- Most of the world was hopelessly unprepared for a pandemic. I made this point more than six months ago, commenting that “Population density and worldwide travel facilitate rapid transmission of such infections… A panel of international experts concluded recently that the world is ill prepared to handle a pandemic of major magnitude.” In addition, we lost many valuable days of preparation even AFTER experts knew in January that a potential pandemic was beginning in China and on its way to overtake the rest of the world.
- The worst is yet to come in the U.S. This is probably true over the next two weeks or more, with rising numbers of infected people and deaths. We have insufficient amounts of personal protective gear, ventilators, hospital beds, and other equipment. This is unfair to health care workers who are battling this scourge at great personal risk and to patients who need ventilators to increase their chance for survival.
- Older people, especially older men with co-morbidities, are at greater risk of dying, most often from a respiratory illness. This is true, BUT it is quite clear that people of all ages can become infected and die, and the virus can affect the heart and other body systems.
- Asymptomatic people can be infected and contagious. There seems to be little doubt about this now. In Florida I watched in horror last month as people on spring break congregated on the open beaches or in New Orleans, enjoying Mardi Gras celebration, only to become infected and then infect others.
- The actual mortality may be less than 1 percent. This may be true but without widespread testing, we don’t know the denominator of the equation, i.e., how many are actually infected. But it is likely that the numerator is also underestimated, i.e., some are dying unrecognized from COVID-19.
- It is NOT true that COVID-19 is no more lethal than ordinary influenza. COVID-19 is about ten times more lethal, and more infectious.
- Social distancing is effective and is our major treatment approach. It’s like a circuit breaker. If the virus runs out of hosts, it has no place to go and will die out. I am concerned about geographic areas that are not mandating stay-at-home isolation. This is an invitation for the virus to perpetuate. Hand washing, wearing a mask outside when in contact with others, staying away from people coughing and sneezing, and keeping at least a six-foot distance are all essential as well.
- It is NOT true, or at least has not been proven, that drugs like chloroquine, hydroxychloroquine, and azithromycin will effectively fight the COVID-19 virus. The only data that these drugs may be useful come from anecdotes and some test tube information, clearly insufficient to rely on. And, importantly, these drugs, especially when used in combination, can cause cardiac arrest and sudden death by affecting the electrical system of the heart. Ongoing studies of these and other drugs will provide important information about efficacy and risk.
- Serum-containing antibodies to the COVID-19 virus from people who have recovered from the infection appear useful, even lifesaving. However, the only long-term reliable treatment will be prevention with a vaccine, and that is many months to a year away.
- Outdoor activities appear to be safe, depending on the area and keeping your distance from others. However, it is better to do your shopping online, with some sort of a delivery service, than going to the store yourself.
- Maintain physical health. Exercise, even in your living room.
We are tougher than this pandemic and will defeat it. Our lives will be different afterwards, but, that which doesn't kill us, will make us stronger and wiser. Please stay healthy and follow what you just read. I'm hoping I can do the same. It was another extraordinary day in the life of an ordinary guy.
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