Category: Health

Traveling during the COVID-19 pandemic can be a challenge.

What is the safest way to travel? What mode of transportation should you take? Should you even travel at all?

Doctors at the University of Kansas Health System said it might be safer now to travel by plane, with safety precautions that have been put in place.

Dr. Wissam El Atrouni, associate professor of medicine in the division of infectious diseases at the University of Kansas Medical Center, said air travel is safer with various precautions that have been taken, such as extra cleaning and social distancing. Planes are often half-empty and passengers can socially distance. There are also changes at the airports to make it safer, and a lot of the stores there were closed.

He said he would recommend wearing a mask on the airplane, using hand sanitizer and social distancing.

The drawback to air travel is you don’t choose who sits next to you and you might not know if they have an infection or symptoms, according to Dr. El Atrouni.

Dr. Steve Stites, chief medical officer at KU Health System, said it’s all about the bubble and who is in it. In a car, you have control over who’s in your bubble and on a plane, there isn’t that degree of control.

There is a certain amount of anxiety people have about traveling, according to Dr. Danielle Johnson, a psychologist. It goes back to what they can control and what they can’t, she said.

In cars, people can sanitize the vehicle and know who’s in it and who’s not, while on an airplane they don’t have that sense of control.

A lot of people may struggle with the fact they have to accept what they can’t change, she said. If people decide they want to take a trip for their own mental health, for example, they may want to do things that make them feel safer, such as wearing masks, social distancing and using hand sanitizer.

Some people may benefit from building up to a larger trip by taking some smaller trips first, she said.

Dr. Dana Hawkinson, medical director of infection prevention and control at KU Health System, said people may want to wear masks and eye protection while flying on a plane. They probably don’t need gloves, he said. Hand hygiene is important, he added.

Dr. El Atrouni, who has enjoyed traveling in the past, said he doesn’t have any plans for immediate travel. He reminded travelers to check the rules for states they want to travel to, and see if a quarantine is needed, and also to check their own state’s rules to see if a quarantine is needed coming back from the trip.

He said he would hesitate to make an international trip because of the risk that there could be a second wave that could make it difficult to come back.

He also said the epidemic isn’t over yet, and people should continue to take precautions such as wearing masks and social distancing.

Individuals are facing anxiety, a sense of loss and grief as the effects of COVID-19, Dr. Johnson said.

According to Dr. Johnson, families and individuals may find some sense of control through regularly scheduled activities such as meditation, yoga and running.

Dr. Greg Nawalanic, a psychologist, said working at home, and at the same time being with the family, can be stressful.

He said structure is a great benefit to people. Set a time to get up, to go to bed and have a dedicated work space, he said.

Two-parent families should work as a “tag team,” one working while the other takes care of the kids, then swap, he said.

With more people traveling this summer, there is a question about how to handle family gatherings.

Dr. El Atrouni said he would worry about elderly members of the family and those with health conditions, and also if they are in a high-risk exposure area.

Dr. Hawkinson said people could find out about the other family members who are coming in. Some data show that wearing a mask in family households reduces transmission as well, he said, and may be an option if the gathering is in a confined space. Otherwise, be outdoors as much as possible, he advised, and be careful to clean surfaces and avoid touching hands to the face.

Dr. Johnson said it’s possible to go outdoors to have a gathering with family. Set up tables outdoors, socially distance and find creative ways to get together, she said.

Dr. Stites said a lot has to do with a person’s tolerance of risk. It’s a personal decision.

Travel and gatherings are not as safe as home, he said, but things can be done to minimize the risk, such as social distancing, washing hands and wearing masks.

Dr. Hawkinson reported KU Health System had 11 positive COVID-19 patients on Tuesday morning, up one from Monday. Five persons were in the intensive care unit and two on ventilators.

In Wyandotte County, the Unified Government COVID-19 website at 4 p.m. Tuesday reported 1,520 positive cumulative cases, with 76 deaths and 13 hospitalizations. It was an increase of 18 cases since 1 p.m. Monday, and an increase of one death since Monday.

On Wednesday, June 10, a pop-up testing site is at New Bethel Church – Forest Grove Baptist Church, 745 Walker Ave., from 2 p.m. to 5 p.m. For more information, visit https://wyandotte-county-covid-19-hub-unifiedgov.hub.arcgis.com/pages/what-to-do-if-you-think-you-have-covid-19.

The KU doctors’ news conference is online at https://www.facebook.com/kuhospital/.

The UG’s COVID-19 information page is at https://alpha.wycokck.org/Coronavirus-COVID-19-Information.

Wyandotte County is currently under Phase 3. See covid.ks.gov.

The state plan’s frequently asked questions page is at https://covid.ks.gov/wp-content/uploads/2020/05/Reopening-FAQ_5.19.2020_Final.pdf.

Test sites are listed at https://wyandotte-county-covid-19-hub-unifiedgov.hub.arcgis.com/pages/what-to-do-if-you-think-you-have-covid-19.

The CDC’s COVID-19 web page is at https://www.cdc.gov/coronavirus/2019-nCoV/index.html.

With today as the original date for the Phase 3 reopening in Kansas, Gov. Laura Kelly said it is nearly three months to the day when they reported the first COVID-19 case in Kansas.

The governor in a news conference today said she was very proud of the way Kansas responded, with teachers providing lessons online and businesses finding creative ways to stay open.

While remarking that it probably will not get a lot easier until a vaccine is available, she said economic recovery was scheduled to begin today, and was transferred two weeks ago to local communities. The state continues to monitor and assist local communities.

She said she felt comfortable for the state to move to Phase 3, and that counties that were plateauing shouldn’t feel pressured to leave Phase 2.

Wyandotte County decided last week to move to Phase 3 today, citing some improvements in the hospitalization rates and in lower death rates. The University of Kansas Health System in Kansas City, Kansas, saw COVID-19 patients in the hospital at less than half of what they were a month ago. In Phase 3, gatherings up to 45 persons are allowed, with health measures, swimming pools can reopen and businesses can reopen.

In Phase 3, health guidelines are still being practiced, including frequent hand-washing, remaining home when sick, following isolation or quarantine orders, and wearing a cloth face mask while in public, according to officials.

Gov. Kelly said the S.P.A.R.K. Taskforce Executive and Steering Committee met today to discuss distribution of up to $525 million in CARES Act federal funding. The state received $1.034 billion of federal funding. Last week, the task force decided to distribute $400 million to local governments for health and economic challenges inflicted by COVID-19. The local counties were to receive at least $194 per person under last week’s plan, and additional funding based on case rates and unemployment rates.

She said they need to seek out as many ideas as they can for how best to deliver economic support, so businesses can reopen, residents can find jobs and pay rent, and local and state governments can be prepared to handle any future outbreaks.

While legislation she signed earlier today will continue the state’s COVID-19 response efforts, it isn’t perfect, she said. It will allow the state to provide resources for businesses, residents and communities that help economic recovery and will put a structure in place in case of another COVID-19 outbreak, she said.

Dr. Lee Norman, Kansas secretary of health and environment, said there were 10,650 positive cases in Kansas on Monday morning, an increase of 257 since Friday. There was an increase of five deaths sine Friday statewide, for a total of 236. Eighty-nine counties reported positive cases.

Dr. Norman reported 153 clusters, with 91 of those active. The clusters included: corrections, 3 clusters, 1,019 cases and 7 deaths; school and daycare, 2 clusters, 5 cases; gatherings, 14 clusters, 8 inactive, 183 cases, 13 deaths; group living, 7 clusters, 5 inactive, 57 cases, 3 deaths; health care, 7 clusters, 4 inactive, 55 cases; long-term care, 35 clusters, 16 closed, 756 cases, 126 deaths; meatpacking, 11 clusters, 2,868 cases, 12 deaths; and private industry, 74 clusters, 29 closed, 590 cases and 6 deaths.

Most counties are improving their metrics, according to Dr. Norman.

Some are plateauing or have slightly unfavorable trend lines, he said, including Douglas, Greenwood, Leavenworth, Riley, Sedgwick, Wyandotte, McPherson, Reno, Pottawatomie, Stevens and Meade.

One of the counties had an outbreak at a jail, where all offenders were tested, and a few came back positive, he said. In some of the counties, just a case or two can throw off the trend line, he said.

At the Thursday, June 4, Unified Government Commission meeting, Wyandotte County health officials stated that there had been good progress in general and the numbers looked good for moving to the next phase.

To see the governor’s news conference, visit https://www.facebook.com/GovLauraKelly/videos/592899934976032/

To see the June 4 UG meeting where moving into Phase 3 was discussed, visit https://www.youtube.com/watch?v=J60ySSjaQZs.

The UG’s COVID-19 information page is at https://alpha.wycokck.org/Coronavirus-COVID-19-Information.

Wyandotte County is currently under Phase 3. See covid.ks.gov.

The state plan’s frequently asked questions page is at https://covid.ks.gov/wp-content/uploads/2020/05/Reopening-FAQ_5.19.2020_Final.pdf.

Test sites are listed at https://wyandotte-county-covid-19-hub-unifiedgov.hub.arcgis.com/pages/what-to-do-if-you-think-you-have-covid-19.

Case numbers for individual counties in Kansas can be found at https://www.coronavirus.kdheks.gov/DocumentCenter/View/1125/Historical—June-8?bidId=.

The CDC’s COVID-19 web page is at https://www.cdc.gov/coronavirus/2019-nCoV/index.html.

As Wyandotte County entered Phase 3 of the reopening plan, doctors at the University of Kansas Health System discussed why positive case numbers are going up but hospitalizations are generally down.

Hospitalizations of COVID-19 patients at KU Health System have been reduced in the past few weeks.

Dr. David Wild, vice president of performance improvement at KU Health System, said there is an increase in the rate of new COVID-19 cases in the metropolitan area and across Kansas.

“That is sort of contradictory to the number of patients we’re seeing in the hospital,” he said.

The number of COVID-19 patients in the hospital is a function of a couple of factors, including the number of new cases, and as that number goes up, there are more people in the hospital, he said. Also, as the number goes up, the number also reflects how long the people are staying in the hospital. Those who don’t need intensive care and ventilators are there only for a few days, while those who need critical care are there longer, he said.

As the number of people who are really critically ill has gone down, so has the number of people in the hospital, he said. It’s probably mostly because those coming to the hospital are younger and don’t have as much co-existing disease, he said. That’s related to the fact that they are not seeing a large number of new nursing home outbreaks, and also that they are picking up patients who are being screened. For example, two positive tests were found when screening patients who were admitted to the hospital for other reasons recently, he said. The trend is pretty consistent in most places, he said.

It’s a combination of those things, but probably most related to the age of people, according to Dr. Wild.

Dr. Dana Hawkinson, medical director of infection prevention and control, said there have been some reports from Italy about the possibility of the virus shifting and being milder, but there has been no clinically significant strain change. The virus is still out there, he said. There have been some single mutations but there is no

Initially, in China they thought 2 to 3.5 percent of the population might be asymptomatic, and other doctors now are wondering if that number was actually higher. Reports here are saying about 30 to 40 percent of people in the United States were asymptomatic, he said.

Dr. Wild said the 40 percent was true at the time of testing, but perhaps some were pre-symptomatic.

Dr. Hawkinson said while duration of exposure is important, with more risk of coming into contact to the virus, but in theory, it takes just one viral particle to infect a person. Winter and cooler seasons are typically worse for viruses, and duration in confined spaces is important.

Dr. Wild said large numbers of tests, for example, at meatpacking plants, that impacts the numbers. Over the course of time, since late May, the trend of percent positive is up, he said. For example, at the hospital Sunday, 109 tests were run, with 4.6 percent, or five cases, positive. For many weeks, the percentage was less than 1 percent, he added, and they are testing the same way now as previously.

“That trend is the same in most places,” he said. He doesn’t think the general population rate is as high as 5 percent positive.

When the disease started, they didn’t know how it worked, he said. They received information from China and Italy, and thought the greater the physical distance, the more they could reduce the spread of the disease. Early, there were predictions of 2 to 11 percent hospitalizations from China and Italy. They had models for emergency preparedness of 2, 4 and 5 percent hospitalizations, he said. It has been pretty close to across the state, although higher in Wyandotte County, but they expected that based on age, co-existing disease, access to health care and other factors, he added.

As they look forward and forecast what they think will happen in the next two, three or four weeks, they’re using a smaller hospitalization rate, more consistent with what they’re seeing, he said. He thinks it’s good the number is declining. They’re not currently forecasting the hospital being overrun with cases, he said, although there may be some increase in the next few months.

Dr. Hawkinson said they’ve been extremely lucky here, after seeing what happened in New York and other states. They have prepared for a surge, and hope it doesn’t happen, he added.

Dr. Wild said they originally thought they might see a peak of new infections two weeks or 14 days after exposure. What they are actually seeing in the data is increases resulting from some party, or decreases resulting from an intervention such as a stay-at-home order, are starting to have an impact three weeks later on new cases and peak at four weeks. Hospitalizations are peaking at five weeks and deaths are peaking at six or seven weeks, he said. He added that’s true in the hospital’s data, in the 14-county metro area and in the state of Kansas.

Just from that perspective, it’s too early to know if there will be cases resulting from the Lake of the Ozarks parties, Dr. Wild said.

“What we’re seeing right now is really related to Mother’s Day,” Dr. Wild said. “What we’ll see next week is related to Memorial Day. And two weeks from now will be related to the protests and demonstrations.”

The “next normal” will change, he said. He expects a small increase, but he doesn’t know how many, in the next week or two.

Dr. Wild said many of the interventions have worked to reduce the spread of COVID-19. There is a national plateau of more than 20,000 new cases a day for about 40 days, he said. It is a stable number for new cases, he added.

He said if they can continue to isolate nursing home populations well, it is not likely to result in large numbers of hospitalizations and deaths.

Wyandotte County has allowed swimming pools to reopen today, although the Unified Government’s only public swimming pool, Parkwood, will remain closed. Pools such as hotel pools, backyard pools and Turner Recreation’s pool may reopen under Phase 3. Dr. Hawkinson said people should continue to maintain 6 to 10 feet of distance if they can. They are not worried about the virus droplets getting into the pool, but more about the closeness of people to each other.

While people have gotten sick from being in gatherings outside, they are safer outside than inside an enclosed space, according to Dr. Hawkinson.

“We’re going to learn a lot about intensity of exposure as well as if you’re inside or outside. I think we’re going to learn outside is better,” Dr. Stites said. “I’m not saying go to Arrowhead Stadium yet.”

Dr. Hawkinson said it was important for people to wear masks. In a recent case in Missouri, when both hairstylists and clients were wearing masks, the initial testing didn’t turn up any positive cases.

Dr. Wild said there has been much discussion recently about what percentage of those who are positive are super-spreaders of the virus. He said it’s not related to a change in the virus or whether there is a different strain or whether it’s getting more or less infectious, but it is the behavior of people that’s leading to more people getting infected.

“It’s important for us to realize there are a number of things we can do to reduce spread,” Dr. Wild said. “It’s not only staying in your home or keeping 6 feet.”

Dr. Hawkinson said wearing a mask is especially important when people are closer than 6 to 10 feet away from others, and other factors include how long they will be around others. If people are not in confined spaces, if they are outdoors away from others, the risk is very minimal, he said. The more to distance from other people, then the less they need a mask. When going into a store, a mask is important, he said.

Dr. Wild said that in some meatpacking plants, the workers were wearing masks at the point of the outbreak, but some of them were not wearing the masks properly. Some persons pulled their masks below their nose, covering the mouth and not the nose, he said. Whenever he sees someone wearing a mask like that, he stops and tells them to cover both the mouth and the nose, he added.

Dr. Hawkinson recommended that people get their flu shots this fall, as well as social distancing, continuing hand hygiene and wearing masks.

Johnson County has been reported an increase of COVID-19 positive patients in the intensive care unit. Dr. Wild said it is related to other things, as well, including patients in the hospital for other conditions.

Dr. Stites said they are not seeing a surge right now, and that they have opened up other procedures knowing they have personal protective equipment, flexibility and capacity. The closing gave hospitals the potential to build up their personal protective equipment and to work on what their plans would be.

KU Health System had nine COVID-19 patients over the weekend, and 11 on Monday morning, Dr. Hawkinson said. That included six in the intensive care unit and two on ventilators. There were two deaths over the weekend, he said.

Wyandotte County reported 1,502 positive cases at 11:30 a.m. Monday, as compared to 1,496 cases at 1 p.m. Sunday. There was an increase of six cases since Sunday.

The KU doctors’ news conference is online at https://www.facebook.com/kuhospital/videos/552088238822078/?v=552088238822078.

The UG’s COVID-19 information page is at https://alpha.wycokck.org/Coronavirus-COVID-19-Information.

Wyandotte County is currently under Phase 3. See covid.ks.gov.

The state plan’s frequently asked questions page is at https://covid.ks.gov/wp-content/uploads/2020/05/Reopening-FAQ_5.19.2020_Final.pdf.

Test sites are listed at https://wyandotte-county-covid-19-hub-unifiedgov.hub.arcgis.com/pages/what-to-do-if-you-think-you-have-covid-19.

The CDC’s COVID-19 web page is at https://www.cdc.gov/coronavirus/2019-nCoV/index.html.