Dr. Terrence Reidy Discusses COVID-19
West Virginia’s COVID-19 cases rose in July, reported Dr. Terrence Reidy, Health Officer for the Berkeley, Jefferson and Morgan County Health Departments, in a phone interview. “In the spring, we saw cases spike in Berkeley and Jefferson Counties. We got it early because we’re part of the Baltimore-DC metro area. Many people drive back and forth to work daily, so it’s not a surprise. Now we see big spikes in Morgantown, Huntington, Parkersburg, Charleston. The further you get from the dense cities, the less the initial peak is, as far as density, but then it spreads out like a forest fire.”
Case count statistics are based on residence. That means the test results of a Virginia resident are counted towards Virginia’s COVID-19 figures, even if the individual was tested in West Virginia. College students are considered residents based on where they attend school. “The number most important to me is cases per 100,000 people,” said Reidy. “Berkeley and Jefferson County numbers are similar, based on cases per 100,000 people. We think for every case we prove with a test, there may be 10 more. But based on the week-to-week trends we can measure, we seem to be stable.”
“There are no vaccines, so we are trying to give advice on how to stay safe,” said Reidy. “It’s all new, and the answer over months has changed whenever the governor changed the law — like masks or no masks, how many people can get together. The law is one piece and then there is the biological part.” He explained, “The law may allow you to have 100 people together, but it’s not a good idea — just like the law allows you to drink a fifth of whiskey a day, but that’s not a good idea from a health standpoint! So, we try to interpret it. Because we all have experience knowing what happens when people drink large amounts of whiskey, we can relate to that. But it’s harder to relate to this new reality.”
The role of the Health Department has changed considerably since the appearance of COVID-19. Sanitarians in the department’s Environmental Division who previously focused on food safety and health inspections of restaurants are now answering questions about when different businesses can open up and what sort of precautions they have to take. “It’s a lot of answering the same questions over and over. The biggest obstacle and the biggest benefit is the media,” Reidy declared. “The enemy is gossip and rumor, lack of knowledge or incorrect knowledge. The biggest tool is that people get the knowledge, and they say, ‘Oh, if I can stay away from others, if I alter my behavior, I decrease the chance I can get it.’”
There are certain things that look like they do help — wearing a mask, keeping social distance and avoiding crowds. “Ideally you want people to do that voluntarily,” said Reidy. “In some cultures, people are much more willing to accept that kind of advice, but their governments don’t give them a choice. In America, some of our individualistic values don’t work well with a situation like this. For the most part, people do very well following traffic regulations, which are somewhat arbitrary, but we know we have to do that if we are going to function as a society. It doesn’t matter if you drive on the left or the right side of the road, just so everyone does it in the correct way.”
The Health Department has been offering free COVID-19 testing at various locations. When individuals test positive, or if they have symptoms that strongly indicate they have COVID-19, the Health Department calls them to see how they are doing. The department also tries to notify any people that may have been exposed to the original individual during the period when they were infectious. Individuals notified through this contact tracing process should stay isolated for about 14 days to prevent potentially spreading the virus to others. “For the most part,” Reidy reported, “14 days after someone has tested positive or has had symptoms, they will not be infectious any more. But we don’t know if or how long before they could get infected again.”
Reidy observes that there is sometimes almost too much news coverage. “Every little new suggestion gets equal weight because it’s new — every drug that might work or something that might work. With new treatments, it takes time to find out what really does work — things like antibody testing and how long people are immune. It’s hard because we want answers now. There’s always the race to be first to give the answer, and the trouble is that it may not be correct. So when we find something works, we want another study to validate it because it often turns out that it might not have been quite so good. So we wait.”
The Health Department gets information from many sources, including medical literature, now mostly internet-based. Recommendations from doctors, hospitals, and infectious disease specialists are funneled to public health departments. “Of course we see a lot about new things on television, but now we can go check on it in medical journal articles. We can see information by leading people. As Health Officer, I’m talking to people at the state level several times a week and meeting with the Commissioner of Health by Zoom or telephone once a week. Communication is so easy now — both to get detailed articles and guidelines. Years ago, you had to wait for a book to be published.”
Reidy continued, “You can get different opinions by different experts looking at the same information. What does this mean? This is, of course, highly involved in politics because it’s not simply about medical aspects, it’s about how the society responds to it. You have to figure out what part is public health and what part is governance. But that’s true of smoking, HIV, drug use, traffic control and all those things. Medical statistics are part of it, but then how you alter society to reduce risks becomes a big part of public health.” Since the governor’s proclamation requiring masks indoors starting July 7, Reidy has noticed a big change. “I see more masks. People recognize the authority of the governor and respect the law.”
