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COVID-19

This article is adapted from the message Dr. Eswara sent to his Spring 2020 General Microbiology students. Periodic updates will be added at the end of this page. Scroll to the bottom of the page for relevant infographics and other informative animations.

Disclaimer: This is Dr. Eswara's personal view as a Microbiologist. This article is intended to dispel misinformation and inform the readers who are getting mixed messages from several media sources. Things written here are neither comprehensive nor current (as the news regarding COVID-19 are rapidly evolving) and therefore should only be used as an educational resource. The readers are expected to pay attention to the public health announcements and act accordingly.
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March 14, 2020

Dear readers,

COVID-19 is considered a pandemic since March 11.

First of all, there is no need to panic! We have more knowledge about epidemiology, resources such as advanced modeling now than 100 years ago when the 1918 Influenza Pandemic killed approximately 50 million people. Here is an article that describes that time period in Florida. Although summertime minimizes the spread of many seasonal viruses, it is not yet clear if that would be the case with this SARS-CoV2 coronavirus that causes COVID-19. So we may be in this for the long haul (hope not!).

Are we all going to die because of this pandemic?
No! Most of the infected develop only mild symptoms (meaning no need for hospitalization; could still be bad). Here is a simplified cartoon that describes the infection mechanism. The severely affected populations are older adults (especially 60+, see age-groups graph below) and people with diabetes, lung, and/or heart diseases. So chances are most of you will be just fine, even if infected. It is possible that some may experience irreversible reduced lung function. There are reports of young people showing serious conditions emerging from Italy, so don’t take the warnings lightly. For reasons that are still unclear, surprisingly and thankfully, children even with immature immune system are largely spared. Although less likely, the data is not clear regarding transmission between humans and pets.

Why are schools and universities closing?
It is a social distancing measure which is used to flatten the curve, see the animated infographic below and this associated article for more information. Briefly, it is to minimize the impact on underprepared healthcare facilities so our parents and grandparents can get proper care, if needed (again hope not!). Imagine a near-future week where say an underestimated 0.02% of population in the Tampa bay area (3 million) is seriously affected - that is 600 patients needing 2-week intensive care. This will easily overwhelm all the hospitals in the area and deplete the resources such as mechanical ventilators in a matter of days and leave future patients helpless. In that case, a physician may have to choose between saving the life of a 40 year old or a 70 year old. Which is what is happening in the field in Italy and we are merely few days away from reaching that emergency situation if preemptive actions are not taken and strictly followed.

What should I do?
Stay home! Avoid public gatherings. Cancel all non-essential visits to a clinic/hospital for the next few weeks. Check on your elderly relatives and neighbors via phone/online. People who are asymptomatic or in early stages of infection and/or after recovery may still shed virus, so just because someone appears healthy does not mean they are uninfectious. Make it a habit to often wash your hands with soap thoroughly. Clean your cell phone, keys, steering wheel of your car, computer keyboard/mouse, anything your hand touches frequently. Change your clothes as soon as you come back home, don’t re-wear without washing. If you cough or sneeze, to cover, use your elbow (not the palm of your hand) or a napkin (don’t reuse). Stay at least 6 feet from anyone especially people who appear sick. If you have symptoms (see the graph below for common symptoms), self-quarantine yourself for at least 14 days, take precautions to not possibly infect family members or friends. Follow these guidelines from Florida Health. Only if infected or someone close to you is infected, wear a mask to limit getting infected or spreading the virus through cough (otherwise save it for the healthcare workers). Use your best judgment, don’t overwhelm the healthcare providers unnecessarily!

What should I stock up on?
Your normal hurricane prep will do, a month-long supply of non-perishable (or perishable - loss of electricity is less likely) food, access to good water (our city water supply should be okay and unaffected), alcohol? (if over 21!), napkins/tissues, cough medicine, disinfectant wipes, not excessive toilet papers (see symptoms graph - diarrhea is not a major symptom). Prescription medicines if you need them. Possibly video games, board games, craft supplies, or anything to save you from boredom.

Other useful resources:
Here are some useful tips from WHO.
FAQs about COVID-19 from CDC.
COVID-19 cases in Florida by Florida Health.
COVID-19 cases in the US by CDC.
COVID-19 updates from USF.
If you are interested in the source of SARS-CoV2, read this article (spoiler alert: bats!).
Here is a YouTube video that explains the basics.

Stay safe and stay informed!

Best,
Prahathees Eswara
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Updates:

March 20, 2020
Useful news articles:
Trials of potential coronavirus treatments start for some existing drugs - Reuters (March 16, 2020)
First person injected with trial coronavirus vaccine in Seattle - Forbes (March 17, 2020)
A one-page, printable guide for preparing to shelter at home - Vox (March 19, 2020)
Coronavirus: the hammer and the dance - Medium (March 19, 2020)
Why the coronavirus has been so successful - The Atlantic (March 20, 2020)
Coronavirus cases strain New York City hospitals: ‘We’re getting pounded’ - The Wall Street Journal (March 20, 2020)

March 22, 2020
Hang in there! Social distancing or more accurately physical distancing (because you are still connected via social media) works, see the animation below that shows how you staying home help curb the spread of the coronavirus. Also see how Lodi province in Italy flattened the curve by enacting strict movement restriction on Feb. 23, just 2 weeks earlier than Bergamo (Mar. 8) - the speed of shutting down things is key. Although there are some encouraging development in the therapeutic options (see above links posted on March 20), they are still in the "experimental phase" and not ready for wider use at this time. The best thing you can do today and for the near future is to stay home and limit getting exposed to (or spread) the coronavirus. It is very likely there will be a "shelter in place" order soon, which would mean you can only go out of your house for bare necessities such as buying groceries or visiting a pharmacy/doctor. That is what you should have been doing anyway. Eat healthy, sleep well, exercise, and use this time wisely!

Informative articles:
Why are bat viruses so harmful to humans?
The Toughest Triage — Allocating Ventilators in a Pandemic

Watch "What Coronavirus Symptoms Look Like, Day By Day" on YouTube (or see video below)

March 26, 2020
Useful news article:
How blood from coronavirus survivors might save lives - Nature (March 24, 2020)
How the pandemic will end - The Atlantic (March 25, 2020)
Value of Diagnostic Testing for SARS–CoV-2/COVID-19 - mBio (March 26, 2020; see types of test information below)

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