Brace. Brace. Brace.
The next couple of weeks and months will be tough for all of us. There is no need for panic or hysteria but there is need to prepare. The flu pandemic in 1918 tore through the globe and killed somewhere between 20-50 million people. At that time, world travels were not as common as today, but the virus still managed to spread through the planet. Today we have the ability and the opportunity to alter the progress of this pandemic. We have the ability to cope with the severity of illness thanks to medical advances and we are able to coordinate the community response through communication and connectedness. Your personal act today has social repercussions to those in your community.
There are many great websites, articles and information out there which I have listed at the end of this article. I am going to focus on what we can do in the next few weeks. Time is of the essence.
COVID-19 is the disease name for a severe respiratory illness caused by the virus SARS-CoV2. On 31st Dec 2019, the World Health Organisation (WHO) received the first report of a pneumonia of unknown cause from Wuhan, China. The outbreak was declared a Public Health Emergency of International Concern on 30 January 2020. On 11 February 2020, WHO announced a name for the new coronavirus disease: COVID-19. On the 11th of March, The WHO says “we are deeply concerned both by the alarming levels of spread and severity, and by the alarming levels of inaction. We have therefore made the assessment that COVID-19 can be characterized as a pandemic.” The WHO is worried about our lack of action.
The virus spreads rapidly through droplet and contact surfaces. Symptoms become obvious a couple of days later. The COVID-19 test takes time. Many are not tested as there are some limitations to access (cost in some countries) or resources (not enough testing kits). We don’t know a lot about this virus because it is novel. We have not seen this virus before. We have no immunity to it. We have no vaccines for it. All we know based on what we see happening in China, South Korea, Japan and Italy is that the virus causes a respiratory illness. Eighty percent of patients get a mild form while the rest get severe form and the severity is strongly associated with advanced age (up to 8% mortality in those above 80 years old) and comorbidities (diabetes, hypertension and chronic illness).
Containment lines have been broken. The virus has entered multiple countries. The case rates in each countries are skyrocketing. It is not just the flu. It is a lot worse. South Korea, which has reported the lowest coronavirus death rates, has a COVID-19 death rate more than eight times higher than that of the flu. We are rapidly realising that inaction may mean death. The modelling and projections I am seeing is very concerning.
What can we do now?
Mitigate the spread. Slow the spread. Flatten the curve. The hospital system and health services can only cope with a fixed amount of resources. If we had a massive spike of COVID-19 cases, the hospitals will not be able to cope with the tsunami. There will be many deaths. But if we spread out the same number of cases over a longer period of time, the hospital will be better able to handle the wave. This is flattening the curve.
Wash your hands. Do not steal alcohol hand sanitiser from hospitals or health care facilities. They need them! Soap and water for 20 seconds has been shown to be effective against the virus. Wash your hands as regularly as you possibly can.
Hand sanitiser with at least 60% alcohol is good but in short supply.
Do not touch your face. The virus enters through nose, mouth and eyes.
Reduce physical contact with others. Less than 15minutes face to face. Less than 2 hours in the same room. Keep a distance. No hand shakes. Wave.
Cough into your elbow. But don’t do an elbow handshake after that!
Do not touch public surfaces and properties (door handles, lift buttons, etc). Use a wipe, tissue, etc.
Wipe surfaces with alcohol, detergents, soap and water.
Avoid crowded places.
Close down big meetings.
Work from home if possible.
Stay at home.
Only do essential activities: essential work, health, finance, groceries, supplies, etc. No retail, shopping, amusement parks, etc.
Essentially quarantine yourself as much as you possibly can.
What do we do if we are in lock down like Italy?
There will be various levels of “lock down”. Essential services will continue to run, so do not worry, stockpile or hoard necessary items.
Look after each other. Phone calls, FaceTime, whatsapp, texts, email, social media. #SocialDistancing does not mean Social Isolation. With all the communication tools we have today we must continue to be engaged with each other.
Keep yourself mentally and physically healthy. Read books, meditate, write. Walk around the neighbourhood with your family. Talk on the phone more with people you have not spoken to due to your busyness.
Be kind and pay attention especially to those in the edges of your community. Do the grocery for the elderly family member. Provide practical help for single parents who have to stay home. Cook extra food for someone who can’t afford food as their work is closed down.
Do not overwhelm the health services with things that can wait. The health system needs to cope with COVID-19 tsunami. Attention and resources to non-urgents need to be devoted to COVID-19 cases. Do not overwhelm the front line clinicians (GP, Emergency, Respiratory units, Infectious Diseases, ICU etc.) One exhausted or ill doctor, nurse, clerk, physio, etc mean that some patients may not get the care they need.
If you’re an “Upstairs Clinician”, please support your front line “Downstairs” colleagues. You know what I mean. Watch out for burnout and exhaustion. There will be many emotionally challenging decisions that have to be made during this time. One ED, ICU, Respiratory Physician, or nurse is probably worth 10 ENT surgeons in this pandemic (personal value opinion 😉 )
Listen to your leaders. Not a time to argue over non-essential matters.
Learn from China, Hong Kong, Taiwan, Singapore, Japan, Italy.
We will get through this together. We can flatten the curve together and reduce the mortality rate from this pandemic.
Some helpful sites below. (I married an Infectious Diseases Specialist. I read what she reads. Thanks dear.)
Global Daily Update from WHO
Local (Victoria) Daily Update from Chief Health Officer
Local (Victoria) Info for the public
Coronavirus in children
Coronavirus explained to kids by Nanogirl (NZ)
My favourite public health promotion video from this hilarious Italian Nonna
Practical Guide to self-isolation/quarantine