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Lessons That Go Beyond the Coronavirus Outbreak Lessons That Go Beyond the Coronavirus Outbreak
(about 8 hours later)
News of coronavirus infections is causing many people to panic.News of coronavirus infections is causing many people to panic.
It’s unclear how widespread or deadly this illness is going to be, but for once, instead of telling you not to worry, I’m going to suggest riding that wave. Channel that fear into useful action — and find the lessons that go beyond this outbreak.It’s unclear how widespread or deadly this illness is going to be, but for once, instead of telling you not to worry, I’m going to suggest riding that wave. Channel that fear into useful action — and find the lessons that go beyond this outbreak.
There are absolutely things we can do to protect people from infection by this novel respiratory virus, which has caused hundreds of deaths in Wuhan, China, and has spread to other countries. Some involve a societal response, but others are very simple.There are absolutely things we can do to protect people from infection by this novel respiratory virus, which has caused hundreds of deaths in Wuhan, China, and has spread to other countries. Some involve a societal response, but others are very simple.
Most important, wash your hands. Wash them often. Wash them for at least 20 seconds with soap and water. Wash them especially well if you’re about to eat. Wash them after you’ve blown your nose, coughed or sneezed. Make it routine that all members of the household wash their hands when they get home.Most important, wash your hands. Wash them often. Wash them for at least 20 seconds with soap and water. Wash them especially well if you’re about to eat. Wash them after you’ve blown your nose, coughed or sneezed. Make it routine that all members of the household wash their hands when they get home.
I’m a pediatrician, and I know it can be hard to do this yourself, let alone get others to do it. So make it a game. Offer incentives. There’s almost nothing that you, or your family, can do that will protect you more from infections.I’m a pediatrician, and I know it can be hard to do this yourself, let alone get others to do it. So make it a game. Offer incentives. There’s almost nothing that you, or your family, can do that will protect you more from infections.
Here are five steps: (1) wet your hands, (2) lather them, and then (3) scrub them for at least 20 seconds. No one ever looks at a clock, so try singing the “Happy Birthday” song twice, from start to finish. If you’re trying to get kids to do this, come up with a funny hand-washing song to the same tune. A colleague of mine recommends singing the alphabet.Here are five steps: (1) wet your hands, (2) lather them, and then (3) scrub them for at least 20 seconds. No one ever looks at a clock, so try singing the “Happy Birthday” song twice, from start to finish. If you’re trying to get kids to do this, come up with a funny hand-washing song to the same tune. A colleague of mine recommends singing the alphabet.
I know that 20 seconds seems like a long time. While we don’t have huge randomized controlled trials to prove this is the optimal amount, research does exist to say that shorter times aren’t as good at removing germs, and much longer times can actually damage the skin and can be counterproductive.I know that 20 seconds seems like a long time. While we don’t have huge randomized controlled trials to prove this is the optimal amount, research does exist to say that shorter times aren’t as good at removing germs, and much longer times can actually damage the skin and can be counterproductive.
Then (4) rinse, and (5) dry. It’s not that hard. If you can’t wash your hands, then hand sanitizer with at least 60 percent alcohol will work in a pinch, but it’s not as good.Then (4) rinse, and (5) dry. It’s not that hard. If you can’t wash your hands, then hand sanitizer with at least 60 percent alcohol will work in a pinch, but it’s not as good.
Don’t touch your face in general, especially with unwashed hands. Don’t shake hands with people who are sick. If you’re sick, stay away from other people. Clean the objects and surfaces that you touch a lot.Don’t touch your face in general, especially with unwashed hands. Don’t shake hands with people who are sick. If you’re sick, stay away from other people. Clean the objects and surfaces that you touch a lot.
What’s not recommended for everyone? Face masks. If you’re sick, they may help prevent you from spreading the virus, but they don’t do as much to help keep healthy people from getting sick. [Update: The C.D.C. later changed its guidance, recommending that everyone wear a face mask]What’s not recommended for everyone? Face masks. If you’re sick, they may help prevent you from spreading the virus, but they don’t do as much to help keep healthy people from getting sick. [Update: The C.D.C. later changed its guidance, recommending that everyone wear a face mask]
This is not the first coronavirus to cause worldwide concern. The 2002 outbreak known as SARS (Severe Acute Respiratory Syndrome) and the 2012 outbreak of MERS (Middle East Respiratory Syndrome) both originated from this same type of virus.This is not the first coronavirus to cause worldwide concern. The 2002 outbreak known as SARS (Severe Acute Respiratory Syndrome) and the 2012 outbreak of MERS (Middle East Respiratory Syndrome) both originated from this same type of virus.
This new version, “2019-novel Coronavirus” or 2019-nCoV, is at the moment thought to be more infectious than those two, but less likely to cause death. There are more than 40,000 cases (almost all in China), with more than 900 deaths linked to it. Many more cases are probably unreported, of course.This new version, “2019-novel Coronavirus” or 2019-nCoV, is at the moment thought to be more infectious than those two, but less likely to cause death. There are more than 40,000 cases (almost all in China), with more than 900 deaths linked to it. Many more cases are probably unreported, of course.
The best-case scenario for this outbreak would be containment. If China can pull this off, and other countries can keep those who are infected to a minimum, it’s possible that we could prevent widespread infection and eradicate 2019-nCoV in humans. This is what we accomplished with SARS, so it’s possible.The best-case scenario for this outbreak would be containment. If China can pull this off, and other countries can keep those who are infected to a minimum, it’s possible that we could prevent widespread infection and eradicate 2019-nCoV in humans. This is what we accomplished with SARS, so it’s possible.
But as international travel becomes easier, eradication becomes harder. Should we be unable to contain the disease, and this coronavirus sticks around, it’s still not necessarily cause for panic.But as international travel becomes easier, eradication becomes harder. Should we be unable to contain the disease, and this coronavirus sticks around, it’s still not necessarily cause for panic.
It would be the fifth coronavirus that’s endemic in humans. (SARS and MERS did not become endemic.)It would be the fifth coronavirus that’s endemic in humans. (SARS and MERS did not become endemic.)
A recent article by Sharon Begley in STAT News laid out the two most likely scenarios for an uncontained outbreak. The first is that 2019-nCoV winds up being like the other four endemic coronaviruses, which cause less serious coldlike illnesses. Should this happen, we’ll worry for a few years as we track the rate of infections and make sure that it’s not more severe than we think. But eventually we won’t worry about it any more than we worry about which virus is causing our latest cold. More than a third of people infected with the other coronaviruses don’t even notice they are ill.A recent article by Sharon Begley in STAT News laid out the two most likely scenarios for an uncontained outbreak. The first is that 2019-nCoV winds up being like the other four endemic coronaviruses, which cause less serious coldlike illnesses. Should this happen, we’ll worry for a few years as we track the rate of infections and make sure that it’s not more severe than we think. But eventually we won’t worry about it any more than we worry about which virus is causing our latest cold. More than a third of people infected with the other coronaviruses don’t even notice they are ill.
This doesn’t mean that some people don’t become sicker — with pneumonia, for example — after contracting these coronaviruses. They do. But the rates of bad outcomes aren’t usually high enough to make the news.This doesn’t mean that some people don’t become sicker — with pneumonia, for example — after contracting these coronaviruses. They do. But the rates of bad outcomes aren’t usually high enough to make the news.
The other, more worrisome, outcome would be that 2019-nCoV becomes a more significant seasonal virus, like influenza. That would be bad. The Centers for Disease Control and Prevention estimates that the flu has already caused up to 310,000 hospitalizations this year and 10,000 to 25,000 deaths.The other, more worrisome, outcome would be that 2019-nCoV becomes a more significant seasonal virus, like influenza. That would be bad. The Centers for Disease Control and Prevention estimates that the flu has already caused up to 310,000 hospitalizations this year and 10,000 to 25,000 deaths.
Updated June 5, 2020Updated June 5, 2020
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
Time will tell if the new coronavirus ends up being less or more dangerous than the flu; we don’t fully know yet how bad it is. Usually, the diseases that stick around tend to become less lethal. Only live hosts can continue to make more viruses. Influenza is also pretty devious in how it mutates its surface molecules from year to year to evade immune system detection. If 2019-nCoV is not able to do that, people’s immunity to it could gradually improve.Time will tell if the new coronavirus ends up being less or more dangerous than the flu; we don’t fully know yet how bad it is. Usually, the diseases that stick around tend to become less lethal. Only live hosts can continue to make more viruses. Influenza is also pretty devious in how it mutates its surface molecules from year to year to evade immune system detection. If 2019-nCoV is not able to do that, people’s immunity to it could gradually improve.
But therein lies the paradox. The outcome that has public health officials really concerned is that 2019-nCoV will turn into something like a disease that we have a tough time making you worry about right now.But therein lies the paradox. The outcome that has public health officials really concerned is that 2019-nCoV will turn into something like a disease that we have a tough time making you worry about right now.
Every year physicians and public health officials try to get you to immunize yourselves against the flu, and far too many of you don’t. We beg you to practice proper precautions and hygiene — and, still, tens of thousands of people die, and too few worry enough.Every year physicians and public health officials try to get you to immunize yourselves against the flu, and far too many of you don’t. We beg you to practice proper precautions and hygiene — and, still, tens of thousands of people die, and too few worry enough.
Governments and employers could help by making it easier for sick people to stay home from work. Many Americans without paid sick leave go to work despite feeling ill, and many of those work at restaurants, schools and hospitals, where disease is easily spread.Governments and employers could help by making it easier for sick people to stay home from work. Many Americans without paid sick leave go to work despite feeling ill, and many of those work at restaurants, schools and hospitals, where disease is easily spread.
The most significant defense the United States has to prevent pandemics is a solid public health infrastructure. The public has to trust it. The system also needs to be properly prepared and have the resources to handle a widespread infection. (The system is currently stretched thin and underfunded.) It’s critical to make sure there are enough medical supplies available, as well as necessities like food, to get a community through an outbreak.The most significant defense the United States has to prevent pandemics is a solid public health infrastructure. The public has to trust it. The system also needs to be properly prepared and have the resources to handle a widespread infection. (The system is currently stretched thin and underfunded.) It’s critical to make sure there are enough medical supplies available, as well as necessities like food, to get a community through an outbreak.
Should you be worried about getting infected with viruses? Sure. Have you gotten a flu shot yet?Should you be worried about getting infected with viruses? Sure. Have you gotten a flu shot yet?
Channel your fears into productive behaviors. That’s how you’ll significantly reduce your risk from being infected with 2019-nCoV. It’ll also help you from being infected with the flu. It’ll even help protect you from getting a cold. Wins all around.Channel your fears into productive behaviors. That’s how you’ll significantly reduce your risk from being infected with 2019-nCoV. It’ll also help you from being infected with the flu. It’ll even help protect you from getting a cold. Wins all around.