We need to stop panicking about Covid-19.
Covid-19, otherwise known as the novel coronavirus, 2019-nCoV, and as “the coronavirus” is a mutation of a common upper respiratory infection that has been making headlines for everything from its death toll to cleared shelves at Costco.
Friends and patients alike have asked me for my opinion about Covid-19 and I thought I would write a newsletter to send out. And then it exploded into an essay.
Before we get into it I want to be abundantly clear: Covid-19 is serious. Deadly serious. You might be fine. You might catch it and feel like you only have a minor cold. Or you might catch it and spend the next four months recovering your ability to breathe.
I mention the flu A LOT in this piece. Covid-19 isn’t a “bad flu.” And to understand the difference we have to get down to basics.
Please note that since this post was published the situation in the US has changed drastically. Follow all shelter at home and stay at home orders as a necessary measure of social distancing. Don’t panic, don’t hoard, go outside for walks if you can. We’ll get through this as a country and come out stronger on the other side. <3 -3/26/2020
I didn’t want to have to write this. It’s not that I don’t want to talk about Covid-19, it’s just that I don’t want to add to the cacophony and panic surrounding its spread. But seeing my personal Facebook feed, my friends in online chat rooms, and patients in my clinic has made me realize that I need to do more than reassure people privately.
People are scared. Fear is a disease and it spreads like one. I see friends in other states buying “a couple of weeks of supplies” and I wonder if I’m a bad mom for not having rice and beans in the cupboard. But I have to ground myself in reality because I can’t be scared.
This is how the disease of fear spreads. Person A is afraid of Covid-19 and sees what is happening in Italy so she buys 48 rolls of toilet paper and 4 gallons of water. Person B isn’t afraid of Covid-19 but trusts Person A’s instincts, so he buys 48 rolls of toilet paper and 4 gallons of water. Person C isn’t concerned at all about Covid-19 but says:
“I’m not panicking either but I’m not going to allow myself to calmly walk into an empty grocery store either because I wanted everyone to calm the fuck down.”My friend, Person C
So they go to the store to stock up on items. The fear spreads.
But fear isn’t real. Anxiety isn’t real. It’s just a chain of thoughts triggering neurotransmitters and hormones making you feel and act a certain way. Your brain is tying together news stories, scuttlebutt, and snippets you hear on the train to create a story that makes you wonder if it’s safe to travel or even to go outside. That story isn’t real.
But facts are real. And these are the facts.
Coronaviruses are so named because when you look at them under an electron microscope, it looks like they have a crown:
This crown is made of proteins that bind to certain cells in our body in order to replicate. There are many types of coronaviruses that bind to cells slightly differently. These differences in how the virus binds to a cell are the difference between the coronaviruses you’ve had and never known about and the ones you’ve heard of and never want.
The ones you’ve had
I’m going to tell you something that you’ve probably not yet heard or read in all of the media buzz about “the coronavirus” that is going around.
You’ve had a coronavirus.
The statistical likelihood of you never having had a coronavirus is astronomically low. It’s estimated that about 10-30% of all colds are caused by one of four common coronaviruses.
These viruses are so common and so easy to fight off that in studies examining how the coronavirus develops, 30% of inoculated volunteers didn’t even develop symptoms. Of the volunteers that did develop symptoms, they complained of a runny nose, stuffy nose, cough, and possibly a headache.
These coronaviruses bind to the most superficial layer of your upper respiratory tract – your nose and throat. That’s why the symptoms are so mild.
Things start to get a heck of a lot more serious when a coronavirus develops the ability to bind to the lower respiratory tract.*
*This section is largely informed by ‘This Podcast Will Kill You – Episode 43 M-m-m-my Coronaviruses
SARS and MERS
SARS and MERS* are two relatively recent coronaviruses that developed the ability to bind to tissue in the lower respiratory tract. When they bind with the tissue in the lungs and replicate they cause viral pneumonia.
In addition to a cough and runny nose , SARS and MERS also have the symptoms of fever, chills, shortness of breath, chest pain, fast breathing, muscle and bone aches, and gastrointestinal symptoms like diarrhea, nausea, and vomiting.
As of April 21st, 2004 the WHO stopped updating the SARS report. SARS had a total of 8,096 cases with 774 deaths.
By November of 2019 the WHO had found a total of 2,494 laboratory-confirmed cases of MERS with 858 deaths.
If you want to dive into these two Big Name coronaviruses, I highly recommend checking out ‘This Podcast Will Kill You – Episode 43 M-m-m-my Coronaviruses. Erin Welsh and Erin Allmann Updyke do a fantastic breakdown of all the known coronaviruses including the most current outbreak. But honestly, we don’t have time to dive deeply into them because we need to get to Covid-19.
*SARS – Severe Acute Resiratory Syndrome and MERS – Middle East Respiratory Syndrome
Now that we’ve establish what a coronavirus is, lets look at the facts regarding Covid-19.
Many of the symptoms of Covid-19 are the same as the symptoms of influenza:
- night sweats
- nausea and vomiting
The same as influenza. Put a pin in that.
What’s different is the shortness of breath and chest pains caused by viral pneumonia. This infection is what leads to the scarification and long term consequences of Covid-19.
I know you want statistics about mortality rate versus recovery rate and you’re hearing all sorts of different numbers from various media sources. The reason they’re all different is because you cannot calculate the recovery rate of an outbreak until the outbreak is over.
Before an outbreak is over, recovery rates are a moving target. Anyone reporting a recovery or fatality rate instead of numbers is doing us a disservice.
As of March 10th at 1:39 PM, Covid-19 has 117,730 worldwide cases with 4,259 deaths and 64,391 recoveries. Many of these deaths occurred in China before medical experts were able to appropriately respond. As of right now, 3 of those 117,730 cases of Covid-19 are in Minnesota.
Let’s compare that to the CDC report that there have been up 49,000,000 cases of the flu this season with up to 52,000 deaths. Just this week, in the US alone, there have been 10,829 cases of the flu reported. One of them was my friend.
Covid-19 is serious and you should take it seriously. You should also take the flu seriously; it has similar symptoms and it is much more widespread.
|Worldwide cases||up to 49,000,000||117,730|
|Deaths||up to 52,000||4,259|
Here’s where it’s different
You are much more likely to get the flu than Covid-19. But if you get Covid-19 the chances of you developing life-threatening symptoms is much higher. And should you survive, you may never have the same lung capacity again.
And here’s what really sucks: you can get both the flu and Covid-19. This is a disease in addition to another disease not an either or situation. Both of these are deadly so for the sake of the at-risk groups in our society we all need to take precautions.
The at-risk groups
Again, just like with influenza, at-risk groups are:
- the elderly
- the extremely young
- the immunocompromised
- those with underlying conditions
- pregnant people
The main transmission of both influenza and coronaviruses of all kinds is by touching contaminated surfaces and through inhalation of respiratory droplets (saliva and mucus in the air from an infected patient coughing or sneezing).
This means that for both the flu and Covid-19 your best bets for prevention are to avoid crowded areas (please see the social distancing section) and to wash your hands frequently.
The good news
So, now we’ve seen that Covid-19 has over 10 times the confirmed cases as SARS did and 46 times the confirmed cases as MERS. But it only has 5 times the number of deaths of SARS and 4.9 times the deaths of MERS.
Those numbers sound terrifying but it’s actually really encouraging. While we can’t make any ratio claims until the outbreak is over, it’s looking like while Covid-19 is a heck of a lot more infectious, the proportion of those infected who have died is a lot lower than SARS and MERS.
On top of that, a preliminary study showed that 80.9% of Covid-19 cases are mild.
This is a lot of information to assimilate so let me recap:
Covid-19 is serious. The flu is too, but it’s a lot less serious. You are much more likely to get the flu, but if you do contract Covid-19 there is a much greater potential for severity.
However, since transmission is similar, by taking measures to prevent influenza you are also protecting yourself from Covid-19.
The real dangers of Covid-19
So, we’ve established what a coronavirus is and how Covid-19 is a novel mutation of a coronavirus that can impact the lower respiratory tract and that is what flips the switch from “a minor cold” to “viral pneumonia.”
We’ve established that you are much more likely to get the flu than to get Covid-19. But, since the transmission and prevention of the flu and any coronavirus is the same that means that all the same prevention measures will be effective.
This means that the actual physical danger for most Minnesotans is really small.
But there’s a completely different sort of danger that we need to address and it has everything to do with how people are reacting to news of Covid-19.
Please stop panicking
For the past week, my Facebook feed has been plastered with images of people panic buying toilet paper, bottled water, rice, beans, and other staples. While it’s always a good idea to have a moderate amount of staples on hand, this isn’t the apocalypse. As I mentioned above, this panic buying is just driving more panic.
If you wanted to make sure you have some canned goods at home just in case, that’s fine. But you don’t need to buy all the soap on the shelf and hoard hand sanitizer. Remember, fear isn’t real. Anxiety isn’t real. They just feel real.
There is a difference between panic and precaution. One comes from emotion, one comes from fact. Take some time to ground yourself in fact.
The people who profit
One thing about every outbreak that drives me absolutely insane is the people who come crawling out of the woodwork to sell snake oils and curealls. Remember in 2014 when the FDA formally reprimanded dōTERRA and Young Living for claiming their essential oils would cure ebola?
It’s the same thing with every outbreak. Someone always has a “tried and true cure” that will cost you a pretty penny.
Chinese Medicine is helping 85% of patients in China recover (because acupuncture and herbs are used alongside modern medicine in hospitals), and it can be great for building up immunity. But it’s not a cure, it’s not magic, and it’s not guaranteed.
What you can do
If you’ve been around this blog any length of time, you know that I’m all about actionable advice. I don’t tell people who are trying to conceive or waiting to go into labor to calm down, and I’m not just going to tell you to calm down either.
What I am going to emphasize is that all of these actions are effective against any upper respiratory infection that is going around. These aren’t special Covid-19 measures, they’re the things you can do every cold and flu season.
Often the best way we as an action-oriented culture can calm down is to take action, and here are some actions you can take:
Wash your hands regularly
You should be doing this anyway during cold and flu season, every year. Wash your hands with soap and water for 20 seconds regularly throughout the day.
Washing your hands at the sink is more effective than hand sanitizer. A huge part of handwashing isn’t the soap, it’s the mechanical action of one hand against the other that removes debris.
Practice good respiratory hygeine
Cover your mouth when you cough or sneeze. If you have a cold, the flu, or Covid-19 this won’t be preventative for you but it is preventative for everyone else around you.
Remember the vampire cough. Coughing into your elbow is the most effective way to keep potentially infectious material off your hands so that you won’t spread it to surfaces through touch.
Dispose of tissues immediately after use. Don’t store them in your pocket for later use. And I know it’s not zero waste but don’t use a handkerchief, especially if you suspect that you’re contagious.
Preventative medicine for cold and flu season
Whatever you do for any cold and flu season is going to be good for this season, too. Some people use elderberry syrup, some people do vitamin C, some people do herbal decoctions, and some people get acupuncture.
Whatever has worked for you in the past will work for you now. Rest often, eat good quality food, stay hydrated, and lightly exercise; all of this supports immune function.
Regularly wipe down surfaces and frequently touched items in your home
While we don’t know how long Covid-19 can live on surfaces,* we do know that influenza can live on hard surfaces for up to 48 hours. Regularly wipe down your phone screen, door handles, light switches, steering wheel, and other hard surfaces.
3/18/2020 – recent studies show that it may be able to live 36-48 hours on hard surfaces
This section wasn’t in the original published draft of the essay. I thought about adding it but I felt like the piece was getting too long. But I can tell you that it is 12:30 AM and I’ve been unable to sleep because of that decision.
Wash your hands. Wipe down your surfaces. Cover your mouth, yes. That’s all well and good.
But just like you should be doing but probably never do during a bad flu outbreak: avoid crowded spaces. In fact, medical experts in foreign countries most affected by Covid-19 are recommending avoiding gatherings of more than 20 people.
And because of the more severe consequences of Covid-19 they’re also recommending school closures and travel restrictions. This is why since writing this post the U of M has shut down, Trump restricted travel from Europe, and the NBA cancelled it’s season.
Why? We need to flatten the curve.
Flattening the curve
By taking all of the measures mentioned above what we can do is potentially limit the amount of cases that develop . Even if you can’t limit the number of cases, you can limit the rate at which they occur which means the medical systems won’t get overwhelmed.
We are no longer at a point where it’s sufficient to tell at-risk populations to avoid crowds and wash their hands. With both Covid-19 and influenza on the table if you have the financial capability to stay at home, you have the social responsibility to do so.
Standard clinic precautions
Did you know that, for the most part, if you’re:
- have diarrhea
- have a fever
- are managing symptoms with OTC medications or at home herbal supplements
- and you’re not getting worse
…that every clinic everywhere wants you to stay home? That goes for my clinic, your doctor’s office, the Minute Clinic, and urgent care.
Even if symptoms are mild, you’re still contagious. And since a cold, a mild flu, and a mild case of Covid-19 all look very similar and can be managed at home it’s best if you didn’t come in.
If you have questions about whether or not you should be going in, call the office. They can help you decide. But remember, we’ve got to flatten the curve and your minor cold might make someone else more vulnerable to something more serious.
Covid-19 is a very polarizing topic. People are either in the Apocalypse camp or the It’s a Bad Cold camp.
Before writing this essay I was 100% in the It’s a Bad Cold camp. I thought people were overreacting and that we, as a country, were being ridiculous.
But that’s the beautiful thing about facts. Facts are neutral. They ground you to center. You can interpret facts in a way that has you leaning one way or the other but if you’re grounded in facts you’re not going to sway too far to one side or the other.
And these are the facts:
- Coronaviruses have been around for almost as long as influenza. We don’t have a vaccine for coronaviruses as we do for influenza
- Influenza is much more common and has more numerical deaths, but Covid-19 is much more severe, may have long-lasting if not lifelong ramifications for survivors, and is more deadly across all demographics than influenza
- The precautions that we should be taking for influenza are similar to precautions we can take for Covid-19
- There are certain populations that are more at risk than others, just like with the flu. If you are in a high-risk category you should be more vigilant.
- If you are in a low-risk category you should act in socially responsible ways to protect the more vulnerable members of our communities.
- 80.9% of Covid-19 cases are classified as “mild” and as of yesterday, 70% of all Covid-19 cases in China have already recovered
The fact is that the best way to get through any stressful situation is to work through your feelings back to the thoughts causing them. Break down what’s going through your head into story and fact and make as many decisions as possible from a place of rationality and not fiction.
And if you want some help teasing apart fact or fiction, let’s get on the phone. We’ll all get through this together.
This Podcast Will Kill You – Episode 43 M-m-m-my Coronaviruses
Map Dashboard of 2019-nCoV Cases by Johns Hopkins Center for Systems Science and Engineering
Featured image and cover photo by Susan Jane Golding via Flickr
Disclaimer: I am an acupuncturist in the state of Minnesota, and the information falls within my scope of practice in my state. However, unless I have directed you here as your homework I am probably not your acupuncturist. The information in this post is for general purposes only and does not constitute medical advice. As always, check with your own acupuncturist or primary care provider before making any lifestyle changes. This post does not create a patient-practitioner relationship and I am not liable for any losses or damages resulting or relating to the content in this post.
Jessica Gustafson is a licensed acupuncturist in St Paul and White Bear Lake, MN specializing in women’s health and fertility. She loves working with patients through the Health Foundations Birth Center on Grand Avenue in St Paul, at Naturally Well in White Bear Lake, and doing home visits in the Twin Cities area. Check out the services page for more information!
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