What you need to know about the Coronavirus

The following public service announcement was circulated by Bro. Jordan Barnett, M.D. — Emergency Physician at Lourdes Medical Center of Burlington County, and Medical Director of Mt. Laurel Emergency Medical Services (EMS) and member of Lodge No. 2 — in regards to how the general public can better prepare itself for the impact of the SARS-CoV-2/COVID-19 pandemic. If you have any questions, comments or concerns regarding the coronavirus, feel free to reach out to Bro. Barnett via e-mail at jordbarnet@me.com or via his cell at (856) 889-6682.

Please take the time to review the following points in an effort to mitigate the effects of the SARS-CoV-2/COVID-19 pandemic:

WHAT IS IT?

So, let’s start with science. There are many, many coronaviruses that generally infect animals and occasionally humans.  This particular coronavirus is “novel”, i.e. not seen before.  It shares genetic similarity with coronaviruses sometimes carried in pangolins and bats.  It is very likely that the current coronavirus mutated from an animal coronavirus. The taxonomically correct name of the viral strain currently circulating worldwide is SARS-CoV-2, as the virus closely resembles SARS.  When you get infected with this virus, you have COVID-19, so named because the strain emerged in 2019.  These names are chosen carefully to avoid stigma or association with a geographic region, as it is increasingly clear this will become a worldwide issue in the coming months.  For many years, virologists have predicted  that a virus like this would emerge at some point, it was only a matter of time.  And here we are.  It is not a Chinese bioterror weapon that was accidentally or purposely released, bioterrorism weapons are far more lethal.  It has nothing to do with the beer.  It is not a Democratic hoax.  It is very real. 

HOW WILL IT AFFECT US?

However, it is also not a reason to panic.  Although a lot of us will contract SARS-CoV-2.  The vast majority of people will get a cold like illness, with fever and a cough.  An interesting finding based on the WHO data out of China: If you have cold like symptoms and a RUNNY NOSE, rejoice. It is likely NOT COVID-19. 

Kids and teens under 20 years old based on WHO report from China seem largely spared this disease, with very few COVID-19 infections noted in this age group. The WHO reports that exactly zero kids under 10 years old have died in China from COVID-19, and deaths are extremely rare under the age of 20.  Pregnant females also do not seem to get sick in large numbers.  The group of people that DO seem to get sick from this disease are people over the age of 30, and illness severity and mortality goes up as age increases.  This is not, however, the zombie apocalypse.  In the very highest risk group age of over 80 with multiple medical issues, you are still going to make it, more then 4 times out of 5.  

WHAT SHOULD WE DO?

If you are an adult and certainly a senior >65 years old, it is wise to take precautions and measures to avoid contact with large groups of people over the next few months as this virus circulates. Now is NOT the time to go to the gym, movies, concerts, lectures or conferences or large family reunions, if it can be helped. Consider delaying travel plans if any.  I know it’s not ecologically friendly, but consider getting as much delivered to your home as possible, especially if you are >65 years old.  Groceries, drugstore items, etc.  Maybe ask a younger person in your family to bring you groceries or do your other shopping. Remind them of the generous amounts of cash you placed in their birthday cards when they were little.  It’s payback time. 

Build up your immune system with fresh fruit, veggies, antioxidants and other immune boosters. Cut back on or stop drinking alcohol.  Stop smoking. Yes, that includes not using marijuana, vape pens and e-cigarettes.  Get some fresh air,  but in your backyard,  away from other people.  Get your blood glucose under control if you are a diabetic. Take your medications regularly and stick to a cardiac diet if you are a cardiac patient.  Exercise at home. There are lots of great downloadable exercise videos. 

Surgical masks unfortunately are not protective. They may help decrease the amount of times you touch your face and mouth,  which can help prevent the virus from entering into your body, but the virus particles are small enough to pass through even N95 masks.  Surgical masks are not a bad idea to wear if you are one of those people who when they get sick, feel the need to spew their cough everywhere, instead of (properly) coughing into your elbow, Dracula style. Surgical masks can help to reduce droplet transmission to other people around you when you cough or sneeze.  They protect others FROM you, not you FROM others. The main thing that will prevent transmission is washing your hands and not touching your mouth and nose.  Let me say that again.  Washing your hands and not touching your nose and mouth are the most effective ways to prevent getting and spreading this virus.

Please save the N95 masks for those of us who work at hospitals, who will be exposed to this virus again and again and again in the coming months. N95’s may afford some protection to decrease viral spread, but are far from a magic shield. They only filter down to 5 µm. This virus is about 1 µm. 

PROTECT OTHERS:

If you are under the age of 65, it is your job to protect seniors. The best way to do that is to prevent transmission and spread. None of our bodies have ever seen this virus before, so none of us have any immunity. Generally when cold viruses move through any given community, there are some people who have immunity to them from having seen something similar to that strain before. This is not the case with SARS-CoV-2.  If you get a cough, fatigue and fever  in the coming months, congratulations. You probably have COVID-19.  Post about it on social media, elicit sympathy from your friends, but sharing is not caring.  Do not cough on your family members. Do not go out in public unless you absolutely have to.  Stay away from public transport. Work remotely from home if possible. Wipe down doorknobs and handles and surfaces in your home with bleach or alcohol solutions or wipes to prevent spread to those you live with.  Cover your cough, wash your hands multiple times per day, use hand sanitizer if you are out and about. But you shouldn’t be out and about.  

Keep your kids home from school if they become sick. Children are perfect little vectors, and can smear virus everywhere.  It’s interesting, unlike with other viral illnesses, that kids under 20 do not seem to get infected with COVID-19 for the most part.  Anticipate school closures. This is not to protect children, but rather to reduce the spread of the virus.  

Along that vein, if you do get sick,  it may last for a while.  Those with mild symptoms are usually better after 2-3 weeks, but those with more severe infections may be sick up to 4-6 weeks. Stock up now on a good quality oral thermometer, lots of fever reducers like acetaminophen and ibuprofen, teas, chicken soup, whatever you use to make yourself feel better when you are ill. You don’t want to be going out to shop for these items when you are already sick.

If you are under the age of 65 and get mild symptoms, and you are just idly curious to see if you are infected with SARS-COV-2, that is not in itself a good reason to come to the emergency department (ED) or your doctor’s office.  If you have a fever and mild cold like illness, you probably have this virus.  Millions and millions of people in the US will eventually turn COVID-19 positive.  You know what?  Unless you are really sick, or public health is trying to do contact tracing,  or the government decides to do large scale testing to prevent spread, there is no reason to prove that it is a COVID-19 infection versus the flu or a cold.  We have little to offer in the way of effective treatment for any of those things.  I know it’s hard to hear, but you will not be unique in your situation.  This is bigger than any of us.  

WHEN TO SEEK MEDICAL ATTENTION:

HOWEVER If you develop fever, cough AND severe shortness of breath, please consider evaluation by a medical professional. You may need something like intubation (ventilator, breathing machine) or concentrated oxygen to get oxygen into you. If you do get sick enough to need oxygen or a ventilator to support your breathing, expect to be in the hospital for several weeks before you recover.  

If you think you have a severe COVID-19 infection and are planning to go to the hospital, it would be great if you or someone with you could alert the ED or the advice nurse or your doctors office that you are coming in.  A heads up would be great. We may want to bring you in a separate entrance or into a tent or other area so you don’t spread the virus to patients in the hospital that are elderly or have little to no immune systems from disease, cancer, etc.  

Hospitals are going to try their best to prevent spread in the hospital, but SARS-Cov-2 is crazy contagious.  When you are in the hospital and have a cough, THAT’S the time to wash your hands or use hand sanitizer.  If you see a sink or sanitizer dispenser, use it!  That’s what they are there for.  And please wear a surgical mask.  Over your nose and mouth. Masks aren’t chin decorations. Keep a clean, properly positioned mask on the whole time you are in the hospital if you are sick.  No cheating.  I’ll be doing everything I can to prevent the spread of this virus.  I ask that you do the same.

GET READY TO WAIT:

In the ED, we will be doing lots to decontaminate and work to decontaminate the things we touch regularly.  Please be patient, as there may be unusual delays as we work to care for patients and prevent spread of this virus.  Lots of smart committed people are working on ways to prevent the spread of this new disease.  This is a virus we haven’t ever encountered before. The information we have about SARS-CoV-2  is evolving and could change. 

GET RELIABLE INFORMATION: 

Questions or concerns? The Centers for Disease Control (CDC) has some great resources. The World Health Organization (WHO) has some great info as well.  Johns Hopkins University has a good live tracker so you can see if cases are increasing in your area.

We are all in this together.  Let’s all take good care of ourselves and each other.

For additional resources pertaining to the SARS-COV-2/COVID-19 pandemic, consult the following videos:

Forest W. Arnold, D.O., M.Sc., FIDSA, Associate Professor of Medicine and Hospital Epidemiologist, University of Louisville Health System provides an overview of the Coronavirus pandemic.

Bro. Jordan Barnett, M.D., is interviewed on The Corey Jones Show where he provides a summary of the Coronavirus outbreak (starting at 18:20) and what to expect in the coming days, weeks and months.