We are 78 days since our first confirmed case of Covid in Connecticut. We are 5 days into our reopening.
Hospitalizations are down 23 to 701
18 more have died, for a total of 3693
Everything you wanted to know about Covid but we’re afraid to ask
First off, I’m no expert. I’m not an epidemiologist or a virologist. But I am a nurse and I did work in an emergency room for 21 years. I was involved in the training and development of best practice guidelines for the Ebola response, and we underwent hazmat training in the emergency department for the possibility of chemical spills, radiation leaks, and the like.
We have been tracking this virus since we first heard of it in Wuhan. I’ll admit, at first I through it would be much like SARS 1, MERS, or Ebola and be contained to certain parts of the globe.
Like so many of us, I was wrong.
This Virus seems to be incredibly contagious and carries a high mortality rate. At the same time, we have no vaccine to protect us and are just now learning how to treat it. Add to this is the fact that we are not sure how it spreads, what the long term effects might be on the body, whether it will have a second wave or even become seasonal. All this makes it extremely worrisome and should make us extremely cautious.
In time we will discover answers to these questions.
In the meantime, what do we know?
As of today (May 24,) we know it has killed close to 350,000 people worldwide. We know that it has killed nearly 100,000 in the U.S. (more Americans in 3 months than the 19 years of the Vietnam war)
We know it has hit those above 60 the hardest, especially those in nursing homes, but it has also hit younger people with pre-existing medical conditions hard too. We are only now starting to see its effects on children from a multi system inflammatory illness. We know it has hit healthcare workers hard, with approximately 20% of all cases involving them.
The most important thing to remember is that there is more we are uncertain about than we are certain of.
We believe it is spread by droplets when someone speaks, coughs or sneezes (and perhaps even just breathing) and that it can live on surfaces up to 3 days. We believe that one can become infected by breathing the virus in, or by touching an infected surface then touching our mouth, nose or eyes. Studies indicate this is a significant source of spread for about 6 feet around a person. We believe the virus is in feces. We believe that people can have this virus and spread it before they have symptoms and that some people may have the virus and either never develop symptoms or have symptoms so mild that they may not notice them. Some studies have shown it can remain airborne for up to 3 hours in some conditions and spread as far as 27 feet. We know that soap and water, or alcohol based hand cleaners will kill the virus.
Open for business
As we start to reopen for business, understanding the little we do know and keeping up with reliable new information is important.
On that mater, I must stress this and I cannot stress this enough.
Please to not rely on Face Book, Twitter, our your neighbor for Covid information. Please do not try the “next miracle,” “Cure,” or “prevention,” and don’t follow the leads of non-medical people like politicians or business executives, who all have their own agendas. Please, please, please consult multiple reputable medical resources to inform yourself.
As decisions are made on how to reopen, they should be done with heavy consultations from medical personnel and front line workers. Perhaps we should ask the bedside nurse if she has thoughts on what happens if we get another spike. Perhaps teachers and school support staff should be consulted on what will work or not work in the “new classroom.” The same goes for all industries and settings.
We also have to be ready and willing to scale back reopening plans IF there is a rise in cases or hospitalizations.
We must have the capacity to test and trace outbreaks so we can contain them and we must, must, must have sufficient PPE to protect our frontline workers who are now using inadequate PPE, reusing it for multiple patients and multiple days, and becoming sick themselves and passing the virus to others.
To mask or not to mask- is that a question?
Like most of the world, I have learned more about face masks in the past few months than I ever wanted to know.
Cloth masks, surgical masks, level one, two and three masks, N95s, N100s, elastomeric respirators, and PAPRs.
In fact N95 and Wuhan are now a recognized words in normal conversation, something we couldn’t have said last year.
The breath you see when you speak on a cold day is small respiratory droplet that we expel when breathing or speaking. Those droplets are expelled on a warm day too, we just don’t see them.
Since we believe that coughing, sneezing, and speaking can spread this virus and since some studies indicate that breathing can also, and since we believe we can contract the virus by breathing it in, masks are important.
The CDC has relaxed masks guidance in healthcare settings based a on availability but their guidance has always (and remains) that N95 or better respirators should be used when available by healthcare workers when caring for Covid-19 patients or suspected patients. Since people can spread this virus even without symptoms, EVERYONE is a suspected carrier. We also believe that the risk of infection is greatest writhing 6 feet and the risk of contracting Covid increases with each potential exposure.
Healthcare workers work within 6 feet of patients and have an incredibly high number of exposures in a day/week/month.
We also know that a respirator filters smaller airborne particles than a mask. (N95s filter 95%) We also know that respirators like N95s or better provide a better seal against droplets than a surgical or other mask.
All of this is the basis for the belief that healthcare workers should use N95 respirators or better.
What about the rest of us, when we are out and about? Do we need surgical or cloth masks?
First let’s look at what a surgical or cloth mask does.
This story that someone told me explains it fairly well.
If you are worried about someone pissing on your leg you can put on a pair of pants. That will block some of the urine. Or, they can put on a pair of pants and that will block all the urine.
If you wear a cloth or surgical mask, it will block some of the droplets from others, but it will block almost all of the droplets from you to another. Since you could be a carrier without knowing it, you wear the mask primarily to prevent spread to another (which seems like the right thing to do to me)
Closing thoughts.
What we know clearly is that we continue to learn about this Virus, how it spreads and how to protect ourselves. Much research continues and we may develop a vaccine at some point. In the meantime, we should take all possible precautions to protect each other. Our lives depend upon it.
First off, I’m no expert. I’m not an epidemiologist or a virologist. But I am a nurse and I did work in an emergency room for 21 years. I was involved in the training and development of best practice guidelines for the Ebola response, and we underwent hazmat training in the emergency department for the possibility of chemical spills, radiation leaks, and the like.
We have been tracking this virus since we first heard of it in Wuhan. I’ll admit, at first I through it would be much like SARS 1, MERS, or Ebola and be contained to certain parts of the globe.
Like so many of us, I was wrong.
This Virus seems to be incredibly contagious and carries a high mortality rate. At the same time, we have no vaccine to protect us and are just now learning how to treat it. Add to this is the fact that we are not sure how it spreads, what the long term effects might be on the body, whether it will have a second wave or even become seasonal. All this makes it extremely worrisome and should make us extremely cautious.
In time we will discover answers to these questions.
In the meantime, what do we know?
As of today (May 24,) we know it has killed close to 350,000 people worldwide. We know that it has killed nearly 100,000 in the U.S. (more Americans in 3 months than the 19 years of the Vietnam war)
We know it has hit those above 60 the hardest, especially those in nursing homes, but it has also hit younger people with pre-existing medical conditions hard too. We are only now starting to see its effects on children from a multi system inflammatory illness. We know it has hit healthcare workers hard, with approximately 20% of all cases involving them.
The most important thing to remember is that there is more we are uncertain about than we are certain of.
We believe it is spread by droplets when someone speaks, coughs or sneezes (and perhaps even just breathing) and that it can live on surfaces up to 3 days. We believe that one can become infected by breathing the virus in, or by touching an infected surface then touching our mouth, nose or eyes. Studies indicate this is a significant source of spread for about 6 feet around a person. We believe the virus is in feces. We believe that people can have this virus and spread it before they have symptoms and that some people may have the virus and either never develop symptoms or have symptoms so mild that they may not notice them. Some studies have shown it can remain airborne for up to 3 hours in some conditions and spread as far as 27 feet. We know that soap and water, or alcohol based hand cleaners will kill the virus.
Open for business
As we start to reopen for business, understanding the little we do know and keeping up with reliable new information is important.
On that mater, I must stress this and I cannot stress this enough.
Please to not rely on Face Book, Twitter, our your neighbor for Covid information. Please do not try the “next miracle,” “Cure,” or “prevention,” and don’t follow the leads of non-medical people like politicians or business executives, who all have their own agendas. Please, please, please consult multiple reputable medical resources to inform yourself.
As decisions are made on how to reopen, they should be done with heavy consultations from medical personnel and front line workers. Perhaps we should ask the bedside nurse if she has thoughts on what happens if we get another spike. Perhaps teachers and school support staff should be consulted on what will work or not work in the “new classroom.” The same goes for all industries and settings.
We also have to be ready and willing to scale back reopening plans IF there is a rise in cases or hospitalizations.
We must have the capacity to test and trace outbreaks so we can contain them and we must, must, must have sufficient PPE to protect our frontline workers who are now using inadequate PPE, reusing it for multiple patients and multiple days, and becoming sick themselves and passing the virus to others.
To mask or not to mask- is that a question?
Like most of the world, I have learned more about face masks in the past few months than I ever wanted to know.
Cloth masks, surgical masks, level one, two and three masks, N95s, N100s, elastomeric respirators, and PAPRs.
In fact N95 and Wuhan are now a recognized words in normal conversation, something we couldn’t have said last year.
The breath you see when you speak on a cold day is small respiratory droplet that we expel when breathing or speaking. Those droplets are expelled on a warm day too, we just don’t see them.
Since we believe that coughing, sneezing, and speaking can spread this virus and since some studies indicate that breathing can also, and since we believe we can contract the virus by breathing it in, masks are important.
The CDC has relaxed masks guidance in healthcare settings based a on availability but their guidance has always (and remains) that N95 or better respirators should be used when available by healthcare workers when caring for Covid-19 patients or suspected patients. Since people can spread this virus even without symptoms, EVERYONE is a suspected carrier. We also believe that the risk of infection is greatest writhing 6 feet and the risk of contracting Covid increases with each potential exposure.
Healthcare workers work within 6 feet of patients and have an incredibly high number of exposures in a day/week/month.
We also know that a respirator filters smaller airborne particles than a mask. (N95s filter 95%) We also know that respirators like N95s or better provide a better seal against droplets than a surgical or other mask.
All of this is the basis for the belief that healthcare workers should use N95 respirators or better.
What about the rest of us, when we are out and about? Do we need surgical or cloth masks?
First let’s look at what a surgical or cloth mask does.
This story that someone told me explains it fairly well.
If you are worried about someone pissing on your leg you can put on a pair of pants. That will block some of the urine. Or, they can put on a pair of pants and that will block all the urine.
If you wear a cloth or surgical mask, it will block some of the droplets from others, but it will block almost all of the droplets from you to another. Since you could be a carrier without knowing it, you wear the mask primarily to prevent spread to another (which seems like the right thing to do to me)
Closing thoughts.
What we know clearly is that we continue to learn about this Virus, how it spreads and how to protect ourselves. Much research continues and we may develop a vaccine at some point. In the meantime, we should take all possible precautions to protect each other. Our lives depend upon it.
Be well,
John
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