It’s getting hard to keep up with how to report the spread of this virus, since different sources are reporting different numbers, but it seems that we have about 95,000 cases globally and 3300 deaths. Many of the new cases that are spreading to other countries—like the Netherlands, where cases are up to 82—seem to be linked to Italy. We seem to have about 108 cases in the US with nine deaths.

I’m blessed to be part of a circle of doctors who gather monthly with our mentor Rachel Naomi Remen, MD, and one of them just sent us these precautions from James Robb, MD, a molecular virologist, and former UC San Diego professor who was one of the first to specialize in coronaviruses back in the 1970s and who was involved in SARS and MERS (two other coronavirus outbreaks). While this is only speculation, he projects that this virus is likely to be widespread in the US by late March/April. This projection need not cause alarm.

Again, this is a coronavirus, not ebola virus. Recent reports estimated the mortality rate of Covid-19 at 3.4%, but WHO officials have now said the mortality rate can have great variance—from as low as 0.7% to a max of 4%, depending on the quality of the health-care system where it’s treated. This means the greatest mortality risk may be in populations with poor access to the supportive treatment necessary if lung disease becomes severe. The other high-risk group includes people with underlying health issues and compromised immune systems.

The NIH is saying it will likely take a minimum of three months to develop an effective anti-viral drug or vaccine, but Dr. Robb thinks we won’t see one this year. Because humans have not seen this virus before, we do not have natural immunity, so our best bet is to take precautions to prevent spread and to do our best to keep our immune systems in good shape so we can effectively mount an immune response to the virus if we do become exposed. The good news is that this virus seems to be less infectious than the flu and far less infectious than viruses like ebola.

The most common question you all are asking me is, “Should I avoid public gatherings?” It’s too soon to answer this question, but I’ve been wrestling with something in my heart about this. I read a beautiful essay recently written by a loneliness expert who is concerned that many scared, cautious people are planning to stop attending group gatherings because of this outbreak. She made the point that it’s a kind of Catch 22—that the love hormones caused by gathering together when we are scared and feeling out of control—the oxytocin, endorphins, dopamine, serotonin, etc.—will actually strengthen us and help us fend off the virus. But of course, that means putting us in situations where we could spread a virus together too. I think it’s important to consider the implications of this. Might the benefits of coming together for love, comfort, and connection during a global crisis outweigh the risks? Or are we better off disconnected, isolated, and unexposed? I can’t help being aware that all our best efforts to control life are failing right now. Maybe now is simply a time for deeper and deeper trust and surrender in the mystery of “I don’t know.”

With that in mind, let me offer you some of Dr. Robb’s practical, grounded behavioral recommendations to help slow down any further spread of this virus. Since this virus is mostly spread hand to mouth, most of these regard keeping your hands from contacting infected secretions and doing what you can to avoid getting infected virus into your lungs. I don’t want to feed any hysteria or panic, and I continue to suggest doing what you can to calm your nervous system as the best medicine during an outbreak, but let me share with you these practical tips.

Tips For Preventing Infection

  1. NO HANDSHAKING! Use a fist bump, slight bow, elbow bump, etc.
  2. Use ONLY your knuckle to touch light switches, elevator buttons, etc.. Lift the gasoline dispenser with a paper towel or use a disposable glove.
  3. Open doors with your closed fist or hip—do not grasp the handle with your hand, unless there is no other way to open the door. Especially important on bathroom and post office/commercial doors.
  4. Use disinfectant wipes at the stores when they are available, including wiping the handle and child seat in grocery carts.
  5. Wash your hands with soap for 10-20 seconds and/or use a greater than 60% alcohol-based hand sanitizer whenever you return home from ANY activity that involves locations where other people have been.
  6. Keep a bottle of sanitizer available at each of your home’s entrances. AND in your car for use after getting gas or touching other contaminated objects when you can’t immediately wash your hands.
  7. If possible, cough or sneeze into a disposable tissue and discard. Use your elbow only if you have to. The clothing on your elbow will contain infectious virus that can be passed on for up to a week or more!

The Items Dr. Robb Thinks Are Worth Stocking Up On

1. Latex or nitrile disposable gloves for use when going shopping, using the gasoline pump, and other outside activity when you might come in contact with contaminated areas. [Note: This virus is spread in large droplets by coughing and sneezing. This means that the air will not infect you! BUT all the surfaces where these droplets land are infectious for about a week on average—everything that is associated with infected people will be contaminated and potentially infectious. The virus is on surfaces, and you will not be infected unless your unprotected face is directly coughed or sneezed upon. This virus only has cell receptors for lung cells (it only infects your lungs). The only way for the virus to infect you is through your nose or mouth via your hands or an infected cough or sneeze onto or into your nose or mouth.

2) Disposable surgical masks and use them to prevent you from touching your nose and/or mouth. (We touch our nose/mouth 90X/day without knowing it!) This is the only way this virus can infect you—it is lung-specific. The mask will not prevent the virus in a direct sneeze from getting into your nose or mouth—it is only to keep you from touching your nose or mouth. [Note from Lissa: This is important to understand. Surgical masks and respirators are not effective at preventing you from getting infected since this virus is not airborne. The only reason to wear one is if you’re around infected people, this will protect you from putting your hands near your nose or mouth.]

3) Hand sanitizers. The hand sanitizers must be alcohol-based and greater than 60% alcohol to be effective.

4) Zinc lozenges. These lozenges have been proven to be effective in blocking coronavirus (and most other viruses) from multiplying in your throat and nasopharynx. Use as directed several times each day when you begin to feel ANY “cold-like” symptoms beginning. It is best to lie down and let the lozenge dissolve in the back of your throat and nasopharynx.

I’ll update you again soon. If you’re not on the update list, you can register here.

I hope that helps everyone!

Be well.

 

 

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1 Comment

  1. Adrienne Matthews

    Hi Lissa
    I am concerned that some of the information in your blog “Practical Tips . . . ” are now known to not necessarily be true. For example, recent studies have shown that under some conditions the coronavirus can remain airborne. You also say “The virus is on surfaces, and you will not be infected unless your unprotected face is directly coughed or sneezed upon.” This also is not true. There is increasing evidence that it can be transmitted by the handling of objects that have the virus on them. For example, here in NZ we have a case where it appears to have been caught simply from someone lending a pen to an infected person for 30 seconds. There is mounting evidence also that death rates are higher than originally thought. Information coming out of China suggests the death rate there was far in excess of what was admitted by the Chinese authorities. Italy also has evidently been under counting. As the disease begins to ravage your country I think it is important to be very factual as only the best information will help people keep themselves safe.
    Kind Regards
    Adrienne

    Reply

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