We are the chief medical writer for The Associated Press and a vice dean at Johns Hopkins Bloomberg School of Public Health. Ask us anything you want to know about the coronavirus pandemic and how the world is reacting to it. Science

UPDATE: Thank you to everyone who asked questions.

Please follow https://APNews.com/VirusOutbreak for up-to-the-minute coverage of the pandemic or subscribe to the AP Morning Wire newsletter: https://bit.ly/2Wn4EwH

Johns Hopkins also has a daily podcast on the coronavirus at http://johnshopkinssph.libsyn.com/ and more general information including a daily situation report is available from Johns Hopkins at http://coronavirus.jhu.edu

The new coronavirus has infected more than 127,000 people around the world and the pandemic has caused a lot of worry and alarm.

For most people, the new coronavirus causes only mild or moderate symptoms, such as fever and cough. For some, especially older adults and people with existing health problems, it can cause more severe illness, including pneumonia.

There is concern that if too many patients fall ill with pneumonia from the new coronavirus at once, the result could stress our health care system to the breaking point -- and beyond.

Answering your questions Monday about the virus and the public reaction to it were:

Marilynn Marchione, chief medical writer for The Associated Press
Dr. Joshua Sharfstein, vice dean for public health practice and community engagement at the Johns Hopkins Bloomberg School of Public Health and author of The Public Health Crisis Survival Guide: Leadership and Management in Trying Times

Find more explainers on coronavirus and COVID-19: https://apnews.com/UnderstandingtheOutbreak

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u/APnews Mar 16 '20 edited Mar 16 '20

Thanks for asking. Here is Dr. Sharfstein's reply:

There are different perspectives on whether hotter water is better. CDC recommends warm or cold water. See: https://www.cdc.gov/handwashing/show-me-the-science-handwashing.html

-- The bottom line is wash hands with soap X 20 seconds at key points and even if you just feel like it.

2) There is some evidence emerging of the potential for "fecal-oral" transmission of the virus, which means it could be passed on by people who don't wash their hands well after going to the bathroom. For this reason, some people might suggest sticking to cooked food, rather than uncooked food, for ordering out. Also super important that restaurant workers wash their hands. Restaurants should take extra steps and assure their customers. And people ordering should wash their hands well before eating.

3) Running on a treadmill for 3-4 hours? That does sound exhausting. No clinical studies with coronavirus as yet. I have not seen data on this question.

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u/rjcarr Mar 16 '20

For 2), I’m less concerned about feces, or even dirty hands, and more concerned about an infected person sneezing, coughing, or even breathing on my food. Is that an issue?

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u/HotSauceHigh Mar 16 '20

Agreed. Food prep people don't get masks, and virus can project in droplets from an asymptomatic person for 3+feet. Edit: https://www.google.com/amp/s/www.nytimes.com/2020/03/02/health/coronavirus-how-it-spreads.amp.html

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u/[deleted] Mar 16 '20

People at work keep talking about going to a local restaurant (dine in is all closed) for a lunch pick up....but laughed when I mentioned that the workers preparing their food could still be sick....

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u/potato_aim87 Mar 16 '20

Especially since most, if not all, restaurant workers don't have any type of paid sick leave or vacation policy. If I had to pick the highest risk group for transmitting the disease, it would probably be restaurant workers (outside of people in the medical field).

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u/[deleted] Mar 16 '20

The thing that annoyed me is, they looked at ME like I was the crazy one for not going.

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u/koalaposse Mar 16 '20 edited Mar 17 '20

I keep hearing of that response when people in work places bring up real concerns based on facts, such as lack of test kits in some states, the response from colleagues and superiors to them, is to treated them like they are mad. Yet that is the definition of being gaslighted.

It seems the way people are treated as if mad and their rational concerns dismissed, is because so many people are willfully in denial, they want to be in denial, and support each other in being so, that way they do not have to take personal responsibility on others behalf’s. This is a sad and criminally dangerous side of human nature, to let prevail in the workplace.

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u/maikindofthai Mar 16 '20

Yet that is the definition of being gaslighted.

You might want to refer to the dictionary, yourself. It's only 'gaslighting' if the person doing the gaslighting is being intentionally manipulative. This is just a case of lots of people being ignorant and careless, which isn't at all the same.

It's interesting how, once certain words become 'fashionable', they are overused by people with a tenuous grasp on their original meaning, to the point of taking on a different meaning. Reminds me a bit of the George Bernard Shaw quote:

“The reasonable man adapts himself to the world: the unreasonable one persists in trying to adapt the world to himself. Therefore all progress depends on the unreasonable man.”

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u/koalaposse Mar 16 '20 edited Mar 16 '20

Yes. Some are manipulative, some genuinely ignorant, and as you say there are those that are careless, or as I would say: willfully ignorant.

But... thankfully there’s others, like many of those here, who carefully research and debate matters, are proactive, speak up and do care.

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u/[deleted] Mar 16 '20

[deleted]

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u/robodrew Mar 16 '20

[facepalm]

Don't touch your face!!

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u/Kut_Throat1125 Mar 16 '20

As a pack a day smoker, I’m fucked.

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u/silentgreen85 Mar 16 '20

It’s not gaslighting unless they know we’re right and are fucking with our heads. They can’t conceive of the existence we’re hypothesizing, so it can’t really be correct... ... ...or can it?

But yeah, some people just don’t seem to pay as much attention to things, or deduce their likely outcome as others. It takes some people paying attention, putting 2 and 2 together, and then sharing that conclusion. It’s easy to dismiss stuff as exaggerated until you do some reading yourself, realize that no - shit really has gotten real, yo - that you then start sharing that same idea on to others. We people advocating pretty extreme measures have to be confident enough of our assessment of the situation to make others confront the situation.

Myself, my hubby and one of our friends all effectively told our respective companies to not expect to see us except to pick up our work from home equipment. We don’t know who is sick and who isn’t, we are glorified paper pushers with ZERO reason to be either catching it from or giving it to 1000 other people that pass through that same area. The absolute best thing we can do for everybody is stay the fuck home so we don’t further strain an already burdened medical system. And if our bosses won’t make the call, well- we will. If the CDC is saying no gatherings of 50+ people (unless you have no choice) needs to be stopped. We don’t have to be present to do our jobs, and by us hiding away we’re giving everybody else better odds because I won’t be competing with you for resources

Y’know... it’s basically going on strike to force companies to stop unnecessary in-person contacts. Every illness from an unnecessary contact is another case taking resources away from someone who didn’t have a choice. It’s extreme, but so is the possibility of a 7% death rate, when if we’d just done what was necessary and stopped unnecessary contact, the medical system will only have 1% death rate because they can keep up with the number of sick.

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u/[deleted] Mar 16 '20

[removed] — view removed comment

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u/glodime Mar 16 '20

don't have enough data to say if it's worse or not as bad as the flu

Italy, China, Iran, and Spain has the data. It's worse than the flu.

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u/[deleted] Mar 16 '20

That’s just untrue. We won’t know until we have this “season” under our belt.

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u/ValorMorghulis Mar 17 '20

The statistics don't support the idea that the flu is more deadly. The fatality rate for a normal flu is 0.1% and the fatality rate for the coronavirus is, let's be conservative, say 1%. Then the coronavirus is still 10x more deadly than the flu! How can you say the flu is worse?

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u/[deleted] Mar 17 '20

The fatality rate for Coronavirus is meaningless at this moment in time. Numerous medical professionals have said that over and over. It’s a moving target. We don’t have all of the data yet. The U.K. estimates it’s four weeks behind Italy. That means the US is far more behind those two.

Also, as I said to someone else, the known cases of Coronavirus are totally wrong, as most agree. So that skews the death rate higher than reality. Don’t not accept reality just to argue on the internet.

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u/[deleted] Mar 16 '20

Don't worry, stick to your guns. A few of my family members and close friends all said I was nuts two weeks ago when I told them to buy extra meat, paper goods, and stay inside. Two of them just said today that I was right and they should have listened, because now they're out of food and the local stores barely have even close to the normal selection of stuff.

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u/[deleted] Mar 16 '20

My mom....who JUST finished chemo and radiation for multiple brain tumors.....told me she got her job (elementary teacher) to let her come back early and wants to vacation to Florida in 2 weeks.

She had NO idea what was going on and after explaining it...she said "I just want to go out to a restuarant and a movie with everyone, then go shopping".

I feel like a god damn dream killer telling her she's at extreme risk and needs to stay away from as many kids and public places as she can right now.

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u/[deleted] Mar 16 '20

Well, from her perspective, she just got done with cancer treatment and she fought death and won. She feels invincible now, and elated. I understand that (not that I can relate, thankfully--sorry, not being insensitive). I can only imagine that she feels that she can do anything and be totally fine. Unfortunately, that's not the reality. The problem I have with that situation is... did her doctors not tell her she needs to take it easy for a bit? If that information was not passed on to her, that oncologist needs to be fired.

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u/Kut_Throat1125 Mar 16 '20

My in-laws has a trip to the Virgin Islands next week that they are still going on. I’m like that’s fucking insane, this is serious shit.

My mother in law was like well if I have to be stuck somewhere I would rather it be St. Thomas. I couldn’t really argue her point.

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u/reelznfeelz Mar 17 '20

Probably because they're ignorant jackasses. Sad thing is, if our strong efforts at closing shit down and doing social isolation do limit the spread, those same people are going to say "See told you it was NBD" never realizing it's because of all that rapid response that we slowed it down. It's hard to fight against idiocy or fox news syndrome. You just have to shrug it off and do you.

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u/epukinsk Mar 17 '20

Our brains are very happy to make up stupid reasons why scary things won't happen.

Just trust yourself. And let people know what they need to know. And be kind later when they realize the truth. It's human nature to avoid scary things. Be grateful you're ahead of the curve and you can protect yourself.

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u/Nativesince2011 Mar 16 '20

No matter how bad this gets, prepare for a whole lot of that

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u/PHUNkH0U53 Mar 16 '20

All places that have drive-thru should be drive-thru exclusive. Card only. Everyone there should be wearing masks while working. Gloves will be used by the cashier who can use their pinky & ring finger to handle the card and receipts. Their other three fingers can be used to throw in sauces & hand over food/drinks.

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u/smakinelmo Mar 16 '20

Aw man I hate being more likely. It is true though. For us in the service industry we are stuck working until we are told we can't no more. And more out of necessity to get paid and not being able to do it from home than stubbornness.

BTW, don't be surprised if places that get switched to pick up only don't bother to open or serve. Many places don't stock that many boxes if it isn't a big part of the business model.

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u/agoatonstilts Mar 16 '20

Yesterday was the first day my restaurant even slowed down. Yesterday was my Friday and if we don’t close down for a little while or go to take out only I’m not going back

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u/EpicWordsmith123 Mar 18 '20

The US government’s giving all Americans 2 weeks in paid sick leave, and other governments are taking similar measure, so they’re not quite the highest risk group anymore. I’d go with the homeless, outside of the medical field.

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u/otterom Mar 16 '20

Enh, if I remember anything from my time bartending, it's that Jack Daniels is pretty much a cure-all. Any brown alcohol is, really. /s

A shot (or four) a day keeps the sickness at bay! Or, you wind up too drunk to care!

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u/Isendal Mar 16 '20

I work in fast food and can only speak for my restaurant but we're taking this very seriously. Any chance of contamination is elimanted or cleaned. Last night a new kid got cut and was bleeding in his gloves, every he touched or was near was taken immediately out of service and vigorously wiped down with bleach and then washed again. Our headsets are telling us to wash our hands every ten minutes for cooks and the front/drive workers. Of course this is only for my restaurant but I imagine most places are doing similar things.

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u/Friar-Tucker Mar 17 '20

Is this one of the big chains?

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u/Isendal Mar 17 '20

In the southern USA yes

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u/brryblue Mar 17 '20

The 3 feet in that 3+ estimate is a very enthusiastic number. The droplets can be found as far as 10+ feet away from asymptomatic person (that was in the case of a bus in Germany- and the virus was still found after 30+ mins after the passenger disembarked).

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u/Galaghan Mar 16 '20

Yes, when an infected person sneezes on your food after it has been cooked you can definitely get sick from it.

That's the basic way of transmission for almost any virus. I think that's why people are trying to answer the question with exceptions to the basics.

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u/Harrywhoudinni Mar 16 '20

I'm no expert, but I would assume that everything that comes out of an infected person could carry the virus, along with the other already known risks. So whether we sneeze or poop or both, gotta wash those hands hard. It was common sense before, but now it might just be a matter of life and death for some.

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u/mangatagloss Mar 16 '20

There have been a couple of articles I've seen saying that the virus can still be detected and given a positive (confirmed) status from an anal swab, even after a negative result was gained from a nasal swab. So by that logic, it is more concerning for a person who didn't wash their hands after a bathroom break and prior to cooking, rather than them sneezing around food. Neither are appetizing or safe scenarios...

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u/[deleted] Mar 16 '20

I'd argue that it's concerning for ANYONE not washing their hands before handling food, any time of year or whatever (regardless of an outbreak/pandemic). That's just gross and can cause all sorts of illnesses.

But, do you really think that someone handling and preparing food and them sneezing or coughing on your food isn't a large concern? I certainly do. It's honestly one of the largest concerns I have when it comes to grocery stores and restaurants.

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u/mangatagloss Mar 16 '20

Not sure how you could take what I said and think I’m not concerned. The person i was replying to said they were less concerned about the feces aspect.

I’m not eating at restaurants or fast food at all and haven’t in nearly a week where I am. I’m taking as little risk as possible bc of being pregnant and almost due.

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u/[deleted] Mar 16 '20

Not sure how you could take what I said and think I’m not concerned.

I didn't say that you weren't concerned. I asked if you thought it wasn't a large concern. Don't twist what I asked:

But, do you really think that someone handling and preparing food and them sneezing or coughing on your food isn't a large concern?

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u/mangatagloss Mar 16 '20

You seem to take an issue with the magnitude of concern I have.

My reply was that I’m refraining from eating any food not prepared by myself or husband.

That’s a high magnitude of concern. Hopefully that suffices to answer your original question of how large a concern I have about food preparers being as hygienic as possible. Have a lovely day.

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u/[deleted] Mar 16 '20

Here's your first comment:

There have been a couple of articles I've seen saying that the virus can still be detected and given a positive (confirmed) status from an anal swab, even after a negative result was gained from a nasal swab. So by that logic, it is more concerning for a person who didn't wash their hands after a bathroom break and prior to cooking, rather than them sneezing around food. Neither are appetizing or safe scenarios...

You're saying here that "it is more concerning for a person who didn't wash their hands after a bathroom break and prior to cooking, rather than them sneezing around food."

You're implying that you think people take more care in not sneezing on food than washing hands after using the restroom. So how many times do folks sneeze or cough per day, versus go to the bathroom per day? Everyone sneezes and coughs. Everyone goes to the bathroom. Let's assume not a single person washes their hands after using the restroom. Now let's compare that to everyone who covers their mouth with their elbow when they sneeze. Do you not think that more particles get spread around via the "covered" (which we all know is bullshit) sneeze or folks not washing their hands?

If you honestly think that the concern should be fecal to oral transmission over someone sneezing around your food sitting under a heat lamp, you may want to reevaluate.

And what I took issue with was you twisting what I said. I asked if you didn't think sneezing around food was a large concern, given all of the above. You then claimed I said you didn't care. Two very different things. I don't take issue with your level of concern, especially now that you've clarified. However, I do take serious issue with people twisting what I said, especially when it's on your screen right in front of you while you typed your snarky response to me.

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u/mangatagloss Mar 16 '20

FIND SOMEONE ELSE TO ARGUE WITH. I’m not eating out.

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u/[deleted] Mar 16 '20

I'm not arguing. I am correcting you, where you twisted what I said. I respect your opinion, level of concern, etc. But I don't respect you willfully twisting what I said, when the words of my reply are right in front of you as you type your reply. Then, on top of that, you type a snarky comment and now you're "yelling" at me. Get over yourself, lady.

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u/MoonPiss Mar 16 '20

I have thought about this and decided that if I order food I will bake it before I eat it. This obviously changes the types of food that you can take out but I imagine that 10 minutes at 400° should kill it...hopefully

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u/The_Taytet Mar 17 '20

What I find important in this mans response is his ability to say I don’t know instead of trying to make us feel better by positive speculation. You got my upvote dude!

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u/MonjStrz Mar 16 '20

Fecal-oral sounds like the worst thing to Google right now

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u/HookDragger Mar 16 '20

Damn, so IceSoap won’t do the trick?

https://www.reddit.com/r/MuseumOfReddit/comments/18vujf/shower_to_go_ice_soap/?utm_source=share&utm_medium=ios_app&utm_name=iossmf

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u/[deleted] Mar 16 '20

CDC recommends warm or cold water.

Thanks, I've been rubbing ice cubes on my hands this whole time.

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u/HookDragger Mar 16 '20

IceSoap has a sad

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u/kansascityoctopus Mar 17 '20

Happy cake day!