Covid-19: Good News, Bad News

Health Tips / Covid-19: Good News, Bad News

Before I get into this, I’m still shaking my head in disbelief at my recent brush with accidental carbon monoxide poisoning as I sat in my car glued to the NPR program ironically called “Fresh Air.”

Really, it wasn’t even a close call, just me blurting out loud to myself “Did you really just close the garage door behind you with the motor running? You’re an idiot!”

Apparently, reluctance to leave one’s car occurs not infrequently among NPR listeners. Involved in one compelling program or another, depending on the weather, they may be found half frozen or suffering heat stroke. On the plus side, they never die of boredom.

I thought I’d share the program that held me captive because a lot of you are home today, working or otherwise, and you’ll have time to listen as the incomparable Terry Gross interviews Dan Diamond, the very articulate healthcare reporter from The topic is Trump’s astonishing untruthfulness and utter mismanagement of the Covid-19 crisis, his scientific ignorance, and his support by a team of equally incompetent lackeys whose only goal was and is to gain presidential favor.

It’s unlikely we’ll ever be able to tally the number of utterly unnecessary deaths brought about by Trump’s selfishness and incompetence. Even the most refractory Trump supporter will sit and listen to this interview in horror as she learns of the deliberate release of false information by Trump appointees (who have no expertise in the field) supporting random policy choices whose sole goal was not to protect Americans, but rather to shield the president from anything that might impair his re-election.

So far, the administration’s response to the greatest crisis since 9/11–and possibly the greatest threat to American lives in US history–has been first to call it a hoax and then not dangerous, to propose keeping that cruise ship offshore (in order to keep the numbers of infected people low), and finally and amazingly, to blame President Obama.

Let’s start with the bad news
So in addition to that, here’s the bad news about this coronavirus called Covid-19:

You are likely to get Covid-19. Your symptoms may range from none or a mild respiratory infection that you’ll pass off as a bad cold to a really uncomfortable flu-like illness with fever, muscle aches, and fatigue. Serious illness, including death, is more likely to occur in the frail elderly, especially those who have chronic illnesses. The death rate is now about 2.5%, or ten times that of the standard seasonal flu. South Korea, which is doing the best job in the world of testing for the virus and following up on contacts, has a death  rate of 0.77%.
The virus will spread quickly through the US because most carriers have no symptoms. We could, as South Korea is doing,   screen for at-risk people and then test that group, imposing self-quarantine on those who test positive and also on their contacts. In the US, tests promised by Washington have failed to materialize. In South Korea, testing is automated and can be performed at a rate of 12,000 tests per day via multiple drive-through centers. It’s also completely free. US tests are performed manually at a rate of about 1,000 a day. Read this piece for more on what South Korea is doing to keep its numbers down.
Social distancing is one very effective way we can slow this pandemic. Already, and very sensibly, many schools,  theaters, sporting events, and virtually any location where crowds gather has been closed or cancelled. Illinois has ordered restaurants and bars closed for sit-down service. With social distancing, you reduce the chances of getting the virus yourself, but also of spreading it unwittingly if you’re infected but have no symptoms. This frees up hospitals to treat those in urgent need. Here’s a link to a perfectly-named series of guidelines on self-quarantining/social distancing.
Use common sense. Over the weekend, the Webster Avenue Irish-themed bars were like mosh pits. I shook my head in disbelief, but then I remembered, “All 20-somethings believe they’ll live forever.” The warning not to congregate could have been in Urdu and have had the same effect. Minimize or eliminate social contact and use the gym, grocery, and public transportation in off-hours.
In addition to the frail elderly and those with chronic illnesses, people of any age who have asthma are especially vulnerable to complications from the virus. Use telecommunications to stay in touch with family members and friends.
Take this virus seriously, even if you’re not old. Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, made several important points Sunday:

“Younger people are not immune or safe from getting seriously ill…There are going to be people who are young who are going to wind up getting seriously ill…Even (if) you don’t get seriously ill, you could bring (the virus) to a person who would bring it to a person that would bring it to your grandfather, your grandmother, or your elderly relative.” Click here for the whole story. (Spoiler alert: Dr Fauci want you out and about.)

And now some (guardedly) good news
Despite its gross inequality of access, the US does have a very good health care system. However, it could, like Italy’s very good health system, easily become overwhelmed if the number of Covid-19 patients requiring urgent care outpaces the number of hospital beds (including ICU  beds) and the physicians, nurses, nurse practitioners, and other dedicated staff who care for them. Click here for more.
During times of crisis, Americans have a history of getting off to a slow start but then working together in ways that have surprised the rest of the world. We were slow to perceive the evils of the Nazis but by the time WW2 was over the country was totally united, the post- war years were among the best in our history, and the war became known as “The Good War.” Although we may be disappointed about cancelled concerts and sporting events,  weddings and dinner parties, just like the endless rationing that occurred during WW2 we see that this is all for the common good and we  cooperate.
We also reach out to those in need. Check on your less able neighbors and offer support. Could you grocery shop for them or make a medication run? Also remember that even in the best of times the US has an enormous food insecurity problem. Many people rely on the support of food pantries, which are bravely staying open during this tumultuous time. Lakeview Pantry is an excellent example. Click here to donate or get food or social services. Also, here’s a story about West Side delivery/grab-and-go for seniors and low-income residents.
The US has a lot of businesses involved in health care. What with 17.8% of our entire GNP (more than one trillion dollars) spent on health care, we have a lot (a lot!) of companies that can develop  vaccines, antiviral drugs, and build hospitals.
Americans generally prefer privacy and self-isolation, so self-quarantining/social distancing is a fairly easy proposition. Anyone who has travelled knows that in many other countries the concept of respecting personal space simply does n’t exist. We Americans sit at opposite ends of buses, movie theaters, bars, and restaurants in the best of times. We stand apart in conversations. Most of our shopping areas are larger than airplane hangars with wide aisles and high ceilings and we often find ourselves alone, peering in the distance to find assistance at a Costco or Best Buy. You’ll grin and bear this minor requirement.

In addition to practicing social distancing, the most complete guide to protecting yourself and preparing for the virus is this excellent summary from the New York Times.

I’ll add just a couple more fundamentals:
Open your windows and let in some fresh air every day. Viruses thrive in enclosed environments.
Get outside and into the sun. Viruses don’t like fresh air and sun and you need a nice daily walk anyway. Take your dog, head to one of Chicago’s many parks, or meet up with a friend to walk. Just keep about six feet away from other humans. Click here for a fascinating piece on how outdoor treatment during the 1918 flu pandemic saved lives. One of the theories about viral susceptibility during specific seasons has to do with our vitamin D levels. In spring and summer we’re outside more and in the sun. As a result, our vitamin D levels rise (and then the flu season ends).
Keep a good sleep schedule. Sleep is immune-protective.
Eat nutrient-dense foods. Now’s not the time to gorge on Little Debbies and Fritos, even if it does feel like the end of the world.

Would you have ever thought your netflix subscription could come in so handy? Or your kindle?

Stay well,
David Edelberg, MD

PS: Take your hand sanitizer and vote!