Posted by: notdeaddinosaur | March 7, 2020

My take on the Coronavirus-19 Outbreak

The following represent MY BELIEFS, albeit as a board-certified (and re-certified x 4) family physician with over 30 years experience, about the novel Coronavirus and Covid-19 disease, based upon basic principles of epidemiology and currently available information.

First: I believe that Cov-19 is ALREADY PRESENT in the community. There is currently no way to determine its true prevalance, partially due to inadequate testing, but also because of the nature of the virus (variable disease severity ranging from inapparent infection to fatal disease, and high level of contagion.) What this means is that since anyone could be infected, ALWAYS ASSUME you are potentially in contact with it.

Second: Basic principles like handwashing, covering coughs and sneezes with your elbow, and not touching your face (virually impossible to do, BTW) are important, but in the case, I BELIEVE relative quarantine, also being referred to as “social isolation,” is a good idea. Although officially this only applies to people at increased risk (the very young and very old, immunocompromised individuals, people with risk factors for severe disease like underlying respiratory conditions) I BELIEVE it is a good idea for everyone.

What exactly does that mean?

Risk is roughly proprotional to distance + time. Being very close to an infected individual for a short time is risky, but so is more prolonged exposure even if not as physically close. My random definition of “close” is about three square feet, so avoiding prolonged exposure at that distance should be avoided at least for the rest of the winter, or until authorities give the all-clear.

The phrase “common sense precautions” about contact with others is being thrown around a lot. Here’s a more specific rundown of what that means in this situation, IN MY OPINION:

AVOID:
* Church/religious group worship including choir
* School (if too crowded and at least 3 square foot spacing can’t be maintained
* Theaters, concerts, sporting events, rallies and other group entertainment events
* Meetings, conferences, conventions, and other group professional events
* Social gatherings involving inanimate objects, ie card games, Mah Jong, other board games, etc.

In terms of work: think about your setting. If you spend most of your time at work alone in a cubicle, you’re probably okay to go in. If you go a lot of meetings, telework is probably smarter.

Health care providers are obviously a special case. We need to stay away from patients IF WE FEEL EVEN THE SLIGHTEST BIT UNWELL. And/or follow the policies of your employer (I don’t happen to have one) which are generally aimed at protecting both workers and patients.

SITUATIONS THAT ARE PROBABLY OKAY:
* Grocery and other shopping (Don’t just hang out at the mall, though)
* Solo/small outdoor group activities
* Visiting with friends and neighbors, ASSUMING EVERYONE IS FEELING WELL

You may have noticed a recurring theme: IF YOU FEEL SICK, STAY HOME. Even if you don’t have any known coronavirus exposure, YOU COULD STILL HAVE IT. (AGAIN: My opinion only, but an informed one.)

When to seek medical attention? The same as for any other condition, like a cold, flu, bronchitis, etc: fever, chills, cough, trouble breathing. When NOT to seek medical attention (aka When not to bother the doctor or tie up ER resources): same as any other condition. Slight fever, mild aches, breathing okay. And so on. As of this writing (3/7/20) Covid-19 testing IS COMMERCIALLY AVAILABLE WITH A DOCTOR’S ORDER. I can collect the specimen in my office and send it off, just like any other lab test. BE AWARE that the specimen involved is a nasal swab: I stick a wire Q-tip all the way into the back of your nose (both sides!), which is just as little fun as it sounds. But adequate specimen collection is crucial to accurate results, so be aware that if the guy at urgent care just tickles the inside of your nose for a second, that negative result may not be all that reassuring.

How bad is this going to be? I’m not sure, but I BELIEVE it has the potential to be very bad indeed. Recent reports from China (that the numbers aren’t as bad as originally reported) are suspect, IN MY OPINION. Go back and google statistics from the 2009 H1N1 outbreak: things were very bad then, so we’ve actually been through stuff like this before.

A word about the phrase, “Don’t panic.” It’s inappropriate and sometimes counterproductive to tell people what to feel (or not feel.) Emotional reactions are what they are; issues only arise when people act on those emotions in ways that are inappropriate or counterproductive. I prefer the phrasing: “There is no reason for panic at this time.” (Technically there’s never a reason to panic, as panic precludes necessary actions and responses to crisis situations.)

How long will it go on? I don’t know, but clearly not forever. Life will eventually return to normal, and we can go back to LOLing about cute cat pix (with which I am very well stocked.)

Hope that helps.






Responses

  1. Ah, sanity. Thank you.


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