Well, a month ago, COVID-19 was certainly not on my list of topics to write about. As a matter of fact, on March 6th, when I celebrated International Women’s Day with 700 members of the Greater Niagara Chamber of Commerce, I had forgotten all about it! At our March 10th General Meeting, I was thinking that even if I got infected with the virus, I would likely get well because I have a strong immune system. It never crossed my mind that even if I don’t feel sick, I can be a carrier and infect others. Since then, however, like many of you, I have been listening to reports and updates from Public Health Officials and reading articles by doctors and researchers and I am convinced. This is a highly infectious, dangerous virus. Here is some of the over-whelming information I have learned so far.
COVID-19 is part of a large family of coronaviruses which includes Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS). COVID-19 has never been found in humans and thus is called a novel coronavirus. According to the Public Health Agency of Canada, the flu vaccine will not help you, and there are no known health remedies to protect you. The majority of infections are mild with about 80% of people recovering on their own. About 15% will need hospitalization, and approximately 5% will need intensive care. The death rate is between .5% and 5% depending on age and health.
COVID-19, also known as Coronavirus Pneumonia, causes a dry cough. It often starts with a sore throat lasting for 3 to 4 days, which then blends into a nasal fluid 5 to 6 days later that enters the trachea and then the lungs, causing pneumonia. With the pneumonia comes a high fever and difficulty breathing. You feel like you are drowning! At that point, it is imperative that you seek medical attention. It can take up to 14 days to start showing symptoms–thus the instruction to isolate oneself for two weeks after possible contact with an infected person.
In addition to not shaking hands, using your knuckle to touch elevator buttons and a paper towel to lift the gasoline nozzle, Dr. James Robb, a molecular virologist, points out that since this virus is spread in large droplets by coughing and sneezing, all surfaces where these droplets land are infectious and need to be wiped down. It is killed by soap and detergent so wash your hands often for 20 or more seconds and wash your shirts, if covering your mouth with your sleeve. The virus can live on fabrics up to a week! He also mentions that gargling with warm salt water, and drinking plenty of warm water is effective against all viruses. It washes the virus away from your trachea and into your stomach where the acid will kill it! The access to your lungs is by breathing in airborne droplets from a cough or sneeze, or through your eyes, nose or mouth from contaminated hands touching your face. The primary value of a mask is to keep you from touching your face an average of 90 times a day!
The term exponential growth is often used when describing the COVID-19 Pandemic, so I decided to illustrate it to myself. I used as my example, a body cell which divides once a day to produce two cells, which each divide once a day and so on. After a week, there are 64 cells, not very impressive. But after the second week there are 8,192 cells, after the third week there are 1,048,576, and after a month there are 134,217,72 cells assuming each cell only divides once! Exponential growth starts small and suddenly produces huge numbers! Such growth is not linear.
The article that made the most impression on me was by Tom Pueyo who analyzed data coming from China, Italy, South Korea, Europe, the US and Canada among others. Pueyo’s background is in growth marketing, not in epidemiology, but he applies the same principles. He argues persuasively that we can learn from data from other countries and by applying the models, can estimate what to expect. According to his model of the data, the United States is currently seeing exponential growth in the number of people contracting the disease and that hospitals are likely to be overwhelmed. His analysis shows over and over that the number of reported cases is much lower than the actual ones which are not yet showing symptoms. Knowing that it takes about 12 days for symptoms to show up, the start of an infection can be estimated. On any given day there are cases that are severe enough to be medically diagnosed, and others that are infectious but haven’t started showing symptoms. For example, when 100 cases were reported, 1500 were actually in the works as evidenced by their appearance 12 days later. Read Why We Must Act Now by Tomas Pueyo by clicking Here.
In a New York Times article by Siobhan Roberts on March 13th, an epidemiologist in London England, Dr. Britte Jewell, described how she used US exponential growth data to predict the effect of preventing just one person from infecting others “today”, as opposed to a “week from now”. Her conclusion was stunning. Just one less person infecting “today” meant 2,400 fewer infections a month later, whereas waiting a week resulted in only 600 fewer cases.
The most efficient way to reduce the rate of infections is extensive testing to find and isolate infected persons not yet showing symptoms. But until we have the tests, preventing large gatherings, using on-line classes, and sheltering in place, has a noticeable effect in reducing the number of cases and can help ease the strain on our health system. But sooner than later is very important. On March 17th, our Canadian Chief Public Health Officer, Dr. Theresa Tam, stressed the importance of social distancing and called for the restriction of gatherings to 50 or less. This has come none too soon. According to a graph in Pueyo’s report, on March 5, Canada had a daily increase of known cases of about 15%. The threshold for the doubling cases every two days is 40%. Canada had 611, Ontario 177 and Niagara 3 confirmed cases as of March 17th. Time will tell if we are doing a good enough job of social distancing–that is, staying behind closed doors and preventing contact.