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Dr. Bob

UPDATE - COVID-19

This update is for our patients who follow our clinic on Facebook. I will pass on more about the coronavirus from time to time, as the situation is fluid and we are getting more information daily.


First, understand that COVID-19, the illness caused by the coronavirus, is a totally new disease/condition. It caught the entire world by surprise because it is a new virus, so there is very little known about it. We are all learning together.


Look for your information from the CDC (https://www.cdc.gov/coronavirus/2019-ncov/index.html). Forget the usual squawk boxes on the Internet and Facebook, since very few of these are actually virologists, and some of those sources have political agendas. The CDC will give you up-to-date information about the virus, its spread, and ways to protect yourself.


So far, the virus seems to spread to an average of 3.5 people for every person infected. Compare this with the flu, which spreads to 1 or 2 people for each one infected, or measles, which spreads to 12 to 18 people for each one infected. Clearly, it is contagious, but it is not the worst we have seen.


COVID-19 is not the flu. It is a completely different virus. However, it does spread the same way: when infected people sneeze, cough, or talk, they produce tiny droplets that land in other people’s mouths, eyes, or nose who are within 3 to 6 feet. These droplets can be inhaled directly into the lungs.


COVID-19 may also be transmitted from touching doorknobs. It is quite possible that it may be transmitted from touching any hard surfaces such as grocery store carts, fixtures in public bathrooms, or pens shared when you sign in at a doctor’s office. You might infect yourself if you touch your mouth, eyes, or nose after handling contaminated materials.


You will hear the frightening term “pandemic” when this virus is discussed. Don’t let the word scare you. It simply means that the virus will spread, and is spreading, across multiple countries and continents. This says nothing about severity. It just means that the virus is spreading. This is to be expected with modern modes of transportation they can take people, for example, from Europe to Atlanta in a single flight in just a few hours. A pandemic can spread much faster today than it could even 50 years ago because of the availability of modern travel.


The Trump administration is taking steps now to restrict travel from infected countries in order to protect Americans. Nevertheless, the virus is already here, and there is every likelihood that it was brought here before we even knew there was a problem. People who carry the virus may not be symptomatic.


There are many practical things you can know and do to protect yourself.


  • Avoid contact with people that you know are sick. You can still take them chicken soup, but leave it at the door.


  • Try to avoid touching your eyes, nose, or mouth while you are in public. Keep your hands in your pockets or close to your own body.


  • Wash your hands in warm water whenever you touch something that other people have handled. Sing happy birthday to yourself while you are briskly rubbing your hands together with soap. This should give you the full recommended 20 seconds. Handwashing is not perfect, but there is no substitute for mechanical cleansing.


  • To be on the safe side, use an alcohol-based hand cleaner (at least 60% alcohol) after you wash your hands with soap and water. Some of these have moisturizers in them, and that is actually better because repeated washing may dry your skin and cause cracking. Bear in mind that for the alcohol-based hand cleansers to work, the lotion needs to dry on your skin. So, apply it to your hands and rub briskly, letting your hands air dry.


  • Don’t use a surgical mask to protect yourself. It will not keep you from inhaling droplets. In the hospital setting, a mask might be helpful for someone already infected to keep them from spreading it to others.


  • If you are sick, or feel sick, stay home. Don’t go to church, to lunch with friends, or to any public place. About 80% of people with COVID-19 have mild symptoms, so people discount it as just a sniffle and go about their business. This helps spread the virus farther.


  • If you have fever, cough, shortness of breath, or difficulty breathing, quarantine yourself until you are free of fever for at least 24 hours without the help of any medications.


  • If you are in a public place, avoid hugs and handshakes. At my church today, we practiced “elbow bumps” as an outward show of affection, laughing as we did it. Amusingly, in a Baptist Church, that might be construed as dancing.


  • CDC is recommending avoiding mass transit, such as cruises on ships (at this writing, there is one circling the coast of California) or flying if it can be avoided at this time.


  • If someone in your household becomes ill, clean hard surfaces such as bathroom fixtures, doorknobs, faucets, tables, phones, and toilets. Quarantine the household until everyone is well.


  • Gradually stock up on some things. Do not bum rush the stores, as there is no need for that, and panic buying will cause unnecessary shortages. Specifically, get a bottle of acetaminophen or ibuprofen or both. Get a few cans of chicken noodle soup that you can open, heat, and enjoy with minimal effort, because if you were sick, you will not feel like cooking. Consider picking up Kleenexes, paper towels, soap, etc. Get some bleach or cleaning wipes. Maybe you should throw in some paper plates, plastic utensils and drinking cups so you can throw them away after use.


  • If you do get sick, stay hydrated. Here is a trick that is better and less expensive than Gatorade: in 1 L (or a quart) of water, put 6 level teaspoons of sugar and ½ teaspoon of table salt. This will hydrate you and replace some electrolytes.


  • If you take prescription medications, stay a month ahead in your supply. This will keep you from having to stand in line at the pharmacy. Consider that many people at the pharmacy are already sick.


  • Take a look at your home and think ahead about how you might take care of a family member who is sick. Think of what you might need. It is possible that hospitals could get overwhelmed, and the vast majority of people who have this virus should not be in a hospital anyway.


  • If you work, suggest crosstraining to your boss. Not only will this mitigate the impact of absenteeism, it makes you look good and may get you brownie points.


  • Consider electronic media when you need consultations or meetings with colleagues or coworkers.


So, how big a deal is this? Compare it to flu: since October 2019, there have been 32-45 million cases of flu with between 18,000 and 46,000 deaths/year in the United States. As of 7 March 2020, there have been 106,000 cases of COVID-19 with 3600 deaths globally (429 cases with 17 deaths in the US). However, this is a new phenomenon. There is no vaccine, no stockpile of premade tests, and no history. No one really knows what to expect.

It is expected that most people will be exposed to this virus. Remember that 80% of these cases are very mild--in fact, so mild that many people will not know they had it. It is possible that our healthcare system could be significantly filled with patients, and that is the real danger here.


I will put out more information later. I hope this helps. People get busy and do not necessarily have time to do research, so I will try to help as I can. If I can help you personally, call us at the office.




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