You Should Know… Pamela Hilary Kasenetz



Photo courtesy of Pamela Kasenetz

With the constant bombardment of information about the coronavirus pandemic, it can be hard to tell fact from fiction. Pamela Kasenetz, a physician at Arlington Medical Associates, has taken it upon herself to stay up to date on all things COVID-19 to keep her patients, friends and family informed and safe.

Kasenetz, 38 and a Washington resident, helps break down some of the terms we hear, and gives advice for us all.

What should people know about COVID-19?

I need for people to understand that when we say it’s novel, that it’s new, meaning that when we try to predict things about this disease, we have to model it based on other diseases. So a lot of what we’re telling people to do comes from other diseases and data from other diseases.

Because this is so new in the world — and even newer here in the United States — we don’t have any real data yet. We are just starting to get data from this country. This is new, and things are changing.

What misconceptions are you hearing?

One misconception is this idea of what an asymptomatic carrier is. Just about everyone who has this disease will get symptoms. The incubation period is 1-14 days (average of 4-7 days) after someone becomes infected, meaning it can take up to two weeks for the virus to make itself known after you’ve been exposed. Everybody’s asymptomatic in the beginning, and then everyone who has it will show symptoms. Some people may not get super sick, but they won’t glide through this with no symptoms. Instead of asymptomatic, we should refer to it as presymptomatic.

I hear some people saying, “Oh, well, maybe I had it already. And I’m fine. And I’m actually immune.” And I’m like, no, no, no. The purpose of saying that at any given point, a lot of people don’t have symptoms but their test is positive is to say, “This is being spread by people who haven’t shown symptoms yet,” meaning that we can’t necessarily predict when we see healthy people on the street — we don’t know who’s sick and not sick. Even if your friend says, “I feel fine,” your friend may actually be very, very infectious, they just aren’t showing symptoms yet.

Why is this virus so bad?

One of the reasons why this virus is so bad is because you’re most contagious before you even know you’re sick. And it’s a very contagious virus, so you don’t know that you’re contagious and you’re very contagious. That’s how it spreads so easily. And also it’s just a long disease. The course is very long, and it’s very trying.

This virus has a couple phases and the first phase, during which the virus replicates and your body’s immune system starts to respond, can be a very mild illness. At around day 10, your adaptive immune system kicks in and you may suddenly get worse. It’s very common to hear people say, “Well, I just felt like I had the flu. And then suddenly, I woke up and my lungs were burning.” It’s a little scary, but if you’re feeling great for the first week or so, just be aware that things may change a little bit.

Some people never get worse, but some who do go into respiratory failure and end up hospitalized, maybe intubated. The people who end up in the hospital are the ones who have been sick for a while. They’ve been sick for days, weeks, even. And they end up in the hospital for weeks because this virus likes to linger. You don’t just go from no symptoms to needing the hospital.

Statistically, you’ll be fine. But of course some people who are very healthy will get very sick. It’s like a game of Russian roulette.

What’s the best way for us to consume COVID-19 information?

I don’t want people to freak out when they read overly alarming reports. Whatever news article you’re reading, it always references where they got the information from. My advice is to Google that information because you have access to it. Even the medical journals are free now for COVID information. So if you want to look at The New England Journal of Medicine or JAMA: The Journal of the American Medical Association, you can just go online and you don’t need to have a subscription. Some of it is technical, but if you can at least read the introduction, it gives you a nice background into COVID. And then if you read the discussion, it tells you what the limitations are.

If I feel sick, what should I do?

Flu season, strep season, and cold seasons are all over. And if you have allergies, you know what those feel like. If you feel like you’re getting sick with headache, chills, aches, any sort of cough, fever, sore throat, any of that, it’s likely going to be COVID-19 until presumed otherwise, so call your doctor as soon as possible and stay away from other people.

We hear about social distancing, washing hands, wearing masks. What do you recommend? What are ways to prevent the spread?

This virus is very contagious before people show symptoms, which is why it is important to act like everyone around you is sick, and also to treat yourself as sick when around other people.

When someone coughs or sneezes within six feet of you, you may get sick if you take a deep inhalation of that sneeze cloud through your mouth or nose. Standing six feet or further away limits your chance of breathing in enough virus to cause damage. A sick person speaking is likely not projecting the infectious virus a full six feet, but keep your distance to be safe. Since masks limit sick people from spreading disease and since anyone could be sick, everyone should wear a mask.

I do think people should wear masks because you don’t know if you’re sick. If you’re sick, the mask is designed to keep your secretions away from other people. People who wear masks need to cover their nose. When we talk about not touching your face, it’s really about not touching the nose. And treat like the outside of the mask like it’s toxic. And washing your hands is key.

You literally can make a difference right now. Social distancing is crucial. If you are sick and you don’t know it, staying away from other people makes a huge difference.

How are you doing personally through all this?

I read a lot about this because I care about my friends, family and patients. Reading outside of work helps me feel like I’m on top of the newest research. I’m active in a lot of physician groups online where physicians are sharing data.

A lot of my time right now is spent doing laundry and spraying everything down after work. My nights are spent preparing for the next day.

I’m here with my finance, Matt, and we keep each other sane. I’m doing puzzles, talking to friends and watching “90 Day Fiancé.”

Our wedding was slated for the weekend of April 18 at the Willard but we’ve now moved it to the end of August, which I hope is able to happen. I’m seeing it now as not just a wedding, but it’s something for people to look forward to when we can all get out of the house and see each other again.

Is it hard not to freak out all the time?

In the beginning, I was freaking out because I felt like nobody was listening. The more that I saw people accepting that this is real and staying away from each other, the less stressed I got. Once people accept this, that’s the only way we can move through this. Because once we have acceptance, people will do what they are supposed to do, and that will shorten the length of time that we need to be stuck doing this.

Anna Lippe is a writer based in Washington.

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