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Dr. John Evankovich is an ICU doctor at UPMC Presbyterian and UPMC East and a lung researcher at the University of Pittsburgh, so his life has been consumed by COVID-19 in the past six months. He’s in the unique position of both understanding the science of the disease and having seen firsthand what treating patients has been like.
The conversation with Evankovich has been edited and condensed for brevity and clarity.
Question: When did you start working on COVID-19?
Our lab pivoted around Feb. 12 or 13 to start looking at some of the factors that might regulate how this coronavirus gets into lung cells. In March and April, I was helping prepare hospital staff to get ready for COVID-19. We ran simulations in the hospital, such as donning and doffing (removing) protective equipment. I also did some service time in a number of different coronavirus ICUs in April.
The week after lockdown, I remember driving back and forth to work: It was surreal, I was the only car on the turnpike for miles.
One of my parents works in an eye-glasses place where customers come in and she has to sit pretty much face-to-face with them for some period of time. They have modified safety protocols. The thing about it is, she could wear 35 masks and do all the things right but her risk of being exposed is dependent on how many people in the community have this thing and thus come into the store. Now, I hope at this point that anyone who is sick will not come into the store, but we know there are some fraction of patients who are going to be infectious before they show symptoms.
So let’s say they have 100 customers. If the community prevalence of the virus is 10%, that means 10 of her customers might expose her. Even if those interactions are only two minutes a piece, two x 10 is 20 minutes. She spent 20 minutes a day breathing the same air with someone that is infected.
But if the community prevalence is, say, 1%, and she has a two-minute encounter, that’s only two minutes of total exposure.
So it is a cumulative dose effect. That’s the way I think of it. That’s the way I think of it for people who work in grocery stores or any environment where you’re coming in contact with a lot of people.
I can’t tell you how many people from my hometown … which is just an hour north of here, a very rural place, were convinced of all of the conspiracies about COVID-19. And they were just not taking any of it seriously.
A lot of people, especially in my own family, said they’re just really confused. Even though there is so much information out there, they just don’t know who to believe because they see different things on the evening news, versus their Facebook feed, versus talking to me.
To get those people on board, we’re not going to get them on board by shaming. The behavioral science tells us that doesn’t work. We’re probably not going to get them on board with more information. The research and data have been there for months.
So I started a Facebook group, Western Pennsylvania COVID-19 Stories, for people to tell stories about COVID and asked people to tell their personal stories about this. I think you can break through some of that confusion and some of the ‘That can’t happen to me’ attitude if you see a personal story with someone you have a connection with, someone who lives close to you, who goes to the same church or school district. Those are more powerful than directives from above.
Q: What stories do you have to share with people?
I’ve seen some of these people who are really sick. I’ve seen people pull through. I’ve seen people crying to me on the phone because they are so scared.