Local doctor describes COVID-19 symptoms, safety protocols
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Like most of the rest of the world, in the coming weeks, Lake County will be visited by COVID-19, the illness caused by a novel corona virus, SARS-CoV-2. Though the day to day work of caring for individual patients is vitally important, in times of a public health event it is critical that we consider the health of our whole community. There is a great deal of information out there about COVID-19 but some of the information has caused panic and fear. Much of the fear comes from lack of knowledge, so let’s take a moment to review what we know so far, realizing that when this goes to print, much of the information about case numbers will be out of date.
“Corona” is the name of a family of viruses, like adenovirus and rhinovirus, which cause the common cold. The version of corona virus that has created such a media firestorm (SARS-CoV-2) was first recognized in Wuhan, China in 2019 and the illness was given the name COVID-19 by the World Health Organization. We have all had a strain of this type of virus before, but this particular mutation has made the virus more “sticky,” so it is able to infect our cells more efficiently and makes more people sick. It is estimated that approximately 70-90 percent of people who come in contact with SARS-CoV-2 (corona virus/COVID-19) will be affected by it. By way of comparison, the influenza virus causes illness for approximately 28% of the people who come in contact with it. For SARS-CoV-2, it is estimated that the time from exposure to illness is 5 days, on average, but can be up to 14 days. If you are exposed to this corona virus, the illness you experience will be highly dependent on your current state of health. For most people, it will cause a mild illness with fever, headache, cough and body aches which may last from 7-10 days and your body will make you better on its own. You will get it and you will recover from it. Ibuprofen and over the counter cough medicine can help with your symptoms. This sounds a lot like influenza, which we have also been seeing a lot of in the community recently. Like influenza, there is a population in our community who will be affected more seriously by COVID-19 because they are older, have a chronic health condition like chronic obstructive pulmonary disease (COPD or emphysema), diabetes, asthma, or are immune compromised because of cancer, HIV or other autoimmune conditions which limit their body’s ability to fight off infections. These individuals have a higher chance of getting a serious viral pneumonia.
A few comments about viruses – these are very small disease-causing entities that require a living creature to reproduce themselves. They can live on surfaces for a limited amount of time so it makes sense to practice normal hygiene. At the present time, there is no reliable cure for most viruses, including the one that causes COVID-19. Antibiotics like penicillin, azithromycin and sulfa do not make this, or any other virus, better. Throughout flu season, we have been telling people that we can shorten the course of influenza with medication if we can identify it within the first 48 hours of symptoms. Because of this, many people have been reassured that if they get sick, they can call and come in to get tested for influenza, because there is a medication that ‘fixes’ it. If we continue to rely on oseltamivir (Tamiflu ©) for influenza instead of taking advantage of the vaccine, it will likely become ineffective in the near future. There is currently no medication that cures COVID-19 and there is presently no vaccine for the virus SARS-CoV-2.
COVID-19 will sicken approximately 3/4 of the people who are exposed, so it is CRITICALLY important that we are sensible about how we use our healthcare resources. To protect the most at-risk members of our community, we need to limit the number of people who are getting sick at one time. If the entire healthcare workforce in Lake County gets this virus all at once, we will struggle to be able to provide care for those people who need us the most. Consequently, we need to think about our community with a wide-angle lens. If you are generally healthy and you get sick with fever (greater than 100.4 measured with a thermometer), cough and body aches, it is so important that you stay home and follow grandma’s advice – ibuprofen, fluids and chicken soup. We don’t necessarily need to see you at the doctor’s office right away if you have a mild illness. Parents can be reassured that most children are unlikely to get critically sick from this virus, but they can be a significant reason that the virus spreads. If your child is sick with a fever, cough and body aches, please keep them home. Although it is true that you can spread the virus before you know you have symptoms, all we can do is be sensible once we get sick.
If you come to the doctor’s office, urgent care or ER to get tested “just to make sure,” you will expose our healthcare providers (and others) and they will be unavailable to take care of patients who get very sick. If you have fever, cough, body aches and feel like you cannot breathe, we should see you. If it is not a life-threatening emergency, try to call your primary care provider first and get some information about the safest way for you to come to the healthcare facility. We are not trying to avoid seeing you. And be patient with the people answering the phones – they want to help you, but these resources are also limited and everyone is working so hard. If you are not critically sick, do not be offended if you are asked to wait in your car until you can be triaged so that the people in the waiting room (who may be your loved ones who are in the high risk group) do not get unnecessarily exposed. Right now, we are testing people who have symptoms such as fever, cough, shortness of breath AND who have been potentially exposed to a known positive case. All of our local healthcare facilities are following evidence-based guidelines issued by the Centers for Disease Control (CDC) in coordination with the Lake County Department of Public Health.
SARS-CoV-2, like most respiratory viruses, is spread in our secretions (snot, spit, saliva, etc). In cold and flu season, it is critically important that you WASH YOUR HANDS (a lot), cover your cough or sneeze with your elbow and do your best to avoid touching your face. Frankly, this is good advice in any season. If you have forgotten what good handwashing looks like, ask your elementary school-aged loved ones. When I visited the Boys and Girls Club in Polson last week, they were spot on about handwashing and health! They even reminded me that we should sing the alphabet song twice while we wash! If it is reasonable to avoid gathering in large groups, it makes good sense to avoid it, but don’t stop living your life. If you are sick, you should definitely be avoiding public gatherings. I hope we continue to follow this advice, even after COVID-19 has passed. Our community would be so much healthier.
As I write this, there are currently six confirmed positive cases of SARS-CoV-2 in Montana. That will certainly change on a daily basis. The best sources of information are the Centers for Disease Control website (https://www.cdc.gov/coronavirus/2019-ncov/index.html) and the Montana Department of Public Health and Human Services website (https://dphhs.mt.gov/publichealth/cdepi/diseases/coronavirusmt). I have always been impressed by the way this community rallies around someone who needs our help. This health crisis will be no different. We will rise to the occasion and take care of ourselves, our families and our community.
