Nick, are you a meteorologist or a doctor? It is a question I’ve received a handful of times lately. Sometimes as a friendly ribbing, others as a means to “throw shade” as the kids say.
I think of myself as human. One who cares.
After kicking these updates out for a month now, we have come a long way from teh 19 people who were infected when I made the first post. In that first post I wrote, “If it spreads quickly across this country like it has in other places, it will become a problem. A big one. If it is quarantined and the medical community does a good job at suppressing the risk, it won’t be a problem.”
Fast-forward one month. And, well, yeah.
My professional identity does not come with a background in the medical field. I will never claim to have any medical expertise – outside of how to treat a sore knee. However. I do know where to look for medical expertise, how to track down medical journals, and when to trust the medical community trained to understand the human body and the body’s responses to various things.
I had a chance to track down a few friends in the medical field. They work in varying areas of the medical industry. Some are Operating Room nurses, others Emergency Room doctors. One is an OB/GYN. I asked them what it was like working through this pandemic, how they are mitigating the threat of infection and what words of wisdom they have for the rest of us.
That piece is below.
The latest Statistics
WHO Numbers
Total Worldwide Cases: 571,758
Total Worldwide Deaths: 26,494
CDC Numbers
Total United States cases: 103,321
— Travel-related: 712 (not updated)
— Close contact: 1326 (not updated)
— Under investigation: 83,318 (not updated)
Total deaths: 1,668
States reporting cases: 50 states, District of Columbia, Puerto Rico, Guam, and US Virgin Islands
COVID-19 cases reported by other medical sites:
Johns Hopkins
Total Worldwide Cases: 662,073
Total Worldwide Deaths: 30,780
Total Worldwide Recovered: 139,426
Total US cases: 122,666
Total US deaths: 2,026
Total US recovered: 1,073
These numbers differ because they are constantly being updated rather than just a snapshot upgrade in numbers once per day.
Brian McNoldy, Senior Research Associate at Univ. of Miami’s Rosenstiel School, put a chart together of the growth. 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.
The good news to report is this is now three days in a row where the total has fallen short of the extrapolated trend line. That means the spread seems to be slowing down a bit. Hopefully this trend continues.
Regional Numbers
| Total Cases | Total Tested | Deaths | Percent-positive | Mortality Rate | |
| Mississippi | 663 | N/A | 13 | N/A | 1.96% |
| Louisiana | 3315 | 22467 | 137 | 14.75% | 4.13% |
| Alabama | 720 | 4755 | 3 | 15.14% | 0.42% |
| Tennessee | 1373 | 18338 | 6 | 7.49% | 0.44% |
| Arkansas | 409 | 3398 | 5 | 12.04% | 1.22% |
| Total | 6480 | 48958 | 164 | 13.24% | 2.53% |
A few states in the region do release the number of hospitalized people due to COVID-19. Those numbers are as follows:
Mississippi: 152 (+28)
Louisiana: 927 (+154)
Alabama: Not given
Tennessee: 118 (+15)
Arkansas: Not given
Making Estimates from past research
I talked about research from the Cruise Ships that may be relevant to estimating the number of cases without testing everyone (since that isn’t a feasible option). Plus, this type of estimate would make a good “first guess” at the number of asymptomatic people (the people who don’t feel sick, but are still infected), too.
This type of estimating isn’t perfect. In fact, it is far from it. And it is just an estimate. But based on the past research, it is at least a start.
| Estimated Symptomatic | Estimated Asymptomatic | Estimated total | Actual Deaths | Estimated Mortality Rate | |
| Mississippi | 1011 | 222 | 1233 | 13 | 1.05% |
| Louisiana | 5056 | 1110 | 6166 | 137 | 2.22% |
| Alabama | 1098 | 241 | 1339 | 3 | 0.22% |
| Tennessee | 2094 | 460 | 2554 | 6 | 0.23% |
| Arkansas | 624 | 137 | 761 | 5 | 0.66% |
| Total | 9883 | 2170 | 12053 | 164 | 1.36% |
Direct from Doctors and Nurses Pt. 1
Most of the Doctors and nurses in this next part are from Oregon or Washington. Oregon seems like a reasonable analog to Mississippi. Both have roughly the same number of cases (663 vs 479) and deaths (13 each), and both states are next to states with much higher numbers.
Elizabeth Seely, a Nurse by trade and by formal education, is an RN Operating Room Circulating Nurse.
She says that she is recovering from, probably, being infected.
“I had to take time away from work for about 1.5 weeks, Seely said. “I had a coworker and close friend who had [COVID-19] with textbook symptoms. She was so spot on that they didn’t want to test her and waste a test, since tests were so far and few between at the time. I came down with symptoms about five days after she presented with symptoms. They wouldn’t test me either since they had to save tests for people needing to be admitted to the hospital. By the time they were able to test me, almost all of my symptoms were gone. The test came back negative. So unknown if I actually had it.”
Seely works at Kaiser in Portland, Oregon. A state with fewer cases than Mississippi. As an Operating Room nurse, she said that the only surgeries they are now performing are “emergency surgeries” in order to protect people from infection.
“Our process with surgeries has changed dramatically to take extra precautions while intubating patients,” Seely said. “The hospital is a ghost town, no visitors allowed. We have been preparing our OR to become ICU rooms, since we are the only other ventilators in the hospital.”
Seely noted that the hospital is undergoing construction to make the ICU rooms “negative pressure rooms,” so that the air is pulled out of the room, and not blown into the hallway.
“We also have to check out masks for the day and can only change them if they become visibly soiled (i.e. blood or body fluids from surgery),” Seely said. “It hasn’t happened yet, but they are preparing to send our nurses elsewhere, wherever needed.”
Seely, a self-described “hugger” of friends and co-workers has distanced herself from others, focused on her part to not spread the virus by avoiding touching her face and washing her hands even more. She wants to make sure no one else has to go through this illness.
“Seeing what it does to people is very concerning,” Seely said. “It completely destroys lung tissue if it is able to really take hold.”
Seely also noted the incubation period as a concern, saying the virus can travel long distances with a person before they even know that they have it.
“That’s the biggest recipe for disaster,” Seely said.
Seely also urged people to listen to the CDC and medical professionals.
“Take this seriously,” Seely said “Stay home! Your ‘quarantine dinner parties’ are not cute. You may not get sick but you can spread it to so many people so easily.”
Dr. Claire Steen, MD, is an obstetrician-gynecologist in Portland, Oregon and is affiliated with multiple hospitals..
Steen says that her hospitals are taking extra precautions to protect newborns from COVID-19 if the mother is tested positive.
“We have a few options,” Steen said. “For the mother and for the baby.”
Those options included moving the baby to a different room, or providing protection so that the baby doesn’t come into contact with virus-laden droplets. This could be by offering a mask to the mother.
Steen said that is only for if the mother tests positive for the virus.Otherwise, the team does what they can to ensure the virus never enters the room.
Steen did note, for mothers that do test positive, that that there was no evidence to suggest that the virus can travel through the placenta, infecting the baby at birth. She also noted there was no research-based evidence to suggest the virus would be transmitted through breast milk, either.
“The virus lives in your lungs, throat, nose and mouth,” Steen said. “So, unless the mother sneezes near the baby or sneezes on her hand and touches the baby, the baby should be okay.”
Steen said that since she is just returning to work, she has not experienced any changes in her workflow at this time, but is anticipating changes occuring.
She did take a moment to warn others, though.
“People should take this seriously,” Steen said.
Part 2 will be posted in the coming days, with more information from other doctors and nurses
New Information
Mayo Clinic
The Mayo Clinic has a great piece up about helping kids understand a cope with all of the changes due to the COVID-19 outbreak. If you have kids, it a pretty good (and quick) read about how to help guide the conversation about the illness. The Mayo Clinic suggests using simple facts about COVID-19 that are appropriate for your kids’ understanding:
— Define what it is. COVID-19 is caused by a virus that can make the body sick. People who have COVID-19 may have a cough, fever and trouble taking deep breaths. But some people, especially kids, who have the virus may not feel sick at all or may have mild symptoms like a cold.
— Explain how it spreads. Most commonly, the virus that causes COVID-19 enters people’s bodies when it’s on their hands, then they touch their mouths, noses or eyes. A virus is so tiny that you can’t see it. This is why it’s important to wash your hands often and try not to touch your mouth, nose or eyes. If someone who has the infection coughs or sneezes on you from a close distance — closer than 6 feet — then that also can spread the virus.
— Talk about what’s being done. You’re hearing so much about COVID-19 because it’s a new illness that has not been seen before. Experts around the world are working hard every day to learn about COVID-19 and how to keep people safe.
Be sure to discuss how your kids can stay safe:
— Encourage frequent and proper hand-washing — especially when coming home, before meals; and after blowing the nose, coughing or sneezing. Show them how to sneeze or cough into a tissue and throw it in the trash, and how to cough into a bent elbow. Clean and disinfect frequently touched items and surfaces around the house.
— Demonstrate effective hand-washing. Show your kids how to create tiny soap bubbles by rubbing their hands together, and how to get the soap between fingers and all the way to the ends of their fingers, including their thumbs. Encourage your kids to sing the entire “Happy Birthday” song twice (about 20 seconds) so they spend the time they need to get their hands clean.
— Stay home more. As school and events are canceled, and the family is staying home more, explain to your kids how this can help prevent the spread of COVID-19. Let them know that when the risks of COVID-19 become much lower or go away, they can look forward to being back in their normal routine.
— Practice social distancing. Avoid close contact with people outside of home, even if they don’t appear to be sick. Pretend there’s a bike between you and the person you’re standing near, keeping about 6 feet apart from each other. Instead of giving high-fives, fist bumps or hugs to people outside your family, give smiles and wave hello.
— Don’t forget ways to stay healthy. Healthy habits include eating a well-balanced diet, getting regular physical activity and getting a good night’s sleep.
Also from the Mayo Clinic….
Your sneeze radius is much larger than researchers previously thought. Dr. Gregory Poland, an infectious diseases expert and director of Mayo Clinic’s Vaccine Research Group says this may cause increased transmission.
Dr. Gregory Poland also points out that last week in the U.S. there were 18,000 cases, while today, there are over 85,000. He says there is no evidence that this is going to end soon.
Harvard Medical
Harvard posted another podcast relating to anxiety and COVID-19. I posted about this the other day, but just in case you missed it, here it is again. Dr. Greg Fricchione, director of the Benson-Henry Mind Body Institute at Massachusetts General Hospital, describes the tools and techniques for building resilience into your life during stressful times so we can better manage our anxieties.
John Sharp, MD, of Harvard also suggests to work toward separating out where your feelings are coming from. Doing this work can allow you to take a breath and divvy up the different emotional contributions that feed how you’re feeling.
— Try saying this, for example: “Of course, I’m more concerned than (my roommate/my friend/my family), because I’m practiced at feeling anxious or helpless.”
— The next step is to recognize that the percentage of feelings that stem from the past do not have to govern how you necessarily feel in the present. Try saying this out loud: “Well that was then, this is now.” A simple statement like this can actually open the door to some significant relief.
— Gently remind yourself of this crucial separation, cleaving the past from the present. And kindly and reassuringly remind yourself that you have the resources — both internal and external — to manage your feelings and reactions in the now. This is crucially important.
New England Journal of Medicine
In this audio interview conducted on March 25, 2020, the editors discuss transmission of SARS-CoV-2 and how to prevent it, particularly in at-risk health care workers.
Things you should be doing now
I know this can all seem overwhelming at times. The sheer amount of information being kicked out by every media outlets is like an avalanche.
So, here are some things: Stay home if you can! Gotta work? That’s understandable. Need food? Sure, head to the store. But try to skip any “for fun” activities in public where you would be interacting with others or in a place with multiple other people.
Some CDC’s guidance:
— 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.
Hi Nick. Do you think that a 14 day lockdown across the country would help. I hear Steve Bannon say today ‘if you are going to run through he’ll run quickly.’ That kimda makes sense doesn’t it.
There are medical experts who agree with that, but it would be too difficult to implement in our country. Plus there are too many people who still believe this isn’t even a problem, so they wouldn’t likely listen to a nationwide lockdown. This is a very tricky situation. I don’t envy anyone in the government right now.