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Little COVID-19 lesson
Piedmont Newton Chief Medical Officer talks coronavirus, power of masks with Rotary Club of Covington
Dr. Norris Little
Dr. Norris Little, Chief Medical Officer of Piedmont Newton Hospital

COVINGTON, Ga. — Although masks can be “a pain in the neck,” the Chief Medical Officer of Piedmont Newton Hospital says they work.

During the Rotary Club of Covington’s meeting Tuesday, Dr. Norris Little shared his and the hospital’s experience during the COVID-19 pandemic and also provided a few facts about the novel coronavirus.

After the global health crisis reached Newton County, Little said the hospital instituted a “universal” mask mandate that required everyone inside the facility to don a mask — including patients, if able. Since the mandate went into effect, Little said there have been no staff members to contract the virus from a patient. Staff members who have been infected were infected while out in the community, he said.

“Masks are very effective and work very well,” he told the club. “Because we know that … if you have a mask, it helps prevent you from getting it, but even more importantly, it also keeps you from spreading it to other people.”

Little said 96% of the disease is transmitted through the air, leaving only 4% to be transmitted by contact.

“There are two transmission modes,” he explained. “Six-feet social distancing we talk about is related to droplet transmission. So when I’m talking right now, there are little droplets of moisture that are going out into the air … but those bigger droplets drop to the ground within about six feet. That’s why social distancing is so important.

“The other issue is airborne. Some of you have probably read that, well, maybe some of them hang out in the atmosphere for a while — up to 30 or 60 minutes. Part of that is why the CDC’s recommendation to exposure is 15 minutes of contact without a mask, because there probably is some airborne transmission, but not as much.”  

And masking can help prevent both airborne and droplet transmission, Little said.

Little said the highest contagious period for COVID is probably the day before symptoms develop, which is not unusual for other viral diseases.

“But we know that if we’re really going to be effective, we have to make sure that the asymptomatic person is not at work spreading the disease,” he said. “And so masking has been incredibly effective in preventing that.

“From our perspective, masking is the way to get our society back to business and back to work.”

Once someone has the virus, Little said the person is not infectious to anyone at approximately the ninth day.

Little said Piedmont gets guidance from the CDC and the GDPH, but have to incorporate into practice on their own — no recommendations are made on how to operate.

Though the novel coronavirus draws comparisons to influenza, Little said the two diseases are worlds apart.

“The coronavirus is a very different disease from influenza,” he said. “It’s not the same thing and it causes a very different type kind of illness.”

Little said COVID-19 is a lower respiratory illness that causes disease primarily in the lungs. Infected people can develop a sore throat or nasal congestion, but its effect on the lungs makes it different than influenza, he said.

“When you perform a chest X-Ray on someone with influenza, it’s typically clear,” Little said. “When you perform a chest X-Ray on someone with COVID-19, even if they have mild-to-moderate symptoms, they may have infiltrates in their lungs — patchy fluid areas in the lungs — which is very different from influenza.” 

He said COVID-19 also seems to attack blood vessels, causing small blood clots.

Controversy around the disease has a lot to do with mortality rate and transmission of the illness, Little said.

“To be frank, if you look at the overall mortality rate of COVID-19, it’s significantly less than influenza. But that’s not the problem,” he said. “There’s a lot of focus on that in the media, but the problem is not that it has a low mortality rate. The problem is there’s 360 million people in the country that could get it. And we’ve never had an influenza outbreak that had the potential to infect that many people.”

The mortality rate is important when it pertains to who is infected, he said. For children under the age of 14, the rate was 0.009% — much more than influenza, (0.01%). However, Little said in certain nursing homes the mortality rate of COVID-19 patients was 20%.

“It’s an illness that is serious in our country and around the world, not because it’s more dangerous than influenza. That’s not the issue,” Little said. “The issue is 100 times more people might get it, and that’s the problem … because none of us have immunity from this. There is no vaccine.”

Because more information is made available each day, Little said Piedmont’s ability to treat COVID-19 patients has progressed over the last few months.

“We have some medications like steroids, remdesivir,” he said. “Everybody that gets this in the hospital gets put on a full dose of blood thinners to stop the blood clotting from occurring. And we’ve seen our hospital length of stay shorten, so they’re not staying in the hospital as long and not as many people end up in the ICU.”

He said the hospital was continuing to learn and work on the treatment process. It is still too early to tell if convalescent plasma was helpful in treating the disease, Little said.

Since the pandemic began, the hospital’s number of emergency room patients had dwindled by almost 50%, Little said. But the public should know that the hospital isn’t limited to only COVID-19 patients. It is ready and able to treat all patients, regardless of the need.

“We want people to know that it is safe to come to the hospital and be cared for in a safe environment,” he said. “Our resources are available to all those who need health care.”