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COVID-19: What You Need to Know (March 31, 2020)

COVID-19 is bringing an unpleasant reality to the world.  Here’s what you need to know to keep your health and protect those nearest and dearest to you.

On March 3rd, Keep.Health first wrote about COVID-19. At that time, China, Italy, Iran and South Korea had over 1000 cases each. Epidemic clusters were spreading around the world with over 93,000 cases and 3000 deaths. 51,000 people had recovered.

As of March 17, 2020, the number of world-wide cases doubled from ~90,000 to ~180,000. COVID-19 officially became a pandemic. The number of countries with over 1,000 cases rose from three to sixteen. The number of recovered patients increased from 51,000 to 78,000 while the number of deaths went from 3,000 to 7,000. 

Four weeks later on March 31st, 44 countries have more than 1,000 cases of which now fourteen have more than 10,000. There are over 825,000 cases worldwide with ~175,000 recovered and ~40,000 deaths. This isn’t good news, especially for those with pre-existing conditions like diabetes or hypertension, for those in over-crowded countries with weak medical systems and for those at refugee camps. To see the spread throughout the world, here are the leading COVID-19 tracking sites:

In the United States with ~150,000 cases including many young and middle-aged adults, the rush of patients seeking urgent medical care has begun. On our front-lines, medical personnel are running short of Personal Protective Equipment (PPE), becoming ill themselves and if that isn’t bad enough, hospitals are cutting staff pay and retirement contributions, including for the front-line workers. It turns out the fear of catching COVID-19 in hospitals has caused a dramatic drop in non-essential hospital services, including their main profit driver — elective surgeries. From what we’ve heard from healthcare executives and doctors, hospitals are bringing in only ~30% of typical revenue. Financial hard-times are not the fault of the hospitals themselves. Like restaurants and hotels, they must furlough or lay off staff because of the drop in demand. Hopefully, hospital workers will be compensated well once hospitals receive stimulus money. As one doctor noted, he hopes the stimulus funding does not turn into big bonuses for hospital administrators, especially those who didn’t prepare adequately for a pandemic.

To understand more what it is like for hospital personnel, see these well-written articles.

It is particularly difficult to avoid getting COVID-19 when it survives on plastic and metal surfaces for up to three days as well as cardboard and paper for up to 24 hours. Infectious respiratory exhalations linger for at least three hours. Of note, media reports on the air survival times do not match with the actual results. The many press reports that survival time in air was up to three hours is incorrect. The air experiment lasted only three hours and there were still significant infectious amounts of virus at the end! Additionally, some researchers believe that six feet apart is not enough separation for social distancing. They’ve discovered airborne virus can travel up to 27 feet.

To help ourselves and the frontline healthcare workers, we need social distancing and strict quarantines for travelers. 

Unfortunately, as of March 31st, only 30 of 50 states have issued stay-at-home orders. Inconsistent human behavior will prolong the pandemic. You can track which states are reducing travel the most on the Unacast Social Distancing Scoreboard.

In China, they locked down cities and appointed neighborhood officials to make sure everyone complied with their quarantine. Today, any visitor to China receives a nucleic-acid test and then must undergo a 14 day isolation before they can go outside. These strict measures seem to be working and reports indicate that 80% of China’s economy has returned, but life there is far from back to normal. For more on the experience of traveling to China, see Lukas Hensel’s twitter stream on Why COVID-19 Cases Are Not Increasing in China.

Healthy Investing

Social distancing is changing our lives and negatively impacting many businesses. Many investments have plummeted in value. In China, the market bottom was at the peak of their infections. The United States has not reached peak infections and won’t likely do so for at least a couple weeks. This pandemic will impact businesses for the rest of 2020 and quite likely well beyond it. If you own stock in businesses which cannot survive 1-2 years of social distancing until vaccines become available, take your losses and switch to resilient alternatives which can recover faster. To get a sense of the long-term challenges in containing COVID-19 so we can return to our normal lives, see the insights from these infectious disease experts.

Bill Rodriguez, M.D.: COVID-19 Insights Blog

  1. Respiratory Viruses, Climate, and What to Expect as the Seasons Change (3/23/20)
  2. Treatments and Vaccines (3/21/20)
  3. Transmission and Shedding (3/18/20)
  4. How Does this End? (3/14/20)
  5. Are Some Countries Different Than Others? (3/11/20)
  6. How Worried Should We Be? (3/9/20)

Dr. Tom Frieden: There’s a Long War Ahead and our COVID-19 Response Must Adapt

Mail, Groceries and Takeout Food Safety

For groceries, order from a food delivery service if possible. This avoids infection from shopping carts, other shoppers, store air filtration systems and the checkout process. 

Once groceries, snail mail and packages arrive, assume they are infected. Either wipe down the packaging or let them sit for three days to make sure no COVID-19 survives. 

For takeout, wash hands after any contact with the packaging. Make sure the packaging isn’t placed on counter tops or any place people will contact.

See this comprehensive list on grocery and takeout food safety for more recommendations.

So what’s your path if you are infected? 

For those wondering if they have contracted COVID-19, there are significant improvements in the testing as scientists have found ways to bring the testing time down from 4 days to 15 minutes. Also, patients have discovered that the loss of smell and taste is a likely early warning sign. If you are thinking of getting tested, here’s what you need to know. CNN has also created an excellent COVID-19 Q&A page with helpful answers to many common questions. Additional Q&A on tests, vaccines and recovery is in this article. This graphic shows what you’ll likely experience with a mild case:

Reach out to your doctor for further guidance. Your doctor will likely follow the latest guidelines for COVID-19 Medical Treatment Best Practices for Physicians. This is also informed from the ongoing series of Scientific Collaboration on COVID-19 Treatment and Vaccines among hundreds of scientists.

Additionally, for those wanting more science about what happens to your body during a COVID-19 infection, here’s How Your Immune System Reacts to COVID-19.

Treatments and Vaccines

Here’s the link to Keep.Health’s page for tracking progress on potential drug treatments and vaccines. It is a work-in-progress and improvement suggestions most welcome.

Immunity

Those who survive coronavirus’ such as the common cold develop antibodies which provide immunity. The duration of that immunity varies. For common colds, it is typically from one to three years. For SARS, it ranged from eight to ten years. COVID-19 immunity is expected to be somewhere in-between.

Mutations

As if COVID-19 wasn’t bad enough already, it is mutating to become more structurally stable and thus even more infectious as it spreads around the world. As of March 31st, 2020, there are twenty mutations according to the NextStrain tracking site. Fortunately, it is easier to target a single vaccine for virus strains than for influenza strains. That said, it may require multiple vaccines.

Your Reward for Reading

As your reward for reading and because we need humor to get through tragic times, check out these creative redesigns of corporate brands and famous album covers to encourage social distancing. Stay at home. Stay safe. Do not be tempted by unnecessary food runs or outdoor activities which place you and your family at risk by being too close to other people. 

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