Covid Update
COVID-19 is a new virus that has emerged in December, 2019 in Wuhan, China. Each day we learn more about the virus in terms of diagnosis, infection transmission, and how this impacts on the general population.
Countries most affected
⇢China (80,000)
⇢Spain (21,00)
⇢Italy (12, 500)
⇢Iran (9,000)
⇢South Korea (8,000)
⇢France (2,300)
⇢Germany (1,500)
⇢US (1,000)
*numbers are approximated and taken from WHO website on March 12th, 2020.
Transmission
The virus is transmitted through respiratory droplets and direct contact, meaning that it is spread through droplets in the air through coughing, sneezing, or close interactions as well as touching surfaces or objects.
We still are finding out how long the virus lives in the air (some reports suggest 3 hours), and with the virus may live on surfaces for up to 3 days. The CDC has now confirmed that the virus can be transmitted through fecal matter.
One of the issues with the covid virus is that illness presents 2-14 days following exposure (CDC). People can be asymptomatic for quite some time before symptoms develop, and this is why this virus is spreading so quickly. (I am starting to suspect that it may be contagious for longer than 14 days, some reports are suggesting 28 days).
Key Symptoms include:
⇢cough
⇢fever
⇢shortness of breath (trouble catching your breath)
Other accompanying symptoms may include: fatigue, muscle/body aches, nasal congestion, runny nose, sore throat, and diarrhea (WHO).
These symptoms overlap with influenza and the common cold, so I think this is why we are seeing so many people call into the call centers for assistance. In the last 2 weeks I have seen colds and flu’s making their rounds through our city as well among my patients so this complicates matters a bit.
Here is a link to the Alberta Health Services Screening tool to asses if you should call 811 for testing:
The Numbers
About 80% of people infected with the COVID-19 will completely recover and have a milder version of the illness and will not need specialized medical treatment.
It’s now estimated that 1/6 people that contract the virus will get a more serious version of the illness and develop shortness of breath and breathing difficulties. These patients require specialized medical treatment.
Those most at risk of developing the more serious version of this illness are those over 65, the elderly, and those with health conditions like high blood pressure, heart disease, lung disease, immunocompromised, cancer patients, and those with diabetes (WHO). Our precautions have been catered to protect those most at risk.
A recent article from JAMA article published February 24th 2020 had a summary of infection rates from Wuhan. Their report suggests that overall there is a 2.3 % mortality rate with the virus. Mortality rates are 14.8% in patients greater than 80, and 8% in patients aged 70-79. There were no fatalities in children younger than 9. Those that did get the more severe form of illness, the mortality rate was 50%.
What to do if you are having symptoms?
Here in Alberta it is suggested to stay at home and call Health Link by dailing 811 to get more information about whether or not you need testing. Be mindful that there are long wait times due to high call volume. If you have those key symptoms of fever, cough, and shortness of breath Alberta Health Services is likely to pursue testing.
In other areas and countries it is best to call your doctor’s office rather than just show up with symptoms as we do not want people to contaminate and infect others present in the office or hospital space.
If you are very short of breath, have blue lips, or persistent chest pain, please do call 911.
Testing
There is limited information on the accuracy of the current testing methods. There have been issues with accurate testing methods in China. I’ve recently seem that in China they have started to use CT-scans to help them diagnose the classic pneumonia pattern associated with COVID because some of their testing methods were taking too long to identify infected patients.
There is a shortage of testing supplies right now, so I believe there is an effort to triage people so that the most likely people get the testing. I think we should all feel grateful for living in Canada where we have access to free medical care and testing. In the United States it is looking like people with insurance are being charged $1000-$1600 for this testing, while those paying out of pocket can be paying somewhere between $200-$600.
Supplies
Right now we are getting a very interesting glimpse as to what happens when everyone in the whole world wants the exact same products (masks, hand sanitizer, toilet paper, etc).
First it seemed as though the stores sold out of their inventory, and now most of the medical distributors seem to be restricting or are out of medical supplies. This is ok, we should let the front line healthcare workers have access to these supplies first as they are most at risk for contacting them.
In terms of masks, the N95 is the recommended mask to use when interacting with people on droplet isolation. But, what most people may not know is that there are various sizes and usually people are fitted to find a N95 that fits their face. The common blue paper masks are most helpful for limiting your personal droplets from entering the air if you are coughing or sneezing. The supplies of both types of masks seem to be limited at this time.
At this point in time many stores and distributors are sold out of masks and hand sanitizers.
There is a recommendation from Alberta Health Services to have enough food supplies on hand in case you come down with symptoms and need to be quarantined.
What to expect going forward?
I do think we should all expect to see the cancellation of large planned events over the course of the next month or so. I think there may be more air travel restrictions to come as well.
In the past 24 hours we have seen, NBA, NHL, MLS, Coachella, conferences, and concerts cancelled. I think this trend will continue until we can get a handle on the outbreaks.
I do expect the stock markets to continue taking a hit. The stock markets whole premise is certainty and we are in a bit of an uncertain time right now.
The limiting of gatherings and interactions right now are intended to contain these outbreaks and protect people of course (our elderly in particular), but it is also to avoid overwhelming our systems.
In Wuhan, we saw the sick lined up in hallways in the hospitals. There were too many infected at one time that needed medical care and there were not enough resources available to take care of them. This is what we want to avoid because if too many people need medical care we will see our systems become overwhelmed and people will not be able to receive the high quality medical care that they need.
Another issue presenting itself during this time is paid sick leave. I do hope that this current situation brings light to the importance of paid sick leave. How are we to expect to contain this situation if people are left to choose to going to work sick or paying their rent and having a roof over their head?
A common question I am getting asked if I am afraid?
I'm not afraid and I urge everyone out there to not be afraid. This virus is not near as lethal as SARS or MERS was, but it does seem to be way more contagious due to people not showing symptoms for quite some time while infected. Therefore, we now see a much stricter protocol to help prevent its spread.
Prevention
⇢Avoid touching your face.
⇢Follow social distancing precautions, work from home, avoid large gatherings
⇢Cough or sneeze into your elbow.
⇢Frequent hand washing is one of the best methods for preventing transmission (ideally, 20-30 seconds with soap and water).
⇢There is no need to rush out to buy hand sanitizer unless you have no access to soap and water.
⇢It’s suggested to stay 6 feet away from someone with a potential infection.
⇢Also if we suspect that someone is infected there is a common suggestion of a 2 week quaritne. A two-week quarantine is currently advised if you have travelled out of the country and are back in Canada. It is suggested that international travel is not recommended at this time.
⇢Please stay at home if you are sick. I know we live in a society where we tend to want to push through it, but for the sake of others and our healthcare system please do stay home until you are symptom free.
For Overall Immune Support I Recommend:
⇢Getting Enough Sleep- Women aim for 9 hours, Men aim for 8 hours per night
⇢Eat a Healthy Diet- refrain from overly processed and sugary foods. Vegetables like garlic, radishes, ginger, onions, and leeks are antiviral and support immune health. Mushrooms are also supportive for the immune system.
⇢Practicing Mindfulness: Keep your cool. This is the perfect time to use those skills that you practice for calming yourself. When your stress levels rise your immune system becomes less effective. Practices like, yoga, deep breathing, Emotional Freedom Technique (EFT), meditation, hobbies, and journaling are helpful tools if you are feeling overwhelmed.
*side note, some of the meditators that I know rarely get sick
⇢For supplements, what do you have at home? Hopefully, Vitamin D3 is something you may have at home that you can take for immune health. I generally recommend between 4000-5000IU daily, however it is best to confirm with testing (which is a service that I offer). I don't really want to encourage people to go out and buy a lot of supplements at this time. I’m getting word that even some of our supplement supplies are starting to get a bit depleted. It's best to use what you have a home rather than going out and buying a bunch of things.
⇢Movement: Keep with your movement practices. This will help flush the lymphatic system and keep you healthy.
⇢Hydrotherapy: Finish your showers with a 1 minute bit of cold water. This helps strengthen the immune system and flush the lymphatic systems.
⇢Make a Breath Spray: If you have some essential oils at home you can make a breath spray or mouth wash for antiviral properties. I like clove, cinnamon, tea tree, mint, eucalyptus, fennel and ginger essential oil mixed with some brandy or 60% alcohol. You can use this as a mouthwash as well. Alternatively, you can mix some of those essential oils with a carrier oil like olive oil or apricot oil and apply to your nostrils or under your nose.
Story from Wuhan
My teacher’s teacher is out there in the front line working at one of the hospitals in Wuhan. They are doing acupuncture and Chinese herbs with the hospitalized patients and are getting some pretty amazing feedback and results.
One patient following an acupuncture treatment reported “ this works like a miracle! The stuffy feeling in my chest is completely gone!” another says “my throat and chest area used to feel as blocked as a road during rush hour-- now it has become like an open road without a single soul on it” (Fruehauf, 2020).
The best results are combining the herbs and acupuncture treatments together. We did talk in school a lot about how our natural medicines will be of the utmost importance one day. The chinese herbal medicines that we use are able to treat symptom patterns that have been around for 5,000 years! When western medicine may scramble to come up with a vaccine or medication in times of crisis, the herbal treatments that are have on hand are able to target such illnesses using a symptomatic and physiologic approach.
For those out there that are sick and would like some Naturopathic or Chinese herbal support I am offering (acute/focused) telemedicine visits and can arrange to have supplements shipped to my patients. I do believe that there are a lot of great natural remedies out there to help with faster recovery for cold and flus.
Please contact me through my website for more information.
References
Fruehauf,H. (2020) https://classicalchinesemedicine.org/report-from-front-line-wuhan/