First, COVID-19 is a totally new disease. Therefore, knowledge about it is evolving quickly. Most basic facts remain unknown. Please, be wary of incoming information and restrict your searches to reliable sources like the CDC, Johns Hopkins School of Public Health, and WHO.
Example: the news is reporting that COVID-19’s “basic reproductive number” (R0) is 3.5.. Translation: For every person with COVID-19, they will infect 3.5 new people on average. However, if you click on this link, you can see that scientists are still studying the exact R0 of COVID-19 (probs 2-3).* R0 of flu = 1-2. Measles has the highest = 12-18.
Second, COVID-19 is somewhat like influenza. They are different viruses but spread similarly. When people with COVID-19 sneeze, cough, or talk, they produce droplets that can land in mouths, eyes, or noses nearby (i.e., 3-6 feet). This is likely the main route of transmission. These droplets can also possibly be inhaled, directly into the lungs. People with COVID-19 can also leave the virus on objects like doorknobs. You can infect yourself by touching that object and then touching your mouth, eyes, or nose. Human-to-object-to-human spread is not thought to be a primary mode of transmission though. WHO says COVID-19 is more deadly than flu.
Third, I am 100% positive there will be a pandemic of COVID-19. When I say pandemic, I mean that the disease will spread across multiple continents simultaneously. “Pandemic,” as a word, does not say anything about severity. This might sound scary… and it is. Sadly, at the onset of any outbreak, there’s lots of politics, misinformation, and fear mongering. Focus on info from the CDC. Be calm — there’s little reason to panic. There’s every reason to prepare. Although governments can’t stop the spread entirely, YOU have an opportunity now to act and share information. See “Is this as big of deal as the media is making it?” below.
What can you do, day-to-day? Be hygienic and stay away from people who are sick.
1. Right this very moment, you can practice not touching your face while in public. Keep your hands in your pockets, on your hips, or elsewhere. Avoid the temptation to scratch your eyelid, bite your nails, or use your hand to wipe your nose.
2. Wash your hands for the full 20 seconds with hot water, especially when you return home from being in public. You can sing the ABCs song (or these). They last 20 secs. Handwashing is not a panacea, but it is helpful, in your control, and has no downside.
3. If you feel sick, STAY HOME. About 80% of people with COVID-19 have MILD symptoms, which is why it continues to spread so easily. People feel fine, and then they leave their homes — spreading it further. It is critical for people with a fever, cough, shortness of breath, or difficulty breathing to quarantine themselves and follow CDC guidelines. Stay quarantined until you don’t have a fever for ≥24-hours w/o medications.
Offer “elbow bumps” instead of handshakes. The CDC’s full prevention page is here.
What other preparations can you make?
1. COVID-19 appears most dangerous for immunocompromised and older people. If you know or care for someone like this, make a plan for them to reduce their visits to public spaces. If they live with you, wash your hands every time you return from outside. The way you can protect them is to not take any unnecessary risks — think hard about travel.
2. If COVID-19 begins circulating in your community or someone in your house gets sick, plan to clean “high-touch” surfaces ≥2x daily (faucets, tables, knobs, phones, toilets).
3. It is possible there will be a period of intense transmission in your community or that you get sick. During this time, you might want to socially distance and/or quarantine yourself. So, it may be worth stocking up (slowly!) on enough non-perishable foods to last two weeks. Don’t buy bulk — supply chains won’t be able to absorb the shock. During the worst modern pandemic (1918 flu), most everyone had enough food and water. I seriously doubt that you couldn’t reach a grocery store. The idea here is NOT that there will be shortages. The idea is that you will want to stay home because you are sick or reduce your exposure because others are sick.. Some ideas for stuff to have on hand:
A bottle of acetaminophen or ibuprofen
Sick foods (e.g., 1-2 chicken noodle soup cans on your grocery trip each week)
Ingredients to make an oral hydration solution (6 level teaspoons of sugar and 1/2 level teaspoon of salt dissolved in 1 liter of clean water). This is better and more hydrating than Gatorade.
Bleach or other cleaning wipes
If you are on prescription medications, it may be wise to get a few month’s worth extra. This will help you avoid potentially long lines of sick people at the pharmacy later.
Consider planning how you would care for someone who is sick at home. If hospitals were to become overwhelmed, the best and most comfortable care will be provided in our homes. What would you need? How might you reorganize your living space to minimize the probability of others becoming ill too? These guidelines are for people who are providing home care to COVID-19 cases, but it’s also good practice for preventing transmission of illnesses generally.
Suggest cross-training to your boss at work to mitigate absenteeism and ensure smooth operations. Make a plan to work/meet remotely. If you are in food service, ask your employer about policies to prevent people from feeling pressure to come in while ill.
Here are some other questions that I have been asked recently:
The president says the risk of coronavirus is low. Where do I get up-to-date information about this? A daily risk assessment about COVID-19 is available at this link. You can find a general list of CDC FAQs here.
How many cases are there and where are they? You can check this semi-real time map, which is run by the Center for Systems Science and Engineering at JHU.
Hand sanitizer or soap/water? Both work. Hand washing is usually better. Get hand sanitizer that’s ≥ 60% (CDC).
Is this as big of deal as the media is making it? Here are the numbers: since Oct. 2019, there’ve been 32-45 million cases and 18-46 thousand deaths from the flu in the USA. In comparison (as of 3/7/20) there have been ~106,000 cases and ~3,600 deaths from COVID-19 globally (429 cases and 17 deaths in the USA). HOWEVER, COVID-19 is new. There’s no vaccine, no stockpile of pre-made tests, and no one knows what to expect (How easily will it spread? Who is susceptible? How deadly/serious will it be?). At this speed, the health system will become overburdened quickly so we need to intervene to slow it (link, page 18). That’s why it’s a “big deal.”
- How deadly is COVID-19? Unknown. People want to guess though. For instance, if we divide the number of COVID-19 deaths in China by the total number of cases in China on February 26 (Report), then 3.5% of people infected with COVID-19 have died. The death rate is, on average, likely lower. E.g., China may not have detected mild cases because they didn’t go to the hospital. China may have also been unable to offer sufficient care, which could have led to excess death. The WHO released A Report showing death rates increasing with age. Not enough info for an exact number yet
- Do I need a mask? No. The CDC does not recommend facemasks to protect against respiratory diseases for well individuals. Masks cannot prevent COVID-19 from infecting you via your eyes or from touching infected objects. You may also accidentally touch your face MORE with a mask. Respirators like the N95 mask should be reserved for healthcare providers (who would also use eye protection). Surgical masks should be reserved for sick people, to prevent them from coughing and sneezing on others. This is because “the primary purpose of a surgical mask is to help prevent biological particles from being expelled by the wearer into the environment” (3M)
- Should we close all the schools? Should I travel? It depends on who you ask. Per Dr. Lessler, the disease “is likely [to] become endemic, and most of us will get infected. But one question is super important: How long will it take for that to happen? If it happens in a few months, every hospital will be overwhelmed and people will not be treated... However, if we do our best ... [to] practice social distancing, reduce travel, not go to work when we’re sick, [then] we could slow the spread of the disease.” Basically, if you opt out of traveling/events, then we can slow the disease from spreading. Per Dr. Nuzzo (2:51), it depends on risk aversion. If you are immunocompromised/elderly or living with someone who is, then you may not want to travel/gather unnecessarily. Also consider the healthcare system where you’re traveling — can they care for you if you are sick? Will you be able to realistically stay quarantined and afford it there for 2 weeks?
- What are the early symptoms? Fever, cough, shortness of breath (More). Coronavirus impacts the lower (vs. upper) respiratory system, so runny nose or sore throat are likely to be another illness. At first, it just feels like you’re coming down with something though.
- What should I do if I have those symptoms? If you show early signs of illness, then call your doctor's office so they can prepare to care for and assess you. They will use These Guidelines to determine if they should test you. But do NOT go straight to the emergency room or urgent care. You might infect others. Unfortunately, there is no treatment for COVID-19. Also, I’m not a doctor. If you want what the professionals are reading, here are the interim Clinical Guidelines from the World Health Organization.
- Should I drink elderberry syrup to boost my immune system? If you’re considering elderberry as an antiviral, please consult your doctor. Elderberries aren't for everyone.
- What’s “community spread” and why are we concerned about it? Originally, all cases in the USA had a known origin. For instance, at first, most people with COVID-19 were either in China or exposed to someone who was in China. “Community spread” means that the new case of COVID-19 resulted from an unspecified chain of people (traveler to china >> nurse >> other patient >> patient’s visitor >> people at their school). In other words, the new case was caused by an existing case in the USA.
- Why didn’t the USA test people earlier? Since this is a new virus, the CDC has had to make their tests from scratch. To check the tests were accurate, the CDC used them on samples they knew did NOT have COVID-19. Unfortunately, those tests Erroneously came back positive. In short, the tests weren’t working correctly. So, the CDC had narrow guidelines for who to test. The CDC is now allowing states to make their own. The CDC also relaxed The Criteria needed for a test: you don’t need to have traveled to an at-risk area or been exposed. BUT your symptoms must require hospitalization.
- What will happen now that the CDC is allowing states to make their own tests for COVID-19? We will test more people. As a result, I’m guessing you will see a large spike of cases in the USA. Not because there was a true, sudden surge of new cases. But rather, when you look harder for something, you will find it.
- Why are people with COVID-19 supposed to avoid pets and other animals? COVID-19 and many other “novel diseases” (e.g., Ebola and swine flu) are the result of a sick animal transmitting to a human. If a pet gets COVID-19, there’s a possibility the pet could then transmit the disease onward. COVID-19 could also mutate in that pet to make a new disease. Both are pretty far fetched, but the CDC is advising Extra Caution.
- Who are you and why are you suddenly an expert? Howdy! My name is Brooke Jarrett. I’m a PhD student at the Johns Hopkins School of Public Health. I study Infectious Disease Epi. I am not an expert on respiratory diseases. I’ve just studied public health for 4.5 years. I was inspired to collect this basic information to help my grandma consolidate what she heard on the news. This letter was heavily modeled after This Article and links throughout. I even stole sentences, word-for-word. My main concern is providing accurate, timely info to people whom I love. I thought plagiarism was justified.
- Where are you getting your information? The CDC, The Coronavirus Expert Reality Check, and The Hopkins Center For Health Security (and this Guy)
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