What I've Told Our Parents about COVID-19 (The Coronavirus)
As most of you know, we are presently in Mexico. That means we have days of really good service and then days with minimal to no service. This week we spent three days in Todos Santos without much in the way of internet and, upon our return, the COVID-19 virus had dramatically escalated in Europe and the United States.
Given initial reports of the mortality rate being comparable to the Spanish Flu of 1918, it caught my attention very early on and we've been monitoring the situation closely. Upon returning to internet-land yesterday and seeing the progression of the illness across North America and Europe, we decided it was time to talk about it.
You'll find the associated video here.
You may wonder what qualifies me to talk about this topic, so here goes. I am a Physician Assistant-Certified, which means I hold a Master's Degree in Medicine, am board certified and practiced the art of Medicine for 12 years. In reference to the Coronavirus, that means I spend inordinate amounts of time reading about and interpreting what the WHO and global Infectious Disease experts have to say about this bug. Hopefully what I've written below will help you to decipher the information coming at us and decide what it means for you.
What I've written below started out as a message to my Dad, as a reply to him asking me what I thought about the bug and if he should be concerned. It has since evolved into this post as we feel, if people are well informed and know what steps to take, together we can make a big difference by our individual efforts.
DISCLAIMER: I AM NOT PROVIDING ANY MEDICAL ADVICE IN THIS ARTICLE. I DO DISCUSS THAT SOME STUDIES HAVE DEMONSTRATED THE BENEFIT OF VITAMIN C AND ZINC IN BOTH PREVENTING AND TREATING THE CORONAVIRUS, HOWEVER, YOU SHOULD DISCUSS YOUR PERSONAL RISK FACTORS AND BEST OPTIONS FOR PREVENTION AND THERAPY WITH YOUR HEALTHCARE PROVIDER.
I've shared some of the resources and articles that I've referenced in my writings at the bottom. In some cases, they'll scare your socks off, but they are also empowering. We as individuals can make a big difference in the outcome of this outbreak if we follow some basic and common sense principles, which is what I've made every effort to share below.
The following is written based upon the knowledge we have about COVID-19 on March 12, 2020. This is a quickly evolving situation and information is coming fast. In the event of major developments, I will make every effort to update this article.
If you find this information valuable and would like to have access to future content shared, be sure to become a member and receive access and updates from us.
First of all, just to clarify, this virus has been deemed a "BIG DEAL" because:
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It is a novel virus.
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That means, humans have NEVER been exposed to this version of the coronavirus before and thus most lack immunity to it.
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Secondly, it also has a significant mortality rate, some initial studies are indicating an average rate of 3%, which would make it equivocal to the Spanish Flu in 1918. I will discuss this below because, as things wash out, this number is likely to go down; but right now it warrants addressing if it turns out to be accurate because:
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The Spanish Flu wiped out approximately 1/3 of the global population at the time.
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It's also worth considering that this mortality rate exists in the presence of our modern medical wonders, therapies, knowledge and skills that did not exist in 1918; so IF final mortality rates end up reflecting what is currently being seen, it's probably actually more volatile than the Spanish Flu.
And that is a basic explanation for why EVERYONE is making such a BIG DEAL out of this bug.
Whether it turns out to be accurate, we will only know in hindsight; but it means taking action and precautions.
Key Take Away Factors:
1. Be ready to stay home.
- Either to quarantine yourself for 14 days if you show symptoms or up to 21 days if you get sick.
- This means:
- Have some groceries and necessary household supplies on hand.
- Get your chronic medicines refilled, anything you would need in case you can’t go out.
- Purchase medicines you might take to support your body if you were to get sick, cold and flu type medicines.
- Something to help relieve fevers.
- Something for a cough.
- Vitamins you might use to boost your immune system.
- Talk to your doctor about which ones are best for you, some people should avoid Tylenol or Advil because of liver and kidney function. Others should avoid certain cold medicines because of high blood pressure. Your doctor will know what is best for you.
2. Practice Social Distancing as much as possible.
- In other words, avoid large gatherings where you are likely to be exposed to people if they cough or sneeze on you.
- If people start getting sick in your town, stay home.
- Consider changing plans that involve being exposed to others who may have the infection.
- If we can change how people interact with each other for the next few weeks, we can make a big difference in how quickly and how far this bug spreads. It's a small and short term sacrifice to change the course of this outbreak and as the experts refer to it, we can have a direct impact on "flattening the curve" (decreasing the new infection rate). The faster that happens, the faster we can also get back to life as usual.
3. Get chewable Vitamin C and Zinc tabs (the kind that dissolve).
- They are seeing that this combination offers the greatest protection from the virus, it helps to make your airways a less hospitable environment for the virus.
- They are actually using really high IV doses of Vitamin C to treat this infection as well.
- I’ve seen this recommendation across the board, from mainstream infectious disease specialists out of California who have worked with the Coronaviruses for 30 years to alternative docs who have been using it based on what they've learned in Eastern medicine, it seems to be something everyone strongly agrees with.
- The functional medicine doctor I trust the most has made the following recommendation. Below, I've shared one of his articles on this topic.
- Choose a complete C supplement like Systemic C and Ester C (as they are also buffered and not as acidic)
- 1000mg by mouth three times daily.
- One dissolvable Zinc tablet 1-2 times per day.
- Don’t chew it. Let it dissolve and hold it as far back in your mouth and as close to your throat as possible for optimal benefit.
- Don’t use the nasal zinc.
- Choose a complete C supplement like Systemic C and Ester C (as they are also buffered and not as acidic)
- These items aren’t expensive but can be powerful.
- Remember that COVID-19 is a VIRUS. There is no cure for viruses, prevention is your best bet, followed by supportive measures should you become ill. Antibiotics will not have an impact on this infection and we do not have a vaccination at present.
4. Sanitary Practices:
- Wash your hands a LOT and carry hand sanitizer with you, that is at least 60% alcohol base.
- Wash with hot soap and water any time you can for 20 seconds (sing the Happy Birthday song twice).
- Any time you can’t wash your hands use hand sanitizer after you touch public door handles, countertops, tables, before you eat, etc.
- This bug spreads by droplet, so either someone coughs or sneezes on you and you inhale the droplets or they cough or sneeze on a surface, you come behind them, rub your hand across it, touch your face and get it into your respiratory tract.
- IF YOUR LOCAL STORES ARE OUT OF HAND SANITIZER:
- You can make your own with rubbing alcohol and aloe gel. Use a ratio of 1 part aloe to 2 parts alcohol. This will yield a 66% solution.
- When people cough or sneeze near table surfaces, armchairs, sinks, the list goes on or touch them after they've coughed and sneezed into their hands; they leave behind what we affectionately refer to as Fomites, essentially germs on inanimate objects.
- At this time, no one is sure how long this virus can live outside of a host, but they estimate hours to days.
- Thus you want to keep surface areas around you clean.
- Something with bleach is your best bet according to western science, but many studies have indicated that essential oils like Tea Tree Oil (also known as Melaleuca), Lemon and Eucalyptus Oil have demonstrated equal or better capabilities at killing germs and they smell better. The choice is yours.
- This is especially valuable when you are out and about:
- Shopping cart handles
- Arm rests, chairs and fold down tables on mass transit vehicles including buses, trains and airplanes.
- Work stations
- Rest rooms
- Find other ways to offer greetings and stop shaking hands.
- It's not rude, it's prudent and people will understand.
General thoughts and a consolidation of some information currently available:
1. It’s reasonable for everyone to be prepared and act with "an abundance of caution," but especially if you are of a certain age or have pre-existing health conditions that preclude COVID-19 patients to having a poor outcome.
- Mortality rates are hard to pin down right now.
- The WHO reports mortality rates of anywhere between 0.7% and 5.8% in China based on region, age of the patient, gender and risk factors. Globally they are seeing overall rates between 0.5% and 7%.
- Complications secondary to COVID-19, appear to increase exponentially for people over the age of 40, the risk increases even more for people over 60 and again for people over 80.
- Anyone who has the following conditions are at greatest risk according to the WHO. I've included current mortality rate findings for each as well, to demonstrate the significant increase in risk for these folks. If you or your loved ones have these conditions, it's reasonable to take extra precautions.
- 13.2% for those with cardiovascular disease
- 9.2% for diabetes
- 8.4% for hypertension
- 8.0% for chronic respiratory disease
- 7.6% for cancer
Most experts agree that once this all settles out, the OVERALL mortality rate will be much lower than the currently estimated 3%.
2. After seeing what's been happening in Italy where they didn't institute nation-wide social distancing in the form of "lockdowns" compared to China where they initiated a lockdown around Wuhan rather quickly, most experts are agreeing that it's a reasonable course of action to cancel events, close schools, encourage people to work from home, etc. If we will go on some form of a "lockdown" before this thing gets out of control in the US and stay that way for a few weeks, we can have a better outcome than some others have experienced. It doesn’t have to be forever, but a few weeks will make all the difference.
3. Experts also agree we are greatly underestimating the number of cases in the US; so its reach is already far greater than the public is presently lead to believe based on:
1. Mortality rates we are seeing, which can infer what is referred to as "true cases."
2. The lack of testing that has been done in the US, which means we don’t have as many "confirmed cases."
4. Why the R0 (pronounced "R naught") is actually a factor for the Coronavirus and you can't currently compare it to the R0 of Measles, for example:
- The R0 refers to how many people someone will infect if they have a disease, i.e., how contagious the disease is.
- The R0 for COVID-19 is currently estimated at 2, meaning that each infected person will likely infect two additional people. You can see how over time this has an exponential effect on the spread of an illness.
- The R0 only matters when we are dealing with a new bug, one that people do not have natural or induced immunity towards.
- In other words, if you went back and looked at the impact of Measles (R0 = 8), when it was first introduced into the population, at a time when people didn't have immunity to it and we didn't have a vaccine, you would see how powerful the impact an illness with an R0 of 8 really is.
- That's why we worked so hard to create vaccinations for illnesses of this nature.
- Telling people that this illness doesn't warrant careful observation, because it has a lower R0 is giving a false sense of security because modern people don't remember a time when Measles had a significant impact on public health. Sure it has minimal impact on our society now, but open a history book and you'll soon see a different picture.
- So to give you a comparison you can make based on RECENT history, the Ebola virus also has an R0 of 2 and you see how hard it is to control an outbreak of that disease.
- The thing that plays in our favor with COVID-19 is that while it is equally as contagious as Ebola, it does not share the same mortality rate of ~90%.
- The R0 only reflects how CONTAGIOUS a bug is and doesn't have anything to do with how lethal it might be, how sick it might make people or any other factor we consider in Public Health.
- It is an IMPORTANT factor for new bugs because when people don't have immunity, we know how likely they are to get the bug if they are exposed to it and this allows Public Health outlets to prepare accordingly.
- WHY DID I TELL YOU THIS????
- Unless you love epidemiology and teeter on the geek scale like I do, you're probably bored out of your mind by now, but I HAD to explain this!!!
- I have repeatedly seen people share an image on Facebook comparing the R0 of diseases and using it as a reason that this bug doesn't matter.
- If you don't understand what the R0 is and why you can't look at what the world population currently experiences as Measles and compare it to the COVID-19 outbreak, then you won't realize how foolish sharing information like this really is.
- Okay, stepping off the soap-box, sorry, not sorry. I just want you to make sure you aren't making your decisions based upon information shared by people who got their degrees at Facebook University. Enough said.
5. Timeline:
- China reported 19 new cases two days ago, a dramatic reduction from the hundreds of new cases reported daily, just a short time ago. So we can deduce that we are looking at about 10-12 weeks for this thing to peak and slow down. We are likely already 2-3 weeks into it and that may be a conservative estimate, some evidence indicates this bug may have been present in the States since mid-February.
- There is evidence that this bug is very temperature-sensitive and doesn’t tolerate heat well, so many experts are cautiously optimistic that it may start to die off as the warmer temps in the northern hemisphere come on. We can hope this is the case.
What does it all mean??
- The big concern overall isn’t just the mortality rate which is significant, but also the issue of resources. If we get a massive number of people infected with this, it will tax our health care system beyond capacity.
- 5-20% of the people who contract the illness will require some level of medical care.
- In Italy, they have such a high infection rate, they are having to decide who receives life-saving care and who does not, because they don’t have enough medical supplies, hospital rooms, artificial ventilation machines and health care workers to care for everyone who requires hospitalization.
- That means more people will die than was necessary in the day of modern medicine, simply because of the inability to meet demand.
So how does this translate into you making a difference?
- All experts agree that if we can engage the practice of social distancing and quickly adopt measures such as school closures, event cancellations and people working from home, we can dramatically reduce the number of people who become ill right now.
- The fewer people who become ill, the fewer people there will be requiring advanced healthcare intervention and we reduce the taxing of our medical system.
- They will be able to save more people because they will have more resources at their discretion.
BIG TAKE HOME FACTOR:
- This won't last forever. A few weeks can make all the difference in changing the progression of this disease.
What I told my Dad yesterday: This is not the apocalypse, but we need to pay attention to what’s happening, prepare and do our part to prevent the spread by instituting social distancing, especially if we fall into high-risk categories. And this too, shall pass.
Our last bit of advice, which we shared in the video as well: Be thoughtful about what you share across social media, not every article written is true and false information only contributes to the panic. We shouldn't be panicking, we should be prepared. So double-check the articles you're reading via Snopes, and other fact-checking websites before you proliferate the madness.
A few articles that have been referenced in the writings above:
1. https://medium.com/@tomaspueyo/coronavirus-act-today-or-people-will-die-f4d3d9cd99ca
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https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6