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COVID-19: Prepare, don't panic
(okay I understand if you're panicking a little)
Welcome to Not a Doctor, a newsletter about health and science. These days, I’m pretty focused on COVID-19, so you’ll see plenty of news and personal reflection on the epidemic. But I also write about everything from mental health to climate change.
Wait, who are you?
My name is Melody Schreiber, and I’m a freelance journalist based in Washington, D.C. I’ve reported from nearly every continent on the planet, which has been really cool. I’m the DC correspondent for ArcticToday, a news site for the circumpolar North, and I’m also the editor of a book about premature birth, What We Didn’t Expect, which will be published in November 2020.
What I’m not: A doctor. I’m also not a scientist, or really an expert of any kind. (Unless you count turtle enthusiasm! I am VERY enthusiastic about turtles.) I’m a journalist, so I like asking questions and following the news. But if I ever get something wrong (here or elsewhere), please get in touch so I can correct the error.
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In the News
A LOT happened over the weekend.
First, on Friday, the WHO announced that the world has topped 100,000 confirmed cases of COVID-19.
Before I go on, a quick definition of terms: COVID-19 is a viral pneumonia caused by the coronavirus SARS-CoV-2. Coronaviruses are different from, say, the flu, which is a different virus family. While the coronavirus family also includes some common colds, COVID-19 has proven way more, shall we say, intense. (Every family has that intense one.) And since it’s a brand-new-to-humans virus, no one has developed immunity to it except for those who were recently infected and survived.
As of this writing, more than 3,800 people around the world have died from the disease; by the time I send this, the number will have certainly gone up. (Check out this dashboard if you <3 numbers and graphs.)
On Saturday, Italy announced it was locking down about 16 million residents, becoming the first country after China to institute cordons sanitaires -- zones where people are prevented from leaving or entering. Although the WHO has praised aggressive techniques like this, some public health experts have warned that such measures violate international health law. (More on this in a future installment.)
In the United States, COVID-19 numbers increased dramatically over the weekend, with 500 confirmed cases and 22 known deaths.
But global health experts believe these numbers are much, much higher. In Washington state, for instance, the virus has been circulating for at least two months, researchers found; they estimate that around 1,100 people in Washington alone have the virus.
I expect these numbers to continue to rise quite a bit in the coming weeks -- honestly, I’ll be more worried if they don’t, which would mean that testing continues to be a major issue.
President Trump, in a visit to the Centers for Disease Control and Prevention (CDC) on Friday, said, “anybody, right now and yesterday, that needs a test gets a test. They’re there, they have the tests, and the tests are beautiful. Anybody that needs a test gets a test.”
Yet accounts across the United States show that this is not true. Many people have been denied tests, and local health departments still report that they have very limited test kits; in Ohio, for example, test kits only arrived over the weekend; and it’s still not clear how many tests each department is receiving. In Washington, D.C., for instance, officials say they’re able to test “dozens” of people a day. South Korea, in contrast, can do about 10,000 tests a day.
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Community transmission in D.C.
Here in Washington, D.C., we had our first confirmed case of COVID-19, and it seems to be community transmission -- meaning the patient hadn’t traveled internationally, and he hadn’t come into contact with another known case.
The man is a reverend at the Christ Church Georgetown, where he presided over services and a retreat for the past two weeks. He first developed symptoms on Feb. 23, but he was diagnosed with the flu first before later being tested for COVID-19.
This case tells us two things:
1. It’s possible that people who are showing up at their doctor’s office or local hospital with symptoms similar both to the flu and to COVID-19 are first tested for influenza. If it’s positive, it seems that’s the end of it -- the patient is sent home with a flu diagnosis.
Yet it’s possible to be infected with both at the same time, so it’s possible the flu season is masking the true extent of COVID-19 spread. Since this has been a particularly brutal flu season, I wonder if we might see some flu cases retroactively added to the COVID-19 count.
This idea first began to worry me when I read a story about a Miami man who went to the hospital after traveling to China in January and then developing symptoms. The hospital staff gave him a flu test, which was positive, and sent him home with a hefty bill. But could he have had COVID-19 as well? It’s not out of the question.
2. There is community spread of COVID-19 here in DC -- and it may have been going on for several weeks.
Let’s do a little math. Say this man developed symptoms two to fourteen days after he came into contact with it. That means he was exposed to the virus sometime between Feb. 9 and Feb. 21. If that exposure happened here in DC, and not on the business trip to Louisville that he took the day before symptoms appeared, that means the virus has been circulating in DC for at least two weeks. Also, regardless of where he first got it, for the past two weeks the man has had symptoms of COVID-19 -- meaning he was able to transmit it to others.
I focus on DC first because it’s where I live (if perhaps a little less excitedly now) but secondly because there’s nothing about this case that makes it unique to DC. It could have happened anywhere -- which tells me that it could be happening everywhere.
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It’s impossible to know what will happen in the next few days, weeks, and months. It’s important to have contingency plans in place -- if you’re able to work from home, what does that look like? If you have a kid in daycare or school, who will care for them if those centers close? I’ll get into these plans in a future installment, but it’s good to start thinking about this now.
If I had a crystal ball, I would expect work-from-home and school closure announcements to happen when there is evidence of community transmission.
So far, officials in DC have not said that the (now two) confirmed cases came from community spread, even though it seems as though they did. When they do make the official announcement, however, closures are likely to follow.
I think this could happen in our area in the next week or so (though of course I always hope I’m being pessimistic!). Things are moving very quickly, and I believe the next two weeks will be a whirlwind of cancelations and closures across the country, as community-spread cases are confirmed.
Which leads me to my next point.
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Let’s get personal
It’s time to prepare. But try not to panic.
Panic can be a useful emotion. It can alert you to danger so that you can take quick action. That’s a good thing at a time like this -- that sense of worry you feel means it’s time to start making preparations.
But when the panic begins to balloon out of control and overwhelm you, that’s when it becomes less useful -- and sometimes downright dangerous. That’s when some people might start to say, “Oh, well, I’m going to get this virus anyway, why change the way I do things?” or “We’re all doomed, humanity is screwed, let’s throw a party and go out in style.”
I get it -- oh, boy, do I get it. When I first heard of the first DC case, I felt my chest tightening in panic. I sent out too many tweets, trying to feel like I had some control by building some sort of narrative, as though understanding as much as I could about this virus and this disease would make me a little less anxious, a little less helpless. I stayed up late, working, checking the news obsessively, and when I woke up way too early (Daylight Savings Time, I’m coming for you next), I still felt overwhelmed.
I’ll be honest here. I’m not very worried about me, or my husband. We’re pretty healthy, we’re somewhat young, and we just have to hold out hope that will protect us somehow (along with safety measures, of course!) if/when we are exposed to the virus.
But I’m terrified of what will happen if my toddler gets sick. He’s not even three years old yet, but he’s already faced so much difficulty in this world. Those difficulties place him squarely in the category of vulnerability to the virus due to preexisting conditions.
Every time someone tells me “it’s okay, kids are fine with this virus,” I think of the last time he went to the hospital -- for a respiratory illness that other kids did just fine with. I think of the oxygen tubes, and the nurses and doctors swathed in personal protective equipment (PPE), and the way he just laid there in bed, his eyes on me, confident that somehow his parents would help him feel better.
What will happen if he gets sick again? What if the hospitals are overwhelmed by then?
And, of course, I’m worried about my parents, and my in-laws, and my elderly neighbors, and the people who don’t have the resources to lay low at home with a stash of food and medicine.
This kind of fear can crush you. It can grind you into the ground; it can make you feel like whatever you do is futile.
So I woke up this morning with a news hangover, far too early, reaching for my phone to read the latest updates, fear already coiled in my stomach.
And then I saw my son. He was smiling up at me, way too excited about this brand-new morning. He wrapped his little arms around my neck and gave me a kiss.
And I remembered: it’s these moments that I’m living for. I’m doing my best -- I’m doing all that I can do -- to preserve this. To continue giving this kid as happy and carefree a life as possible.
I might not always be successful. I can’t protect him from everything. Some things are entirely out of my control -- but what I can control is the way I react. I can set the phone down. I can put a smile on my face, I can wrap my kid up in a hug, and I can give him a kiss too. And I can try to file this perfect moment away in my mind for the next time I feel the panic rising.
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Tomorrow, I’ll share some tips on how to prepare.
I’m planning to host a Q&A later this week, but if you have any questions, concerns, feedback, or cute stories about kids and/or animals, please reach out to firstname.lastname@example.org.
In the meantime, if you know someone who might appreciate this newsletter, please feel free to forward it to them!