Saturday, March 21, 2020

COVID-19 Q&A

by Dr. Iva Lloyd, ND

A crisis generally evokes confusion, anxiety and for some fear; and this pandemic is no different. To a large degree, the anxiety is due to the fact that there are so many unknowns - which is understandable as this virus is new.

As a naturopathic doctor, what I find encouraging is that there have been hundreds of research papers  published in the last few months. Doctors and researchers are madly working to understand how to manage COVID-19.  Rest assured that the information we are gathering is helping the medical profession figure out what needs to be done.  I trust the following answers some of your questions:

Q: What are the symptoms of COVID-19? 
A: The most common symptoms of COVID-19 are a fever, dry cough and shortness of breath or tiredness. A person might have additional symptoms such as aches and pains, runny nose, sore throat or diarrhea, but at least two of the three main symptoms are generally present. 

Q: Who can get COVID-19? 
A: Anyone can get COVID-19, but currently older adults that have hypertension, heart disease, diabetes or lung disease are at a higher risk of developing serious complications. It is important that everyone be diligent and take the proper precautions. 

Q: How is COVID-19 spread? 
A: The virus is believed to be spread primarily by person-to-person through respiratory droplets from a sneeze or cough of an infected individual. It can also be transmitted by touching surfaces where infected droplets have recently landed. 

Q: Is the COVID-19 virus airborne?
A: NO! COVID-19 virus is NOT airborne. It is spread through respiratory droplets produced when an infected person coughs or sneezes. The respiratory droplets quickly fall to the ground or on a surface. They only stay in the air for a very short period of time. 

Q: How long do the respiratory droplets last on surfaces?
A: Respiratory droplets can last between two to three days on plastic and/or stainless steel.  Keep in mind, the viral-load (concentration) of the droplets decreases quite quickly. Respiratory droplets can appear on other surfaces (e.g. clothing) but they do not last for very long and are not easily transmitted to someone from these surfaces.

Q: Why the 6 Foot Rule?
A: You never know when you may cough or sneeze and the six-foot rule is based on the fact that respiratory droplets from a sneeze or cough may travel up to six feet. Social distancing is primarily about protecting you from a cough or sneeze.  Coughing and sneezing into a tissue or into your sleeve is important to contain the spread of respiratory droplets. 


Q: What is Social Distancing? Why is it important? 
A: Social distancing, quarantines and self-isolation are terms in wide use during the COVID-19 pandemic. Social distancing involves avoiding crowds and keeping a safe distance between you and others when shopping or going for a walk.  It is a preventative measure through limiting inter-personal contact. Until we understand more about COVID-19, it is important to follow the social distancing guidelines set by your government.

Q: How can I protect myself from COVID-19?
A: The best way to prevent illness is to avoid being directly exposed. Four things to keep in mind:
  1. The most important is to avoid close contact with anyone who is showing symptoms of COVID-19 or who has been diagnosed with COVID-19.
  2. Wash your hands frequently especially after coughing or sneezing and being in public places. Wash your hands with soap and water for at least 20 seconds. If soap and water is not available, use hand sanitizer.  Avoid touching your eyes, nose, and mouth with unwashed hands after touching surfaces that others would have commonly touched. 
  3. Practice social distancing. 
  4. Maintain a healthy lifestyle
Q: If you have symptoms or if you have tested positive for COVID-19, is it important to self-quarantine? 
A: YES.  First and foremost, if you have symptoms of COVID-19 it is important to call your local public health for testing. Anyone who has symptoms or has been tested positive MUST self-quarantine as directed by public health, usually for 14 days.  When self-quarantining it is imperative that you stay home, avoid visitors, and stay at least six-feet away from other people in the household. It is also important to avoid sharing things like towels and utensils and that you use standard hygiene measures. Ask friends and family to do your shopping and drop groceries or other supplies outside your door, in order to limit personal contact. If your symptoms worsen, call public health and they will direct you further.

Q: How long is the COVID-19 incubation period?
A: FIVE days! The time between exposure and showing symptoms of the COVID-19 virus can be 1-14 days. Most commonly it is about 5 days. 

Q: What is flattening the curve? Why is it important?
A: Flattening or slowing the rate of infection helps prevent overloading of local healthcare providers. Social distancing helps to spread out the rate of people with severe symptoms so that the hospitals are able to effectively manage the situation and it gives researchers and other medical professions more time to understand how to manage COVID-19.

Q: Can I get the COVID-19 virus from my pet?
A: NO! There is no evidence that pets can carry the COVID-19 virus. However like any surface that an infected person sneezes or coughs on, infected droplets can be carried on pet fur for a short period of time. Anytime you happen to cough or sneeze on your pet, please wipe their fur down with a damp towel before another family member or another person interacts with them.

Q: Who should wear a facemask?
A: If you are sick wear a facemask when you are around other people and before entering a public place or a healthcare provider's office. A facemask minimizes the chance that a cough or sneeze will affect others. If you are unable to wear a mask, or do not have one, it is important to follow the proper hygiene protocol for a cough or sneeze and to avoid close contact with others.  If you are NOT sick it is only necessary that you wear a facemask if you are caring for someone who is sick. 


Q: Is it helpful to wear gloves?
A: Gloves are necessary for those in the service industry, especially with those involved with food preparation or handling. For the general population, gloves are not necessary.  Gloves, whether they are latex, cloth or winter gloves, can all carry the virus. When you touch a surface that has respiratory droplets from the virus then the virus may be transferred to your gloves. My experience is that people are more likely to touch their face while wearing gloves than they are to touch their face if they are hanging onto a disinfectant wipe or tissue.  Keep in mind, healthcare workers have an increased risk of exposure and wearing gloves is important for them.

Q: What is the overall mortality rate of COVID-19?
A: It is going to take awhile to figure out the actual mortality rate (the number of people who may die if they catch COVID-19).  The World Health Organization (WHO) currently suspects that the mortality rate is around 3.4%. It currently appears higher in some countries (such as Italy), but is also much lower in other countries.  As the testing for COVID-19 has primarily focused on those that have symptoms, there is a chance that the mortality rate will decrease as we learn more about this virus.


Q: How many people who get infected will have significant symptoms?

A: Research currently indicates that about 80% to 90% of those that have the virus will be asymptomatic or will have mild or moderate symptoms. Which means that about 10% to 20% will have concerning symptoms that will require medical intervention or hospitalization. That being said, it is important for everyone to practice proper hygiene and social distancing.

Q: How many people will someone who is sick infect?
A: Reproductive rate is a measurement of how many people an infected person will infect. For example, the reproductive rate for the common flu (Influenza) is one - which means that for each person that is sick they will infect one other person. Recent research is indicating that the reproductive rate for COVID-19 is between 2 and 2.5.  There is speculation that as we learn more about COVID-19 the reproductive rate may actually decrease closer to that of the flu. 

Q: How long is someone who is infected able to infect someone else?
A: It is generally believed that someone who is showing symptoms can affect someone else for about 10 days. The term viral shedding relates to the ability of the virus to move from one part of the body to another (i.e., from your hands to your mouth) and from an infected person to the environment (i.e., from an infected person's hands to a hard surface) where it can affect others.  The current research indicates that it less likely that someone who is symptom-free will affect others with the virus.

Q: What is the difference between COVID-19 and SARS-CoV-2?
A: COVID-19 stands for Coronavirus Disease 2019. It is the name of the disease. SARS-CoV-2 stands for SARS (Severe Acute Respiratory Syndrome) Coronavirus 2 and it is the name of the virus.

Q: What is the source of SARS-CoV-2?
A: Based on the analysis of the virus, the source is from a dead animal. The transfer from animal to human would have occurred at a meat or fish market when humans were interacting with meat - NOT a live animal and NOT from a pet. At this time, the actual animal source has not been found but many are working tirelessly to figure it out. Part of the "unknown" factor for SARS-CoV-2 is that it originated from an animal and hence humans do not have the same natural immunity to this virus.

Q: How can your naturopathic practitioner help?
A: The naturopathic community is here to help you through this pandemic. Check out our blog "A Crash Course on Respiratory Health" The focus of naturopathic practice is to provide:
  • Health Promotion: guidance on a healthy lifestyle
  • Prevention: reinforcing the importance of hygiene and social distancing
  • Supportive Care: providing guidance on how to support your overall health. Currently there are no proven treatments - conventional or naturopathic - for COVID-19.
  • Recovery: helping patients recover and reestablish their health if they have had any symptoms.
Q: What is best to do when home in self-isolation or quarantine for a couple of weeks?
A: Situations like this are a good reminder of the importance of a healthy lifestyle. Here are some tips while in self-isolation:
  • First and foremost, create a routine. Plan out your day. Avoid the tendency to sit around and watch movies or television all day.  
  • Exercise is important. This might be a great time to focus on stretching, walking (even if it is around your house) or other activities you can do at home.
  • Work on a project. Take the time to clean out the garage, paint a room in the house, clean out those closets that you never get to, or other tasks at home.
  • Eat healthy.  This is a time to focus on healthy eating. Avoid filling up on junk food and high starch foods. To help the body stay healthy, eat your fruit and vegetables, adequate protein and healthy starches. 
  • Keep in touch with friends and family. Self-isolation and quarantine can be quite uncomfortable for may people. It is important to reach out to others. 
  • Mindfulness and meditation are very helpful in times of stress.  If you are not familiar with these coping strategies there are a number of apps that you can download and enjoy.
  • Limit the amount of time that you are listening to the news. Think of news, especially "bad news" as a challenging workout for your mind. Like any muscle, it can handle a bit, but it can't handle too much!
By ensuring a holistic approach to this problem, we will get through this pandemic together. As new information and research is available the global health care community will master this infection as it has all others.