March 10, 2020 / by Quinn Norton

 

A helpful FAQ on Covid 19

1. Am I going to die?

Yes, unfortunately everyone dies.

2. No, I mean am I going to die of Covid 19?

Oh right, that! Probably not. Most people who get it have fairly minor symptoms. Though by minor, I mean not life threatening, not necessarily pleasant to experience. Current estimates are that 80% of cases are minor, 20% require some kind of medical intervention, and somewhere between .7% and 5% may die or get close enough to see that bright light coming for them.

3. You mean a near-death experience for as much as 5% of people?

No, I mean hospital lighting, it’s so bright, and so unpleasant! It gives me a headache every time. Why can’t they use warmer bulbs?

4. I’m asking the questions here.

Right, sorry, go on.

5. Will a lot of people need to be hospitalized? 

It looks that way. Mostly people around 70 or older, and people with existing health conditions, are going to need what’s called “supportive care.” Supportive care means we don’t have a cure or direct treatment, but we can often keep the body going while it fights the good fight to created enough antibodies to kill the viruses floating around inside the Covid 19 patient. That can mean extra oxygen, monitoring by healthcare staff, or more, all the way to a machine that breathes for the patient.

6. What do we do about too many people needing to go to the hospital at once? 

This is the nightmare we’re trying not to have, and we need to practice what epidemiologists call delay, to slow the rate of people heading for the hospital. You can wash your hands, clean the surfaces around you (more on that soon) and avoid getting close to other people outside. But mayors, governors, school administrations, and other authorities in charge of spaces where a lot of people are close together can do a lot more by canceling events, encouraging work from home, closing schools and universities, and limiting how many people can congregate and how close they can be. Anywhere the public comes together will become a place where the virus travels from person to person. This is important, because if we can slow it down, then the line for those plush Intensive Care Unit beds will be balanced out, and everyone won’t be rushing for ventilators like it’s Black Friday at Medical Walmart.

Here’s a great visual of what we’re trying to do with all this social distancing and hand washing especially hand washing did I mention hand washing?

The pokey curve is uncontrolled infections, the smooth, slower curve we want is what we want by delaying the spread.

7. Why don’t we have a cure? Who do I yell at about this?

Look, we live in such and age of wonders and such an age of political duplicity and ineptitude that it can seem like anything bad that happens is negligence or malice. But the fact is, Nature can still kick our collective ass anytime it wants to. This isn’t anyone’s fault, this is the kind of thing humans have been dealing with since before we were humans.

8. There must be something I can yell about and someone to yell it at?

Don’t worry! There is. There’s a lot both authorities and regular people can do to manage the spread of this disease and make the treatment more effective. On the personal level, you can yell at your children/roommates/parents/etc. to wash their hands for 20-30 seconds several times a day, before and after going out, before preparing food, using the toilet, touching food, touching their face, sneezing, coughing, spitting, or cursing…

9. Wait, cursing?

Well, it can’t hurt.

10. sigh Go on. 

You can also clean commonly touched surfaces a lot — think doorknobs, handles, counters, light switches, keyboards, knobs, buttons, faucets… your germ-nursery of a cellphone, just walk around the spaces you’re concerned about, public or private, and think about where people touch, cough, sneeze or lick.

11. LICK? You know what, I don’t want to know. What do I have to clean everything with? Alcohol, bleach, fire?

All of those things will work, but honestly soap or basic surface cleaners are fine. Disinfecting wipes are good for quick cleaning and for cellphones but you can also just spray a little surface cleaner on a paper towel and wipe things down well with a good amount of cleaner, including your disgusting cell phone. Soap (detergent) is great. In fact, it’s often better than alcohol or hydrogen peroxide. Here’s the thing, this coronavirus, SARS-CoV-2, has a single strand of RNA and four specialized proteins all supported by a lipid bilayer holding the package together. Having a lipid viral envelope makes it susceptible to detergents…

12. Could you stop with the nerd talk?

Sorry. If you put soap on the virus and rub a bit, it pops, and then it dies.

13. Wow!

I know, right? You can set it on fire and pour alcohol on it or whatever, but anything that cuts grease and little back and forth, and you can just imagine those tiny little spiky balls popping and spilling their tiny little guts everywhere. It’s great. Just makes you want to scrub everything.

Hand sanitizer works similarly, but not actually as well as regular old soap. There’s a lot of cleaning products out there, but you’re really much better off with soap. You also don’t want to use things that will dry out and cause cracking in your skin — any bloody spot is an entry point. That might also mean you should get some lotion and keep your hands soft, supple, and free of extra holes.

But seriously, wash your hands with soap and water, and don’t touch your face. That’s pretty much the best thing we can all do.

Here’s a Baby Shark video with dancers showing proper hand washing technique, and here is another. The internet is truly full of things .

14. Ok, but let’s get back to the part when I get to yell at people about this. 

Sure. The virus travels between people on the tiny droplets that we cough, sneeze, or even just exhale. It’s also potentially in our tears, spit, blood, and our bathroom business. That’s a lot of ways for it to get from one person to the next, and that means we need to get away from each other to slow the spread of the disease. You can yell at local officials and event organizers to cancel or postpone gatherings where people might be in close contact, and those people might include children. Schools, conferences, church services and other public event cancellations are already happening, and they need to happen a lot more. You can yell at your local authorities about that.

15. What about testing?

Oh, yell your head off about this. Testing, especially in America, has been abysmal. Widespread testing is one of the best ways to map out and contain any epidemic, and given that many people (especially children) seem to have mild symptoms, it’s even more important to have widely available testing. Ideally testing should be available to everyone in an infected area. South Korea has drive through testing, China made a lot of their testing mandatory. In most cases, if you have the virus you just need to know to go home and stay there until you get through it. But if you don’t know it, you can run around spreading it, which is exactly what many people who were turned down for getting tested in the USA, Australia, Japan, and more, ended up doing. Testing only the sickest people tells you about them, but not about how the virus might be spreading at the moment. Very sick people aren’t walking around anymore coughing on everything. In some ways knowing if the very sick have the virus is less important than knowing about the still walking sick who may have it.

Whatever is causing the delay in US testing, the excuse isn’t good enough.

16. Is Covid 19 the fault of Trump/Mitch McConnell/Nancy Pelosi/Jay Inslee/Gavin Newsom/Rush Limbaugh/Etc.? 

Honestly, it doesn’t much matter whose fault it is right now. The house is on fire, and we need to put it out. We can figure out who to blame later. The important thing is that we start testing as widely and quickly as possible, and getting that information into the communities to help them make decisions based on good data. Also just to be on the safe side don’t lick any pangolins you come across.

17. How do I get my uncle/mother/child/self to stop COMPLETELY FREAKING OUT about all of this?

If you’re reading this you’re probably not a medical professional working the front lines of the response or an administrator planning logistics for your area. You just don’t need to know the latest news and speculation about Covid 19, and neither does your child, spouse, cousin, or cat. Informed is good, but drowned in information and emotionally paralyzed is bad. Pick a time of day to get your Covid 19 news, and then just… stop. If you really must, go ahead and check two times a day. If people bring it up, talk about hand washing and cleaning surfaces until they drop it. Nobody wants to talk about hand washing and cleaning that much, except possibly me.

If you’re dealing with a loved one that’s just losing it, plan an activity. A board game, a movie, something that gives everyone’s brain a break from it all. Accidentally unplug your internet for a while. If you just feel like you need to do something about it, clean house, it can’t hurt. Print up hand washing posters and put them up in bathrooms you visit. Do, and talk about, other things. The world is still turning, there are books to read and movies to watch and work to do and being scared of Covid 19 is not your full time job.

18. Is this the Zombie Apocalypse?

No, this is just another boring bug that causes a bad lung infection. There are a lot of them, but because this one is new (hence novel) we don’t have any immunity to it. It’s just going to be difficult and sad for a while.

19. You know what I mean. Is this… that virus? Is it the deep state, or an escaped bioweapon from an evil government lab? Is the SARS-CoV-2 virus going to be played by Dwayne “The Rock” Johnson one day, when the Truth is Revealed? 

Oh Lord, OK, this one. Let me tell you how boring, and inevitable, this kind of thing is. This novel virus is from a family of viruses called Coronaviruses. They were discovered in the 1960s, most of them cause common cold symptoms. They’re genetically similar RNA viruses, but you can almost just think of them as simple machines for injecting RNA into certain cells who then unwittingly make copies of them. But none of this is very precise, and errors get into the next generation of RNA viruses all the time, which is how you end up with new viruses. It’s about as sinister as self replicating Roombas, which is kind of sinister but also kind of stupid. Novel emerging viruses that cause epidemics are inevitable, and they’ve been happening not just since before we were humans, but before we were even animals. Not only is creating a viral bioweapon that happens to mostly kill older people and people with immune conditions not terribly possible with current technology, it’s also not particularly desirable.

This is not the only novel infectious agent we’ll see, it’s not even the only one we’ve seen in recent years — SARS, MERS, AIDS, H1N1, Ebola, MRSA, they’re all new(-ish) infectious agents we’ve been fighting in the last few decades. As we disturb habitats and invade bat caves viruses and bacteria that aren’t used to our bodies will end up trying us out. Most of them will die and we’ll never know they were there in us, looking for something to latch onto. But every once in a while, one of these tiny bastards hits the Lotto numbers. That’s part of what we have the scientific and clinical field of Epidemiology for. We forget this in our age of technowonders, but Nature is still the OG asskicker, and always will be.

20. That’s depressing, and kind of a letdown. 

I know. Maybe we can get Dwayne Johnson to play Dr. Tedros Adhanom, head of the World Health Organization (WHO) and he can beat up people who are withholding testing and demand that the public be allowed to go home and practice social distancing.

21. OK that’s a terrible idea for a movie, but fine, it’s not a secret government plot. If I’m not even a zombie, how do I know if I have Covid 19?

The symptoms to keep an eye out for are a fever, shortness of breath (difficulty breathing), and a cough.

22a. Whoa wait that exactly what I-slash-the person reading this next to me have! WHAT DO I DO NOW?!

First off, calm down. Those can be common flu symptoms, and thankfully the flu (with its much lower fatality rate) is still more common. But if you’re in an area with community transmission or have recently traveled to an area with an epidemic outbreak, it’s worthwhile to get testing if testing is available. If you’re sick, don’t go to the hospital or the doctor’s office. Call your doctor or the hospital, and tell them why you think you might have Covid 19. If you’re very sick, and you need to go to the hospital, call for an ambulance, and tell them you believe you may have Covid 19. That way they can show up with the right equipment to keep you and everyone else safe.

22b. I have a runny nose and a sore throat and generally feel a bit crap.

Chill. I have that too, it’s a cold. It’s why this FAQ is so late.

23. Will this just all go away when it warms up?

Well… It’s complicated. The short answer is no, but maybe it kind of could? A lot of this has to do with how well the SARS-CoV-2 virus survives on surfaces, and it doesn’t survive as long on warm surfaces, or enjoy being hit by UV rays from the sun. That could, in theory, lower the overall infectiousness of the disease, but we just don’t know yet.

24. I have really great health insurance, that means I’m cool, right?

Oh, sorry, not this time. The problem is whether or not we can slow the virus down enough to make sure the hospital beds aren’t full when you need them. No matter how good your health insurance is, if hospitals are racing to catch up with how many sick people there are and the epidemic is in a crisis, you’re going to be stuck waiting. Have I mentioned washing your hands a lot?

25. Why are children immune? Why don’t they suffer like the rest of us? 

Harsh, but ok. Children aren’t immune, they get the virus in the same timeframe and probably have it as long as we grown-ups do. They just don’t seem to have a lot of symptoms. If you put a swab in their nose you can detect the virus, but they don’t seem to get very sick. As for why, we don’t know. They could have very little viral activity, or they could be shedding it like tiny adorable Typhoid Marys all over their grandparents. There’s a lot we just don’t know about this virus or what it’s doing the the world. It’s novel, and that’s hard to deal with. Many papers are coming out about it, many scientists are pouring over all the data we have. Research on Covid 19 may be one of the only things traveling faster than than the virus, but there’s still so much to figure out.

26. How much social distancing should I be practicing?

Some of that depends on you. If you’re older, immunocompromised, or otherwise high risk, you should probably at least be prepared to stay home for a few weeks if the virus comes to town. If it’s in town already, avoid crowds and busy transit. Work from home if you can, and prepare for school closures. If you’re sick with something else and you must go out, that’s the time to wear a mask, but a surgical mask is fine. Wash your hands and don’t touch your face. If you’re sick with Covid 19, really, don’t go out. Try to get anything you need delivered until you’re well again.

27. Once I’m well, and I’ve beat the virus, I’m an invulnerable coronavirus superhero, right?

Well, uh, there’s more than one strain, and we don’t know if having one confers general immunity. Until we know you should probably still be careful.

28. SERIOUSLY?! 

Yeah, we’ll probably know more soon, but this is novel, and we’re all still figuring it out.

Sorry.

29. It looks like I’m living with someone who has the virus and I have to take care of them, or they are high risk and I’m worried about giving it to them. 

That’s beyond the scope of a sarcastic FAQ, but I’ll try. If you’re living with a vulnerable person, you need to go their speed when it comes to social distancing, self-isolation, and safety precautions. If you’re taking care of someone, this is the situation in which you need PPE (Personal Protective Equipment) like N95 masks, gloves, etc.. And you need to fit the masks correctly. Youtube tutorials are your friends.

30. Should I go to school? To work? Can I still go out to eat? Or get delivery? Man, I don’t know how to boil water. 

A lot of this depends on what’s going on where you are. There should be local announcements about schools, work, and gatherings that help guide your decisions, but you may also need to be more careful based on your own health situation.

As for getting prepared food, a cooked meal is going to kill the virus, though it would be nice for people working in commercial kitchens to wear masks and wash their hands a lot. If you’re going out, don’t go somewhere crowded. You want 4-6 ft between between people, with good ventilation. If you’re getting delivery, make sure your food is hot and treat sacks and containers as possible contaminated — wash your hands, throw packaging out, wash your hands again.

31. What are you doing about it, yourself? Huh, Quinn?

Oh, put my money where my mouth is, eh? (That’s a terrible idea, money is almost always contaminated, so I’m using my credit card as much as possible) I’m currently in San Francisco, where there isn’t a medical crisis (yet) but we do have community transmission. My daughter’s school is still open, which I’m unhappy about but for now she’s going. When I had cold symptoms I wore a mask out. I’m checking my temperature periodically and so are my roommates. I wash my hands a lot. I’m wiping down high-touch surfaces with detergent a few times a day.

My daughter and I are taking multivitamins. Some people think Zinc can help, or Vitamin D, or C, or whatever, and honestly no one knows — novel virus! What I am sure of is that deficiencies make illness worse, and a multivitamin can’t do any harm. (Except biological males should not take women’s vitamins due to the iron they contain.) I’m still going out and doing a few things, but I don’t stand in lines or get close to people. I went to Safeway, saw lines, and noped right out of there. I’m usually walking to get around, but will get on a mostly empty tram. I’m still going for runs, and see people walking dogs. That’s fine, as long as we stay well away from each other.  When I get back, I wash my hands.

32. Where do I find good and reliable information that’s less sarcastic than this FAQ?

Did I mention you should wash your hands?


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Originally Posted @ https://www.emptywheel.net/2020/03/10/a-helpful-faq-on-covid-19/