Category Archives: helping during covid 19

Honest Answers Concerning the COVID-19 Pandemic.

As far as I’m aware the following post provides accurate information as of 5/19/20. I have heard so much bad, inaccurate, and dangerous false information on this topic that I felt it necessary to address this topic. If you read all of the questions you will have a good and reasonable understanding of this pandemic as of this date… Dr. Mike.

What is a virus?

A virus is a microscopic parasite that consists of an outer protein coat that houses genetic material. Think of genetic material as a set of instructions. Some viruses also have a lipid (fatty) outer coating. For instance, the coronavirus has a lipid outer coating. A virus is very different from living organisms as it does not have the internal machinery to build those things necessary for life and to create useable energy molecules that are needed to live. Also, a virus cannot reproduce/replicate on its own. 

A virus is simple in its structure. Many viruses have projections on their outer surface that allow them to connect to the host’s cells. Once connected, the virus injects its genetic material into the host cell and tricks the host cell into making more viruses. It hijacks the cell to do its bidding. Once the host cell fills up with newly manufactured virus, it bursts (and dies), releasing many new copies of the virus. These copies infect other cells, and the process repeats.

Is a virus a living organism?

Many scientists would say that all living things have specific characteristics in common:

  1. All living things are made up of cells.
  2. All living things have the machinery needed to metabolize. In other words, they can make things that they need, like proteins. They can also create energy molecules needed to power their internal machinery.  
  3. All living things can reproduce/replicate themselves.

Viruses do not have any of these characteristics, so most scientists would say that they are not living. However, some may argue that they are living, but very different from all other forms of life on this planet.  

Are bacteria and viruses the same thing?

No. A bacteria is a single-cell organism that has the internal machinery to metabolize and reproduce. Bacteria are considered living. Also, bacteria are usually much larger than viruses. 

What is a coronavirus?

Coronaviruses are a group of viruses that have a crown of spikes on them. Corona means crown. These spikes allow the virus to connect with the host cells and infect them. There are many different types of coronaviruses, and some have infected humans for millennia. The most common human coronaviruses cause mild upper respiratory symptoms (they are one of several virus groups that can give you a common cold).

Different types of coronaviruses infect different organisms. Most are species-specific. In other words, a virus that can infect your dog won’t infect you. However, this is not always the case. Sometimes a specific virus can mutate, which allows it to infect other species. When this happens, it can be dire to the new organism as it may not recognize the virus, which allows it to spread further and cause more damage. This is the case with the coronavirus that is currently causing global problems. It has never infected humans before, so its impact is severe.  

What is immunity?

When we are exposed to a dangerous agent like a virus, our bodies launch a defense against that agent. If we survive the infection, our bodies can remember the virus. If we are reinfected again with the same virus strain, we quickly recognize the agent and launch a counter-attack to neutralize it. This ability to neutralize a formally dangerous agent is called immunity.

How do vaccines work?

In most cases, a vaccine contains unique parts of the virus, but not those parts that can cause disease. When injected with a vaccine, our bodies recognize those parts as foreign and launch an attack to eliminate the invader. Once exposed, our body remembers these parts as dangerous—exposure to the real virus at a later date now results in the rapid elimination of the virus.

Do vaccines cause autism?

NO, NO, NO… this has been researched many times. Don’t believe bull**t.

Can vaccines cause illness or death?

Vaccines are generally very safe. A tiny percentage of people receiving a vaccine may experience an adverse reaction, and some of these reactions could be serious. Overall, vaccines have saved millions of lives and have reduced or eliminated many terrible diseases.

What is herd immunity? 

Everyone in the group has resistance to a virus. This is often done by immunization. When done effectively, herd immunity can eliminate a virus. A virus needs a host to reproduce. If there are no hosts, it will disappear.

What is the official name for this coronavirus?

Severe acute respiratory syndrome coronavirus 2 

(SARS-CoV-2)

What is COVID-19

This is the name for the illness caused by SARS-CoV-2.

How do you catch this virus?

This is a respiratory virus. A sick person will shed the virus in respiratory droplets when they cough, sneeze, sing, or even talk. The particles infect the next person by entering that person’s body through their eyes, nose, or mouth (not the skin). If you have a high concentration of the virus on your hands, you can transfer the virus to your eyes, nose, or mouth by touching your face. This is why handwashing is important.  

Does wearing a mask protect me?

It’s complicated. Special masks (N95) can filter the air that you breathe and prevent the virus from entering your nose or mouth. However, these are in short supply and are reserved for people who are working on the “front-line,” like doctors and nurses.

Other types of masks have only a limited ability to block the virus from entering. However, they do reduce the travel distance of an aerosol (spray) when someone coughs. Less spray means a safer environment for those around you. If I wear a mask, I protect you, and if you wear a mask, you protect me. If we are all wearing masks, we are protecting each other.

What is an ACE2 receptor?

This is a particular part of the surface of a human cell that is involved with blood pressure regulation. This receptor is found in abundance on lung cells, but it is also present in many other parts of the body. The novel coronavirus that causes COVID-19 binds to this receptor, which is the first step to cause an infection.

What is zoonoses?

This is when a disease in an animal infects a human.

Where did this virus come from?

All scientific indications point to a bat as the original host for this coronavirus. It is likely that the virus mutated and then infected another type of animal and that a human caught the virus from this secondary host.

There is NO evidence that this virus was created or modified in a lab.  

Do all pandemic viruses come from China?

Not at all. For instance, the Spanish Flu of 1918 likely originated in the US, and the MERS pandemic of 2012 started in the Middle East. 

Are coronaviruses common?

This is a large class of viruses. Most of this class of virus doesn’t infect humans, but several do cause the common cold. However, the coronavirus that causes COVID-19 is new to humans, making it much more dangerous.

Why are health officials concerned about this novel coronavirus?

No humans had ever been exposed to this virus before 2019. This allowed the virus to run rampant and allowed it to cause life-threatening problems in those who were infected. This virus also seems to be very infectious. There are people who can contract the virus who are symptom-free, but they can still spread the virus to others. 

What does the term pandemic mean?

A widely spread epidemic. In this case, worldwide.

Is COVID-19 just another flu?

NO! Strains of the influenza virus cause flu or Influenza. COVID-19 has respiratory symptoms that are similar to the flu, but a coronavirus causes it. It is more dangerous and appears to be more infectious than the flu. However, the flu is also pretty dangerous in its own right. Remember that the “stomach flu” is just a generic slang term for GI distress and has nothing to do with respiratory flu. 

Why is COVID-19 more dangerous than the flu?

For many reasons, it is likely more infectious, more lethal, and impacts more organ systems than the flu. The respiratory flu is a severe illness, but COVID-19 is worse.

Was the Spanish flu of 1918 caused by a coronavirus?

No, it was caused by a mutated influenza virus that initially came from birds.

Is this the first time that humans have been infected with a novel coronavirus?

No, the SARS outbreak happened in 2003, and the MERS outbreak happened in 2012. Different members of the coronavirus family caused these. MERS killed about 40% of those infected, but it was harder to spread than the virus that causes COVID-19. As of the time that I’m writing this post, over 3 million people have been infected, and over 300,000 have died. The highest number of deaths have occurred in the US, with (at the time of this writing) over 90,000 deaths.

Do viruses mutate, and how does that change them?

All viruses mutate. Many mutations result in an inactive virus. However, some mutations can make a virus more infectious or deadly. 

What are the symptoms that COVID-19 cause?

The classic symptoms of this virus are fever, shortness of breath, and dry cough. However, many other symptoms can occur, including mental fogginess, pink eye, sore throat, loss of smell, blood clots, strokes, heart attack, skin conditions, GI distress, and more. 

Some of these symptoms happen directly due to the virus, others due to overactivation of our body’s defense systems, and others due to unknown reasons.

What is a cytokine storm?

This term is used when the body launches such an aggressive attack against a virus that it also starts to destroy parts of itself. Think of this as “friendly fire.”

Is it dangerous to take ibuprofen (Motrin) if I’m ill with COVID-19?

There is NO credible evidence that taking ibuprofen will worsen a COVID-19 infection.

What increases my chance of getting sick with this virus?

The only way to catch COVID-19 is to be exposed to the virus. The higher the concentration of the virus and the longer the length of exposure to the virus, the higher the chance of infection. If a sick person coughs in your face, that is a load of virus! If you spend time in a confined space with a moderate concentration of virus (church service, crowded bar, airplane), that’s a lot of exposure. Either scenario increases your chances of getting the illness. 

The virus has been found on everything, from cardboard boxes to the soles of shoes. However, these are unlikely to cause an infection due to the above reasons. 

However, if someone with an active infection coughed on a hard surface (like a keypad) and you touched that device shortly after that, you could transfer the virus from your hands to your face and infect yourself. Bottom line, wash your hands!

What is the kill rate?

Deaths divided by the rate of infection. 

Other viruses have higher kill rates, so why are we so worried about this virus?

Because this virus is so infectious. The more individuals infected, the higher the actual death rate!

Many people die from the flu, so why are we so worried about this virus?

Is this a serious argument? Really? We already have 90,000 deaths in the US, and the number will probably approach 120,000 by summers end. These are not just numbers; these are human beings. Are you willing to sacrifice your mother, or father, or favorite teacher, or great co-worker, or best friend unnecessarily? 

Do I have to have symptoms to spread this virus?

NO, this fact makes this virus very dangerous for obvious reasons.

Did China withhold information about this coronavirus, and why?

It appears that they did. I don’t know why, but it was likely for economic reasons, and also to stockpile equipment (like PPE and respirators) needed to treat the illness. 

Did China’s delay in telling the world about this coronavirus worsen the epidemic?

Yes.

Why is the outbreak so much worse in the United States than in other countries?

I am despondent to say this, but the US response to this pandemic has been shameful. We had all sorts of data from past pandemics. We also had data from this current pandemic. Yet much of this information was ignored. We never had a cohesive strategy and never used the full power of the federal government to direct us. Experts were ignored, rumors were deemed as important as facts. The list goes on. History will look at this time very unfavorably. It is so sad to me.

Can I get this virus from touching packages or the mail?

This is very unlikely, and there have been no reported cases of transmission by these routes.

Can I get this virus from having sex?

There have been reports of infected men expressing virus in their semen. Is this a problem? The answer is unknown, but it is MUCH more likely that you will catch the virus from an infected person by all of the other things related to having sex—proximity, deep kissing, etc. 

What are the best practices to avoid becoming infected with the virus?

  1. Stay away from sick people and from places where you can have long exposures to lower concentrations of viruses (large assemblies, bars, planes, etc) when at all possible.
  2. Socially distance. The virus only travels a few feet when someone coughs before it falls to the ground.
  3. Wash your hands thoroughly. Soap inactivates the virus.
  4. When you can’t wash your hands, use an alcohol-based hand sanitizer at the right concentration (many DIY sanitizers on YouTube won’t work).
  5. Wear a mask when you can’t socially distance (for instance, when grocery shopping).
  6. Limit trips to places like the grocery store. Shop deliberately and quickly.
  7. Use on-line services if possible.

Should I wear gloves?

I have seen so many people misuse gloves that it is hard to recommend using them. If you know how to use them, gloves can help protect you in some situations. However, misusing them could potentially increase your chances of infection.

What kind of soap should I use to wash my hands?

Any type of soap will work well. Just wash for at least 20 seconds and try to rub all parts of your hands as this increases the chance of breaking down the virus.

What kind of hand sanitizer should I use?

The hand sanitizer must have (by volume) 70% isopropyl alcohol or 60% ethyl alcohol. Commercial sanitizers that are alcohol-free won’t kill this virus. DIY sanitizers that don’t have this concentration of alcohol (by volume) won’t be effective. Rub your hands for 20 seconds to help destroy the virus.

I hear that the virus can survive on surfaces for a long time, should I worry about this?

In most cases, this is not an issue. However, it can be a problem if the viral concentration is high and the “seeding” is recent. An example would be an infected person coughing on a touch screen that you touch and then rub your eyes. In this case, you would be infecting yourself with a high concentration of fresh virus. Always us sanitizer when you get to your car, and then wash your hands when you get home.

People are telling me to take certain supplements or remedies, should I do this?

People are making money off of this tragedy. No remedy or supplement is helpful.  

Is it important to eat well, get enough sleep, and try to do those things that generally keep us healthy?

Yes, a healthy lifestyle, along with good practices, can increase your chances of staying well.

Why did states need so many ventilators? Was this a scam?

No, there was no scam. Many of the early deaths from COVID-19 were due to respiratory failure. In these cases, a respirator would be the only option. However, we are now learning that some individuals with low oxygen in their blood do well with more conservative treatments, like CPAP or O2.

Why did states want us to shelter-in-place?

This is a tried and true (Think Spanish Flu of 1918) way of reducing the rate of infection. If everyone got sick at once, the health care system would become overwhelmed, and more people would die due to reduced access.

Why are we supposed to stay 6 feet away from others when we are out and about?

The virus spreads by respiratory droplets, which typically don’t travel farther than this. When out in public, keep your distance. The 6-foot rule doesn’t work when you are in a confined space, like a church. There have been reports of many people who were more than 6 feet away from an infected person getting sick and dying in such situations. Although they were exposed to a lower concentration of virus (likely expelled in smaller droplets when the parishioner sang), they were exposed for a longer time.

Do I need to sanitize everything?

Use common sense. Clean things as you usually would, wash your hands frequently or use hand sanitizer when you are out and about. Higher precautions are needed when people work in highly contaminated areas (for instance, a doctor working with COVID-19 patients in the hospital). 

What should I do when I go to a grocery store?

Wear a mask, keep as socially distant as reasonable, shop quickly and deliberately, wash/sanitize your hands as soon as possible when you leave the store. Consider using on-line services, “senior store hours,” or other ways to keep those most at risk safe.

Is it safe to go to church, bars, concerts, or other enclosed experiences?

I answered this above. At this time, I would avoid these places. Remember, it is not all about you. You may get sick and recover, but are you willing to kill your spouse, child, or friend as an expression of your independence?

Does the time that I’m in a risky place matter?

Yes. More time equals more exposure.

What is more important, the virus or the economy?

This is not an either/or choice. Both have to be addressed concomitantly. 

I don’t like the government telling me what to do; they are not the boss of me!

Really? If you can’t move to a deserted island, suck it up and grow up. It not just about you and your wants. This virus is a big deal. I could go on, but I would just get progressively more pissed off.  

I’m young; I don’t care if I get COVID-19 because it won’t kill me.

First, it could kill you. Second, it could kill someone you love. Third, it could kill someone who could help you in the future (like a doctor). We live in societies for a reason.

If I’m older and get COVID-19, will I wind up on a ventilator?

Older people are more at risk for respiratory failure, but we are now learning that some of these patients can do well with less invasive treatments, like CPAP.  

What is happy hypoxia?

Some patients with oxygen levels so low that would typically be in a coma have been alert and appear almost normal. The reasons for this are unclear. However, it may mean that some individuals who would usually be placed on a ventilator may do well with more conservative treatment.

Are there treatments for COVID-19?

At this time, the only known treatment is supportive care. However, new treatments are being explored, and some appear promising. This history of medicine is full of examples of things that were thought to help particular problems. However, when put to rigorous study, they either didn’t help or caused more harm. PLEASE, let health care professionals do what they have been trained to do. A video on YouTube or an endorsement from a celebrity means little and could potentially harm you.

Can I catch this coronavirus a second time?

Despite some reports, this seems unlikely. Successful exposure to a virus typically leads to immunity that can last for years or longer.  

Will there be a vaccine for this coronavirus soon?

In the past, it would take many years to create a vaccine. New biochemical methods have reduced this development time. Remember that a vaccine has to be developed, tested to see if it works, tested to see if it is tolerated, and then it has to be made in high quantity. A vaccine in 12-18 months could happen if all goes well. 

Why are some countries that seemed to stop the virus now seeing a re-emergence of the virus?

This is expected as countries start to open up. The goal of social isolation is to reduce the rate of infection, so there is available medical care and to give time for vaccine development. However, foolish openings will result in unnecessary deaths. We need to look towards those countries that have had the most success and follow their lead. 

Are containing the virus and reopening the economy two separate things?

Both have to be considered. They are interconnected in every way.

Isn’t it worth having a few old people die to save the American economy?

As we now know, COVID-19 affects every age. However, it does seem to be that older individuals are at higher risk. As an older person, I can say that I’m still relevant to the people who love me, and I’m contributing to the world at large. Stop using the term “people” instead substitute the name of a real person. “Isn’t it worth having my mother die to save the American economy?” That little substitution makes a big difference, doesn’t it?

Will this virus go away?

The virus will not go away. It may fade for a bit during the summer (or not, depending on how states reopen). It is likely to return during the flu season. This will be rough as hospitals will already be taxed at that time. However, treatments will be developed, and a vaccine will become available. Over time COVID-19 will become a preventable disease.

Will we ever have another pandemic?

Yes, with 100% certainly. It is critical to learn from our successes and failures in treating this pandemic. I can’t emphasize enough that we will need a strong and clear direction from our experts and leaders. Without this, we will have a repeat of our current disaster. 


Dear readers, we will get through this crisis. We need to be sensible, and we need to look at the entire situation. The economy does need to open up, but it needs to open reasonably and rationally. Individual rights are important, but so are the rights of those impacted by others. This is not our first pandemic rodeo The playbook is already available; we need to look at it.

Peace

Mike

Dr. Mike, Day Laborer

Shelter-in-place and social isolation are two terms that were new to me but have become familiar phrases in the last few weeks. I’m a person who feels that every event can be a learning opportunity, including our current viral crisis.

In an earlier post, I explored my continued awareness that despite being an introvert, I need people in my life. The first few weeks of shelter-in-place were tough as the only real contacts that I had were with my immediate family, and they had their activities and interests.  Julie was working, Kathryn was adjusting to life back in the USA, and Will and Grace were attending classes online. 

I didn’t feel like doing much of anything, and I spent most of my energy trying to put together a survival plan for the family.  Where could we get toilet paper?  Did we have enough soap? How could I make DIY hand sanitizer and disinfectants?  Emergency planning was all that I could do.

I was prevented from doing things that I loved as I was isolating indoors.  I couldn’t go on a camping adventure with Violet, the campervan.  I couldn’t take myself on a photography safari, and there wasn’t much to write about as my daily life had been reduced to the mundane.  

One of my favorite retirement activities before the pandemic was hanging out with my friend, Tom.  We have always gotten along well, and we saw each other often. We were keeping up with each other electronically, but for whatever reason, that wasn’t cutting it for me.  I mentioned to Tom that I was feeling frustrated and bored, and he suggested that I stop by his backyard for a socially distant barbecue, which I did.  I was surprised by how much better I felt with the addition of a little bit of normalcy. 

Tom recently purchased an older townhome close to downtown Naperville that had never been updated.  He planned to gut the place entirely and to reconfigure the interior into a more modern and efficient space.  He was going to demolish the interior on his own to save funds for the actual remodel. Tom is an experienced contractor who knows the protocols for such a task; however, he is only one person. I was concerned that he would injure himself by tackling all aspects of this enormous job alone. I was determined to help, but my efforts were met by family concerns for my safety due to the coronavirus.  I felt that their worries were unfounded as I would be wearing a respirator and gloves during the demolition process.  Besides, I would take other precautions, like bringing my homemade hand sanitizer to the job site.

I knew that one of my primary functions would be as a photographer to document the process.  We write a weekly construction blog, and photos always make the posts better.  However, this would not reduce Tom’s chance of injury. Multitasking presented the most significant injury risk to my friend. He would be inherently safer if he could concentrate on a single task rather than trying to do everything by himself.  

I have been hanging around construction sites for some time, and I am starting to get an understanding of the construction process. However, knowledge isn’t the same thing as skill.  

During most of my life, I have been thrust into leadership positions. This is likely because I’m responsible, organized, and I have good problem-solving skills.  As a physician, I was a chief resident, co-founder of a successful psychiatric practice, and served as a medical director in several positions. I am comfortable in leadership roles, but leadership was not needed here. I needed to be a follower, a gofer, a grunt. The most helpful thing that I could do for my friend was to become a day laborer.

Some of you may think that it is beneath a physician to do such things, but I disagree with this idea completely. I am many things beyond a doctor, and I feel that all honest work is honorable.  

Tom’s townhouse is an easy walk from my home, and I have been going there in the mornings to do whatever was needed.  I have pried tacking strips off of floors, taken countless loads of refuse to the dumpster, and even sawed through a pipe or two.  My actions have allowed Tom to concentrate on methodically stripping the interior down to the studs.

My stated goal was to help my friend and to increase his safety. However, I also have benefited from my actions. I’m getting a little exercise, I have social contact, and I am continuing to learn by observation.  Hosts on DIY TV shows often state how much fun it is to deconstruct before they construct something.  Frankly, I think their statements are total crap.  The process is physically challenging, filthy, and potentially dangerous.  However, the method also serves as a classroom for an uninformed person, such as myself.  Each layer of the interior has to be removed and properly disposed of.  Appliances have to be recycled, ceilings and walls have to be cut away, insulation discarded, plumbing fixtures removed, and electrical connections isolated. Deconstructing a house is another way of learning how to construct a house, and I find that process very fascinating. By participating in the process, I have gotten a master’s class in home construction.

Soon tradespeople will descend on the property.  Plumbers, electricians, carpenters, and others. I’ll help in whatever way that I can, but, likely, I’ll mostly be photographing and writing about the construction experience in Tom’s blog. However, after all of these years, I know most of Tom’s subcontractors, and they usually don’t mind my picture taking and obsessive questions. 

When I first met Tom, he was surprised that I was always asking questions. “Why do you want to know that it is useless information to you?” He would ask.  I would always respond that there was no such thing as useless information.  Over the years, I have put to use some of that “useless” information, but for me, the process of learning is reason enough to learn. 

I choose to be a competent human being. To me, that means that I am more than just a title or job description. I’m glad that I have had the training to adjust complicated pharmacological cocktails for schizophrenic patients.  However, I’m also happy that I have the knowledge base to make a meal from scratch for my family, fix a friend’s computer, or put together a solar-powered electrical system for Violet the campervan. Each activity has worth, as does picking up clumps of insulation and tossing them into a dumpster. It gives me pleasure to think that in some small way, I am helping my friend.  Every slab of wallboard that I chucked is one less that he had to do.  To me, a friend is someone who is there for you when you need them.  Tom has certainly been there for me, and I enjoy returning the favor.

During this terrible time, it is easy to feel sorry for ourselves.  To think that we are being cheated, or put upon by the world.  This is a perfect recipe for sadness.  I would suggest that it is better to think about what you have instead of what you are missing.  Extend yourself to someone else and try to be supportive of them. I’m not Mother Theresa. Yes, I feel that I’m helping a friend, but I’m also getting quite a bit in return from the interaction.  The result of helping someone has made me happier.  We live in a world of “me,” and with it, we see higher rates of depression, anxiety, and addiction.  In my career, I saw individuals who were always looking for ways to feel better about themselves.  They judged their happiness with their latest purchase.  They would blame others for their unhappiness and take no responsibility for their own dysfunctional behaviors. These patients were almost impossible to help as they expected someone else to do their work.  Their lives could have been transformed by taking some of their self-absorbed energy and “spending” it to make someone else’s burden lighter. During this crisis time, we all need to work together. There is strength in numbers; if we stand alone, we will become dust in the wind.

Tom’s construction blog post can be found at: HTTP://gizmohomecraft.com

The original 1970s kitchen.
The wall between the kitchen and living room.
Original appliances taken to a recycler.
Mike in demolition garb.
The bathrooms will be completely remodeled.
Walls between the kitchen and living room and the kitchen and dining room removed.
getting rid of a sea of “blown-in” insulation.
Stripped down to the studs.