COVID-19 Health Info Summary and What We Can Do

I found it incredibly helpful when a friend sent a summarized document with good sources about key information on COVID-19, so I thought I would do the same in case it is helpful for anyone.*

It has been tricky to filter through and find reliable information. However, after many days of intense investigation and the help of other people’s investigations, I was able to find some emerging themes of agreement by the majority of experts (as opposed to politicians and journalists) that I’ve compiled here. I am not an expert, and I have done my best to keep my opinion out of this and only repeat what experts have said.

While the situation continues to change, the trends tell a story of the seriousness of the situation due to the threat of overloading the health care system with the problems from this virus. Here’s my brief analysis looking at the charts from the JHU dashboard.

If you have come across better sources, contradicting information, other ways to help, or additional important information, please let me know so we can keep each other informed and wade through the good and bad information to make the best decisions for our families and communities.

Why we’re worried: Overload of hospitals due to the rapid spread and respiratory problems caused by this virus. (Leading to having to choose which patients will receive critical treatment and which will be left to luck, as they have had to do in Italy. (a))

What we need to do: Quarantine ourselves NOW and prepare to respond to increasing hospital overload – lack of personnel and lack of equipment (ventilators, oxygen, and PPE (masks and gloves) for health professionals). Note that this could last as short as two weeks, but more likely a month or more.

https://tincture.io/dispatch-5-from-the-front-lines-eb672f2f2988

But can’t we just quarantine affected areas?  – To some extent but not really. Why?

  • Symptoms can take more than a week to show up, so seemingly healthy people continue to infect others, and areas that seem to be free from cases could actually have cases.
  • The virus has spread to all 50 states rather than being contained in one or a few controllable areas, due to not being able to test and contain it early on. Since it’s too late to easily isolate it, a more extensive quarantine response is needed to control it.
  • We don’t have enough tests to do widespread testing and be able to isolate all existing clusters.

But do we really all have to stay at home in this draconian measure of isolation? -Well, yes, if we want to minimize the overload of hospitals and extra deaths caused by that overload.(a)

  • For the measure to work, a full quarantine is needed for at least a couple of weeks. At this stage in the spread of the virus, full quarantine is the only thing that has been shown to help slow the spread. (b)
  • Examples of how other countries have handled a late response (Europe’s weak restrictions) show that “the weaker the freeze, the more people die in overburdened hospitals — and the longer it ultimately takes for the economy to restart.” (b) At this point, limited restrictions don’t work and a nation-wide freeze is the only strategy that has been effective in slowing the increase in new cases. (Some Asian countries didn’t use the full country-wide quarantine, but they also acted early and contained the virus quickly. Unfortunately, the US has most likely long passed that window of opportunity.)

“If it were possible to wave a magic wand and make all Americans freeze in place for 14 days while sitting six feet apart, epidemiologists say, the whole epidemic would sputter to a halt. The virus would die out on every contaminated surface and, because almost everyone shows symptoms within two weeks, it would be evident who was infected. If we had enough tests for every American, even the completely asymptomatic cases could be found and isolated.

The crisis would be over.

Obviously, there is no magic wand, and no 300 million tests. But the goal of lockdowns and social distancing is to approximate such a total freeze.” (b)

“Active Cases 3-26”. Southeast Asia, while it used to be the epicenter of the epidemic, is controlling the spread, whereas Europe has exploded as the new epicenter. The US is currently following in Europe’s footsteps in terms of policy actions and rate of increase. https://coronavirus.jhu.edu/map.html

Personal Prevention (for the next few weeks to a month, at least):

  • Quarantine ourselves – practice physical distancing. Don’t visit others. Do video meetings, create social events over video.
  • Wash hands with soap and water often and keep surfaces disinfected. The virus can live on surfaces for up to 9 days.(c)
  • To get groceries (or go where there are other people) maintain 6 feet between people and wash hands with soap and water afterwards.
  • Don’t hug or shake hands with neighbors and those outside of your house – do the elbow bump or wave from a distance
  • Stay home if we are sick or vulnerable to get sick (ask for help and send someone else to do the purchases), (except for seeking medical attention if necessary).

 

What if I show symptoms or someone I know is does?
Most common symptoms of COVID-19: Fever, Dry cough, Difficulty breathing (c)

  • If you have these symptoms but they are not critical, the ideal thing is to get tested. The CDC is recommending that you stay at home (c) so as not to spread the virus and overwhelm hospitals. If you decide to recover at home, isolate yourself from others in your house to prevent spreading it to your family members. (How to isolate: https://hub.jhu.edu/2020/03/23/how-to-self-quarantine-self-isolate/) (Note that 70-80% of transmission in China occurred among families, so experts recommend isolation, as crappy as it sounds.) (b). HOWEVER, If you decide to seek medical care instead of staying at home, I personally think that’s a great idea for your own health, the health of your family, and also because getting tested can be helpful in tracking and controlling the virus.
  • Wash hands with soap and water often and keep surfaces disinfected. The virus can live on surfaces for up to 9 days(c)
  • Notify all those that you’ve been in contact with in the last 14 days so they can be sure to quarantine themselves and be extra careful not to spread the virus to others just in case they were exposed.
  • CDC says: Definitely seek medical care if you have these symptoms: Trouble breathing, persistent pain or pressure in the chest, new confusion or inability to arouse, bluish lips or face. (c)
  • You can check your symptoms here: https://c19check.com/terms-and-conditions

 

What if I was in contact with someone that tested positive

  • Symptoms appear 2-14 days after exposure (c)
  • Stay in isolation for 14 days, checking your temperature daily. “Finding and testing all the contacts of every positive case is essential, experts said. Contacts generally must remain home for 14 days and report their temperatures twice a day.” (b)

 

What can I do while I’m sitting at home in quarantine? Individual Action – what we need to (and can) do:

“In my experience, success is dependent on how much the public is informed and participates,” Admiral Ziemer said. “This truly is an ‘all hands on deck’ situation.” (b)

  • Help each other out, have a little more patience and compassion since we’re all going through crazy times
  • Do you happen to have nitrile gloves, hand sanitizer, surgical masks, or especially N-95 masks that could help protect a medical professional? Find a donation center here: https://getusppe.org/give/ and donate N95 masks here too https://www.projectn95.org/
https://getusppe.org/give/
  • Plan for a few months of economic disruption the best you can, and if you can, help those that are more vulnerable and those who can’t work from home and won’t be able to receive income during the quarantine.
  • Check for a “Virtual Tip Jar” in your area (google it for your area). Forward your payment to the handyman, keep paying your dog walker or cleaning person if you have one and are able.
  • Share ideas on how to help in meaningful and practical ways.
  • Be creative in connecting with family, friends, roommates, etc. whether it be virtually or those with whom you live. https://www.convers-ate.com/
  • Learn something new, practice singing and dancing, try yoga, try meditation, do home workouts to keep the blood (and endorphins) flowing.
  • Ask to your reps to prioritize health worker protection: https://p2a.co/LPxXH7j
  • If you’re into communicating with our representatives, here’s the experts’ thoughts on action at the national level:

Federal Intervention Necessary:

  • Coordinate an effort for the production of ventilators. “The roughly 175,000 ventilators in all American hospitals and the national stockpile are expected to be far fewer than are needed to handle a surge of patients desperate for breath.” (b)
  • Coordinate an effort for an increase in supply and delivery of oxygen. “The United States must also work to increase its supply of piped and tanked oxygen, Dr. Aylward said.” (b)
  • Coordinate a mass scale of training volunteers. “With training, volunteers were able to do some ground-level but crucial medical tasks, such as basic nursing, lab technician work or making sure that hospital rooms were correctly decontaminated. Americans often step forward to help neighbors affected by hurricanes and floods; many will no doubt do so in this outbreak, but they will need training in how not to fall ill and add to the problem.” (b)

“Federal intervention is necessary for some vital aspects of life during a pandemic. Only the federal government can enforce interstate commerce laws to ensure that food, water, electricity, gas, phone lines and other basic needs keep flowing across state lines to cities and suburbs.” (b)

 

-Footnotes-

*I found that finding reliable information on the COVID-19 situation is full time work, especially if one actually looks across the spectrum of sources (because unfortunately much of the information is politicized, some outdated, and some misleading.) Here’s the best readable source I found, in case you want to read a doctor’s perspective: https://tincture.io/dispatch-5-from-the-front-lines-eb672f2f2988

a. Situation in Italy: https://www.npr.org/2020/03/21/819645036/u-s-hospitals-prepare-guidelines-for-who-gets-care-amid-coronavirus-surge

https://www.nejm.org/doi/full/10.1056/NEJMp2005492

Text message received from a contact in Italy (Carlos, Wednesday, 25 March) (translated from Spanish): Here in Italy hospitals are overloaded and don’t have the PPE (masks, gloves, etc) for the hospital personnel, but every day they are mobilizing more to create space in hotels and other sites. The military has also helped build infrastructure for aid. Everything has been closed for 17 days and until April 3rd, though this timeline will probably be extended. Since yesterday, the number of deaths increased but the number of cases decreased. This week is the key week that will tell if the quarantine measures are working and if the decrease in the spread has started.

b. This is one of the best summaries (though still really long) of all the most common conclusions among reliable sources: https://www.nytimes.com/2020/03/22/health/coronavirus-restrictions-us.html

c. https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html

d. “As soon as possible, experts said, the United States must develop an alternative to the practice of isolating infected people at home, as it endangers families. In China, 75 to 80 percent of all transmission occurred in family clusters. Instead of a policy that advises the infected to remain at home, as the Centers for Disease and Prevention now does, experts said cities should establish facilities where the mildly and moderately ill can recuperate under the care and observation of nurses.” https://www.nytimes.com/2020/03/22/health/coronavirus-restrictions-us.html

 

Maps visualizing case numbers:

  1. https://coronavirus.jhu.edu/map.html (I find it more helpful to view the tab at the bottom of the map “actual cases” to see the current situation. In my opinion, the most important information is in the bottom, right hand corner, watching and comparing the “Daily Increase” of each country.
  2. https://www.nytimes.com/news-event/coronavirus

 

Note that Europe is now the epicenter and Asia is controlling the epidemic, with Italy and Spain our examples of the worst case scenarios. https://www.npr.org/sections/coronavirus-live-updates/2020/03/25/821370109/spains-coronavirus-death-toll-soars-past-china-s-trailing-only-italy

 

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