Just passing this along.
Dear neighbors, I thought I would share the following to provide some practical information from my perspective: please excuse typos as I’m dictating this long post. An Emergency Physician’s Guide to Novel Coronavirus in the US and Infection Control 101:
So, let’s start with science. There are many, many coronaviruses that generally infect animals and occasionally humans. The taxonomically correct name of the viral strain currently circulating worldwide is SARS- CoV-2, As the virus closely resembles SARS. When you get infected with this virus, you have COVID-19, so named because the strain emerged in 2019. These names are chosen carefully to avoid stigma or association with a geographic region, as it is increasingly clear this will become a worldwide issue in the coming months. For many years, virologists have predicted that a virus-like this would emerge at some point, it was only a matter of time. And here we are.
It is not a Chinese bio-terror weapon that was accidentally or purposely released, bio-terrorism weapons are far more lethal. It is not a democratic hoax. It is very real. However, it is also not a reason to panic. Although most of us will contract SARS-CoV-2, is not terribly lethal. The vast majority of people will get a cold-like illness. Kids seem to get symptoms in large numbers, but very, very few get very sick.
The group of people that seem to get quite sick from this disease are people over the age of 60, and illness severity goes up as age increases. If you are a senior, it is wise to take precautions and measures to avoid contact with large groups of people over the next few months as this virus circulates. Now is NOT the time to go to the gym, movies, concerts, lectures or large family reunions. Consider delaying travel plans if any. I know it’s not ecologically friendly, but getting as much delivered to your home as possible if you are >65 yo. Groceries drugstore items etc. Build up your immune system with fresh fruit veggies antioxidants and other immune boosters. Cut back on or stop drinking alcohol. Stop smoking. Yes, stop smoking marijuana too. Get some fresh air, but in your backyard, away from other people. Wash your hands. A lot. This is the best way to prevent spread and decrease your own viral load.
Surgical masks, unfortunately, are not a magic shield. They help decrease the amount of times you touch your face and mouth, which can help prevent the virus from entering into your body, but the virus particles are small enough to pass through this barrier. Surgical masks are not a bad idea to wear if you are one of those people who when they do get sick, feel the need to spew their cough everywhere, instead of coughing into your elbow, Dracula style. They help to reduce droplet transmission to other people around you when you cough or sneeze, but they won’t protect you much from the virus. The main thing that will prevent transmission is washing your hands and not touching your mouth nose and face. Let me say that again. Washing your hands and not touching your nose and mouth are the most effective ways to prevent getting this virus. Please save the N95 masks for those of us who work at hospitals, who will be exposed to this virus again and again and again in the coming months. N95’s may afford some protection to decrease viral spread but are far from a magic shield. They only filter down to 5 µm. This virus is about 1 µm. If you are under the age of 60, it is your job to protect seniors. The best way to do that is to prevent transmission and spread. None of our bodies have ever seen this virus before, so none of us have any immunity. Generally, when cold viruses move through any given community, there are some people who have immunity to them from having seen something similar to that strain before. This is not the case with SARS-CoV-2.
If you get a sore throat headache and fever in the coming months, congratulations. You probably have COVID 19. Post about it on social media, elicit sympathy from your friends, but sharing is not caring. Do not go out in public unless you absolutely have to. Stay away from public transport. Work remotely from home if possible. Wipe down doorknobs and handles and surfaces in your home with bleach or alcohol solutions or wipes. Cover your cough, wash your hands multiple times per day, use hand sanitizer if you are out and about. But you shouldn’t be out and about. Keep your kids home from school if they become sick. Children are perfect little vectors and smear virus everywhere. As I’m sure you know from colds, kids are sick for about 2 seconds, and then all the adults are sick for a week. Anticipate school closures. This is not to protect children, but rather to reduce their spread to others.
Along that vein, if you do get sick it may last for a while. Like a few weeks. Stock up now on acetaminophen, ibuprofen teas soups, Hippie elixirs, whatever you use to make yourself feel better when you are ill. You don’t want to be going out to shop for these items when you are already sick.
And finally, if you are under the age of 60 and get symptoms, we really do not want to see you at the hospital. Really. If you are over 60 and feel very ill, call your doctor for advice. If you have a fever and cold-like illness, you probably have this virus. We will not test you if you are at low risk. If you need something like intubation to support your breathing, come in. Short of that, stay at home. Millions and millions of people in the US will eventually turn COVID 19 positive. You know what? Unless you are really, really sick, there is no reason to prove that it is a COVID 19 versus the flu or a cold. We have no effective treatment for any of those things. You don’t need to come see us. I know it’s hard to hear, but you will not be unique in your situation. This is bigger than any of us.
I will, of course, do everything I can to prevent transmitting my virus to you when you encounter me in the emergency department. OK, I’m not shaving my head, but I’ll be doing lots to decontaminate myself and the things I touch regularly. Despite taking these precautions, if you see me in the ED in the coming weeks to months, there is almost a 100% chance that I will be carrying this virus, simply by the fact that I will be encountering multiple people with this virus every day. If you think you are seriously ill, for example, breathing has become a severe struggle, please call 911 or us before you come in. Hospitals are going to try their best to prevent spread in the hospital, but SARS-Cov-2 is crazy contagious. We may want to bring you in a separate entrance or into a tent or other area so you don’t spread the virus to patients in the hospital that are elderly or have little to no immune systems from disease, cancer, etc.
Questions or concerns? The CDC has some great resources. Check it out at CDC.gov. You can also direct message me. I might not get right back to you as I anticipate being very very busy with patients in the coming months, but I will do my best to get back to you. We are all in this together. Let’s all pull together and be patient and take care of ourselves and each other in the coming weeks and months.
Sincerely, your friendly neighborhood Emergency Physician.
