David Meltzer, MD, PhD, is Chief of the Section of Hospital Medicine at University of Chicago Medicine. Dr. Meltzer also is Director of the Center for Health and the Social Sciences, and Chair of the Committee on Clinical and Translational Science at the University of Chicago, where he is Professor in the Department of Medicine, and affiliated faculty at the University of Chicago Harris School of Public Policy and the Department of Economics.
Meltzer received his MD, and his PhD in economics, from the University of Chicago and completed his residency in internal medicine at Brigham and Women’s Hospital in Boston.
Dr. Meltzer is the recipient of numerous awards, including the Lee Lusted Prize of the Society for Medical Decision Making, the Health Care Research Award of the National Institute for Health Care Management, and the Eugene Garfield Award from Research America.
We asked Dr. Meltzer to share his expert opinion of the COVID-19 threat and responses.
In all Kaufman Hall interviews, the expert opinions expressed are those of the interviewees and should not be considered opinions of Kaufman Hall. This interview was conducted on March 16, 2020.
Q: Given the rapid spread of the novel coronavirus or COVID-19, from your perspective as the Chief of the Section of Hospital Medicine at University of Chicago Medicine, what actions do you recommend individuals and communities take?
A: First and foremost, I would urge everyone who possibly can to stay home, and not just if you are elderly or have health chronic problems. Staying home means staying in your house or apartment unless you must leave for absolutely unavoidable work responsibilities or essential supplies, like food or medicine. No vacations, social engagements (even with close friends or relatives) , trips to restaurants, bars, theaters, or any other non-essential outings. Social distancing is important because it decreases exposure to the virus and the likelihood that you will contract it and spread it to others. There is increasing reason to believe that this virus may be spread often even by people who have no or very mild symptoms. As a result, social distancing by all persons is essential to controlling spread. We must all make these changes now, both for our own health and for the health of others at greater risk.
Individuals must take personal responsibility for keeping themselves home and try to influence others to stay home also. I have been surprised how many people need pushing to take this threat seriously. Getting the message out to people who have not yet changed their behavior to socially distance is hard but crucial. Think also of the vulnerable people you may know around you and how you might help them as they try to socially distance and deal with the effects of this crisis, for example, by delivering food or picking up medicine.
Government and private sector leaders need to do all they can to support people staying home by closing schools, non-essential businesses, providing emergency financial and other aid for needy families, banning even small public gatherings, and encouraging people in every way possible to stay home.
Q: What else is important in addition to staying home whenever possible?
A: Washing your hands often with soap and water or hand sanitizer for at least 20 seconds throughout the day and after touching surfaces that have not been disinfected is important. Try not to touch your face, mouth or eyes with your hands unless you have just washed them. Disinfecting your home surfaces, particularly the kitchen and bathroom surfaces and door knobs, a couple of times each day may help. If you do leave your home, keep 6 feet between you and others, and wash or sanitize your hands after touching any services. These behavioral changes are hard, but essential to slow the spread of the virus.
Q: If many of us in the US will get the virus eventually, what is the point of trying to avoid it?
A: Many of us will eventually become infected, but slowing down the rate is essential to help hospitals manage the influx of patients who will require hospital beds and ventilators. About 20% of COVID-19 cases need hospitalization, including 10% that need ventilators. If social distancing is not widely followed, cases will spread more rapidly and hospitals will quickly become overwhelmed, similar to what is happening in Italy where doctors and nurses are having to make terrible decisions about who will get beds and ventilators and who may have to be denied lifesaving care. If we are able to slow the spread, we will be able to give more people access to hospital care and keep more people from getting the disease before effective treatments or a vaccine can be developed. There are also reasons to think the virus may become less lethal over time if we can delay its spread. Time is on our side if we can delay spread.
Q: Are certain populations at greater risk and should these precautions be especially applied to them?
A: Yes. Risk of hospitalization and mortality increases significantly for older adults and those with compromised immune systems and underlying health conditions. It is especially important for these persons to socially distance from others. This includes child care and non-essential family contacts. Some people, particularly those in the medical field, will have to continue going to work. As schools increasingly transition to remote learning, child care needs will increase. However, we should not be asking our parents or grandparents to care for our children, as they are more vulnerable. This is especially important because children may be more likely to be asymptomatic than others when infected.
Q: What do you suggest people do if they get sick?
A: Call your primary care provider or clinic. Many are offering virtual visits and will assess if you need to come to the clinic or hospital. Avoid going directly to the Emergency Room or clinic to avoid exposing yourself and others. Wear a mask when outside of your home.
Q: Is there anything else people can do to prepare or decrease their chances of contracting the virus?
A: In addition to the social distancing and hygiene techniques, some experts are suggesting that increasing intake of certain vitamins may help prepare our bodies to fight the virus. Some research finds that, for individuals who are deficient in Vitamin D, taking Vitamin D supplements daily may greatly reduce their likelihood of contracting viral respiratory infections. Vitamin D deficiency is estimated to be present in about 70-80% of African-Americans and Hispanics and in persons who get little sun exposure. Taking a Vitamin D supplement and getting direct sun exposure, even for 15-30 minutes per day, may be a good idea. I try to get 15-30 minutes of direct sun every day by going outside, making sure to maintain social distance from others.
Q: Any final thoughts or advice?
A: The single most important and effective thing that we can do to soften the impact of the COVID-19 pandemic is to closely adhere to social distancing techniques, specifically to stay home whenever possible. Start today if you have not already, and work hard to maintain that distance over time. Try to stay calm and be creative. Avoid crowding into stores to buy or hoard supplies. We must all work together to slow the spread of the virus, decrease the chance of a surge of cases, and allow hospitals to effectively care for those who most need it.