Your Life Simplified

Coronavirus Update with Dr. Chris Jenson (23:54)

March 17, 2020

As you practice precautions to help keep yourself and your family healthy, consider these additional safety tips. Dr. Chris Jenson, a former ER doctor who spent time with the CDC and is now an educator, joins us to help break down COVID-19 and what you should do to help protect yourself.

Scott Sturgeon: 

Welcome to another episode of Your Life, Simplified. I’m Scott sturgeon once again with hosting duties for this episode. Today we’re going to focus in again on the coronavirus, but I think from a little bit of a different perspective than what our previous episode covered. Today is much more from kind of the public health perspective and really specifics on the virus itself. What the public should know, what you specifically should know and best practices as it pertains to ideally preventing the virus or dealing with it as it continues to spread throughout our society. So, our guest today is Dr. Chris Jensen. Chris has experience of 13 years as a physician in an emergency room setting. He also served as a science ambassador fellow for the Center for Disease Control and Prevention, known as the CDC. He currently works in education now. Chris, thank you so much for taking the time to sit down and talk through this a little bit. 

Dr. Chris Jensen: 

Absolutely. Thank you for having me. This obviously is an important topic for pretty much all of America. 

Scott Sturgeon: 

It really is. It has completely dominated the headlines for the last two weeks now. And I have a hunch that it’s really going to continue to do so at least from what we can tell. This thing is not going away. So I guess I’ll add two caveats before we start. Number one, the information on this is constantly changing. So even what we’re saying today could be completely changed within a few weeks. And number two, there’s a lot of information out there, some of it very clear, some of it not so clear from lots of different sources. With that small caveat in mind, Chris, the virus itself could, could you kind of give us a breakdown on where it really comes from and how it really works? 

Dr. Chris Jensen: 

Sure. So coronavirus in general has been around for a long, long time and it’s one of the familiar viruses that typically cause a common cold symptoms. What’s different about COVID-19 is that the virus had a crossover event that caused it to change. And the ability of the virus to access certain parts of the body is now more adept. And so we’re seeing this virus making infiltration into the human lung and doing things that it hasn’t done before. When you go all the way back to the end of 2019 and look at what was going on in China and obviously the epicenter was Wuhan and there some animal involvement and obviously some population density that plays into that. And then the outbreak really occurred. But basically what you’re seeing is a beta coronavirus that is typically found in animals and that’s what we’re dealing with. And this virus has the ability now to cause problems, not just in animals but in humans.  

Scott Sturgeon: 

Right.  

Dr. Chris Jensen: 

And so that’s what makes it novel or new is because we’re seeing chunks of a virus that most human immune systems haven’t dealt with before in some regard.  

Scott Sturgeon: 

So hence the spread. It’s almost like, I think what I had seen quoted from a physician to some news article was that coronavirus seems now almost like what a flu pandemic would look like if there were no vaccine for the flu. Is that accurate? Kind of fair to say?  

Dr. Chris Jensen: 

There’s some overlap that applies to that. I think the thing that they’re honing in on with that aspect of the conversation is there are parts of this virus that are novel and new and giving immune system fits. You really need to have a healthy immune system to combat the virus. And the good news right off the bat is, you know, most people do. Most people have a highly effective immune system that can deal with these challenges. And although we are expecting to see a good number of cases in the United States based on evidence in other countries, keep in mind that we’ve been seeing a play by play of the worst of coronavirus, you know, social media, regular media, and to no fault of their own, they’re just trying to report what’s going on. But we’re kind of seeing the worst aspects in the news. 

And if we broadcast influenza A or B every year, it would look scary like this. Now what’s odd about coronavirus, and I’m sure we’ll get into this a little bit, is that it tends to target specific groups and it’s a little different from the flu in that regard. The groups that is causing some serious mayhem with.  

Scott Sturgeon: 

Yes. So one of the things I think that maybe you’ve mentioned it, was differentiating this virus from others has a lot to do with the transmission of it, number one, and then as I guess, a part of that transmission process. A lot of is asymptomatic. Somewhere I’d read, it’s essentially five days. You could have it within your system, be transmitting it to other individuals around you, but have no idea that you have the virus. 

Dr. Chris Jensen: 

Right. So it’s tricky. This COVID-19 virus has a wide array of symptoms. And for folks who are generally young with effective immune systems, the symptoms can be rather minimal; as simple as a cold. By a cold, I would define it as nasal congestion, stuffiness, runny nose, typical things we’d all describe as cold. And there are some folks, as you alluded to that are virtually asymptomatic, meaning that they were unaware they had it. And then of course the severe cases tend to seek out medical attention. And your point is excellent that that’s what makes it so hard is it’s very plausible that a lot of folks are going to get the coronavirus and be completely unaware. It will be no worse than any other typical cold they’ve endured, and they unfortunately might transmit it to other folks. The virus, to your earlier question, is spread by respiratory droplets. 

So you’re thinking of sneezing and cough. And you know, most of our common cold and flu viruses are spread that way.  

Scott Sturgeon: 

Sure.  

Dr. Chris Jensen: 

That’s nothing atypical. But we really had a very interesting situation to study how the virus works. And that was the unlucky situation with the Diamond Princess cruise ship. And there is a lot of data that we’ve looked at with China, South Korea, Japan, but the cruise ship, in a very odd way, you know, obviously you feel for the folks who got sick and the situation they were in, but in a very odd way, it was an isolated situation to watch the virus do its thing and have the roughly 3,700 people on that cruise ship. Approximately 700 ended up testing positive, and when you break that down, some of them were asymptomatic, most were mild to moderate cases and only a few were severe. 

And when we studied the transmission rate of the virus on that cruise ship, when people are isolated to that proximity and ended up having what’s called an R0 or the infectious rate of spread of about 2.28 and that means that if I had it and I was on that cruise ship, I’m likely to give it to slightly more than two people before I’m really aware of what’s going on.  

Scott Sturgeon: 

Right.  

Dr. Chris Jensen: 

And so that interestingly enough that R0 of two, or my likelihood of giving it to two other folks is pretty comparable to garden variety, influenza. However, there are some aspects of the virus that seem to, as we learn more about it, seem to be particularly durable. It lasts a little longer than expected on hard surfaces and things like that. And so, you know, if I sneezed on this desk and unfortunately had the virus, it might be around, for more than a day. But those things vary depending on temperature and conditions. So they’re really not reliable. But in terms of its ability to spread, it looks like it’s comparable to influenza with an R0 of right around two.  

Scott Sturgeon: 

Right. Well, that’s an interesting point you bring up. I think some of the information we’d seen in the last few days, as you know, looking back to previous kind of epidemics, you know, differentiating that from a pandemic. I think that’s kind of what the world health organization came out with, that the coronavirus is. But really, you know, society today, even looking back to versus 2003 especially in China, I think we saw, we see that we just live in a very interconnected world. And so when you talk about accidentally sneezing on your hand or something and touching something that the virus can then live on that surface for, I mean conceivably days, you know. 

Dr. Chris Jensen: 

I think some of the rumors, although I don’t know if they’re really validated or anywhere, are from 24 to 48 hours. Typically viruses don’t last that long. And that would also be other environmental conditions. But, to your point, yes, if it’s out there, it’s possible to contract. But I don’t want to steer people in the wrong direction. Its transmission seems to be similar to a lot of respiratory viruses. So although we are seeing some unique problems with Covid-19, you know, it’s, it’s not really deviating that much from a typical respiratory virus in terms of transmission. 

Scott Sturgeon: 

I think that a good question then comes up, is there anything I should be doing? During cold and flu season, we say wash your hands, cover your coughs. Are those the kinds of things that people should be mindful of? Or do I need to go to the drug store right now and buy a mask and hunker down in my basement? Is that right? 

Dr. Chris Jensen: 

Yes, I think the latter is a little bit of overreaction. I’m glad you brought up the question. It doesn’t seem particularly exciting to do these necessary precautions, but they do go a long way. Handwashing is an absolutely highly recommended event, and, in fact, the CDC devotes an entire webpage to it. Who knew that washing can be so exciting, but all sarcasm aside, whether it’s soap on your hands for 20 seconds or hand sanitizer, both are going to be effective. Sneezing and coughing into your elbow. But the bigger things are probably this crowd deterrence, staying away from large groups. It’s an exercise in responsibility to do in terms of limiting the spread. Another thing to consider is that if you are sick, really social responsibility comes into play. 

Keep in mind between now and summer, it’s highly likely that the listeners in this podcast will get a cold. And you know what, probably won’t be coronavirus, but this is a time to be vigilant where you don’t know what you have. You know, if you’re able to take care of yourself and medicate at home, that’s great. Keep yourself isolated from work. Certainly we all want people to be as productive as possible, but this is the time where don’t get back to work if you have a fever. Don’t go back to work if you’re hacking all over the place regularly because, we’ll get into this I imagine, but the young tend to do extremely well. You know, there are very few severe cases of coronavirus, in folks under 60, and that’s most of our workforce. What we really need to think about is how can we limit the overall spread of the virus because all of us undoubtedly have people in our lives who are elderly or fall into a high-risk category, and we don’t want to make them susceptible to it. If you put a virus in a lot of people, well then you’re playing a numbers game, there’s more likelihood that you’ll spread it to someone who really is at risk.  

Scott Sturgeon: 

Right. 

Brian Leitner: 

Thanks again for downloading this episode of Your Life, Simplified, which is produced by Mariner Wealth Advisors. At Mariner Wealth Advisors, we’re here to serve as your advocate. We help people chart a course to reach their personal and financial goals so that they can have greater peace of mind that may lead to a more fulfilling life. We do this by always putting our clients first, because as fiduciaries we’re required to provide guidance that’s in the best interest of clients. As you listened to this podcast and have questions about maybe your own financial situation or would simply like a second opinion or even you have an idea for a future podcast, please go ahead and email us at podcast@marinerwealthadvisors.com. If you found the information on this podcast valuable, please share it with friend or family member who you think might benefit from this information. And please subscribe to this podcast so you don’t miss an episode. Thanks for listening. And now back to the episode.  

Scott Sturgeon: 

I guess, I’m just kind of playing devil’s advocate, you know, or fast-forwarding. It’s like you said, there may be is some eventuality to the spread of this that, if you haven’t had it yet, it’s very potentially possible that within the next year or what have you, you might contract it. I think we’ve heard a lot that 14 day time frame is the appropriate amount to quarantine yourself or isolate yourself. Is there a credence to that or is there, a line in the sand that is best practice?  

Dr. Chris Jensen: 

Yes, great question. So on the CDC website, if you look at it, there is, for lack of better description, an incubation period or time period between two to 14 days where if I make contact with someone and they transmit it to me effectively, so I’ve taken in the virus. I may not present symptoms anywhere from two to 14 days. And so the thought is that if you have someone around you who was a known case. If someone has a cold at the office but they come back a couple of days later and seem fine, chances are they’re fine. You know, we can’t look at every possibility, but if you have a known exposure, and you’re around someone who is a proven entity be coronavirus. Yes. I mean, making sure in the next 14 days that you don’t pop up with cold and flu symptoms is a very reasonable precaution. 

And how they pick that as they look at how the virus works and it takes its genetic material and it puts it inside cells and sometimes it doesn’t go from the inactive phase where it’s just sitting with this genetic info inside your cells to the active phase when it’s making actual viral copies. It may not do that for two to 14 days. I believe the average onset is still around five days, but the CDC is trying to be thorough with their recommendations, and I think the WHO confirms that 14 days would be the most thorough event.  

Scott Sturgeon: 

That makes sense. Yes.  

Dr. Chris Jensen: 

I think the spirit of that recommendation is supposed to be for folks who have known travel exposure or known contact exposure, being judicious about that. And if you’re unsure whether you should engage in that type of quarantine cause it is disruptive to work, I get that. 

Making a phone call to your primary care physician explain the situation is an excellent way to sort that out. You know, if you’re not a nurse or a doctor or a pharmacist, that’s what we’re here for is to try and help.  

Scott Sturgeon: 

That makes a lot of sense. I guess in that same vein is what’s the best place to go for information on the disease.  

Dr. Chris Jensen: 

Sure. Well, as you mentioned, there are tons of things out there. There are three things that I’m going to try and recommend that folks consider. The first one is the Centers for Disease Control has a special webpage with many, many tabs with specific information and how you find it, the best way is just simply Google “CDC and coronavirus.”  

And it has a situation summary that they update very regularly and with statistics, information, cases in the U.S., testing in the U.S., and a global map in terms of the pandemic spread. For folks who are interested, what is the current plan out of the CDC and what initiatives are they taking? So that’s a great way to make yourself knowledgeable. It’s written at a level that’s very science-focused, but it’s written at a level that most deal with and understand. There are also additional tabs about what you should know in general for your own personal health, travel information and how to prevent the spread of COVID-19 in your community, specific patient populations that are at risk and what you can do. The amount of information they’ve dedicated to this is really well done and excellent. And I’m not just saying that as a physician. My family found it useful, and I referred my parents to it. 

It was a very thoughtful and helpful read. A second thing that I would tell you is that the World Health Organization also has a lot of data and very similar Google search. “WHO” for World Health Organization and “COVID-19,” will refer you to that. Now that’s going to be more things in terms of the general spread and looking at data from other countries. And more of the pandemic aspect. Some people might find that interesting, but if you want, again, personal, insightful things you can be doing to prepare yourself and to prevent things, the CDC webpage will be more helpful.  

Scott Sturgeon: 

That’s great. Those are excellent resources. And again, I think it’s great to have a very clear, succinct place you can go as opposed to just Googling coronavirus, and you’re going to be inundated with, everyone’s an expert now, you know, in immune systems and what have you.   

Dr. Chris Jensen: 

Absolutely. I mean the just generic Google searches, would be like me Googling stock advice, and I don’t have the financial wherewithal that you do. You want to be specific about who you trust and you know, no organization is perfect, but the CDC information seems to be reliable. 

It coincides with the World Health Organization. All of these things are, verifying each other’s data and are well done and they’re all three different sources with the same information.  

Scott Sturgeon: 

Chris, there’s one question I think maybe it would be decent to end on; this one’s tough. You know, at the beginning of the podcast, we said this is constantly changing. All the numbers are changing, the countries affected are changing, even our knowledge of the virus is changing. From your perspective though, if you look out over the next six months, 18 months, what do you see occurring as it pertains to whether it’s spread or public health and the ability to deal with the virus, that sort of thing. With your kind of knowledge and understanding of what’s occurred thus far and in relation to previous pandemics, do you have a kind of a vision or an idea of where we’re headed? 

Dr. Chris Jensen: 

Yes, that is the million dollar question that I’m probably not qualified to answer, but I’m going to give you some insight that I think is reasonable and trustworthy. I think if you look at the progression of the disease through China, the initial country, I think to say that this is at least an eight week process is conservative and how long it’ll stray after that. I’m not sure. But we are seeing case numbers, new incidents cases, in China start to decrease and that’s promising. And so the time frame I think is, you know, obviously well over two months and how far it’ll extend, we’re not quite sure. It depends how well we can isolate and limit the virus and the social responsibility that people engage in. So that’s going to obviously be huge. I think that it’s realistic to assume, much like influenza, that a lot of people will get the virus. 

The good news is that statistically very few people will have severe cases. So once again, it goes back to that point we discussed earlier that you may get COVID-19, and that is obviously unfortunate, but if you are under 60, and you don’t have significant cardiovascular disease, and you don’t have severe chronic lung disease, and you don’t have out of control diabetes, chances are you’re going to do well. So now it just comes down to, how do I protect folks in those groups and isolating yourself if you are sick until you’re better and staying away from large crowds and handwashing are probably three reasonable things we can all do and remember. It also comes down to how effective we test in the near future. There were some hiccups with that testing process, things to seem to be in a better state now, but every medical community’s ability to identify those who are sick does two effective things. 

One, it gets them the appropriate help they need and two, it, it removes them from the population and unknowingly infecting others. And so I think we do need to test aggressively. If you look at the South Korean model, they have tested a lot of folks and they may arguably have over-tested, and you look at their CFR or Case Fatality Ratio and that number will change over time.  

Scott Sturgeon: 

Sure.  

Dr. Chris Jensen: 

Right now it’s right around 0.7% right? Well that is because when you calculate that ratio, it’s simple math, your numerators, your deaths, your denominator is the number of people with the disease. And so they’re testing and catching a lot of the asymptomatic folks. But the benefit of that is they’re isolating those asymptomatic folks who otherwise would feel fine and go around their day.  

Scott Sturgeon: 

Right.  

Dr. Chris Jensen: 

I think a lot of healthcare workers would prefer that we over aggressively test, and identify folks, because if I had COVID-19, and I’m doing fine, well that’s wonderful, but I also genuinely don’t want to give this to someone else. 

And so even if it’s an a, a tedious self-quarantine, just to know that I kept that away from high-risk groups would make me feel better. I think generally most people are that way.  

Scott Sturgeon: 

Yes. You know, not to ever make light of the situation. Obviously there’s been a lot of lives lost and it is a tragedy to a certain extent, but you, I think you’re exactly right that I think an important point to take out of it is make sure you’re informed on what’s correctly, you know, up to date and really going on, but also kind of that social responsibility element of, you know, maybe it is an inconvenience for you if you were diagnosed with it and got better, but making sure that you’re taking precautions for whoever down the line. It could be a family member. 

It could be a stranger, you don’t really know at the end of the day but taking those steps in the long run is a relatively small burden to put off.  

Dr. Chris Jensen: 

I totally agree. And I think that’s one of the homerun messages that we hopefully get across to our listeners today. Is that just simple point. And you know, when you go to the CDC, you are welcome to read who’s at higher risk and it’s going to identify the elderly. Those who have significant cardiovascular disease, significant chronic lung disease, high blood pressure and diabetes are the main ones and that corresponds with the Chinese data as well.  

Scott Sturgeon: 

Right. 

Dr. Chris Jensen: 

Keep in mind that that most Americans first of all are not in those risk factors and tend to do extremely well. And when you look at the potential case fatality rate of let’s say the average 30 or 40-year-old, booming through the workforce right now, that doesn’t have those comorbidities, it’s somewhere around 0.2%. So I certainly take this virus seriously, and I worry about the folks who are in the higher risk groups and I just want the general population to do what we can to help those folks who are actually at risk.  

Scott Sturgeon: 

I think that’s the perfect perspective to have. I guess one of the elements we didn’t touch on just to quickly address it as the children aren’t as impacted by the disease.  

Dr. Chris Jensen: 

Correct. One weird variation from influenza. You know, if you look at just this year season influenza, we hospitalized more kids than we have in a long time. Typically respiratory viruses wreak havoc on the young. And we’re seeing the young do great or their immune systems are usually prolific. They mobilize a response in a quick fashion. To the best of my knowledge as of March 10th, there were still no fatalities under nine-years-old. We obviously hope that this illness is minimized in that age group.  

Scott Sturgeon: 

Absolutely.  

Dr. Chris Jensen: 

That is the weird, weird thing about coronaviruses. It seems to be targeting specific groups, and so I think for most of us, we kind of just need to take a deep breath and think about the social responsibility we can exercise to really help those folks that are at risk.  

Scott Sturgeon: 

So true. Words of wisdom. Chris, thank you so much for taking the time to talk through all this. It’s been really enlightening.  

Dr. Chris Jensen: 

Well I appreciate the opportunity and thanks for having me. 

Scott Sturgeon: 

For those of you listening, again, we can’t stress enough all these resources that are available, and I’ll just reiterate the CDC is an excellent resource just by Googling “CDC coronavirus.” You can find that information and also the World Health Organization, “WHO, coronavirus,” just Googling that should provide resources that Chris talked about. As always, thank you for tuning in. If you have thoughts or suggestions for new episodes for us, by all means reach out. We really encourage your interaction. You can reach us atpodcast@marinerwealthadvisors.com. Thanks for listening. 

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