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HUS medical chief warns of second wave of coronavirus

HUS hospital district infectious diseases chief Asko Järvinen answers audience questions on the coronavirus.

Helsingin ja Uudenmaan sairaanhoitopiriin (HUS) infektiosairauksien ylilääkäri Asko Järvinen
Asko Järvinen, chief physician of infectious diseases at Helsinki University Hospital District (HUS), was a guest on Yle’s discussion programme Ykkösaamu on Saturday. Image: Henrietta Hassinen / Yle

Officials’ positions and recommendations on personal protective equipment (PPE) vary. Do regular people need to cover their nose and mouth, and if so, in which situations?

"In general, very rarely would a regular person need PPE. But in crowded places, like full buses, they could be useful. The problem is that masks give people a false sense of safety. Appropriate behaviour--social distancing, hand washing, crowd avoidance--offers the most effective protection."

I’ve had coronavirus and my blood test showed antibodies. When can I safely visit my elderly parents?

"We believe the infection risk is practically gone after two weeks. This means it’s okay to visit the elderly and run errands outside."

How can asymptomatic carriers spread the virus since they don’t spread droplets through coughing or sneezing?

"People showing no symptoms probably spread the virus less than those exhibiting symptoms, but apparently some silent carriers can spread the virus quite a bit."

"One peculiar characteristic of the novel coronavirus is that infected people shed large quantities of the virus early on when symptoms first appear or even right before the onset of symptoms."

Why do symptoms differ greatly from person to person?

"I don’t really know. Is it because the virus is better able to multiply in some people’s lungs? If that’s the case, there’s some underlying factor, such as a receptor making it easier for the virus to permeate cells. Or is it related to the functioning of the immune system, indicating that some people have very strong immunological defence mechanisms? The answer is likely a combination of both."

Is it true that men get sicker than women--and if so--why?

"This seems to be the case. In all research that I know of, more men than women have developed serious complications. So for some reason, this virus hits men harder. I just wish I knew why."

"There’s been some speculation that female hormones may play a role. It may also be that men have more underlying risk factors, but these two explanations are unlikely to provide the full picture. Perhaps men overall get sick more often than women."

How long will this still go on? What is your estimate for when we will beat the virus and the disease (Covid-19) it causes?

"Nobody knows. The virus has practically spread worldwide. In no way can we prevent its transmission through a part of the global population, including a segment of Finns. But not everyone will contract it."

"Naturally there’s a small chance that the virus would slowly disappear but I would consider that scenario highly unlikely. It's possible that if we manage to snuff it out temporarily, a so-called second wave would eventually emerge."

What does a second wave mean and how would it affect us?

"A second wave would put us back in the same situation we are in now. Hopefully at that point those who had already contracted the disease would only experience mild symptoms if reinfected and would be less efficient [than now] at spreading the virus. This would soften the blow of a second wave."

"With some diseases, the second wave can be even more difficult."

What do we know about immunity?

"We know antibodies are produced during the infection, but we don’t know what sort of defence these antibodies provide or for how long. There won’t be enough information until more time has passed. The assumption is that antibodies offer some protection in terms of a few months."

Harvard University researchers say that without an available treatment or vaccine, social distancing may be necessary into 2022 to curb the spread of the virus. What are some of the repercussions of prolonged social isolation?

"All sorts of problems will arise. Reports of mental disorders are already emerging, families will be become burdened and the elderly will face more difficult circumstances. Many other medical conditions will be left untreated. It’s up to decision-makers now to ponder which courses of action carry the least detriment and risk."

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