Published On: Thu, Jul 23rd, 2020

Weekly COVID-19 update with Dr. Bunio

 

One Feather Staff Report

 

Each week, Chris McCoy, director of EBCI Communications, interviews Dr. Richard A. Bunio, Cherokee Indian Hospital Authority executive clinical director, about current COVID-19 updates and news.  It is aired via Cherokee Cablevision Channel 28 and livestreamed by Communications. 

Here is an edited transcript of the Q&A session on Wednesday, July 22.  All answers presented below are from Dr. Bunio who has been in practice for more than 20 years.  

What is happening with the yellow mask?

“The Chief rolled out the Tribal Dashboard and we now have COVID risk levels. There’s red, orange, yellow, and green. Obviously, green is as good as it gets and red is trouble. I offered to wear a mask to represent our current risk level. We are currently at the yellow level. We were in the orange, now we are in the yellow.” 

What does the yellow level signify?

“Yellow means that we are still having community spread. That it is really important that people keep following our advice. But things have improved a little bit. We want to say to the community that what you are doing is working.” 

“One of the things you know, there have been some people who refuse to wear a mask. I just wanted to take a minute and say you know these are not bad people. In everything, there are people, we call them early adopters; the people who are standing in line waiting to get the very latest IPhone. Then there are other people who like to sit back and wait. Maybe they have a story – maybe they have been burned before. So, not everybody is going to jump on the bandwagon right away. We’ve got more and more data that masks work and they protect you and they protect other people. People who haven’t been wearing masks, I see them starting to wear masks and I think that is great.”

“One of the benefits of us getting started on this so early up at the hospital and public health we started talking about this in February. So, we have had a lot of practice and we have built our contact tracing team so that when we find a case we can respond to it very quickly. Again, I want to emphasize if you get a call from the hospital or Public Health, answer the phone, share your information. We’ve actually been able to tamp down a couple of very worrisome cases.”  

Should we get our kids tested?

“If your child is sick, contact your primary care provider, contact the team. They will advise you whether you should have your children tested. We know children can get the virus. We know they tend to have less serious illness, but they can spread it. And of course, there are those rare cases where they have life-threatening issues. Get your kids tested, especially if they are sick.” 

The criteria has changed for what is considered a direct contact. Can you explain what has changed and why?

“The CDC changes this based on new science and new evidence. A direct contact is someone who you have been around less than six feet for 15 minutes. These are just rough guidelines. How long does it take to catch the virus from somebody? If somebody sneezes or coughs and you are not wearing a mask, it will take a couple of seconds. So this is just general guidance the CDC has been updating. We believe it makes a difference if you are wearing a mask. If you are wearing a mask and the other person is wearing a mask, you may still be considered a direct contact but we believe the risk is way down. I was reading a study that if you are wearing a mask in a household, you could reduce the infection rate by 80 percent. Unfortunately, you have to be wearing the mask almost before you know you are sick a lot of the time. We still have that where we are spreading the virus before we even know it.”

If I end up testing positive should I call the people that I know I’ve been around? Or, do I wait on the contact tracing team to do that?

“If you give them that list of names, the contact tracing team will take care of that for you and they will not reveal your identity. (There is nothing stopping you from contacting your contacts directly if you choose to or you feel that the contact tracing team might have difficulty locating or communicating with a contact.) If we have someone who is reluctant to share who they have been around, that is when you will see the public service announcement asking if you were at a particular gathering on a certain date.”

One of my friends was contacted by Contact Tracing and notified they were a direct contact and we had gone to dinner together the day before. Do I need to worry?

“This is basically a contact of a contact. The risk there is probably low. First of all, if you are going to dinner, you should be keeping your distance from people who are not in your household. You could consider getting tested, but I would say your risk is pretty low. You may want to keep in touch with that person because they are going to be asked to be tested. If they test positive, then you’re up next.”

How long should I wait to be tested after I’ve been in contact with a COVID positive person? What precautions do I take while I wait?

“The sweet spot is about eight days or the very first day you start feeling sick. The precaution you should take while you are waiting is that you should be quarantined. You should stay home. You should isolate yourself from vulnerable people. Unfortunately, we are experiencing some longer delays in getting these tests back.”

“If you get tested too early, there is a really good chance, like if you were in contact with someone yesterday, we test you today, almost a 100 percent chance that test is going to come back negative. The virus has not had enough time in your body to replicate.”

What do I do if I was around someone who just tested positive but I have not been contacted by the contact tracing team?

“If you think you have been around someone, call the hotline. We can talk you through it and see if you were really a contact and we can even schedule some testing. If you come up to the drive-thru without calling or appointment, we will ask you ‘Why are you here? Are you feeling sick?’  So, tell them there ‘Hey I was around a person’ and we’ll make a note of it and then we’ll make sure that we track everything. If you are really worried and want to get tested, eight days after contact is the best time.”      

Someone that was in line in front of me at the grocery store tested positive a few days after I seen them. Should I be tested?

“Most of the grocery stores have those little marks that you are supposed to stand six feet away. The other benefit is that person is not facing you unless they are on their phone and they turn around. So, I think that risk is pretty low. When you get out of the grocery store, use your hand sanitizer, you know, just take all those precautions. I wouldn’t recommend necessarily getting testing.”

“You are not going to catch it just from touching (an item after someone who is positive touched it). It is when you touch it and you touch your eye, nose, mouth. So, if you hand sanitize, you are good.”

There’s been people calling for the border to close and upset about tourists potentially bringing the virus to our people. Am I more likely to get the virus from someone coming into town to visit than I am going to a friend’s BBQ?

“So we actually started looking at this because we knew that the community was concerned about tourism. So, there are a couple of different factors here. How likely are you to get near a tourist? Me, not very. I may pass by them in the grocery store but I am not going to spend a whole lot of time with them. So, I think the risk there is pretty low. But, if I am going to a friend’s BBQ, unless I am wearing my mask and keeping my distance, I think that is actually a higher risk. We looked at all the positive cases that we’ve had and about 25 percent of the cases are related to people in the same household. So, no tourists there. Another 25 percent are related to these gatherings – cookouts, some funerals. And then there is another 50 percent that we call community spread where somebody tests positive – we don’t know where they got it. Could it have been a tourist? Maybe, but I think we have to ask ourselves, aside from the casino, how often do tourists really interact with us less than six feet for more than 15 minutes? So, I think the risk is pretty low and this is where we are; the virus is everywhere. We are probably just as likely to give it to a tourist as they are to give it to us. It depends on where they come from too. People coming from high risk areas could be a little bit concerning. You know, even when we closed the border, we didn’t stop people in Cherokee from traveling back and forth.  I think the community can take some credit for keeping us in this yellow zone. One person in a big gathering, that is where the risk is.”        

If we have family members who are coming into the community to stay with family to avoid hot spot areas that they are currently living in, what’s the safest way to make that transition?

“Put them on a 14-day quarantine. Isolate them from the rest of your family. If you want to get them tested that is another strategy that could be used, but anyone coming in contact with the virus could get sick anytime within the 14 days. If after a 14-day quarantine they are feeling fine, then the risk is pretty low. And then they become part of what we call your quarantine bubble. These are people that if any one of them tests positive, the whole household is probably going to have to quarantine.” 

The updates are currently being broadcast live on Wednesdays at noon.  

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