening in your practice and what you're seeing locally.

Speaker 2 (01:31):

That's a long question there.

Speaker 1 (01:33):

It's a lot to cover. We can break it down if you want

Speaker 2 (01:37):

I think that, um, you know, it's interesting to see this, but Corona viruses have been here for millions of years. Um, we have, as a matter of fact, a flu flu like illnesses are caused by coronaviruses 10 to 25% of them. And, um, but what's going on right now? It's that this is a novel coronavirus it's a, it's a virus as has never been developed or has not been discovered until this, uh, episode. Um, we've been dealing with, um, epidemics, um, obviously ones, smaller proportions for what we're dealing with. Uh, for many years. I mean, as you recall in, um, 2002, um, we had the SARS epidemic, um, which, um, it only affected a very small, uh, amount of people and a very small amount of that that, um, was a little bit scary because the, uh, the, uh, the fatality rate, and we'll talk a little bit more detail about why was that was 10%, but it was only a very limited amount of tests at that time.

Speaker 2 (

Transcript

Speaker 1: 0:00

Hello plantation. Welcome to the city of plantations podcast. I'm dr Jay formerly with plantation information radio. Thank you for tuning in. We hope the information provided within the episodes of this podcast helped keep you your family and your friends safe during this pandemic. Today we are pleased to have with us Dr. Daniel Perez, a specialist in infectious disease at Westside regional medical center. As an epidemiologist. Dr. Perez spends his days often nights and now of course weekends dealing with infectious diseases. Unquestionably, Dr. Perez is currently overwhelmed in dealing with the Corona virus outbreak. However, he has graciously agreed to spend some time on his day off with us to speak about coven 19 and its impact on plantation residents. So Dr. Perez, first of all, welcome and thank you for joining us. Thank you for having me. You know, and let me, let me start by just thanking you, your staff and all the healthcare providers out there for really putting themselves in harm's way to try and protect the citizens, not just the plantation, but really globally. So let's dive right into this if we can. What we'd like is if you can just kind of give us an overview of what is coven 19, what is coronavirus, what does it mean, what is it all about? Um, you know, what's happening globally around the world and then maybe focusing in on what's happening in your practice and what you're seeing locally.

Speaker 2: 1:31

That's a long question there.

Speaker 1: 1:33

It's a lot to cover. We can break it down if you want, but, but

Speaker 2: 1:37

I think that, um, you know, it's interesting to see this, but Corona viruses have been here for millions of years. Um, we have, as a matter of fact, a flu flu like illnesses are caused by coronaviruses 10 to 25% of them. And, um, but what's going on right now? It's that this is a novel coronavirus it's a, it's a virus as has never been developed or has not been discovered until this, uh, episode. Um, we've been dealing with, um, epidemics, um, obviously ones, smaller proportions for what we're dealing with. Uh, for many years. I mean, as you recall in, um, 2002, um, we had the SARS epidemic, um, which, um, it only affected a very small, uh, amount of people and a very small amount of that that, um, was a little bit scary because the, uh, the, uh, the fatality rate, and we'll talk a little bit more detail about why was that was 10%, but it was only a very limited amount of tests at that time. And it was controlled obviously with, um, um, a lot of, um, uh, help and, um, healthcare workers who did a lot of work in controlling this, uh, epidemic. Then we, they had the Merce epidemic, which was in 2012, 2013. It was only localized in the area in peninsula, but that, uh, had very high fatality rate. So obviously there, the, the, it was not as contagious as what we're dealing with right now with the, um, covert. But, um, the fatality way was up to 30%, and that only affected that only like 5,000 people. Now we're seeing another outbreak of this, uh, novel coronavirus infection that obviously has started in the Wohan, uh, city of, in China, uh, in December of 2019. And unfortunately, this one, which is what we call a so Nautic infection, it started from an animal, a jumped into a human being and then obviously spread, um, um, uh, among, uh, China and now all over the world. Um, and obviously that's a, the, the scary part is that I would see this, it's highly contagious, uh, in comparison to the other epidemics of coronavirus infections.

Speaker 1: 3:53

I want to try and clear up a little confusion, cause obviously the messages that are coming out are all different. And depending on who you talk to and what time of day we're hearing different things we've had. And you talked a little bit about the pandemics that we've had over the years. What is it that's making this one so different? I mean, we've had them, we've dealt with them, we've survived them. But this one seems to be just, just compare the others pale. And in,

Speaker 2: 4:19

in the face of this, it's, um, it's a problem of how contagious it is. And I think that, um, in, um, if we see the numbers of, um, uh, infected people and a number of, uh, that's, you're seeing that obviously this is something, um, that has no, uh, that we'd never seen before. Um, obviously, unfortunately we have to say that today I think that we are reaching the a million, um, uh, Mark of, um, uh, cases, um, around the world and, um, and it's gonna continue to go up. So it's, it's, it's a matter of how, um, uh, how contagious this, uh, this infection is in comparison to other, other current rhinoviruses outbreaks that, um, that, um, uh, that it's obviously, um, um, uh, a concern for, for, for us right now.

Speaker 1: 5:14

Yeah. So let, let, let's get into that a little bit if we can. Um, you mentioned about the, the, the fatality or the death rate. Um, and, and we talked before when you first arrived off, you know, off Mike about the fact that we just come to the realization that we haven't peaked yet, that, that really we're, we're approaching what could potentially be the high point of this scenario. And, and th th the, you know, they came out, dr Fowchee came out with numbers the other day and he said, if we don't do anything, we're going to lose up to 2 million people. Uh, and, and if, even if we do make efforts a hundred to 250,000, um, what about that? What can we do? Can, what can we as average human beings do to say, Hey, I don't want to die. I want to do what I can to keep everybody alive.

Speaker 2: 6:05

Well, we just need to follow the guidelines of, um, what the government is recommending. I mean, obviously, uh, the social distancing and isolation that needs to be followed. Um, strictly, um, I think that I was the, I mean, you see it. Um, unfortunately I still see a lot of people driving around, um, going into social meetings or, um, family meetings that are, have a lot of, uh, people inside a house, um, going to beaches and churches. And I don't think that we, we are realizing the severity of this situation and that we need to follow a strict rules of isolation.

Speaker 1: 6:42

So let, let, let's get into the self isolation because that also has in the last day or so become a real, real big thing. Uh, the governor just signed the executive order. Um, what does that mean? What is self isolation or what is, what is social distancing? And now I guess they're calling it physical distancing. They've kinda changed the terminology a little bit. What are we talking about here? Well, what does it mean? Cause I think everybody looks at it and interprets it to their own benefit.

Speaker 2: 7:08

I mean, if not essential. It's pretty much staying at home at all times. That's how I feel it. I mean, obviously you'd need to go out for, um, pharmacy, doctor's appointments, um, um, um, grocery, picking your food that you need. But it's only limited to just, um, uh, essential, uh, situations that you need to get out of the house. I'm not saying that obviously you have to stay at home all the time. I mean, obviously if you want to walk in the neighborhood is to remain at least six feet apart from, from individuals, uh, to make sure that there's no risk of, of, of, of contracting the infection.

Speaker 1: 7:47

And for the lay person who doesn't really understand this, why is that so important? That six foot distance to space, the cover up all that,

Speaker 2: 7:56

it's all about the, um, physio pathology and the development of the risk of development going for infections, especially in Corona viruses. Um, we do know that these infections can be transmitted by secretions, obviously. Uh, we do know that they're not as highly contagious as other infections like tuberculosis and measles, but we do know that for coronaviruses at least six feet away apart in regards to just the, uh, potential for either transmitting secretions to other people, we do also do know that this infection can be transmitted through, um, uh, surfaces. Um, and it is important to know that the[inaudible], that the infection can be transmitted if you touch or in contact with objects that do carry the virus. Um, unfortunately, this virus is hard, uh, uh, to die. Um, it can stay up to, uh, hours or days in hard surfaces. So that's why importance of um, uh, washing, um, all objects that are in touch with, um, uh, contact with hands and most importantly, uh, the hand washing is critical. We do know that obviously we need to wash our hands at least for 20 minutes extra me. Well, uh, sorry, 20 seconds extra me while to make sure that, um, uh, that we don't transmit the infection to other people.

Speaker 1: 9:17

We, we've also heard in line with all this, we've heard the conversations about masks and gloves and, and 95 masks versus surgical masks versus something you can make at home and all this stuff going on. And obviously there's a tragic or or, or a horrible shortage of these supplies who needs to wear a mask and you know, you talk to everybody again, just like, you know, all the, all the prevention stuff. It's, you get different answers. Who needs to wear masks? Who needs to wear gloves, and what do they need to actually do?

Speaker 2: 9:51

The, um, the debate about, uh, masks obviously has been going on for weeks. Um, and I think that ultimately that it's going to change. I mean, obviously from what I listening from Tony[inaudible], from um, all the other, uh, experts in the field, um, I think that things will change. I honestly believe that right now. Um, um, who needs to wear masks? Uh, um, we're talking about obviously you're in the hospital, that's a different thing. Um, the[inaudible] are only indicated for, um, healthcare workers who, um, uh, who are on in battle or, um, taking care of, of sick individuals who have the, uh, covert infection. Um, the regular surgical masks. Um, like I said, I, I don't think they're recommended, but that will change. I think that for a normal population who is at no risk of any exposure, um, I don't think that the surgical monastery indicated, uh, there was a debate that obviously that we had a shortage of these, um, uh, masks a couple of weeks ago. And I think that's a real thing that is going to happen if this continues to go the way that it's going. But, um, I think that obviously we're, um, our, at least the government and other people are under a lot of pressure that they might recommend, uh, wearing just regular surgical mask, uh, for everybody. Uh, later one.

Speaker 1: 11:19

All right, well we'll have to keep an eye on that I guess. Um, all right. So obviously, you know, we all want this thing to end today. We just want to throw the switch and say this was a bad dream and wake up tomorrow and everything will be wonderful. Um, but obviously that's not realistic. We've also heard from different authoritative individuals about the duration and how long this thing is going to last. And we mentioned earlier that we haven't even reached the peak yet, especially here in South Florida. Based on what you know, and based on what you've seen in your experiences over the years, and not going to hold you to this by any means, but how long do we anticipate this could last?

Speaker 2: 12:00

I mean, Joel, if you want to be optimistic, I mean tomorrow we would hope for it, but realistic, I mean we have to see exactly how the world is going through. I mean, obviously China, Europe, there are a couple of weeks ahead of us and, um, I honestly believe that would, seeing that what it's going through right now and obviously the, uh, district protocols that we're trying to follow to make sure that this, uh, we're able to control this. And, uh, what we're, everybody's saying, flatten the curve or kind of slow things down a little bit. Um, I mean, if we flatten the curve, I mean, things are going to continue for weeks. I mean, I honestly believe that, uh, April and may is pretty much going to be, we're going to continue dealing with this. Um, and hopefully by summer everything come, we'll kind of slow down. Um, so, um, I'm hopeful that I was, like I said, I think, uh, six weeks, eight weeks we'll, we're going to continue to,

Speaker 1: 12:59

so, so this kind of intensity for at least another six to eight weeks and then start to see it ramp down. Right. And what maybe like, I mean, I, and again, I hate to put dates on anything but made end of summer to see this go away.

Speaker 2: 13:12

Well, I, I think that uh, uh, uh, the remnants will, will, will still persist. But yes, I think that I would see by, by mid summer, end of summer, I think hopefully everything will go away. I think the scar will be left there. I think that I was the, um, from a, from a mental standpoint, I think that I would say we are going to be affected by this for a longer period of time, but I'm hoping that I would see that the cases, the number of, of new cases and the number of, uh, of that will hopefully will be, uh, done by the middle or end of summer.

Speaker 1: 13:45

So let's, um, Oh, I want to go back to the social distancing thing for just a second. The governor signed the order, you know, uh, effective really tomorrow, which is Friday, uh, saying, you know, kind of giving enforcement to the whole social distancing and the, and the, you know, identifying essential travel. Are we as a community doing everything we can to be wary and, and, and to, to aid in the prevention of the spread or is there more that we can do as individuals?

Speaker 2: 14:17

That's a hard question to ask, but to answer, but I, I think that, um, a lot of people, I'm not sure if they still, um, understand the gravity of the situation. Um, I think that, um, uh, we need to be a little bit more, uh, strict about following, um, the rules and guidelines or that they're suggesting for us to follow. Um, so I think that we need to be a little bit more serious and taking it a little more, um, concerning[inaudible] to make sure that we need to do everything where we need to do. Um, I still see, like I said, I mean driving around, I'm still seeing a lot of people just, I'm not sure if all is all those travel that they're doing as essential, but we just need to take it a little more serious, honestly, I believe.

Speaker 1: 15:04

And just one other thing I want to look at. Um, we've sort of segmented the population, you know, it, we've said these people are, are, are, you know, at high risk, these are low risk, et cetera, et cetera. We obviously find the elderly or the older population is at extreme risk. What is it that makes it so risky for them?

Speaker 2: 15:26

It's a multiple situations. I mean, obviously the, uh, the um, the, uh, the numbers are scary. Um, I mean if you see, and if I go backwards in age and we do know that I would see people are older than 80, who have, um, uh, covert, Oh, 15% will die. Um, if you're older than 70, it's going to be 8%, and it goes lower, lower, lower. So obviously anybody who's older than 60 has a much higher risk. And obviously then the younger, younger population. So we do know obviously from, um, what happened in China and what's happening in Europe that obviously the older you are, the, the higher, the risk of, of death. And if you contract this infection, it's, it's, it's an, it's an age issue. And, uh, I mean I can go scientifically why that would be. Um, but I think that, um, we do know that there's a probably a, um, a loss of, of, um, immunity the older you get. And if I, if I, that's why we'll call immunity set essence, meaning that the older you get, your immunity starts coming back down and your memory or your cells that are in charge of, uh, of infections is pretty much gone. That's one, probably the main reason. But obviously we also have to highlight the importance of comorbid conditions and, uh, elderly population. We do know that I would see coronary artery disease, um, chronic obstructive pulmonary disease, renal disease, liver disease, um, uh, if you're an immunosuppressant medications either for, uh, cancers or any other conditions, you're a much higher risk of developing this infection.

Speaker 1: 17:03

So it's really important that not just the elderly take care of themselves and practice social distancing, but those that have contact with the elderly or those that, that associate with the older population really also have to be respectful of that scenario.

Speaker 2: 17:19

And, and, and I think that's one, one of few things that are coming. Um, over the past day or two, we are not realizing the asymptomatic carrier. So the potential individuals who don't have any symptoms, uh, the risk of they are to give it to somebody who is at risk for the infection. And, um, we do know that a number of, of, of patients don't have any symptoms at all. Usually it's a younger population who will carry the infection without having any symptoms. Those are the ones that are our biggest concern right now I think.

Speaker 1: 17:52

And that presents a challenge, doesn't it? Because how do you tell somebody who has no symptoms? You might be a carrier, you know, where do we even start to define that? Exactly. All right, so this is, this has been great. And, you know, I, I wanna I want to start to close it down, but what I'd like to do is I'd like to, you know, it, it's, it's rare that we have the opportunity to have such an expert here with us. Um, I like to give you the opportunity to talk about what we haven't talked about. What haven't we ask, what are some things that you've got an audience now you can speak directly to the community. What do you want to tell them?

Speaker 2: 18:32

I think that, um, obviously the[inaudible] a couple of things that we want to highlight. I wanna I want to highlight will be that, uh, people have to take this, uh, this, um, uh, situation seriously. Um, as we have seen and I imagine that everybody looks and hears the news and we see the number of cases significantly increasing in specific areas within the United States. And, um, and we have to take this, uh, very seriously and made sure that I would say we do what we can, what we need to do in order to control this infection. Um, I think that obviously the important thing, I was, like I said, it's a younger population, um, that obviously has a significant risk of transmitting the infection. Even, even though they don't have any symptoms, they just have to be careful with their parents or grandparents and make sure they don't, they don't, they don't transmit this infection. Um, but at the end, I think that what I want to highlight in, uh, for everybody to hear is that we're going to get through this. This is obviously something that I would say we have expected to happen. Um, and obviously everybody working together. Um, we're gonna overcome this and where am I going? Gonna make sure that, uh, everything will be back to normal, hopefully in the coming weeks to months. So, um, I'm hopeful. I'm optimistic that, uh, with everything that we're, we're doing specifically the, um, social isolation, um, and um, controlling and making sure that you do everything that you need to do that. Uh, we're gonna we're going to go over the take. I mean, we're gonna make sure that we're gonna overcome this and everything will be back. So hopefully soon.

Speaker 1: 20:06

Outstanding. You know, I, I just, I just thought of something else. There has been some conversation out there and we, we talked earlier about, you know, it dissipating toward the end of the summer possibly. Um, you know, and, and you said the scars will be around, the remnants will be around. What about the incidence of a possible re-infection, you know, a recurrence of it. You know, as the flu season comes back again, that's very real Joel.

Speaker 2: 20:32

I mean, obviously I'm listening to the experts in the morning and there's a possibility that I might happen. Um, I think that, um, if you know there's going to be something, um, and there, there is some hypotheses that there will be either a, an animal who will be kind of an intermediary intermediary host that will keep this virus, um, uh, upon us and it'll just kind of wake up whenever it wants to. So there's a very real possibility that this will be something like a, like an influence, uh, uh, and be kind of a cyclic, uh, uh, outbreaks of my many outbreaks. Um, there's obviously the, the possibility that obviously once everybody gets infected, uh, then we'll develop our herd immunity, meaning that obviously that, uh, people who got the infection will be able to protect the other people who are susceptible to infection. And I'm really hopeful for vaccine development obviously that, well, maybe by next year or maybe by the end of this year, uh, we will have a vaccine that obviously we'll be able to, uh, get everybody vaccinated to protect the ones who have never had the infection.

Speaker 1: 21:43

Wow. That would be great. Let's hope so. All right. Well, Dr. Perez, thank you again very much for spending the time being with us, uh, giving us your expertise and your insight. I think it's invaluable and hopefully the people who listen to this will, we'll heed those, those words from you. Um, and we really, really appreciate it. Again, thank you for all you're doing your staff and all the health care workers out there for doing their very best and really, really putting themselves in harm's way. So from us to use stay safe, stay well and thank you.

Speaker 2: 22:14

No, same thing to Joel. I mean, thank you for inviting me here. And like I said, I appreciate the invitation here and also want to thank you, uh, the plantation, uh, fire department and everybody else out there who is, uh, who's working hard to make sure we get this thing under control soon. Great. Thank you. Thank you. You've been listening

Speaker 1: 22:31

to the city of planned patient podcasts here in plantation. We're working hard to bring you the latest, most accurate information available about the Corona virus pandemic. Remember, if you have specific questions, you can email them to ask cityHall@plantation.org don't forget to visit the Cobra 19 page on our website and register forever bridge for up to the minute changes regarding the outbreak. We want to thank you for tuning in and taking the time to listen to the experts about how to keep yourselves, your family and your business safe and healthy during the prices. And don't forget to wash your hands, cover your cough and maintain a safe distance.