Dr. Escabí: What we know about COVID-19

Let’s talk about coronavirus, COVID 19, SARS-CoV-2, or other names that are inappropriate, either because they are inaccurate or make light of something serious. Call it what you will, but the fact is that we are dealing with a situation that has fundamentally altered our lives, possibly in a permanent way.

I had been trying to avoid publishing anything about it because I did not want to add to the overwhelming stream of information coming in from local, state, federal, academic and communications media sources.

Most of that information can be very helpful if interpreted appropriately, but it is often too much, sometimes seemingly conflicting, and at times just flat out useless. So, when BJ asked me if I could write an editorial on it, I thought I would take the opportunity to write a short distillate of the most practical and pertinent information. I hope this helps.

First, let me recap what we know to be true, then we’ll address what is suspected. It is a well-documented fact that this respiratory virus is transmitted through exposure to contaminated secretions, most notably droplets that are expelled when we breathe, cough, sneeze or speak. Only a few practices have been shown to minimize the risk of coming in contact with those droplets: not touching one’s face, staying six feet away from other people, wearing a face mask and simply staying away from crowds.

Regular handwashing with soap and water for 20 seconds helps by removing any contaminated droplets that might have come in contact with our skin before they are transferred to our mouth, nose or eyes, which would be the places where the virus could enter the body. Hand sanitizers may not be quite as effective as soap and water, but those with an alcohol concentration of at least 60 percent (preferably 70 or 75 percent) when carefully applied to all parts of the hands are still very effective.

It has been well established that an infected individual may be contagious without showing any symptoms or signs of being sick. The virus survives on certain surfaces more than others, able to infect people that may come in contact with certain contaminated metals for several days after the metal was contaminated. Disinfecting frequently touched surfaces also helps minimize the spread.

We know that people with long-standing illnesses, the elderly and people with weak immune systems are at higher risk of serious complications and death, although this is not a hard-set rule as younger, healthier individuals have also fallen victim to the illness.

There are some things that are suspected, but a definite conclusion hasn’t been established. It is unknown how long the virus can remain suspended in the air, but it is suspected that it can be as long as several hours, so there is concern that it may be transmitted in an airborne fashion, without any immediate or direct contact from person to person.

It is suspected that it may affect certain pets, but that has not been clearly established either. Some animals have tested positive for the virus, but whether this poses a significant threat for spreading the virus or the animal’s own health is yet unknown.

Finally, although it is suspected that homemade face masks may provide a limited amount of protection, more so from the virus being spread by the individual wearing the mask, their true efficacy has not been determined and may never be because of how variable the materials used to make them can be.

There are some medications that are being studied as potential treatments either for the viral infection itself or its complications, but none of them have shown definitive proof that they work or have been authorized for treatment. In fact, it is strongly discouraged that patients fill prescriptions for chloroquine, hydroxychloroquine or azithromycin, to name a few, to take if they have symptoms or keep in the event that they come down with the illness. These medicines could have disastrous side effects if not taken properly or with adequate medical supervision. Furthermore, they are used for other conditions as well, and stockpiling doses has created a shortage for people that take them regularly because they are being purchased by others just in case.

So where does that put us, only a few days prior to Easter when people traditionally get together? I’m afraid that as much as it hurts to stay away from friends and family, physical distancing is still the best course of action. Even though cases are expected to peak in certain places as early as next week, if we lower our guard too quickly, we risk ushering a second wave of infections. It is better to keep our current practices. Staying home unless absolutely necessary, regular handwashing and wearing a mask if a person is symptomatic (in which case, they shouldn’t be around anyone else to begin with) are still critical for this pandemic to subside.

The latest numbers suggest better outcomes that were expected based on the original predictive models, but only because people are mostly doing what they are supposed to, more so than it was assumed we would. This is not a time to change that. So avoid gathering and visiting with people. If you absolutely must gather, keep it to a small group and keep your distance. Let us sacrifice getting together for Easter, so that we can be free of this burden for many other important dates, but more importantly so we don’t put anyone at risk of contracting this potentially fatal disease.

It should go without saying, but anyone with symptoms should be contacting their primary care physician, or their local health department if they don’t have a regular health provider, as soon as possible. While there is no real treatment for this virus, other possible causes for the symptoms should be ruled out and early treatment of resulting complications could make a big difference in the outcome.

Napoleon Hill once wrote, “Great achievement is usually born of great sacrifice, and is never the result of selfishness.” This pandemic will go away sooner or later, but it is up to us to be selfless and keep the casualties at a minimum; that will be our great achievement.

One life lost to this is one too many. The tragedy is not so much the passing away in general, as that is part of the human condition. The tragedy lies in those lives that will be cut too short because we could not sacrifice.