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How is it affecting our lives in the United States?

I am a medical director of a community hospital based clinical pathology laboratory. We have been preparing for the COVID-19 for a few weeks at the hospital. It became urgent and real when someone rushed into the lab through the patient collection area to steal hand sanitizer and masks. Then we started getting calls from the emergency department. The virus was literally within an arm’s reach! The wolf was huffing and puffing at our door! We have currently 6 confirmed cases in Alabama. This prompted me to write an article about all the facts I have gleaned by talking to my medical colleagues. 

What has happened?

In 2019, an animal virus of the Coronavirus family jumped from a small mammal into humans. MERs and SARs are two other examples of viral infections that spread from animals to humans and caused epidemics in the recent past. The epicenter of COVID-19 was in Wuhan, China but now it has infected more than 149596 people and caused more than 5604 deaths in several countries world wide. The reported overall mortality rate varies from 0.6 to 4 percent. Children under ten don’t show symptoms but those over the age of 60 with other comorbid conditions are at risk of developing pneumonia and dying. To put it in perspective the mortality rate may be taken as 1 percent if you are fifty. 2-4 percent of you are sixty. 8-10 percent of you are seventy and 50 percent or more if you are eighty. There are more infected people around us who are shedding virus in droplets because they have not been tested, or the test came back negative because it was improperly collected.

What are the symptoms?

High fever, body ache often described as the worst flu with slight betterment of simpletons followed by difficulty breathing and dry cough. Some people have nausea, vomiting and diarrhea. 

How does it spread?

When an infected person coughs or sneezes, the virus particles enter the air around him in the form of droplets and then settle on the surfaces which can be contagious from 1-9 days. The virus survives for 1-2 days on paper but longer on glass, granite and handles. 

Why is it bad?

This is a new virus that we do not have any exposure to and it seems to be more infectious and contagious than influenza to the tune of 1: 40 compared to 1:9. Unlike Ebola or SARS, infected people can shed it in the incubation period while being asymptomatic and also after they have recovered. The most vulnerable people are the elderly in nursing homes who are suffering from congestive heart failure, COPD, hypertension, diabetes, cancer and other autoimmune diseases. 

What are the limitations? 

As we have seen in China and now in Italy, and other countries in Europe, COVID 19 infections have exponentially increased overwhelming the health system: isolation resources, health care providers and ICU beds providing life support to the critically ill. 

How is it tested?

Your health care provider will collect a sample from your nasopharynx (high up in the nose) and put the collected sample in a special viral transport medium to send it frozen or refrigerated to the testing laboratory. The results will be released to your provider. The federal and state governments are working overtime to make tests available to everyone in the near future. The vaccine is being tested and may be available to us by the end of this year. 

What we all can do

  • Social isolation by staying about six feet apart, not shaking hands, hugging or touching your own or others face. Indian Namaste is the best greeting! 
  • If you have to travel in a public transport, don’t touch the handrails and handles with bare hands.cruise ships are a complete NO! In the plane, wipe down your seat and hand rests and preferably sit on the window side with the air vent blowing directly on your face. 
  • Cover your cough and sneeze properly. 
  • Wash your hands thoroughly, cleaning, fingertips, thumbs and backs of hands. I chant the Gayatri Mantra twice while working up the soap suds. 
  • At the gas station use a paper towel to pump gas and knuckles to punch in your zip code. 
  • It is best to keep children at home because although they don’t get sick they can transmit the virus to grandparents and elderly relatives. 
  • Don’t share food, don’t eat snacks in between meals while working. Stock up on essentials, like water, canned vegetables, lentils, rice and medicines. 
  • You do not need to wear a mask right now unless you are sick to protect others from droplets. You do not need a N- 99 mask because the viral particles are bigger and an ordinary medical mask can serve the purpose. If you wear a mask, dispose of it properly.
  • If you are sick stay at home because even if you are not feeling poorly you can prevent spreading the disease to others. If you think you have the symptoms get in touch with your medical provider and they can help you with testing. Apart from state departments of health, private laboratories like LabCorp and Quest are testing for COVID-19.

What I have done 

  • Stopped all congregations: Churches, celebrations, museum events, literary gatherings, medical conferences, nonessential travel. 
  • Stopped cleaning service and nonessential shopping. 
  • I have designated clothes, outerwear and purse etc. for work and wash those items daily. 
  • I don’t wear shoes at home and clean all surfaces by spraying them with disinfectant spray. 
  • I only use a few areas in my home and have made a “hot zone” in the basement to isolate if any of our family members get sick. 
  • I put all sheets, comforters and sweaters in the sunlight when I can. I keep the temperature higher in my bedroom and have a humidifier to prevent the air passages from drying and allowing virus to enter. 

In conclusion

Stay clean, stay safe, stay informed. Do not take this as a joke. Do not hoard toilet paper or masks. Please help in every way you can to flatten the epidemic curve so that we can handle the sick patients without running out of supplies especially ICU beds with respirators. 

Remember, social distancing is not an act of fear it is an act of love and care.

Monita Soni is a pathologist and a free lance journalist in Madison Alabama. 

 

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