Coronavirus Update for Detroit Michigan March 2020
Coronavirus Update for Detroit, Michigan for March 2020
I’m a Family Doctor in Detroit, and today I’ve gotten a ton of questions about the Coronavirus - ask me anything!
For starters, here’s what I sent out to all of my Plum Health DPC (https://www.plumhealthdpc.com/) patients earlier today and I thought everyone should know these things as well. Beyond what’s written below, ask me anything:
Plum Pack!
The Coronavirus is causing concern at this time - the President spoke last night about closing access to the USA from Europe, the NBA, NHL, and NCAA have cancelled/postponed all of their games, and other major events have been cancelled - but do not panic.
People Will Become Sick This Spring
Many people will get sick and have upper respiratory symptoms over the next few days and weeks. Most of these will be from the common cold, many of these symptoms will be from seasonal allergies, some will be the flu, and some may be due to the Coronavirus.
What I can do for you is to help you triage - I can help you determine if you're sick with the flu, a cold, or having an allergy flare up. I can help you determine if you have symptoms that are concerning for the Coronavirus.
If you contact me and I'm concerned, I may send you to the emergency department for further testing. As of now, Coronavirus testing is not available at our clinic.
Here are some algorithms about how I approach caring for our patients, caring for all of you.
Additionally, heres information from the State of Michigan regarding Coronavirus, released earlier today:
Finally, below is what we know and what you can do to protect yourself:
What You Can Do to Prepare for the Coronavirus
You can prepare for the Coronavirus by taking several actions and non-actions:
wash your hands thoroughly before eating
wash your hands thoroughly after using the bathroom
wash your hands thoroughly before touching your T-zone (eyes, nose, or mouth)
Cough or Sneeze into the crook of your arm/the bend in your elbow; again, wash your hands after coughing or sneezing
purchase food and supplies in case you need to be self-quarantined
if you become sick with a respiratory infection, but you’re not sick enough to require hospitalization, you may need to self-quarantine or stay at home to avoid infecting your neighbors and co-workers
if you become ill, call your doctor and discuss your symptoms. It may be better to call or text your physician, as going to the doctor’s office may
cancel any non-essential travel to areas where the virus is spreading like China, Iran, South Korea, and Italy
avoid large gatherings - parades, sporting events, campaign rallies - to avoid catching the virus or spreading the virus
What We Know About the Coronavirus or Covid-19
Here’s what we know thus far:
Every single one of us has had a coronavirus infection in the past — it’s one of the viruses (along with rhinovirus, adenovirus, etc.) that causes the common cold. This novel Coronavirus (COVID-19) is just a variation (or mutation).
This new coronavirus can cause anything from nothing to a mild cold to a potentially lethal viral pneumonia.
Those who seem to be most affected by COVID-19 thus far are those who are more at risk to begin with: those who are older, those with multiple chronic health conditions, etc.
The evidence out of the initial outbreak in Wuhan, China revealed:
Median age = 59 years of age
Estimated basic reproduction number (the number of people an infected person infects) is approximately 2.2
The average length of time from the onset of symptoms to hospitalization was 9.5 to 12.1 days
There have been new coronaviruses in the past — most notably the SARS (2002, 2003) and MERS (2012 – Present) epidemics; however, the mortality rate of COVID-19 (2.0% to 4.0% or below) is notably lower than SARS (9-10%) and MERS (36%).
From the WHO, they estimate that the mortality rate is somewhere around 3 - 4%. We are more concerned about this Coronavirus than the typical flu virus because of this higher mortality rate. https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200306-sitrep-46-covid-19.pdf?sfvrsn=96b04adf_2
This virus spreads from person to person, though we aren’t exactly sure how. Our best hypothesis is that it is spread via bodily fluids and droplets from speaking, breathing, coughing, sneezing, etc (and potentially through the GI tract).
Children absolutely can get the Coronavirus that causes COVID-19. Two interesting points about pediatric patients: 1) there is early evidence that they carry a high “viral load” and — combined with the fact that they aren’t great at washing hands, not touching their face, etc. — because of this may be more likely to spread the illness and 2) children who do get COVID-19 seem to have a lower mortality rate than those who are older who contract the disease.
Here’s what we don’t know:
We don’t know if this virus will peter out as the warmer months kick in; we also don’t know if this is a one-season thing or if it will come back strong again next cold & flu season.
We don’t know when or if we’ll have a successful vaccine to prevent against this new virus. In a late February 2020 press conference, Dr. Anthony Fauci did a great job describing how a vaccine is created (starts at about 11:00 into the clip) and how far we are away from a successful vaccine.
How to Protect Yourself and Others from the Coronavirus
How to protect yourself & others:
Just like any other respiratory virus: stay home if you’re sick!
Just like preventing any other respiratory virus: take good care of yourself! Exercise regularly, eat nutritious, balanced meals, practice stress mitigation techniques, and get a solid 7-9 hours of sleep a night, etc.
Just like preventing any other respiratory virus: wash your hands! A lot!
Just like preventing any other respiratory virus: don’t touch your eyes, mouth, nose, etc., and get into the habit of washing your hands before eating.
If you can, avoid contact with those who are sick or are caring for the sick.
If you are not actively sick (or caring for someone who is), ear-loop/surgical masks are not likely helpful. Healthcare workers will wear masks (and often higher-rated ones than the ear-loop masks), as they have a much higher likelihood of caring for someone with the disease and are prioritizing mitigating the spread to others.
Those who are exposed to someone with COVID-19 or those who are being tested for COVID-19 will likely be asked to self-quarantine (currently not mandatory). If your job permits, start asking your employer about work-from-home opportunities; if your job doesn’t permit work-from-home, ask your employer what their plan is to keep you safe!
Because of the real possibility of a quarantine, stock a couple week’s worth of non-perishable foods items in a pantry. Also make sure you have the basics — like medications, OTCs like ibuprofen, acetaminophen, diphenhydramine, and pseudoephedrine, and (a rational amount of) toilet paper, facial tissues, etc.