PREVENTION – How do we protect ourselves?
COVER UP – SOMETHING IS BETTER THAN NOTHING
KEEP WASHING THOSE HANDS.
KEEP WASHING THOSE HANDS.
The main way coronovirus is spread is through droplets from coughs and sneezes from an infected person. They have found that it can hang in the air from being aerosolized but we don’t know if that is just from medical procedures or if it is in the community that way. The absolute best we can do now is continue to self-isolate ourselves and our families. Keep your face covered when you are out and about, if you are working with people (supermarket, seeing patients, etc), when you are with people, and when you are with a sick person.
- The single most important thing now is social/physical distancing – keeping people at 6-10 feet away from you when you are out and about – if you both stretch out your arms, your fingertips should be at least one foot apart. Limit trips out of your house to essentials only. It is ok to hike or walk outside so long as you are not driving far to do it and don’t go with more than one other person. Never shake hands; acknowledge people with a nod, a namaste, or a wave. Don’t allow others in your house unnecessarily. In New Mexico, we are now limited to gatherings of a maximum of two people outdoors.
- Second most important is to wash our hands frequently or use an alcohol-based hand sanitizer. (Wash your phone and your glasses every time you wash your hands.)This is because the virus is spread by droplets and things we touch and it has a fatty envelope which is broken down by good old soap and water, or alcohol. Wash hands for 20 seconds (the time it takes to sing Happy Birthday slowly to Elizabeth Ortiz y Pino!) Rub every surface of your hands including the backs and between your fingers, rub the tips of your fingers on your your palms and grab and rub each thumb. Avoid touching your eyes, nose and mouth. This is easier said than done. We touch our faces more than 90 times a day. Face masks/coverings and glasses help you to avoid touching these areas especially when out. Clean surfaces that you regularly touch both at home and work. Clean your computer keyboard and mouse. Wash your phone and glasses regularly. Have family members wash their hands as soon as they enter your home. Quarantine your mail and parcels and shopping for several days or clean it when it enters your house – include your car keys in this.
- Third – Wear face covering when you are in public or with other people. You can make your own masks from common materials around your home that are between half and almost as effective as a surgical mask. Better if you can get the fit right. The WHO does not recommend medical masks because of the global shortage for medical personnel on the front lines. Homemade masks made of hundred percent cotton T-shirt and or pillow case seem to be the best so long as they fit well. You have to take into account breathability as well as effectiveness of filtering out virus. One study says diy masks can filter about 57% of the virus out of the air if it’s being shot directly at the material. The duckbill pattern is good, but you can also make a simple pattern like a surgical mask with pleats. Just make sure it’s sealed all the way around your face and sew in a paper clip for the nose area so that you can bend it around your nose. Find a simple Pattern here.Use one of these best materials for a diy facemask. There are a couple of simple no-sew designs out there too. If you need a face shield, use a plastic page protector for a three ring binder with elastic.
- Stay Informed.
Use this WHO daily update site for daily world reports – https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports/
Use this site for USA cases by state and by county in some states https://www.livescience.com/coronavirus-updates-united-states.html or the John Hopkins Coronavirus Dashboard at https://www.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6. If you click on the US in the left column then change the lower Admin0 to Admin1 you can see data by state.
Check the NM Dept of Health website daily for NM data, updated restrictions and timely info https://cv.nmhealth.org/
BACKGROUND – Some Background about Coronavirus
Coronavirus (2019-nCoV) and the disease COVID-19 has reached many countries including the United States, and has reached New Mexico. The number of cases in China is decreasing which is implying that with good management it could be a three-four month cycle but we should be prepared for longer.
Here is some basic information gleaned from the US Center for Disease Control (CDC), the World Health Organization (WHO), the American Public Health Association (APHA), the NM Dept of Health, as well as The Guardian newspaper and LiveScience websites.
Starts like a common cold, then:
Fever, Dry Cough, Shortness of breath,
Can have cold-like symptoms. Can progress into life threatening pneumonia.
Other symptoms can include: chills, aches, runny nose, diarrhea, nausea and vomiting, fatigue, loss of sense of smell, sore throat, severe headache.
80% of people have mild symptoms, Children tend to have mild symptoms altho they are at risk of a severe immune response that can be fatal. People most at risk are the over 60s, with the risk doubling for each decade above age 60, those with underlying respiratory conditions (COPD, emphysema) or other chronic conditions (diabetes, heart disease, cancer) – so that includes a very high proportion of us at CAA – both patients and staff! Pregnancy doesnt seem to pose any extra risk. Cats and the cat family (lions, tigers) can get COVID – we don’t yet know if humans can catch it from cats. If someone pets your dog it could theoretically be passed to you but there is no known case yet of dog to human. Either way I would keep my pets inside or under my control. Young people are not immune. Both here in the USA and in Italy, 35% of the intensive care patients are under the age of 40. Young people are just less likely to die from COVID, they are catching it at the same rates as others, but we do not yet know what the long-term effects of having COVID-19 are.
Coronavirus is concerning because of the death rate. You may have heard that more people die of flu every year, which is true, however, the death rate from this coronavirus is high – 3-20 people in 100 positive cases die. By contrast,13 people in 10,000 die of the flu. We are not yet certain of the death rate by population for COVID and won’t be until this is all over. Also, although the WHO and others are working on a vaccine and treatment, there is currently no coronavirus vaccine, whereas there is for the flu.
How is it spread?
Almost always through close contact with a sick person. The virus is spread via droplets from coughing, sneezing, or talking. Some think it can hang in the air (aerosol) for up to 3 hours – but this is not clear whether it aerosolizes through medical procedures or can happen by coughing or talking. It can be caught sometimes through droplets landing on surfaces, a person touches the surface then their nose, mouth or eyes. The virus only enters through one of these routes (nose, mouth or eyes). Most commonly though it is caught through someone coughing or sneezing near you or you are in close contact with someone with COVID according to the CDC and the WHO.
It is not known how long it survives on surfaces – it could be from a few hours to a few days., what I have read recently says from 2-3 hours up to 3-9 days! Quite a range. Recent tests from the cruise ship that had lots of cases showed fragments of virus at 17 days, however they may not have been viable (alive). It survives longer on hard surfaces than soft ones – perhaps because paper or fabric dry it out. So, lets just assume it is everywhere. Quarantine anything that comes into your house, mail, packages, your son’s basketball, for one to two days. Cleaning with soap and water, spraying with 70% alcohol are good ways of dealing with anything that comes into your house. Disinfecting surfaces with disinfectant after cleaning with soap and water will kill the virus. Disinfectants that work are; Bleach (5 tablespoons in a gallon water or 4 teaspoons in a quart); Ethyl or rubbing alcohol (60-90% in water – check the bottle to see starting % then use math!); Hydrogen peroxide (3% is how you can commonly buy it. Use it straight and leave on surface for 6-8 minutes). Disinfectants are recommended if you are living with a person positive for COVID-19
The incubation period is commonly found to be between 1-14 days – typically 5 days. This is the time when a person has no symptoms and doesn’t know they have it. Some people never know that they have it. It is possible that you can continue shedding virus after symptoms are gone, but right now for people who are sick the CDC recommend that you can stop isolating 3 days after you have no fever (without medication) and your other symptoms are improving.
There is no treatment for coronavirus, just rest and take care of yourself. Most people (80%) have mild symptoms to severe flu-like symptoms. If you get short of breath, contact your healthcare provider immediately. Serious infections are treated using support measures at hospitals. The WHO and other organizations are testing Western and traditional medicines to see if they will help. Antibiotics do not help because this is a virus. About 16% will need to be hospitalized and about 5% will need to go into intensive care usually on a ventilator.
When to Self-isolate?
To avoid the spread to others self-isolate in your home for 14 days when indicated! (So be prepared with food, water and things to amuse yourself now.) These are current NM department of health recommendations
- when exposed to a person with a COVID-19 positive test, or who is sick with COVID-19
- when traveling from a high risk area – pretty much anywhere out of state at the moment – https://cv.nmhealth.org/
- When traveling by plane
- when you have cold or flu symptoms or high fever before having a negative test.
When to wear a mask?
WHO suggest only those who are sick or are caring for the sick should wear masks due to there being a shortage for medical personnel. However, recently the CDC recommended that everyone wear a face covering when out in public as well as social distancing. NM mandates that we wear face coverings in public. Masks do help us not to touch our faces, they also prevent the spread of disease by asymptomatic people, and they will prevent 50-90% of the virus getting to you depending on the material and whether the mask is well fitted to your face. A bandana or balaclava would do that as well but it might scare people. If you use a mask when you are out and about, throw it away or directly into the wash if someone coughed on you and don’t touch the outside of it. Have 4-5 face coverings and wash them after use. You cannot wash surgical masks as they will no longer work.
What if I am sick?
If you have any of the virus symptoms – fever, dry cough, shortness of breath – call into your doctors, don’t go in person, and they will direct you where to go. Do not go into any medical facility without being instructed to. You can also call the NM coronavirus info hotline at 855 600 3453.
Should I get tested?
You should get tested if you have a fever of over 100 degrees, and a cough, and shortness of breath (difficulty breathing). If you have been exposed to a COVID-19 positive person, you should get tested. The NM Dept of Health is also encouraging the following to get tested: people who live or work in long-term care, homeless shelters, jails, prisons or other institutional settings; people who are working with the public; health care workers
What does Flattening the Curve mean?
Approximately 40-70% of people are expected to get the virus unless we get a vaccination before then. What health departments and governments are trying to do with isolation and other social restrictions is slow down the number of cases so that the number of people who need hospitalizing does not overwhelm the healthcare system. If they keep the number of serious cases lower, even if they are spread out over a longer period of time, the hospitals will be able to cope and the death rate will be much lower. Examples of countries where the healthcare system is overwhelmed include Italy (13% death rate) Spain and UK (20%). By contrast, two countries that enacted an immediate and efficient response to the pandemic, both South Korea and Germany have a death rate of less than 1.5%. Anything over 5% shows the healthcare system is becoming overwhelmed.
Strengthen our Immune Systems
This is somewhat of a concerning thought – so the next question is what can we do? Remembering that 80-84% of the cases will not need hospitalization and will have something like a bad bout of the flu – we should do everything that we would normally do to strengthen/balance our immune systems so that we get a mild version – that includes not getting stressed or panicky – I know that is hard at the moment. If you take vitamin C in flu season or other supplements, go ahead and take them now or when you feel vulnerable – remembering that this is for the long haul. You can use acupressure or acupuncture to balance your immune system. Continue to practice excellent hygiene and be super careful whatever risk group you are in. More techniques here.
What do I do if someone in my house is sick with COVID-19 or the flu?
First, we are sorry. Then follow the CDC guidelines for living with a person with COVID-19 and also caring for yourself if you get sick. Isolate the person in your house with a separate bathroom if possible. Disinfect after use. Everyone should wear masks and if you can get an N95 mask for when you are in direct contact with the sick person, that is the safest. Make sure it fits tightly, wear goggles or a face shield and change your clothes after being in the room. Learn how to take off gowns and protective gear.
Should I cancel my social groups?
As of 3/26 numbers were doubling every two to three days. Due to social distancing methods we have slowed our doubling rate down to 34 days (as of 6/15/20)! The concern now comes with reopening. We still don’t have a treatment or a vaccination, so further spikes will happen if we do not continue to limit our contact with others. Along with exponential growth (doubling), another of the hardest concepts to get across to people is that of networks. Even if you do not leave your house, if your son goes over to his girlfriend’s house where her mother works as a counselor and sees 8 people a day, it does not take long before with those people’s contacts you have reached several hundred contacts in a few days. However, we need to balance our mental health needs. Two or more months alone is very hard on us humans who are wired to be social animals. Right now (June) the weather still permits us to be outside in the mornings or evenings. So meeting friends for a walk, or in the backyard, while wearing face coverings and staying at least 6 feet apart, is probably our best solution at the moment.