Florida Doctor Urges Young Residents Not To Assume COVID-19 Is 'Benign'

Jun 23, 2020
Originally published on June 23, 2020 6:28 pm

Florida Gov. DeSantis recently announced a dramatic decline in the state's median age for coronavirus patients: from 65 years old in March to 37.

Dr. Cheryl Holder, an associate professor at Herbert Wertheim College of Medicine at Florida International University, says that's likely due to older people heeding warnings about how to stay healthy.

"It's really basically who gets exposed," Holder tells NPR. "If you look who is staying in and following the guidelines, [it's] older people who are at risk. The older folks got [the message]; the young people, not so much."

On Monday, Florida hit the grim milestone of more than 100,000 confirmed coronavirus cases, shortly after it reported a day of record-breaking new cases.

The records come after life in the state has resumed post-lockdown. Most of Florida is now in phase 2 of reopening; bars, movie theaters and tattoo parlors opened, with restrictions, earlier this month.

Holder is seeing the state's rise in coronavirus cases up close. She's treating coronavirus patients in Miami, one of the areas hardest hit by the spike in cases.

Here are excerpts of the interview:

Are you treating young people? Is there any sort of warning that you can give to younger people that even if you're not going to be on a ventilator, this is still a dangerous disease?

The issue I always tell my patients is that yeah, when you look at population studies, when you look a large group of numbers, yes, maybe a percentage won't get it, or maybe a percentage will not get it as badly, but will you be in that percentage? You have no clue that you will be that person who will be well. And also, even if you get this infection, we don't know what's going to happen 5, 10, 20 years down the line from an infection that we know so little about. So it's not just protecting you now, but it's protecting you for the future. I often tell my young patients, HPV – the human papillomavirus virus – was asymptomatic. Yet 10, 20 years down the line, we're seeing cervical cancer, we're seeing penile cancers. So you can't really rest on the fact that a disease that is new, that we know very little about, is going to be so benign, that it's just a little cold – it's not. ...

I don't think the message has been clear enough, so I can't say young folks are being disobedient and invincible completely. But because the message hasn't been consistent, and we see many times people are out without masks, and they seem to be well, that we will take a chance. Everyone's ability to take risk varies. And younger people will take more risks. But it shouldn't be used against them, if we consistently as a community speak clearly and speak that this is the best method to protect you and protect others: to socially distance, use your mask, use a face shield — that may be even better.

Are you saying we should go to face shields?

We may have to because looking at the data, it protects the eyes, protects the nose, the mouth, and it may be easier to use. ...

It's not airborne, but if somebody is speaking and the droplets come out at you, it's anything to protect you. The key is we've got to protect ourselves and our communities until a vaccine comes in or even proper treatment.

Listen to the full interview at the audio link above.

Copyright 2020 NPR. To see more, visit https://www.npr.org.

DAVID GREENE, HOST:

It would be a mistake to assume that this pandemic is waning. As countries have allowed life to resume, the coronavirus is spreading in some parts of the world. Three nations really stand out for their increases in cases - Brazil, India and the United States. U.S. states are seeing more COVID-19 cases and more hospitalizations. The numbers are especially concerning in places like Texas, Arizona, also Florida, which hit a grim milestone - 100,000 confirmed cases.

Dr. Cheryl Holder is seeing this close-up. She's an associate professor at Herbert Wertheim College of Medicine at Florida International University. Dr. Holder, good morning, and thank you for taking time for us.

CHERYL HOLDER: Good morning.

GREENE: Can you give us the view from Southern Florida? What are you seeing, and how concerning are these numbers that are going up?

HOLDER: Well, seeing the rapid increase over the last, I would say, 10 days. Because we hit a low - about 500-something per day - in June 11 - around June 10, June 11 and in 10, 12 days have seen a rapid increase. And it's very concerning 'cause we know a certain percentage of the people who get infected will be very ill, and a large - another percentage of that will die. And as a physician - and as we've been trying with this pandemic is to reduce the number of infections so we can reduce the number of bad outcomes, death being the worst of all.

GREENE: Well, one of the changes that we've been reporting on around the country is that younger people seem to be hit right now. I know the governor of Florida said the median age of people testing positive in your state is now 37 years old. Can you help us understand that?

HOLDER: Well, it's really basically who gets exposed. So most of the older people, and I know my patients in particular - all my older patients, we have calls. We have - any appointments I've had, we've kept them telemedicine. And one of the things we've insisted - and I know all the physicians and it's all over - if you're high-risk and you're older, stay in. And I think if you look who's staying in and following the guidelines are older people who are at risk. Everybody's very - the older folks got it. The young people, not so much.

GREENE: Well, I thought about that when I saw the story of a bar in Orlando that was serving dollar Bud Lights when they reopened back up again. I mean, it looks like more than 40 people may have been infected at that one bar. So is that what's happening? Younger people are just treating this as if it's over and heading back and enjoying life again?

HOLDER: Yeah. Well, they're getting different messages. And some of the messages - and this is what we find with most people. If you hear different messages, you're going to choose the one you like. And I think young people, who feel much more invincible, and the message coming in that you're not going to be that sick anyway, and most time, it's asymptomatic anyway, and we reduced it, and not fully understanding flattening the curve doesn't mean the virus is gone. So I think because of the messaging, which has been inconsistent across the country, in populations where you're going to go out there and people cannot distance easily unless you make an extra effort, you're going to be exposed more. So I'm not surprised that it's younger people.

GREENE: Well, let's talk about younger people because I know there are a couple of things worth mentioning here. One is that younger people, even if they are asymptomatic or don't get such a severe case, they could still spread it to relatives who are older and more vulnerable. But I wonder, I mean, are you treating any young people? Is there any sort of warning that you can give to younger people that even if you're not going to be on a ventilator, this is still a very dangerous disease?

HOLDER: Absolutely. The issue I always tell my patients is that, yeah, when you look at population studies, when you look at a large group of numbers, yes, maybe a percentage won't get it, or maybe a percentage will not get it as badly. But will you be in that percentage? You have no clue that you will be that person who will be well. And also, even if you get this infection, we don't know what's going to happen five, 10, 20 years down the line from an infection that we know so little about. So it's not just protecting you now, but it's protecting you for the future. 'Cause I often tell my young patients that I see, HPV, which everybody knows about - the human papillomavirus - was asymptomatic, yet 10, 20 years down the line, we're seeing cervical cancer. We're seeing penile cancers.

So you can't really rest on the fact that a disease that is new, that we know very little about is going to be so benign, that it's just a little cold. It's not. And so our pushing everyone to flatten the curve and stay in is so when you go out, you can take the precautions that we have studied. We're not 100% sure everything is the best, but these are the best measures right now that we have to make a difference.

I don't think the message has been clear enough, so I can't say young folks are being disobedient and invincible completely. But because the message hasn't been consistent and we see many times people are out without masks and they seem to be well, that we will take a chance. And everyone's ability to take risk varies, and younger people will take more risk, but it shouldn't be used against them. If we consistently as a community speak clearly and speak that this is the best method to protect you and protect others is to socially distance, use your mask, use a face shield - that may be even better.

GREENE: We should go to face shields now. Are you saying we should go to face shields from masks? I mean, is that...

HOLDER: We may have to, because some - looking at the data, it protects the eyes. It protects the nose, the mouth. And it may be easier to use.

GREENE: Sounds like we might have a long way to go here.

HOLDER: Some people - yeah. We have to find anything. Because it's in the air - it's not airborne, but if somebody is speaking and the aerosol - and the droplets come out at you, it's anything to protect you. The key is we got to protect ourselves and our communities until a vaccine comes in or even proper treatment, so if you're the 1% or the 2% that gets ill, there's something to do for you that's going to make - save you.

GREENE: Dr. Cheryl Holder, so much to talk about, and we hope to have you back on. Thanks so much.

HOLDER: Thank you. Transcript provided by NPR, Copyright NPR.