PLEASE NOTE, DUE TO MANY INCONSISTENCIES IN THE INFORMATION AVAILABLE ABOUT THE VIRUS (INCLUDING INFORMATION FROM THE OFFICIAL SOURCES AND FROM THE SCIENTIFIC STUDIES), I HAVE DECIDED NOT TO SHARE ANY ADDITIONAL DETAILS ABOUT THE VIRUS FOR THE TIME BEING.
THANK YOU FOR UNDERSTANDING!
IF YOU HAVE ANY SPECIFIC QUESTIONS, I AM STILL OFFERING INDIVIDUAL CONSULTATIONS:
THANK YOU FOR UNDERSTANDING!
IF YOU HAVE ANY SPECIFIC QUESTIONS, I AM STILL OFFERING INDIVIDUAL CONSULTATIONS:
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Dr. Maria Danilychev, MD
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WHERE DID THIS VIRUS COME FROM?
Up to date as of 04/14/2020.
There are many coronaviruses in nature, most cause infections in animals and humans (generally respiratory infections). This particular coronavirus is "novel" (new) caused the first outbreak of a respiratory infection in humans in December of 2019 in Wuhan, China.
It appears that this particular virus originally comes from bats, but now it is transmitted exclusively between humans. As far as whether or not humans have manipulated the virus, this part is uncertain.
There are many coronaviruses in nature, most cause infections in animals and humans (generally respiratory infections). This particular coronavirus is "novel" (new) caused the first outbreak of a respiratory infection in humans in December of 2019 in Wuhan, China.
It appears that this particular virus originally comes from bats, but now it is transmitted exclusively between humans. As far as whether or not humans have manipulated the virus, this part is uncertain.
WHAT'S THE DIFFERENCE BETWEEN COVID19, CORONAVIRUS, AND SARS-CoV-2?
Up to date as of 04/15/2020.
There are many different kinds of coronaviruses in nature.
This particular coronavirus is called “severe acute respiratory syndrome coronavirus 2” (SARS-CoV-2).
The disease that this virus causes is called “coronavirus disease 2019” (COVID-19)
Initially, this new virus was called "novel coronavirus 2019", and later on "COVID-19 virus', until the scientists gave it its current proper name. Also, you may have noticed that many people call the virus and the disease “coronavirus”, but the medical terms are SARS-CoV-2 and COVID-19 respectively.
Also, SARS that you may have heard about is a different virus (it is also a coronavirus, but it caused a different condition, was a lot more deadly, but did not spread as easily).
There are many different kinds of coronaviruses in nature.
This particular coronavirus is called “severe acute respiratory syndrome coronavirus 2” (SARS-CoV-2).
The disease that this virus causes is called “coronavirus disease 2019” (COVID-19)
Initially, this new virus was called "novel coronavirus 2019", and later on "COVID-19 virus', until the scientists gave it its current proper name. Also, you may have noticed that many people call the virus and the disease “coronavirus”, but the medical terms are SARS-CoV-2 and COVID-19 respectively.
Also, SARS that you may have heard about is a different virus (it is also a coronavirus, but it caused a different condition, was a lot more deadly, but did not spread as easily).
WHAT ARE THE SYMPTOMS?
Up to date as of 04/15/2020
This particular coronavirus generally causes respiratory symptoms and may result in a serious pneumonia; however, we are learning that symptoms may vary pretty widely.
Although according to WHO and the CDC the typical symptoms are fever, cough, shortness of breath, in reality it is more complicated than that. Many people only have a low grade fever in the beginning and may not have shortness of breath until they are sicker.
It appears from the published literature that the most common symptoms of COVID-19 are:
Other symptoms may also include:
Many other conditions may cause various combinations of the above symptoms, so please do not panic if you have some of them. Please consult a doctor for diagnosis. (Scroll down for information about testing.)
This particular coronavirus generally causes respiratory symptoms and may result in a serious pneumonia; however, we are learning that symptoms may vary pretty widely.
Although according to WHO and the CDC the typical symptoms are fever, cough, shortness of breath, in reality it is more complicated than that. Many people only have a low grade fever in the beginning and may not have shortness of breath until they are sicker.
It appears from the published literature that the most common symptoms of COVID-19 are:
- cough
- fatigue
- body aches
- fever (may be low grade)
- shortness of breath (may not be present initially)
Other symptoms may also include:
- sore throat
- nasal congestion
- sputum production
- chills
- loss of smell or taste (may be one of the first symptoms)
- diarrhea
- nausea
- abdominal pain
- chest pain
- headache
- confusion
- dizziness
- and other symptoms
Many other conditions may cause various combinations of the above symptoms, so please do not panic if you have some of them. Please consult a doctor for diagnosis. (Scroll down for information about testing.)
HOW SEVERE ARE THE SYMPTOMS?
Up to date as of 04/08/2020
Most cases are mild. In mildest forms of the disease there are minimal to no symptoms.
In more severe form, the disease causes a serious lung infection / pneumonia that may be life-threatening to the point of requiring life-support in intensive care unit.
As of 03/25/2020, according to the World Health Organization, "most people (about 80%) recover from the disease without needing special treatment. Around 1 out of every 6 people who gets COVID-19 becomes seriously ill and develops difficulty breathing.
Most cases are mild. In mildest forms of the disease there are minimal to no symptoms.
In more severe form, the disease causes a serious lung infection / pneumonia that may be life-threatening to the point of requiring life-support in intensive care unit.
As of 03/25/2020, according to the World Health Organization, "most people (about 80%) recover from the disease without needing special treatment. Around 1 out of every 6 people who gets COVID-19 becomes seriously ill and develops difficulty breathing.
HOW LONG DOES IT TAKE TO SHOW SYMPTOMS?
Up to date as of 04/14/2020
Symptoms may begin anywhere between 1 day and 27 days from the time of being exposed to the virus.
In most cases, it takes about 3-5 days from the time one contracts the virus till the symptoms appear. In some cases it can take just a few days; however, it is possible for it to take longer to develop symptoms.
In 99% of people the symptoms appear in less than 14 days from the exposure. During this period of time (“incubation period”) the infected person may have no symptoms but may still be contagious, infecting others.
There have been cases reported of symptoms developing even three-four weeks after known exposure; however, it is possible that this was due to double exposure, meaning that people were exposed twice during those three weeks. The longest reported incubation period that I've seen so far was 27 days.
Currently, anyone who has been exposed to the virus, should be in a quarantine/isolation for AT LEAST! 14 days in order to prevent potential spread of the infection.
2 weeks of "perfect" isolation will help prevent the spread tremendously; however, 4 weeks of "perfect" isolation could prevent transmission 100%. This is my opinion based on what we know and common sense: if it may take as long as 27 days to start showing symptoms after exposure, obviously the longer a person self-isolates, the better - the closer to those 4 weeks of isolation that you can get the better. In reality, it's nearly impossible to achieve a "perfect" level of isolation, so in some countries longer quarantines have been used (up to 8 weeks after exposure) and successfully so.
Please note, you may (and likely will) hear different recommendations from the news, from the CDC and from your doctor who will be following his or her healthcare organization's directives which are supposed to be based on the CDC recommendations. Of course, follow your doctor's orders, but also use common sense. If you can self-isolate a little longer than requested - great, but don't confine yourself for a whole month if it is to your detriment.
Symptoms may begin anywhere between 1 day and 27 days from the time of being exposed to the virus.
In most cases, it takes about 3-5 days from the time one contracts the virus till the symptoms appear. In some cases it can take just a few days; however, it is possible for it to take longer to develop symptoms.
In 99% of people the symptoms appear in less than 14 days from the exposure. During this period of time (“incubation period”) the infected person may have no symptoms but may still be contagious, infecting others.
There have been cases reported of symptoms developing even three-four weeks after known exposure; however, it is possible that this was due to double exposure, meaning that people were exposed twice during those three weeks. The longest reported incubation period that I've seen so far was 27 days.
Currently, anyone who has been exposed to the virus, should be in a quarantine/isolation for AT LEAST! 14 days in order to prevent potential spread of the infection.
2 weeks of "perfect" isolation will help prevent the spread tremendously; however, 4 weeks of "perfect" isolation could prevent transmission 100%. This is my opinion based on what we know and common sense: if it may take as long as 27 days to start showing symptoms after exposure, obviously the longer a person self-isolates, the better - the closer to those 4 weeks of isolation that you can get the better. In reality, it's nearly impossible to achieve a "perfect" level of isolation, so in some countries longer quarantines have been used (up to 8 weeks after exposure) and successfully so.
Please note, you may (and likely will) hear different recommendations from the news, from the CDC and from your doctor who will be following his or her healthcare organization's directives which are supposed to be based on the CDC recommendations. Of course, follow your doctor's orders, but also use common sense. If you can self-isolate a little longer than requested - great, but don't confine yourself for a whole month if it is to your detriment.
HOW IS THIS DIFFERENT FROM A COLD OR A FLU?
Up to date as of 04/14/2020
Although there are "typical" symptoms of a cold, of a flu, and of COVID-19, there is some overlap, and the diagnosis is not always very obvious.
If you are at all suspecting that you may have COVID-19, please call your doctor and get tested.
Typically, it's unusual to develop shortness of breath from a cold or a flu, but not uncommon with SARS-CoV-2 infection.
Also, nasal congestion seems to be less common in COVID-19 comparing to a cold.
It sounds like some people just have body aches and low grade fever, others have some vague symptoms and diarrhea, the bottom line at this point it appears that COVID-19 may present with a wide range of symptoms (it may not be a "textbook case" every time).
One may have no symptoms at all and still have the virus, infecting others (that's why physical distancing is so important.)
As far as the mortality rates. COVID-19 has a higher mortality rate then the flu, but the biggest issue is that the flu affects more or less the same number of people every year. COVID-19, unfortunately, has an exponential increase in cases (the numbers double every few days), and increasing number of deaths every day. So yes, it is completely different from the flu.
Just watch the visualization below how COVID-19 deaths are surpassing everything else... It's not like the flu... (Click on the arrow at the bottom right of the graph if it doesn't start playing automatically):
Although there are "typical" symptoms of a cold, of a flu, and of COVID-19, there is some overlap, and the diagnosis is not always very obvious.
If you are at all suspecting that you may have COVID-19, please call your doctor and get tested.
Typically, it's unusual to develop shortness of breath from a cold or a flu, but not uncommon with SARS-CoV-2 infection.
Also, nasal congestion seems to be less common in COVID-19 comparing to a cold.
It sounds like some people just have body aches and low grade fever, others have some vague symptoms and diarrhea, the bottom line at this point it appears that COVID-19 may present with a wide range of symptoms (it may not be a "textbook case" every time).
One may have no symptoms at all and still have the virus, infecting others (that's why physical distancing is so important.)
As far as the mortality rates. COVID-19 has a higher mortality rate then the flu, but the biggest issue is that the flu affects more or less the same number of people every year. COVID-19, unfortunately, has an exponential increase in cases (the numbers double every few days), and increasing number of deaths every day. So yes, it is completely different from the flu.
Just watch the visualization below how COVID-19 deaths are surpassing everything else... It's not like the flu... (Click on the arrow at the bottom right of the graph if it doesn't start playing automatically):
Please note, the graph above shows the actual daily deaths from COVID-19 in the US against the backdrop of the extrapolated daily average from the latest available (2018) CDC data for top 15 causes of death.
WHY SHOULD WE CARE ABOUT THIS VIRUS?
Up to date as of 04/14/2020.
At this point, I am sure everyone is on the same page, about the fact that this virus is not a joke.
The issue with the virus is how fast it spreads, especially through asymptomatic transmission, as well as the fact that we don’t have immunity to it, and that there is no treatment or vaccine available at this time.
Unfortunately, as a global community, we have missed a chance to prevent the spread of the virus. The prevention challenge lies in the fact that people with no symptoms could be infecting others and unless an extremely strict quarantine is followed (like they’ve eventually done in China and now in Italy) there is no way to monitor or control the disease outbreak. In Italy, the quarantine was initiated too late, and that's why there has been a catastrophic increase in the number of cases and deaths.
The other challenge is that most societies will not be able to create the environment where all citizens will stop contact with each other. Each government will have to make difficult choices regarding this and find a nearly impossible balance between several critical aspects of this pandemic:
At this point, I am sure everyone is on the same page, about the fact that this virus is not a joke.
The issue with the virus is how fast it spreads, especially through asymptomatic transmission, as well as the fact that we don’t have immunity to it, and that there is no treatment or vaccine available at this time.
Unfortunately, as a global community, we have missed a chance to prevent the spread of the virus. The prevention challenge lies in the fact that people with no symptoms could be infecting others and unless an extremely strict quarantine is followed (like they’ve eventually done in China and now in Italy) there is no way to monitor or control the disease outbreak. In Italy, the quarantine was initiated too late, and that's why there has been a catastrophic increase in the number of cases and deaths.
The other challenge is that most societies will not be able to create the environment where all citizens will stop contact with each other. Each government will have to make difficult choices regarding this and find a nearly impossible balance between several critical aspects of this pandemic:
- need to isolate everyone to stop the spread
- avoid excessively infringing on individual freedoms
- prevent panic/chaos in the society
- prevent complete economic collapse
CAN I BE TESTED FOR CORONA VIRUS?
Up to date as of 04/15/2020
Currently testing for Coronavirus is increasing, but it is not available to everyone.
Testing availability and exact criteria may depend on your location and specific healthcare organization. Sorry for being so vague! The available information about testing is really vague and conflicting. So I guess, what I am writing here reflects that...
Currently testing for Coronavirus is increasing, but it is not available to everyone.
Testing availability and exact criteria may depend on your location and specific healthcare organization. Sorry for being so vague! The available information about testing is really vague and conflicting. So I guess, what I am writing here reflects that...
The more people are tested, the easier it it is to track and contain the virus. The more people stay home, the fewer people will get the virus. My view is that it's best to do everything you can minimize your risks of getting infected.
There are many logistical challenges surrounding testing:
Currently, most testing is done similar to a flu test - by using a long q-tip type swab in the back of the throat and deep in the nose (it's uncomfortable but not painful).
The swab is then placed in a test tube and sent to a laboratory for diagnosis. To find whether or not there is any SARS-CoV-2 on the swab they use a technique called RT-PCR or "reverse transcriptase polymerase chain reaction" test. It's is basically similar to a DNA test - it checks for the exact "identity" of the virus.
(It is important that this is done properly - if the swab doesn't go in all the way to the back of the nose or throat it might not pick up any virus, so there would be nothing to test. )
Normally, it should take 4-6 hours to get the results; however, because so many tests are being done at the same time, realistically it may take days in most places to get results back with current type of test.
There are many logistical challenges surrounding testing:
- inadequate availability of test kits
- limited laboratory availability to do the actual testing
- risk of exposure in areas where the tests are conducted if those locations are not properly set up and are treating every single person who come in with the same precautions as if each person has the virus
- the length of time it takes to get the results in many places
Currently, most testing is done similar to a flu test - by using a long q-tip type swab in the back of the throat and deep in the nose (it's uncomfortable but not painful).
The swab is then placed in a test tube and sent to a laboratory for diagnosis. To find whether or not there is any SARS-CoV-2 on the swab they use a technique called RT-PCR or "reverse transcriptase polymerase chain reaction" test. It's is basically similar to a DNA test - it checks for the exact "identity" of the virus.
(It is important that this is done properly - if the swab doesn't go in all the way to the back of the nose or throat it might not pick up any virus, so there would be nothing to test. )
Normally, it should take 4-6 hours to get the results; however, because so many tests are being done at the same time, realistically it may take days in most places to get results back with current type of test.
On 03/21/2020 FDA approved a new, more efficient test for SARS-CoV-2 made by Cepheid. Testing will be done at hospitals and laboratories that will be able to use existing testing equipment. It should be available now.
The test requires the same type of log Q-tip type swab that will be used to swipe a the back of the nose or throat of a patient. The swab will be then placed in a special cartridge, which is then inserted in the existing specialized testing equipment.
It should only take 45 minutes to get results.
Abbott, another pharmaceutical company, has developed a rapid 5-minute SARS-CoV-2 test. This should be available in many US locations soon as well.
As far as antibody testing for SARS-CoV-2, here is the information from the FDA as of 04/14/2020.
I will keep you updated on this new rapid test availability.
The test requires the same type of log Q-tip type swab that will be used to swipe a the back of the nose or throat of a patient. The swab will be then placed in a special cartridge, which is then inserted in the existing specialized testing equipment.
It should only take 45 minutes to get results.
Abbott, another pharmaceutical company, has developed a rapid 5-minute SARS-CoV-2 test. This should be available in many US locations soon as well.
As far as antibody testing for SARS-CoV-2, here is the information from the FDA as of 04/14/2020.
I will keep you updated on this new rapid test availability.
WHERE CAN I GET TESTED?
Up to date as of 04/15/2020
You doctor or a local hospital should have testing available, or direct you where you could get tested, if it's appropriate.
Drive-through test centers are being established throughout the country to conduct the testing. www.CORONATESTMAP.com is a free private website that will be adding new drive-through centers daily. Please check them out, and spread the word (Please contact them if know of a location that they haven't listed yet.)
In the beginning, if a person tests positive by the local laboratory, it is called "presumptive positive". The test was then confirmed by the CDC, at which point if it became "confirmed positive". But it doesn't appear that they are doing this anymore - local test results is what we can go on, no confirmation needed.
The numbers of testing locations is growing rapidly and it is hard to have a clear up to date picture of what's available and where. If you have any good source of information for test site locations, please let me know.
You doctor or a local hospital should have testing available, or direct you where you could get tested, if it's appropriate.
Drive-through test centers are being established throughout the country to conduct the testing. www.CORONATESTMAP.com is a free private website that will be adding new drive-through centers daily. Please check them out, and spread the word (Please contact them if know of a location that they haven't listed yet.)
In the beginning, if a person tests positive by the local laboratory, it is called "presumptive positive". The test was then confirmed by the CDC, at which point if it became "confirmed positive". But it doesn't appear that they are doing this anymore - local test results is what we can go on, no confirmation needed.
The numbers of testing locations is growing rapidly and it is hard to have a clear up to date picture of what's available and where. If you have any good source of information for test site locations, please let me know.
IF I TEST "NEGATIVE" FOR THE VIRUS IS IT FOR SURE NEGATIVE?
Up to date as of 04/15/2020
No laboratory test is perfect. Let's start with that. Obviously, when scientists are developing various tests, they want to make them as accurate as possible. It's not an easy task, and it depends on many factors.
To make the long story short, ANY test that is in existence today, will have some "false positives" and some "false negatives". Meaning that some people who have a positive test, don't necessarily have the condition, and some people who test "negative" may actually have it. Tests for SARS-CoV-2 are no exception.
So currently, you can't know for sure (like 100% sure) that you don't have the virus even if you test negative.
I know. It's not anything anyone wants to hear...
Current estimates of false negatives may not be accurate, but around 30% of people who test negative may actually have the virus (please note that this estimate is very vague).
The exact chance of testing negative while having the virus depends on a wide range of factors, from the way the sample was obtained to the timing between onset of symptoms and testing. One study, has found the following:
So, clearly it's complicated :/ and not very reassuring, to be honest. My advice: if you tested negative, but are not feeling 100%, I would most definitely recommend self-isolating, and contacting your healthcare provider if your symptoms get worse.
This is my personal view that is based on what we know about the virus and on common sense.
Don't panic, just take precautions in case you could be infectious to others.
No laboratory test is perfect. Let's start with that. Obviously, when scientists are developing various tests, they want to make them as accurate as possible. It's not an easy task, and it depends on many factors.
To make the long story short, ANY test that is in existence today, will have some "false positives" and some "false negatives". Meaning that some people who have a positive test, don't necessarily have the condition, and some people who test "negative" may actually have it. Tests for SARS-CoV-2 are no exception.
So currently, you can't know for sure (like 100% sure) that you don't have the virus even if you test negative.
I know. It's not anything anyone wants to hear...
Current estimates of false negatives may not be accurate, but around 30% of people who test negative may actually have the virus (please note that this estimate is very vague).
The exact chance of testing negative while having the virus depends on a wide range of factors, from the way the sample was obtained to the timing between onset of symptoms and testing. One study, has found the following:
- Day 1 of infection 100% false negative
- Day 4 of infection ~ 60% false negative
- Day of onset of symptoms ~ 40% false negative
- Day 3 after symptoms onset ~ 25% false negative
- Day 21 of infection ~ 60% false negative
So, clearly it's complicated :/ and not very reassuring, to be honest. My advice: if you tested negative, but are not feeling 100%, I would most definitely recommend self-isolating, and contacting your healthcare provider if your symptoms get worse.
This is my personal view that is based on what we know about the virus and on common sense.
Don't panic, just take precautions in case you could be infectious to others.
COMPLEXITY OF THE TESTING SITUATION
Up to date as of 04/15/2020
So here are some of the complex multilayer challenges (you can skip through this part, it's a bit detailed and may be boring):
So here are some of the complex multilayer challenges (you can skip through this part, it's a bit detailed and may be boring):
- From epidemiological perspective (meaning tracking the spread of the virus and preventing it), it is critical that as many people as possible get tested and as soon as possible.
- From infectious disease perspective, any time a person who may or may not have the virus comes to a testing center where some people are definitely infected, that person may be at risk of getting it if the test center is not set up properly (which would not be surprising since we are learning how to do everything as we go).
- From a medical perspective, doctors normally do not do tests UNLESS they will impact a treatment decision. So if the treatment is going to be the same no matter what, normally we don't order a test in question. This is standard medical practice around the world, and this is what we do every day. Why order a test, when it will not change the treatment plan even a little bit? Makes sense, right? So, we are at a point, where it is the case with COVID-19. It is not clear whether or not knowing whether someone is infected will change treatment decisions. Since many COVID-19 patients are asymptomatic, doctors need to take precautions as if everyone has the virus. For those patients who do show some symptoms, here is the likely scenarios, regardless of the test result:
- If a person's with a suspected COVID-19 infection has very mild symptoms, the treatment would be the same no matter whether the person is positive or negative, which is go home, stay there for two weeks, do what you normally do for a cold. (At this point everyone is self-isolating anyway, and if the test results take days anyway, there is no point - it's best just to assume you are positive and sit it out, while protecting others from yourself.)
- If a person with a suspected COVID-19 has severe enough symptoms to get hospitalized, the treatment would be to help the person breathe, stay hydrated, maybe get antibiotics if a bacterial infection if present in addition to the suspected viral infection. As of right now, there is no specific treatment for COVID-19 that's either clearly effective or approved. So basically the treatment would be the same even if we don't know if the person has COVID-19. (Also, hospital staff should be fully suited no matter what just in case, so even that would not change.)
- Keep in mind, that this will no longer be the case when specific treatment for COVID-19 becomes available. It that point, testing will clearly help make treatment decisions.
- Another challenge is the false positives and the false negatives.
WHAT SHOULD I DO IF I AM SICK?
Up to date as of 04/15/2020
If you think, you might have been exposed or have symptoms that make you worry about Coronavirus. Do not panic. Do what you normally do when you are sick - consult a medical professional.
CALL IN FIRST to your doctor's office or a designated phone number in your town/city/region. (Don't go to see your doctor directly until after you call in. It will allow the clinic to take appropriate precautions.)
If you are severely ill, Call 911 (or a specific coronavirus-designated emergency number in your area).
Also:
If you are tested, and your results come back "negative" but you are still not feeling mildly well, personally, I would recommend to self-isolate as above, just in case. Obviously if you are feeling severely ill, then call 911.
CLICK HERE for official recommendations from Centers For Disease Control.
If you think, you might have been exposed or have symptoms that make you worry about Coronavirus. Do not panic. Do what you normally do when you are sick - consult a medical professional.
CALL IN FIRST to your doctor's office or a designated phone number in your town/city/region. (Don't go to see your doctor directly until after you call in. It will allow the clinic to take appropriate precautions.)
If you are severely ill, Call 911 (or a specific coronavirus-designated emergency number in your area).
Also:
- Wear a mask (be creative if you don't have one, use common sense).
- Isolate yourself from others in your household.
- Do not share objects/utensils with the others in you home.
- Wash your hands often and sanitize surfaces.
- Do not leave your home except to go to a doctor (call him/her first for instructions).
If you are tested, and your results come back "negative" but you are still not feeling mildly well, personally, I would recommend to self-isolate as above, just in case. Obviously if you are feeling severely ill, then call 911.
CLICK HERE for official recommendations from Centers For Disease Control.
HOW LIFE-THREATENING IS IT?
Up to date as of 04/01/2020
The exact mortality rates from COVID-19 may vary from country to country, but overall, the mortality rate is somewhere between 3 and 4% (out of 100 people infected with the virus, around 4 people may die). The range may be as wide as 0.1% and can be over 12% according to some studies.
Officially, as of 03/13/2020, World Health Organization is estimating the overall mortality rate at 3.4%. However, this number will depend on many factors - it will vary by region based on the overall health of the population, and on the preparedness of the local healthcare system.
Time from first symptoms to death may be as short as a several days in severe cases.
Mortality tends to be higher in the older patients, and patients who have severe rapidly developing symptoms. It appears that people who have high blood pressure are at higher risk. People with multiple underlying health problems such as heart disease, diabetes, smoking, obesity, chronic lung disease, cancer, chronic kidney disease among others. Mortality appears to be slightly higher in men comparing to women.
It is not clear at this point how a person's ethnic background may affect the seriousness of the disease (published demographic data idoes not provide the knowledge of the virus affects people of different backgrounds).
The exact mortality rates from COVID-19 may vary from country to country, but overall, the mortality rate is somewhere between 3 and 4% (out of 100 people infected with the virus, around 4 people may die). The range may be as wide as 0.1% and can be over 12% according to some studies.
Officially, as of 03/13/2020, World Health Organization is estimating the overall mortality rate at 3.4%. However, this number will depend on many factors - it will vary by region based on the overall health of the population, and on the preparedness of the local healthcare system.
Time from first symptoms to death may be as short as a several days in severe cases.
Mortality tends to be higher in the older patients, and patients who have severe rapidly developing symptoms. It appears that people who have high blood pressure are at higher risk. People with multiple underlying health problems such as heart disease, diabetes, smoking, obesity, chronic lung disease, cancer, chronic kidney disease among others. Mortality appears to be slightly higher in men comparing to women.
It is not clear at this point how a person's ethnic background may affect the seriousness of the disease (published demographic data idoes not provide the knowledge of the virus affects people of different backgrounds).
WHO CAN GET SICK FROM CORONAVIRUS?
Up to date as of 04/15/2020
Any person can potentially get sick from SARS-CoV-2
Very little data is available in terms of whether or not pets can be affected (please see below.)
Any person can potentially get sick from SARS-CoV-2
- Symptoms tend to be mild in children
- Older people, especially those with underlying health conditions tend to get the sickest from the virus.
- Many healthy adults can get really sick too. In fact, in the United States, most cases of COVID-19 appear to be in 20 - 49 year-olds!
- It is not clear how a person's ethnic background may affect the seriousness of the disease. Demographic data is widely published, but it is too early to interpret it - there are so many factors that could impact these numbers (cultural behaviours like hugging and kissing when greeting others, socioeconomic status with inability to self isolate when sick, etc. may make the demographic data look a certain way, but does not necessarily mean that certain groups of people are "predisposed" and others are "safe".
Very little data is available in terms of whether or not pets can be affected (please see below.)
CAN OUR PETS GET THE VIRUS?
Up to date as of 04/15/2020.
There is some preliminary data that ferrets and cats (especially young cats) who have been exposed to a large quantity of the virus may be susceptible to it. Dogs, pigs, chickens, and ducks are unlikely to be affected or to transmit it.
This information comes from a small study which did not replicate a typical household environment, which means that we should not jump conclusions as far as what it means for our pets or for us as pet owners.
With that said, we should be mindful of the potential transmission from humans to cats and ferrets and vice versa.
We should also keep in mind that we do not yet know for sure whether other animals can get infected and/or transmit the virus.
Please use common sense when approaching this situation in your home by practicing good hygiene:
Based on personally reading and analyzing the study, I believe that in real life, the risk of transmission between humans and pets is rather low, but not impossible (especially with ferrets and cats).
So I would recommend the "MCH approach" of MINDFULNESS + COMMON SENSE + HYGIENE
The bottom line, is that we know very little about the extent of the potential virus transmission between humans and animals in a household setting. We should know more in the upcoming months.
There is some preliminary data that ferrets and cats (especially young cats) who have been exposed to a large quantity of the virus may be susceptible to it. Dogs, pigs, chickens, and ducks are unlikely to be affected or to transmit it.
This information comes from a small study which did not replicate a typical household environment, which means that we should not jump conclusions as far as what it means for our pets or for us as pet owners.
With that said, we should be mindful of the potential transmission from humans to cats and ferrets and vice versa.
We should also keep in mind that we do not yet know for sure whether other animals can get infected and/or transmit the virus.
Please use common sense when approaching this situation in your home by practicing good hygiene:
- avoid direct contact with droplets from animals' coughs or sneezes.
- do not let your pets lick your face
- wash your hands after handling/disposing of their feces
- wash your hands after direct contact with animals
Based on personally reading and analyzing the study, I believe that in real life, the risk of transmission between humans and pets is rather low, but not impossible (especially with ferrets and cats).
So I would recommend the "MCH approach" of MINDFULNESS + COMMON SENSE + HYGIENE
The bottom line, is that we know very little about the extent of the potential virus transmission between humans and animals in a household setting. We should know more in the upcoming months.
HOW DOES THE VIRUS SPREAD? WHAT CAN I DO TO PREVENT THIS?
Up to date as of 04/15/2020
The virus spreads through cough, sneezing (so if someone is sick they should wear a mask to protect others). The virus may also stay in the air for a period of time (although this type of transmission is not very common).
When the virus lands on surfaces, it can be contagious through touch (if a person with the virus touches something, that object may be contagious for hours after). So if you touch the object with this virus on it, and then touch your face (eyes, nose, mouth), you can get the virus. That’s why it’s important to take various precautions such as hand washing, using hand sanitizers, and keeping everything clean - disinfecting surfaces.
Based on currently available data, this coronavirus may stay around for a period of time:
So cover your cough and sneeze, cover your face when you know you will have contact with people outside of your household, wash your hands, sanitize everything.
Also, it's important to avoid touching your eyes, nose or mouth.
In addition, in some patient diagnosed with COVID-19, virus was also found in urine and stool.
This means that we must most definitely wash our hands each time we go to the bathroom. We should flush the toilet with the lid closed (it prevents the invisible fountain of microscopic droplets from the toilet bowl into the air).
Healthcare workers (as always) should take extra precautions with patients' bodily fluids, as does anyone who may come into contact with those (use gloves, wash your hands if that happens).
As far as hand washing it should be with soap and water and for at least twenty seconds (sing the “Happy Birthday” song twice for good timing). When soap and water are not available, use hand sanitizers with at least 60% alcohol.
You can use bleach-based disinfectants on surfaces, but NOT on your body.
The best way to avoid the virus is to minimize contact with other people until the pandemic is controlled.
The virus spreads through cough, sneezing (so if someone is sick they should wear a mask to protect others). The virus may also stay in the air for a period of time (although this type of transmission is not very common).
When the virus lands on surfaces, it can be contagious through touch (if a person with the virus touches something, that object may be contagious for hours after). So if you touch the object with this virus on it, and then touch your face (eyes, nose, mouth), you can get the virus. That’s why it’s important to take various precautions such as hand washing, using hand sanitizers, and keeping everything clean - disinfecting surfaces.
Based on currently available data, this coronavirus may stay around for a period of time:
- air - over 3 hours
- cardboard - up to 24 hours
- steel - up to 48 hours
- plastic - up to 96 hours
So cover your cough and sneeze, cover your face when you know you will have contact with people outside of your household, wash your hands, sanitize everything.
Also, it's important to avoid touching your eyes, nose or mouth.
In addition, in some patient diagnosed with COVID-19, virus was also found in urine and stool.
This means that we must most definitely wash our hands each time we go to the bathroom. We should flush the toilet with the lid closed (it prevents the invisible fountain of microscopic droplets from the toilet bowl into the air).
Healthcare workers (as always) should take extra precautions with patients' bodily fluids, as does anyone who may come into contact with those (use gloves, wash your hands if that happens).
As far as hand washing it should be with soap and water and for at least twenty seconds (sing the “Happy Birthday” song twice for good timing). When soap and water are not available, use hand sanitizers with at least 60% alcohol.
You can use bleach-based disinfectants on surfaces, but NOT on your body.
The best way to avoid the virus is to minimize contact with other people until the pandemic is controlled.
- Stay home
- If you have to leave your home for an emergency, do your best to keep at least 6-foot distance with other people and wear a mask
- Wash your hands often and sanitize surfaces
- Get food and supplies delivered.
- You may need to wait 1 full day before opening your packages, since virus can survive on cardboard for up to ~24 hours.
SOMETHING TO LIGHTEN THE MOOD
Last week, as I was writing about Coronavirus transmission and about the best precautions for this "invisible little guy", and I remembered an old Cheetos commercial.
I think it illustrates what we need to do perfectly! Watch it, and you'll know why it is so important to wash your hands and not to touch your face, even when your hands look perfectly clean :) Enjoy! P.S.: Cheetos have nothing to do with coronavirus transmission - I am sharing this as an illustration of the importance of proper handwashing :) |
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SHOULD I WEAR A MASK?
Up to date as of 04/15/2020
The short answer is YES! CDC is finally recommending it, that if you are outside of your home and may come in contact with people outside of your household that you should wear a mask. (CDC has been saying for a while that you do not need to wear a mask unless you are taking care of someone who has COVID-19.)
Wearing a regular face mask/surgical mask is mainly useful if you yourself have symptoms. Although masks do not fully protect you from others who are sick, they do offer partial protection from the virus.
My personal view on it is as follows:
1) On an individual level, the idea is that each person should minimize exposure to the virus. How? By staying home and avoiding contact with people. If you are out near other people, wearing a face mask may offer you some protection. So if you really have to leave home for an emergency and you happen to have a mask, you should wear it. If you don't have a regular mask, use a scarf or a cloth mask to cover your face any time you are somewhere where there are people other than members of your household. Wash the scarf after each time you are out. (Virus can stay on clothing, so it's a good idea to wash the clothes you wore outside every time you are out.) Cloth masks are helpful, but may not offer as much protection as regular surgical facemasks.) PS: scarfs and fabric masks only offer partial protection, but they are certainly better than nothing.
In my opinion, you should not even put yourself in the position of getting exposed - if you are out, chances are, you are exposing yourself, as well as putting others at risk in case you yourself have the virus but no symptoms. So please STAY HOME. By staying home I don't mean that you have to completely lock yourself up. You can still go outside, go for walks, etc. - the key is that you should avoid going anywhere where there are people and avoid touching anything anyone else has touched.
2) We have to also look at the big picture. If everyone wears masks (which is not 100% protective), changes them regularly (facemasks don't last very long at all), then as a society, and is hoarding masks "just in case", then we are running a huge risk of running out of mask for healthcare providers, which is not a good thing. Unfortunately, in many places around the country healthcare practitioners already don't have enough masks! So please don't hoard them - if you have extras consider donating to any nearby hospital or clinic - they can really use them right now! Healthcare workers need so-called "N95" type masks, but a regular surgical face mask is better than nothing - so if you have extras, please, please consider donating.
Doctors, nurses and other medical professionals are exposed to the virus more than anyone, simply because of where they work, and if they are not properly protected, they might get sick, infect others, might no longer be able to work, leading to a shortage of healthcare providers. We certainly do not want for this worst case scenario to happen.
So we have to have common sense about it. If you cough or sneeze, please cover the cough or sneeze. Wash your hands. Disinfect surfaces.
Since many people have no symptoms, anyone is a potential carrier. So social distancing makes sense.
Social distancing, good hygiene, and common sense are a must! Mask or scarf are a good idea if you find yourself around other people.
Check out my blog post regarding this.
PS: "social distancing" is now called "physical distancing" - you can still be social (and should be!) just keep your distance!
The short answer is YES! CDC is finally recommending it, that if you are outside of your home and may come in contact with people outside of your household that you should wear a mask. (CDC has been saying for a while that you do not need to wear a mask unless you are taking care of someone who has COVID-19.)
Wearing a regular face mask/surgical mask is mainly useful if you yourself have symptoms. Although masks do not fully protect you from others who are sick, they do offer partial protection from the virus.
My personal view on it is as follows:
1) On an individual level, the idea is that each person should minimize exposure to the virus. How? By staying home and avoiding contact with people. If you are out near other people, wearing a face mask may offer you some protection. So if you really have to leave home for an emergency and you happen to have a mask, you should wear it. If you don't have a regular mask, use a scarf or a cloth mask to cover your face any time you are somewhere where there are people other than members of your household. Wash the scarf after each time you are out. (Virus can stay on clothing, so it's a good idea to wash the clothes you wore outside every time you are out.) Cloth masks are helpful, but may not offer as much protection as regular surgical facemasks.) PS: scarfs and fabric masks only offer partial protection, but they are certainly better than nothing.
In my opinion, you should not even put yourself in the position of getting exposed - if you are out, chances are, you are exposing yourself, as well as putting others at risk in case you yourself have the virus but no symptoms. So please STAY HOME. By staying home I don't mean that you have to completely lock yourself up. You can still go outside, go for walks, etc. - the key is that you should avoid going anywhere where there are people and avoid touching anything anyone else has touched.
2) We have to also look at the big picture. If everyone wears masks (which is not 100% protective), changes them regularly (facemasks don't last very long at all), then as a society, and is hoarding masks "just in case", then we are running a huge risk of running out of mask for healthcare providers, which is not a good thing. Unfortunately, in many places around the country healthcare practitioners already don't have enough masks! So please don't hoard them - if you have extras consider donating to any nearby hospital or clinic - they can really use them right now! Healthcare workers need so-called "N95" type masks, but a regular surgical face mask is better than nothing - so if you have extras, please, please consider donating.
Doctors, nurses and other medical professionals are exposed to the virus more than anyone, simply because of where they work, and if they are not properly protected, they might get sick, infect others, might no longer be able to work, leading to a shortage of healthcare providers. We certainly do not want for this worst case scenario to happen.
So we have to have common sense about it. If you cough or sneeze, please cover the cough or sneeze. Wash your hands. Disinfect surfaces.
Since many people have no symptoms, anyone is a potential carrier. So social distancing makes sense.
Social distancing, good hygiene, and common sense are a must! Mask or scarf are a good idea if you find yourself around other people.
Check out my blog post regarding this.
PS: "social distancing" is now called "physical distancing" - you can still be social (and should be!) just keep your distance!
WHAT SHOULD I DO IF I DON'T HAVE SYMPTOMS?
Up to date as of 04/15/2020
If you don't have any symptoms, it doesn't mean you haven't been exposed and are transmitting the virus to other. So for ANYONE without symptoms, I would recommend the following:
Basically behave as if you've been exposed.
- Wash your hands often and sanitize surfaces regularly
- Keep at least a 6-foot distance between you and anyone outside your home
- Do not leave your house except for most emergent needs (like to see a doctor or get groceries). That includes not going to work (unless you are a in the medical or law enforcement fields or provide the most essential services like deliver mail, sell groceries, collect trash, etc. - use common sense about this)
- If your household needs something, try to get it delivered. If you have to go somewhere in person - go one person at a time (don't bring your whole family to Costco with you).
Basically behave as if you've been exposed.
SOCIAL DISTANCING* EXPLAINED
Up to date as of 04/05/2020
On average each person infected with this Coronavirus will infect about 2.5 other people (the actual number is probably much higher than that). Also, note, that 10% of cases happen because of a completely asymptomatic transmission! (That's a lot!)
So any time you are physically around people not from your household, you might be exposing yourself and/or others to the virus, and propagating the spread.
On average each person infected with this Coronavirus will infect about 2.5 other people (the actual number is probably much higher than that). Also, note, that 10% of cases happen because of a completely asymptomatic transmission! (That's a lot!)
So any time you are physically around people not from your household, you might be exposing yourself and/or others to the virus, and propagating the spread.
* "Social Distancing" is now called "Physical Distancing"
You can still communicate with others by phone, various video chats, etc. You can go outside for walks, enjoy nature. The key thing here is not to be in physical proximity to people from outside of your households or the objects they may have touched.
I am sure by now you've heard a lot about "flattening the curve". The idea behind social distancing, is not only that it will help flatten the curve by reducing a flood of sick patients all at once (which could overwhelm our healthcare system) by making the spread of the infection slower, but more importantly, it will reduce the total number of people who will get the virus, and the number of people who will die from the disease. So social (physical) distancing will save lives.)
I am sure by now you've heard a lot about "flattening the curve". The idea behind social distancing, is not only that it will help flatten the curve by reducing a flood of sick patients all at once (which could overwhelm our healthcare system) by making the spread of the infection slower, but more importantly, it will reduce the total number of people who will get the virus, and the number of people who will die from the disease. So social (physical) distancing will save lives.)
WHO SHOULD BE IN ISOLATION?
Up to date as of 04/01/2020
If someone has been exposed to the virus and is asymptomatic, it makes sense to quarantine (be isolated from other people) for at least 14 days or longer! (See section above on "How Long Does It Take To Show Symptoms").
If someone has tested positive for coronavirus, based on what I’ve read in the scientific studies of the virus, I would lean towards a longer quarantine - around 6-7 weeks. The authorities of each region and country will determine what's not only scientifically sound but also what's feasible and realistic based on how the pandemic is unfolding. So these decisions are made with the big picture in mind, not only based on medical data or scientific evidence. If we go strictly with science - I'd say 4 weeks is definitely better than 2, if you are able to self-isolate a little longer, that's even better. In China people were isolated for up to 8 weeks. Just use common sense, and do your best.
In most cases, if someone tests positive for the virus, it is very difficult for the person to be completely isolated from the rest of the household. So truth be told, the whole household should self-isolate if possible (while also continuing preventing spread in the home, of course). None of it is easy.
The bottom line is that every attempt at minimizing contact with other people is essential in slowing the spread of the disease.
Remember, people who have contracted the virus may be infectious to others without showing any symptoms. Including you!
If someone has been exposed to the virus and is asymptomatic, it makes sense to quarantine (be isolated from other people) for at least 14 days or longer! (See section above on "How Long Does It Take To Show Symptoms").
If someone has tested positive for coronavirus, based on what I’ve read in the scientific studies of the virus, I would lean towards a longer quarantine - around 6-7 weeks. The authorities of each region and country will determine what's not only scientifically sound but also what's feasible and realistic based on how the pandemic is unfolding. So these decisions are made with the big picture in mind, not only based on medical data or scientific evidence. If we go strictly with science - I'd say 4 weeks is definitely better than 2, if you are able to self-isolate a little longer, that's even better. In China people were isolated for up to 8 weeks. Just use common sense, and do your best.
In most cases, if someone tests positive for the virus, it is very difficult for the person to be completely isolated from the rest of the household. So truth be told, the whole household should self-isolate if possible (while also continuing preventing spread in the home, of course). None of it is easy.
The bottom line is that every attempt at minimizing contact with other people is essential in slowing the spread of the disease.
Remember, people who have contracted the virus may be infectious to others without showing any symptoms. Including you!
IS THERE TREATMENT?
Up to date as of 04/15/2020.
According to World Health Organization,
"While some western, traditional or home remedies may provide comfort and alleviate symptoms of COVID-19, there is no evidence that current medicine can prevent or cure the disease. WHO does not recommend self-medication with any medicines, including antibiotics, as a prevention or cure for COVID-19. However, there are several ongoing clinical trials that include both western and traditional medicines. WHO will continue to provide updated information as soon as clinical findings are available."
I my personal opinion, the most promising results so far have been seen with Avigan (favipiravir) in Japan and China. Chloroquine and hydroxychloroquine are being evaluated for potential usefulness in treatment of COVID-19. Vitamin C, Zinc, and melatonin might have some effect as well, but it is not definite yet. Other medications are being investigated as well.
Vitamin-wise I would recommend getting vitamins from the foods you eat - it is the best and most natural way to stay healthy.
PS: I know there are rumors that vitamin D may be helpful aslo, but based on my literature search, currently, I would not recommend starting Vitamin D for COVID-19 prevention (unless you are on it per your doctor's recommendations), I may change my view once more data is available.
Ultimately, each patient has to be approached individually - just like with any other condition that's out there. It is between each individual and their doctor(s) to determine the best course of action for that person specifically. It's not one size fits all.
According to World Health Organization,
"While some western, traditional or home remedies may provide comfort and alleviate symptoms of COVID-19, there is no evidence that current medicine can prevent or cure the disease. WHO does not recommend self-medication with any medicines, including antibiotics, as a prevention or cure for COVID-19. However, there are several ongoing clinical trials that include both western and traditional medicines. WHO will continue to provide updated information as soon as clinical findings are available."
I my personal opinion, the most promising results so far have been seen with Avigan (favipiravir) in Japan and China. Chloroquine and hydroxychloroquine are being evaluated for potential usefulness in treatment of COVID-19. Vitamin C, Zinc, and melatonin might have some effect as well, but it is not definite yet. Other medications are being investigated as well.
Vitamin-wise I would recommend getting vitamins from the foods you eat - it is the best and most natural way to stay healthy.
PS: I know there are rumors that vitamin D may be helpful aslo, but based on my literature search, currently, I would not recommend starting Vitamin D for COVID-19 prevention (unless you are on it per your doctor's recommendations), I may change my view once more data is available.
Ultimately, each patient has to be approached individually - just like with any other condition that's out there. It is between each individual and their doctor(s) to determine the best course of action for that person specifically. It's not one size fits all.
IS THIS PANDEMIC AS BAD AS IT SOUNDS?
Up to date as of 04/15/2020
Unfortunately, yes, it is.
On March 11th, 2020, World Health Organization has called it a pandemic - a major global disease outbreak
We are trying to fight an invisible enemy that we don't understand. In addition, we as global citizens, must use common sense when deciding how to react to this event and especially to the aftermath of the pandemic.
From what I’ve read and the from the graphs I’ve seen in terms of infection rates, it would not be surprising that this pandemic will continue into 2021, and I would expect a rapid increase in cases in the upcoming weeks, which will start resolving, which would force the governments around the world to loosen the restrictions to prevent complete collapse of the economy, which will reduce social distancing and increase the spread of the virus. So we will likely see a couple of waves of increase in the number of cases, but probably not as bad as the one coming this month.
No need to panic. Just prevent as much as we can, adjust as well as we can, share positivity as much as we can, use common sense as much as we can, insist on maintaining our freedoms as the events related to the pandemic or its aftermath begin to unfold.
Unfortunately, yes, it is.
On March 11th, 2020, World Health Organization has called it a pandemic - a major global disease outbreak
We are trying to fight an invisible enemy that we don't understand. In addition, we as global citizens, must use common sense when deciding how to react to this event and especially to the aftermath of the pandemic.
From what I’ve read and the from the graphs I’ve seen in terms of infection rates, it would not be surprising that this pandemic will continue into 2021, and I would expect a rapid increase in cases in the upcoming weeks, which will start resolving, which would force the governments around the world to loosen the restrictions to prevent complete collapse of the economy, which will reduce social distancing and increase the spread of the virus. So we will likely see a couple of waves of increase in the number of cases, but probably not as bad as the one coming this month.
No need to panic. Just prevent as much as we can, adjust as well as we can, share positivity as much as we can, use common sense as much as we can, insist on maintaining our freedoms as the events related to the pandemic or its aftermath begin to unfold.
HOW MANY PEOPLE IN THE WORLD HAVE THE VIRUS?
As of 04/15/2020 4:15 PM PT people in 210 countries have been affected by the disease. (See details for top 10 countries with the highest number of cases in the table below.)
The issue is not how many people are sick right now, but how quickly the disease is spreading - the numbers of infected and dying are rising exponentially every day. That's why it is such a concern and that's why we cannot approach like we would a cold or a flu.
The issue is not how many people are sick right now, but how quickly the disease is spreading - the numbers of infected and dying are rising exponentially every day. That's why it is such a concern and that's why we cannot approach like we would a cold or a flu.
WORLD: 2,075,532 cases (134,286 deaths).
The data in the chart above is from 04/15/2020. Top 8 countries listed by number of total COVID-19 cases. Blank areas mean that the updated numbers are not available yet.
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Please note, another way of looking the severity of the pandemic in each areas is looking at the # of cases/million of the population (as opposed to simply the total number of cases). So check out the 4th from the right column of the table.
The actual numbers may be different based on testing availability and reported data, but this is as close as we can get. Source of data is Worldometer.
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WHAT IS A GROWTH RATE?
Growth Rate or Growth Factor is an important number which tells us how things are going - whether the infection is on the increase or the decrease. Growth factor should be less than 1 and eventually 0.
This is how growth rate is calculated:
(Please note, I am using /day as an example, it can be calculated over any time period)
Growth Rate = new cases each day / new cases the day before.
For example, if yesterday there were a 100 new cases, and today there are 150 new cases, the growth factor is 150/100 = 1.5.
We want the number of new cases to be less each day than the day before.
You can calculate the growth factor for your region to know whether to be relieved or concerned.
Based on how [slowly/inadequately] the governments around the world are responding to this crisis (I am sure to the best of their abilities), I would expect that the growth factor will be above 1 for several months around the world with an exception of only a few regions, unless drastic containment measures are instituted world-wide immediately.
This is how growth rate is calculated:
(Please note, I am using /day as an example, it can be calculated over any time period)
Growth Rate = new cases each day / new cases the day before.
For example, if yesterday there were a 100 new cases, and today there are 150 new cases, the growth factor is 150/100 = 1.5.
We want the number of new cases to be less each day than the day before.
You can calculate the growth factor for your region to know whether to be relieved or concerned.
Based on how [slowly/inadequately] the governments around the world are responding to this crisis (I am sure to the best of their abilities), I would expect that the growth factor will be above 1 for several months around the world with an exception of only a few regions, unless drastic containment measures are instituted world-wide immediately.
HOW ARE WE DOING IN THE US?
Up to date as of 04/08/2020
We are not doing very well... The number of cases are still going up rapidly.
According to the experts, from a few weeks ago "the outbreak will continue to grow in the US in coming weeks, ... well less than 50% of all COVID-19 cases have been detected" Meaning that more than half of the people with the infection (some may be asymptomatic) in the US will be in the community!
According to the experts, from a few weeks ago "the outbreak will continue to grow in the US in coming weeks, ... well less than 50% of all COVID-19 cases have been detected" Meaning that more than half of the people with the infection (some may be asymptomatic) in the US will be in the community!
P.S.: I am sharing this in an effort to raise awareness and yes, concern, but not panic. The more aware the people are, the more we can do to contain the virus as humanity. Worry has never helped anything.
Let's work together to contain this! Please do your part! Minimize contact with others, wash your hands, if you are sick self-isolate and contact a doctor.
Let's work together to contain this! Please do your part! Minimize contact with others, wash your hands, if you are sick self-isolate and contact a doctor.
There are many challenges. There are not enough test kits, testing labs are overwhelmed with the numbers of tests being done, not enough people are tested, not enough people are taking it seriously, not enough people are staying home except for emergencies, not enough masks are available for healthcare workers.
Let's focus on WHAT EACH OF US CAN DO to HELP the situation!
Cover your cough, wash your hands
Minimize spread
Use common sense
Cover your cough, wash your hands
Minimize spread
Use common sense
ARE TRAVEL BANS HELPFUL?
Limiting travel is most definitely helpful. However, partial travel restriction will not solve the problem.
I would recommend NO travel, local and domestic using busses, trains, ships, airplanes (basically any multiperson methods of transportation), even if it is not restricted by the government.
Keep in mind, the government has to keep a balance between what's necessary to contain the virus vs. what's realistic. So we, the citizens of the world, can take on some of the burden off our governments' shoulders and self-restrict travel as much as possible.
Let's stop the spread of this virus!
I would recommend NO travel, local and domestic using busses, trains, ships, airplanes (basically any multiperson methods of transportation), even if it is not restricted by the government.
Keep in mind, the government has to keep a balance between what's necessary to contain the virus vs. what's realistic. So we, the citizens of the world, can take on some of the burden off our governments' shoulders and self-restrict travel as much as possible.
Let's stop the spread of this virus!
WHEN WILL THIS VIRUS GO AWAY?
Up to date as of 04/15/2020
Unfortunately, based on various predictions from the experts on pandemics, most likely the virus will continue its "disruptive work" into 2021.
Most definitely, it will not be "just a month or two".
Epidemiologists will have better predictions soon.
Most definitely, it will not be "just a month or two".
Epidemiologists will have better predictions soon.
You can come across social media posts that claim that a vaccine against the virus has been found. In my opinion, those statements have to be false. It takes many, many months to develop a new vaccine. I highly doubt that we will have a vaccine before 2021.
I would expect more effective treatment to be available within a few months and herd immunity accumulating towards the end of the year.
As I am sure you are well aware, there is a major controversy surrounding vaccinations against SARS-CoV-2 and vaccines in general. My take on it: the risk and benefits of getting a vaccine should always be a discussion between a patient and a doctor, it should never be mandated by an administrator, a government official or any other organization or entity.
I would expect more effective treatment to be available within a few months and herd immunity accumulating towards the end of the year.
As I am sure you are well aware, there is a major controversy surrounding vaccinations against SARS-CoV-2 and vaccines in general. My take on it: the risk and benefits of getting a vaccine should always be a discussion between a patient and a doctor, it should never be mandated by an administrator, a government official or any other organization or entity.
SHOULD I GET TOILET PAPER? SHOULD I STOCK UP ON EVERYTHING?
Up to date as of 04/15/2020
My general advice would be to stay calm, and make clear-headed decisions using common sense.
The virus will be around for a while, so we will need to calmly adjust to the situation, and take everything day by day, focusing on the positives and maintaining our humanity through these challenging times.
So in terms of stocking up on the essentials, be smart about it :)
The virus will be around for a while, so we will need to calmly adjust to the situation, and take everything day by day, focusing on the positives and maintaining our humanity through these challenging times.
So in terms of stocking up on the essentials, be smart about it :)
It's ok to get toilet paper, but only as much as you need. Don't hoard it. If you have extra, please share with friends and neighbors (PS: they should consider "quarantining" it for 24 hours before use).
If you are standing in line to get toilet paper "just in case", chance are you could be exposing yourself to the virus. There is a lot of conflicting information out there about what to do. In my opinion, it is wise to get the basic essentials, but conser doing it without major exposure to crowds of people who are trying to do the same. Realistically, chances are, most basic needs of the population (at least in the USA) will be met during this pandemic. So don't panic and don't hoard the basic necessities to the point that no one everyone would be able to get what they need. Get what you need. Not 100x what you need. |
HOW MUCH TOILET PAPER DO I NEED?You are right, it's not a question we usually ask ourselves under the normal circumstances. Well, in these challenging times, creativity is booming!
Here is a nifty website that will let you calculate EXACTLY how much TP you need :) Genius! CLICK HERE or on the image below to access the toilet paper calculator: |
As much as you can, try to get everything delivered. Deliveries will reduce your chance of exposure. (Don't shake hands with the delivery person - wave instead and smile - they won't be offended. Check out THIS LINK for a list of home delivery services ranging from food to supplies.
Sanitize your deliveries, wash produce, wash your hands. If the delivery is something that's not perishable, consider not touching it for 24 hours.
Same with general mail - get it out of your mailbox an hour or so before your usual mail delivery time - this way you are always getting your mail about 24 hours after someone touched it. It's a simple precaution - all we know that the virus may stay on cardboard for up to 24 hours, so it might be similar for mail. This would be my personal advice, we don't yet have guidance from the CDC on that (it may take time) - so I am just sharing what I know based on my research on the subject.
Again, use common sense about deliveries as with everything.
Here is what San Diego County recommends to help prepare for the pandemic.
Stay home, stay calm, but be prepared, talk to your family and friends.
HAVE A PLAN
Up to date as of 04/15/2020
I think that over the last few weeks it has become quite clear to most people that we were not prepared for this as a country or as world. It has also become clear that most of us are completely unprepared for a dramatic change. So we as individuals were not prepared as well.
It is hard to manage world-wide preparations for something like this. It is even more difficult, as a country, to make a grand and efficient response plan to what's going on. However, you in your household can have a plan - a plan to stay informed, to do what's right, to help each other.
Think about the situation in a calm way. Talk about it. I would strongly encourage everyone of you to do it.
Think about what's important to you, think about your basic necessities, ask yourself important questions.
Ultimately, most of these tough but important conversations should have happened long before this emergency, but most of us don't rush into these types of discussions, delaying them until the last possible moment.
It's ok. Let's be compassionate with ourselves. If we didn't talk about these things before, we can now.
What I'd like to emphasize, that it is not about being fearful of the worst-case scenario, it is about being smart and making appropriate choices TO PREVENT the worst case scenario.
I think that over the last few weeks it has become quite clear to most people that we were not prepared for this as a country or as world. It has also become clear that most of us are completely unprepared for a dramatic change. So we as individuals were not prepared as well.
It is hard to manage world-wide preparations for something like this. It is even more difficult, as a country, to make a grand and efficient response plan to what's going on. However, you in your household can have a plan - a plan to stay informed, to do what's right, to help each other.
Think about the situation in a calm way. Talk about it. I would strongly encourage everyone of you to do it.
Think about what's important to you, think about your basic necessities, ask yourself important questions.
- What will you do if someone in your home gets the virus?
- Which precautions will you take to help the person self-isolate?
- What happens if someone is hospitalized?
- What happens if someone you know gets really sick?
- Do you have a list of emergency numbers?
- Do you have a supply of basic necessities and routine medications?
- If you are too sick to make decisions for yourself, who would you designate as your decision maker?
- These and many other questions are important to talk about.
Ultimately, most of these tough but important conversations should have happened long before this emergency, but most of us don't rush into these types of discussions, delaying them until the last possible moment.
It's ok. Let's be compassionate with ourselves. If we didn't talk about these things before, we can now.
What I'd like to emphasize, that it is not about being fearful of the worst-case scenario, it is about being smart and making appropriate choices TO PREVENT the worst case scenario.
DON'T FORGET TO SMELL THE ROSES
Up to date as of 04/15/2020
What's happening around the world right now is hard to comprehend. It's hard to believe. It may feel like it's too much. Do your best to stay grounded. You can stay informed without watching the news 24/7 or getting scary social media updates. Take a break!
Slow down and don't forget to smell the roses!
I know I keep talking about staying home, but what I really mean - avoid being around people not from your household or touch anything that someone else may have touched. You can still go outside, go for walks, be outdoors.
Use this time to do something amazing. You can get back to an old hobby or pick a new one. You can call a distant family member or a friend with whom you haven't spoken in a while. You can read and watch movies. You can get into a new at home fitness routine.
We are in "Groundhog Day", and we all have a choice of what will do with it, and whether we'll see it as a curse or a blessing. It really is our choice.
Slow down and don't forget to smell the roses!
I know I keep talking about staying home, but what I really mean - avoid being around people not from your household or touch anything that someone else may have touched. You can still go outside, go for walks, be outdoors.
Use this time to do something amazing. You can get back to an old hobby or pick a new one. You can call a distant family member or a friend with whom you haven't spoken in a while. You can read and watch movies. You can get into a new at home fitness routine.
We are in "Groundhog Day", and we all have a choice of what will do with it, and whether we'll see it as a curse or a blessing. It really is our choice.
NON-MEDICAL "SIDE EFFECTS" OF THE VIRUS
Up to date as of 04/15/2020
Sadly, there are also several predictable, and distasteful non-health-related "side effects" of this virus:
- Racism - in many places around the world the virus has been inappropriately called "Chinese coronavirus". Why is that wrong? Yes, the first cases did indeed originate in China, but realistically speaking it could have happened anywhere. It is simply WRONG to connect the virus to Chinese people, and there are no "ands, ifs, or buts" about it!
- Stigma - people tend to overreact to anyone who sneezes these days. This is absolutely unwarranted. Each of us must do our OWN job at self isolation instead of shunning out or lashing out at others who are sick (regardless of the nature of their illness). Do the right thing, protect yourself through personal hygiene, and staying away from other people as much as possible. This is not the time of hatred. It is the time to for realizing that we are in this TOGETHER! We need to help each other, support each other. We need to be KIND!
- Scams - there are a number of scams out there. Most target emails. By false advertising information about the virus, scammers may try to get your important passwords. SOLUTION: DO NOT OPEN EMAILS FROM PEOPLE YOU DON'T KNOW, AND MOST DEFINITELY DO NOT OPEN ANY ATTACHMENTS FROM THOSE EMAILS. (PS: easier said than done, I personally have oped a few "phishing" emails myself, but PLEASE be mindful of this. There may be other scams (especially on social media) proclaiming testing, vaccines, cure availability, as well as financial support.) Please be mindful of this, and please help those who are not email or online new savvy avoid these traps.
- Negative economic consequences.
- Potential government infringement on social liberties in order to contain the virus.
- There are also emotional side effects of the pandemic. Let's deal with everything one day at a time. Take care of your heal and your emotional well-being first. Trust that everything will work out as it meant to be. We are all under stress, let's be kind with one another. Let's be supportive instead of antagonistic.
- Domestic violence - this has been on an increase. If you or someone you know are suffering the burden of this, please ask for help. Here is the domestic violence hotline (you can call, chat online and get other helpful resources there: https://www.thehotline.org/help/)
WHAT ABOUT ALL THE CONSPIRACY THEORIES?
Up to date as of 04/15/2020
There are many conspiracy theories that are circulating around. There is also a lot of misinformation in the news and on the social media.
It is essential that we maintain common sense during this pandemic and that we do not blindly follow ANY rhetoric regardless of the source.
There are a lot of things that do not add up epidemiologically and not everything is as it seems.
However, at the moment, it does not matter where the virus came from or who was responsible. (If you take the time and dig deep enough you will come across various potential origins of the virus, but chances are no one will ever know which one is the real one, so you are probably just wasting your time.)
At this point, the only thing we should worry about staying safe and preventing unnecessary losses. Plain and simple.
So don't add this extra stress and worry about conspiracies to your plate. I am sure that your plate is full as it is!
If you have information that is completely contrary to what we are being told by the official sources, something that others may perceive as "crazy", and if you simply can't get it off your mind, please do not hesitate to reach out or to schedule a virtual appointment. Sometimes talking to someone who will not judge you because of your views is exactly what's needed. I am here to provide support to anyone who is under stress during this challenging times.
It is essential that we maintain common sense during this pandemic and that we do not blindly follow ANY rhetoric regardless of the source.
There are a lot of things that do not add up epidemiologically and not everything is as it seems.
However, at the moment, it does not matter where the virus came from or who was responsible. (If you take the time and dig deep enough you will come across various potential origins of the virus, but chances are no one will ever know which one is the real one, so you are probably just wasting your time.)
At this point, the only thing we should worry about staying safe and preventing unnecessary losses. Plain and simple.
So don't add this extra stress and worry about conspiracies to your plate. I am sure that your plate is full as it is!
If you have information that is completely contrary to what we are being told by the official sources, something that others may perceive as "crazy", and if you simply can't get it off your mind, please do not hesitate to reach out or to schedule a virtual appointment. Sometimes talking to someone who will not judge you because of your views is exactly what's needed. I am here to provide support to anyone who is under stress during this challenging times.
ARE THERE ANY GOOD NEWS ABOUT ANY OF THIS?
Up to date as of 04/15/2020
I think all of us are tired of bad news, stress and the negativity.
There are several positive things that are indeed happening in the world.
For one, the outbreak appears to be more better controlled in countries which exercise strict containment measure. That's a relief. So we know - quarantine and testing definitely work.
Because of the quarantine, there fewer people on the road and so there is less pollution. Also, in spite of the physical distancing, many people are connecting with those they care about more. Many people now have time to think about what's important to them, and are considering devoting more time to their passions, and finally doing things they've been postponing "forever". This can be a perfect time to take up a new hobby, learn something new, start a new home exercise routine, and spend more time in nature.
In Italy, where the virus has spread like wildfire, and extreme measures of nearly complete isolation of the entire country has been ordered, the people are creating new coping strategies. According my Italian friends, many people have been creating virtual social gatherings with friends like daily virtual happy hours or virtual workout parties. Also there are numerous balcony-singing flashmobs - people in different towns sing and playing musical instruments on their balconies, often creating beautiful neighborhood performances singing together from their windows. I am sure you've seen plenty of youtube videos :)
I am sure you've also noticed that there are a lot of funny memes that are in circulation. It feels like everyone's sense of humor has been amped up 10 fold! Let's keep it up! Let's keep smiles and laughter going. You know what they say, "laughter is the best medicine" :) (PS: trust me, I am doctor ;)
On 03/21/20 a rapid test for the virus has been approved by the FDA (results in 45 minutes). Rapid (minutes) testing has also become available at many hospitals in the US and around the world.
In Japan and China doctors have been successful at treating COVID-19 with Avigan (favipiravir); however, the drug appears not to be widely available at this point.
As for many of us, our lives have been turned upside down, people are tapping into their potential, becoming more resourceful and more creative.
Parents have unique opportunity to spend time with their children and teach them about life, things that one would never learn at school.
Spiritually, many people are experiencing an "awakening" of sorts. People are feeling more connected to each other in spite of social distancing. There is this paradoxical sense of calm in the spiritual communities around the world - a sense of knowing that that we have all the tools we need to win this fight of light against darkness.
There are several positive things that are indeed happening in the world.
For one, the outbreak appears to be more better controlled in countries which exercise strict containment measure. That's a relief. So we know - quarantine and testing definitely work.
Because of the quarantine, there fewer people on the road and so there is less pollution. Also, in spite of the physical distancing, many people are connecting with those they care about more. Many people now have time to think about what's important to them, and are considering devoting more time to their passions, and finally doing things they've been postponing "forever". This can be a perfect time to take up a new hobby, learn something new, start a new home exercise routine, and spend more time in nature.
In Italy, where the virus has spread like wildfire, and extreme measures of nearly complete isolation of the entire country has been ordered, the people are creating new coping strategies. According my Italian friends, many people have been creating virtual social gatherings with friends like daily virtual happy hours or virtual workout parties. Also there are numerous balcony-singing flashmobs - people in different towns sing and playing musical instruments on their balconies, often creating beautiful neighborhood performances singing together from their windows. I am sure you've seen plenty of youtube videos :)
I am sure you've also noticed that there are a lot of funny memes that are in circulation. It feels like everyone's sense of humor has been amped up 10 fold! Let's keep it up! Let's keep smiles and laughter going. You know what they say, "laughter is the best medicine" :) (PS: trust me, I am doctor ;)
On 03/21/20 a rapid test for the virus has been approved by the FDA (results in 45 minutes). Rapid (minutes) testing has also become available at many hospitals in the US and around the world.
In Japan and China doctors have been successful at treating COVID-19 with Avigan (favipiravir); however, the drug appears not to be widely available at this point.
As for many of us, our lives have been turned upside down, people are tapping into their potential, becoming more resourceful and more creative.
Parents have unique opportunity to spend time with their children and teach them about life, things that one would never learn at school.
Spiritually, many people are experiencing an "awakening" of sorts. People are feeling more connected to each other in spite of social distancing. There is this paradoxical sense of calm in the spiritual communities around the world - a sense of knowing that that we have all the tools we need to win this fight of light against darkness.
ADDITIONAL RESOURCES
Up to date as of 04/15/2020
As a medical doctor, I am obligated to share official sources of information, such as what's recommended by WHO and CDC.
Unfortunately, over the last few weeks of me doing extensive research on Coronavirus, it has become very clear to me that both organizations not only lag substantially with their recommendations, many of their suggestions are not based on the available data.
I am NOT a conspiracy theorist. I believe in science - I need scientific evidence before I commit to any view. In this case, I simply had two weeks off work and had a lot of time which I devoted to Coronavirus research (personal time, not being paid to do it, motivated by the sense of duty as a doctor nothings else).
During the last several weeks I've read thousands of pages of available research. Based on that research, it has become clear to me that some of the information that is shared with us by the official sources does not accurately reflect medical and scientific findings. I am not saying that the healthcare guidance organizations like WHO and CDC are purposefully misleading the public and healthcare professionals, but I am simply sharing what I've discovered. So I am not speculating about the reasons for some of the misinformation, but only stating that some of the guidance is out of date and may be inaccurate.
I know that I am not the only one who has changed my views about the current recommendations.
Since the beginning of the pandemic, many of you may have changed your views about certain events, about certain political figures, government officials, and other authorities. Please continue to be open to changing your mind about what's going on more than once - it is a lot more complicated than it seems.
Look at everything with a critical eye, use common sense, trust your gut feeling.
Here are the official resources for your information:
Unfortunately, over the last few weeks of me doing extensive research on Coronavirus, it has become very clear to me that both organizations not only lag substantially with their recommendations, many of their suggestions are not based on the available data.
I am NOT a conspiracy theorist. I believe in science - I need scientific evidence before I commit to any view. In this case, I simply had two weeks off work and had a lot of time which I devoted to Coronavirus research (personal time, not being paid to do it, motivated by the sense of duty as a doctor nothings else).
During the last several weeks I've read thousands of pages of available research. Based on that research, it has become clear to me that some of the information that is shared with us by the official sources does not accurately reflect medical and scientific findings. I am not saying that the healthcare guidance organizations like WHO and CDC are purposefully misleading the public and healthcare professionals, but I am simply sharing what I've discovered. So I am not speculating about the reasons for some of the misinformation, but only stating that some of the guidance is out of date and may be inaccurate.
I know that I am not the only one who has changed my views about the current recommendations.
Since the beginning of the pandemic, many of you may have changed your views about certain events, about certain political figures, government officials, and other authorities. Please continue to be open to changing your mind about what's going on more than once - it is a lot more complicated than it seems.
Look at everything with a critical eye, use common sense, trust your gut feeling.
Here are the official resources for your information:
WHO (World Health Organization) - WORLD primary source of information
CDC (Centers for Disease Control and Prevention) - USA primary source of information Worldometer (statistical website run by an independent company) - additional information Johns Hopkins Coronavirus Research Center - live map of global COVID-19 cases Google Coronavirus site - announced 3/21/20 (currently basic, likely to become a great resource soon) CDPH (California Department of Public Health) - CA primary source of information San Diego County official government website - local information. In San Diego you can also call 211. As of 03/20/2020, World Health Organization can send you direct COVID-19 updates through a WhatsApp App on your phone or your computer. To get these alerts CLICK HERE. You can visit WHO website to learn more.
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INTERVIEW WITH AN EXPERT - DR. BRUCE AYLWARD
Please note, information in the videos below was accurate at the time that they were created. Since the situation is evolving so rapidly, I cannot guarantee that the video below will be relevant. As of 03/23/2020 they still were (I will rewatch again in a few days to confirm whether or not this information is still up to date).
CHRIS MARTENSON, PhD ON CORONAVIRUS SITUATION
DR. ZUBIN DAMANIA ON CURRENT CORONAVIRUS SITUATION
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