Tired of the stress and worry over COVID and the state of our country during this unprecedented time? Me too! But now is NOT the time to let down your guard, as very concerning increases in COVID cases and hospitalizations are being seen in the past month. And the trajectory upwards is very scary. For those of you who still don’t understand the full implications of this horrible virus unlike any we have ever experienced, let me spend a few minutes explaining the reason we in healthcare are so concerned.
- It is MUCH more transmissible (as much as 2 and a half times) than other viruses. So much so that it’s difficult to imagine how easily it spreads. Think about the typical cold, “flu”, or GI virus that may spread through our schools, workplaces, and homes. Depending on who has it and whether they take precautions such as washing hands frequently and avoiding breathing or coughing on those nearby, viruses can be widespread and affect lots of people. So for years we have known and hopefully heeded medical professional’s advice to wash hands and avoid close contact with others who are infected with a virus, and we’ve accepted it as the medical truth it is known to be. For some reason many people who would otherwise use common sense medical advice to stop the spread of a viral illness seem to be ignoring this advice with COVID, which is SO MUCH more easily spread.
- Unlike other cold and flu viruses, we are now finding COVID can affect almost every organ in the body. That’s really scary, especially since we are now seeing patients (even those with mild cases) who have long term effects from the virus- cardiac symptoms, cognitive and brain symptoms, chronic fatigue, liver problems, etc. While scientists don’t yet know the exact reason for or if these symptoms will eventually clear up, it has become such an issue that many hospitals and healthcare providers are now beginning to be overloaded with thousands of these kinds of cases.
- Scientists don’t know how long IgG antibodies to COVID will last. Think of antibodies as two kinds of troops your body produces in response to an assault by an illness. Our first line of troops (the entry level, general response, get in to establish a presence troops) are called IgM antibodies. They are produced in the first days to weeks of an illness and help the body respond to a foreign invader until the specialty troops (IgG antibodies) can be trained up and deployed to recognize and address a specific threat. IgM antibodies fade quickly, but IgG antibodies generally hang around, and in many cases then provide lifelong immunity to that specific virus. That’s the whole thing behind vaccines- they expose us to a tiny bit of the virus (live or killed depending on the vaccine) and this causes our body to “train up” antibodies to attack that specific virus. More about vaccines in the next section…
- Based upon the data we have at this point for COVID, we don’t know if antibodies do stick around, and if they do, they may only stick around for some patients. We are seeing more patients get re-infected, and often the second round is more severe than the first.
- Which brings us to the discussion of viruses morphing and becoming more harmful…which they do! Think about H1N1 flu, and how we are seeing more severe cases and hospitalizations every year even with the standard flu, which seems like child’s play compared to COVID. The more opportunity the virus has to spread, the more opportunity it has to mutate into more and more severe (virulent) strains. Now add the fact that COVID spreads much easier (remember it’s 2.5 times as contagious as a typical virus) with the fact that so many people have become infected because we are largely ignoring medical experts’ advice, and that is a virus dream! More people infected means more opportunities to become more severe, and we have the perfect storm (or worsening pandemic we are seeing now).
- Now let’s talk about positivity, a statistical calculation used with every communicable disease since we recognized its value in predicting spread a long time ago. Which gets into another statistical term- incidence- the occurrence rate of a disease. Epidemiologists (that branch of medicine that has long been valued and paid attention to for their expertise in monitoring the spread of disease) use statistics; it’s how they help us monitor the spread and severity of disease. I get that it can be confusing, but it’s really quite simple. The more people tested who turn up positive, the more disease (or COVID in this case) we have in the population.
- Positivity rate, not number of tests performed, tells us if a disease is spreading. Whether we test 10 people or 10,000 people, the percent positivity is important. In fact, testing more people gives us a more accurate positivity rating. Let’s make this really simple- if you check 2 kids’ lunchboxes in the class and see that one has an Oreo, you can say that 50% of kids in the class have Oreos in their lunchbox. But if you test half the kids in the class, that number is very likely to go down- and also be much more accurate.
- The concerning part with COVID testing is that the more people we test, the higher the positivity rating is moving- not a good direction and a strong indicator of even more widespread viral illness than we thought.
- Positivity rate, not number of tests performed, tells us if a disease is spreading. Whether we test 10 people or 10,000 people, the percent positivity is important. In fact, testing more people gives us a more accurate positivity rating. Let’s make this really simple- if you check 2 kids’ lunchboxes in the class and see that one has an Oreo, you can say that 50% of kids in the class have Oreos in their lunchbox. But if you test half the kids in the class, that number is very likely to go down- and also be much more accurate.
- Hospitalizations and deaths lag behind infection with the virus by several weeks- that’s just how this virus works. Most hospitalizations happen 2-3 WEEKS after infection, not the few days often seen with severe flu or pneumonia. So those million people who tested positive over the past ten days are still a few weeks away from up to 20% of them presenting to the emergency room. And deaths lag behind further still, so numbers of dead from this virus won’t really be fully understood for weeks to months from now. Given that hospitalizations in northeast Florida have increased dramatically over the past few weeks, we will be filled beyond capacity within the next few weeks with a percent of those people who recently tested positive. If that happens, how will we take care of patients who have serious non COVID related symptoms that need to be treated in the hospital? And if our numbers keep going up….
There is so much more about this virus that is very worrisome, but I hope you get the point.
Now that I’ve (hopefully) scared you, I hope and pray that you will take every precaution to keep both yourself and those around you safe. I’m a firm believer in Love Thy Neighbor, and what better way to do it RIGHT NOW than to use safety precautions.
Let’s talk about what to do and how to protect yourselves and others, especially during the holidays when being together is what we do. Some key points here.
- This virus is not about you- it’s about all of us. Whatever political side of the fence you place yourself on, the virus really doesn’t care. Almost half of the transmissions we are seeing are from either asymptomatic or pre-symptomatic (you don’t yet feel sick) people just going about their business and not taking precautions.
- WEAR A MASK. It’s not fun, and it can take getting used to, but masks are the best option we have to protect ourselves and our neighbors from being infected. Of course the face masks we wear in public aren’t as protective as the N95 hospital type (which is still in short supply), but they sure help protect us by blocking a good percentage of droplet spread. You wouldn’t sit outside during mosquito season without being on a screen porch here in Florida (even though you know some of those nasty little buggers will get through), so why go out in public without a mask when the consequences of being exposed to COVID are significantly worse than a mosquito bite!
- In a recent sermon, Pastor Rick Warren responded to the fact that many people are saying a mask is too restrictive by commenting that a coffin or ICU bed is much more restrictive. Kudos to him for making this dreadful but true analogy.
- Practice social distancing. The further away you are from others decreases risk of spread. And it’s not as if there is this invisible line of 6 feet the virus will not cross- this is where Physics (science again!) comes into play. The force at which droplets move is determined by the force at which you expel them (coughing or shouting will propel them further than talking in a “normal voice”) and any air currents like wind or fans to move those droplets further along. Just think how bad you would feel if you ended up spreading the virus to your or someone else’s grandma because you were just being selfish.
- Wash your hands frequently. It’s a scientific fact that frequent hand washing prevents the spread of germs, and we’ve heeded this advice from our medical experts for years. I’m constantly amazed how our little kids are setting such a strong example for the rest of us, when we are supposed to be the adults in the room. They wash hands and wear masks with hardly a complaint- studies actually show that our younger ones are the most compliant with medical recommendations, even though most of them have no idea what a virus even is…Go elementary schoolers!!!
- Consider the vaccine when it is safe and available. The data and details are not yet available to healthcare providers, but you can be sure this one is waiting to read the details. Also consider that availability for most of the population will likely take months if not longer- so not a help in the short term here. For those of you following some of the “information” out there that speaks to the “evils” of nanotechnology, I suppose if I didn’t understand the way nanotechnology works and was reading some of the questionable stuff out there I might be concerned. But for me as a healthcare provider, nanotechnology is a really cool way to deliver medicines and vaccinations in a much more targeted way. Think of the mosquito and the screen porch again, only this time the mosquito that can’t get in to bite you- that’s where nanotechnology would help the mosquito! Nanotechnology- which we have been working on for a decade or more- offers ways of delivering medications to areas of the body and in more effective ways than ever before. As with anything scientific, vaccine, or pharmaceutical, there are risks. But using tiny technology to deliver a vaccine to address a tiny virus may be what is needed here. Stay tuned…
- There are many guidelines by a host of medical organizations that can be very helpful, but they all boil down to social distancing, avoiding gatherings of more than a few, and wearing a mask.
- I would add the very important Functional Medicine component of building and maintaining a strong immune system, especially if you are someone who may be at increased risk due to previous or existing health conditions. A healthy immune system allows the body to respond more effectively to exposure to any communicable illness, and in this case it is all the more important. And by the way, there are considerable studies that show how diet and certain supplements can effectively treat viruses, and many preliminary reports of Functional Treatments that are showing some promise with COVID based upon how we know they affect the immune system. For example, a recent report outlined that patients with low Vitamin D levels are at higher risk for complications from COVID. Vitamin C and a specific from of zinc are being clinically studied to treat COVID. And elderberry is also getting a second pass as an effective preventative for viral illness based upon previous research. As a Functional Medicine provider, I know how a healthy immune system can impact overall health and immune function.
I know it’s not fun. I too have had to quarantine on more than one occasion, and I too miss my loved ones, especially the holiday gatherings. I am so tired of wearing masks and having to worry about where I go and if the people there will be practicing safe guidelines. I’ve had to adjust how, when, and where I shop, which is definitely a strain on a busy lifestyle. It’s impacting every aspect of my life too, but as a healthcare provider who reads the data and sees the patients, I know how bad this virus is. And my complaints seem trivial when I see the deadly potential of this virus. Social distancing, mask wearing, and maintaining a healthy immune system are the best ways I can show love to my family and those around me.
If you are sticking to your “political guns” and still not agreeing to listen to the evidence, then please at least think about our overburdened, overtaxed, over stressed and everyday exposed healthcare and hospital workers. Imagine going to work every day and seeing the sickest people you’ve ever seen in your career, and wondering if the patients you treated yesterday are still alive today. I’m not on the front lines, but I have patients who are and I can tell you it is causing all kinds of chronic health issues for them- this level of stress is just not sustainable. They are literally putting their lives on the line every day for you, and the only way you can help at this point is to help reduce hospitalizations by just wearing a mask and following safety guidelines. And what about our teachers? They put their lives on the line every day so our kids can have at least some sense of normalcy during this stressful time. Would you want to put them at risk too by ignoring safety recommendations? It might be your “right” to ignore medical advice, but it is also your responsibility as a citizen of this great country (and as a human being) to make this small sacrifice to save someone else’s life-literally.
I welcome your comments and questions, but will not respond to those that are mean-spirited. Be safe, and God Bless you and yours during this holiday season!
Informational & Helpful Links:
SafeKids
CDC Guidance
https://www.cdc.gov/coronavirus/2019-ncov/index.html
American Medical Association COVID information
World Health Organization Guidance for School Age Children
Nanotechnology and vaccine development
https://www.sciencedirect.com/science/article/pii/S181808761400035X
Vitamin D and COVID
Vitamin C, Zinc and COVID clinical Trial
https://clinicaltrials.gov/ct2/show/NCT04342728
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