Commentary: Covid-19 An Update

by Tia Will

I want to stress this is an opinion piece. I am a retired gynecologist with a special interest in and many years of experience sitting on public health councils and boards in Sacramento and Yolo counties. I am not an expert in infectious disease nor public health. These are my personal recommendations. For official recommendations, I recommend checking the Yolo County Public Health web site.

On February 15, I wrote an article on corona virus along with my advice based on the presence of a total of 15 cases in the US at that time. My advice at that time was as follows:

  • Do pay attention to symptoms, especially fever, cough & difficulty breathing.
  • Do stay home if you are feeling ill
  • Call your physicians line for advice. Do not present to the office with these symptoms without calling first as there may be special protocols in place.
  • Do not get your news about CoVid-19 from social media.
  • Do not get your medical advice from online purveyors of “cures”.
  • Do not get health tips from social media
  • Do not hoard masks which are badly needed by health care personnel.

Much has changed since I wrote that.

We now have a case of Covid-19 in Yolo County. We have evidence of community spread of the virus. We know we are underestimating the number of cases due to insufficient testing. So with that background and the following Johns Hopkins world wide data as of this am:

https://www.usatoday.com/in-depth/news/2020/03/03/coronavirus-map-tracking-spread-covid-19-outbreak-us-and-worldwide/4906772002/

I am making the following recommendations in addition to those of 2/15:

  • For the vulnerable (over 60, with respiratory condition, diabetes, any source of immune compromise) please consider limited self -quarantine. Work from home if possible. Avoid large
    groups of people (conferences, seminars, indoor sporting events, concerts…).
  • Wash hands frequently with soap and water for 20 seconds/ use hand sanitizer/ use antiseptic sheets to clean frequently touched items such as door knobs, handles, cabinet pulls and counters especially upon return to your home after going out.
  • Do have an approximate 2 week supply of food, medicines, household necessities on hand
  • both to avoid unnecessary shopping trips but also in the less likely event of community quarantine.
  • Do use a mask only if you must go out and yourself have a cough. The goal is the protection of others. Do not hoard masks for use when you are asymptomatic as they are in short supply and needed by health care workers.
  • Avoid using taxis, Uber, Lyft, and public transportation if possible, especially if you are a member of a vulnerable group
  • Avoid cruises
  • Avoid unnecessary airline travel
  • Remember when considering what if any special steps to take that while you yourself may not be at risk, you may be taking the risk of exposing someone else in your family, friends or associates.
  • In our current political and news climate, when considering whether any piece of information of advice is accurate, consider checking multiple including overseas sources of information.

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15 comments

  1. Thank you for not telling us to stop touching our faces – the single most ridiculous recommendation of all time, right up there with “stop blinking”.

    I would recommend people continue to use public transportation, however, cuz that my thing.  And to save the planet.

     

     

  2. The press has people totally overreacting to this.

    Yes it’s good to take precautions but no need to cancel your flights unless you’re flying to someplace like Italy or Wuhan China.

    Not to mention the panic the press has caused on Wall Street.

     

  3. The flu has already killed as many as 2,400 people this season in the U.S.
    Twelve states reported high levels of flu activity in the most recent CDC report.
    The CDC says as many as 2.5 million have been infected.
    Experts say it’s too early to tell if the rapid start means a more severe flu season is ahead.

    These figures were posted DEC. 11, 2019 before anyone knew of Coronavirus.

    Currently we only have 500 total cases of COVID-19 in the U.S. and state after state are declaring an emergency?

    https://weather.com/health/cold-flu/news/2019-12-06-flu-season-fast-start-cases-spread

  4. Messrs. Olsen and Oertel are underplaying the severity of this disease outbreak. Yes, the flu has resulted in many deaths. But that is over the first third of the flu season. The COVID-19 virus has infected over 110,000 individuals since mid-January. The case fatality rate of seasonal flu is about 0.2%. It has been estimated that the case fatality rate of COVID-19 is between 0.5% and 2% (see https://www.nytimes.com/2020/03/05/health/coronavirus-deaths-rates.html).

    Think about it for a second, this is an unknown respiratory virus with a case fatality rate probably higher than the flu layered on top of the seasonal flu. We have a vaccination for seasonal flu. There is no vaccination for COVID-19.

    This is not “corona porn”. If one is in a high-risk group, precautions are not some overreaction. We know much more about seasonal flu than about COVID-19.

    This from the World Health Organization: “Allowing uncontrolled spread should not be a choice of any government, as it will harm not only the citizens of that country but affect other countries as well…We must stop, contain, control, delay and reduce the impact of this virus at every opportunity. Every person has the capacity to contribute, to protect themselves, to protect others, whether in the home, the community, the healthcare system, the workplace or the transport system.”

    The CDC’s travel warning page is here: https://www.cdc.gov/coronavirus/2019-ncov/travelers/index.html

    Blaming the press, IMHO, is not helpful and can cause individuals to act without regard to their own health and the health of others around them.

    1.  The COVID-19 virus has infected over 110,000 individuals since mid-January. 

      Yes, worldwide with the overwhelming majority in China.

      Here are some updated numbers from the flu, more current than I stated above:

      At least 19 million people have come down with the flu in the U.S. with 180,000 ending up in the hospital, according to the Centers for Disease Control and Prevention. The flu season, which started in September and can run until May, is currently at its peak and poses a greater health threat to the U.S. than the new coronavirus, physicians say.

      That’s just in the U.S. and even these numbers are a month old.

      https://www.cnbc.com/2020/02/03/the-flu-has-already-killed-10000-across-us-as-world-frets-over-coronavirus.html

       

    2. Robert:  Messrs. Olsen and Oertel are underplaying the severity of this disease outbreak.

      I believe that both Keith and I are primarily commenting on the media coverage, not necessarily the severity of the disease (especially for older people, apparently).

      One unknown factor is how many people have already been exposed to it, but whose symptoms haven’t been severe enough to seek medical treatment.

      1. One unknown factor is how many people have already been exposed to it, but whose symptoms haven’t been severe enough to seek medical treatment.

        This is true Ron and if the actual numbers were known it would bring the COVID-19 death rate way down to probably the same as the everyday flu.

  5. Like I said: coronavirus layered on top of the flu; no vaccine; no idea about incubation period; no symptomatic treatment (as opposed to the flu in which we have a number of antivirals), etc.

    It pays to be prudent in the face of something we know little about.

    1. We supposedly have flu vaccines yet 19 million people have caught the flu with over 10,000 deaths in about half a flu season.   Looking at the numbers it sounds like we know little about the flu.

      But yet the flu isn’t crashing the economy or causing the second biggest tennis tourney to cancel.

      No, 500 cases of COVID 19 with only 15 deaths did.

      It all comes down to the overhyping media sensationalism.

      And I think if we were all to be honest we know why.

      1. And I think if we were all to be honest we know why.

        I think the biggest reason is because it “sells news”.  Or, Kobe Bryant’s death.

        Much like development advocacy articles, on the Vanguard.

        Pretty challenging to blame this on politics (e.g., Trump’s response), in my opinion.  Certainly, some will try.

        It does seems as though China ultimately controlled it effectively.

      2. 19 million people have caught the flu with over 10,000 deaths in about half a flu season.

        Just think how many lives would be saved every year re: flu death if we cancelled all large entertainment events, cancelled all small entertainment events, drove instead of using public transit, stopped shaking hands and hugging, had our groceries delivered, held church on-line, had virtual city council meetings, worked 100% from home, and rolled around in plastic bubbles.  Think how many of those 10,000 people would still be alive today.  Wouldn’t it be worth it?

      3. It all comes down to the overhyping media sensationalism.”

        This is where we disagree. I do not believe it all “comes down to” any one thing. Yes, we have more deaths from the flu to date. Yes, people die from collisions and many other sources. Yes, there are people who want to turn a profit from this new threat.

        None of that means we do not have a new threat. One of unknown behavior and potential harm. The trick is finding a balance of precaution vs carelessness. This is why I have recommended a stratified response based on an individual’s risk factors. It may be entirely reasonable for the health 30-year-old to carry on their usual life (maybe postponing that visit to their 95-year-old grandparent) while at the same time reasonable for a 75-year-old to postpone that trip abroad.

        As in any health-related situation, I recommend a thoughtful approach based on up to date information and careful self-assessment. One positive I hope will come from this situation is that developing a greater awareness and implementation of the basic sanitary behaviors we should all be using during every cold and flu season.

    2. Prudent, yes… paranoid, no.

      Sometimes I wonder if they’ve cloned Henny-penny without telling us…

      Mildly screwed up my knee muscles last week… been doing the icing thing, and mild exercise… was ready to go to a remedy that has worked well for me in the past… aspirin dissolved in iso-propyl alcohol (it actually works… unsure how much is the conconction, and how much it is the massage) but that, along with masks, are sold out @ CVS and Nugget… so, back to icing and mild exercise… until CVS gets more alcohol sometime next week…

      And to refute Keith…  don’t blame the media, unless you include “social media”… actually saw the paranoia alarm there (stock up on masks now, before it’s too LATE!!!) long before CNN, mainstream media picked up on it… ‘tail wagging the dog’?… Wall street feeds on both, and the real concern that Chinese responses are messing up the supply chain of goods (particularly component parts) that feed the US and global economy.  And the restrictions on airlines (who will be taking huge hits, economically!)… the markets are reacting to REAL effects, not mainly ‘media’…

      But Keith is correct that so far, the covid-19 thing has indeed been overblown… but it and flu are real, and folk should be prudent… particularly folk who have been dying in the US… elderly, with compromised immune systems… look who died in WA state and Placer Co.

      We’ve had H1V1, SARS, etc., and the world keeps turning…

      CDC is a good source of info… actually, the only one I trust.

  6. This from the linked CNBC article you quoted: “The coronavirus outbreak, however, is proving to be more deadly than the flu. It has killed roughly 2% of the people who have contracted it so far, according to world health officials. That compares with a mortality rate of 0.095% for the flu in the U.S., according to CDC estimates for the 2019-2020 flu season. The CDC estimates that 21 million people will eventually get the flu this season.”

    That article is from February 2, 2020.

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