In a war of any kind, it’s best to learn from those who are fighting on the front lines. This is certainly true of those healthcare providers who are treating COVID-19 infected patients every day.
Dr. David Price is a pulmonary specialist at Cornell Medical Center in New York City, the epi-center of the U.S. virus pandemic. The medical experts from the White House Corona Virus Task Force are specialists in seeing the big picture of world-wide infection, but doctors like Price are actually treating patients every day.
Recently, Price held a teleconference with his family to educate them about this virus and reassure them as they face the challenge of remaining healthy in this environment. His video conference can be viewed at https://vimeo.com/399733860?ref=em-share. For those who don’t have access to this video or the time to watch it, I’ve tried to highlight the salient facts for your review:
Dr. Price starts by making one thing very clear – this virus is transmitted by droplets. That means from droplets of virus on skin or surfaces that our hands touch and then we bring to our face. It is not transmitted from infected people to uninfected people through the air that we breathe. Most transmissions of virus from one to another occurs from sustained (15-30 minutes) contact with actual touching of the infected person.
That means the key to protection from the virus is clean hands and avoidance of touching your face. In the confines of your home where no one is infected, such precautions are unnecessary. But in public spaces, we must be constantly aware of what our hands touch – and then compulsively clean our hands with soap and water or hand sanitizer – before ever touching our faces. This will prevent the transmission of virus if you happen to be in contact with the virus.
That brings us to the importance of masks. Dr. Price says the main value of wearing masks is to prevent us from touching our faces! He estimates that plain surgical masks are worn 80% of the time in the ICU. He says that the much-heralded N-95 masks are only used in his ICU when nurses are suctioning patients or providing respiratory therapy that might cause the patient to cough. This is when healthcare providers are at greatest risk. For those who are uninfected, there is absolutely no need for these masks. Anything that inhibits your ability to touch your face is effective, including plain cloth masks or bandannas.
Lastly, social distancing is important. Maintaining distance of approximately 6 feet prevents contact between infected and uninfected individuals. This is especially important to prevent asymptomatic infected individuals from transmitting disease to others inadvertently through touching.
In summary, Dr. Price’s rules for preventing virus transmission:
- Keep hands clean– with soap and water or hand sanitizers
- Avoid touching your face– especially just after touching unclean surfaces
- Masks prevent virus spread –by preventing you from touching your face
- Social distancing matters– unless you’re certain others are uninfected (family)
Symptoms and Treatment
The most common symptom is fever, usually greater than 100.0 F, but up to 80% simply describe “not feeling good.” Other common symptoms are sore throat, cough, and shortness of breath. Dr. Price says the only symptom severe enough to warrant going to the hospital is shortness of breath.In their hospital, everyone else gets sent home unless there is a serious co-morbidity that makes the patient high-risk. If you have symptoms, but not shortness of breath, stay home and call your doctor.
Families should isolate the infected family member as much as possible; preferably with their own bedroom and bath. The infected one should wear a mask whenever in the presence of other family members, but others need not wear masks. Strict adherence to hand washing, surface cleaning, and avoidance of touching the face should be maintained by all. Family members should refrain from taking the sick one’s temperature because this increases the chances of virus transmission. Let the infected one take their own temperature, if possible. If a family member with high-risk co-morbidities becomes infected, they should try to find alternative living conditions, if possible.
Only about ten percent of the infected are requiring hospital treatment and only about one percent intensive care. Most patients requiring ventilators will recover. The average time for recovery is about 5 days. Those who recover develop antibodies and immunity from re-infection.
The young are being spared from this virus. Infections below the age of 14 years are practically non-existent, however, anyone from the upper teens to a hundred years old is vulnerable. Most serious cases are in the elderly with co-morbidities but even healthy young people are at risk. Former NFL lineman Tony Boselli, age 47, recently was discharged from the Mayo Clinic after five days in the ICU.
Dr. Price strongly believes there is no reason to contract this virus if we “follow the rules.” We may have to get used to this new normal for months to come, but we can limit the spread until eventual herd immunity, new viral treatments, and viral weakening reduce the risk to more manageable levels like other similar respiratory illnesses.