Lessons learned from COVID-19 experience
Since COVID 19 moved into the United States, reaching the Miss-Lou in March, I have learned a few things I want to share.
Keep in mind, these ideas represent my opinion and do not serve as medical advice and may not completely mesh with some mainstream pool of experts such as the CDC.
1. This is a real virus that is quite contagious because it has not been here before so there is no prior immunity among us humans.
2. It kills a higher percent of people than typical influenza and most other commonly acquired viruses. Many infectious organisms can be deadly in some people, but this one is bad because it is spreading rapidly and therefore is making more people very ill than what we typically see.
3. You do not want to get this if you can help it. It is true that over 95% of people survive the acute infection, but we really don’t know whom that will be. We also have no idea what long-term effects may occur. For instance, more people who got the 1918 influenza subsequently got Parkinson’s disease. Certain risk factors like older age, obesity and lung disease may make it more likely you won’t do well, but I know of young healthy people who have died (a 30-year-old nephew of a friend in Baton Rouge). Even a rare child has died. I have also known people with every classic risk factor who did well. My 98-year-old mother with very frail health and diabetes barely blinked from this killer. I hope I got her genes.
4. It is spread mostly from family and friends who think they are well or “just have a cold,” so they don’t take precautions such as distancing at least 6 feet or wearing masks. If you are ill, stay isolated until tested and you sure as heck need to have on a mask if you come near anyone including family until you know your results are negative.
5. A small but unknown percent of people — maybe 10-15% but perhaps higher — can get and spread this virus with no symptoms. That is why wearing a mask around others is helpful even when you think you are well, especially if you have been exposed to a known case within the past 10 to 14 days. Most infectious organisms behave like this with some victims having no symptoms. Those people are an important source of spread of disease. Think about it, if you were a virus that wanted to keep going you better not kill all your victims or you, too, will die out.
6. Anytime you have exposure and go to get tested even with very mild symptoms, you should isolate from others until your results are known.
7. Despite our best efforts, this disease will continue to spread. Wearing masks, especially for all indoor activities, social distancing and hand washing after contact with potentially contaminated surfaces, do help slow the spread of this virus. The mask only protects you a little (as can shields), but it can reduce spread to others from your aerosols that could carry the virus. Those who claim these measures don’t help are disingenuous. They aren’t perfect, but they do help. Remember, you may get over the illness, but the friend you infect who infects his wife who infects her child fighting leukemia who dies after infecting her caregiving grandmother who also dies won’t appreciate your stubborn adherence to your independence from the recommendations of the vast majority of experts.
8. Legitimate exposure is generally considered contact within 6 feet from an unmasked infected person for at least 15 minutes. Variations in air movement, coughing or sneezing or singing or shouting, colder temperatures and lower humidity, which keep aerosols airborne longer, can all increase exposure. This is why outdoor activity is safer, but even then distancing is important. People who remain indoors with more people in smaller spaces for periods of time over 15 minutes are at greater risk. Everyone indoors should wear masks if possible. If ill, don’t go to restaurants or your office where others work until you are tested and clear.
9. Most people we test are negative. This means many normal and common things cause symptoms that overlap with COVID-19. These symptoms include cough, shortness of breath, sore throat, fever over 100.4, headache, muscle aches especially in the low back, loss of taste or smell, nausea, diarrhea and mostly fatigue. If you feel ill, get in touch with your doctor and get tested. You may have other illnesses that must be treated. This virus has not made our other illnesses go away. Keep in touch with your medical team to manage your routine care for all typical problems we dealt with before COVID-19 appeared.
Kenneth Stubbs M.D. is a Natchez internal medicine specialist and partner at Internal Medicine Associates of Natchez.