hi INDiA Copyright 2020
DrTJ, Thomas John, MD, DTM | drthomasjohn.com
Historical Perspective:Dear readers, let us first look at some of the major milestones with the coronavirus. More than half a century ago, Tyrrell and Bynoe in 1965 isolated the first human coronavirus while at the Common Cold Research Unit in UK. This virus was HCoV-OC43. Now, let us fast-forward to 2019.
In December 2019, the Wuhan outbreak in China takes the world by surprise. About a month later, in Wuhan, the COVID-19 virus was first detected. On February 11, 2020, World Health Organization (WHO) assigned the name COVID-19 to this disease.
From Wuhan, this virus spread fairly rapidly throughout the world resulting in the pandemic that we currently face.
The Basic Facts:
- The name coronavirus comes from the crown-like appearance of the virus particle under high magnification microscope, namely, electron microscope.
- There is no antiviral agent or medication that can kill the virus at present.
- There is no vaccine that is currently available against the coronavirus.
- Bats can serve as a reservoir for coronavirus.
- Once infected the person may or may not be symptomatic. This poses a problem of not knowing who is infected.
- To detect who is infected, one has to undergo testing. The gold standard for viral testing is called reverse transcriptase polymerase chain reaction or RT-PCR. However, the sensitivity of this test may be less than optimal. Therefore, a single negative test should not rule out COVID-19.
- The testing is done by taking a swab or sample from the nasopharynx, upper region of the throat behind the nose.
- The diagnosis of COVID-19 therefore includes in addition to the RT-PCR, other considerations namely, exposure history, travel history, patient’s symptoms, CT scan, and beyond, to increase the diagnosis of COVID-19.
- The symptoms of COVID-19 includes fever, cough, dyspnea or shortness of breath.
- The battle between the coronavirus and our immune defense system takes place primarily within our lungs and later if it continues to progress other systems and organs in the body can be compromised.
- Once infected, then the only defense against this deadly virus is one’s own immune system that includes cells like the neutrophils and the killer T-cells (cytotoxic) among various other defense mechanisms.
- Problem with our body’s immune system is that when it fights this battle against the coronavirus, there is collateral damage where our healthy tissues get damaged as well. In other words, it does not selectively kill the virus and leave the rest of the normal tissues undamaged.
- When there is extensive normal tissue damage there can be severe pneumonia, or even a total system shut down, namely, multi-organ failure and the person can die.
- Person-to-person spread of the coronavirus occurs via the droplets produced when the infected person coughs.
- It also spreads when you touch a contaminated surface and then you touch your face, eyes, mouth, and nose.
- Once infected, it can take anywhere from 2 days to 2 weeks for the symptoms to appear.
- The coronavirus can live on surfaces outside the human body anywhere from a few hours to several days.
- Coronavirus-related mortality rate according to WHO estimate is about 3.4%.
- WHO: As of March 20, 2020, the total number of coronavirus cases globally has been about 234,073 with 9,840 deaths, and 177 countries, areas, or territories. These numbers clearly are fluid and changes from day-to-day.
March 21, 2020: Cases 301,630, deaths 12,955. Notice, the significant increase in these numbers in just one day.
This is where the commonsense part should kick in– Steps to implement:
Follow the CDC recommendations and other local and federal agency recommendations.
- Do not shake hands or hug someone.
- Use an alcohol-based hand sanitizer. The alcohol content should be at least 60%.
- Wash hands regularly with soap and water for at least 20 seconds. The soap destroys the membrane of oily lipid molecules of the virus.
- Wear mask even though it is not a 100% protective device. It is especially useful if the person has some respiratory symptoms and the mask is used to prevent droplet spread to others.
Health facility overload: If the total number of coronavirus infected individuals rapidly rise then it can potentially over-run the total number of cases the health facilities can handle. This will be a sad day if that happens, because, while some are treated, others will be left to die without medical care.
- To prevent this situation, quarantine and social distancing of 6 feet, the length of a full-size bed, is essential so that the total number of cases don’t exceed the total number of cases that the hospitals can handle. Effective quarantine will help flatten the epidemic-curve and move the paradigm from a rapid-spread to a slower-spread that can be well managed by the health care facilities of the country.
- Hand dryers are not effective in killing coronavirus.
- Coronavirus can be transmitted all over the world regardless of the external temperatures of hot, cold, or humid conditions.
- Mosquitoes do not transmit coronavirus.
- Hot bath does not provide protection against coronavirus.
- While people with pre-existing conditions like diabetes, asthma, and heart disease can be more vulnerable to coronavirus, it can infect all people regardless of their age, namely, both young and old and everyone in between.
- To date no antiviral agents or vaccines exist against coronavirus.
- Most important 3-steps include, limit unnecessary exposure by going to places with more than 10 people if you can avoid it, instead stay at home, what is now termed self-quarantine, even if you feel good and healthy, hand washing with soap and water, and masks mainly to prevent spread to others if you happen to have any respiratory symptoms.
- If you are using hand sanitizer then make sure the alcohol content is at least 60%.
Fear is a natural visitor when it comes to coronavirus infection.
Fear is based on the fact that this small virus particle can kill you, especially since we do not have medications to directly kill and destroy the virus before the virus can potentially kill and destroy you.
Infected individuals also may experience stress and emotional turmoil partly from quarantine, partly from the uncertainty of disease resolution or progress with possible poor prognosis, travel restrictions, and concern over potential spread to other family members.
What we need to understand is that fear will not make the situation better, in fact it may make it worse from an emotional standpoint. Let us try our best to exhale fear and inhale steps of prevention.
While at home use this time for:
- Mind – Meditation that can provide a calmer mental state.
- Body – Engage in exercise that does not require heavy weights, treadmills, etc. Clearly, you cannot go to the gym as they are closed. Instead, perform simple pushups, squats, if you have 10-pound dumbbells you may consider standing overhead press with the dumbbells, sit-ups, etc.
Do the exercises that you are comfortable doing and you may need to consult with your physician for his recommendations as it applies to your unique situation.
- Spirit – Keep your spirits up! May watch movies that you did not have time for in the past. May complete small projects that has been on hold in the past. Completion makes you feel good.
- Facetime – Aristotle stated, “Man is by nature a social animal.” While in self-quarantine, let us connect with family and friends via facetime. This makes us share our thoughts and enhance our positive states. At all time avoid negative energy, and negative thoughts.
- Bonding – It is family time and bonding time. Let us make use of this golden opportunity to unite more closely with our loved ones in our own homes.
- Food – Let us eat wisely. Do not over-indulge in our food intake.
This is clearly a time of great concern. But, just like all pandemics from the past, this coronavirus will also pass. In the interim, we need to be cerebral in our approach, compassionate to others, and take every precaution we can take while following all local and national guidelines to help curtail, control, and hopefully find a cure for coronavirus.
Steps to consider:
- Let us accept what we cannot change. Let us tap into our self-discipline and follow the recommended guidelines to tide over this pandemic.
- We cannot change what has happened, namely the coronavirus pandemic. However, we certainly can try to control our reactions to this situation. Let us control how we react in our thoughts, words, and deeds. Let us not spew negative energy and complain and point fingers at others. Instead, let us indulge in and behave in a constructive manner.
- This is an opportunity to work at home if you are so inclined. You may consider cleaning your homes, refrigerator, storage area, garage, basement, living room, kitchen, etc.
- You may consider reading your favorite book(s) that may have collected dust over time and now it is your time to indulge in reading your favorite books that were on hold.
- Take rest especially if your workdays in the past were very busy and stressful. This is time to rest and may be take it easy for a while.
- Sleep well but do not overdo it.
Hope is in the air:
- The very first human trial of a vaccine that can potentially provide protection against coronavirus has begun in the United States. This is an accelerated route without animal experiments. The emphasis is on obtaining a vaccine fast so that more lives can be saved and win the war against coronavirus. However, realistically, this may require a year or longer to become a reality, only time will tell.
- While the development of the coronavirus vaccine takes the center stage, potential antiviral drugs under consideration include, chloroquine used to treat some forms of arthritis and malaria, remsdesivir, and a combination of HIV drugs, namely, lopinavir and ritonavir.
- Scientists and doctors are working hard to find a cure against coronavirus.
- In the interim, let us all follow the 3-Cs, namely, common sense, calmness, and cerebral approach to overcome and succeed in our fight against the deadly coronavirus!
References and Further Reading:
DrTJ, Thomas John, MD, DTM, is a Harvard-trained eye surgeon, with offices in Tinley Park (708.429.2223), Oak Lawn (708.499.3939) and Oak Brook (630.573.0360). He is an Amazon-published author. His book: “Your Lifeonomics.”