Coronavirus – March 10, 2020


I have been getting messages from patients concerned about the current coronavirus pandemic (COVID-19) who would like me to share my perspective, so here it is.  THIS IS NOT INDIVIDUAL MEDICAL ADVICE, just my take on things.  If you are my patient, give me a call.  And you can find up to date medical information about this illness on the WHO website, the CDC website, as well as your local health department website.

https://www.who.int/emergencies/diseases/novel-coronavirus-2019

https://www.cdc.gov/coronavirus/2019-ncov/index.html

https://www.larimer.org/health/communicable-disease/coronavirus-covid-19

 

What we know so far:

There is little immunity worldwide to this strain of coronavirus which means that most, if not all, of those exposed will probably catch it.

(Other strains include several which cause common cold symptoms,  and SARS and MERS, which can cause severe respiratory symptoms.  COVID-19 is considered a SARS-type coronavirus.)

The incubation period is 1-14 days, with 5 days being most common (time from being exposed to when symptoms show up).

Unlike influenza, this virus seems to develop symptoms over days to a week.  Which means a person may be sick with milder symptoms for a while before serious breathing symptoms start.

There is community spread now, in general, which means you may catch it from someone who has not been out of the country recently, and who may not even know that they have been exposed.  In fact, it appears COVID-19 IS in our area.  A 50 year old woman with pneumonia has tested positive in Larimer County and is waiting on confirmation from the CDC.  In an abundance of caution, I would assume that it is spreading here.

Approximately 80% of those who get this illness will either have no symptoms or will have mild symptoms.  20% will have more a more serious course and need hospitalization.

Our best current estimate of COVID-19 death rate is somewhere between 0.6%-3.4% (general population), but the death rate in China so far for those over 80 years of age may exceed 20% and there is increased risk of death in those over age 50, smokers, and those with underlying health issues like asthma, heart disease, and diabetes.

Children have a much lower risk than adults.  As of now, no children under age 9 have died.  It seems they do catch the virus, and do spread it, but typically show minimal symptoms.

There’s no current indication that summer weather will impact the spread, as the southern hemisphere has cases, however, past viral epidemics have shown a seasonal pattern, so it’s still possible.  In the 1918 Spanish flu (H1N1) epidemic, for example, there was a milder spring outbreak followed by a severe fall outbreak.

Spread is primarily through droplets (cough and sneeze) and touch, which includes surfaces.  The virus may last more than a week on surfaces.  There are indications it is likely spread by the fecal-oral route also.

Handwashing with soap (any kind) and water for 20 seconds reduces spread.

If you don’t have access to soap and water, hand sanitizer with at least 60% alcohol content is second best.

COVID-19 primary symptoms are fever, fatigue, body aches, and cough – the virus seems to preferentially infect lung cells and the majority of patients won’t experience nasal/sinus symptoms or GI symptoms (diarrhea, nausea, vomiting), although these symptoms are more common in children.

There most likely will be no vaccine approved for general use for this virus for at least a year.

 

Recommendations:

General:

If you have a fever and a cough, your best bet for getting tested is at your local hospital.  Call ahead to let them know you’re coming so that they can take appropriate safety measures.

The CDC is now recommending that all people over the age of 60 and anybody with underlying health conditions self-quarantine at home as much as possible.  Consider online shopping and telemedicine visits where possible.  Regardless of age, I would avoid large groups of people when possible.

Those of us who are able to self-isolate and prepare will make it easier for those who can’t, such as health care workers, those without paid time off, and low income people.  Slowing the spread lessens the impact on healthcare facilities.

If you are younger and healthy, check in with your friends, family, and neighbors who are at higher risk to make sure they have what they need.

Prepare for school closures and the possibility of needing to self-quarantine by having a 2-3 week supply of food, pet supplies, toiletries, paper goods, and medicines.

 

Hygiene:

Wash hands with soap and water for 20 seconds – of course after using the restroom, but also before you leave the house and as soon as you get home.

Try not to touch your eyes, mouth, or nose with your hands.  This helps prevent you from putting your germs on other people or public surfaces, and also prevents you from transferring germs from surfaces to your mucus membranes.

Don’t shake hands.  Wave, elbow bump, get creative!

 

Support your immune system so that you are in the best position to handle any illness:

Get plenty of sleep and rest – sleep deprivation suppresses immune function

Don’t overdo your workouts – overtraining can also suppress immune function

Get fresh air

Stay hydrated

If possible, humidify your home/office – recent research suggests around 40% humidity is ideal for minimizing infectious spread

Eat nutritious food and minimize sugar, alcohol, and junk food.

Antioxidants such as vitamin C, vitamin A, selenium, and zinc have all been shown to reduce the risk of viral illness and/or reduce symptom severity.  Talk with your doctor about the right doses for you.

Vitamin D is essential for proper immune function and may decrease the risk of viral illness.  Consider getting tested.

Elderberry has been shown to reduce the incidence of influenza infection, and to shorten the course of infection in both adults and children – by up to 3-4 days.  We don’t know the effect on coronavirus yet, but it is a very safe herb for adults and children when dosed appropriately.  (High doses may cause nausea or diarrhea.)  Don’t use honey preparations in infants under a year old. Sambucol is the brand generally used in studies.

Many other foods and herbs have immune supportive and/or antiviral activity in general, including garlic, astragalus, nettles, and several species of mushroom.

There is a study in progress on using quercetin (a bioflavonoid in apples, onions, and other foods) in higher doses to treat COVID-19, so this may be a consideration in older children and adults.

 

Homeopathy:

For those who use homeopathy, the main remedies that seem to be helpful in this outbreak according to homeopaths who have been working in current epidemic areas are Gelsemium, Bryonia, Mercurius, and Eupatorium.  A common recommendation is to use Gelsemium 30c once a week if not in an outbreak area, Gelsemium 30c once a day for 7 days if in a local outbreak area, and the appropriate remedy if you do get sick.

 

In short, there’s no need for panic, but we should be preparing for an increase in illness in our community.  The very best things we can do are to be prepared to stay at home, wash our hands diligently and often, minimize unnecessary contact with others, and check in on the vulnerable members of our community.  If you get sick but you are okay, stay at home or call your doctor’s office.  If you think you may have coronavirus, call your doctor or call ahead before going to the hospital.  Let’s take care of each other.

Dr. Caron

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