Q & A provided by the courtesy of Dr. Burnett Gallman,Jr, MD
Introduction
The “invasion” of the novel coronavirus has caused a worldwide crisis. This virus causes a disease called COVID-19. It was declared a Public Health Emergency of International Concern by the world Health Organization (WHO) on January 30, 2020 and was declared a worldwide pandemic by WHO on March 1, 2020. A pandemic is a disease that is spread out and affects people over a wide geographic area, from a country to the world (as opposed to an epidemic which is a outbreak of a contagious disease that spreads rapidly and widely in a community). More than 10.2 million cases have been identified worldwide with more than 505,000 deaths in 216 countries or territories. Since the first documented case in the US in Washington state on January 20, 2020, in the United States, there have been more than 2.6 million cases and more than 128,400 deaths. (this is information from fifty states, the District of Columbia, Guam, Puerto Rico, the Northern Mariana Islands, and the U.S. Virgin Islands). In South Carolina there have been more than 31,800 cases and more than 707 deaths. The United States has the highest number of COVID-19 deaths in the world (“We’re number one” is not something to be proud of in this circumstance). In fact, even though the US contains only 4% of the world’s population, we make up 25% of the world’s coronavirus infections. It has been estimated that approximately 2.5% of the US population is infected with coronavirus. The case numbers differ in certain locations and these numbers depend on the density of the population, the availability of testing, the actual amount of testing that is done and the cooperation of the population to measures designed to prevent the spread of the infection. Although many experts have predicted a second wave of infections, it seems as though the first wave has worsened with an increase in infections and increased number of deaths most likely due to premature “openings” of certain states. Interestingly, the states that were hardest hit initially were New York, New Jersey, Illinois, Massachusetts and California have now flattened or decreased the curve of infections due to vigilant and aggressive measures. The states that are currently experiencing rapid increases in the rate of new infections (Texas, Georgia, Florida, Arizona, South Carolina and almost twenty more) are the states that “reopened” before the infection rate had even flattened. Ironically, New York, New Jersey and Connecticut have required that travelers from these hyperinfected states be quarantined for fourteen days when entering their states. Unfortunately, these disparities appear to be due to a lack of central (national) leadership which conceivably could have controlled the disease early on. If you have seen previous versions of this document, you may notice that there are many changes in several of the recommendations. As we study COVID-19, we discover more information that may change previous recommendations. Remember, this is new.
What is Coronavirus (COVID 19)?
COVID 19 Is an extremely contagious infectious disease caused by a new (novel) coronavirus (I stress that it is a virus and not a bacteria) first noted in Wuhan China in mid-2019 but formally identified on January 7, 2020. Interestingly, the strain that hit the United States came from Europe and not China. COVID-19 is short for COronaVIrus Disease 2019. Another name for the virus is SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2). This virus is very tiny. It is 10,000 times smaller than a millimeter (which is less than half an inch). This virus affects humans and can be passed from person to person, primarily through droplets of saliva or discharge from the nose or mouth when an infected person coughs, sneezes, or talks or sings close to another person. There have been cases of humans passing the virus to animals. Coronaviruses are a large family of viruses that can cause illness in animals or humans. There are hundreds of coronaviruses. They are called zoonotic in that some can jump from animals to humans. SARS-CoV-2 has not definitely been associated with a specific animal although bats have been suggested. Other animals that have been associated with coronaviruses are camels, cats and chickens. Only seven of the coronaviruses infect humans. These illnesses can be as minor as the common cold (strains 229E,NL63,, C43, and HK111) or as serious as Severe Acute Respiratory Syndrome (SARS-CoV) and Middle East Respiratory Syndrome (MERS-CoV). MERS-CoV and SARS-CoV are also believed to originate in bats. Again, COVID-19 is a new virus. The virus capsule (covering) is fat soluble and can be destroyed with soap and detergent. It is also unstable in water and sensitive to Chlorine. There are many theories as to where the virus came from and these theories range from it being a mutation of a previous coronavirus to an animal virus that infected humans to it being developed in a lab as part of a biological warfare program to escaping from a lab due to an accident. Most virologists (scientists who specialize in the study of viruses) have gone on record in saying that COVID-19 was definitely not made in a lab. At this point, however, it really doesn’t matter where it came from because we should concentrate our efforts on containing and preventing its spread while experts try to find a cure. When that is achieved, we can and should investigate its origins and evaluate whether we could and should have handled it better.
How does this coronavirus affect the human body?
Simply put, the virus attaches to areas on the surface of the lungs, blood vessels and other organs. It triggers an immune response (which is normal) from our bodies in which cells are attracted to the virus and attempt to eliminate it. In most infections, this immune response is successful. With COVID-19 however, the immune response is occasionally overreactive and the body’s defenses not only attack the virus but also attack the parts of the body that the virus is attached to. This is called “cytokine storm” and is responsible for many of the adverse affects of COVID-19 on not only the lungs but the heart, the kidneys, the brain, the blood vessels, the pancreas, the liver, and other organs.
What are the symptoms of COVID-19?
It should be stressed that most people infected with coronavirus recover from the initial infection. It was initially thought that SARS-CO-V-2 was a respiratory virus, but we now know that it affects that entire human body including the brain, the heart, the pancreas, the liver the kidney and other organs. It can cause blood clotting problems that can lead to strokes and heart attacks at all ages as well as neurological problems from headache to seizures to severe muscular weakness. The most common early symptoms are fever (at above 100 degrees Fahrenheit), cough (dry or productive), sore throat, body aches, chills, and fatigue (tiredness). It can cause shortness of breath and inability to walk long or short distances without getting out of breath. Another significant early symptom is loss of the sense of smell and taste. Other less frequent symptoms are nasal congestion, runny nose, diarrhea and nausea. Some people develop skin symptoms like hives or different kinds of rashes. The symptoms are usually mild and begin gradually. Note that any of the symptoms mentioned above can be the first symptom. Severe symptoms that should stimulate involvement of emergency medical personel are: shortness of breath, chest pain or discomfort, confusion, inability to stay awake and pale or bluish discoloration of the lips or nailbeds. Some infected people have no symptoms at all but still can infect others. These people are a major factor in the spread of the disease, Not everyone who is infected will have a fever (it takes 2-10 days after being infected to develop a fever). About 80% of infected people recover without serious illness but about 16% of infected people become seriously ill. Some studies find that people are most contagious when they are sickest, however some other studies suggest that people are most contagious 2-3 days before they develop symptoms. This is called presymptomatic transmission and one study found that 44% or more of transmission comes from people who have not developed symptoms. The most serious complication of COVID-19 is a type of pneumonia which is called 2019 novel coronavirus-infected pneumonia (NCIP). Children and young people can be infected but their symptoms are usually less severe. However, there is a syndrome called Multisystem Inflammatory Syndrome in Children (MIS-C) that occurs in some children who have been exposed to COVID-19. This syndrome causes multiple body parts to become inflamed, including the heart, lungs, kidneys, brain, skin, eyes and gastrointestinal organs. Although MIS-C can be fatal, fortunately most children recover with appropriate medical treatment. Also, there have been reports of young adults developing strokes after being infected with COVID-19. This is believed related to the fact that there appears to be a higher incidence of blood clots with COVID-19, as mentioned. It is very important for young people to adhere to the precautions so that they don’t pass the virus to their elders and potentially cause their deaths. It has been noted that men suffer from serious disease more frequently than women although the reason for this is not known. It is important that if you feel sick, call your doctor. Don’t go to the emergency room before you speak to your doctor.
Who gets COVID-19?
A common saying is that when white Americans catch a cold, Ausa (Afrikans from the United States of America) get pneumonia. Although everyone is at risk of contracting the infection, Ausa become infected and die more frequently and have poorer outcomes. In fact, Ausa are likely to die from COVID-19 three times more than whites and 2.2 times higher than Asians and Latinos. Put another way, 1 in 2000 Ausa have died from COVID-19, 1 in 4,300 Asians and Latinos have died and 1 in 4,700 white Americans have died. In Arizona, Native Americans die five times more than all other groups and in New Mexico, the rate is more than seven times all other groups. Pregnant people seem to have the same risk as non-pregnant people. People who are at increased risk are those in nursing homes and other long-term facilities such as prisons. People with pre-existing conditions such as cardiovascular disease, diabetes mellitus, cirrhosis, HIV with low CD4 counts, transplant recipients, chronic lung disease such as asthma, hypertension, chronic kidney disease on dialysis, obesity and cancer tend to develop more severe and often life-threatening illness. Smokers tend to have poorer outcomes when infected. Although many reports indicate that the elderly are especially vulnerable to the worst effects of the virus, young people and children are just as likely to be infected and some have died. In fact, most new infections are in young people. Children and adolescents are less likely to have severe disease. Ausa are affected by these health problems (disparities) at a rate greater than the overall population. These existing documented health disparities place us at greater risk of not only developing the infection but also having worse outcomes. Nationally, at least 33% of all patients that are hospitalized with COVID-19 are Ausa. The problem is that data on race in their statistics has been inconsistent so that it is difficult to accurately track the racial information. Recently, two legislators (Rep. Ayanna Pressly and Sen. Elizabeth Warren both of Massachusetts) have called on the federal government to keep racial statistics. Interestingly, Florida and Georgia were accused of “fudging” the numbers in order to speed up the “reopening”. Of those states that do keep accurate statistics, the facts are alarming. There are other factors, according to the CDC and other sources, that make Ausa and Hispanics more at-risk. What isn’t stated explicitly is that most, if not all these factors are related to the systemic and institutional racism that is ubiquitous in the American environment. Some of these factors are:
Ausa and Hispanics are forced into living conditions that are detrimental to good health such as living in densely populated areas that are segregated and located in food deserts (where there are no grocery stores with healthy food or medical facilities nearby). The effects of redlining from the 1930’s are still present.
Many Ausa and Hispanics work in environments where there is a higher risk of being infected such as in service industry jobs and agricultural work.
Although Ausa make up 12% of all employed workers, they make up 30% of all LPN’s and LVN’s.
Ausa and Hispanics are at least twice as likely to be uninsured.
Physicians are less likely to refer Ausa for testing in fact, Ausa are refused testing at alarming rates.
Ausa are disadvantaged in receiving treatment for the disease.
Racism causes chronic stress which adversely affects overall health. There is a great deal of evidence supporting this fact.
The way that people perceive COVID-19 differs also:
46% of Ausa see COVID-19 as a major threat.
39% of Latinos see COVID-19 as a major threat.
20% of whites. See COVID-19 as a major threat.
There is some information that suggests that certain blood types may influence the severity of the disease. It is suggested that people with blood type A have a 50% greater risk of having severe disease if they are infected while people with blood type O have a 50% lower risk of having severe disease. The medical significance of these findings is yet to be realized. More than 50% of Ausa and Latinos have type O blood and less than 50% of whites have type O blood. Ausa also have a lower proportion of type A blood than whites. These facts do not mesh with the clinical realities so while they are statistically interesting, they are not clinically useful yet.
So often we hear the term “incubation period” used as if it is understood that everyone knows what it means. The incubation period is the time between catching the virus and developing symptoms. This range is from 1-14 days with an average of five days. People who have been infected but have not started having symptoms can still transmit the virus so it is extremely important for us to act as if we are infected and try not to give it to anyone else. After recovering from most viral diseases, people become immune because of developing antibodies to that virus. This is the basis of vaccination which was developed by Afrikans in the 17th century. It was brought to America by the enslaved Afrikan, Onesimus, during the smallpox epidemic of Boston. His so-called “owner”, Cotton Mather, a prominent enslaving clergyman of that era noticed that many Afrikans seemed to be immune from smallpox and was told of the Afrikan procedure called “buying” the smallpox”, which was an early (Afrikan) method of vaccination. A fairly recent observation in China and In the United States was that about 10% of people who recovered initially tested negative for the virus but later tested positive again. This suggests that there may be carriers without symptoms so that widespread screening will become necessary. This may also be related to the fact that the commonly used test for COVID-19 has a 10% false negative rate (more about that later). It has been estimated that not only are there asymptomatic carriers but that approximately 80 % of those with the virus don’t know that they are infected. This is another reason why we must all act as if we are infected. It is not known yet whether the antibodies developed from COVID-19 infection causes immunity (such as what happens with Hepatitis and some strains of the flu) or even decreased severity of reinfection. Research is ongoing.
What is the incubation period of Covid 19?
So often we hear the term “incubation period” used as if it is understood that everyone knows what it means. The incubation period is the time between catching the virus and developing symptoms. This range is from 1-14 days with an average of five days. People who have been infected but have not started having symptoms can still transmit the virus so it is extremely important for us to act as if we are infected and try not to give it to anyone else. After recovering from most viral diseases, people become immune because of developing antibodies to that virus. This is the basis of vaccination which was developed by Afrikans in the 17th century. It was brought to America by the enslaved Afrikan, Onesimus, during the smallpox epidemic of Boston. His so-called “owner”, Cotton Mather, a prominent enslaving clergyman of that era noticed that many Afrikans seemed to be immune from smallpox and was told of the Afrikan procedure called “buying” the smallpox”, which was an early (Afrikan) method of vaccination. A fairly recent observation in China and In the United States was that about 10% of people who recovered initially tested negative for the virus but later tested positive again. This suggests that there may be carriers without symptoms so that widespread screening will become necessary. This may also be related to the fact that the commonly used test for COVID-19 has a 10% false negative rate (more about that later). It has been estimated that not only are there asymptomatic carriers but that approximately 80 % of those with the virus don’t know that they are infected. This is another reason why we must all act as if we are infected. It is not known yet whether the antibodies developed from COVID-19 infection causes immunity (such as what happens with Hepatitis and some strains of the flu) or even decreased severity of reinfection. Research is ongoing.
What are the differences between COVID-19 and the flu?
Up to 0.2% of people with the flu die from the flu but up to 5.6% of people with COVID-19 die from COVID-19. This is tens of thousands in the US (flu) as opposed to more than 128,000 and counting dying from COVID-19.
Both begin as primarily respiratory illnesses.
COVID-19 is more contagious and spreads more easily.
Flu symptoms come on suddenly and COVID-19 symptoms are more gradual.
Most people with the flu recover completely within two weeks while COVID-19 symptoms last longer.
In the US, there are approximately 20 times more deaths weekly from COVID-19 than from the worst weeks of the flu.
The genome of SARS-Co-V-2 is more than two times the size of the average flu virus.
You can have the flu and COVID-19 at the same time.
What is the difference between quarantine, isolation and social distancing?
Quarantine is a method used to prevent the spread of an infection and occurs when people are separated who are not ill themselves but may have been exposed to COVID-19 (being within six feet of someone who tested positive for the virus). This should last for 14 days from the last day of exposure. Before re-entering the public, those who have been sick with COVID-19 should quarantine until at least three days without fever and improved symptoms and 10-14 days since first noting symptoms. They should have two negative test results in a row at Least twenty-four hours apart. After a positive test, even with no symptoms, persons should wait at least ten days before mixing and mingling. Isolation occurs when people are separated who are ill with symptoms. Physical distancing (or social distancing) is being at least six feet apart.
How long does coronavirus live outside the body?
There are three main ways that infections in general can be transmitted from person to person.
The first way is bloodborne in which the infectious particles enter tears in the skin or mucus membranes in the mouth, nose and rectum, such as in Hepatitis B, Hepatitis C and HIV. This has not been seen in COVID-19.
The second way is called fecal-oral in which microscopic infectious particles from fecal matter gets on hands and is ingested, such as in many diarrheal conditions. COVID-19 has been found in feces. There has been one report that microdroplets from stool are released into the air when the toilet Is flushed, making the bathroom potentially infectious. This is a minor way of transmitting COVID-19 even if there is any validity to this report and there have been no reports to date of this type of transmission of COVID-19.
The third way is respiratory, which is the main way that COVID-19 is transmitted. Virus particles that are coughed or sneezed into the air are called droplets. People can also spread these droplets while talking (especially “spit talkers”) and even singing. It has also been noted that loud talking can expel droplets up to three feet. According to a recent study, these droplets can remain suspended in the air for eight to fourteen minutes and travel only a short distance (3-6 feet) before gravity pulls them down. A single cough can produce up to 3,000 droplets and a sneeze can produce as many as 10,000 droplets. A single cough can also produce a fine mist of mucus and saliva that leaves the mouth at nearly 100 miles per hour and travel up to 27 feet leaving a droplet containing gas that remains suspended for at least several minutes. These droplets can be breathed into nearby peoples’ airways or fall rapidly to the ground, floor, or whatever surface they land because of gravity. Smaller droplets (called aerosol) can remain in the air for a longer period of time (up to three hours). One researcher (from the Massachusetts Institute of Technology who has studied the mechanics of coughs and sneezes for many years) has reported that droplets of all sizes from coughs and sneezes can travel 23-27 feet and can remain in the air for hours. These particles can fall anywhere along the path of the cough also. These are called fomites, which are inanimate objects or materials that can carry infection. If people touch these surfaces and get the viruses on their hands, they can transmit the virus to themselves (by touching their eyes, nose and mouth with the infected hand) or to others (if they shake hands or touch others). This is now believed to be a minor way of transmitting the virus, but it is still possible. This is another reason why wearing masks, handwashing and sanitizing and social distancing are so very important.
Researchers are not absolutely sure about how exposure to heat, cold, and sunlight affect how long the virus lives on surfaces (even though most respiratory viruses do better in cold dry climates than in warm, moist climates) but they have come up with estimates. Please note that according to the Center for Disease Control, transmission through surfaces happens less often than was previously thought as spread is noted to be person to person via respiratory droplets and aerosol. However, this Is dependent on frequent handwashing and avoiding touching your eyes, nose and mouth after touching these inanimate objects. Again, please note that recent advisories have minimized this form of transmission.
On metal surfaces, such as doorknobs, jewelry and silverware, the virus can live approximately five days,
On wood surfaces, such as furniture and decks, the virus can live approximately four days,
On plastic surfaces, such as remote controls and credit/debit cards, the virus can live approximately 2-3 days,
On stainless steel surfaces, such as pots and pans, sinks and refrigerators, the virus can live 2-3 days,
On cardboard surfaces, such as shipping boxes, the virus can live approximately 24 hours,
On Copper, such as pennies and cookware, the virus can live approximately 4 hours,
On Aluminum, such as soda cans and tinfoil, the virus can live 2-8 hours,
On glass surfaces, the virus can live up to 5 days,
On ceramic surfaces, the virus can live up to 5 days,
On paper surfaces, the virus can live from a few minutes to 5 days.
Coronaviruses have not been found in water,
The presence of coronavirus in food is uncertain but the virus has been identified in human feces so it is entirely possible that it can be in food. This is another reason to thoroughly wash your hands, especially after using the bathroom. It is also a good idea to wash fruit and vegetables before cooking them.
It has been estimated that the virus can live several hours to a day on fabric or clothes. If no one in your household or surroundings has tested positive for the virus you should do your laundry as per usual. However, if someone in your household is sick or has tested positive, extra precautions should be taken with their clothes, towels, and bed linens such as wearing disposable gloves. Do not shake their clothes (may spread the virus) According to the Center for Disease Control (CDC), it is acceptable to wash dirty laundry from a sick person along with dirty laundry from a well person because the detergent will kill the virus. Clothes hampers should be cleaned and disinfected after they’ve come in contact with the sick person’s clothes. Do not hand wash these clothes. If you use a public laundromat, clean and disinfect the surfaces well, wear gloves and wash your hands.
There is no evidence of the survival of COVID-19 in water or sewage. In fact, the risk for people swimming is not from the water but from exposure to other people near them.
The question is frequently asked about how safe it is to be outside. Experts have said that its safer to be outside than in closed spaces indoors but social distancing and masks should be used when appropriate. The wind outside can scatter the virus. We should keep gatherings small and avoid sharing food, utensils and beverages. We should not develop a false sense of safety around people who may not have been being safe themselves. The bottom line is that social distancing, masks and frequent hand hygiene are important outside as well as inside.
I’m reminded of one of my uncles who was a germaphobe stating that money carries more germs than anything.
What can be done to prevent COVID-19 and stop its spread?
Avoid close contact with people, maintaining a distance of at least 6 feet from others. This is called social distancing. This is especially difficult for many people of Afrikan origin because so many of us are “huggers” and we have also developed many hand shaking styles (“dap”).
Wear a mask in public places. This may be problematic for many Ausa who are frequently racially profiled even without masks. This is so problematic that some Ausa legislators sent a letter to Attorney General William Barr and FBI Director Christopher Wray urging federal law enforcement agencies to provide anti-bias training to police officers. This profiling has already begun as evidenced by videos on social media involving Ausa men, even a physician. What is truly interesting is that Ausa men were actually harassed and manhandled by police in some places for not wearing a mask. It should be understood that masks are most effective when worn by those people with the virus. This is very important because, again, more than 80% of infected people don’t realize that they are infected because they have mild or no symptoms. These people are potentially walking around infecting those around them.
Avoid gatherings of large groups in public places where many people are closely gathered. Stay home as much as possible.
Frequent handwashing using soap and water for at least 20 seconds is extremely important. Cleaning the hands with alcohol-based sanitizer (at least 60% alcohol) is also important. I have heard that we should wash our hands with soap and water every 4-5 times that we use hand sanitizer
If you don’t feel well, stay home and call your doctor. Also, avoid people who are sick. If you have fever, cough and problems breathing, you should seek medical attention but call first so that they can be prepared for your visit.
Cover your mouth and nose with a disposable tissue or flexed elbow when you cough or sneeze. Touching elbows as a greeting is questionable when we cough into our elbows. The Wakanda Salute may be more appropriate.
Avoid touching your eyes, nose and mouth (and some experts say don’t touch your ears) because these are the main ways that the virus enters your body. You can actually wash the virus off your hands before It enters your body through the mucus membranes of your nose, mouth and eyes. Another reason to wash your hands frequently.
Frequently and regularly disinfect high touch surfaces such as door handles, phones (including cell phones), desks, keyboards, elevator buttons, remote controls, grocery carts, and bathroom fixtures etc. Chlorine (e.g. in Clorox) is effective in deactivating the virus.
Be very careful wearing gloves. You should still wash your hands frequently, even wearing gloves. Don’t develop a false sense of security because the virus can be passed from gloves to your cell phone and credit cards and other surfaces.
Stay up-to-date on the latest information about COVID-19.
It is interesting that many Afrikan countries have done a much better job of containing the virus than the US and Western European countries. One reason is that many of these African countries instituted the public health measures suggested above and tracking infections and contacts as governmental policy early on in the development of the disease. They also instituted mass testing. Perhaps the experience with Ebola was instructive. There have predictably been attempts to depreciate these facts stating that Afrika is hot and humid and the virus doesn’t survive well in that climate. Many of the Afrikan countries that have done well with coronavirus are temperate and do have winters. That excuse doesn’t make sense also when it is realized that Brazil, which is tropical and Singapore are experiencing huge numbers of infections. Afrika does have a problem with COVID-19 and all Afrikan countries have not performed this well, but it is interesting to do the “compare and contrast” evaluation.
What is the treatment for COVID-19?
Presently, there is no definitive treatment! Efforts are currently being made to develop a specific antiviral medication for COVID-19 (studies on remdesivir look promising). There has been a recent report that a steroid, dexamethasone, may reduce deaths in people with severe infections. This is being evaluated to ensure that the report is accurate and that no harm comes from the use of this drug. This drug is inexpensive and common (although drug companies may boost the price and manufacture a “shortage” in order to increase the price if it is found to be effective). Dexamethasone is the first drug studied that has been shown to possibly improve survival. Many studies all over the world are ongoing furiously and looking at relationships between medications that the patient may already be on. Several medications used for other illnesses have been suggested but any suggestion that these drugs work consistently is at present premature at best and reckless at worst. Specifically, several studies that have tried to evaluate the effectiveness of hydroxychloroquine were stopped because the cardiac (heart) side effects caused too many of the patients to develop dangerous heart rhythms. It was also noted that patients treated with hydroxychloroquine had a higher risk of death than those people not taking it. In fact, several studies found that the combination of hydroxychloroquine and azithromycin was ineffective. Efforts are also ongoing to prepare a vaccine (at least ninety projects) but estimates are that this will not be completed until late 2020 or early 2021. There are problems with developing a vaccine for coronavirus. The common cold is caused by a coronavirus and no vaccine has been developed despite many attempts. These viruses tend to mutate frequently, making the development of a vaccine extremely difficult.
What is “herd immunity”?
According to Wikipedia, herd immunity “is a form of indirect protection from infectious disease that occurs when a large percentage of a population has become immune to an infection, whether through vaccination or previous infections, thereby providing a measure of protection for individuals who are not immune”. Those immune people will not infect non-immune people. Some studies suggest that there might be temporary immunity against reinfection. People who have recovered from the flu do not have prolonged immunity and the vaccine must be given at the start of each flu season. Sweden tried to control coronavirus with herd immunity but this has failed and as a result, Sweden’s per capita death rate is the highest in Europe. Another frequently heard term is “community spread” which refers to people who have been infected within a certain area, including those who are not sure how or where they were infected.
A word on testing
Testing for Coronavirus in the United States has been woefully inadequate (at best) and criminally negligent (at worst). Everyday we hear or read about people who die from the virus who had been refused testing (sometimes on multiple occasions). Testing is extremely important because it helps us to understand where the virus is spreading. The types of tests are:
Polymerase Chain Reaction (PCR). This is also called a diagnostic test. With this test, a swab is taken from the nose or throat or a sputum sample is obtained. The lab then tests for genetic material from the virus. If this genetic material is found, the test is positive and if it isn’t found, the test is called negative. There are three problems with this test. The first problem is that the results can take several days to be final (rapid tests have been developed but have increased false negative results). The second problem is that there have been as much as 10-30% false negatives (this means that the tests show negative results even though the patient is infected). False positives also occur but are merely inconvenient but not dangerous. False negatives may cause infected people to develop a false sense of security and spread the virus to people around them. The third problem is that the specialized supplies and instruments are extremely expensive and many small labs are unable to afford them.
Antibody tests (serology) detect antibodies in the blood that the body develops to fight the infection, not the viruses themselves. They should not be the sole basis for diagnosis but they do give information about how widely the virus has spread. They give information as to whether you have been infected, the stage of infection, whether you’ve recovered and whether you’re immune to further infection. Most people who recover from infections develop antibodies that produce immunity and help protect against reinfection. This is part of the basis for immunization. We don’t know yet whether this will occur with COVID-19 (it hasn’t happened for the coronaviruses that cause the common cold).
Antigen tests look for specific foreign substances like bacteria and viruses. They are generally inexpensive comparatively and are currently done to diagnose strep throat and flu. It is also similar to a home pregnancy test. Unfortunately, a reliable antigen test for COVID-19 has not been invented (although research is ongoing to make one). This kind of test could theoretically be mass produced for home use.
Myths about COVID-19
Ausa have been treated so badly in America that many of us have become paranoid and see conspiracy theories in everything. Indeed, it has been said that an Ausa who is not paranoid is mentally ill. Reading the well-documented work of Harriet Washington (Medical Apartheid: The Dark History of Medical Experimentation on Black Americans From Colonial Times to the Present and A Terrible Thing to Waste: Environmental Racism and Its Assault on the American Mind) and the work of Dr. Robert Bullard on environmental racism does indeed fuel this paranoia. The way that the American system has been engineered to adversely affect people of Afrikan origin in economics, education, healthcare, criminal justice, and housing (to name a few) also gives credence to the necessity for some paranoia. Remembering the smallpox soaked blankets given to the Native Americans should also be important. We must always consider the definitions of the terms genocide (defined by the United Nations in 1948 as “acts committed with intent to destroy in whole or in part a national, ethnic, racial or religious group, including the killing of its members, causing serious bodily or mental harm to members of the group, deliberately imposing living conditions that seek to “bring about its physical destruction in whole or in part”, preventing births, or forcibly transferring children out of the group to another group)”. The relatively new concept of necropolitics (which is the use of social and/or political power to dictate how some people may live and how some may die) should also be considered and remembered. However, we must not let our righteous distrust of the system push us into believing things that have no basis in fact.
Black people CAN be infected. Melanin does a lot of excellent things but there is no evidence that melanin protects against COVID-19. In fact, Ausa have a significantly high infection and death rate in the places that track race in the statistics.
So far, America has not been locked down, but many states have issued “stay at home” orders intended to slow the spread of the disease.
Drinking hot lemon juice (or bleach) does not prevent or cure the infection. The vitamin C in the lemons might help strengthen your immune system but there is no evidence that it will prevent a COVID-19 infection. Vitamin D can also strengthen your immune system but has no direct effect on COVID-19. Certainly, injecting bleach will do nothing to help and is quite dangerous.
COVID-19 can be spread in hot climates as well as temperate climates. However, most respiratory viruses do better in cold, dry environments than they do in warm, moist environments, but cold weather and snow cannot kill COVID-19. Because COVID-19 is new, we do not know how it will behave as the weather gets warmer. We do know that COVID-19 spreads in locations of all climates.
Taking hot baths do not prevent infection and hand dryers do not kill COVID-19.
There is no evidence that COVID-19 can be transmitted by mosquitoes.
Spraying alcohol or Chlorine all over your body will not kill the viruses if they have already entered your body. They can be harmful to your mucus membranes (mouth and nose).
Vaccines already in use for other illnesses, such as pneumonia do not protect against COVID-19. The virus is new and a specific vaccine has to be developed for it.
Regularly rinsing your nose with salt water has not been shown to protect against the infection.
There is no evidence that eating garlic protects people from infection with coronavirus.
People of all ages can be infected. Older people and people with significant medical problems are more vulnerable to becoming severely ill.
Antibiotics work against bacteria, not viruses.
COVID-19 can be caught from someone who appears well and feels well.
Drinking alcohol does not help prevent or treat COVID-19 and actually weakens the immune system.
COVID-19 is not just like the flu. It is more contagious than the flu and is at least 10 times more deadly.
Advil and other non-steroidal anti-inflammatory drugs (like aspirin, aleve, Indocin, ibuprofen, naproxen, motrin and others) do not make the illness worse.
Sniffing steam from boiling water with lemons or anything else does not kill the virus.
Drinking more water does not flush the virus out of your throat and prevent the infection.
Breathing hot air from a sauna or blow dryer does not kill the virus.
Vitamins don’t give immunity from the virus although Vitamin D can strengthen the immune system.
Ozone therapy has not been proven to kill the virus and often causes more harm than good.
Thermal scanners are effective in detecting fevers but this is not specific to COVID-19. As stated, it may take 2-10 days for infected people to develop a. fever.
Being able to hold your breath for ten seconds or more without coughing or developing shortness of breath does not mean that you are free from COVID-19.
5G mobile networks do not spread COVID-19. Viruses do not travel on radio waves. The virus is spreading in countries that don’t have 5G mobile networks.
It is not necessary to change clothes and shower when you get home unless you are working directly with COVID-19 patients.
Ultraviolet (UV) light should not be used to sterilize the hands or other areas of skin because it can cause significant irritation and burns. There are three types of UV light from the sun. UVA penetrates deep in the skin and is felt to be responsible for 80% of skin aging, wrinkling and age spots. UVB damages DNA and causes sunburn and eventually, skin cancer. UVC destroys genetic material (human and viral) but is fortunately filtered out by Ozone in the atmosphere before it can reach our skin (another reason to protect the environment and the ozone layer). UVC is being used in China to clean floors in hospitals, public transportation and banks are using it to disinfect money. Despite what has been said by high profile individuals, UVC cannot be brought inside the body. Scientists are now experimenting with a new type of UVC that has shown promise.
Exposing yourself to the sun or temperatures of 77 degrees Fahrenheit or hotter does not prevent COVID-19.
Silver compounds have not been shown to affect coronavirus.
Coronavirus DOES EXIST!!! Denying this is dangerous and could potentially be fatal for the carrier or the person to whom it is transmitted. Remember that 80% of infected people have no symptoms or mild symptoms.
Domestic Abuse
It has also been reported that cases of domestic abuse have increased greatly during this period of being homebound. If someone gets on your nerves to the extent that violence occurs, stay in separate rooms and get help. If you are an abuser, STOP IT!! If you are being abused, tell a friend, family member, neighbor, counselor or the police. Examples of abuse are when someone’s phone or internet activity is being monitored, limiting someone’s communication with others, and using threats to control or manipulate someone. Physical abuse is not the only form of domestic abuse. Abused people should also make a safety plan, keep essential items readily available, develop a code with a trusted person and formulate an escape plan in case it becomes necessary.
Final Commentary
We are confronted with a public health crisis, the dimensions of which have not been seen before. Although the numbers are far greater, the reaction of many people in the American public brings to mind the case of “Typhoid” Mary Mallon. She was an asymptomatic carrier of Typhoid Fever in New York in the 1900’s and infected a great many people, some of whom died from the infection. She refused to cooperate with the authorities and continued to work in areas that caused her to spread the disease. Ultimately, she was involuntarily quarantined for many years until her death. Some people feel that the illness and her condition were not properly explained to her which is why she didn’t cooperate. While this may or may not be true for then, today, information is readily available to everyone, but some people simply refuse to believe it. This makes a statement about the state of our nation in terms of trust in science, medicine and political authority, but that is another conversation. Some may point to the HIV epidemic several decades ago. The difference is that many of the people identified as the primary risk group quickly took appropriate steps to reduce the spread of HIV, to agitate and stimulate discoveries of effective treatment of HIV and to provide a national educational program about the disease. They also stimulated the passage of laws that punished those who carelessly and sometimes intentionally spread the infection. The situation that we face today is similar in some respects but so very different in other respects. We are again confronted with a new infection but we have identified it almost immediately and have found out how it is spread. The similarity to the case of “Typhoid Mary” is that many people refuse (for whatever reason) to take the steps necessary to prevent the spread of the disease and possibly eliminate the infection, like smallpox. The difference from the case of “Typhoid Mary” lies in the fact that Mary Mallon was not educated on what she had and how she was spreading the infection. Today, with TV news that is on multiple channels twenty-four hours daily, radio and the internet (not to mention barber shops and beauty parlors), everybody can get information. The question is whether these unbelieving people represent extreme selfishness or toxic stupidity, or both. The eminent biochemist and science fiction writer commented on the anti-intellectualism that has been growing in America : “Anti-intellectualism has been a constant thread winding its way through our political and cultural life, nurtured by the false notion that democracy means that ‘my ignorance is just as good as your knowledge’”. In the opinion of many experts, the states “opened up” too soon. Many epidemiologists feel that it will be at least one year before large crowds can safely gather and some feel that we may never safely be able to hug or shake hands again. The CDC came up with guidelines in three phases for various businesses in opening but, it is reported, the White House interfered with the suggestions, as it had been doing since the pandemic started. For that information, please refer to the Centers for Disease Control (CDC) website. Unfortunately, at this point, many experts are saying that the US has moved past the point of no return and that it is too late to stop the spread of COVID-19. Nonetheless, we still must ALL do our parts in attempting to at least slow the spread of this horrible disease.