Top 8 Corona Questions for NYMC’s Public Health Expert

Dr. Robert Amler Discusses Immunity, Hitting the Peak and More

April 06, 2020
Dr. Robert Amler, giving an interview on WNBC

Dr. Robert Amler, Dean of the School of Health Sciences and Practice at New York Medical College, has given dozens of media interviews since the coronavirus outbreak began. He’s addressed virus “super-spreaders,” the effectiveness of face masks, how to safely shop for groceries and more. Here, he answers top-of-mind questions about who’s immune, what’s next and healthy holiday cooking in the current environment.

1) We’ve been hearing that we are “hitting our peak.” What does this mean and what happens next?

This means we will get to a certain point where the number of new cases per day is less than the day before. This needs to be a trend that holds, beyond some expected day-to-day variations in reporting efficiency, i.e. that there is possibly more testing done during the week or on the weekend. But if we see that with each new day, we have a smaller amount of new cases and it’s beginning to decline (even though cumulative numbers will not decline), this will mean that we have reached the peak. That will be a sign that the intensity of the outbreak is slowing and we are beginning to recover.

The same could be said for the number of deaths each day. When the number of new deaths declines each day, that means we are making headway in the fight against disease.

2) Can you get coronavirus again? Are you immune if you contracted it once?

It’s really not clear if you can get it again. Many other coronaviruses can affect you more than once and we don’t know about this one – COVID-19. We are seeing antibodies in some people who have had it, which means that they have some immunity, but we don’t know how long these antibodies will last in their systems and whether they will be protective for a long time. Some antibodies are more protective than others and this is so new that no one can say with certainty if the antibodies will be protective and long lasting. We will likely know the answer in several months or a year but right now, it’s part of the uncertainty.

3) Is it only older people and those with compromised immune systems or underlying conditions who are at risk of contracting severe, fatal cases?

No, there are case reports of fairly young and healthy people who contracted the virus and got very sick and some have died as a result. The nature of the risk for young, healthy people is low but if it hits you severely, it can be very bad, so young people should be mindful of all the safety and health guidelines.

4) Will the virus come back in the fall?

The prevailing wisdom is that it probably will come back in the fall but by the time that happens, we will have gone through this cycle so we will have more answers and people will know the drill. We will likely have antiviral treatment (like a penicillin) in the fall and possibly immune plasma treatment. We will also have a better understanding of who is really at risk for severe complications so we will be prepared and better equipped to handle a fall surge.

In terms of treatment, there is a race to the top, which is wonderful news. Researchers are testing drugs that work for rheumatoid arthritis and for Ebola and they are working on it as quickly as possible. There are lots of intelligent, entrepreneurial people working on this and everyone wants to be the Louis Pasteur of COVID-19, which is obviously a good thing. Therefore, I am hopeful that we will have some kind of treatment if there’s a fall outbreak.  

5) People are cooking for the holidays and while families won’t be together, is it safe to cook and send over food to adult children and other family members?

High heat is protective so it is okay to send cooked food to others. Also, the virus can be transmitted from the surface of a sealed package for 2-3 days so if a packaged item has been in your house for that time, handling it should be fine.  Grocery items can be wiped down on the outside with hand sanitizer when you bring them home and obviously, hands should be washed very well while cooking. Produce should be scrubbed vigorously with water as well.

6) How long will we be sheltering at home? Will we go back to normal when we are able to go out in the world again?

We cannot predict when this will end, but the first sign that we are making headway is when the number of cases per day and the number of deaths per day go down.

Prudent people will still take common sense precautions – hand washing, social distancing of six feet, sitting father apart in classrooms, in meetings and restaurants. People have already adjusted to these measures so continuing with them in a modified manner shouldn’t be difficult and it will help protect all of us.

7) Does a mask protect the wearer?

Not directly, but indirectly. If everyone wears masks, the wearer is protected by other people wearing them. When you go out in public, you should wear a mask to protect everyone else but everyone else is also protecting you.

8) Anything you want to leave us with?

Yes, of course. My three public health principles – block exposure as much as you can by limiting contact in every way, use common sense and do the best you can. Using common sense means letting a plumber in if you need one and doing your best means following the rules and not beating yourself up or getting stressed out if you make a few small errors along the way. There usually are… we are all human.