Category Archives: COVID-19 Q&A

COVID Q&A-October 2020

Last week I wrote about COVID fatigue. This week I thought I would write about COVID awareness. I did a similar Q&A to this one early on in the pandemic, and in retrospect, it has proven to be accurate. That blog post was based on available data at that time. This blog post is based on more current information. My goal is to present these questions and answers in an understandable format, as I believe that knowledge is power. 

My background:  

I am a physician who trained at Northwestern’s Feinberg School of Medicine. Although I specialized in treating disorders of the mind (psychiatrist), I was trained in all areas of medicine as a medical student. Before becoming a medical doctor, I obtained a graduate degree, where I studied microorganisms’ biochemistry. I have also worked in research centers, where I participated in basic research on cancer and multiple sclerosis. Years ago, I was part of a research team that used monoclonal antibodies as a research tool. It is incredible to see these agents now being used to treat medical illness. Although I’m not a specialist in infectious disease, I can read scientific information and determine good data from bad information.  

What is this virus?

This virus belongs to a large family of viruses called coronaviruses. These viruses have a common characteristic: they have a “crown” (or corona) of protein spikes on their surface. These spikes can attach to specific receptors on host cells, which allows the virus to inject its contents into the cell. The virus uses the “machinery’ in the host cell to reproduce (or replicate). This process, and how the body reacts to it, can cause illness and death.

How does one contract this virus?

The virus has to enter a host’s body through a vulnerable site. These places include the mouth, nose, and eyes. You cannot contract the virus by just touching it. However, you can touch a contaminated surface and then rub your mouth, nose, or eyes to inoculate yourself with the virus. You can also contract the virus by more direct means. If someone with the virus coughs, they send a spray of droplets into the air. The virus can exist in very high concentrations in these droplets. If they land on your face, they can infect you. These droplets are pretty heavy, and most of them will fall to the ground within a few feet of being “coughed up.”  

It now seems likely that the virus can also float in the air. In these situations, the virus can travel further.

Can you tell me more about airborne spread?

It is likely that the virus can be spread in smaller particles that are expressed when a person exhales. These particles are lighter, so they can travel further and potentially infect a person who is further away than 6 feet from the infected individuals. However, the conditions have to be just right for this to happen-I’ll talk more about that later.

If you understand the answers to the following question, you will have a firm understanding of the relative risk of any activity that you may want to do. 

The most important answer in this post:

What are the factors that make it likely that someone will get infected by this coronavirus?

The number one factor is called “the infectious dose.” That is the number of particles of virus needed to cause a successful infection. Different viruses have different infectious doses. It is unclear how many virus particles are required to cause a COVID infection, but the number is likely considerable. In other words, if you somehow accidentally inoculate yourself with only a few viral particles, you won’t get sick. Four main factors determine if exposure to the virus will infect you.

  • The concentration of the virus-the higher the concentration, the higher the infection rate.
  • The length of exposure to a virus-the longer you are in a place contaminated with the a virus, the more virus you are exposed to.
  • The viability of the virus-viruses are fragile. A freshly expressed virus will be more potent (virulent) than one that has been drying on a surface.
  • The vulnerability of the host. For instance, individuals with weakened immune systems can be infected by fewer virus particles than a person who has a robust immune system.

How likely is it that you will infect yourself with a virus by touching an inanimate object (like a package) and then touching your face?

It is doubtful that you will infect yourself in this manner. If there is a virus on a surface, it is likely that the virus’s concentration is low and that the potency is low. However, there are some cases when the risk can be higher. For instance, an infected person coughs into their hand, which you then shake. You then touch your face and inoculate yourself. Or a person coughs on a hard surface like a credit card touchpad. Immediately afterward, you use the same touchpad for your transaction. You then rub your nose.

Beyond specific cases, it is unlikely that you will contract the virus from an inanimate object. There is no compelling evidence that you have to wash your groceries or sterilize your mail.

Then I don’t have to wash my hands?

NO, YOU HAVE TO WASH YOUR HANDS AS RECOMMENDED. It is a simple precaution that is easy to do. We are always touching our faces with our hands. By making hand washing routine, you eliminate those times when you could be exposed to a high virus concentration.

Why should I socially distance?

Remember that it is proven that you can contract the virus by respiratory droplets and that these droplets can only travel a short distance. By staying at least 6 feet from individuals, you place yourself in a safer zone, as most large droplets will have fallen to the ground before then.

This airborne thing frightens me? Do I have to be afraid to breathe?

NO. Airborne transmission seems to be most significant in specific situations that cause higher viral exposure to the recipient. These are situations that increase small particles in the air, such as talking loudly, shouting, and singing. These airborne particles then need to be trapped in an enclosed space (like a room). Lastly, a person needs to be exposed to this environment for a more extended period. Here are a couple of examples where airborne infections could occur:

  • Attending a church service where there is singing.
  • Hanging out at a bar where there is a lot of loud talking and shouting.
  • Having a leisurely meal in a noisy restaurant where everyone has to “speak up” to be heard.

What is a super spreader, and what is a super spreader event? Why do these individuals and events occur?

There seem to be specific individuals who can spread the virus more effectively to others. Also, there appear to be situations that seem to spread the virus to more individuals than in other cases.

We understand some of the reasons for this (see my answers above), but we still don’t fully understand why some people or situations are more infectious than others.

What can I do to protect myself when flying?

Airplanes have effective air cleaning systems, and so it is most likely that you will become infected by a person who sits close to you on an airplane rather than someone who is many rows away. Therefore it is critical that everyone on a plane wears a mask. Also, try to keep your hands to yourself and consider some eye protection. Wash or sanitize your hands as needed.  

Are outdoor rallies safe?

In general, a well ventilated outdoor event will be safer than a poorly ventilated indoor event. However, you can make such an event even safer by socially distancing, hand washing, and wearing a mask. Remember, if someone close to you has COVID, they can quickly transfer the virus to you by their proximity in any setting. 

Why should I wear a mask? The CDC initially said I didn’t need to. What about my civil rights?

The CDC based its initial recommendation on two factors. The INITIAL data didn’t support layperson mask-wearing, and there was a shortage of masks needed by first responders. Their recommendations changed when it became abundantly clear that masks (even homemade ones) could prevent the spread of COVID. This fact has been shown over and over; it is not in question. Masks save lives.

As far as your civil rights, let me be direct, if you believe that not wearing a mask somehow demonstrates that you are a patriotic American, I am here to tell you that you are being played, and played most cruelly. This simple act (mask-wearing) can not only prevent you from getting sick; it can save the lives of others.  

We do things all of the time necessary for both our’s and the greater society’s safety. It is illegal to drive while intoxicated, you are not allowed to smoke in public places, and factories are not allowed to dump toxic chemicals into our public water systems. These are just a few of many examples. Please don’t be played by others. Masks save lives.

Why do some people die from COVID, and others have no symptoms?

There are likely many factors, but the answer to this question is that we don’t completely know. However, we do know some groups are more vulnerable than others. Older individuals and those with certain medical conditions are at the highest risk. However, sometimes young and healthy individuals die from this disease too. It also appears that some younger individuals develop problems after they recover from their initial infection. 

Do we have a cure for this virus?

Contrary to what you may be hearing from politicians, the answer is no. However, data has been examined from many thousands of cases, and we have been able to refine our treatment of this disease based on that information. We know that certain drugs, like steroids and anticoagulants, can help with recovery when given in the right situations and at the right time. Other modalities, like serum treatments and monoclonal antibodies, may help some individuals. We are getting a handle on when a person needs assistance with their breathing and what works best to treat particular issues. As our knowledge improves, so does the survival rate of infected individuals.

Is it true that we have more cases because we are doing more testing?

This is an outright lie, a manipulation to make things sound better than they are. There is no other way to say this. We know that we have more infections based on multiple streams of information that include testing results and hospitalization stays, community information, and COVID mortality numbers.  

Testing gives us a window into the virus’s activity at any location and also lets us know how successful our efforts are in combating a virus in any particular area. Any action to limit or discourage testing is criminal, in my opinion. Limiting testing allows the virus to flourish. Limiting testing makes it worse for everyone. Imagine if someone said that they were going to limit unwanted pregnancies by limiting pregnancy tests. Ridiculous, no?

I need to get on with my life, but how can I?

Go back to the “most important answer” above. What we can do for a week is different from what we can do for months. What is the safest way to work? How can I socialize responsibly? How can I modify my life to get what I need while being safe? Base your decisions and actions on thoughtful reflection and reliable data. In life, there are reasonable risks and foolish risks. 

Why are some people asymptomatic and others very ill?

At this time, we don’t know.

Can asymptomatic people spread the virus?

It is unclear how infectious asymptomatic people are, but YES it appears that they can infect others. Some asymptomatic individuals genuinely have no symptoms. Others may have mild symptoms that they ignore. Still, others may be infected and will show signs in a day or two. If you practice CDC guidelines, you are in the best position to protect yourself. 

Will I be back to normal once I recover from COVID?

We are seeing cases where individuals have long-term effects that range from neurological complications to breathing problems. It is unknown how these individuals will be impacted years from now.

I don’t follow CDC guidelines and I’m fine.  Therefore, COVID is a hoax!

I’m glad that you are both healthy and lucky.  However, a single (or small group) of individuals does not determine a pandemic.  The data is out there, the numbers are in the millions.

Is a vaccine the solution to all of our problems with this virus?

NO, but it is a critical step. At this time, we still don’t know how effective a vaccine will be, or how long its effectiveness will last. However, once it is determined to be safe and reasonably effective, I plan on getting innoculated. 

Will we get through this?

Of course, we will. However, we need to use the information we obtain from this pandemic to implement changes to deal with future pandemics effectively. Remember, knowledge is power.


I hope this Q&A has answered some of your questions on COVID. To the best of my knowledge, the answers are accurate as of 10/29/2020

Peace

Mike

Simple and inexpensive items can keep you safer from this virus.

BTW  Comments have been turned off as I was getting hundreds of SPAM messages from a Spanish bot.  If you want to email me, you can take my web address prefix and add @gmail.com. 

Bomb Shelters And COVID-19, More Related Than You Think.

I read the email from Ralph.  He was inviting my family and me to his farm for the weekend.  I felt reasonably confident that Julie would want to go, but I was less sure of my kids.  To my surprise, they were eager as they had fond memories of outings there when they were younger.  Our invitation was at the beginnings of the lifting of shelter-in-place restrictions in Illinois; I knew that both Ralph and Anne had been carefully isolating.

Ralph is my former business partner, and his wife Anne is my dentist.  They live in a nearby suburb, and the farm is their get-away place.  To call it a farm isn’t exactly accurate, but that descriptor is about as good as any other.

Ralph’s father was a famous researcher who was a professor at a prominent university.  Along with his pediatrician wife, he decided to purchase the farm in the 1960s.  This move was stimulated by several factors, including the fact that a few of his colleagues had bought vacation cottages on the nearby Rock River. However, his father had bigger plans and eventually obtained 650 acres of land that included fields, forests, and a former rodeo.  The rodeo’s site had a main house, nine log-style cabins, a two-story barn, and various other outbuildings.  It was situated on an idyllic pond and became the family’s weekend home. In the 1970s, Ralph’s parents built a new home on a ridge overlooking their lake.  This is the place that I have visited over the years.  The first time that I saw the old homestead was last year as it is about a mile walk from the “new” house.

Visiting the farm is a unique experience; in reality, it is a private preserve.  There are expansive open fields, densely wooded forests, ponds, creeks, and a lake.  The site also contains a helicopter landing field, an abandoned caboose, and a 7-foot plaster-cast statue of Cleopatra.  Edmonia Lewis sculpted the original sculpture (The Death of Cleopatra). Ralph’s dad donated it to the Smithsonian American Art Museum in Washington, D.C. but had a cast made to keep for himself.

The property’s most unusual feature is a buried, multi-room bomb shelter that even includes a garage to store a car. Under a hill, the shelter has several entrances, including a secret tunnel to the main house.  That opening was located in one of the bedrooms, and to reach it you had to propel yourself down a hidden slide. 

Current observers would likely view the building of a massive bomb shelter as eccentric or possibly even a little crazy.  However, I would disagree with both descriptors.  To understand why someone would go to great effort and expense, you need to understand the era when the shelter was built.  The Cold War was in full swing in the 1960s, and the treat of a nuclear attack from Russia was a genuine fear.  Many people had makeshift bomb shelters in their basements, and students practiced “duck and cover” exercises in school.  In fact, in 1962, it was revealed that Russia was building missile launching pads in Cuba, only 91 miles away from the U.S. mainland.

Ralph’s father’s actions were consistent with the fears of the time, except he had the financial means to protect his family on a grander scale than most.  Thankfully, for all of us, the family never had to use their hidden bunker. 

I am also trying to protect my family, not from a nuclear blast, but a novel coronavirus.  I have instilled in them the need to socially distance, and they know the importance of handwashing. I have laid in some extra food and supplies so they would be safe and fed if, for some reason, I couldn’t go to the grocery store.  I have kept abreast of the latest news and medical research since knowledge is often the most potent weapon against any adversary.

Now that the country is opening up, it is important to know what situations are safer and what situations are more dangerous.

Most research has shown that the best practice is to stay far away from others, as individuals can be infected while exhibiting no physical symptoms.  The 6-foot rule is an excellent place to start.  The more open the setting, the safer the environment.  The more confined the setting, the more dangerous.  The more talking, singing, coughing, laughing, sneezing, the worse the setting. Short periods spent in places offer less viral exposure than extended periods. To put this in practical English:

-Outdoor open spaces with few people are relatively safe. 

-As outdoor spaces become more crowded, they become less safe.

-When you can’t maintain at least 6 feet of distance, wear a mask.  Even a homemade mask offers some protection to the wearer and benefits those around the wearer.

-If possible, avoid closed spaces with poor air circulation (bars, churches, movie theaters).  Such places are even more dangerous when people are singing, shouting, or doing other activities that move a lot of air.

-Eye protection may be useful in “trapped” spaces, such as an airplane.  

-Washing your hands regularly is one of the most important things that you can do to stay healthy.  Do this often, and every time you return home, even in situations where you think you haven’t touched anything. 

-Use an appropriate hand sanitizer when you can’t properly wash your hands.

– The amount of time that you spend in a given place counts.  The chance of getting coronavirus from a short visit to the grocery is relatively low.  If you work in a grocery store for 8 hours a day, being infected by a coworker is higher. 

As the country opens up, it is essential to choose your activities wisely.  You don’t need an elaborate bomb shelter to protect you and your family, just some masks, a little soap, and a heavy dose of common sense.

BTW, we had a great time at the farm.  Instead of writing a narrative about it, I thought I would end today’s post with some photos.

Peace,

Mike

The “new” house built in the 1970s.
The view from our bedroom.
The “new” house sits on a ridge overlooking this lake.
We toured around the farm “hayride” style. Ralph is an expert at driving a tractor.
One of several ponds.
Only a few of the original log cabins remain, and they are returning to nature.
Transportation consists of one of several 1950s tractors.
A huge bonfire often ends the evening.
View of the lake from the patio.
Getting ready for an adventure.
Many stairs down to the lake.
Wandering in the forest.
Wandering in the field.
Going down to explore the old bomb shelter.
Our ride.
“The Death of Cleopatra” Image courtesy of the Smithsonian.

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