Illness and viruses are on everyone’s mind right now, so I wanted to offer some perspective on the situation. There are a lot of trusted resources (the CDC, physician-led organizations), so try to stick to those and stay away from scripts that feel fear-based or overly dramatized. Given what I know about the corona virus circulating today (COVID-19), here are some thoughts and answers to questions that I am getting.
Why is this such a thing? Corona viruses are not new, but this strain is behaving slightly differently than others. The numbers are still very low and flu is much more of a public health concern given the numbers and morbidity/mortality, so we still need to keep that in mind. (The good news is when you take measures to protect yourself against COVID-19, you also protect yourself from the flu.) The reported mortality associated with this coronavirus is a bit higher though (2% vs 0.2%), BUT I firmly believe that we are currently looking at skewed numbers given that those numbers when applied to the US. Those numbers are worldwide (so reflect the living conditions and medical systems of other countries) and there are very likely many mild cases that are not included in that data. The numbers do reflect common trends in that the immunocompromised, very young and elderly are the most susceptible to the severe cases.
Transmission The virus is transmitted through droplets. This means the risk of getting the virus by inhaling air that those infected exhale is not the issue. Unless someone coughs or sneezes into another’s nose/mouth (not likely), infection is taking place via surface transmission. When you cough and sneeze, you transmit droplets that contain the virus and those land on surfaces. You touch those surfaces and then have contact with mucous membranes (eyes, nose, mouth). SO masks are primarily meant to keep those infected from spreading their droplets around for you to touch and eventually make their way to your mouth/nose/eyes. Masks among the lay public have been shown to increase your risk because you actually are more likely to be touching your face with the mask on. I know this is hard to wrap our heads around because we all think that we don’t touch our eyes, nose and mouth with our hands but WE DO (about 90 times a day studies show)! Masks worn by healthcare professionals who are working in close proximity to the body fluids of infected people and know how to properly use them are a different issue.
Prevention So given the situation in total, what am I doing/recommending for prevention at this stage?
Wash your hands of course. Soap and water multiple times per day and definitely after using the restroom, before and after eating, when you know you’ve touched your face, after you've been in public, upon entering your house, etc.. Hand sanitizer (alcohol-based and greater than 60%) is helpful on the road as well. My kids have a supply and know when to use it and how to wash their hands. I have hand sanitizer at the dinner table and the entrances to the house.
No handshaking. Fist bumps, a pat on the back, but no need for your palms/fingers to touch anything you don’t need to.
Disinfectant wipes and sprays. Worth wiping down anything you have to come in contact with in the public domain or not touching it with your hand (use disposable tissues). Think gasoline pump handles, grocery carts, door knobs, elevator buttons, light switches...use knuckles if possible or hips/feet...get creative, but don’t fall. : )
No matter what you have (cold, virus, allergies), your cough and sneeze spread your personal germs to the world so do your best to keep them to yourself. Even better than coughing into your sleeve (which can harbor droplets for later contact to other surfaces), cough into a disposable tissue if possible. Do cough closely into your sleeve, down your shirt, into a scarf if needed though. Consider taking off your “day clothes” when you get home. Wash your clothes after one wear.
Exposure - Well I am an introvert, so this is easy for me. This is not a time to hunker down and panic, but I am thinking similarly to when I did when my babies were newborns. I am not panicked, but I don’t have a strong desire to spend the day at the mall, go to parties where I don’t know a lot of people, go to the movies, go on nonessential travel, etc.. My kids are still going to school and will continue to do so unless exposure risk increases. If I see someone who is ill, I try to keep my distance.
Supplements - There is good data on certain supplements that decrease transmission and help with treatment. My family is taking a supplement daily that contains zinc, echinacea, elderberry, Vitamin C and Vitamin C among a few others. At any sign of cold/flu symptoms we increase the dose. (Let me know if you want more specific recommendations.)
Immune support - more powerful than supplements are the basics. SLEEP - I am the sleep police in my home. WATER - hydration is key to prevention and treatment. DE-STRESS - You know it, but I know it’s hard to check sometimes. If you panic and worry, you are MORE LIKELY TO GET SICK. It’s a biological fact.
Treatment Resting at home, sleeping more, increasing hydration (liquids that do not contain caffeine, excessive sugar or alcohol), controlling fever with over the counter remedies, humidifier/diffuser with eucalyptus, Bergamot and tea tree oil, supplements listed above are all helpful. Even though you are meant to rest, “getting the blood/lymph pumping” is helpful too...intentionally taking deep breaths, massage, hot shower, walking around, stretching, ankle circles, a few jumping jacks every hour is a good thing for multiple reasons.
Seek attention if you are having difficulty breathing, shortness of breath, severe chest pain, severe stomach pain, severe or persistent vomiting or diarrhea, sudden, severe dizziness or ongoing dizzy spells.
If you are sick, please stay home! I talk to people everyday who “can’t afford to miss work.” I don’t know what that means sometimes. Financially, if you can’t afford to miss a few days of work to help you recover and decrease spread to others, then you need to reevaluate your life choices and make sure they are in alignment with building an emergency fund. If your child is sick and you don’t have childcare or can’t stay home with them, same thing. Time to reevaluate life choices. If you think you are too irreplaceable in your job or you will be harassed by your boss for missing, same thing. Reevaluate. Even within your own home, try to stick to one room, not touch things as much as possible, cover your mouth/nose, etc..
If you have to go out and you are sick (fever and respiratory symptoms): First step is to think, do you really need to go out? Can someone else go for you? You pretty much should only be going to the doctor in my opinion. If this is the case, call first. You may be able to be triaged over the phone or they may have special instructions for you when you get there. If you haven’t gotten special instructions when you get there, stay in the car and let your driver go in and ask what you should do first. If you have a fever and respiratory symptoms, you should have your face covered at all times (mask, scarf). You should have tissues and hand sanitizer with you. You should try not to touch anything.
Let me know what questions you have!
Best,
Dr. Paige
