Coronavirus Q&A with Infectious Disease Doctor Isaac Bogoch

Do have questions about COVID-19? We asked an infectious disease doctor really patients questions about this new virus and how to best keep you and your family and friends safe.

This episode features Dr. Isaac Bogoch, an Infectious Diseases Specialist at Toronto General Hospital, working in travel and tropical medicine.

For more information on COVID-19 please visit www.VirusFacts.ca

Transcript

OMA Podcast Episode 13: Coronavirus Q&A with Infectious Disease Doctor Isaac Bogoch

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Voice-over: In this podcast, the Ontario Medical Association looks at current health issues that are on everyone’s mind. Spotlight on Health gives you the straight talk. We’re Ontario’s doctors and your health matters to us. 

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Anne Marie Flanagan: I’m Anne Marie Flanagan, Director of Earned and Social Media with the Ontario Medical Association.

Dr. Isaac Bogoch: My name’s Isaac Bogoch, and I’m an infectious disease physician and scientist based out of the University of Toronto and the Toronto General Hospital.

Flanagan: We're here today to talk about the recent COVID-19 outbreak and get some answers to frequently asked questions.

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Flanagan: Now, we’re talking a lot about social distancing right now, and I think people are curious about a few things there. What's the difference between social distancing and self-isolation?

Dr. Bogoch: They’re sort of intertwined. Self-isolation means that you are staying home. And in Canada, for example, self-isolation really means that most people are… are going to be doing this self-isolation for 14 days. 

So, for example, yesterday we heard from our senior leadership in the country that any person coming into the country from an international destination, regardless of the international destination, needs to self isolate for 14 days. 

That basically means you... you stick around your home for a 14 day period of time. That's self-isolation. 
 
Social distancing can really refer to a lot of different things, but essentially it means: keeping your distance from other people. So, at an individual level, it means, you know, not going to crowded restaurants or crowded bars. It also means that work forces can encourage working from home, so people don't all come into an office all at the same time.

Another manifestation of this is how schools have been essentially cancelled, and there’s home learning rather than getting a bunch of students together under one roof.  

So really doing things that will physically separate people from one another. That's... that’s social distancing.

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Flanagan: There's been questions about whether people could be re-infected. There’s, you know, rumours of a case in Japan where that happened, but there's been sort of mixed science on that. Do you know what recent guidance is on that?

Dr. Bogoch: Yeah, most people believe that re-infection is probably a very unlikely scenario. And I think that, when we look at these instances, there are probably other explanations as to why the diagnostics tests unfolded the way they did. So, most people don't believe that re-infection is that high on the list of possibilities in this scenario. 

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Flanagan: How long does the COVID-19 virus live on different surfaces?

Dr. Bogoch: Oh that's a great question. This has been a contentious issue for some time but now there's some decent data to drive our decision-making. 

And there... there was a really neat study that was done looking at this virus in particular—before we were just extrapolating from other related viruses. it looks like, depending on the surface and depending on the environment around the surface, this will likely be able to live for about two hours to two days. 

Wash your hands! Hand hygiene is so important. 

Because it can live for a couple of hours to a couple of days, depending on the surface and the environmental conditions, I think it's extremely important that people wash their hands, especially after they're in high-contact areas—like they ride the bus or the subway and they’re holding on to a guardrail, if they’re pushing elevator buttons, you know, anywhere in public. We know that this virus can… can live on surfaces, so hand hygiene is extremely important.

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Flanagan: One of the other questions we've gotten from people is around washing of produce. Is there anything people should be doing in terms of washing their fruits and vegetables to make sure that they don't catch COVID?

Dr. Bogoch: We know the amount of time that this virus can live on different surfaces is limited, and it probably doesn't live that long on organic surfaces, so I think just regular… I don’t think any new precautions need to be taken. Just washing your fruits and vegetables should be just fine.

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Flanagan: When people are washing their hands, what's better, soap versus hand sanitizer?

Dr. Bogoch: Technically soap might be a little bit better, but practically I think it doesn't really matter; I think we're splitting hairs.

Whatever people can do: do it. Whatever's closest, use it. They will both likely be fine. If you have a choice, and there's no delay? I prefer soap and water over the hand sanitizer. But if; certainly hand sanitizer will do just as fine job. 

The key point is hand hygiene and not to get too caught up on one versus the other.  

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Flanagan: Now I've seen a lot online about people sending around recipes to make their own hand sanitizer. 

Dr. Bogoch: Ah… it’s probably the wrong thing to do. I mean, there's no standardization. Just use hand sanitizer. I know that many stores are well supplied despite early sell outs of products, but I think you can use a commercially available product with a minimum of 60 percent alcohol in it. 

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Flanagan: And now, we know that this time of the year there's a lot of snowbirds returning to Canada from the States, and we’ve seen new guidance in terms of self-isolation. What's recommended for folks returning to Canada?

Dr. Bogoch: It’s pretty clear now from the Government of Canada. Anyone returning to Canada from any destination, doesn't matter if it's the United States or anywhere else in the world, you are expected to isolate yourself at home for a 14 day period of time. And, in fact, coming into Canada you will see border guards parlaying that message very clearly to everyone coming in. 

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Flanagan: Another question we're getting is: why do people need to self-isolate for 14 days? Is there a certain incubation period where people might not test positive but they may develop it?

Dr. Bogoch: Yeah, absolutely. So from the time someone's exposed to the time they develop symptoms of this infection is usually about five to seven days, in the vast majority of people. But it can be as long as 14 days. So that's why the 14 day period of time is chosen. 

Now most people, if they are infected and they’re going to develop symptoms, they’ll have it much earlier. So the 14 day is a pretty conservative cut off. And it seemed to have worked well, in most settings where this 14 day period has been employed, for a self isolation policy.

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Voice-over: This podcast is brought to you by the Ontario Medical Association. It is produced and edited by Jodi Crawford Productions. This podcast is not intended to provide medical advice for specific situations and is for general educational purposes only. Please consult your doctor if you have symptoms or questions about your health.

For more information, please visit our website at oma.org.

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