The current coronavirus outbreak and the news reporting surrounding it is understandably generating a lot of fear and uncertainty at the moment. A good part of that fear comes, I believe, from the tone of media reports and statements by public officials that communicate a sense of danger that is pushing people into into fight or flight mode. While it is wise that we as a nation are taking protective measures, promoting fear is counterproductive. The precipitous drop in the stock market over the last few days is a very good example of that.
While it is true that we will almost certainly be seeing fairly widespread rates of infection in our country the reality is that most of those infections will be fairly mild. It is also true that we have a good idea who is the most vulnerable to developing serious illness and that there are measures we can take now, and if we become infected, to optimize our body’s ability to successfully eliminate the virus. Natural medicine (particularly homeopathy) was an important and effective part of the response to the Spanish influenza epidemic of 1918 and should be a part of our response to this pandemic.
Please remember that currently, confirmed cases of coronavirus in Placer and Sacramento counties are still quite low (8 in Placer and 17 in Sacramento county as of March 16th). We still have time to prepare. My purpose in writing this post is to provide brief, accurate and useful information to assist you in taking appropriate action to minimize your chances of becoming infected and improve your ability to successfully fight off the virus should you become infected.
To reduce your risk of infection it’s important to understand exactly how the virus does and does not become transmitted. This virus only infects the respiratory tract. For transmission to occur it must find its way from the respiratory tract of one person to the respiratory tract of another person. It cannot infect a person through the skin, eyes, urinary tract, digestive tract or an open wound. If you happen to touch a surface, such as a door handle, that has virus on it, that will not, in and of itself, infect you. You must then place your hand in your mouth or nose, or touch something which you then place in your mouth or nose, such as a pen or food. This is why the CDC and others are strongly urging people to wash their hands frequently and avoid touching their face. It is also why it is important to clean frequently touched surfaces with a disinfectant solution on a regular basis.
Again, the virus must find its way into your mouth or nose in order to infect you. The primary way this can occur is through direct inhalation of respiratory droplets from an infected person. Respiratory droplets are projected when a person coughs or sneezes. They are heavy enough that they generally don’t travel very far, perhaps 3 to 6 feet, however, a particularly vigorous sneeze may send them as far as 10 feet. If you are around someone who is coughing or sneezing, do your best to appropriately distance yourself from them.
As mentioned above, infection can also occur if a person touches an object or surface that is harboring infected respiratory droplets. Droplets expelled with a cough or sneeze may land on surrounding surfaces, such as countertops. Someone may also cough into their hand, or touch their mouth and then place their hand on a door handle, gas pump handle, or other object that is then touched by others. As infection becomes more widespread in our area it will become more and more likely that we will come into contact with surfaces that are harboring the virus. Stay aware and use common sense. Try to minimize contacting doorhandles and other frequently touched surfaces while in public but if you must, make sure not to touch your face before washing your hands thoroughly. Finally, be aware that it is also possible to become infected by kissing or directly sharing food or drink with an infected person (such as drinking from the same glass or eating from a common plate).
Lastly, and this is an important point, it is now understood that an infected person can become contagious before they start showing symptoms. Because of this it is important that we practice common sense preventive measures at all times, even when we are not around anybody who is showing symptoms. We also need to consider that we may be contagious when we are not showing symptoms. This is particularly important when we are close to high risk individuals such as the elderly and those with pre-existing health conditions.
For more detailed information on how to prevent infection and boost your immune system please see my previous blog post: The Coronavirus: What You Can Do.
Symptoms of the Coronavirus
Unfortunately, the symptoms of the coronavirus are not that distinct from other acute respiratory infections such as the cold or flu, which are still circulating. The primary symptoms are fever and dry cough. Muscle aches and fatigue are also common. If you have a fever and are producing copious amounts of mucus, or have a runny nose, then it is unlikely that you have the COVID-19 virus.
For about 80% of people, the infection will be an uncomfortable nuisance, similar to having the flu. For about 20% of people, however, the infection can become more serious with progression to pneumonia (a direct infection of the lungs). The primary symptom associated with this is shortness of breath, the feeling that you aren’t getting enough air. If this occurs, contact your doctor immediately. If you are a patient of Four Rivers Clinic please contact us as well and we will recommend appropriate naturopathic therapies.
How dangerous is this virus?
Estimates of mortality related to this virus have been highly variable, which has contributed to fear and confusion. I have seen early news reports stating that mortality might be as high as 15% (nobody is saying that now) and others claiming that mortality will ultimately be well under 1%. I have been monitoring predictions made by various epidemiologists and public health experts, along with the reasoning behind these predictions, and I believe that the evidence is leaning strongly towards a very low overall rate of mortality, very likely well under 1%, perhaps 0.4-0.7%. This does not make it any less of a tragedy for those who lose loved ones, but it is important to keep this pandemic in perspective. It is also important to understand that a) not everyone is at the same level of risk and b) we can take steps to reduce not only our risk of infection but our ability to successfully fight off the virus should we become infected.
Who is at greatest risk?
Increased risk occurs with age. A study of people infected with COVID-19 in China showed that those under the age of 50 had a 0.2% mortality risk, from ages 50 to 59 the risk rose to 1.3%, from 60 to 69 3.6%, from 70 to 79 8% and for those over 80 the risk was 14.8%. However, this association of increased risk with age needs clarification. Age, in and of itself, is only a piece of the puzzle. As we age our immunity naturally declines somewhat but the degree to which it declines has a lot to do with our overall level of health, nutrition and self care. This has been almost entirely ignored by public health officials, the media and our culture at large. This is why we are recommending that everyone take steps to improve their immunity now, including diet, sleep habits and nutritional supplementation (see my previous blog post for more information).
Reports of coronavirus associated deaths in the US have almost universally been of people with pre-existing health conditions. Specific high risk conditions that have been identified include heart disease, diabetes, cancer, obesity and smokers. It is likely, however, that any chronic health condition (or medical treatment, such as prednisone, immunosuppressants or chemotherapy) that leads to suppressed immunity increases risk of mortality. Similarly any health condition that causes diminished lung capacity such as asthma or COPD is likely to increase risk.
If you have a chronic health condition (even if you are below the age of 50) or if you care for someone with a chronic health condition you need to take extra precautions. People in this group should be staying home if at all possible and limiting exposure to situations involving close contact with others. When at home, make sure that people coming into the home, such as friends, service people or home health care workers are taking appropriate precautions (washing hands frequently and wearing masks) and maintaining appropriate distance to the degree possible. People in this group should also be taking steps to optimize their nutrition and immunity.
Availability of goods and services
We are already seeing disruption in supply chains for a number of products and as the pandemic progresses it is likely that we will see further disruption of goods and services. The CDC is currently recommending that at risk individuals stock up on food and medicine. The Canadian government is recommending that their citizens buy a little extra food every time they go shopping rather than trying to do it all at once. This should put less stress on supply chains and decrease the sense of fear and panic. It makes sense for Americans to follow this approach as well.
The Placer County Public Health department is currently requesting that anyone who is showing signs of an acute infection (wether they believe it is coronavirus or not) should stay home until at least 72 hours after symptoms resolve (fever, cough or other respiratory symptoms) OR for 7 days after symptoms began, whichever is longer. Infection with the coronavirus may last for two to three weeks, so ideally there should be enough food stored for everyone in the household for that period of time.
What Four Rivers Clinic can do
We have been monitoring the progression of this pandemic and trying to gather and disseminate the most accurate and useful information possible.
At this time we are continuing to operate as usual and are taking every precaution to minimize risk of transmission in our office, including frequent disinfecting of commonly touched surfaces, maintaining appropriate distances and scheduling patients so as to minimize the number of people in our reception area at any one time. We are also setting ourselves up to be able to continue delivering care via video conferencing or telephone if that becomes necessary.
In addition, we have been increasing our inventory of appropriate antiviral, immune stimulating and other support remedies to the degree possible, including remedies that have shown efficacy against previous strains of coronavirus. While there is no approved conventional antiviral treatment for COVID-19, naturopathic doctors have been successfully treating virally infected individuals for over a hundred years using natural therapies and we are confident that our approach will be helpful with the current virus.
For more information on the novel coronavirus