CORONAVIRUS – COVID-19 ADVICE

The primary sources to follow:

National – CDC website:  https://www.cdc.gov/coronavirus/2019-nCoV/index.html

State -- California Public Health system:   https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/Immunization/ncov2019.aspx

Local – Santa Cruz County: http://www.santacruzhealth.org/HSAHome/HSADivisions/PublicHealth/CommunicableDiseaseControl/Coronavirus.aspx

A good collection of up to date articles by The Atlantic:  https://www.theatlantic.com/category/what-you-need-know-coronavirus/


Updated 3/29/20:

Additional crowd sources ideas from patients and others:

Dear Friends:

As I sit down to write this, things are moving very fast. There is also a lot of dubious information being circulated.  My best advice is to go to the sources above and their links, that is, the actual scientific article and READ it.  The abstract, discussion and conclusions should state whatever you are seeking to verify.  Trust but verify secondary sources, even in reputable places like the New York Times or the French Health Minister.  I think the Ibuprofen meme is seriously overblown.

 

I HAVE DECIDED TO MAKE TELEMEDICINE SERVICES AVAILABLE TO PEOPLE OUTSIDE MY NORMAL PATIENT PANEL.  YOU CAN REQUEST AN APPOINTMENT BY PHONE AT 831-421-0197

 

I will post updates on twitter @askdrdawn is the place to reach out and I will try to respond to messages.  If you begin a new message with my twitter handle it does not broadcast to everyone who follows me.  From 6pm – 7pm PST on Wednesdays you can email my live streaming radio program on KSQD.org at onair@KQSD.org 

 

FOR THE MOMENT, THE BEST ADVICE I CAN GIVE YOU IS STAY HOME, COOK YOUR OWN FOOD AND STAY 6 FEET AWAY FROM PEOPLE AS THAT IS THE DISTANCE COUGHED UP VIRUS CAN TRAVEL.

 

ON THE SUBJECT OF TESTING: You really must be quite sick to qualify as they are currently rationing tests – which we HOPE will change in the next week anyway.   The STATE labs are flooded and the commercial labs will be able to run 5000-10,000 tests nationally per week as I learned in a briefing this morning.

 

I know how hard it is to deal with the uncertainty and I’m sorry that the kits were not deployed properly – the back story on this is available on the March 11 podcast at https://www.nytimes.com/2020/03/11/podcasts/the-daily/coronavirus-us-testing.html?showTranscript=1

 

Here is the official CDC advice on who should be tested – this may change:

Clinicians should use their judgment to determine if a patient has signs and symptoms compatible with COVID-19 and whether the patient should be tested. Most patients with confirmed COVID-19 have developed fever1 and/or symptoms of acute respiratory illness (e.g., cough, difficulty breathing). Priorities for testing may include:

  1. Hospitalized patients who have signs and symptoms compatible with COVID-19 in order to inform decisions related to infection control.
  2. Other symptomatic individuals such as, older adults and individuals with chronic medical conditions and/or an immunocompromised state that may put them at higher risk for poor outcomes (e.g., diabetes, heart disease, receiving immunosuppressive medications, chronic lung disease, chronic kidney disease).
  3. Any persons including healthcare personnel2, who within 14 days of symptom onset had close contact3 with a suspect or laboratory-confirmed4 COVID-19 patient, or who have a history of travel from affected geographic areas5 (this link is outdated-DM) within 14 days of their symptom onset.

 

Here is another link that is quite informative and models what we can expect depending on how our nation behaves in the next week of so.  I cannot emphasize how much we all need to stay home.

https://medium.com/@tomaspueyo/coronavirus-act-today-or-people-will-die-f4d3d9cd99ca

 

This link has good animations to explain the spread of the disease:

https://www.washingtonpost.com/graphics/2020/world/corona-simulator/

 

SUGGESTIONS FOR KEEPING YOURSELF SAFE (Trigger alert, if you have OCD already skip the next 8 items.)

 

·         We’ve covered social distancing and crowd avoidance.  You already heard this.

·         Shoes, I think germs fall on the floor and get picked up on shoes.  If you are going out, I advise you have a designated pairs(s) of shoes that stay outside.  Avoid tracking anything into the house.  Your car floor has germs. 

·         Please carry some kind of hand sanitizer in your pocket.  Just rubbing alcohol in a little spray bottle will do if you don’t have the commercial gels (you can dilute if by 1/3 with aloe vera gel if you can get it or just plain water.)  This is hard on your hands so you’ll need to follow it with a lotion.  Use it after you touch door handles, bannisters, gas pumps, your credit card etc.  A dry tissue will protect you from this type of contamination.

·         Incoming mail and food items may be contaminated, You can reduce risk if you spray with or dip for 10 seconds in dilute bleach then rinse off food items until there is no odor.  Throw away the envelopes and keep items off the food preparation surfaces until “decontaminated”

·         Money is porous and can vector germs, coins are also a potential vector.  Your money is dirty.  Use a credit card if you can but sanitize it after and go wash your hands.  CARRY YOUR OWN PEN  to avoid touching a surface that may have been handled by many people.

·         Your phone needs frequent wiping down with alcohol, not bleach.  Your computer keyboard is contaminated.  Clean it regularly but go wash your hands anyway if you’re are in a public area.

·         Keep a small toothbrush handy and use it to clean under your trimmed nails when you wash your hands.  First soap up then brush under nails then rub between your fingers while singing happy birthday twice (20 seconds).

·         Clean your hands, then steering wheel and car door handles when you get into the car from a public space unless you are absolutely positive that you don’t need to.  Soapy water works just fine on surfaces as a decontamination tool.

·         DON’T SMOKE OR VAPE ANYTHING!  Your biggest risk is viral pneumonia which in Covid-19 starts deep in the lungs.  You have a street sweeping mechanism in your airways that keep the virus from getting down into the air sacks, but you impair it’s function when you smoke. 

·         Get enough sleep, meditate and don’t overwork.  Meditate or doing other stress lowering things will help your innate immune system fight COVID-19.

·         Eat mushrooms and fermented foods which stimulate the immune system in a good way. Unfortunately, all sources of mushroom-based immune supplements are sold out now.

·         Monitor your temperature and notify me if it goes above 101 degrees.  If you do not have a thermometer, order one on-line or purchase one if you have to go out for another reason.  They cost under $10 for the electronic oral version which can be cleaned off with soap and water and rinsed. Absence of fever is NOT a guarantee that you are not contagious, but this is now considered a droplet borne disease so if you don’t sneeze or cough on anything you haven’t spread it at least.

 

One other bit of advice.  This is a very bad moment to get in a car accident, get seriously injured or have any other kind of health crisis.  Also, be very careful with ladders, flames, etc.  In short, you don’t want to need emergency services, hospitalization or fire fighters even more at this moment than usual as services are stretched thin and response times will be slow for the foreseeable future.

 

So long and stay healthy!

Dr. Dawn