The internet and 24 hour news cycle provide us with non-stop information. That can be a wonderful thing. It can be a terrible thing as well. We are now inundated with messaging about coronavirus and its associated disease, COVID-19. Much of this information is very anxiety provoking.
The medical community is constantly collecting and sharing information about coronavirus. Because it’s a new strain of an old virus, it is still being evaluated and best practices are still developing as data is collected in the US and around the world.
Still, there are essential things about coronavirus that citizens should know.
1. Coronavirus can cause a wide variety of symptoms. Most commonly it seems to cause fever, dry cough and in more severe cases, shortness of breath. Some patients may show signs of intestinal upset early in their illness.
2. It appears that it takes 2-14 days to develop symptoms after exposure. This is referred to as the “incubation period.” It also seems that a significant number of people may be exposed and carry the virus but have no symptoms at all. These are “asymptomatic carriers.” It’s hard to track them since most people now being tested are already showing signs of sickness and those without symptoms aren’t being tested. In some cases, patients can be infected with both coronavirus and other illnesses, like influenza.
3. Testing is limited. In hospitals, testing depends on local capacities. In some instances, only those who are ill and being admitted are tested. Some states have drive-thru testing locations so that individuals can be tested without exposure to other patients. Frequently, the decision is being made to treat individuals as if they are infected without testing. This is because they don’t require hospitalization and no treatment is necessary at home except for symptom control. Before going to a physician about testing, call or check online to see what criteria are being used for testing due to the limited availability of the test for now.
4. The virus appears to spread by droplet; that is, people sneeze or cough and the respiratory secretions come out in either “droplets” or “aerosols.” A droplet is larger and falls more easily to the ground, while an aerosol stays in the air longer, possibly for several hours. Persons should cough or sneeze into tissues or their elbow but should not cover their cough or sneeze with their hands. On surfaces, the virus can persist for hours to days (depending on the surface material), so it’s possible to become infected either by exposure to droplets from people or on surfaces. A person becomes infected when they get those droplets directly in their eyes, nose or mouth or are inhaled. This is why everyone is urged to wash hands with soap and water for twenty seconds, or use hand sanitizers with at least 60% alcohol, avoid touching their own faces and the faces of others. It is possible, but unclear, whether the virus is transmitted by blood or feces.
5. Because of the way it is spread, and the fact that so many carriers don’t have symptoms, the CDC and World Health Organization recommend “social distancing.” This means staying away from situations and places where other people might be carrying the virus. A good recommended distance for social distancing in public is six feet. A virus needs a host to reproduce. If it cannot move to other people, the virus will die in time. It is hoped that with enough isolation, the viral spread will stop. This is why restaurants, schools and other gathering places are being closed.
6. It is best to avoid visiting friends or relatives who are in assisted living or nursing home facilities since many of them are either of advanced age, or have illnesses making them more susceptible to severe sickness from coronavirus.
7. Some individuals will be exposed, or have mild illness, and need to be quarantined at home instead of in the hospital. They should stay in a separate room and, if possible, use a restroom, separate from others. They should wear a mask, wash hands frequently and should not share utensils or other personal items. It is advised to clean surfaces frequently. Guidelines for ending this quarantine are changing but most recommendations seem to suggest that two weeks is the recommended duration.
8. Unlike many diseases, there is no vaccine. However, at least one vaccine is in human trials right now. This happened with unprecedented speed and is a very hopeful development. However, it may still take one full year to go into production, so it can’t be counted on in the short term. Those who are sickest are hospitalized for “supportive” care, like oxygen and IV fluids. A smaller number go on to require intubation (a tube placed through the mouth into the trachea) and a ventilator to breathe for them. There are some other medical therapies being used and investigated, but there are no solid recommendations for any preventative treatment as yet. The virus-fighting benefits of vitamins C and D3 have been touted by some, but currently there is no quality evidence to show that they have any effect against the coronavirus. Remember that some of the best medical minds in the world, indeed in history, are working diligently on this problem
9. COVID-19 can affect persons of any age, but seems most severe in those age 65 and older. This group has the highest “case fatality rate,” meaning the percentage of people with the disease who die. It is also worse in those with what doctors call “comorbidities.” This means underlying medical problems such as heart disease, lung disease, diabetes, kidney disease and conditions that reduce their immunity like cancer or HIV infection. Individuals in these groups should be most diligent about limiting social contact. Their families should also be careful not to accidentally infect them, especially since many young people will carry the disease and have no symptoms.
10. It is best to avoid going to the emergency department, doctor’s office or hospital unless absolutely necessary. If a person feels that they should, and are not in immediate distress (with severe shortness of breath or chest pain, for instance), then it would be wise to call ahead and see if testing is available and if the facility is already overwhelmed with patients. If it is, other options may be suggested. In addition, if they agree to take you they may ask you to use a separate entrance or they may meet you outside the building so that other patients aren’t exposed to the virus. The concentration of infected persons will be greatest in those places. Even persons who think they have coronavirus should stay home unless they develop severe symptoms like shortness of breath. Over the counter medications are the mainstay for mild symptoms. It has been suggested, but not proven, that non-steroidal anti-inflammatories make symptoms worse. So drugs like ibuprofen and naproxen should be avoided in treating fever and aches. It appears acetaminophen is acceptable and safe in proper doses.
11. Stay in touch with primary care physicians and local health departments for guidance. Many health systems are offering tele-medicine consultations to help give patients advice. Some insurance programs offer access to this as well. There are private companies that offer telemedicine subscriptions also.
12. Grocery stores, gas stations and carry out restaurants will remain open. There is no need to hoard supplies as manufacturing will continue. Refilling existing prescriptions is a good idea. Likewise, for those in high risk groups, consider having groceries and prescriptions delivered or picked up and brought by friends or family.
It is important to remember a few things in a time like this. Humans focus on bad news, even when there is good news available. This may be something built into us so that we’re more careful. But it isn’t always helpful. Get sound information from sound sources. Organizations like the Centers for Disease Control and Prevention, the World Health Organization, and state health departments provide the best, most up-to-date information.
Happily, there are some shining lights to help us deal with our worry. It appears infections are going down in several countries, including China where it all started. Some viral illnesses are seasonal, so Spring weather may produce temperatures unfavorable to the virus, or may help because people are outside more, rather than bunched together inside.
It is also hopeful that many people are trying to do the right thing, rather than panicking. We are a civil, lawful society of people who care about one another in large part. Enormous medical and government resources are being brought to bear.
Everyone should use technology to see, or hear, online worship services and sermons. Social media can often do little more than inflame anxiety and misinformation; if it is entertaining or provides pleasant contact with loved ones, then it can be useful. Otherwise it would be better to turn off the computer or phone, exercise, clean the pantry, take a nap and talk to friends and family.
Finally, God is in control. We do not always understand these events. Especially when we lose a loved one to a disease, or when it affects our daily lives. But the word of God is clear; we should not worry. The Word says ‘who of you by worrying can add a day to his life?’ We could also say ‘who of you by worrying can control a virus?’ The God who sets our days also controls all things.
Coronavirus is a very real problem. But humanity has endured far worse; our ancestors certainly did, or we wouldn’t be here. Through wars, plagues, famines and assorted disasters, the Church, holy and universal, has endured and provided for those in need, both among her numbers and in the world at large.
So read the Word and pray. Care for family, friends and neighbors. Obey the law as we are called to do since it is for our safety and prosperity. And remember that there is nothing beyond the control of our Father. Not even viruses.
This will end. God speed that it may end soon.
Dr. Edwin Leap is a board-certified emergency physician, who lives and practices in rural South Carolina. He is also a columnist and blogger. Dr. Leap serves on the Physicians Resource Council of Focus on the Family.