COVID-19 – Some Answers and a Perspective on Ending the Quarantine

Nearly 20 years ago, Dr. Stanley Burns (ophthalmologist and curator of the Burns Archive in New York City) and I wrote and produced a program for PBS entitled “Death In America” which was “a chronological history of how Americans dealt with illness and death from colonial times to now”. The program looked into the religious, social, cultural and medical aspects of outbreaks of disease across time.

At the time, I interviewed 20 experts on the history and genesis of disease, the misconceptions, medicines, advancements and fraud. Working on the program gave me some insight as to American’s attitudes toward illness and death and made me acutely aware of how quickly facts can become distorted and how panic replaces logic in emergency situations.

COVID-19 is just one more outbreak to be dealt with over the long history of humankind. It’s not going to take society down nor is so virulent that we can’t deal with it. That’s not my opinion, it’s a fact and if you want to feel a little better about what’s happening, Dr. John Swartzberg from the University of California, Berkley, School of Public Health, points out that “coronavirus is not very hardy (and is) easily destroyed by most disinfectants”.

After looking over my wife’s shoulder as she peruses Facebook, I got motivated to write something specific because of all of the misconceptions and misinformation going around. It’s clear that everyone has an opinion and the bottom line is that fear and ignorance is ruling the day.

All outbreaks of disease have several things in common. First of all, to keep a virus in check, you need to be smart. You need to not only take measures to protect yourself but also to protect those you encounter in your community. You simply can’t be uninformed about how to handle your life. You need to be responsible for your own education. Unless your friend is a healthcare professional, don’t listen to what they've heard or what someone on social media says, because a significant amount of the time, they're just plain wrong.

Keep your personal environment clean, disinfecting everything that’s been touched. One of our family got COVID-19 just over a month ago and we got the test results back while he was visiting. After he left, we disinfected everything in the house, on every floor. Every bathroom, doorknob, light switch and piece of furniture. We disinfected liquor bottles, pool table balls and pillows. We washed all of the bed linens on the two-hour “sanitize” setting. We self-quarantined for a full two weeks and had groceries delivered to our door. To keep sane, we walked the dog at around 10pm at night when no one else was around and none of us got sick.

It wasn’t luck and we didn’t dodge a bullet. He wasn’t feeling well when he was here and we all kept our distance from each other. He never felt anything severe. He ran a low-grade fever and felt lousy for several days. He lost interest in food. He never had a cough nor any congestion.

The doctor’s office didn’t want to test him for COVID-19 because he wasn’t showing clear signs. He insisted and tested positive. He worked in the food service industry and was exposed to lots of people before he knew he was sick and no known person that was in proximity to him got the virus.

Just remember to also keep your external environment clean, including your car, so that when you go out, you’re not putting others at risk. Use hand sanitizer and keep your distance from other people. If you have the virus, stay home. If you’re at risk or recovering from the virus, wear a mask! These measures aren’t complicated. They’re logical and reasonable.

Let’s take a look at a few issues that are still apparently confusing people:

Is there a connection between HIV, the virus that causes AIDS and COVID-19?

No. This has been the subject of more than 20,000 tweets and was allegedly picked up by at least 25 news services. The report was of an alleged study by scientists in New Delhi, India, wherein “uncanny similarities” were found between HIV and COVID-19. The story was quickly put down as “fake news” by real scientists around the world.

COVID-19 is airborne and you catch the virus simply by being too near someone who’s infected.

I have to say that in my opinion, someone at the CDC (Centers for Disease Control and Prevention) made a bad PR decision when they suggested that people should consider covering their faces with a cloth when in public - and President Trump didn’t help matters by further confusing the issue.

It isn’t that the CDC got the facts wrong. It’s that people just don’t listen to what’s being said. To be clear, what IS being said is that if you can’t get a hold of an N95 series mask and use it properly, then you can use a home-made “cloth face covering” if you feel the need when going out in public.

I think it would have been a much better decision just to leave the existing mask parameters out there on their own, rather than attempt to mitigate someone’s personal fears by creating a “how to” on making your own face covering. People are going to get it wrong anyway.

The cloth face covering, as described by the CDC, isn’t just a bandana tied around your face or a t-shirt pulled up over your nose (ref: Mort from Bazooka Joe comics). It’s a very specific method of creating a filter that will protect those at the greatest risk from getting infected, as U.S. Surgeon General Jerome Adams illustrates here: MASK LINK.

The short answer is that you don’t need to wear a mask when you’re outside your home, pretty much doing anything you might do. Such as, mowing the lawn, taking out the garbage, playing with the kids or walking the dog. There’s no such thing as “bad air”. This concept of a “miasma” that pervasively carries disease in the air and throughout a community became obsolete in the late nineteenth/early twentieth century when scientists discovered that germs cause disease.

The World Health Organization (WHO) continues to state the following: “Only wear a mask if you are ill with COVID-19 symptoms (especially coughing) or looking after someone who may have COVID-19. Disposable face masks can only be used once. If you are not ill or looking after someone who is ill then you are wasting a mask. There is a world-wide shortage of masks, so WHO urges people to use masks wisely.” COVID-19 droplets from infected people are “too heavy to hang in the air. They quickly fall on floors or surfaces.”

Recent studies have shown that the duration of how long particles can stay in the air varies depending on any number of circumstances; did the person simply cough into their elbow or did they cough at you? Did they sneeze into their hand or openly in your general direction? Do you live in a small apartment or a large home where the air is generally stagnant or constantly circulating? Is the infected person at the beginning of an active phase of the disease or are they in recovery? That last question goes to the current research that shows that COVID-19 is far more infectious in the beginning phases than even 3-4 days into the disease.

The general answer therefore is to be aware and smart – as you would with any infectious disease. If you’re compromised in any way, protect yourself as best you can without causing yourself undue mental strain. As with all viruses, COVID-19 is infectious. You need to be mindful of your environment and again, disinfect with an appropriate household cleaner.

Pets can contract COVID-19

According to the CDC, MERS (Middle East Respiratory Syndrome) and SARS (Severe Acute Respiratory Syndrome) and COVID-19 are all versions of coronavirus and all have a common origin, emanating from bats.

In various parts of the world different strains of coronavirus do affect certain species of animals including camels, cattle and cats.

Occasionally, “coronaviruses that infect animals can evolve and make people sick and become new human coronaviruses” (CDC).

That noted, there is NO valid evidence to indicate that COVID-19 itself can either be given to or gotten by pets or companion animals.

I see everyone else buying supplies and I just figured that someday we’re going to run out and I want to be ready – and – hospitals don’t have the supplies they need to deal with the pandemic.

The amount of supplies and equipment, of all types and forms, that the U.S. has already manufactured, is massive. The main issue is one of transporting those supplies from their warehoused locations to their final destinations. Therefore, buying too much of anything is ill-advised and just plain stupid. The shelves will be full of products of all kinds, every week, as long as we exist as a country.

It also bears mentioning that most stores are refusing the return of items that certain people bought too much of while panicking and that Amazon and E-bay are stopping price gouging on these same items.

The fact of the matter is that America started to institute a “just in time” mentality back in the 1980’s in an effort to make manufacturing, healthcare and even corporate operations more efficient and productive. The idea is to not keep supplies on your shelves that just take up space but to deliver those supplies as you need them. Not having excess stock saves money.

The fact that healthcare providers are short of gloves, masks and polyethylene face shields is based on the simple rule of supply and demand. This means that we normally have the ability to supply critical care for most people, given an average emergency. 

Ventilators as an example, are an expensive item. According to the Washington Post, ventilators cost $25,000 to $50,000 each, depending on the model. Hospitals aren’t going to keep this equipment on hand, “just in case”. Unfortunately, that means that some people infected with COVID-19, especially those with pre-existing conditions, will die.

The fact that hospitals aren’t prepared to deal with pandemics is no surprise to healthcare professionals. In these situations, the government is expected to step in and foot the bill when the system experiences a state-wide or national emergency.

All U.S. Presidents have the ability to exert control over industrial production during a national emergency by instituting the “Defense Production Act” (DPA). Which means that the President can instruct manufacturers to build whatever the U.S. might need to survive any emergency.

Under DPA authority, the Trump Administration has directed the Department of Health and Human Services to contract with General Motors to build 30,000 ventilators “for the national stockpile” at a cost of nearly $490 million.

Lots of other companies are answering the call without specifically being directed to do so. Tesla and SpaceX are producing ventilators. CleanTechnica is manufacturing hundreds of thousands of N95 series masks and world-wide, distilleries are producing hand sanitizer.

The bottom line is that no one can deny that hospitals haven’t had - and will never have - all of the tools they need to fight a pandemic. The system just isn’t set up that way.

The demand has caused American industry to act now, addressing the shortfall. The pipeline is filling and deliveries are getting where they need to go.

A little background

COVID-19 (SARS-CoV-2) is one of seven types of coronaviruses that can infect people. Human coronaviruses were first identified back in the 1960’s but COVID-19 was new as of 2019. Hence the abbreviated name for “coronavirus disease 2019”.

As noted earlier, COVID-19 is related to MERS and SARS as they are also coronaviruses but this one is different in structure. The Mayo Clinic says that “coronaviruses are a family of viruses that can cause illnesses such as the common cold…” that all coronaviruses have a similar structure (“corona” meaning crown structure) and that “they are all able to stick to surfaces but are also able to be killed with disinfectants”.

What makes COVID-19 new (“novel”) is that the best evidence shows that it comes from the animal world. Quoting the Mayo Clinic’s Dr. Clayton T. Cowl, “our immune systems have never seen this particular strain of virus before, so we haven’t developed immunity.” Dr. Cowl also notes that it’s these traits that make COVID-19 more contagious and more dangerous to people already at risk than certain known forms of influenza or colds.

Data

As of this writing, Johns Hopkins University reports that more than 775,000 people have tested positive for coronavirus and that COVID-19 has killed at least 37,000 people worldwide.

There are several diseases that regularly affect Americans at a much higher rate and for a far longer period of time than COVID-19. These include heart disease, cancer and stroke. In Illinois, these three categories account for more than 55,000 deaths annually or about 150 people every day. Complications from these pre-existing conditions can severely affect a person’s chances at recovery once infected with COVID-19.

Noting that I’m neither a healthcare professional nor a statistician, I created the following chart in an effort to better understand overall percentages. Specifically because I’m not an expert in these fields I also used percentagecal.com to calculate percentages based on total populations.

The population figures listed for the U.S., Illinois and New York are taken from Google/Wikipedia daily surveys (that utilize other data resources). I also researched COVID-19 data from 30 other sources but opted to rely on the Google/Wikipedia surveys because they illustrate individuals infected, recovered and dead (noting also that the “recovery” figures are not accurate). The chart compares some of the most common causes of death in relation to COVID-19 infections and deaths, showing affected percentage at the bottom:

This chart is as of Tuesday, April 8th, 2020, two days ago from the publishing of this article. We know of course that the figures change on a daily basis and that more people are dying every day, with certain actuarial models showing the U.S. reaching the apex of the crisis this and next week.

The overall percentages seem strikingly low based on the total population figures. The issue is clearly that this singular disease is causing damage and hardship throughout the world and its immediacy is therefore frightening. It’s right and appropriate then that the world is taking every preventative action we can. That said, we have to make sure that we measure our response as we go forward.

The numbers seem to indicate that preventative measures are working. During previous outbreaks and pandemics over the past centuries, tens and even hundreds of millions of people were infected with many millions dead. Disease was not only pervasive but annihilated entire countries.

Ending the Quarantine

The worst pandemics of all time include HIV/AIDS; various influenzas and pneumonia, all of which are within recent years. Measles, mumps, rubella, whooping cough and chicken pox have all had serious outbreaks because ignorant people refused to vaccinate their children. None of those situations ever merited a quarantine.

In the past century we’ve seen the 1918 flu that infected 500 million people and ended the lives of as many as 50 million. We continue to see cholera and various plagues rise around the world.

Even with the media focusing most of their time on COVID-19, it’s still difficult for people who live in less densely populated regions of the country to comprehend the rising death toll in places like New York and New Jersey. We’re simply not used to seeing people dying as was commonplace in the past.

That’s why our reaction to COVID-19 is unique, with never before seen quarantining actions around the world. 

It’s also for this reason that we accept putting aside our civil rights through the end of April. After that point, we should see a marked decrease in what the experts call the “velocity and fatality rates” of the disease.

As everyone can see, the economy is taking a major hit with unemployment being at an all time high. State and federal support networks are supplying cash payments to individuals and businesses but that has a limit.

Remember that it’s you who is actually paying for your own survival and it’s the entire country that will be paying it back for many years from now. Being out of work and getting an unemployment check isn’t a gift, it’s a right. You paid into the system and now it’s the government’s responsibility to support its people.

We already see one political party trying to use this tragedy as fodder against the other. With control and reason, we need to plan now to begin releasing restrictions on both our personal liberty and on small business, with new businesses and services being opened in the weeks that follow.

The curve is flattening.