Mark's (COVID-19) Musings – March 16

Below is an aggregation of the stories I posted on LinkedIn since my last edition. I curate them through the prism of an "intersection of chronic pain and appropriate treatment" and so they come attached with my opinion. This is a special edition.

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Things are moving quickly related to the Coronavirus pandemic. Early evening on Sun Mar 15 ...

"Therefore, CDC, in accordance with its guidance for large events and mass gatherings, recommends that for the next 8 weeks, organizers (whether groups or individuals) cancel or postpone in-person events that consist of 50 people or more throughout the United States ... This recommendation does not apply to the day to day operation of organizations such as schools, institutes of higher learning, or businesses."

In addition, Massachusetts is shutting down on-premise consumption at bars and restaurants from Mar 17 thru at least Apr 17. Illinois has done the same thing, effective today (Mar 16) thru at least Mar 30. Ohio's prohibition started at 9pm on Mar 15 with no deadline established. California's Governor said on Mar 15 that bars and restaurants "should" close but you can see the writing on the wall (and not just in California). It follows the example of China who completely shutdown the 11 million inhabitant city of Wuhan (COVID-19's genesis) on January 23. And Italy and Spain where currently only allow grocery stores and pharmacies remain open: "According to the government decree [in Spain], people will only be allowed to leave their homes to buy food and medicine, commute to work, go to medical centers and banks, or take trips related to the care for the young and the elderly."

The most important phrase in America right now is "social distancing."

The most important concept in America - and the entire planet - right now is "be compassionate - it's not about you."

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COVID-19 - How to overcome

Thanks to Mark Walls for the reminder. For some numerical comparative perspective ...

For those not familiar with the 1918-19 H1N1 virus ("Spanish") influenza pandemic: "It is estimated that about 500 million people or one-third of the world’s population became infected with this virus. The number of deaths was estimated to be at least 50 million worldwide with about 675,000 occurring in the United States." This obviously came right after World War I where 9.7 million soldiers and 10 million civilians were killed. That decade was lethal.

And don't overlook the 2009 H1N1 virus ("Swine flu") pandemic: "From April 12, 2009 to April 10, 2010, CDC estimated there were 60.8 million cases (range: 43.3-89.3 million), 274,304 hospitalizations (range: 195,086-402,719), and 12,469 deaths (range: 8868-18,306) in the United States due to the (H1N1)pdm09 virus." It killed as many as 203,000 people worldwide.

The CDC estimates from October 1, 2019 through March 7, 2020 the U.S. annual influenza (aka virus) season has resulted in:

• 36,000,000 – 51,000,000 illnesses
• 17,000,000 – 24,000,000 medical visits
• 370,000 – 670,000 hospitalizations
• 22,000 - 55,000 deaths

The CDC estimates the flu has resulted in "between 12,000 – 61,000 deaths annually since 2010."

Worldometer provides a very helpful resource to follow the trends as it is updated on a daily basis. As of Mar 16 @ 8:40am ET there are (worldwide):

• 173,281 Coronavirus total cases (3,806 in the U.S.)
• 6,665 Deaths (69 in the U.S.)
• 77,789 Recovered (73 in the U.S.)
• Seven percent of the "active cases" are "serious or critical." Of the "closed cases" there has been a 92% recovery rate.

While the contagion of a virus is easier in 2020 than in 1918 due to the speed of transportation and global inter-connectedness, we also have much better forms of communication (e.g. the Internet, good and bad) and healthcare capabilities (e.g. testing, vaccinations, intensive care techniques, ventilators and antiviral drugs). And we have philanthropists: "the Bill & Melinda Gates Foundation and 2 other large charities on Tuesday (Mar 10) pledged up to $125 million to help speed the development of treatments for the fast-spreading coronavirus."

Although the concept of risk management ...

a process that allows individual risk events and overall risk to be understood and managed proactively, optimising success by minimising threats and maximising opportunities

... has been around for centuries, it only evolved into a discipline and profession around 1955. To Mark's point, "this is the type of event you are trained for."

So as bad as COVID-19 (the disease is actually named SARS-CoV-2, which stands for Severe Acute Respiratory Syndrome Coronavirus 2) seems, especially if you look at social media, the inhabitants of planet earth are much better positioned to address a pandemic. In other words, we got this.

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COVID-19 - How to differentiate

The above is how to tell the difference between #COVID19, a cold, the flu and (coming soon) seasonal allergies (runny nose, itchy eyes, sneezing). Until more test kits arrive it's upon each of us to recognize - and differentiate - the symptoms using deductive reasoning. One of the keys to overcoming this worldwide pandemic is to NOT overwhelm healthcare / first-responders with the wrong conditions so those brave people can focus their life-saving efforts on those that truly need it. Thanks to Dr. Pamela Zink for sharing this very helpful comparison. A starting point is to check your temperature:

"Fever presents in 99% of COVID-19 patients ... The fever is usually the first symptom to arrive, according to the research. An increase in body temperature is a sign the immune system is fighting an infection ... a mild fever of about 100.4 degrees (and a more severe fever of 103 degrees) is a way to fight off pathogens."

Irrational "herd mentality" behavior, for example hoarding toilet paper (diarrhea is "rare" for COVID - see above), is often a result of anxiety. When facts and objectivity can rule the day instead of speculation and subjectivity the resulting clarity is an antidote to fear and anxiety. Get your information from reputable, non-partisan sources:

• The CDC (in the US)
• The WHO (everywhere)

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By Mark Pew

Courtesy of The Rx Professor