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We Must Stay Calm and Carry On

As many of you know, I am a nurse with a master’s degree in public health.  I worked within the health care system for over 50 years (starting as a nurse’s aide when I was 15) and have always been very interested in individual, community and worldwide health.

This is a time of uncertainty as the coronavirus spreads from country to country affecting many people/populations, economies, lifestyle, and really everything.

In the interest of disseminating information that will be helpful and understandable, I have been doing some research that I want to share with all of you.

What is Covid-19?

Covid-19  is in a large viral family (Corona), which is responsible for about 25% of common colds. Six Corona strains are known to us, four of which cause the common cold. Two of the known strains, however, are more dangerous — SARS (Severe Acute Respiratory Syndrome) and MERS (Middle Eastern Respiratory Syndrome).

In November of last year, a cluster of patients in China developed an unexplained pneumonia and when it was discovered that the virus causing this was a) in the Corona family and b) linked to SARS, grave concern emerged and this is what sparked the initial response.

Coronavirus (Covid-19) is different from the flu because it’s from another viral family. They do share similar symptoms (fever, cough, sore throat, body aches, nausea, vomiting and diarrhea) but they are two very distinct viruses. Covid-19 is a virus that needs to be taken very seriously. But when asking the question, “Am I at risk?” the answer needs to be nuanced.

High Transmission Rates Are The Danger

For the average person who is not elderly or immunosuppressed, the mortality rate is low. However, when a hospital administrator or a government official of a town, city, state or country asks the question, “Is my hospital, town, city, state or country at risk, the answer is a resounding YES!” This is because Covid-19 is highly transmittable. If exposed, a very high number of individuals will become infected and even though only a small percentage of that large number will require hospitalization, our healthcare system (ICU capacity) will be overwhelmed and crash.

Modeling Outcomes via The Washington Post

There is a very interesting model that the Washington Post came out with simulating the different scenarios for a fictional disease they call simulitis. They use it to demonstrate for different scenarios.

Model #1

A “free for all” where the population moves about without restrictions and very quickly the disease spreads to everyone. Denmark is using this model in the hope that their population will develop what is called “herd immunity.” Herd immunity occurs if a sufficiently high proportion of individuals contract the disease and develop natural immunity to it. Unfortunately, this is a dangerous scenario for at-risk populations and ICU capacity.

Model #2

Attempted quarantine  where portions of the population (elderly/at risk) are sequestered from the general population. This slows the rate of primary infection. However as the door opens between the two groups, the infection spreads as a secondary wave.

Model #3

Moderate social distancing where a quarter of the population is out and about and everyone else remains at home, self-isolating. This results in the disease vector moving much more slowly, which (hopefully) results in a scenario where the disease doesn’t overwhelm ICU bed capacity.

Model #4

Extensive social distancing where basically everyone is self-isolating. Here the caseload grows very slowly and the bell curve is significantly blunted and backloaded in the hope that warmer weather will kill the virus, a vaccine developed and made available, and in the meantime medical capacity to care for hospitalized patients increases before the second wave begins in the fall.

Other Sources of Reliable Information

I have found CIDRAP (University of Minnesota Center for Infectious Disease Research and Policy) to be a source for easily digestible articles with trustworthy information. Other sources include the U.S. Center for Disease Control, and of course, your own state and local news and government websites to stay informed about what is happening in your local area.

There is hope!

Here is the hope for our near future. The rate of infection will be significantly slowed due to moderate and extensive social distancing (Models #3 and #4, above), rising summer temperatures while ICU capacity is built up, and a vaccine is developed and made available.

Will this virus go away? No, but populations will increase natural immunity through herd immunity and vaccine development. We will likely see a strong first wave of Covid-19 with a decrease in transmission during the summer. So, herd immunity and vaccine development will positively impact the mortality rate of this virus, but for now, we all need to understand that Covid-19 will always be with us.

Three Basic Principles To Help You Stay Healthy

It is important not to get too fixated on numbers because this is such a fluid situation. Experts are learning about this virus on the fly and guidance will change. While that can be confusing, three very basic principles will remain fixed:

  1. Wash your hands frequently, especially if you’ve been out or been near somebody who is suspected of having Covid-19;
  2. Avoid touching your face unless your hands are clean;
  3. Self-isolate as much as possible and certainly if you feel at all ill.

Mike and I are wishing all of you well and are sending out our prayers for our collective, continued health and well-being. This too shall pass, but in the meantime, be wise, wash your hands, stay at home as much as possible, and keep in touch with those you love who may be doing the same.

All the best,

Nan and Mike (self-isolating up here in Maine!)

Photo credits:

Burst

Pete Linforth

Chokniti Khongchum

Polina Tankilevitch

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