Have we hit a tipping point? Sure sounds like it, so what should we do now?
Let’s put this in perspective, We have known about this illness for all of 75 days, and it appears now that the spread of this disease will continue and containment is probably not an option, so what do we do. The most important thing is to be educated on what one can personally to prevent the illness and protect themselves and others.
One is to limit the emotional contagion that we are seeing run across this country, the 24/7 media coverage, and the social media promote this. We need to understand the stress that this is putting on ourselves. In reality we know this virus for 80% of the population would end up with minimal or minor symptoms, similar to what we see with the 4 common Coronavirus.
Stories this weekend about Spring Training not allowing kids to get autographs, major conventions being cancelled, talk of the Final Four and Olympics being held without fans in the stands, do we all need to stop and take a deep breath. Stockpiling supplies does nothing but add to the hysteria
So lets have a reality check.
If you had common cold symptoms would you want to be tested for Coronavirus? Why? What would you do with the results of the test. If positive, will we accept a 14 day isolation? How will we decide who actually needs to be tested? Is the testing being completed to limit the spread or is it out of personal concern.
The concern raised in the media touts the number of deaths from the virus and unfortunately is projecting a mortality rate that is being compared to influenza without true or accurate numbers. We do not even have a good definition of what is a positive case, as China has changed the definition, and now testing around the world is giving us a number of positives, but what about the individuals who have minor symptoms and don’t get tested, what about the individuals who have probably already had the illness and have recovered, how do we count them.
When we discuss the mortality rate of influenza we take the known deaths due to a complication with influenza, and we divide that by the projected number of cases we are seeing based on data from previous years as well as the tracked numbers of those hospitalized for influenza. In the case of Coronavirus we are taking the number of deaths and dividing that by the number of known cases, this gives us a high number. What it doesn’t take into consideration is the cases that go undiagnosed and are mild symptoms cases in most cases less severe than annual influenza. We don’t know the true number of cases and thus the hysteria around death rates is probably wrong. If we used the math that is being used for Coronavirus on Influenza cases we would see a death rate much higher than the rate being reported for Coronavirus, yet time has told us that we have millions more cases of influenza that is actually reported, tested or needing hospitalization. The student that was traveling abroad in Italy who contracted Coronavirus, in interviews said, he had a runny nose and a little cough, he was discharged from the hospital after a day.
We need to realize that we have no treatment, so the identification would be to only to indentify and isolate, we will eventually will hit a tipping point where isolation does not have an impact. When we hit that point which we will, we need to ready to switch quickly to protecting those at most risk as well as maximizing our immune system to fight this off. We have seen those who have died from this illness be for the most part older and with other chronic illnesses. This is not dissimilar to what we see with influenza, a disease that kills 30,000 people in the United States each year.
What can we do? Important for all of us to maximize our immune system as we know the impact of this illness is hitting those with a compromised immune system the hardest, so doing all we can to have a strong immune system is important. What simple things can we do? These are things we should be doing during every cold and flu season. Just a few practical points, one is social distancing, staying 6 feet away from an individual who is ill, a cough or sneeze will project viral droplets up to 6 feet. This is something we should be doing thru out the flu season.
1. Get enough sleep, this is simple, costs nothing and everyone can do it
2. Wash your hands, even if it just with soap and water, but make sure you wash for 20-30 seconds to get the true response needed not the 5 seconds most normally do. The type of soap really does not matter
3. Minimize shaking hands and hugs during cold and flu season
4. Keep your environment clean, especially in common areas where equipment is shared.
5. Cough into your elbow or into a tissue as coughs and sneezes spread virus materials about 3-6 feet
6. Use social distancing when appropriate
7. Do not go to work or public events when you are sick, this one is the most important and amazing to me. I see patients all the time who are sick with influenza and want to go back to work because they are needed or they can’t miss a day, yet they are sick with 103 fever and body aches but now we have people who want to be tested who have minor symptoms and will be told not only can’t they go to work for 14 days but they can’t leave their homes
8. Take vitamins and eat a good diet, more on this later.
9. Stay away from older and immunocompromised individuals if you are ill, a face time call can still be supportive without risking transmission
10. Calm down and do things that will decrease your stress levels, we know that the emotional contagion we are seeing now is impacting more than our immune system
Let’s talk a little bit about diet and how a good diet can impact our immune system and health. We know that a good balanced diet is good to minimize our chance of cancer and heart disease, well it can also boost our immune system and let us fight infections more efficiently. So what foods should we consider at a time when we are trying to protect ourselves from any viral infections
1. Citrus fruits are very important, Linus Pauling noted the importance of Vitamin C, in fact many people still to this day turn to Vitamin C after they have an infection. Taking it on a regular basis before having an infection is a good idea. We do not store Vitamin C in our body so a daily dose of this in pill or fruit form is great. With the fruit you also get the benefit of fiber
2. Red Bell peppers- if you want vitamin C and don’t like fruit, Red Bell Peppers are your answer as they contain more Vitamin C than citrus fruit.
3. Broccoli- this is one of the healthiest foods you can eat, not only is it loaded with Vit A, C and E, it also has antioxidants as well as fiber. Cooking this without boiling it maximizes the vitamin content
4. Garlic has always been known to help our immune system, it is also thought to help lower blood pressure.
5. Spinach- this leafy vegetable is not only loaded with Vitamin C, but it also has antioxidaents and beta carotene which helps raise our immune system
6. Kiwi- this unusual fruit is loaded with potassium, folate along with Vitamin K and C
7. Shellfish- this is not a food one would think but a lot of shellfish are loaded with Zinc
8. Vitamin D- although we had a great sunny weekend this is the time of the year that we do not get enough of this important vitamin
Vaccine- many think we should have a vaccine made already and President Trump has misspoken when he said we will have a vaccine in six months. Experts have corrected him to let us all know that the timing for a commercial available vaccine is more like 12-18 months away. That timeline also would not allow for extensive testing of the vaccine.
The interesting thing about this idea is that we don’t know a lot about this virus, will those who have been infected already have immunity and not need a vaccine? Will young healthy get a vaccination, when many won’t get a flu shot for an illness that causes much more severe symptoms than Coronavirus appears to cause in healthy individuals which are minimal upper respiratory symptoms. Remember we have about a 45% immunization rate for Influenza which is an illness that causes 29 million cases, 280,000 hospitalization and 20,000 deaths each year.
The big message is do what you can to protect yourselves mechanically, physically and mentally. Protect those around you, limit any exposure that you can, so don’t go to work if ill. Again these are all simple things we should do during all cold and flu seasons. I wonder what impact we would make on the 20,000 deaths from influenza we see each year if we took it ½ as serious as we have this illness.