March 16, 2020 — Whenever people gather, there are opportunities to spread germs.
From one recent corporate conference in Boston, where 175 people gathered, for instance, the new coronavirus spread to more than 100 people.
Although not every gathering will be so contagious, it’s impossible to know ahead of time who is going to be coughing or sneezing and remember: You don’t have to have symptoms to be infected and contagious.
That’s why the Trump administration on March 16 asked everyone to avoid gatherings of 10 or more for the next 15 days, including restaurants and bars and food courts, along with discretionary travel. It’s why more states are taking the extra step to close restaurants and bars. It’s why schools and universities are closing and why people are working from home. They want us to stay apart — “self-distancing” in their lingo. If we don’t get within 6 feet of another person, or at least lessen the number of people we let into this 6-foot zone, we will cut our chances of getting sick, says Jeanne Marrazzo, MD, a professor of medicine and director of the Division of Infectious Diseases at the University of Alabama at Birmingham.
“At this point, we’ve got nothing else, which is why people are willing to jump on board,” she says.
It’s hard to make life-altering decisions based on what may seem like a theoretical threat to those who apparently aren’t infected.
“I and many other Italians just didn’t see the need to change our routines for a threat we could not see,” Italian journalist Mattia Ferraresi wrote in a Boston Globe op-ed published over the weekend, headlined: “A coronavirus cautionary tale from Italy: Don’t do what we did.” Now, the entire nation is on lockdown. “In the end,” Ferraresi wrote, “each of us is giving up our individual freedom in order to protect everybody, especially the sick and the elderly.”
That’s the best approach right now, echoes Michael Mina, an assistant professor of epidemiology at Harvard T. H. Chan School of Public Health.
“It seems like in the U.S., people are really starting to take this seriously and we are starting to see cities empty out,” he says. “I can only hope that this is going to be beneficial to reduce the peak of the curve of this epidemic and slow it down.”
Unfortunately, there is no specific treatment for COVID-19, the disease caused by the new coronavirus, and no vaccine to protect against it, though researchers all over the world are rushing to develop both. Treatments are likely to come first, with one already being tested; vaccines could take several years to be approved and then made on a large enough scale to make a difference.
For people who think “I’m going to get it anyway, so why to bother” — yes, it’s possible that 40%-70% of the public may ultimately get COVID-19, says Seth Berkley, CEO of Gavi, the Vaccine Alliance, a nonprofit that supports the use of new and underused vaccines for low-income countries and outbreaks.
But if it’s unrestrained in the community, “then, it’s a numbers game,” he says. Several Chinese doctors died, despite being in their late 20s and early 30s. “If enough [young] people get it, there will certainly be deaths” among them, he says.
Tips and tricks aplenty
So, what does it mean to socially distance yourself? Here are some guidelines from Marrazzo, Mina, and the CDC:
- Stay at least 6 feet away from other people, if possible.
- Avoid sports arenas, theaters, museums, and other places where you are likely to come into contact with large numbers of people. The Trump administration on March 16 asked all Americans to avoid gatherings of more than 10 people for the next 15 days.
- Avoid restaurants or bars. Mina, who ordered takeout over the weekend, says that’s a better way to go. Many states are already ordering bars and restaurants to close, except for takeout and delivery.
- It may also be a good idea to stay away from hairdressers, barbers, and nail salons, for instance, because these folks have to get closer than 6 feet. Massages may be great for easing stress, but you might consider finding another path right now.
- Skip playdates, parties, sleepovers, or families visiting each other’s houses. Do not visit nursing homes, rehab centers, or assisted living facilities, as older people are at the highest risk for complications and death from coronavirus. Find virtual ways, such as FaceTime or Skype video visits, to lessen the social isolation of people in these kinds of facilities.
- Riding mass transit is a major challenge because it’s hard to stay 6 feet from other straphangers. Having fewer people go to work will help cut the risk for those who don’t have an alternative.
- WebMD Countdown: Dirtiest Things You Touch Every Day
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WebMD Countdown: Dirtiest Things You Touch Every Day
- Arm yourself with some soap and hand sanitizer, cause it’s a dirty world out there! These surfaces are just crawling with germs that can make you sick.
- Wash your hands frequently and longer than you usually do. The recommended length of time for handwashing is 20 seconds, or about as long as it takes to sing “Happy Birthday to You” through twice. Soap and water are just as good if not better than hand sanitizers. But hand sanitizers are OK to use if you can’t get to soap and running water.
- The virus can remain alive for up to 3 days on hard surfaces, meaning if you touch a metal doorknob that someone with the virus has recently touched, you could pick up the virus. (But the CDC does not consider this to be a major way the virus spreads.)
- Touch your faceless, especially your eyes and mouth.
- Don’t wear a mask unless you are sick yourself. Every available mask may soon be needed by health care workers, and masks haven’t been shown to prevent healthy people in the general public from falling ill.
- It’s important to stay healthy, so don’t forget to get enough sleep, and ease stress by exercising, talking with friends and family, and practicing your hobbies, if possible.
- Walks outside and hikes can be a good way to get exercise without coming into close contact with others.
- If you must go to the gym, wipe down equipment before and after use, but Mina thinks exercising outdoors is a much better idea, as people might emit more virus particles when they are breathing heavily.
- Keep going to the grocery store and drugstore as needed, but postpone other nonessential shopping trips.
- Purchase a 1- to a 3-month supply of prescription medications, if possible.
- Monitor information about COVID-19 in your community.
- Know the signs and symptoms of COVID-19, such as fever, coughing, and body aches. (It’s spring allergy season in some parts of the country, with trees budding, so stuffy noses maybe allergies.)
- If you think you may have COVID-19, call ahead before going to your doctor’s office or an emergency room to avoid spreading germs to others.
Be ready to hunker down a while
- If you are sick or have likely been exposed to the virus, you should take even more extreme measures, staying at home and sending others to the store and on other crucial errands on your behalf. If you live with others, you should try to isolate yourself as much as you can, staying alone in a bedroom and using a dedicated bathroom, if possible. Obviously, frequent hand-washing becomes even more important for everyone in this situation.
People over 65, those with reduced immunity — because of cancer treatment, other medications, or medical conditions that weaken the immune system — and people in contact with either of these groups need to be particularly careful.
“I realize that not everyone can do everything,” Asaf Bitton, MD, an assistant professor of medicine at Harvard Medical School, wrote on Medium. “But we have to try our absolute best as a community, starting today. It is a public health imperative. If we don’t do this now voluntarily, it will become necessary later involuntarily, when the potential benefits will be much less than doing so right now.”
- How long will we need to keep this up? Projections suggest that the U.S. is less than 2 weeks behind Italy in terms of the growth of our COVID-19 caseload.
No one can predict how quickly the danger will pass. In China, at the epicenter of the outbreak, where the virus raged out of control for weeks, the government shut down all public life and enforced quarantines beginning almost 2 months ago, and they haven’t let everyone out yet.
- President Donald Trump said at a White House news conference that experts have told him the outbreak could last until July or August. That doesn’t necessarily mean we’ll be in self-quarantine for that long. Trump said they will evaluate whether the social distancing measures need to be extended beyond 15 days at that time.
Coronavirus: What Happens When You Get Infected?
How Does Coronavirus Attack Your Body?
A virus infects your body by entering healthy cells. There, the invader makes copies of itself and multiplies throughout your body.
The new coronavirus latches its spiky surface proteins to receptors on healthy cells, especially those in your lungs.
Specifically, the viral proteins bust into cells through ACE2 receptors. Once inside, the coronavirus hijacks healthy cells and takes command. Eventually, it kills some of the healthy cells.
How Does Coronavirus Move Through Your Body?
COVID-19, the illness caused by the coronavirus, starts with droplets from an infected person’s cough, sneeze, or breath. They could be in the air or on a surface that you touch before touching your eyes, nose, or mouth. That gives the virus a passage to the mucous membranes in your throat. Within 2 to 14 days, your immune system may respond with symptoms including:CONTINUE READING BELOW
- A cough
- Shortness of breath
- Trouble breathing
- Chills, sometimes with shaking
- Body aches
- A sore throat
- Loss of taste
- Loss of smell
The virus moves down your respiratory tract. That’s the airway that includes your mouth, nose, throat, and lungs. Your lower airways have more ACE2 receptors than the rest of your respiratory tract. So COVID-19 is more likely to go deeper than viruses like the common cold.
Your lungs might become inflamed, making it tough for you to breathe. This can lead to pneumonia, an infection of the tiny air sacs (called alveoli) inside your lungs where your blood exchanges oxygen and carbon dioxide.
If your doctor does a CT scan of your chest, they’ll probably see shadows or patchy areas called “ground-glass opacity.”
For most people, the symptoms end with a cough and a fever. More than 8 in 10 cases are mild. But for some, the infection gets more severe. About 5 to 8 days after symptoms begin, they have shortness of breath (known as dyspnea). Acute respiratory distress syndrome (ARDS) begins a few days later.
ARDS can cause rapid breathing, a fast heart rate, dizziness, and sweating. It damages the tissues and blood vessels in your alveoli, causing debris to collect inside them. This makes it harder or even impossible for you to breathe.
Many people who get ARDS need help breathing from a machine called a ventilator.
As fluid collects in your lungs, they carry less oxygen to your blood. That means your blood may not supply your organs with enough oxygen to survive. This can cause your kidneys, lungs, and liver to shut down and stop working.
Not everyone who has COVID-19 has these serious complications. And not everyone needs medical care. But if your symptoms include trouble breathing, get help right away.NEWSLETTERStay Up-to-Date on COVID-19
What Else Does COVID-19 Do to Your Body?
Some people also have symptoms including:
- Liver problems or damage
- Heart problems
- Kidney damage
- Dangerous blood clots, including in their legs, lungs, and arteries. Some clots may cause a stroke.
Researchers are also looking into a few reports of skin rashes, including some reddish-purple spots on fingers or toes.
A few children and teens have been admitted to the hospital with an inflammatory syndrome that may be linked to the new coronavirus. Symptoms include a fever, rash, belly pain, vomiting, diarrhea, and heart problems. The syndrome, now being referred to as multisystem inflammatory syndrome in children, or MIS-C is similar to toxic shock or to Kawasaki disease, a condition in children that causes inflammation in blood vessels. We’re still learning about these cases.
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Coronavirus: Adults should take vitamin D, researchers say
The Government should immediately change recommendations for vitamin D supplements as a matter of urgency by urging all adults to take them during the coronavirus pandemic, according to scientists at Trinity College Dublin.
This follows evidence highlighting the association between vitamin D levels and mortality from Covid-19 produced by Dr Eamon Laird and Prof Rose Anne Kenny, who lead the Irish Longitudinal Study on Ageing.
They analysed European adult population studies completed since 1999 which measured vitamin D, and compared vitamin D and death rates from Covid-19.
The pivotal role of vitamin D in fighting viral infections is known but it can also “support the immune system through a number of immune pathways” involved in fighting Covid-19, they conclude in a study published in the Irish Medical Journal.
The correlation is so strong taking vitamin D should be advised immediately, Prof Kenny said. This was because vitamin D deficiency was common among those at risk of Covid-19 (particularly older people); there was no toxic risk from taking it at the recommended dosage level, and growing evidence of benefits.
Last week, scientists at Northwestern University in the US found those with severe vitamin D deficiency were twice as likely to experience Covid-19 complications.
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