Friends, please see the following information for us all to understand, details of how this could go if we are not vigilant. We can all do our part to help. Be prepared. Read ahead:
1. This pandemic could kill 1.5 million Americans over 12-18 months and can easily collapse our healthcare system.
This estimate is based on projections presented at a UCSF Expert Panel on March 10, which were posted on LinkedIn, then pulled down soon after. UCSF experts agreed we are well past containment of the virus—it’s spreading everywhere. 40-70% of the US population will be infected over the next 12-18 months. Most of my stats/advice is from that forum below.
2. The local community -- those NOT part of the healthcare system -- will determine if our hospitals get overwhelmed during this crisis, as they are in Italy and Iran.
You must take social distancing seriously: the lives of your fellow citizens depends on this. Do not treat this as just another flu: it is far more serious. Even if you are young and healthy, you can get a fatal infection: don't rely on statistics. (The Univ of Washington has a healthy 20 year old on a ventilator.) But equally important, you can easily spread infection to those who are particularly vulnerable.
3. Social distancing, done aggressively, can save lives.
4. What is aggressive social distancing?
a. No travel outside the home except for food, medicines, and medical needs.
b. The CDC recommendations are to keep six to 10 feet away from other people.
c. Do not shake hands or hug others. Smile and nod in greeting.
d. If you touch other people or surfaces touched by the public, use hand sanitizer or even better soap and water to wash your hands as if your life, or someone else’s, depended on it. It does.
5. How is the virus spread?
Routes
i. Hand to mouth / face (transferring germs from doorknob->hand->face or in reverse to contaminate surfaces)
ii. Aerosol transmission (coughing into other peoples’ faces; wear a mask!)
iii. Fecal-oral route (changing diapers infects adults)
6. Local health care workers have started a petition to demand mandatory lockdown quarantine, similar to Italy. It is the only weapon we have against exponential increase in deaths. No travel outside except for food or medicines, or for medical attention for the life-and-death sick.
7. We expect shortages of vital medical equipment.
· If you are one of the people who bought up N95 masks, you should donate most of your N95s to your local hospital, where front line healthcare workers need those masks, NOW, far more than you do. If you or your family gets ill with Covid-19, masks won't save you: healthcare workers who have the right equipment to avoid infection will. Doctors in Italy and Iran died due to a lack of masks.
· We need more surgical masks, which can be made by quilters following available patterns. If you are a textile arts hobbyist, consider organizing your local knitting group into a surgical masks production quilting group, donating your masks to your local hospital.
· We will need more ventilators than we have; if you are a private business person involved in the production of medical equipment, you should be thinking of ways to greatly increase production of ventilators, to save lives.
8. If someone gets sick:
Have them stay home and socially isolate. There is very little you can do at a hospital that you couldn’t do at home. Most cases are mild. But if the sick person is 70 or older or have lung or heart problems, read on.
If someone gets quite sick who is old (70+) or with lung or cardio-vascular problems, AND their oxygen level is below 93% on an oxygen meter or “oximeter” (available at any pharmacy), then call a doctor for advice or the EMC coronavirus hotline, 760-837-8988.
There is no accepted treatment for COVID-19. The hospital will give oxygen and supportive care (like IV fluids) to help you stay alive while your body fights the disease, i.e., to prevent sepsis/ “blood poisoning.”
d. There are some drugs that seem helpful in early studies, but they are experimental.
e. WARNING: In Italy and Spain, they are turning away people who have a poor chance of survival and sending them to hospice and not admitting to the hospital. Italy is only 11 days ahead of us in this crisis. If the USA goes into mandatory lockdown nationwide on March 15, we will be one week ahead of Italy in slowing this down.
9. Don’t I need to get tested? Answer: Unless a doctor thinks you’re sick enough to need a hospital, you probably don’t need the test right now—it will not change how you are managed.
Bottom line, there is not enough testing capacity to be broadly useful. Here’s why.
Currently, there is no way to determine if a person has COVID other than a PCR test. No other test can yet distinguish COVID-19 from flu or from the other dozen respiratory bugs that are circulating.
A Polymerase Chain Reaction (PCR) test can detect COVID-19’ds RNA. However, we still don’t have confidence in the test’s specificity, i.e., we don’t know the rate of false negatives. In other words, a test can be negative in someone who actually has the disease. No medical test performs perfectly. Our common “flu swab” for influenza can recognize a true flu 90% of the time, but some people with true influenza will still test negative. Knowing how to use a test requires the knowledge and experience of a doctor.
The COVID PCR test requires kits with reagents and requires clinical labs to process the kits.
While the kits are becoming available, the lab capacity is not growing.
The leading clinical lab firms, Quest and Labcore, have capacity to process 1000 kits per day. For the nation.
Expanding processing capacity takes “time, space, and equipment.” And certification. ie it won’t happen soon.
The internet provides a very useful communication platform to organize community response to this crisis. Use it. Use video chat, use email, use social networks to identify those in need, and find ways to help.
The scarcest resource is always leadership. Leadership means not waiting for someone else to solve the problem: if you can see the problem, you organize the solution, working with your neighbors, local government, and other community members.
During a crisis, pre-existing social groups -- sports teams, political action groups, hobby groups -- can find ways to help their community. Now is the time.
Since this is a political year, many people are in touch with fellow campaign supporters and activist groups. Those networks can easily be re-purposed as community pandemic response groups.
Some political groups have precinct/neighborhood level organizations. And there are also sports leagues, PTAs, unions, churches, and community centers that exist as social networks: these same groups can organize to assist vulnerable members of their larger community as well as vulnerable members or their own groups/networks. And they can reach out to local government and offer their assistance with general community response.
It's time to use what we have, imaginatively, to respond to this crisis. As a people, we Americans are known for our creativity and for taking care of each other. This crisis is another historical moment to remind ourselves who we are.
If you have technical expertise, now is the time to help fellow citizens make use of the Internet or their smart phone to solve some of their problems. Teach someone you know how to use video chat or social networking to stay connected to their family.
If you are a restaurant owner: you have a kitchen, a menu, and a staff. Re-calibrate your business for home delivery, and design a delivery approach that minimizes exposure for your delivery people and your customers.
If you are a resort owner: talk to local hospitals about their leasing your space as possible overflow for local emergency rooms.
CDC, 2017: Community Mitigation Guidelines to Prevent Pandemic Influenza
https://www.cdc.gov/mmwr/volumes/66/rr/rr6601a1.htm
Flatten the Curve:
https://www.flattenthecurve.com/
Most useful resource for leaders:
https://medium.com/@tomaspueyo/coronavirus-act-today-or-people-will-die-f4d3d9cd99ca
Asymptomatic people can spread this during prodrome, before they have symptoms:
--Tong Z-D, Tang A, Li K-F, Li P, Wang H-L, Yi J-P, et al. Potential presymptomatic transmission of SARS-CoV-2, Zhejiang Province, China, 2020. Emerg Infect Dis. 2020 May [date cited]. https://doi.org/10.3201/eid2605.200198
--The Journal of Infectious Diseases, jiaa077, https://doi.org/10.1093/infdis/jiaa077
https://medium.com/@tomaspueyo/coronavirus-act-today-or-people-will-die-f4d3d9cd99ca?source=emailShare-c3cc268890ba-1584218497&_branch_match_id=756649845461328075
-- It appears that a Massachusetts coronavirus cluster with at least 82 cases was started by people who were not yet showing symptoms, and more than half a dozen studies have shown that people without symptoms are causing substantial amounts of infection.
https://www.cnn.com/2020/03/14/health/coronavirus-asymptomatic-spread/index.html