The readers of eldiario.es had a new opportunity to resolve their doubts about the pandemic at the hands of the publisher Esther Samper, Doctor in Cardiovascular Tissue Engineering (Regenerative Medicine), as well as a communicator.
With her, who regularly publishes informative articles on the epidemic in eldiario.es, we organize a second session of Questions and Answers in Instagram In which those partners of eldiario.es who preferred to send their questions to Samper through the comments on our website also participated.
There was a lot of participation and unfortunately the expert could not answer everything. Still, there were many issues that were addressed.
Q – Is the coronavirus spread through the water of swimming pools, swamps or the sea?
Esther Samper: Pool water has chlorine, if properly maintained, and chlorine greatly shortens the virus’s survival. Therefore, in principle, the possibilities of contagion by the pool water are very limited. Not only because of the chlorine: if there were any amount of virus in the water, it would spread and this would limit the contagion.
The main danger of swimming pools is not the water itself, but the failure to maintain safety distances. This is one of the main obstacles in swimming pools and swimming areas, keeping the distance of two meters on the grass, or on the sand, in the case of the beach.
In the sea, salt water does not go very well to the coronavirus for its survival, so its contagion by salty water is unlikely, but the safety distance is essential.
In the case of fresh water, such as in a swamp, which has not been treated, there would be more optimal conditions for the coronavirus. If it is a freshwater lake where there are many people bathing, there could be a possibility of contagion because there is nothing wrong with the water.
Q – How long can I wear a surgical mask? Can i wash it
IS. – The recommended time for total use of surgical masks is about four hours. Through respiration or sweat the mask becomes moistened and loses effectiveness. It has certain materials, such as cellulose, that deteriorate with humidity, and therefore it spoils with very short use.
For this same reason surgical masks cannot be washed, they would be destroyed. For effective use, they must be replaced every four hours, or if we see that they are very wet with sweat, they must be discarded.
Q – What masks are reusable? Which can be washed and reused?
The reusable ones are fabric ones, which can be both homemade and some hygienic ones that are washable and made of fabric. If they are made of cotton, they have the problem that they can shrink, because you have to wash them with detergent at 60 degrees. With this washing cycle you make sure you have destroyed the coronaviryus and after drying it can be used without problems. You can also use a bleach solution, one part for 50 of warm water, and then rinsed with soap and water.
These are the most convenient since, unlike the hygienic ones that you have to discard every few hours, they can be reused indefinitely. The disadvantage is that when it comes to limiting the diffusion, the surgical ones are more effective and the effectiveness of the homemade ones varies greatly depending on the layers they have and their tissues. From a health point of view, surgical procedures are more effective, but the downside is that they must be discarded and, from the point of view of the environment, this is their major drawback.
In this guide we explain methods to disinfect Correctly the cloth ones or how to disinfect the surgical ones if you have used them a short time.
Q – After testing positive for antibodies, how long does the immunity last?
IS. – This is one of the great unknowns. It is assumed that around 5% of the population has passed the infection and has antibodies. How long does this immunity last? Nobody knows. We know that it usually lasts a few months, but we don’t really know how long exactly. From references to other coronaviruses, immunity could last one or several years, but it remains to be seen whether this is the same. We will see it over time.
Q – Does heat affect transmission or is it a myth?
IS. -We know that multiple viruses, some coronaviruses among them, survive worse at high temperatures and solar radiation. In principle, this could be a factor in mitigating the epidemic. But as multiple experts have indicated, it is not a deciding factor. There are many people vulnerable to infection and that has much more weight than the heat itself. The heat may give us a hand, to limit the cases, but it guarantees us absolutely nothing.
Q – Are we asthmatics at risk?
IS. -We have studies that have found that asthmatics are no more at risk of contagion than the rest of the population and that they are also no more at risk of serious disease from the coronavirus. It was thought that they would be more vulnerable, having respiratory problems, but it is being seen that they do not have an increased risk. In this sense, asthmatics have reasons to be calm.
Q – Are gloves really essential?
IS. – Gloves are totally unnecessary, because we do not catch the coronavirus through skin wounds, or through the skin. If we have touched something contaminated with the gloves and we take them to our faces, it does not matter if we have gloves or not. If we have good hand hygiene, gloves are totally unnecessary. Another thing is that when going to the supermarket, gloves are distributed so that when it comes to touching the products, the risk of contagion does not increase. But in general a good hand wash is more important.
Q – Is it really possible that we will have the vaccine in a year?
IS. – If we are lucky it may be, but there are not many guarantees. Right now there are at least 170 potential vaccines under investigation. Of these, around 12 are in the clinical phase. In phase 1 its safety is evaluated, whether it can cause health problems, etc. In phase 2 its protective efficacy is evaluated. Much progress has been made, and in just a few months we already have vaccines in clinical trials, but much remains to be done.
In addition, it remains to be seen that those in the clinical phase are effective, many are discarded along the way. In addition, phase 3, the pre-marketing phase, which is that of clinical trials, would be missing. Hundreds and even thousands of people need to be recruited to prove their effectiveness. It is neither fast nor easy.
The commercialization and the challenge of producing the vaccine would remain. Producing a large quantity is not easy, when you have to allocate it to millions and millions of people. It requires investment, logistics and infrastructure, and it can take a long time to produce and distribute.
We have to be responsible because we do not know when the vaccine is going to arrive and we must avoid a new outbreak that is out of control and we have the ICUs and hospitals overflowed again as they did a few months ago.
Q- Could you comment on the study that says that the virus could have passed from bats to dogs, and from dogs to humans?
E.S – The foundations of this study, which I did not know and have been looking at, are very weak. The genetic analysis that has been done and the conclusions around it are very weak. We really don’t know which animal transmitted the virus to humans. It has been proposed to the pangolin, the civet, now the dogs … but we really don’t know.
We are also not sure that there is an intermediate animal in the transmission between bats and humans. There is a possibility that it was direct, although it is less likely. In this sense we still have multiple unknowns.
Q – What research is there on the effectiveness of facial displays?
IS. – I have reviewed the bibliography and there is practically nothing published about the effectiveness of facial screens to limit coronavirus infections or other types of infections. Simulations have been done on how they could protect, but other than that we have no more data.
As a doctor, I would be interested to know if they serve as a protective measure. The masks limit the exit of droplets to the outside, but do not protect the eyes. The screens cover the eyes, although they have the disadvantage that they do not cover the bottom. It would be interesting to know what their role might be in this pandemic.
Q – How can the rate of children with IGG antibodies be so low?
IS. – This information is really important. People who have passed the infection with mild or asymptomatic symptoms have been shown to have a low level of immunizing antibodies.
There are various hypotheses. When we become infected with the coronavirus, there are many facets of the immune system that are active. There is the innate immunity, which appears at the beginning, which is not very specific but serves to get out of trouble. Some pediatricians believe that this type of immunity, which works very well in infants and children, may be why they do not have serious problems with COVID-19.
There is also cellular immunity. They are cells that attack other cells infected with coronavirus, but are not seen as antibodies. A person who does not have immunizing antibodies may have responded to the virus differently.
We have few answers about the antibodies, because we do not know how long they last or what levels can be protective, and others such as cellular immunity, we do not know exactly what role it plays.
Q – What are the sequelae of the coronavirus?
IS. – It is another of the great unknowns. We know that the most serious people affected by the disease, especially those who have had to be intubated and with respirators, may have problems with the respiratory capacity, fibrosis in the lungs, kidney problems and some may need dialysis.
It is a matter of time that in the next months or years we will see sequels due to the disease that we are not seeing right now.
Q – Do you think that the current coronavirus can end up disappearing by natural selection in a few months?
This right now is quite unlikely. The coronavirus is in almost every corner of the planet. There are only 12 countries that have reported no coronavirus cases. It has become so widespread that it is very difficult for us to eliminate it. Most likely, over time it will be more seasonal, like others we have with us. We already have four seasonal ones that cause colds, and that is the most probable destination of this.
Q – What do IGM and IGG antibodies mean?
IS. – IGG stands for inmonoglubin G; IGM inmonoglubin M. They are antibodies that are produced at different stages of the disease. IGMs appear within a few days of infection. They are like the first assault against the coronavirus, they are a bit “sloppy” when it comes to fighting the coronavirus because they are not very specific, but it is the quickest reaction.
IGGs take longer to produce, are more specific, and are memory antibodies. These have the ability to persist in the human body in the long term. We still do not know how much in the case of the coronavirus. If a person is IGM + but IGM- it means that we would be in an initial phase of the infection. If it is the other way around, it means that the infection has passed.
Q – Why is Ivermectin not being used as a treatment?
IS. – Right now we do not have clinical studies that indicate the usefulness of this medicine. Most treatments that are in the preclinical phase do not amount to anything for many reasons: it can be toxic in humans or animals, because it does not get where it needs to go …
A lot of news comes out about drugs that work well in laboratories, with cells in vitro, but don’t have to work in humans. There are clinical trials to evaluate ivermectin, but until we have the results, we don’t know what can happen.
Q – Are the quick tests reliable?
E.S.- Rapid tests abound right now, and most are not reliable, both antigen and antibody tests. Their sensitivity is very low, they can give false positives or negatives quite often. There are many people who are curious to know if they have passed the COVID-19 and if they really want to know, wait, because the rapid tests that abound in the market, at the moment, are unreliable.
Q – Is it harmful to wear the mask for eight hours straight due to work demands?
IS. – Surgical, hygienic and homemade masks normally allow breathing normally. Another thing is to use them when exercising, as they can make breathing difficult. It is true that health professionals, when masks have been on for a long time, have friction on their faces and can be uncomfortable, but they are designed to work with them. People with respiratory problems may feel a little overwhelmed, but the masks are designed to be safe and health professionals always use them without sequelae for health.
Q – Can another pandemic be repeated as strong as this one in this century?
IS. – It’s possible. Pandemics are a matter of time. You do not have to wonder if they are going to happen, but when they are going to happen. It is something that we cannot completely avoid, but we can minimize means to make it happen. The destruction of ecosystems, or wet markets where a multitude of exotic species coexist, are one of the risk factors and hence new pandemics emerge.
What we have to do is invest heavily in health, sanitation and science, to detect any new virus or bacteria, fight it as quickly as possible and be able to apply the best public health measures.
This pandemic could have had much lesser consequences, according to many experts, if it had been committed to public health from the beginning. But this is the case of what you don’t invest in until something happens. I hope that with this pandemic we can learn the importance of public health, science and health and prevent such cases from occurring or at least limit the damage and deaths it is causing.
Q – If the virus is present in the faeces for a long time, is it possible to get the contagion from the sewage treatment gases?
There are studies that have detected remains of the coronavirus in wastewater, and have even seen that it could be useful to detect initial outbreaks to find out how present the virus is in a population.
Now, the possibilities of contagion through wastewater gases is negligible. The gases will not be able to drag infective amounts of the coronavirus into the air, it is highly unlikely.
Transmission of the virus via the fecal-oral route has not been shown to be possible either, we cannot say impossible, but it is quite improbable.
Thanks to all of you who participated in this question and answer session on Instagram and also To all the partners who left your doubts in eldiario.es so that the broadcaster could answer them live. AND If you still don’t follow us on Instagram, follow us!