Current Data Reflects Infections from 2 Weeks Ago
It seems as if most voices in the general media, government, and social media have caught up with the recommendations of medical professionals from ~ 1 week ago to enact "social distancing," and to minimize gatherings. There is a 1-2 week lag time between infection of Sars-CoV-2 and manifestation of severe symptoms, and another 1-2 weeks before development of respiratory failure, need for ventilation, and then subsequent demise or "recovery." We might not be able to stop our lives for much more than a few weeks, but being exposed and getting sick later is better than being sick now. I believe that even a short delay will give medical professionals the time they need to become accustomed to treating this illness and will give people a better chance at survival. To my knowledge, there is no ground-breaking treatment or vaccine on the way any time soon, but every day that passes, at least those who are working on these solutions will have more time to do so.
How to Think About Severe and Critical Illness
We are finding out this week and next how many people are infected and how many of them will become critically ill. We’ll also learn if we’re able to achieve better outcomes here than have been achieved in other countries. Based on reports from the medical community in our country, the presence of severe disease in the US is appearing just as it appeared in China and Italy. Exactly how these numbers will shake out is an unknown, but one thing is certain, this is not a cold virus or an influenza. I don’t have any good reason to believe that in the past 1-2 months, we’ve learned enough to stop the 0.5-5% case fatality rate being seen elsewhere. Currently, as of this writing, there have been 769 cases in Washington State with 42 deaths for a CFR of 5.5%. From unofficial reports that I’ve heard, the majority are 60s-80s+ in age, but 20s-50s are not exempt from severe illness, even if previously "healthy." These reports are lacking in detail, but are sobering for me as a medical professional, to say the least. The last thing to consider is that I’ve seen no reports of what it means to "recover." The people who are making it out of the ICU and off of vents may not recover normal heart or lung function afterwards. It’s too soon to tell. I am taking this disease quite seriously and trying to buy as much time as possible.
Corrections and Updates
- I removed my initial video to prevent any confusion. Most of it was accurate, but there were a few things I thought at that time on 3/4 which are now less certain. It’s also redundant content given how much time has passed and how much content is now available.
- Fecal-oral spread is a theoretical possibility. Avoid putting contaminated hands in your mouth. Though I still think this is a less likely route of transmission, it’s certainly not worth it. Avoid touching eyes, nose, mouth, face with infected hands.
- Risk to the young — seemingly remains quite low. Age 20 and under seem to be almost untouched in terms of critical illness and death. There are reports of critical illness in people aged 20-40, though still low. The older (50s-80s) and those with metabolic syndrome or its constituent elements (obesity, hypertension, diabetes, coronary artery disease, etc) seem to remain at very high risk.
My Current Action Items
- Storing 2-3 weeks worth of non-perishable foods and water — (beans, legumes, rice, pasta, oatmeal, frozen meat/fish/vegetables, nuts, seeds, energy bars).
- Getting delivery of 1-3 days worth of fresh foods — meat, fish, vegetables, fruit.
- Maintaining a low-moderate intensity workout program which includes body weight movements such as pushups, pull-ups, burpees, planks, and air squats.
- Maintaining a normal sleep and work schedule which includes minimum 7 hours of sleep (8 hours in bed), and focused work during the day.
- Eating a healthy diverse diet with a full complement of nutritious foods, and a focus on maintaining my weight without developing any additional risk factors for metabolic syndrome.
- Maintaining a positive outlook and preparing to live and prosper post Covid-19.
- Preparing mentally for the likelihood that myself, a friend, an acquaintance, a colleague, or family member will become sick or even die. If Rose Schindler can make it through Auschwitz — we can make it through this.
- Afraid you could die? Me too. But, almost all of us will live. Ric Elias taught me how to make this a positive experience when he shared his story of almost dying when his plane landed in the Hudson River.
- Avoid spending much time on social media, or watching or reading the news. You already know what you need to do.