I am beyond excited (obviously not excited for the terms of this post – to clarify!!) to have my older sister Gwen Seamon as a guest editor for this week’s post. With so much happening in the world pertaining to COVID-19 we didn’t think it was right for us to ignore it on our platform. However we also didn’t think it was right to give a perspective from our POV, with no medical backgrounds. With my sister being on the front lines of this pandemic, I wanted her to use her voice to bring facts to this subject. Below is a photo of my sister – she is on the right!
Hi loyal M&M followers!
I am Courtney’s sister, Gwen (which makes me another cousin of Kelly!). I work as a clinical pharmacist practitioner at a family health center in North Carolina. Unlike how you may traditionally think of a pharmacist, I do not work in a pharmacy nor do I dispense medications. Instead, I work directly with patients to manage chronic diseases (think diabetes, high blood pressure, osteoporosis, etc.) and work alongside patients with substance use disorder and chronic hepatitis C. I love my job.
Because I work in a family health center, I am witnessing the impact of coronavirus on frontline healthcare professionals. Currently, we do not have any active cases in western North Carolina which is truly a blessing, but patients present every day worried about exposure to the virus! However, in cities where active cases do arise, most patients are transferred to hospitals.
So I want to take a moment to extend my upmost respect and gratitude to all physicians, providers, pharmacists, nurses, medical assistants, and healthcare workers working in hospitals across the US (and the world), providing the highest level of care to our most vulnerable patient populations, often times putting themselves at risk of contracting the virus during these times.
Most of the patients I have seen over the past couple weeks have had a lot of questions about coronavirus and want to know the facts. Based on questions submitted by readers and those I receive in practice every day, I put together a FAQ post. I wanted this to be a blog post (versus on Instagram) so that I could provide links to the best resources where you can access up-to-date information. The most important to remember is don’t panic. In any situation, panic will make things worse. Please be appropriately apprehensive and cautious as well as mindful of what the CDC, WHO, and public health services recommend.
**As a caveat to this post, please remember that information about COVID19 is rapidly changing and the information in this document is current as of March 12, 2020. I primarily based this information on that provided by the CDC. Follow THIS LINK for additional info. Further, the opinions presented in this article are mine alone, not of my organization or other affiliations.**
QUESTIONS AND ANSWERS BELOW
QUESTION: What does “COVID19” mean?
ANSWER: The name of this disease is coronavirus disease 2019, abbreviated as COVID-19. In COVID-19, ‘CO’ stands for ‘corona,’ ‘VI’ for ‘virus,’ and ‘D’ for disease.
QUESTION: How do I know where cases are being reported?
ANSWER: Johns Hopkins put together a FABULOUS resource to track global confirmed cases of coronavirus, deaths, and recoveries. This is updated in real time. I highly recommend checking it out HERE. As an example, I added a snippet of what the United States map looks like as of March 12, 2020 at 2 PM.
QUESTION: Who is at higher risk of developing complications from COVID19?
ANSWER: 1: Older adults (age >60 years old).
2:Those with serious medical conditions: Heart disease, Diabetes, Lung disease
3: Those with immuno-compromising diseases: Undergoing chemotherapy, Rheumatoid arthritis, Many more, those are just two examples
QUESTION: I am in my 20s or 30s, have no medical conditions, and lead a fairly healthy lifestyle. What does that mean for me when it comes to COVID19?
ANSWER: An article was recently published in the Journal of the American Medical Association (JAMA) highlighting the preliminary findings from COVID19 in China. This study showed that people 60 and older accounted for more than 80% of the deaths. However, exceptions have, and will, occur. You should also be mindful of preventing the spread of disease to those patients that are much more vulnerable to serious consequences. Just because the likelihood that you will develop complications from COVID19 is low, does not mean you can be reckless. Don’t forget about those in your life that could suffer as a result of your decisions, like your grandparents, those affected with cancer, etc. Continue making common sense decisions (like washing your hands, avoiding crowds when you have symptoms!)
QUESTION: I keep seeing this graph (above), what does this mean?
ANSWER: This chart explains why slowing the spread of the infection is nearly as important as stopping it. The blue section of this graph represents what happens when geographic areas implement “community mitigation measures”. These are actions that persons and communities can take to help slow the spread of respiratory virus infections, including seasonal and pandemic influenza viruses. The object of these measures is too slow the rate of infected people, so as not to overwhelm the healthcare system.
Categories of community mitigation measures include personal protective measures for everyday use (e.g., voluntary home isolation of ill persons, respiratory etiquette, and hand hygiene); personal protective measures reserved for influenza pandemics (e.g., voluntary home quarantine of exposed household members and use of face masks in community settings when ill); community measures aimed at increasing social distancing (e.g., school closures and dismissals, social distancing in workplaces, and postponing or cancelling mass gatherings); and environmental measures (e.g., routine cleaning of frequently touched surfaces). (Reference: HERE)
My take: I hear a lot of patients concerned about school closures, voluntary quarantines, and reducing flight schedules. But I try to reinforce that these are GOOD things, meant to control the rate of infection and keep our health systems from being overwhelmed. When our hospitals and health centers become overwhelmed (as what seems to be happening in Italy), the resources to care for patients will be scarcer and the proper care may not be able to be provided. So instead of feeling panicked by these measures, think about them as ways to slow the rate and keep the number of cases within the capacity of the healthcare system.
The New York Times also did a nice discussion about this graph that is not quite as dense: LINKED HERE.
QUESTION: What should I do to prevent COVID19?
ANSWER: The best way to prevent illness is to avoid being exposed to this virus. I’m sure you have heard this, but WASH YOUR HANDS. You can follow THIS LINK HERE for the best guidance on cleaning and disinfecting your home properly. You may also consider limiting exposure to groups of >50 people, crowded areas (think Times Square), and areas with recirculated air (such as planes). Some guidance also recommends keeping windows open, if possible, in public transportation such as cabs and Ubers.
QUESTION: How is the virus spread? (Reference: CDC)
ANSWER: Mainly person-to-person spread, meaning: Being in close contact with someone, defined as being within approximately 6 feet of a COVID-19 case for a prolonged period of time; close contact can occur while caring for, living with, visiting, or sharing a health care waiting area or room with a COVID-19 case – or – having direct contact with infectious secretions of a COVID-19 case (e.g., being coughed on). These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs. (This is one reason why the CDC recommends not touching your face with your hands).
QUESTION: Can someone spread the virus without being sick?
ANSWER: People are thought to be most contagious when they are most symptomatic (the sickest). Some spread might be possible before people show symptoms; there have been reports of this occurring with this new coronavirus, but this is not thought to be the main way the virus spreads.
QUESTION: Can this be spread from contact with contaminated surfaces or objects?
ANSWER: It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes, but this is not thought to be the main way the virus spreads.
QUESTION: What are the symptoms of COVID19?
ANSWER: Reported illnesses have ranged from mild symptoms to severe illness and death for confirmed coronavirus disease 2019 (COVID-19) cases. Symptoms may appear 2-14 days after exposure. (This is why they are generally quarantining for 14 days)
QUESTION: What if I have these symptoms?
ANSWER: Call your doctor if you develop symptoms, and have been in close contact with a person known to have COVID-19 OR have recently traveled from an area with widespread or ongoing community spread of COVID-19.
*As of March 12, 2020 this list includes China, Japan, Italy, Iran, and South Korea, but is subject to change rapidly. Follow this link for up-to-date information about travel advisories.
QUESTION: How do I tell the difference between COVID19 and the flu?
ANSWER: First, I do want to make it clear that they are different. However, the flu is also still actively circulating so it is still a good time to get your flu shot!
For more information about the differences between COVID19 and the flu: CLICK HERE.
QUESTION: What happens if I get COVID19?
ANSWER: You should always follow your doctor’s instructions and recognize that what is necessary for each person may change! But for many people that only experience mild symptoms, the most important thing will be to prevent spread throughout your community. The CDC offers guidance to prevent spread HERE but I will summarize it briefly below.
1: Stay home except to get medical care. Separate yourself from other people and animals in your home.
2: Call ahead before visiting your doctor: This is a BIG one I have noticed from my setting! If you have, or suspect you have, COVID19, PLEASE give your doctors office a heads up before you get to the clinic. They may ask you to stay in your car or use a separate entrance to avoid unnecessary exposure to other patients.
3. Wear a face mask if you are sick. Cover your coughs and sneezes. Clean your hands often. Avoid sharing personal household items (i.e. dishes, cups, cutlery, bedding, towels, etc.)… After you use any of these items, clean them thoroughly
3. Clean all “high touch” surfaces everyday (i.e. tabletops, door knobs, toilets, phones, etc)
4. Monitor your symptoms. Most importantly, seek medical attention if your symptoms are worsening (e.g. difficulty breathing). Stay at home until you are instructed to leave.
QUESTION: Will warm weather stop the spread of COVID19?
ANSWER: Per the CDC, it is not yet known whether weather and temperature impact the spread of COVID-19. Some other viruses, like the common cold and flu, spread more during cold weather months but that does not mean it is impossible to become sick with these viruses during other months. At this time, it is not known whether the spread of COVID-19 will decrease when weather becomes warmer. There is much more to learn about the transmissibility, severity, and other features associated with COVID-19 and investigations are ongoing.
(I’m getting married in June, so I am really hoping this answer will turn to a YES!)
QUESTION: Wait, so is my dog at risk of getting COVID19?
ANSWER: There is no evidence your pet can get sick from coronavirus. Both the Centers for Disease Control and Prevention as well as the World Organization for Animal Health have issued advisories saying there is no evidence that companion animals can spread the virus. “Therefore, there is no justification in taking measures against companion animals which may compromise their welfare,” the animal health organization said.
But I read a dog was infected in Hong Kong….
Per this article in the NYTimes : “Here’s what has happened so far. A coronavirus patient in Hong Kong had a dog, and the authorities tested the dog which showed some level of virus in its nose and mouth. They’ve tested it several times, and the test still show a “weak positive.” The dog will remain in quarantine, the authorities said, until its tests are negative.
What does that mean? Raymond R.R. Rowland, a veterinarian who is a specialist in swine viruses at Kansas State University, said so-called weak positives often show up in testing pigs, where a farmer’s livelihood can be at stake. “I’ll tell you what I tell them,” he said. “Wait and see.” Even if there is a low-level infection, he said, “That doesn’t say the animal is sufficiently infected that it can spread the virus.” It may be a dead-end host, neither becoming ill nor infecting any other people or animals.”
QUESTION: What do I think is one of the most important things to note about COVID19?
ANSWER: STOP THE STIGMATIZING.
I think we have all seen the news articles about people of Asian descent or those who traveled recently to Italy being subjected to harassment, sometimes verbal, and other times physical. THIS HAS TO STOP. I copied what the CDC says about this as I think it summarizes my thoughts perfectly.
“Please do not stigmatize a group, ethnicity, or race in relation to COVID19. Fear and anxiety can lead to social stigma, for example, towards Chinese or other Asian Americans or people who were in quarantine. Stigma is discrimination against an identifiable group of people, a place, or a nation. Stigma is associated with a lack of knowledge about how COVID-19 spreads, a need to blame someone, fears about disease and death, and gossip that spreads rumors and myths. Stigma hurts everyone by creating more fear or anger towards ordinary people instead of the disease that is causing the problem. People can fight stigma and help, not hurt, others by providing social support. Counter stigma by learning and sharing facts. Communicating the facts that viruses do not target specific racial or ethnic groups and how COVID-19 actually spreads can help stop stigma.”
Resources I recommend if you want to learn more:
The World Health Organization (WHO) Mythbusters: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/myth-busters
Johns Hopkins also put together a True v. False section about coronavirus and false information you may see on social media, or hear in public: https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/2019-novel-coronavirus-myth-versus-fact
The local health departments and state organizations for the areas you live in will also provide location-specific information about COVID19. These can be found by googling “coronavirus” and then your county or state.
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