By Adem Lewis / in , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , /


Hi, my name is Kate Sullivan and I’m here
representing the Medical Advisory Board of the Immune Deficiency Foundation with
some information on the coronavirus outbreak. The coronavirus that is now
known as COVID-19. There are four parts to this short video designed to give you
some practical information. So, first, I’ll give you an update as of March 3rd, 2020,
then I will talk about how to prevent infection for yourself. I will talk about
some logistics and these are taken from National Public Radio and then I will
talk about what to do if you get sick and at the very end, I have some
resources if you want to get some further information. So in this first section, I will just
give you an update on the coronavirus. So this coronavirus has now been named
COVID-19. It is a virus. It’s not a bacteria, so antibiotics will not work.
Where did this virus come from? It’s not entirely clear but right now, people
think that it’s circulated in bats in China for some period of time and then,
in the fall of 2019, it first infected people and now the major transmission of
this virus is person-to-person transmission through respiratory
droplets. What is an infection look like? It typically has consisted of fever
cough and in the severe cases, shortness of breath. Now, where will this virus hit?
It is pretty unpredictable. At the end, I will give you a website where you can
check the most recent maps for both international and within the U.S., the
current state of the spread of the virus. As of today, it is on both coasts of the
United States and if past epidemics of influenza are any guide, it will shortly
be throughout the United States within a month or two. In addition, although there
are lots of international efforts to contain the virus, it does appear
relatively widely spread and it’s unlikely that we will be able to prevent
it spread throughout the rest of the world. So that’s the bad news. There is
some better news. The better news is the more we know about it, the less severe it
appears. So, initially only the most severely affected patients were
identified. Now, it appears that there are lots of people who have minimal symptoms
where it’s really nothing more than a cold. You will no doubt have heard on
television a lot of discussion about the case fatality rate. In fact, we won’t know
for another few months what the true case fatality rate is. Right now, it is
being cited as between one and two percent and just for some perspective
that is higher than influenza which is usually about 0.1 percent.
However, as I said the more we learn about the virus, the more we
learn that there are lots of people with relatively minor symptoms. Along the
way, and particularly from our colleagues in China, we have learned that there are
some high-risk groups. So, the predominant risk factor for severe disease is age. So
those over 60 have an increased rate of severe disease and those over 80 have an
even higher rate of severe disease. In China, they have also identified some
additional health conditions that are associated with more severe disease. The
one that has been spoken of most frequently is diabetes. Immune deficiency
has not yet been called out as a particular risk category for severe
disease. However, again, our experience with other viruses is that immune
deficiency is likely to cause some increase in severity, although it may be
different across different diagnoses. So I just want to say a word or two
about how respiratory viruses spread, in general, because I think it comes as a
surprise to people that it’s not about being coughed on. It’s not about the
droplets landing on your face or going up your nose from someone who’s actively
coughing. Although, to be sure, that is a significant source of infection but
probably more people get respiratory viruses by touching something that has
virus on it and then rubbing their face. And so a lot of what I’m going to talk
about is changing our own behavior to minimize that phenomenon. So a lot of the
behavioral changes that I’m going to recommend are really interrupting that
cycle of touching something: a person, a doorknob, a hand railing and then rubbing
your face, itching your nose, something like that. You know, it’s very hard so I suggest we
all start now. So the easy thing is shaking hands.
Unless it’s absolutely required in your workplace for etiquette,
I would suggest an elbow bump or a very respectful bow. You don’t have to shake
hands necessarily to demonstrate respect. If shaking hands is absolutely required,
please go ahead. I don’t want anyone to lose their job but be mindful, now, that
there is likely something on your hands that you could then put on your face.
Well, what about touching your face? So it is just human nature. Everyone touches
their face hundreds of times a day. So one thing to do is to try putting on
large glasses. So if you don’t normally wear glasses, put on a large pair of
sunglasses and just notice how often you are sort of pushing it to one side to
rub your eyes. Notice how often you touch your face. I guarantee it will be more
than you think so this has to stop. And so what I suggest is that if you have an
itch on your face and you just have to do it, grab a tissue and use the tissue
to rub your eye, itch your nose, whatever is needed. Use the tissue, not your hand.
So what about those hands? So you want to wash your hands all the time and
remember adequate hand washing with soap and water takes 30 seconds. That’s a lot
of soap. Don’t forget your thumbs. There’s a lot of stuff that doesn’t get cleaned
off of thumbs. So hand washing requires a lot of soap, warm water, and 30 seconds of
sudsing your hands. That’s one chorus of happy birthday to you or one run through
the ABC song. It’s longer than you think. So to be really adequate with soap and
water, you have to really commit and it’s not always that easy to do. If you’re
busy at work, interacting with clients, or at school. So the alternative is Purell
or some alcohol gel. The alcohol gels must have at least 60% alcohol. This is
not the time to try and figure out if some lemon scented sal can be the same
thing. You really want to be sure you’re killing the virus.
And so use an alcohol gel that is at least 60% alcohol and the way it works
is by drying. So I’ve seen people put alcohol gel on their hands and then wipe
it off. You really need for that alcohol gel to dry on your hands to kill things.
Does it kill everything? No, soap and water is still better but the
accessibility of alcohol gel makes it a lot more useful in your everyday
circumstance so just tuck a little bit into your pocket. They make little
bottles. There are you know really reasonable to carry around so always
carry some with you. Everyone has been talking about masks so let me also talk
about masks. You may say why not? Why won’t this help me? I want a mask. And so here
is why. These masks are designed for surgeons. They’re designed to ensure that
a surgeon doesn’t spit or cough or sneeze or otherwise spread particles
into the surgical field. They are not designed to prevent stuff from getting
in and in fact, I’m going to put this on in a minute, what you will notice is that
my breath is actually coming in through the sides and under through the bottom.
It doesn’t actually go through the paper filter here and so you’re not actually
doing much when you put on a face mask and that’s why you’re hearing that it
doesn’t prevent the coronavirus. And in fact because most people are
uncomfortable wearing masks, they probably touch their face quite a bit
and then that represents a potential for infection. I’ll just pop this on for a minute and
you will notice that there’s all this gap and that’s where the air is coming.
The air is not going through the filter so the masks don’t work and please don’t
waste your money on them. First thing is to just think about
alternatives so maybe this is not the time to get on an airplane and go
somewhere. Maybe you could have a meeting that is web-based or you could have a
digital conference. Maybe there are opportunities to modify the the times
that you need to be in large groups of people so that’s number one. Schools are looking into modifying some
of their lessons and whether lessons could be broadcast so that kids can stay
home. And then the last tip from the NPR article is the same that you have been
hearing for ever and ever. Always have two weeks of food, water and medications
at home. This is good advice for tornadoes, hurricanes, earthquakes, all
natural disasters. It is especially good advice now. If there is a quarantine of
your city or your building, those quarantines have been lasting two weeks
so you want to have two weeks of food, water, and all medications that you can
imagine and maybe some entertainment. It’s no fun to be quarantined. So two
weeks worth of things in your house so that you don’t have to go outside. And the last section I want to address
is what to do if you get sick. What happens if you get a fever or a cough in
these uncertain times? So, first of all, do not go to the hospital. You do not want
to be surrounded in a waiting room with people who might have COVID-19. So if you
have a cough or a fever, unless your doctor has told you
otherwise, and certainly there are some people where doctors would want to see
them for every fever, so unless your doctor has told you otherwise, if you
have a cough or a fever, stay home. Use the usual treatments that you have, make
generous use of inhalers if you have been inscribed if you have been
prescribed inhalers, and stay home and see how it goes. Again most cases of the
coronavirus are going to be mild. You do yourself no favor by going to the
emergency room. Maybe you just have a simple cold but you go to the emergency
room and there you are infected with the coronavirus so do stay home unless your
doctor tells you otherwise. The other thing I would say is that, even in the
hospital, the medications that are being used are supportive and symptomatic.
Remember, antibiotics don’t work. As of right now, there are no antivirals. So the
care that is being given in the hospital, in the urgent care centers, in the
emergency room is not markedly different than what you can do at home. The
exception being if you develop shortness of breath and you cannot manage it at
home or you have another symptom where you cannot manage it at home then you
would want to alert your doctor and possibly go to the hospital. So I’m going
to end. I hope this has been useful. I am going to leave, at the end of this video,
some resources. The World Health Organization has an update every single
day with international maps. The CDC has an update with U.S. maps and then there is
a lovely video about how far sneezes travel that I think is just a useful
thing to see in this time in particular.


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