Hospitals in the Greater Houston area are continuing to respond to the new coronavirus outbreak as case counts across the region climb. Community Impact Newspaper recently spoke with Dr. Jason Knight, chief medical officer at Houston Methodist The Woodlands Hospital and medical director of Houston Methodist Emergency Care Center in The Woodlands, about the hospital system's preparations for the current situation in addition to personal strategies for preventing the spread of the virus and managing health. This interview has been edited for length and clarity.

'Where germs hide'

How can people keep their living spaces safe and sanitary?

“A lot of the places where germs hide are kind of the more unexpected or unanticipated places. So make sure you change your kitchen sponge often. Make sure you wash your kitchen towels on a frequent basis. Obviously, wiping down your counters and cleaning your floors and cleaning your bathroom [and] the tables [is] pretty standard. But I would also consider wiping down a lot of other things that people don’t usually think to wipe down, like your pants, your phones [and] your computer keyboard.”

What sanitary efforts can people make when coming home after being out in public?

“Nothing actually really changes unless you’re in a particularly high-risk area. If you’re going to Costco or H-E-B and kind of doing grocery shopping, ... it’s important to use Purell—alcoholic hand sanitizer—and wash your hands. I think the vast majority of people I’ve seen in the community are going way overboard—like, you don’t need to wear an N95 mask at Costco with gloves and [a] gown. I think a lot of that is really silly, to be honest with you. I think not touching your face and practicing good hand hygiene is the way to go.”

How can people maintain a sanitary home shared with family members? What if a family member becomes ill?

“If people are coming and going, I would suggest that they take minor additional precautions. ... A lot of people don’t end up washing their suits very often, and so I think if you are in a high-risk area, it’s probably a better idea to wash your clothes on a regular basis [and] wash your hands on a regular basis.

If you do have somebody that’s sick at home, especially with possible COVID or flu or another viral illness, one of the best things you can do is—if you have the option—you can try to isolate that person into a different room of the house as much as possible. But if that’s not possible, you want to have that person wear a mask, [and] you want to increase the times that everybody in the house washes their hands. You obviously want to wipe down all the frequently-touched surfaces, like counters and bathrooms and things like that. You definitely don't want to share a bed with somebody that’s sick, and you want to wash bed linens and towels and things that person came into contact with on a regular basis.”

How can people continue to be good neighbors in their residential communities?

“The best thing that people can do right now is to practice social distancing, and I think that’s the best and most respectful thing that you can do for everybody. So stay at least 6 feet apart. I think it’s very, very important that if you are sick, you not go out and expose other people. Unfortunately, right now, there’s some suboptimal behavior, with people hoarding toilet paper and hoarding food and medicines and everything else you can think of. I think part of being a good neighbor is to be generous and help other people that may not have a similar stockpile or are potentially running out of things.”

Is there anything else people should know about general sanitation or prevention practices?

“One of the most important things to know is that RNA viruses like COVID are easily killed by a number of household cleaners. So Purell kills the virus; alcohol kills the virus; Lysol kills the virus; 5% bleach kills the virus; 10% bleach kills the virus. ... It’s not that hard to kill the virus.”

Personal health

How can people prepare themselves against some of the negative effects of social isolation while practicing social distancing?

“Humans are incredibly social beings. Even before this corona outbreak, there was a massive epidemic of anxiety and depression in this country. ... In my opinion, this quarantine is an amazing time to reset a lot of those bad habits that people have developed and really focus on a lot more of the fundamentals, like getting a good amount of sleep, going to sleep every night at the same time, not watching TV right before bed, cutting down on your stress and anxiety, eating healthy food ... It’s a great opportunity for people to really take some time and evaluate the regular decisions that they’re making in life and what’s important to them and kind of hit the reset button.”

What mental health strategies can people use if their therapists or other professionals are not available in person?

“There’s a lot of telemedicine options right now, and a number of psychiatrists and regular doctors have completely switched their practice over to telemedicine. And I also would suggest that this is a really good time to reach out to friends and family, to socialize and to really turn your life a little bit more virtual.”

Do you have any other recommendations on keeping up personal mental health?

“One of the best treatments for social isolation and for anxiety and depression is exercise. And so I think that people really, really need to prioritize eating good food and exercising. ... Drinking, like, 10 hours a day of alcohol is not the way you want to spend your quarantine. ... Exercise is unbelievably positive on mental health. A number of studies have shown that exercise [can be] even better than taking antidepressants in treating depression.”

What are some of the other most important pieces of general information or advice for personal health?

“First of all, if you have a really minor illness, not everybody needs to get tested because testing, in general, will not change anything you do and will not change management, and there’s no know treatment for COVID-19 right now. So aside from getting rest and taking Tylenol and staying well-hydrated and eating good food and getting sleep, if you do have a minor illness or a minor cold, you don’t need to go to the emergency department."

What should people know about possible treatment options at this time?

“There are a lot of different medications under investigation right now, but just because COVID-19 is kind of a new, emergent pandemic doesn't mean that we can just get away from science and throw science out the window and just start treating people with a bunch of random medications that we think need to work. We need to follow [Dr. Anthony Fauci’s] recommendations, which are [that] we need good, well-done, randomized, double-blind clinical trials to make sure these drugs are actually helpful and actually work. ... [And] people need to be careful with their hoarding or stockpiling medication.”

Hospital preparedness

How did Houston Methodist plan for this situation?

“We did a lot of these mental exercises for the ebola outbreak all the way back four years ago now. ... Fortunately, back in December, when the outbreak was just in China, Houston Methodist started ... taking out and dusting off all those old policies. And we’ve gone all the way through [questions, such as,] 'Who should get CPR and who shouldn't get CPR? What happens if we have to ration ventilators? How are we going to cohort patients and keep the rest of our patients safe? What are we going to do about elective surgery? How are we going to keep our front-line staff safe during this particular episode?' ... Back in December when this was just in China only, we actually maxed out the amount of personal protective gear we ordered in the months of December and January just to make sure we had an adequate stockpile to protect our patients and our staff and our physicians.”

What other medical resources are your hospitals currently utilizing?

“Houston Methodist has been incredibly fortunate and lucky to have our research institute downtown and all of our laboratory infrastructure because we are one of the few places in the country that created our own COVID-19 tests. ... Houston Methodist has its own test that’s FDA-approved, and we actually are running it twice a day, so we have, on average, about a six- to eight-hour turnaround. As you can imagine, to know days sooner whether or not someone has COVID-19 dramatically improves patient care and the efficiency of the health system and the safety of our staff. ... We are also part of the three out of the four of the biggest U.S. clinical trials for medication to treat COVID-19.”

How is your current supply of essential medical and personal protection items?

“We have several weeks of supplies right now to protect our staff. We’re in a good place and a good position right now. We’re being incredibly conservative with our personal protective gear and making sure we’re only using it when it’s absolutely necessary to try to make sure we keep our staff and our patients and our doctors safe. Depending on how many people get incredibly sick and need hospital-based services, we may or may not have enough beds. It all just depends on the numbers. So right now, we’re at least one to three and a half weeks away [from the peak], just because people tend to get hospitalized between eight and 10 days after contracting COVID-19, and so there’s a pretty significant delay between infection and needing hospitalization. And the cases in Houston right now are doubling ... every five days.”

What can community members do to support local health care providers’ efforts over the coming weeks?

“Donating N95 masks are great. And ... I think practicing that social distancing and quarantining at home and not being out unless you absolutely need to and practicing good hand hygiene ... is incredibly key right now. So if they’re telling you not to travel to certain locations, please, please, don’t go. And if they’re telling you to quarantine at home, they’re saying that for a reason. Please follow the recommendations."

What else would you like people to know about the situation right now?

“Eighty percent of people are going to be asymptomatic or only have very minor cough and cold symptoms. So I think everybody needs to take a deep breath and relax and calm down. ... Older people are at significant risk. But that being said, [for] most people, it’s much, much, much more likely that you’re going to recover from this or only have mild symptoms if you’re healthy [rather than] pass away or die or have a severe problem. That doesn’t mean you can ignore all of the recommendations to try and prevent the spread, though.”