News

Mask on, gloves off: How to stay safe as counties loosen restrictions

Infectious disease expert speaks on protective practices, the debate on COVID-19's seasonality and where we are in terms of a vaccine

Retailers that can provide curbside service will have to limit their employee count to one person per 300 square feet of space in Santa Clara County under a new order effective May 22. Photo taken March 14 by Magali Gauthier.

Wherever residents and politicians may stand in the contentious debate on when to reopen the entire economy, local health officials seem to agree that Bay Area counties have slowed the spread of the coronavirus.

As a result, county leaders have allowed businesses that can offer curbside pickup and outdoor museums to operate again; Mountain View and Palo Alto already reopened tennis courts and a few other outdoor facilities; and Gov. Gavin Newsom recently hinted at a press briefing that some regions can expect to see in-store retail services and hair salons resume in the next few weeks.

But even as residents are gradually allowed to step outside to enjoy the warm weather and shop, Dr. Jonathan Blum, chief of infectious disease at Kaiser Permanente Santa Clara Medical Center, said in an interview that stopping the spread of COVID-19 is an ongoing mission: The virus continues to linger within the population and the chances of a second wave of the virus are high.

"It's likely there will be additional waves of infection," Blum said. "We don't know exactly when, we don't know exactly where, we don't know how big they will be, but that is going to happen. So the real lesson of this is that we need to continue to do whatever we can to prevent the spread of the virus."

The risks are evidently still present and nonessential travel continues to be discouraged because of it. However, it doesn't mean residents must remain locked in place. Even an infectious disease expert admits that he goes on bike rides, albeit no longer with his cycling club.

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"I go out for bike rides by myself," Blum said. "I wear a mask when I'm out and bring my hand degermer. It all really comes down to the basics."

Despite small signs of improving times, Blum said there are several simple but effective do's and don'ts people should continue to practice in order to be mindful of their own and other people's health.

"Once someone is outside their home, they should wear masks anytime they're around other people," the doctor said. "Anybody who's sick, of course, should stay home and not go outside where they might come into contact with others. Anyone who's been in contact with a COVID patient — the same."

Two other tips people should continue to follow include not touching your face in order to avoid spreading germs to the eyes and nose as well as keeping a hand sanitizer, consisting at least 62% of alcohol, close by and using it.

Gloves, on the other hand, are not recommended. Blum said that wearing gloves often provide people "a false sense of reassurance," in which they end up skipping the decontamination step of washing their hands before and after they put on the gloves. It's also very common to contaminate hands while people remove the gloves, he said.

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"One other way to think about this is to remember that this virus does not infect the hands," Blum said. "The role of the hands is to spread the virus around to other objects and ultimately to the nose or eyes, which they can infect. So gloves provide no protection from infection, but they actually enhance spreading it by inhibiting hand decontamination."

As county and state officials continue to loosen restrictions on stores and public spaces, Blum said that part of minimizing the further spread of infections will depend upon people using their best judgment.

Arthur Chen and Caroline Lee take a walk in downtown Palo Alto on April 29. Dr. Jonathan Blum of Kaiser Permanente Santa Clara Medical Center recommends people wear a mask when they step outside of their homes. Photo by Magali Gauthier.

For example, the 6-feet-distance rule has been the gold standard for social distancing. But a bicycle rider such as Blum may want to consider riding more than 6 feet away from another cyclist if he is downwind of the other person and in the same airstream.

And though county guidelines apply to everyone, Blum explained how not every resident may want to immediately step into public places even if health officials give the green light.

"The reality is that more exposure to other people has higher risks than less exposure to other people," Blum said. "And so if you're a person who's at greater risk for (health) complications, such as an older person, you might choose to be more cautious than the county guidelines recommend."

Some residents are already following suit.

John Reid, 66, has been impacted by the pandemic as an Uber driver and substitute teacher but still believes counties should remain more restricted. Reid said he would be leery of going out to restaurants even as they reopen.

"I may get my haircut, but I don't really need to dine out," he said. "Delivery service is fine."

Even Dena Hill — a Stanford Health Care employee within the finance department who believes "it's time to start thinking about the economy more than the pandemic" and expressed she would "immediately" go back to dine-in restaurants and hair salons — said she would still wear a mask out of consideration for other people.

"I would probably still wear a mask if I couldn't socially distance," Hill said. "Just out of respect to people who might be uncomfortable."

'It's likely there will be additional waves of infection.'

-Dr. Jonathan Blum, infectious disease chief at Kaiser Permanente Santa Clara Medical Center

Blum emphasized that a critical "culture shift" needs to be made to continue preventing the spread of COVID-19.

"It's important for people to know that the fact is these masks are effective at reducing the spread of the virus," he said. "When you make a choice about whether you're going to wear a mask, you're not just making a choice for your own health — you're affecting the health of all the others around you."

For those such as Reid who are hoping to rely on a vaccine to truly get back to some semblance of normal times, they may not want to hold their breath.

Blum said he is "cautiously optimistic" that there will one day be a safe and effective vaccine, with promising candidates currently out in the field but all in the very early stages of development.

"In order to be used, a vaccine has to be shown to produce an immune response, has to be safe, has to protect against disease, and then it has to be produced in sufficient quantity to be deployed," he said. "All these things take time, and the candidate vaccines out there are promising, but they have a long way to go. The timelines for when it's going to be widely available is really unclear."

As for whether there's a seasonality to the virus and its prevalence can diminish in warm weather, Blum said it's all still speculative.

In the meantime, as health professionals continue to search for an answer to the ongoing pandemic, Blum said residents should continue to follow the advice of public health officials.

"There are some pretty simple rules that have been put out there by our public health people," he said. "We gotta follow them."

Find comprehensive coverage on the Midpeninsula's response to the new coronavirus by Palo Alto Online, the Mountain View Voice and the Almanac here.

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Mask on, gloves off: How to stay safe as counties loosen restrictions

Infectious disease expert speaks on protective practices, the debate on COVID-19's seasonality and where we are in terms of a vaccine

by / Palo Alto Weekly

Uploaded: Fri, May 22, 2020, 6:51 am
Updated: Wed, May 27, 2020, 9:29 am

Wherever residents and politicians may stand in the contentious debate on when to reopen the entire economy, local health officials seem to agree that Bay Area counties have slowed the spread of the coronavirus.

As a result, county leaders have allowed businesses that can offer curbside pickup and outdoor museums to operate again; Mountain View and Palo Alto already reopened tennis courts and a few other outdoor facilities; and Gov. Gavin Newsom recently hinted at a press briefing that some regions can expect to see in-store retail services and hair salons resume in the next few weeks.

But even as residents are gradually allowed to step outside to enjoy the warm weather and shop, Dr. Jonathan Blum, chief of infectious disease at Kaiser Permanente Santa Clara Medical Center, said in an interview that stopping the spread of COVID-19 is an ongoing mission: The virus continues to linger within the population and the chances of a second wave of the virus are high.

"It's likely there will be additional waves of infection," Blum said. "We don't know exactly when, we don't know exactly where, we don't know how big they will be, but that is going to happen. So the real lesson of this is that we need to continue to do whatever we can to prevent the spread of the virus."

The risks are evidently still present and nonessential travel continues to be discouraged because of it. However, it doesn't mean residents must remain locked in place. Even an infectious disease expert admits that he goes on bike rides, albeit no longer with his cycling club.

"I go out for bike rides by myself," Blum said. "I wear a mask when I'm out and bring my hand degermer. It all really comes down to the basics."

Despite small signs of improving times, Blum said there are several simple but effective do's and don'ts people should continue to practice in order to be mindful of their own and other people's health.

"Once someone is outside their home, they should wear masks anytime they're around other people," the doctor said. "Anybody who's sick, of course, should stay home and not go outside where they might come into contact with others. Anyone who's been in contact with a COVID patient — the same."

Two other tips people should continue to follow include not touching your face in order to avoid spreading germs to the eyes and nose as well as keeping a hand sanitizer, consisting at least 62% of alcohol, close by and using it.

Gloves, on the other hand, are not recommended. Blum said that wearing gloves often provide people "a false sense of reassurance," in which they end up skipping the decontamination step of washing their hands before and after they put on the gloves. It's also very common to contaminate hands while people remove the gloves, he said.

"One other way to think about this is to remember that this virus does not infect the hands," Blum said. "The role of the hands is to spread the virus around to other objects and ultimately to the nose or eyes, which they can infect. So gloves provide no protection from infection, but they actually enhance spreading it by inhibiting hand decontamination."

As county and state officials continue to loosen restrictions on stores and public spaces, Blum said that part of minimizing the further spread of infections will depend upon people using their best judgment.

For example, the 6-feet-distance rule has been the gold standard for social distancing. But a bicycle rider such as Blum may want to consider riding more than 6 feet away from another cyclist if he is downwind of the other person and in the same airstream.

And though county guidelines apply to everyone, Blum explained how not every resident may want to immediately step into public places even if health officials give the green light.

"The reality is that more exposure to other people has higher risks than less exposure to other people," Blum said. "And so if you're a person who's at greater risk for (health) complications, such as an older person, you might choose to be more cautious than the county guidelines recommend."

Some residents are already following suit.

John Reid, 66, has been impacted by the pandemic as an Uber driver and substitute teacher but still believes counties should remain more restricted. Reid said he would be leery of going out to restaurants even as they reopen.

"I may get my haircut, but I don't really need to dine out," he said. "Delivery service is fine."

Even Dena Hill — a Stanford Health Care employee within the finance department who believes "it's time to start thinking about the economy more than the pandemic" and expressed she would "immediately" go back to dine-in restaurants and hair salons — said she would still wear a mask out of consideration for other people.

"I would probably still wear a mask if I couldn't socially distance," Hill said. "Just out of respect to people who might be uncomfortable."

Blum emphasized that a critical "culture shift" needs to be made to continue preventing the spread of COVID-19.

"It's important for people to know that the fact is these masks are effective at reducing the spread of the virus," he said. "When you make a choice about whether you're going to wear a mask, you're not just making a choice for your own health — you're affecting the health of all the others around you."

For those such as Reid who are hoping to rely on a vaccine to truly get back to some semblance of normal times, they may not want to hold their breath.

Blum said he is "cautiously optimistic" that there will one day be a safe and effective vaccine, with promising candidates currently out in the field but all in the very early stages of development.

"In order to be used, a vaccine has to be shown to produce an immune response, has to be safe, has to protect against disease, and then it has to be produced in sufficient quantity to be deployed," he said. "All these things take time, and the candidate vaccines out there are promising, but they have a long way to go. The timelines for when it's going to be widely available is really unclear."

As for whether there's a seasonality to the virus and its prevalence can diminish in warm weather, Blum said it's all still speculative.

In the meantime, as health professionals continue to search for an answer to the ongoing pandemic, Blum said residents should continue to follow the advice of public health officials.

"There are some pretty simple rules that have been put out there by our public health people," he said. "We gotta follow them."

Find comprehensive coverage on the Midpeninsula's response to the new coronavirus by Palo Alto Online, the Mountain View Voice and the Almanac here.

Comments

Anon
Another Palo Alto neighborhood
on May 22, 2020 at 8:41 am
Anon, Another Palo Alto neighborhood
on May 22, 2020 at 8:41 am
4 people like this

I have to disagree with the good doctor about one thing. I think people should wear "exam" gloves when using touchscreens at banks and grocery stores, and afterwards, decontaminate those gloves, and then carefully remove them without touching the exterior. Not difficult with a little practice.


Rubber Gloves = Overkill Measures
Barron Park
on May 22, 2020 at 8:44 am
Rubber Gloves = Overkill Measures, Barron Park
on May 22, 2020 at 8:44 am
4 people like this

> "I think people should wear "exam" gloves when using touchscreens at banks and grocery stores, and afterwards, decontaminate those gloves,"

^^ Many touchscreens now have plastic covers so all one needs to do is use some hand sanitizer afterwards.


Brit
Another Palo Alto neighborhood
on May 22, 2020 at 8:46 am
Brit, Another Palo Alto neighborhood
on May 22, 2020 at 8:46 am
4 people like this

Great article and common sense advice! Now open ALL businesses and churches back up that social distance ASAP


resident
Downtown North
on May 22, 2020 at 12:03 pm
resident, Downtown North
on May 22, 2020 at 12:03 pm
12 people like this

I'm reading news reports from states that reopened local businesses in the past couple of weeks, then saw a surge in new COVID-19 cases 1-2 weeks later. States were reopening because they had excess hospital capacity, not because the virus is under control. Some are now afraid that hospitals are again filling up. The disease is still not curable and there is still no vaccine.


Let us out
Duveneck/St. Francis
on May 22, 2020 at 12:38 pm
Let us out, Duveneck/St. Francis
on May 22, 2020 at 12:38 pm
14 people like this

Resident - what you are hearing is about georgia, Texas, Alabama, which opened up everything. We are doing slow, modest openings. Nothing on the scale of those states.
What do you suggest, we remain Cody's prisoners until there is a vaccine?


resident
Downtown North
on May 22, 2020 at 2:21 pm
resident, Downtown North
on May 22, 2020 at 2:21 pm
19 people like this

We need a more open discussion about how many fatalities is acceptable. At one time, Fox News was saying a 4 percentage point increase in nationwide fatalities should be tolerable to protect the economy and some southern governors were even saying that senior citizens should be willing to sacrifice their lives to protect the economy. They quickly shut up after cries of "I'm not sacrificing my parents for your profits" and no one seems to be willing to talk about this anymore. If we are going to reopen the economy without any vaccine for the virus, fatality rates have to be part of the equation. Don't keep this discussion hidden. It affects all of us.


Walker
Menlo Park
on May 24, 2020 at 2:10 pm
Walker, Menlo Park
on May 24, 2020 at 2:10 pm
1 person likes this

It would be really helpful if people walking outdoors at night would carry a flashlight or attach some kind of light to themselves that would make them visible. I carry a light so I can be seen but there are so many I encounter who wear dark clothing and can't be seen. They don't seem to care about social distancing and walk right into me, even though I have a flash light. Although it is irritating, I'm happy to get out of the way of those who walk with their heads down, focused on their cellphones, but if I can't see them I don't have time to step into the street. I'm a caregiver and can't risk getting sick.

I've noticed that the younger folks I've encountered while walking outdoors don't seem to care about social distancing. They walk right into me or creep up behind me while I'm waiting for a traffic light to change or a car to pass. They don't seem to understand the six foot rule or even worse, don't seem to care.

Wearing a mask and standing six feet apart are very simple things that could save lives. I don't know why there are so many who won't comply.


Observer
Duveneck/St. Francis
on May 24, 2020 at 2:55 pm
Observer, Duveneck/St. Francis
on May 24, 2020 at 2:55 pm
4 people like this

I continue to see young adults and teens (who are not from the same household) out together in public close together.


Let us out
Duveneck/St. Francis
on May 24, 2020 at 3:49 pm
Let us out, Duveneck/St. Francis
on May 24, 2020 at 3:49 pm
7 people like this

Observer - how do you know they are not from the same household?


Observer
Duveneck/St. Francis
on May 24, 2020 at 8:30 pm
Observer, Duveneck/St. Francis
on May 24, 2020 at 8:30 pm
2 people like this

Young people, in some cases apparent romantic partners who look strikingly different. Different hair colors, heights. Acting romantic but too young to be live in or marrieds.
Three young men, again not highly similiar in characteristics, cycling two feet apart. Huge conversation, I doubt siblings.
Three YA girls chatting up a storm.
You see it.


Let us out
Duveneck/St. Francis
on May 24, 2020 at 9:07 pm
Let us out, Duveneck/St. Francis
on May 24, 2020 at 9:07 pm
6 people like this

[Post removed.]


Anon
Another Palo Alto neighborhood
on May 24, 2020 at 10:50 pm
Anon, Another Palo Alto neighborhood
on May 24, 2020 at 10:50 pm
Like this comment

Posted by Let us out, a resident of Duveneck/St. Francis

>> Resident - what you are hearing is about georgia, Texas, Alabama, which opened up everything.

Lots of statistics here: Web Link
What do you want to know? You can look up Georgia, Texas, Alabama, as well as countries like Sweden. Sweden that we've been told is a great example of what we should be doing-- and, has the highest current per-capita death rate at this moment and top-10 (looks like approx. #6 or so) in overall death rate up to now.

>> We are doing slow, modest openings. Nothing on the scale of those states.
What do you suggest, we remain Cody's prisoners until there is a vaccine?

"Prisoners?" If you really want to expose yourself, I'm sure there is a way. For my part, I'm trying to avoid it.


Let us out
Duveneck/St. Francis
on May 25, 2020 at 11:08 am
Let us out, Duveneck/St. Francis
on May 25, 2020 at 11:08 am
5 people like this

Observer - those young men could have been a gay couple or housemates.

Anon- please read my initial post. I do not expect us to open the way georgia and Texas did. I never said that Sweden was the example to follow. I said slow and modest openings. Do you think the current way is sustainable until we get a vaccine. At last Sundays town hall Cody stared we were not ready to move on. By Monday morning, we were ready.

Just read that houses of worship will open.
If you do not want to go out than don't.


Anon
Another Palo Alto neighborhood
on May 25, 2020 at 2:11 pm
Anon, Another Palo Alto neighborhood
on May 25, 2020 at 2:11 pm
1 person likes this

Posted by Let us out, a resident of Duveneck/St. Francis

>> At last Sundays town hall Cody stared we were not ready to move on. By Monday morning, we were ready.

I don't think there is anywhere in the world where people have a solid, time-tested process for balancing economic necessity v. public health necessity. I can second-guess SCC public health just like anyone. (How many Covid-19 transmissions have actually occurred via outside park benches?) But, knowing how difficult this is, I'm going to mute my criticism of public officials who are having to try to achieve that balance.

>> Just read that houses of worship will open. If you do not want to go out than don't.

Trust me, I won't. Apparently group singing is *the* most efficient way known to spread COVID-19:

Web Link

Web Link

So, I'm glad that you brought that up, because, a lot of RWAs are trying to make that an issue of religious freedom, but, it actually is a public health issue.


Let us out
Duveneck/St. Francis
on May 25, 2020 at 3:20 pm
Let us out, Duveneck/St. Francis
on May 25, 2020 at 3:20 pm
5 people like this

Anon- my take is that between the disasterous town hall on Sunday and the abrupt turn around on Monday is that Cody heard from the person she answers to. I think that person told her you cannot imply that because there is no vaccine that we must remain in this situation until we have one.
I cannot think of another reason for the numbers suddenly looking good in less than 24 hours.


Resident
Another Palo Alto neighborhood
on May 25, 2020 at 4:18 pm
Resident, Another Palo Alto neighborhood
on May 25, 2020 at 4:18 pm
1 person likes this

@Let us out

Change of heart of Dr. Cody was, in my opinion, due to sales tax dollars. With SCC retail closed, and retail open in other counties, where would people go to spend their money? Of course, to the retail that was open.

SCC did not want to lose sales tax dollars to other counties. Dr. Cody couldn't care less about sales tax dollars, but those who pull her strings do. Money speaks louder.

At least it is my reading of what changed in 24 hours.


Let us out
Duveneck/St. Francis
on May 25, 2020 at 4:55 pm
Let us out, Duveneck/St. Francis
on May 25, 2020 at 4:55 pm
5 people like this

Resident--at first I thought that her strings were being pulled by others ( Palo Alto's dream - one of their own controlling the county). But then I learned she is answerable to only the governor.
That explains the frustratiom of the supervisors. She is not answerable to them and does not have to give straight answers or facts to anyone.
I am sure they explained to her that SCC is not an island.
Let's be honest the current situation is not tenable forever. People will have to Mahe decisions based on what they are comfortable with


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