Dr Charles Hurbis

Dr Charles Hurbis

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Coronavirus monthly update:

Isn’t it odd that true crisis can bring out the best in us as well as the absolute worst, sometimes all at the same time? And you don’t need to look very far for examples: Selfless citizens delivering groceries to the elderly, those still working in plagued nursing homes caring for our frightened parents and our brave healthcare workers who report to the front line putting their lives at risk daily. The flip side would be fights breaking out in the toilet paper aisle. And the stories are tragic, such as elderly passing away in nursing homes unable to see their families due to lockdowns.

Many people draw a similarity of our current crisis to a time of war, perhaps in some respects, but this really is different. The villain here is invisible. Individuals, instead of being unified working shoulder to shoulder against an obvious foe, stand polarized against one another. Everyone you pass on the street is potentially your enemy and a competitor for your needed rations. While it is valiant to help out your fellow man, there are times when survival instincts overtake, and the preservation of self and family will win over. This is a time of huge internal national stress.

On top of this the media and our leaders are bombarding us with conflicting messages, some with hope, some despair, many short-sighted and inaccurate. Now comes the economic component. It seems that many of our leaders are inclined to get back to business as usual as soon as possible. But, there may never be an “as usual” again. The human toll will be huge and everyone’s life will be touched somehow. They estimate that the average person knows maybe 600 others. At a viral penetration of 25% and a mortality rate of 4% we will all lose six people whom we know.

There is a lot of misinformation out there and while not always intentional, once out, is extremely harmful. It takes mere seconds to release inaccurate news and can take years to convince people to not act on incorrect information.

With this third in a series article, I will try to bring you up to date with the best information we have thus far. Again, it may seem a bit scattered and haphazard and I apologize for that.

Facts and Findings:

Survival seems related to be the inoculum level vs. your immune response. It’s a race of your body trying to keep up with the rate of viral growth without overdoing it. Deaths coming from viral overload or a toxic excessive immune response.

In one Korean study, 8% of those that recovered did not develop antibodies against the virus, meaning they could possibly be infected more than once. This tended to be in younger patients that had milder cases of the disease. Also, there were indications the virus has the capacity to mutate, making vaccination success a moving target as it is with the flu.

Sequelae of advanced infection: Cardiac failure, pulmonary failure, kidney failure, etc. This thing just keeps getting uglier, you don’t want it.

Those at higher risk from severe infection: pulmonary or cardiac disease, immunocompromised such as elderly, diabetics, those undergoing cancer treatment, steroid users, those on immunosuppressive drugs or pregnancy.

Theories:

1) There may have been an early outbreak in the US back in December. This is highly unlikely as the wave of severely ill patients didn’t arrive until March.

2) This virus originated in a viral bio-lab in China. Viral labs have many purposes, most have scientific value, still some may be less well-intentioned. One of these labs is located in Wuhan, constructed in 2017 and was noted to have safety issues in 2018, so it’s possible.

At risk of being repetitive I’m quickly listing symptoms again:

1) Shortness of breath

2) Fever

3) Dry cough

4) Severe chills and body aches

5) Sudden confusion

6) Digestive issues

7) Pink eye

8) Loss of sense of taste and smell

9) Severe fatigue

10) Headache, sore throat, congestion

Rules to currently live by:

1) The 6-foot rule makes infection transmission less likely unless someone coughs or sneezes. Even then the odds are in your favor. This is even better if you are wearing a mask, which is now recommended. Sure an N-95 is great, but anything covering your face helps. Large sneeze particles rapidly fall to the ground. There are stories of smaller particles remaining airborne for up to three hours. Still, the smaller particles are unlikely to become attached to clothing, so with distancing, a mask and hand washing, you’re pretty well protected. Following these guidelines make it less likely you will contract an infectious dose of this virus.

2) Just because viral RNA can be detected for long periods of time (remember 19 days on the cruise ship?) doesn’t mean it remains infectious for that long. We know that the virus is susceptible to heat, sun, detergent/disinfectant and drying out. A porous surface supports drying out, which is why paper and clothing are believed to retain the virus for 24 hours. So, wash your clothes in hot water with a good detergent and perhaps hold your mail and packages for one day before opening them.

3) Shoes are a problem, and studies show that in higher risk areas, 50% of healthcare workers are wearing shoes which are virus positive. This is best managed by a “no shoes” policy in your home or laundering them if possible. Never wipe down the soles, this only further risks transmission to you.

4) Safety of shopping: Let's say someone sneezes all over your cereal box. The virus has a half-life of only 70 minutes on paper. A small amount of infectious virus is transferred to your hands when you pull it off the shelf. The virus cannot burrow into your skin, it requires contact with a respiratory cell to infect , which requires nasal or ocular entry. On your hands some will break down, more will fall off whenever you touch anything else. By the time you accidentally touch your face or wipe your nose there isn’t much left, and then it's just on your face, only close to a respiratory membrane. Unless you take a deep admiring sniff of your cereal box it's tough to get infected this way.

I wondered if it was wise to even include this next quote, but I’m putting it in. These are thoughts from a Yale cardiologist (keeping in mind he only sees the worst cases):

“(The disease) can attack almost anything in the body with devastating consequences,” says cardiologist Harlan Krumholz of Yale University and Yale-New Haven Hospital, who is leading multiple efforts to gather clinical data on COVID-19. “Its ferocity is breathtaking and humbling. The virus acts like no pathogen humanity has ever seen.”

Certainly, this is something to be respected. Thoughts like these get your attention.

So, if I were to end this with a final bit of advice it would be the following 5 rules:

1) Maintain social separation.

2) Observe the 6-foot rule whenever outside the house

3) Wash your hands, avoid touching your face

4) Leave your shoes at the door

5) Wear a mask whenever out

Nothing groundbreaking here. Stay virus free.

Doc H

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