The Current Status of the CoVID-19 Pandemic
CoVID-19 started infecting people in the city of Wuhan, China in mid-December of 2019. Within a month, more than ten thousand people were infected and hundreds had died. The death rate was about 16% in the first two weeks but reduced to about 4% by mid-February and currently stands at about 2%. The initial outbreak caused many people to die who would have survived if they had received medical treatment. Unfortunately, the Wuhan medical system was unable to treat the extremely large number of seriously ill people seeking help. Simply put, the large number of seriously ill people greatly exceeded hospital capacity. Consequently, many people who needed basic care for dehydration and fever could not find care. China now reports a death rate of 0.7% outside of Hubei Province.
A death rate of 2% is about 13 times greater than the incidence of death from seasonal flu. During the last flu season, 2018/2019, CDC reports 35 million Americans caught the flu and about 56,000 people died establishing a death rate of 0.15%. If the same number of Americans, 35 million, became infected with CoVID-19 and the death rate was actually 2%, CoVID-19 could be responsible for 700,000 deaths. However, there are several reasons to believe that the death rate is much less than 2%.
As of 10 March 2020, when this essay was prepared, there were about 100,000 confirmed cases and about 4,000 deaths for a death rate of 4% (but this includes the data from Wuhan). Data from many countries now reporting show that about 80% of infected people experience mild to moderate symptoms. It is likely that a large number of infected people with mild or very mild symptoms are not represented in the data because they never felt sick. The missing cases skew the death rate towards a higher rate. So, the 2% death rate is probably high due to the “non reports” of people simply not accounted for in the data.
The U.S. will not see anything like what happened in Wuhan, China for the following reasons: 1) our medical systems are prepared to some extent, we hope; 2) individually, we have had time to prepare; 3) the symptoms and infection vector of CoVID-19 is well fairly-well understood; and, 4) our collective understanding of the threat and hygiene vigilance will slow the spread putting less stress on our health systems.
Regardless of what you have heard – even the President telling people it is ok to go to work – we should prepare for a possible mandatory or voluntary 14 day quarantine. This requires at least 14 days imprisoned in your house. It is possible or likely that your office building, place of work, church, your children’s school or other group activities will be cancelled or closed for a period of time. It is more probable than not that you will be exposed to CoVID-19 in the near future.
For updates on the spread of the virus, check this CDC web page. https://www.cdc.gov/coronavirus/2019-ncov/cases-in-us.html CDC updates the page every day at noon. Another good site is the John Hopkins “dashboard” at https://coronavirus.jhu.edu.
What is a Virus
Not all scientists agree on the history of viruses or even whether they are actually “a living organism”. Biologists don’t agree even on where to place them on the “Tree of Life”. Viruses are very complex and come in many shapes and modes of action but they have the following generalized features in common:
- They are a very, very, small – around 200 nanometers (nm) in length or circumference. How small is 200 nm? They are about a million times smaller than the head of a pin. So, yeah, they are pretty small. When first discovered, they were called, “ . . extremely small infectious particles” because microbiologist and other scientists did not know how to classify them.
- All viruses are composed of a small piece of DNA, RNA or both. You remember DNA, the stuff made from nucleic acids, Crick and Watson, “double-helix”. As you remember, it is the memory bank that holds all the information necessary to make you – YOU. A virus is a short piece of DNA or RNA, or both wrapped inside a protein shell sometimes called an envelope, or just “enclosure structure”. The shape of the envelope is quite diverse and can be very complex.
- Some viruses are very “sticky” and remain in spittle and adhere to surfaces like your hand or the deli countertop. You are exposed to sticky viruses when an infected person sneezes or coughs on you. There are thousands or millions of viruses in the water/mucus droplets (aka, “spittle”) expelled in a sneeze or cough. You are also exposed if you touch a surface where infected spittle landed like the movie theater candy counter. Some viruses are not sticky but can float in the air after being released in a sneeze or cough. As you could imagine, these are much more contagious than the sticky kind.
- Viruses do not have the capacity to reproduce by themselves. They duplicate by drilling through the membrane of a living cell and inserting their piece of DNA, RNA or both into that living cell. Since there are about 6 billion cells inside each of us – new viruses have many to choose from.
- The inserted piece of viral DNA or RNA then hijacks the human cell and forces it to make copies of the virus. The human cell makes many copies before it eventually dies and releases all of the newly made viruses. The new viruses are inert. They just float around in your blood stream, or climb aboard the spittle launching pad for an inter-host joy ride, until they find another cell to hijack.
How CoVID-19 Got Its Name
CoVID-19 actually has two names. It was given a formal name using international conventions that go like this. CoVID-19 is in the class of viruses known for having “crowns” on the surface of their envelopes. The first definition of the Latin word “corona” is crown – the second definition is “beer with lime”. It was first identified in Wuhan, China in December 2019. So, its formal name according to convention is, “Corona Virus Identified in 2019”. That name was too long and no one liked saying it, so it was given the nickname, “CoVID-19”, that we all use today.
CoVID-19 is related to the virus that caused the Severe Acute Respiratory Syndrome (SARS) epidemic in 2003/2004. That virus had the name, CoV-SARS, which stood for “Corona Virus that causes Severe Acute Respiratory Syndrome”. CoVID-19’s other name is “CoV-SARS-2”, but no one uses it.
How You Get Infected
Our principle exposure to CoVID-19 is coming into close contact with an infected person. Typically, you are exposed when someone close to you (as in proximity, not as in relationship) coughs or sneezes either directly on you, your clothing, or on a surface that you later touch like your iPhone. Viruses in dried spittle from an infected person can be found kitchen counters, doorknobs, telephones, light switches, water faucets, handrails, computer keyboards etc. The exact amount of time the virus can survive in dried spittle is unknown. Data suggests it can survive from 2 to 7 days. Viruses cannot penetrate your skin. You become infected when you touch the contaminated surface and CoVID-19 takes a joy ride on your finger or hand until you touch exposed body tissue, typically on your face like rubbing your eyes, poking your nose, or using your fingernail to get that piece of orange pulp stuck between your teeth. I’ll say it again. The most frequent form of virus transmission is by getting cough or sneezed on, and data suggests that you can get infected from touching a contaminated surface for up to 7 days after the surface became contaminated.
Once transferred to your body tissue, the virus spreads throughout your body and implements a Dr. Evil-like master plan to enslave your cells and force them to make many copies of the virus. That is right, think of many “Minnie Me” evil doers.
So, wash your hands (like 10 times a day) and stop touching your face. You just touched your face! Yes, you did. I saw you.
A Bit More on Viruses
Viruses have been around through all recorded human history. They are a human parasite. They are extremely complex and reproduce by varied and intricate strategies. If we were to anthropomorphize viruses, we would conclude that they are extremely intelligent or clever. Some viruses, such as HIV, incubate for years inside their host before the host becomes sick. Some goofy viruses, like common measles (Rubeola) and German measles (Rubella) are totally not sticky and infect other hosts as aerosols (i.e., floating on the air). When an infected person sneezes, the virus and the spittle are injected into the atmosphere. Rubeola, being a non-sticky virus jumps off of the spittle and floats on the air until someone comes into contact with it. It can stay suspended for fairly long period of time – like days. On rare occasions people have been infected by walking into a closed room where an infected person sneezed two days before they entered the room.
The Cure for CoVID-19
There is no cure for the vast majority of human pathogenic viruses including CoVID-19. We are sick until our body devises a way to kill the invader. Our bodies have many defense plans to counter a viral attack. The first line of defense is to understand the vector of infection: “one if by hand, two if by spittle and three if by air”. Not really, but our immune systems do need time to identify the invading virus and let the rest of the body know about the invasion. Our bodies create specific proteins to attack and more importantly mark the invader virus with something like a “Scarlet Letter” so our warrior cells, called lymphocytes can identify them and devour them. Each virus requires a unique counter-attack and this takes time. Think of a virus infection as a race between the virus trying to make as many Minnie-Me(s) as possible and our body’s immune system struggling to devise and implement a defense plan. For this reason, people who are immuno-compromised (i.e., have a weakened immune system) are most vulnerable to virus infection. Immuno-compromised people include the elderly (over 70), people who are already sick from another disease, people taking chemotherapy to fight cancer, and children who don’t have a fully developed immune system. There is a CoVID-19 exception for children. For some reason, still unexplained, children under the age of 14 do not seem to be affected by CoVID-19 at the same rate and intensity as adults.
Do Vaccines Cure Us
In case you were absent that day, vaccinations can protect us from viruses like CoVID-19 but do not cure us. It takes time to develop and test an effective vaccine. Vaccine development and preparation can be quite complex, but in its simplest form, a vaccine is a sterile-water filled syringe containing millions of dead viruses floating around in the water. The viruses cannot attack our cells BECAUSE THEY ARE DEAD, but our body doesn’t know they are recently deceased and attacks them anyway. The presence of the dead viruses in our body triggers a full immune response including the creation of virus-specific proteins and activated warrior cells. It is not a fair fight! The dead viruses lose every time. Our immune system has an exceptional memory and will be immediately ready to fight that virus if it ever sees it again. With this giant head start, the virus is guaranteed to lose in a future infection because —- we are immunized, which is sort of like a Super Power.
We can expect there will be a vaccine for CoVID-19 in the future. In the meantime, our best defense is to delay our exposure or avoid catching CoVID-19 altogether.
The Public Health Perspective
The goal of our public health systems is threefold: 1) slow or stop the spread of the virus through the general population; 2) identify and protect immune-compromised people; and 3) develop effective medical treatment strategies.
In general, epidemics spread within a bell curve. Epidemics begin with a few new infections per day. As time goes by, the rate of new infections per day increases exponentially. Within a week or month there is a surge of sick people looking for medical help. If the surge is greater than the medical system can handle, you have what happened to the City of Wuhan, China. The peak was so large, hospitals ran out of beds and the medical system was overwhelmed. After the peak of new infections per day passes, the rate of new infections declines as the epidemic wanes. Public health systems make recommendations designed to slow the spread of the infection. By slowing the spread of the infection, the number of sick people needing medical assistance during the peak of the epidemic will be smaller reducing stress on the system. If there is going to be a shortage of medical professionals, medicine or hospital beds, it will happen during the peak.
Many of the people who died in Wuhan during the early days of the outbreak, died because they could not get medical care. The Wuhan medical system was caught off guard. They did not know an epidemic had started and subsequently, were not prepared for thousands of seriously ill people to descend on the hospitals. Some argue that Chinese officials knew but did not respond soon enough. Some argue that the U.S. is not responding fast enough. These arguments are a waste of time. We have been warned. We will benefit from the accumulated knowledge of prior treatment strategies, and we are already taking personal steps to avoid and prepare for a quarantine or the illness itself.
What You Can Do
The greatest risk of exposure (i.e., catching the virus) occurs at places where people meet or gather, such as, church and schools, retail stores and malls, nightclubs and transportation hubs like airports and train stations. Essentially, any place people get together and are likely to come within one meter, or three feet of each other. For this reason, many sporting events and conferences are being cancelled or postponed.
If you attend a place where people gather, consider a fist bump or a Buddhist bow of gratitude instead of shaking hands. Shaking hands is an exposure multiplier. When you shake someone’s hand you are not
doubling your exposure, you are increasing your risk of exposure by a multiplier equal to the number of potentially contaminated surfaces the other person’s hand touched prior to touching you.
Carry a pen with you at all times. Avoid using the pen provided when paying for a meal, signing for a purchase or taking notes at a class or conference.
Make a habit of using a finger other than your index finger to do mundane tasks because you touch your face most frequently with your index finger. Use your little finger to sign at checkout, when entering a PIN at an ATM machine etc. Use your little finger because you are unlikely to use that finger to touch your face, rub your eyes or wipe your lips. By concentrating on using your little finger, you will also be reminded of the other precautions you should be taking.
WASH YOUR HANDS FREQUENTLY FOLLOWED BY HAND SANITIZER
The first line of defense from pathogenic bacteria and viruses is handwashing. The CDC recommends handwashing and the use of hand sanitizer in addition to hand washing. The CDC does not recommend hand sanitizer as a replacement for handwashing. Hand washing is preferable because soap contains surfactants and dispersants. Surfactants are chemicals that lift dirt from your skin (or any surface) while dispersants keep the dirt suspended in the soapy-water mix before it is rinsed down the drain. In reality, many surfactants are also dispersants but we don’t need to go there. The word “surfactant” explains what it does – it squeezes into the very small space between the skin of your hand (a surface) and the dirt sticking to your hand. Think of surfactants as chemicals that peel dirt off of you. Along with the dirt, surfactants also peel off sticky viruses and other pathogens. It is easier for soap to peel the virus off of you than for the hand sanitizer to kill it.
Wash your hands for 20 seconds!! How long is 20 seconds? If you wash your hands while singing Happy Birthday twice, you will have washed your hands for about 20 seconds. Bring your hands to a frothy lather (lather is important), rinse with clean water and dry hands with a clean cotton towel, paper towel or air dry.
CDC does not recommend hand sanitizers as a replacement for hand washing with soap. A full hand washing followed by hand sanitizer is best. Do you get it? Washing your hands is better than using hand sanitizer.
Use store bought varieties of hand sanitizer if you were lucky enough to stock up before stores ran out. The effective agent in commercial sanitizers 60% to 70% by volume ethanol. Ethanol is the drinking kind, which means vodka can be used as a sanitizer. However, most vodkas are “80 Proof”, which means they are 40% ethanol by volume. Unfortunately, pharmacies and convenience stores never thought of stocking enough hand sanitizers to cover an epidemic and most have run out. No reason to fret, there are many substitute products still available at stores or you can make your own. Even if you have hand sanitizer, wash your hands frequently. It is all about washing your hands!!
Make your own hand sanitizer.
Organic Hand Sanitizer Formula
- 8oz of Aloe Vera
- 1 tablespoon Witch Hazel
- ½ teaspoon Tea Tree Oil
- ¼ teaspoon Vitamin E oil (break open a capsule)
- 10 to 20 drops of Lavender Oil and/or Peppermint oil for scent
- Mix into a squeeze or squirt bottle and shake.
Witch Hazel has antiseptic qualities equal to alcohol. Lavender also has some antiseptic qualities. Everything else is fragrance and skin conditioning.
Isopropyl Alcohol (aka, Rubbing Alcohol)
- Mix rubbing alcohol with a few tablespoons of glycerin, lanolin or vitamin E
Rubbing alcohol is as effective as ethanol and the glycerin is for skin conditioning.
Windex™ is 4% isopropyl alcohol and ammonia with a few common surfactants and dispersants (it is a cleaner after all). Windex can be used both a cleaner and a sanitizer. Throw in some glycerin, lanolin, vitamin E if you want a skin conditioner.
Mouthwash is 21% methanol, which is 44 proof. Methanol is poisonous if swallowed but not dangerous as a hand wash. After all, it was intended for your mouth anyway. It has other antiseptic chemicals as well.
Maintain A Strong Immune System
The best way to maintain a strong immune system is to eat fruits and veggies, exercise by walking for 20 minutes a day, get adequate sleep, remember to unwind after stressful situations by taking centering breaths or a brief meditation.
Vitamins and supplements can help especially if you think you might be immuno-compromised.
Non-western medical experts I respect recommend the following herbs and plant extracts to strengthen your immune system and/or as part of your response to a viral infection:
Extracts of plants used in Gemmotherapies include:
- Black Current and Dog Rose strengthen your immune system
- Hazel supports respiratory function
- Oak is an antiviral agent
- More information at: Maegan Lemp, L.Ac., Dipl.Ac. (http://aculemp.com)
Herbal supplements include:
- Echinacea, an anti-viral agent and boost to the immune system. Echinacea is frequently combined with other herbs that work closely with Echinacea to strengthen the immune system.
- Andrographis combined with other complimentary herbs is popular with Ayurvedic and Chinese approaches to support immune and respiratory system health.
More information at: Melissa Gale, L.Ac., Dipl.Ac. (https://www.facebook.com/MelissaGale.Acupuncture/ )
Now for the Nitty-Gritty
The greatest risk of infection is coming in close contact with an infected person at home, work or in public spaces. So, you skipped church, they cancelled the PTA meeting but you still have to go to work and maybe travel. This will undoubtedly put you into close contact with people like the public restroom. Here are a few, but not at all exhaustive, strategies you can use to get in and out of public restrooms where you will be required to touch doorknobs, faucet handles, and toilet paper and paper towel dispensers.
How to Choose a Stall
Studies that tracked toilet paper use in public restrooms found that most people pick the middle stalls in a public bathroom. Assuming all stalls get cleaned at the same frequency and to the same extent – statistically the end stalls have the greatest chance of having toilet paper and being exposed to fewer people, which reduces the number of potentially infected people having used the stall before you.
Do Not Fear The Toilet Seat
Don’t fret over the toilet seat. Many studies show there is very little risk of exposure to a contagion from the seat. If you are still concerned, use some toilet paper to wipe it down before use. Even better, if you carry an alcohol based sanitizer, put some on to the toilet paper before you wipe. If you are a responsible male, use toilet paper when you lift the seat. If you are an irresponsible male, use toilet paper when you lift the seat.
The real nitty-gritty, no one who used the stall before you washed their hands before touching the stall handle while exiting. You should assume your hand is contaminated and head straight to the sink to wash your hands. Here again, no one washed their hands before they turned the water on. Hopefully, there is a motion sensor faucet, but if there isn’t, you can use your bare hand because you are already working from the assumption that it is contaminated.
There is scientific – though not conclusive – evidence that CoVID-19 can be transmitted on feces. The same was found for the last coronavirus outbreak, SARS, in 2003/2004. Building code modifications specific to stopping the spread of coronavirus were released in 2008. There were many changes but the most noticeable change was the removal of bathroom doors on high volume public restrooms, such as, federal highway system and airport rest rooms. Instead of a door, you walk through a short maze. The modification reduced the necessity of touching the door handle while entering or leaving.
So now you washed your hands while singing Happy Birthday, but you need to turn off the faucet (maybe); and you need to dry your hands; and you need to get out of the bathroom without getting contaminated. What do you do? For fun, I put together a bathroom exit strategy flow-chart on the next page. It is goofy, but fun.
A Few Closing Thoughts
You do not need to put away enough food and toilet paper to wait out the Zombie Apocalypse, but you should stock up with enough food and household items to live comfortably through a two or three week quarantine. This includes food and drink for three weeks, extra paper products including Kleenex™ tissue, and typical non-prescription medications like Advil® and Tylenol® and decongestion and cough medicines (if you use them). You might consider buying a few books to read, a new puzzle or board game – after all – you will have time on your hands.
If you or someone you care for gets sick, make sure you call ahead before you go to the doctor’s office or hospital. If you suspect CoVID-19, make sure to have them wear a mask to protect other people in the house and/or people you meet along the way and to the doctor’s office or hospital. Masks do little to protect you but are very good at protecting other people if you are sick.
Don’t be fooled into thinking that the CoVID-19 threat will be over anytime soon. It could take a considerable amount of time for the initial wave of infections to pass through the U.S. – like many months. It is possible and likely it will remain in the news through the summer. It is reasonable to think the Summer Olympics will be postponed and baseball will be played in empty stadiums. It is more likely than not that CoVID-19 will show up in the future as localized breakouts or associated with seasonal cold and flu.
If you work in a group setting, consider weekly meetings to discuss load management if someone or multiple people get sick at the same time. Establish a phone/text/email tree and make sure you check-in on each other frequently.
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