Preparing for COVID-19

What is COVID-19?

As global markets continue to adjust to the fears and disruption caused by COVID-19, many of our clients are asking for guidance on how to protect themselves, their businesses, and institutions. This article is a condensed report on how to accomplish these important goals. The main source of information for this article is the Centers for Disease Control and Prevention, CDC. 

https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-home-care.html

COVID-19 is a coronavirus. Coronaviruses are so named due to their appearance under the microscope. Coronavirus is a family of viruses commonly found in a number of animals, including bats, camels, fish, cats and cattle. In rare cases coronaviruses can spread from animals to humans. Other examples of this disease include SARS and MERS. This family of viruses cause everything from the common cold to more serious respiratory issues.

The current outbreak of COVID-19 is believed to have originated from a seafood market in the central city of Wuhan, China. Initially it spread from animals to people. As of February 11, 2020, this respiratory disease has been named COVID-19 or coronavirus disease 19. The virus that causes this disease is called SARS-CoV-2. So far, COVID 19 appears to have a mortality rate of 2.3%. Like similar viral illnesses, mortality in high risk populations such as the elderly or critically ill is much higher. 

Symptoms and Diagnosis

The symptoms of COVID-19 are difficult to differentiate from other upper respiratory infections. They include fever, cough, some chest pain and shortness of breath. Based on previous similar illnesses, the CDC believes symptoms are likely to appear between 2 and 14 days after exposure. While the most distinguishing factor in the U.S. has been travel to China, in particular to Wuhan, as the disease has spread this travel test has become a less reliable way to track COVID-19 exposure.

The CDC has just revised its guidelines to allow clinicians to test more people suspected of carrying COVID-19. Under the prior federal guidelines, clinicians could test suspected COVID-19 patients if they had traveled recently from China or had been in contact with someone known to be infected. Some lawmakers criticized that guidance as too restrictive. The new guidelines were posted to the CDC’s website Thursday and place more power in the hands of health practitioners to determine who should get tested. Regardless of the guidelines, physicians can order whatever test they deem necessary for their patients. Reimbursement is another issue.

Prevention

There is currently no vaccine to prevent COVID-19. COVID-19 and similar airborne pathogens can spread quickly from sick people to others who are nearby at home, school, work, and public events. Coronaviruses such as COVID-19 are mostly spread by droplets traveling through the air (up to 6 feet) when a sick person coughs or sneezes. Less often, people also might be exposed by touching surfaces or objects with viruses on them and then touching their eyes, nose, or mouth.

The best way to prevent contraction is to avoid being exposed to this virus and taking everyday preventive actions. These include:

• Avoid close contact with people who are sick (any illness). Stay six feet away.
• Avoid touching your eyes, nose, and mouth.
• Stay home when you are sick or think you may have been exposed.
• Cover your cough or sneeze with a tissue, then throw the tissue in the trash
• Clean and disinfect frequently touched objects and surfaces using a regular household cleaners.
• Follow CDC’s recommendations for using a face-mask. CDC does not recommend that people who are well wear a face-mask to protect themselves from respiratory diseases, including COVID-19.
• Face-masks should be used by people who show symptoms of COVID-19 to help prevent the spread of the disease to others. The use of face-masks is also crucial for health workers and people who are taking care of someone in a close setting (at home or in a healthcare facility).
• Wash your hands often with soap and water for at least 20 seconds, especially after going to the bathroom; before eating; and after blowing your nose, coughing, or sneezing. If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol. Always wash hands with soap and water if your hands are visibly dirty

Treatment

There is no specific antiviral treatment recommended for COVID-19. People with COVID-19 should receive supportive care to help relieve symptoms. For severe cases, treatment should include care to support vital organ functions. People who think they may have been exposed to COVID-19 should contact their healthcare provider immediately. Early treatments for COVID-19 have been similar to those used to treat influenza and the common cold.

Planning

Create an emergency plan of action for COVID-19 and similar viral illnesses including influenza. This plan should include:

1.    Talking with the people who need to be included in your plan. This would include household members, business associates, employees, religious and school leaders, or anyone in your various “groups.” Discuss what should be done to prevent illness and limit it’s spread.

2.    Plan ways to care for those at greater risk for serious complications. Certain people are at greater risk for serious complications if they get the virus such as the elderly or critically ill.

3.    Get to know your neighbors. Talk with them and do some emergency planning. If your neighborhood has a website or social media page, consider joining it to stay connected to neighbors, information, and resources. Also use quarantine and support where it makes sense.

4.    Identify organizations in your community that can offer assistance. Create a list of community and faith-based organizations that you and your household can contact in the event you lack access to information, health care services, support, and resources. Consider including organizations that provide mental health or counseling services, food, and other supplies.

5.    Create an emergency contact list. Ensure that your household has a current list of emergency contacts for family, friends, neighbors, carpool drivers, health care providers, teachers, employers, the local public health department, and other community resources.

6.    Practice good personal health habits and plan for home-based actions to prevent spreading COVID-19.

7.    Get yourself and your group members in the routine of practicing everyday preventive actions to prevent the spread of respiratory illnesses. Avoid close contact with people who are sick. Practicing other good health habits, such as getting plenty of rest, exercising, drinking plenty of fluids, eating healthy foods, and managing stress, can also help stop the spread of germs. Remember, normal healthy people will recover from COVID-19 in a manner similar to the flu.

8.    Plan to have extra supplies of important items on hand. For example, keep on hand extra supplies like soap, hand sanitizer with at least 60% alcohol, tissues, and disposable facemasks. If you or your household members have a chronic condition and regularly take prescription drugs, talk to your health care provider, pharmacist, and insurance provider about keeping an emergency supply of medications at home. These supplies can always be used for a different emergency and then restocked.

9.    Choose a room in your home that can be used to separate sick household members from those who are healthy. If possible, also choose a bathroom for the sick person to use. Plan to clean these rooms daily. Learn how to care for someone at home and how to clean a flu patient’s room. Practice good personal health habits and plan for home-based actions to prevent spreading flu

10. For businesses and other organizations such as churches or synagogues, establish clear guidance on when people should not come to the group location. Be specific and have sick leave and alternative work options such as work at home available. Keeping people who have been exposed or are ill away is critical to the safety of other people. No hero workers who “tough it out” to show their loyalty to the organization. It’s better to have a few lost work days, than to lose a significant portion of your work force or group. This may require creating a culture of prevention.

Executive Summary

COVID-19 is a new disease that is closely related to other corona viruses like MERS-CoV and SARS-CoV. COVID-19 has been known to cause severe illness in people. The complete clinical picture is not yet fully understood. Reported illnesses have ranged from mild to severe, including illness resulting in death. Researchers from China's Center for Disease Control and Prevention today describe the clinical findings on more than 72,000 COVID-19 cases reported in mainland China. The study reveals a case-fatality rate (CFR) of 2.3% and suggests that most cases are mild. The disease, like influenza, hits the elderly and critically ill the hardest. The CFR jumped considerably among older patients, to 14.8% in patients 80 and older, and 8.0% in patients ages 70 to 79. Among the critically ill, the CFR was 49.0%.

Most people who are less than age 70 and who do not have underlying health conditions will not become critically ill from COVID-19. However, the illness has a higher chance of leading to more serious respiratory symptoms than seasonal flu. The actions that young, healthy people take, including reporting symptoms and following quarantine instructions, will play an important role in protecting the most vulnerable in our society and in shaping the overall trajectory of the outbreak. For this reason, universal precautions should be taken by people of all ages and health levels.

Most of the physicians and scientists contacted have reported that they feel that the US is in a good position to deal with COVID-19. Many told me that China is doing a good job of containing it. While the outbreak could become a pandemic, spread worldwide, it is best thought of as a health issue to “take seriously”, rather than one to “panic over.” One researcher said, “We have to remember that COVID-19 with a mortality averaging 2.3% is nothing like Eboli with a mortality of 50%.” A US based physician told me that, “Organizations like the CDC, World Health Organization and China's Center for Disease Control and Prevention have this well in hand. What’s needed is for people to observe reasonable precautions such as what you have outlined here.”