I live in an area where the schools
have officially transitioned to distance learning for the remainder
of the school year in light of the steadily worsening Coronavirus
pandemic. The implications of this did not fully sink in until my
husband reminded me that the kids are here all day, every day for the
next five months. Furthermore, I suddenly became responsible for
ensuring they meet the requirements to complete their school year and
succeed in progressing to the next grade level. This is definitely
not what parenting was like several weeks ago, and I was feeling less
than prepared for the changes. For one thing, I did not keep anywhere
near enough school supplies on hand.
The moment that my new reality sank in,
our living room was covered from one end to the other in school
papers for the kids, their computers, my husband’s papers and
computer, and my papers and computer. It looked like someone had
haphazardly poured the contents of an office recycle bin across every
couch and table with plenty spilling over onto the floor. The peace I
normally feel in my home dissolved because disorganization feels
itchy and panicky. Apparently, I might be slightly neurotic.
Fortunately, my most useful mantra
happens to be “panic does not solve problems.” So, I closed my
eyes, took some deep breaths, and reminded myself to not panic. I
spent some time thinking about what my new schedule would look like
and tried to prioritize the needs. In this case, it was obvious that
the kids required some supplies for organization, so I immediately
ordered a supply of paper and file folders. It was amazing how much
better I felt just knowing the materials needed to bring order to
all that chaos were on the way. Moving step-wise through my new list
of tasks now seemed at least manageable.
For many of us, reality just drastically changed. Even for anyone whose days are mostly similar to what they were a month ago, there is an added component of uncertainty and the knowledge that the days could be upended very soon. This is not the type of situation people predict and prepare for well. Scientists have been saying for many years that there will be more pandemics, but our level of preparedness given this knowledge is marginal. I have taken many classes and been to numerous lectures about pandemics, and I am caught unprepared, too.
The learning curve on this is steep. We
are required to immediately adapt all of our planning, shopping,
cleaning, time management, and childcare to match the current health
crisis. Of course, there are plenty of complications, like supply
shortages and internet connections that are slower than usual. Not to
mention having a plan in the event you or a family member contracts
Coronavirus and becomes sick.
All you parents who are struggling and
feel like you are not getting things right, take a deep breath. Do
not panic. You are doing your best. Take the challenges one step at a
time. If you get it wrong, learn and try again. You have never been
here before, and you deserve some leeway for a mistake or two (or
three). Keeping your family healthy and fed in the midst of this
pandemic is more than enough. Maybe if we can move beyond the other
stresses and being stir-crazy, we can take some of this time to enjoy
a slower pace of life for a little while. Things will eventually get
back to being normal, and our kids will once again be over-scheduled.
For now, enjoy the extra rest and time with your family as much as
you can.
The headlines today include several about busy public areas at a time when officials are asking people to limit their contact with others. Just one example is the busy National Tidal Basin for the Cherry Blossom celebration. While this is a beautiful American tradition, it seems like it would be best to avoid it this year, especially in a city where Coronavirus is clearly spreading in the community. From this to crowded beaches and packed malls and stores, many people are not heeding the warnings from officials.
A variety of reasons for this have been
suggested, among them that younger people do not feel like they are
at a significant risk for serious illness due to Coronavirus and are
therefore not changing their decisions and behaviors at all. It makes
sense that people will feel stir-crazy and miss their time with
people. Even just feeling rebellious makes sense to a certain extent.
Maybe there is no way to effectively communicate the reasons that
people should limit their activity, but slowing the spread of this
virus depends on people understanding and acting accordingly. So, I
am starting today with reasons that even younger people should
consider using caution.
Q: Are younger people at risk for serious illness or death due to COVID-19?
A: The CDC publishes a report called
Morbidity and Mortality Weekly Report (MMWR) that details instances
of illness and death and the causes in the United States. A report
about severe outcomes of Coronavirus infection was issued on March
18, 2020. The early information for infections in the United States
indicates that the risk for severe illness and death does increase
with age. Most hospitalizations and deaths have been in people who
are 55 years old and over. However, 20% of those sick enough to need
hospitalization were adults age 20 – 44 and another 18% were 45 – 54.
While younger people are at a smaller risk of death, they can still
become very ill, and any long term effects of COVID-19 are not
understood. Reports indicate that the virus damages lung and sinus
tissue and can result in loss of smell and/or taste. There is no
understanding about how long these effects may last after recovery.
The bottom line is that young adults can definitely become seriously
ill as a result of Coronavirus.
Q: What does flattening the curve mean, and why does it matter?
A: Very simply, flattening the curve
just means that we can take steps to slow down how fast Coronavirus
spreads through the population and reduce the number of people who
are severely ill at once. There are several great thorough
explanations if you are interested, but the concept is very basic. If
many people require hospitalization at the same time, supplies and
medical attention will be in short supply. People will not get the
care they need to recover, and some who would not have died if given
proper care would die needlessly. The extra time would also allow for
the medical and scientific community to find effective vaccinations
and treatments, further reducing the fatality rate.
Q: What can people do to minimize the impact of Coronavirus?
A: Individually, you can limit your
potential exposure by avoiding public places, especially crowded
ones, and through hand washing and cleaning surfaces. This also
limits the possibility that you could infect someone else if you
become infected.
China has been rather successful at
stopping the spread of Coronavirus by shutting down workplaces,
schools, etc. That will be key to slowing down the spread in the
United States and other countries as well.
Q: How long is the incubation period, and why is it important?
A: The incubation period is the time
between when a person is exposed to Coronavirus and when that person
starts to have symptoms. Based on current data, the average
incubation period is 5 – 6 days, but incubation can be as much as
14 days. This is important because it is not unusual for a person
with a respiratory infection to be contagious before they realize
they are sick. Most people with the flu are contagious for about 24
hours before they start to have aches or a fever. We do not know if
or how long Coronavirus patients are contagious before showing
symptoms, but a long incubation period means people could be
spreading virus long before they know they are infected.
Q: How long does Coronavirus live outside of the body?
A: This has not yet been fully
determined, along with a number of other important facts about this
Coronavirus. We also don’t know how many viruses you have to be
exposed to in order for an infection to develop. Estimates are being
made based on early testing and what we know about other
Coronaviruses. Of course, the answers to these questions can be
different in different environments: hot vs. cold or humid vs. dry to
name just a couple of examples.
Based on early testing reports, this
one could remain infectious on surfaces for up to several days. So,
avoid touching objects as much as possible, and try to stop touching
your face. Wash your hands thoroughly with soap and warm water. If
soap and water are not available, CDC recommends hand sanitizer that
is at least 60% alcohol.
Respiratory droplets containing
coronavirus can remain suspended in the air or settle on surfaces.
The current recommendation is to stay at least 6 feet away from any
person spewing infectious waste and be careful not to touch things
near them or that they have touched.
Q: Will Coronavirus go away when the weather warms up?
A: We know that flu season ends when temperatures and particularly humidity increase in the spring, but we do not know if the same will be true for Coronavirus. Looking at maps showing locations where the Coronavirus is thriving, it would seem that this virus is not really impacted by climate. In addition, not all strains of a virus are equal. The Spanish flu did not respond to seasonal temperature and humidity variation the way flu viruses usually do. So, we really can not determine yet if this Coronavirus is seasonal. I hope it is.
I’ll be keeping an eye out for more questions, but I plan to write next about parenting in a world where schools are closed and we have to adapt to being a parent with less personal time. As before, if you have other questions or concerns about Coronavirus and the best way to prepare, I always recommend trusting the experts. The WHO and CDC websites dealing with Coronavirus are:
The Coronavirus pandemic is certainly
turning life upside down. In our household, the kids are home from
school indefinitely, my husband is teleworking full time, and we are
keeping our ventures out of the house to a minimum. My refereeing
responsibilities have more than doubled and will probably continue to
increase. It is always amazing to me how the kids are kind and
respectful with everyone in the world except each other. (Sadly, my
wardrobe lacks black and white stripes.) I am beyond grateful for the
schoolwork packets that keep them occupied and learning for a couple
of hours each day, giving me some time to do some writing.
Earlier this week, I read an article
about divorce rates spiking in China after couples were forced to
spend more time together. So far, I have no thoughts of killing my
husband, which seems promising. Even so, I am thinking about how
unusual and nice it is to have some extra time with my favorite
person and that this is something to appreciate. Soon enough, he will
be back to commuting and the house will seem very quiet.
Beyond all that is happening in my
personal world, the rest of life seems surreal right now. We are in
the midst of what could be a once-in-a-lifetime type of crisis. When
something like this happens, you see all of the extremes. Some are
panicking and hoarding. Others are going about life like everything
is perfectly normal. I feel like both panic and “head in the sand”
responses are counterproductive, and I try to find the informed,
rational approach. This can be quite an undertaking in our world of
abundant misinformation and changing information.
As it turns out, this particular situation is not so difficult for me. I write under a pen name to respect the privacy of the people I will be writing about: my husband and children in particular, but also extended family and friends. However, my real name includes some credentials, and my fields of expertise are microbiology and genetics. I am not a medical doctor, and will therefore not be providing medical advice, but I do know some things about pathogens like Coronavirus. So, I am going to write for the next few days about the questions I see people asking and the changing information from the scientific community that may seem confusing.
In answering questions, I will
sometimes refer to influenza because it is a virus most people are
familiar with and that causes pandemic disease periodically. I am in
no way suggesting this is just like seasonal flu, as you may have
read elsewhere. It is not, and I will describe some of the reasons
for that in answering questions. Keep in mind, we do have vaccines
and targeted antiviral medications to prevent, minimize, and treat
influenza. The novel Coronavirus currently does not have a vaccine or
treatment. Critically ill patients are treated to minimize their
symptoms and keep their body going while it fights, and hopefully
overcomes, the infection on its own.
Q: How bad is this going to get?
A: No one knows for certain. There are
many factors that determine how severe an outbreak of a new
infectious disease will be. Some of them are:
How easily it spreads from person to person
How frequently it kills an infected person
How long the virus can live in the environment
The incubation period
How long it takes for an infected person to become contagious
The way people respond to prevent spread of the disease
Q: How does Coronavirus spread?
A: There is evidence that this
Coronavirus spreads both by the respiratory route and by indirect
contact. That means the virus can spread if an infected person coughs
or sneezes and someone else inhales some of the droplets that contain
viruses. It can also spread if an infected person touches or sneezes
on an object and someone else touches the same object then rubs some
part of their face so that the virus can get into the eyes, mouth, or
nose. Since we obviously need to breathe, and we have a tendency to
touch our faces much more often than we realize, this virus does
spread quite easily. The current evidence suggests the average person
is more likely to get coronavirus than influenza, so this could
infect a very large number of people.
Q: What is the fatality rate, and
why is there so much uncertainty about it?
The fatality rate is a topic I have
seen discussed quite often and with a large amount of disagreeing and
changing information. The reported fatality rate for COVID-19 is
preliminary. A reliable rate won’t be calculated until the pandemic
has died down. In the meantime, health organizations track a
preliminary fatality rate because it can give us information about
the severity of the disease and the groups of people who are most at
risk of dying.
The preliminary fatality rate stands at about 1.4%, according to the World Health Organization (WHO). This will probably change in the coming weeks and months. It is true that fatality rate does tend to decrease as the disease spreads through the population, but the rate can also increase and there are a number of factors.
At the moment I am writing this, there are about 270,000 verified cases with about 102,000 either recovered or dead. That mean that there are about 168,000 cases that are ongoing. We don’t yet know how many of those will contribute to the fatality rate. Hopefully, that will be a small number. With so many unresolved cases, it leaves a lot of room for the fatality rate to change.
It is also true that the more severe
cases are usually reported while mild cases are under-reported. This
is the case for all diseases. For example, I have never tested
positive for influenza, but I am very certain I have had influenza
multiple times in my lifetime. So, the real fatality rates are pretty
much over-stated across the board. This is not some scientific
scandal, though. Scientists can only work with the numbers they have.
It would be impossible to accurately estimate how many people have
any kind of mild infection so that exact fatality rates can be
calculated. While not exact, having an idea of the severity of any
infection can give us an idea of what we are dealing with and the
best ways to minimize the impact of a disease.
Fatality rates can be different in
different groups of people. The initial fatality rates in China were
lower for Coronavirus, while the fatality rate in Italy is much
higher. No one knows precisely why yet, but it could be that the
first groups of people had a smaller percentage of individuals who
qualify for the high risk category. Another factor could be that
those individuals had a history of infection with other coronaviruses
and had some existing immunity because of it. Their immune systems
have been given at least a heads up instead of being caught off
guard. Whatever the real combination of factors, those infected early
in China experienced a lower fatality rate, and we have seen an
increase in that rate as it has spread across the globe.
In addition, viruses are notorious for
rapid mutation. Scientists have found evidence of at least two
distinct strains already, and there could be more as the epidemic
proceeds. There is no way to predict how fatal the various mutant
forms will be. Some will be more fatal and others less so. We see
this with influenza. The average fatality rate of seasonal flu is
about 0.1%. The Spanish flu from the 1918 pandemic had a fatality
rate around 2.5%.
The overall take home message here is
that even if the current rate of 1.4% is over-estimated, that number
is still cause for concern. Seasonal flu kills about 290,000 –
650,000 every year worldwide. If Coronavirus settles into a fatality
rate of just 1% and it infects a similar number of people, we could
be looking at worldwide deaths in the range of 3 to 6 million people.
Again, no one knows enough to say if this will or won’t happen. The
point is that the potential is there and should be taken seriously.
There are other questions, and I will
discuss more next time. In particular, as scientists are able to
investigate and gather more data, the information being reported is
changing. In the meantime, the World Health Organization (WHO) and
the Centers for Disease Control and Prevention (CDC) both have sites
for information about Coronavirus and guidance for managing your own
and others’ risk. The links below are for each of those sites:
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