Sunday, August 16, 2020

Corona Virus Update 8/16

 I haven't done a Corona Virus update in some time but reading an article on T cell immunity and the many questions I have received from members on safety and school reopening, perhaps it is time.

First, I am not an epidemiologist or a virologist. I am a registered nurse and I have followed this virus closely and tried to learn as much as I can. I can't speak with certainties, but I can give my opinions. A  part of that reason is that I am not an expert and a part is that even the experts are still learning, as this is a relatively new virus, and studies take time.

We were hit early in Connecticut.  Our first confirmed case was on March 8th. The first confirmed Connecticut death was on March 20th. On 4/22 we had 1,972 Connecticut residents hospitalized. On May 20th we started a slow reopening of our businesses.At that time, we had 887 hospitalized and 3,529 residents had died. 

As of last Friday, 8/14, almost 5 months since our first confirmed case, 56 were hospitalize, 4,453 have died, 935,680 have been tested, 50,897 have been positive. Our hospitalizations have hovered between 72-53 for a month and our positive test rate have remained near or below 1% for several weeks. Meanwhile, the rest of the country is not fairing as well.

Scientific studies take time. This virus appeared around the beginning of the year, so much of what we 'know" is yet to be proven. However, we know that this is a Corona Virus, as is SARS, MERS, and the common cold. We are reasonably confident that it spreads primarily, but not exclusively by the respiratory tract. We know it can live outside the body for at least a few hours and maybe under the right conditions, several days. We know that it can be spread by coughing, sneezing, breathing, talking and singing. We are reasonably certain it can be spread 3-6 feet by droplets that we expel when we cough, sneeze, breath, talk and sing. It appears, from some research, that it may be able to be airborne (meaning it could remain in the air longer than a droplet and travel further), although there is disagreement as to the degree this can be so. We believe a person can be without symptoms (asymptomatic or pre-symptomatic) and still spread the virus. There is some evidence that we may build some immunity if we have the virus or perhaps a similar Corona virus, although the degree of protection and how long it would last, is unknown.

Understanding that there is still more we are uncertain of than certain, how should we proceed?

Cautiously, I believe. I believe that is why we have decreased cases in Connecticut. We quickly asked people to stay at home and we have slowly reversed that as the number of cases has decreased. We must also be willing to readjust and tighten our measures if cases increase.

For now, assuming this virus is spread primarily by respiratory means, I believe universal mask wearing, hand washing, cleaning surfaces, avoiding large gatherings, and gathering outdoors when possible, remain prudent measures. Masks decrease the risk that I may unknowingly have the virus and spread it to you. Hand washing in case I touch a contaminated surface. Avoiding large gatherings and being outdoors because increased numbers of people increase the risk of virus being present in the air and being indoor concentrates that virus more than being outdoors.

Those caring for infected individuals or suspected individuals should use full airborne precautions, including gowns, gloves, face shields, and N95 or better respirators, and this PPE should be single use, unless designed to be decontaminated between uses. This PPE should not be used when treating multiple patients or even the same patient on multiple visits.

These are my best recommendations based on what I have read and observed. although some of them are inconvenient, none of them carry any risk, and most experts agree that they will help.

Someday we will have full studies and more certainties, and even a vaccination. Until then we should air on the side of caution. 4,453 have died in Connecticut, 169,000 in the US, 772,000 worldwide.

Be safe.

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