April 15, 2020
A good friend of mine sent me a reminder of an email Adrienne, my wife (aka - the real ER doctor in the family), sent our family and a few friends about the Corona on Feb 27. I’m sure some of you were on it. I wanted to send it for a few reasons:
Interestingly, it’s been almost 2 months since she sent this and you’ll note that all of the main facts were clearly spelled out back in late February and most of what she wrote hasn’t changed too much. We really didn’t obsess about it, or spend days researching the dark web or have any security clearance, this was the mainstream info.
She is wicked smart and she didn’t and still doesn’t think this is the one to wipe us all out ;). Note, she said this isn’t the big one. So maybe this is really the test run for the BIG one. No really, if we don’t learn from this go around then shame on us.
Finally, I am thankful for her and Micah being so patient with me devoting time to writing these letters. It takes time away from family stuff and they have never given me any push back. Anyway, many of you have written to me thanking for putting the time in but a thank you should also go to them for allowing me to do this without any guilt from them.
Without further ado, I bring you Adrienne’s Letter to Friends and Family from Feb 27, 2020...
Friends and Family,
I am writing this out of a sense of urgency. I think it is only a matter of time until Corona virus "hits" the US. What do I mean by this? I believe this will be a viral illness transmitted much like the common cold and influenza, through exposure to the coughs and sneezes of infected individuals. It will be in every city before we know it. We can protect ourselves by avoiding others who are symptomatic, observing good hand washing, avoidance of touching your mouth/eyes/nose when in public, and possibly wearing a surgical mask when traveling, shopping, meeting in crowded places. Also, we can protect others by STAYING at home, effectively self quarantining, when we suffer from fever, muscle aches, headache and cough.
There is no vaccine to prevent this illness. As of yet, there is no antiviral medication (ex. tamiflu) available effective in reducing the severity and duration of the illness. The incubation period (time from exposure to symptom onset/conversion to positive test) is felt to be somewhere between 1-14 days. The MAJORITY of patient's have had mild-moderate flu like symptoms that self resolve. Motrin (800 mg every 8 hours for adults and 10 mg/kg every 8 hours for kids) and tylenol (1000 mg every 6 hours and 15 mg/kg every 6 hours for kids) are your best weapons against the symptoms. We all must resist the urge to go to the doctor or ER unless experiencing intractable vomiting (intolerance even for liquids) or if short of breath. We risk unnecessarily exposing others to the illness in the healthcare setting and we risk overburdening already crowded ER's that still must take care for all the other non-Corona patients. The complications of pneumonia and respiratory failure have occurred on average 9-10 days after symptom ONSET. These patient's have MOSTLY been the elderly or people with other illnesses that weaken the immune system or other respiratory diseases such as asthma.
Unfortunately, there are now confirmed cases of asymptomatic, test positive patients (detected in the population that came off the quarantined cruise ship in Japan) and we have no idea how contagious these people may be. Also, there are now cases in which people are symptomatic and test positive who have not come into contact with any known test positive patients nor have they traveled to endemic areas (South Korea, Italy, Iran, China) or been around those that have. This is why I think our attempts to contain Corona virus will be lost. We can hope that like flu and the common cold, Corona is a seasonal virus that will "die-out" by spring...but we don't know. Notably, when it's summer here, it is winter in the southern hemisphere. What gives us hope is that SARS and MERS, contagious respiratory illnesses with high mortality related to this Corona virus, were contained and haven't re-emerged to epidemic levels.
So what am I doing to prepare? Obviously, as an ER doctor, I'm going to be exposed. I will be wearing a special protective mask at work called an N95. This type of mask is only recommended for healthcare workers at this time. I have heard that N95 masks are virtually unobtainable in stores like Lowes and Home Depot because of the panic. You don't need to panic. The current recommendation is to wear a simple paper surgical mask if you are ill and need to be in public (or possibly to prevent infection, although no definitive evidence on which type of mask, if any, is protective exists). I am stocking up on non-perishables, frozen foods, TP, dog food, etc. I think, just as in cases of blizzards and hurricanes, people will begin to panic about shortages with resultant "clearing" of store shelves. Not to mention the fact, if this virus becomes a pandemic, I don't want to go to places where a lot of other people are hanging out. I am making sure I have some surgical masks handy for my family. I have ample motrin and tylenol in my home. And I plan on following the recommendations of local government (ex. schools may end up being closed (ugh!).
Any of you that know me have heard me prognosticate that a viral epidemic will likely lead to a serious culling of the human population. I don't think this is the BIG one. We need to keep level heads, protect ourselves as best we can, and live life. Please feel free to correct anything I asserted above. I tried to inform myself well before writing this, but I'm certain many know more than I. As a final plug, GET YOUR FLU SHOT. I am still seeing flu in the ER. How smart are you if you're worried about contracting Corona, but you don't take the opportunity to protect yourself against a preventable illness that kills 56,000 people per year?!!
Link to the CDC's website: https://www.cdc.gov/
Stay emotionally connected and physically distant,
PS: Another friend just sent me this video. Hilarious, a conversation talking to your January self.