Updated: Mar 15
With everything that is unfolding before our eyes with regards to Coronavirus, the decision of how to feel and how to act can be incredibly overwhelming. Most of us are teetering on the line between an outlook that is too alarmist and reactions that are too inadequate.
I feel compelled to share my thoughts because I come from the unique perspective of both a healthcare provider and caregiver to an immunocompromised individual but know that I am not nor am I claiming to be an expert on infectious disease or immunology. Just someone from the medical world that will level with you in a digestible way on how to bring back some peace and love in the time of Corona.
First, let's just touch on the pathophysiology and symptoms of COVID19 and when to get help. Imagine the emoji for a virus or microbe - it looks like a sphere with spikes along the outside. That is essentially what COVID19 looks like - those spikes are what bind the virus to receptors on the surface of our cells. Now, imagine the spikes as keys and the receptors as locks. If the spike fits into the right receptor it can enter the cell and starts replicating itself using the cell's machinery. These viruses eventually break out of that cell, spread to other ones, repeat the replication and in this whole process your immune system is triggered to spring to action.
Coronavirus will most often present with sore throat cough and fever plus general fatigue and body aches plus nausea or diarrhea in some cases. These are such nonspecific symptoms that they make it difficult to track the virus. The common cold, the flu, and gastroenteritis or food poisoning present with some of the same symptoms. So if you present with any of the above - stay rational, don't panic, and start caring for yourself at home. Disinfect everything, take over the counter fever and pain medication unless otherwise advised by your physicians, take decongestants to help you loosen and dispose of congestion from your nose, hydrate thoroughly, rest and use natural remedies like echinacea, herbal teas, and humidifiers.
As the illness progresses it causes a rapid onset of widespread inflammation in your lungs and difficulty breathing. As soon as this occurs you need to call your healthcare providers immediately. The number for Telehealth Ontario is +1 866-797-0000 for those of you within the province, 1-877-644-4545 for Quebec residents, and generally 811 for all other Canadian provinces. Most of us will not make it to this point of illness however so that is why it's important to take matters into our own hands while we can and get external care when there is a definite need so as to control the number of cases in hospitals and also keep us away from waiting rooms, public transit, and other situations that amplify the spread of the virus.
In the meantime - however, you intuitively want to approach these next few weeks - do it. Your staying mentally healthy and comfortable in a time of hysteria is of the utmost importance. If you want to wear dust masks outside or else stay indoors - go for it. Statistically and scientifically speaking dust masks will not offer much protection against the virus and will allow retailers to capitalize on our fears, but if wearing them eases your concerns to HELL with it - put them on. Try not to allow them to get damp or humid because this will take away from any protection they might offer. Leave surgical and N95 masks to those at the front lines of this battle.
Washing your hands thoroughly with soap and water is the best method of keeping yourself safe from the transmission, but if you want to make your hand sanitizer you can easily do so with 3/4s 91% isopropyl alcohol and 1/4 aloe vera gel, or 1/2 99% isopropyl alcohol and 1/2 aloe vera gel.
When you go to shops for food and supplies - try to split your purchases between fresh produce and frozen goods so there is enough to go around. Things like toilet paper and baby wipes etc are important but most of us can use bidets or water for the same purpose so let's not stockpile the resources that are far more important for young children and the elderly. I would, however, get a 30 day supply or so of decongestants, Tylenol or Advil, and electrolytes like Gatorade just in case of self-imposed quarantine. Be supportive of your neighbors directly and indirectly by taking only what you need or helping supply those in need.
As far as social distancing is concerned - take this opportunity as often as you can while you can. Keep your kids at home because let’s face it, they may not be at the height of risk when it comes to infection as seen by the behavior of the virus thus far, but childcare centers and schools are breeding grounds for unreliable hygiene, they’re just kids after all! As asymptomatic carriers, they can bring act as vectors for the virus to more susceptible adults. Make this experience enjoyable for them - kids love days off school if they have baking, arts, and crafts, movies and entertainment to keep them busy. Approach this time as a great chance to pause on hectic life and reconnect with your family while they are healthy. Talk to your children about this calmly so they understand the history unfolding around them. Show them what happens when you touch a shallow plate of water sprinkled with pepper with a finger covered in soap. Kids are smart and can be the most responsible when they feel treated like equals.
The demographic most at risk are those above the age of 50 and those with comorbidities so take extra precautions if you fit this category or live with someone fitting this category. As the average healthy functioning middle-aged adult even in infection we generally have the strength to fight the virus but our elderly or immunocompromised loved ones are far more sensitive to the more severe symptoms and development of the virus.
With how long the virus can survive outside the body depending on the surface it lands on, it is impossible to cover all your bases of protection, but the best option is first social distancing and then isolation at the point of symptoms. That was the one factor that turned the trajectory of China's illnesses from concave up to concave down and while their infrastructure is unbeatable in how quickly they implement action, whether it's building an entire hospital in 3 days or locking down a province, we can do our part to accomplish the same.
There are not enough tests, patients will be treated in hallways and stairwells if they aren’t already, healthcare providers are working far beyond their capacity to rush into caring for the ill, prioritizing patient care above their personal health while the rest of us have the option to distance/isolate and take some current or eventual burden off of the entire system. This includes the clinic and hospital administration, custodians, delivery personnel, shop owners, grocery suppliers, public transit drivers, etc. Be mindful of everyone's fear and suffering and nix the every man for himself mentality.
To address the backlash there has been over the ‘comparison’ of coronavirus to non-infectious things like hunger, homelessness, obesity, chronic disease, etc. I think it's important to note that no one is comparing apples to apples here, just trying their best to put things in perspective. Yes, these are threats that may be far more predictable and less aggressively urgent today, but the fact remains that those in immunocompromised and destitute conditions are amongst those at highest risk of disease and their ubiquity in society makes them take a backseat to the urgency of care when without that state of living their risk of all disease would be so far improved. Obesity, for example, is just like smoking in that it causes frail health, increased susceptibility to co-morbidities including coronavirus and will make the prognosis and recovery that much more strained.
Coronavirus is just the latest and greatest in our lifetime of biohazards. In my lifetime alone we’ve seen Epidemics and Pandemics of Cholera, The Plague, CJD, Nipah Virus, Dengue fever, Yellow fever, SARS, MERS, Measles, Mumps, Swine Flu, Ebola, ZIKA and of course H1N1 - this is not even a complete list and yet it’s clear to see COVID 19 is neither the first communicable disease of high fatality nor the last. I am by no means comparing the impact of any of these but the fact of the matter remains that despite the incredible detriment we are in the thick of facing, more of us will survive than suffer. While we take this vulnerable time day by day now that we are just entering the storm, we have an opportunity to rationally prepare ourselves so that we may persevere through this trial in good health long enough to either get more information or find a more secure way to evade illness and ensure we are strong in health to avoid catastrophe as we age and become more vulnerable by the time the next biohazard takes power.
This is by no means an attempt to be insensitive to those in deliberately immunosuppressed conditions, those undergoing chemotherapy or organ transplant, etc, nor to overlook those with potentially life-threatening Acquired Immunodeficiency Syndrome, Human Immunodeficiency Virus and beyond. Individuals in this fragile state are going to need the most protection and care and if the rest of us can do our part to keep ourselves safe, calm and out of harm's way to whatever extent we have control over, our healthcare services can be better allocated to those in dire need.
To conclude this all I'd just like to say we are globally alert to this situation and in this predicament together. Some of us live in countries with universal access to care that we take entirely for granted. We are all holding onto our seats bracing for impact if it hasn’t already hit us, but this is without a doubt just the beginning. As a reminder, cortisol is released in response to fear or stress by the adrenal glands as part of the fight-or-flight mechanism of our body. This, in turn, decreases immune function and thereby puts us at greater risk of all infections. So, for the majority of us, it's important to eat right, stay active, sleep well, stay calm and wash our hands. At the end of the day, this may seem to be cliche, obvious advice, but it is the most we can do at this time.
Clean hands, Full Hearts, Can't Lose