As always, a reminder that I am not a medical doctor. Nor am I a healthcare professional of any kind. The point of these posts is to help people. I’m here echoing messages that are being said by government groups, medial professionals, and researchers.
I am not an expert in any medical field. Nor should you infer from these posts that I think of myself as one. I am not. At all.
These updates are my way of helping everyone sift through the riff-raff with some translation into regular English.
The latest statistics
Latest Numbers:
Total United States cases: 15,219 as of Friday
— Travel-related: 337
— Close contact: 321
— Under investigation: 15,219
Total deaths: 201
States reporting cases: 50 states, District of Columbia, Puerto Rico, Guam, and US Virgin Islands
(Numbers pulled from other reliable resources) Total United States cases reported by other medical sites:
Johns Hopkins:
Total cases: 33,276
Total deaths: 417
Total recovered: 178
Notice that the numbers have increased dramatically since Thursday morning. It could be argued that an increase in the number of tests is revealing just how many people are infected. At this pace, there will be about one million people infected by April 3rd. That has the potential to lead to about 20,000 deaths. This is why social distancing matters. Limiting your interaction with others is important.
And why #StayHome is a thing.
Brian McNoldy, Senior Research Associate at Univ. of Miami’s Rosenstiel School, put this next chart together. As it notes, it is pulling numbers from the Johns Hopkins totals. It shows the double-time of cases as about two-and-a-half days.
Some regional numbers:
Louisiana – 837
Alabama – 157
Map not available
Arkansas – 165
Tennessee – 505
Map not available
Mississippi – 207
Around the World
According to the World Health Organization
Total Cases: 291,430
Total Deaths: 12,784
Slow the spread
According to Johns Hopkins the virus can spread through airborne transmission. Research has shown that tiny droplets remain in the air even after the person with the virus leaves the area. In medical settings, these can remain airborne for up to three hours. In public, for only a handful of minutes. But, this is why it is important to avoid people who are coughing. Even if you are walking 10ft behind them, you may still be at risk for inhaling one of the microscopic airborne droplets. Even a few minutes later.
Those droplets are usually – according to the National Center for Biotechnology Information – under 5 micrometers in size. The Coronavirus itself is about 120 nanometers in size.
So for easy math, let’s say someone sneezes and leaves airborne droplets that at 4 micrometers in size. Those tiny droplets float around – and there could be hundreds – carrying with them about 30 viruses each. And those viruses can start to multiply the second they get into your system.
And because humans don’t have a natural immunity to the infection, each person’s antibodies has to learn how to attack the virus and fight it off. And, due to how the virus multiplies and reproduces itself, that could leave older people more susceptible due to the increased blood sugar (based on research).
Incubation period
I want to run some quick numbers to hopefully help put things into context. If this is your first time here, Johns Hopkins was involved in a research paper titled, “The Incubation Period of Coronavirus Disease 2019 (COVID-19) From Publicly Reported Confirmed Cases: Estimation and Application” that found the incubation period for Coronavirus to be about five days.
The results of the research found that 5.1 days was the average time of incubation and around 97-percent of those who develop symptoms will do so within about 11 days. The research noted it took more than two days for most people to show symptoms.
This creates a problem. That means if you start to feel sick today that yo contracted the disease – at least – two days ago and as long as 11 days ago. Perhaps longer.
Think about all of the places you might’ve went, people you may have seen, things you touched.
Researchers did note that the available data may have been skewed as severe cases may be over-represented in the data. That means, the incubation period may be different for mild cases. Perhaps longer. Perhaps shorter. That is unknown.
Plus, the transmission rate and resulting problem was discussed by another recent paper, “From Containment to Mitigation of COVID-19 in the US,” where the authors wrote:
Eighty percent of patients infected with SARS-CoV-2 have minimal or mild symptoms.2 Combining these characteristics and the emergence of community transmission, it is likely that silent spread has already occurred in multiple US locales. As a result, COVID-19 containment is no longer realistic and further emphasis on containment strategies may have the unintended consequence of hampering effective health care delivery for patients infected with COVID-19 and others who require general hospital care.
More research has noted that the virus can be spread when people are pre-symptomatic. That means even if you feel fine today, but were in contact with someone who was infected yesterday, you may also have the virus. And you would be able to spread it to others.
From the WHO
Sadly, the top thing from the WHO doesn’t have any science. It is about crime. The WHO issued a statement today urging people to be aware that criminals are attempting to get money from people posing as WHO officials, saying, “There has been a rise in criminals disguising themselves as WHO to steal money or sensitive information. WHO urges individuals to stay alert and to verify the authenticity of the request. Information on protecting yourselves against scams as well as reporting the scam to WHO can be found [on the WHO site]”
Incredible that in a time of crisis like this there are still people out there acting like this. Unconscionable.
The WHO did note today, though, that exercise is very important during the pandemic. Research has shown how an active body has a healthier immune response. So the WHO is encouraging people to work out while they are in quarantine.
You can find those workouts here.
From the Mayo Clinic
Along the same lines, the Mayo Clinic released a quick video with Dr. Daniel Montero, a Mayo Clinic sports medicine physician, talking about the importance of working out when you are sick. And when too much is too much.
The Mayo Clinic did mention that with social distancing being a thing, heading to the gym or a densely populated area may not be best. So head outside! So long as the weather isn’t dumping rain, as we move through Spring, outdoor temperatures should be nice enough to take your workout outdoors. The Mayo Clinic did note that if you are going to workout inside, that you should make every attempt to clean up after yourself. Especially if you live with another person / people. That means wipe off equipment, including bikes, weights, benches and yoga mats.
And make sure you are saying attuned to your body’s need for fluid. “Drink to thirst, but be aware if it’s warm outside. You may need to take in more fluid,” says Dr. Montero.
Talk with your health provider if you have concerns or experience additional pain or symptoms when you exercise.
From Harvard Medical
Speaking of wellness, I want to re-post the podcast from Harvard about coping with the stress of all of this Coronavirus stuff. It is really important that you take the time to take care of yourself during all of this.
Mental Health
Dr. Greg L. Fricchione is the Mind Body Medical Institute Professor of Psychiatry at Mass General Hospital and Harvard Medical School, and faculty editor for the Harvard Health Publishing. He offered special health report on Stress Management.
Knowing how to manage your own anxiety always takes a little thought. Ask and answer these questions:
What typically happens to your body when worries mount?
How worried are you?
What do you fear the most?
What usually helps you handle worries?
To help ward off anxiety, they recommend trying to connect with friends and loved ones through video chats, phone calls, texting, and email saying, “It really helps to feel the strength of your connections to your friends and loved ones, even though you may not be with them in person.” And, most important, they recommend to stick with sources of credible medical information, so you can avoid misinformation about the virus and the illness it causes.
For asthma sufferers
Harvard also pointed out recently that people with asthma need to be extra careful with COVID-19. Harvard notes that having asthma may increase your risk of dealing with a more severe illness from COVID-19. They recommend that you should continue to take your asthma medicines as prescribed to keep your asthma under control. If you do get sick, follow your asthma action plan and call your doctor.
Pregnant women
I’ve heard from a lot of women who are concerned about their pregnancy. And I wanted to pass along two questions and answers from Harvard.
If I am pregnant and have COVID-19, does this increase the risk of miscarriage or other complications?
There does not appear to be any increased risk of miscarriage or other complications such as fetal malformations for pregnant women who are infected with COVID-19, according to the Centers for Disease Control and Prevention (CDC). Based on data from other coronaviruses, such as SARS and MERS, the American College of Obstetricians and Gynecologists notes that pregnant women who get COVID-19 may have a higher risk for some complications, such as preterm birth, but the data are extremely limited and the infection may not be the direct cause of preterm birth.
If I get sick from the new coronavirus, what is the risk of passing the virus onto my fetus or newborn?
A study of nine pregnant women who were infected with COVID-19 and had symptoms showed that none of their babies were affected by the virus. The virus was not present in amniotic fluid, the babies’ throats, or in breast milk. The risk of passing the infection to the fetus appears to be very low, and there is no evidence of any fetal malformations or effects due to maternal infection with COVID-19.
Circling back to blood types
I’ve had a few questions from folks recently about certain blood types being at a higher risk for COVID-19. A new research paper that is in pre-print and is not yet peer-reviewed is getting a lot of traction on the web. The paper titled, “Relationship between the ABO Blood Group and the COVID-19 Susceptibility” tries to make a connection between blood type and COVID-19 infections.
In the paper, the authors note:
The ABO group in 3694 normal people in Wuhan showed a distribution of 32.16%, 24.90%, 9.10% and 33.84% for A, B, AB and O, respectively, versus the distribution of 37.75%, 26.42%, 10.03% and 25.80% for A, B, AB and O, respectively, in 1775 COVID-19 patients from Wuhan Jinyintan Hospital. The proportion of blood group A and O in COVID-19 patients were significantly higher and lower, respectively, than that in normal people (both P < 0.001). Similar ABO distribution pattern was observed in 398 patients from another two hospitals in Wuhan and Shenzhen. Meta-analyses on the pooled data showed that blood group A had a significantly higher risk for COVID-19 (odds ratio-OR, 1.20; 95% confidence interval-CI 1.02~1.43, P = 0.02) compared with non-A blood groups, whereas blood group O had a significantly lower risk for the infectious disease (OR, 0.67; 95% CI 0.60~0.75, P < 0.001) compared with non-O blood groups.
This new research cites older research as a starting point. The older paper paper, titled, “Blood Groups in Infection and Host Susceptibility” discusses the SARS outbreak and how a certain group of people – in a small sample – were infected.
Like other human coronaviruses, SARS-CoV infects the mucosal epithelium, causing an acute respiratory illness often accompanied by gastroenteritis. In a Hong Kong outbreak, there was an apparent association between disease transmission and ABO type. An epidemiology study of 34/45 hospital workers who contracted SARS after exposure to a single index patient showed that most of the infected individuals (23/34) were non-group O individuals (groups A, B, and AB). Group O individuals were relatively resistant to infection, with an OR of 0.18 (95% CI, 0.04 to 0.81; P = 0.03).
In short, both the new research and the older research suggest Blood Type A, B and AB had a higher rate of infection than those with Type O.
Before you get too concerned, or breathe a sigh of relief… The new research is not yet peer-reviewed and the old research was one, single and very small, study. On a similar, but not the same, virus.
From the CDC
The CDC has some guidelines for caring for people who end up with the virus.
Caring for someone who is sick and preventing spreading germs
– Have the person stay in one room, away from other people, including yourself, as much as possible.
– If possible, have them use a separate bathroom.
– Avoid sharing personal household items, like dishes, towels, and bedding
– If facemasks are available, have them wear a facemask when they are around people, including you.
– It the sick person can’t wear a facemask, you should wear one while in the same room with them, if facemasks are available.
– If the sick person needs to be around others (within the home, in a vehicle, or doctor’s office), they should wear a facemask.
– Wash your hands often with soap and water for at least 20 seconds, especially after interacting with the sick person. If soap and water are not readily available, use a hand sanitizer that contains at least 60% alcohol. Cover all surfaces of your hands and rub them together until they feel dry.
– Avoid touching your eyes, nose, and mouth.
– Every day, clean all surfaces that are touched often, like counters, tabletops, and doorknobs
– Use household cleaning sprays or wipes according to the label instructions.
– Wash laundry thoroughly.
– If laundry is soiled, wear disposable gloves and keep the soiled items away from your body while laundering. Wash your hands immediately after removing gloves.
– Avoid having any unnecessary visitors.
– For any additional questions about their care, contact their healthcare provider or state or local health department.
The CDC also offers some tips on provide symptom treatment
Symptom treatment
– Make sure the sick person drinks a lot of fluids to stay hydrated and rests at home.
– Over-the-counter medicines may help with symptoms.
– For most people, symptoms last a few days and get better after a week.
When this illness becomes an emergency
– Difficulty breathing or more severe shortness of breath
– Persistent pain or pressure in the chest
– New confusion or inability to arouse
– Bluish lips or face
What should I do, right now?
I know. It can seem overwhelming with the amount of information and updates flying around. But I think it is best to follow the CDC’s guidance at this point.
— Know where to get your local / state-level information
For Mississippi: https://msdh.ms.gov/msdhsite/_static/14,0,420.html
For Louisiana: http://ldh.la.gov/Coronavirus/
For Alabama: http://www.alabamapublichealth.gov/infectiousdiseases/2019-coronavirus.html
If you live in a state outside of the region, head to google and type in, “dept of health” followed by whatever state you live. Google should take you to that state’s department of health and on the main page, most states have a link to an update on the Coronavirus.
— Know the Symptoms
Look for things like a fever, dry cough, and shortness of breath. But also know when it may become an emergency. It becomes an emergency when you have difficulty breathing, a persistent pain or pressure in the chest, you develop general confusion, and if you develop bluish lips or face.
Also recognize that body aches, weak stomach, nasal congestion, a sore throat, and other symptoms of the regular flu are not the same as the symptoms with Coronavirus.
— Stay home when you are sick
Any kind of sick. If you feel like you may have Coronavirus, call your health care provider’s office in advance of a visit. If you have any sickness, the CDC recommends to limit movement in the community, limit visitors, and practice good social distancing.
— Know if you are at a higher risk
Know what additional measures those at higher risk and who are vulnerable should take. Those at higher risk include older adults (over 60), people who have serious chronic medical conditions (like heart disease, diabetes, lung disease). Some research has indicated that people with asthma may also be included in the higher risk category.
— Take steps to mitigate your infection
The CDC recommends to “Implement steps to prevent illness” by washing high-traffic areas more often, washing hands with soap and water and if someone is sick, to isolate the sick person into a low-traffic area of the home.
— Create a Household Plan
Create a household plan of action in case of illness in the household or disruption of daily activities due to COVID-19 in the community.
