Some “Facts” about Covid-19

I use the word “facts” in quotes because there is still much that we do not know about coronavirus and the disease it causes.  In what follows I have cobbled together what we know, or at least what I know, or have gleaned from research and my own experience on the subject.  If you did not read the previous blog, then I will begin by telling you that my wife, Nancy, and I have contracted COVID-19 and, I am happy to say, have survived it and are coming out the other side.

Below you will find some of the “facts” and my conclusions and recommendations about COVID-19.  Understanding these facts will give you a better understanding of what you need to do to prevent being infected:

• The virus is highly contagious and is spread by droplets that infected people spread when they cough, sneeze, talk, or perhaps even breathe. It is generally believed that a person can spray these droplets as far as 6 feet, therefore the 6 foot radius mandated in “social distancing”. We do not yet know exactly how contagious it is because not enough testing has been done of the population to really say how widespread the infection is. Some estimates suggest that it is more contagious than influenza, but really not know that yet.
• A person can be infected and have no symptoms. In some cases it can take as long as two weeks from the time of infection to the point where symptoms appear. This is why, for example, if you have been traveling, or you think you have been exposed to someone with COVID, it is generally recommended that you quarantine for 14 days.
• During the time period between when a person is first infected and when symptoms emerge they are “silently” shedding the virus. This is one of the most important things to know about this disease; people with no symptoms can nonetheless spread the disease.
• Most people have a mild case of the disease, if they do contract it; upwards of 80% of people have either mild or moderate cases. The remainder will have more severe symptoms and a small percentage of those may require hospitalization.
• The people most likely to have severe forms of the disease are generally those who are older (above 65) and who have pre-existing conditions such as Type II diabetes, heart and lung problems, auto-immune disease and those who are on immunosuppressive drugs. Obesity, because it is associated with a number of complicating factors, seems to increase the odds that a person will be more susceptible to the more severe form of the disease.
• Although the people described above are most susceptible and have higher mortality, even younger people can, inexplicably, have more severe forms of the disease. The point is that just because you are young, does not mean that you will be immune to the severe form of the disease.
• The only age group that does not seem to be susceptible to the more severe form of the disease are those between the ages of 0 and 14. That is not to say that younger children cannot be infected; it is more that, if infected, they will generally have either mild or no symptoms at all.  The important thing to know about this is that young children may have little to no symptoms, but can nonetheless be spreading the disease.
• We do not really have accurate data about the disease because testing has not yet been widely available in the US. There are 2 categories of coronavirus tests:
  • Molecular tests which look for signs of the virus’ genetic material. This test can be used to identify whether you have active infection and, at this point, can take a few days to get results. This is the one that you see pictured in the news where they are sticking a swab way up into the nose and back of the throat.  This test is also known as a Polymerase Chain Reaction (PCR) test. Currently we are hearing that there is a shortage of the chemicals (reagents) and even the swabs used for this test.
  • Coronavirus antibody tests which are blood tests and which can tell you whether you have had coronavirus infection and, as a result, have developed antibodies. If you have developed coronavirus antibodies, then it is thought that you will have some level of immunity to the disease. For those who have developed natural immunity from having been exposed to the virus, we still do not know with certainty how well the person will be protected from future exposure to the virus or how long that immunity will last. There are now antibody tests which take as little as 15 minutes and only require a couple drops of blood from a finger stick. Most of these tests are just in the final process of receiving FDA approval and are not yet broadly available. One of them called “Pixel” by Lab Corp has just gained approval and is in the process of being rolled out to the public and is designed as an at-home test. Tests like this will be a game changer because they will finally tell us how widespread the infection is and also might allow us to know who can safely go back to work without risk of being infected and of, then, infecting others.
• Common symptoms of COVID infection are:
  • Cough
  • Fever (above 100.4 is considered significant)
  • Difficulty breathing
  • Headache
  • Diarrhea
  • Fatigue
  • Body aches
  • Loss of taste and smell
• If you have some or all of the above symptoms you should assume you have COVID-19 and should quarantine until your symptoms are gone or, in the case of fever, until you have been fever-free for at least 3 days.
• The most common way that people get infected is through their own families and people with whom they live. Think about senior care facilities where, not only are residents and staff in close proximity to each other, but this particular population is at greatest risk because of complicating health conditions.
• Household pets (cats and dogs) are not generally believed to be susceptible to infection, meaning that they do not get the disease themselves. I recently saw a story about 2 house cats being infected and another about a tiger, but I suspect that these are outliers. However, like any other surface that an infected person touches, they can be a “vector” for the spread of the disease. When an infected person pets them, they can transfer viral particles to the animal’s fur and then, when a non-infected person pets that same animal, the virus can be passed to that person. The moral of the story is that if you are infected, or suspect you are, then you should let someone else care for your pets so that they do not become a source of passive transmission to others.
• If you have, or suspect you have, COVID you should be isolated, if at all possible, in your house. What this means is that you stay in a bedroom and do not come out until your symptoms abate and/or you are fever-free for at least 3 days.
• A couple final notes: There is really no reason to go to the hospital unless you genuinely have difficulty breathing. If you find that you cannot catch your breath and even mild activity leaves you gasping, then you may need to go to the hospital.  If you have to go to the ER, it is best to call ahead so that they know you are coming and that you suspect you have COVID-19; they will need to be prepared for your arrival and they will tell you what to do.  If you have a pulse oxygen meter, one of the little devices that you stick your finger into and which tells you how saturated with oxygen your blood is, your readings should not be below 90%. If your oxygen saturation is below 90% and you have significant breathing difficulties, you should go to the hospital.  If you do not have such a device, then you can also just count how many breaths you are taking per minute.  If your respiratory rate gets above 28 breaths per minute and you find that even mild exertion leaves you breathless, then it is time to go to the hospital.  Some people, when they have severe symptoms, will find that they even have difficulty talking because they are out of breath.
• Under ideal circumstances one would not self-release or be released from quarantine until you had two consecutive negative nasal swab (molecular- PCR) tests, 24 hours apart. Practically speaking, unless you are hospitalized, that is not going to happen, as testing is still not widely available.
• You may not know with certainty if you are still contagious when you are on the tail end of the disease (in the absence of testing as described above). This disease has a long tail and you may be contagious longer than you might think.  It is therefore best to take precautions to prevent others from being infected, even when you are feeling better.
• You should be wearing a face covering when you might be in contact with others and may not be able to maintain social distancing. I say “face covering” because it is not necessary for you to  wear surgical or N-95 masks; they are in short supply and are better left for front-line healthcare workers. If, for example, you are out walking the dog or just walking in the park or on trails where you can maintain serious social distance, then you will not need a face covering.  The point of wearing a face covering is to prevent you from spreading the disease to others.  If everyone wore a face covering, it would prevent a lot of the “silent infection” that occurs when a person is infected and is not yet exhibiting symptoms.
• Of course, as much as possible, maintain social distance.
• Wash your hands for at least 20 seconds (sing “Happy Birthday” twice) with special emphasis on your fingertips. The greatest viral contamination will be on your fingertips. Anytime you may have come into contact with the virus on surfaces that others touch, it is essential that you wash or sanitize your hands. For example, if you are going to the grocery store, you should sanitize your hands before you go in, wear your face covering, and then, immediately upon leaving the store, sanitize your hands again.
• Avoid touching your face, specifically your eyes, nose and mouth. That is another thing that face coverings do; they prevent you from touching your nose and mouth.
• Realize that, while the situation can be scary, there is much that you can do, both to keep from acquiring the infection and to care for yourself, if you do get infected.

In my next blog I will discuss what to do if you should happen to become infected.  As you can tell, there is a lot to know about this whole situation. Thanks for being patient and reading through this material. It is my hope that when you understand more, you will be better able to protect yourself and others. We are all in this together.