My name is Dr. Daniel Ketterer, and I am an Infectious Disease physician practicing in Atlanta, Georgia. My purpose in writing this guide is to address some of the most pertinent questions regarding SARS-CoV-2 / COVID-19, and to provide guidance for what you can do to help your family and society.
This guide is for educational purposes, and is designed to be a primer on SARS-CoV-2/COVID-19 for the layperson. It is not intended to provide individualized medical advice or replace the advice of your physician. This guide features Level 1 and Level 2 learning. Each question will have a concise and correct Level 1 answer. On some questions, there will be a link to the Level 2 explanation after the Level 1 response. Level 2 responses will be longer and more detailed, but no less essential. If you have time, try to read the Level 2 explanations. By breaking the guide up in this way, I can get the most important points for a variety of topics quickly, and the rationale behind my statements and opportunities to learn will also be available to those interested.
This guide is as current as of the revision date above. Science changes with new information, and I recommend regularly reviewing WHO, NIH, and CDC and your local health department websites.
Please share this guide on Facebook by hitting the “Share” button below. As I update the guide in the future, the shared posts will also automatically update so you are sharing the most current version at all times. If you have friends with large social-media footprints, or friends with access to celebrities, encourage them to read and share this guide.
I will not be able to respond to questions posted either in the comments or via messenger. If you think you are experiencing symptoms of COVID-19 contact your physicians office via phone or telemedicine routes or call 911 if you are experiencing shortness of breath.
I am also OK with re-posting this guide on other social media platforms or websites with a few caveats. Please copy the entire guide and make sure to update it as new versions come out. Also, please do not monetize it in any way. Everyone involved in this project is a volunteer that cares about saving lives through education, and this message is too important to have motivations questioned.
With education and a rational, evidence-based approach, we will save lives together.
Daniel Ketterer M.D.
Follow @pusdoctorThe 3 known to cause serious illness are:
Using HIV as an analogy:
HIV is the virus that can cause the clinical syndrome known as AIDS; likewise, SARS-CoV-2 is the virus that can cause the clinical syndrome known as COVID-19.
COVID-19 is very different and much more serious than seasonal influenza.
Unlike seasonal influenza:
Unfortunately, some of the symptoms of seasonal allergies can mimic COVID-19. However, there are some useful (but not 100% conclusive) aspects to consider:
Ultimately, none of the three above tips are entirely foolproof, and social distancing and testing are still advised.
The majority of cases are spread 2 ways:
Droplet respritory transmission:
This is the primary method the virus is spread. This means the infectious virus particles found in the respiratory secretions of those infected with SARS-CoV-2 are being transmitted when in close contact with an uninfected person. If these secretions get in the mouth, nose, or eyes of an uninfected person, they can be infected. Specific activities responsible for droplet transmission include:
Fomite transmission:
Fomite transmission means an environmental surface gets contaminated with virus from an infected person’s respiratory droplets, an uninfected person touches that surface, then touches their mouth, nose, or eyes. An example of fomite transmission would be an uninfected person touching a tissue someone with COVID-19 recently sneezed into, and then that uninfected person touching their mouth, nose, or eyes. Of note, this is thought to be a possibility of infectious spread, but likely much less so than droplet respiratory transmission.
Level 2 Fomite
𝗖𝗹𝗼𝘀𝗲 𝗖𝗼𝗻𝘁𝗮𝗰𝘁 𝗧𝗿𝗮𝗻𝘀𝗺𝗶𝘀𝘀𝗶𝗼𝗻
Most of the transmission is occurring between family members and 𝗽𝗿𝗼𝗹𝗼𝗻𝗴𝗲𝗱 close contacts. This includes churches or spaces where people congregate close for prolonged periods of time like around the dinner table. Health care workers taking care of COVID-19 patients without eye protection and a droplet mask are also at high risk.
𝗜𝘀 𝗙𝗼𝗺𝗶𝘁𝗲 𝗧𝗿𝗮𝗻𝘀𝗺𝗶𝘀𝘀𝗶𝗼𝗻 𝗮𝗰𝘁𝘂𝗮𝗹𝗹𝘆 𝗼𝗰𝗰𝘂𝗿𝗶𝗻𝗴?
Other viruses similar to SARS-CoV-2 have had conclusive evidence of fomite transmission, which is why this is thought to be a possible method of transmission, and mentioned as a plausible route of transmission by CDC, NIH, and WHO. However, the role of fomite transmission in cases of COVID-19 is still unclear and it’s believed most transmission is due to person-to-person spread via droplets.
The CDC estimates that somewhere between 5-13% of new COVID-19 infections occurred from 𝗽𝗿𝗲-𝘀𝘆𝗺𝗽𝘁𝗼𝗺𝗮𝘁𝗶𝗰 individuals. Pre-symptomatic transmission means an individual is infected with the virus and infecting others, but has not yet had any symptoms of COVID-19. This typically occurs in the first week after being exposed.
Asymptomatic transmission implies a person is infected with SARS-CoV-2 and does not develop any symptoms of COVID-19 at any point, but is still spreading the virus. This is uncommon, and is thought to account for 1-3% of cases of COVID-19.
There is no evidence at this time to suggest any cases have been due to airborne transmission.
Level 2 Masks
Masks are best intended for 2 groups right now:
1)Those who have COVID-19 infection.
2)Those in the healthcare field or caretakers in prolonged contact with confirmed or potential COVID-19 patients.
The CDC has also recently advised the public use a cloth mask 𝗶𝗳 𝗶𝗻 𝗮 𝘀𝗶𝘁𝘂𝗮𝘁𝗶𝗼𝗻 𝘀𝗼𝗰𝗶𝗮𝗹 𝗱𝗶𝘀𝘁𝗮𝗻𝗰𝗶𝗻𝗴 𝗰𝗮𝗻𝗻𝗼𝘁 𝗯𝗲 𝗲𝗺𝗽𝗹𝗼𝘆𝗲𝗱 (such as a crowded grocery store) as it 𝗺𝗮𝘆 reduce pre-symptomatic and asymptomatic transmission of the virus. The CDC is very clear that the pubic 𝗻𝗼𝘁 use N95 or surgical masks as they are needed for health-care workers and those sick with COVID-19.
Even if one is utilizing a cloth mask, the data that cloth masks are effective personal protection equipment is poor. When using a cloth mask, social distancing and regular hand hygiene must still be employed to reduce spread of the virus.
Those working in healthcare facilities should wear masks while at work.
Social distancing of a minimum of 6 feet while in the community should be your primary method to prevent transmission, and reduce pre-symptomatic and asymptomatic spread of the virus.
Level 2 Airborne
As of the time of this publication, there are 𝗻𝗼 known cases of COVID-19 that have been linked to airborne transmission. The WHO has investigated almost 75,000 cases of COVID-19 and 𝗱𝗶𝗱 𝗻𝗼𝘁 find a single case due to airborne transmission. https://www.who.int/…/modes-of-transmission-of-virus-causin…
Like everything in science, this could change with new information. This statement was based on the number of cases analyzed and that the 2003-2004 SARS-CoV-1 outbreak was also droplet and fomite transmission in all cases except 1. Additionally, if this virus was transmissible via airborne means, we would likely see each person with COVID-19 causing more infections than we are seeing right now.
𝘋𝘳𝘰𝘱𝘭𝘦𝘵 𝘛𝘳𝘢𝘯𝘴𝘮𝘪𝘴𝘴𝘪𝘰𝘯 𝘷𝘴. 𝘈𝘪𝘳𝘣𝘰𝘳𝘯𝘦 𝘛𝘳𝘢𝘯𝘴𝘮𝘪𝘴𝘴𝘪𝘰𝘯 𝘰𝘧 𝘐𝘯𝘧𝘦𝘤𝘵𝘪𝘰𝘯𝘴
As stated above, droplet transmission of a virus occurs when respiratory secretions containing coronavirus are coughed, sneezed, or breathed out. These droplets are a variety of sizes and the majority of droplets tend to fall to the ground within 6 feet, which is why 6 feet is ideal for social distancing.
𝗔𝗶𝗿𝗯𝗼𝗿𝗻𝗲 𝘁𝗿𝗮𝗻𝘀𝗺𝗶𝘀𝘀𝗶𝗼𝗻 implies the virus-containing respiratory droplets are able to stay floating in the air for a period of time. Droplets that can do this represent the smallest of droplets we can produce via our airways. Most of the droplets we produce by breathing, coughing, or sneezing that contain the SARS-CoV-2 virus, tend to fall to the ground quickly and within about 6 feet of the infected person.
Contrast this with measles, which can stay in the air for up to 2 hours after an infected person has left a room. This virus-laden air can infect those without immunity by just breathing it in. This highlights the importance of universal measles vaccination for everyone who can safely receive it. Another important factor separating measles from SARS-CoV-2 is “infectious dose.”
𝗜𝗻𝗳𝗲𝗰𝘁𝗶𝗼𝘂𝘀 𝗱𝗼𝘀𝗲 is how much of a virus has to get to its target cells to cause a disease. The lower the infectious dose, the more likely one is to get disease after being exposed. The infectious dose of measles is low, and those who are sick with it tend to shed lots of the virus, which is why non-immune individuals in close contact are very likely to get the disease. We do not know what the infectious dose of SARS-CoV-2 is at this time.
There is a possibility that the severity of disease of COVID-19 may in part correlate with how much or how many times one was exposed to the virus. This could explain why health care workers in China early in the disease, even if they were young and healthy, were more likely to have severe disease or die. They were not using personal protective equipment in the care of these early patients and may have been repeatedly exposed to high levels of the virus. This theory is currently being evaluated.
Conversely, being exposed to very low quantities of SARS-CoV-2 may not cause COVID-19, as the virus may not be viable or your immune system response may quickly take care of the infection.
𝘚𝘰 𝘯𝘰𝘸 𝘵𝘩𝘢𝘵 𝘺𝘰𝘶 𝘶𝘯𝘥𝘦𝘳𝘴𝘵𝘢𝘯𝘥 𝘸𝘩𝘢𝘵 𝘢𝘪𝘳𝘣𝘰𝘳𝘯𝘦 𝘷𝘴 𝘥𝘳𝘰𝘱𝘭𝘦𝘵 𝘵𝘳𝘢𝘯𝘴𝘮𝘪𝘴𝘴𝘪𝘰𝘯 𝘪𝘴 𝘢𝘯𝘥 𝘵𝘩𝘢𝘵 𝘵𝘩𝘦𝘳𝘦 𝘪𝘴 𝘯𝘰 𝘦𝘷𝘪𝘥𝘦𝘯𝘤𝘦 𝘰𝘧 𝘢𝘪𝘳𝘣𝘰𝘳𝘯𝘦 𝘵𝘳𝘢𝘯𝘴𝘮𝘪𝘴𝘴𝘪𝘰𝘯 𝘢𝘵 𝘵𝘩𝘪𝘴 𝘵𝘪𝘮𝘦, 𝘸𝘩𝘺 𝘦𝘹𝘢𝘤𝘵𝘭𝘺 𝘪𝘴 𝘵𝘩𝘪𝘴 𝘪𝘮𝘱𝘰𝘳𝘵𝘢𝘯𝘵?
1)If this virus is transmitted through airborne transmission, the methods we are currently employing to slow the spread of the virus would not work.
If the virus can cause infection in the air for up to 2 hours, like measles, then any enclosed space, even if there are no people in it, could become a potential vector of transmission if an infected person was previously in that space. This means that all public transit would be shut down, social distancing won’t work, and it will create even more panic and fear. Thinking of infection as inevitable, people would stop social distancing and pay less attention to appropriate hand hygiene, which will rapidly spread the virus. Stating there is airborne transmission, when we have evidence that it is not occurring, is extremely dangerous.
2) Airborne vs. droplet transmission affects what types of masks are needed.
With airborne transmission diseases like measles or tuberculosis, the infectious agent lives in the smallest respiratory droplets and their infectious dose is very low. Health care workers and uninfected family members taking care of these patients need to have protection to keep them from breathing in the small droplets. To that end, they need a mask with a tight seal around their face that also will filter a large number of these infectious particles out. This is where the N95 and similar high-filtration masks come into play. An N95 mask means a mask filters 95% of all particles larger than 0.00003 centimeters in diameter, which should block enough of the virus-containing droplets in the air to prevent infection from diseases that spread via airborne routes. An N95 mask is only as good as its fit, and if it is not “fit-tested” to make sure there are no leaks in the seal, it might not be effective in preventing airborne transmitted diseases.
As an additional precaution, airborne transmission patients are put in “negative-pressure” rooms, which pump air out of the room so that when someone opens a door, air comes in from the outside, and air containing infectious particles doesn’t leave the infected person’s room.
For taking care of patients with droplet transmitted diseases like COVID-19, a simple surgical face mask (the rectangular masks with 2 loops for your ears), along with eye protection in the form of a face shield or goggles, and a disposable gown and gloves, in concert with effective hand-washing before and after utilizing the aforementioned personal protective equipment, is sufficient.
We in the health-care community are taking extra precautions by requiring N95 masks for healthcare personnel taking care of COVID-19 patients 𝗼𝗻𝗹𝘆 if the infected person is receiving procedures that run the risk of aerosolizing the virus. These procedures include placing a breathing tube down the throat or providing nebulizer treatments which can create high amounts of virus-containing aerosols which could potentially stay in the air and infect others. This is very different from the human-to-human transmission that would be seen outside of ICU settings.
3)There is 𝗻𝗼 need for the public to use N95 masks to protect themselves from SARS-CoV-2.
Healthcare providers working with COVID-19 patients that may be generating aerosols, and other airborne transmission diseases, like tuberculosis, require an N95 mask for adequate protection. Healthcare facilities are experiencing such severe shortages of N95 masks that they are now being rationed and used for multiple days. The only time N95 masks are needed for COVID-19 is for healthcare workers during aerosol-generating procedures. There is not a reason for 𝗮𝗻𝘆𝗼𝗻𝗲 in the general public, neither the sick in self-quarantine, nor the folks caring for the sick at home, to use N95 masks. If you are caring for an individual with COVID-19, a simple surgical mask, gloves, eye protection, and washing your clothes and hands after being in close contact is sufficient to protect yourself.
Regarding the New England Journal of Medicine article that states that the virus lives in the air for 3 hours, that study used a nebulizer to create aerosols laden with the virus. This 𝗱𝗼𝗲𝘀 𝗻𝗼𝘁 represent how the disease is spread from human to human and 𝘀𝗵𝗼𝘂𝗹𝗱 𝗻𝗼𝘁 be used as evidence to state this is an airborne disease. Other papers have also recently come out showing in rare circumstances, the virus was found in the air in some hospital settings, however, there were no cases of human infection linked to breathing that air for those in those settings, which may mean the virus isn’t viable to cause infection or the infectious dose is too low.
There has been evidence in SARS-CoV-2 of small amounts of virus briefly staying in the air in a small amount of samples taken in hospitals but this has been shown to be rare and their role in causing infection is not thought to be significant.
To reiterate, all major global health organizations right now are in agreement at this time that there is 𝗻𝗼𝘁 𝗮𝗶𝗿𝗯𝗼𝗿𝗻𝗲 𝘁𝗿𝗮𝗻𝘀𝗺𝗶𝘀𝘀𝗶𝗼𝗻 of SARS-CoV-2/COVID-19.
It is recommended that until we have large scale testing kit availability 𝗮𝗻𝗱 a way to test people without putting uninfected persons at risk, those with mild symptoms (fever, cough), and who do not have the high-risk factors mentioned in the previous question should stay at home and self-quarantine.
Testing ability has increased in many major cities, but some areas are still struggling with demand. If you are concerned that you or a loved one may have COVID-19, and have risk factors for severe disease, I recommend contacting your physician’s office to set up a telemedicine appointment to see if you should be screened for COVID-19.
Individuals in high risk fields for both acquisition and transmission (such as health care workers), should also consider testing if they become symptomatic. Finally,those with worsening shortness of breath symptoms or high risk of developing severe disease should seek testing.
𝗧𝗲𝘀𝘁𝗶𝗻𝗴 𝘁𝘆𝗽𝗲𝘀:
𝟭)𝗧𝗵𝗲 𝘀𝘄𝗮𝗯 𝘁𝗲𝘀𝘁
The first test developed uses a swab sample from the inside of the nose and the back of the throat of a suspected infected person. The swabs are processed using a technology called RT-PCR to see if they can detect the genetic material of the SARS-CoV-2 virus in the specimen. Additionally, many facilities are also testing for influenza and other respiratory pathogens that mimic COVID-19. The RT-PCR test can take anywhere from hours to days to get a results.
Update 4/7-rapid RT-PCR testing (swab tests) has now been approved in the US which can give results in under 30 minutes and often in 15 minutes. I don't have any info yet on the accuracy of this test and suspect it will have the same limitation as the conventional swab tests.
𝟮)𝗧𝗵𝗲 𝗯𝗹𝗼𝗼𝗱 𝘁𝗲𝘀𝘁
As of April 1st 2020, the FDA now allows the use of a second, rapid blood test. This test detects proteins your body makes in response to infection with the SARS-CoV-2 virus called antibodies. It also will provide results in 15-20 minutes.
Additionally, the antibody test has an added advantage, it will detect if someone has already had the disease and recovered from it. If antibodies confer immunity to the virus. these people can safely return to work without worrying about getting infected or getting others sick. It is not yet known exactly how efficacious the antibodies we make are in preventing re-infection or how long they last in our body. I will go into this more in a later section.
The swab and blood test, if positive, confirms that a person has been infected with the virus.
However, both tests can be falsely-negative early in the disease, usually before symptoms start.
Level 2 Testing Limitations
A negative swab or blood test does not rule out infection with the virus. 𝗙𝗮𝗹𝘀𝗲-𝗻𝗲𝗴𝗮𝘁𝗶𝘃𝗲 𝘁𝗲𝘀𝘁𝗶𝗻𝗴 can happen even if the person has been infected with the virus.
1) The individual is tested early after exposure and not enough virus is present on the swabs to meet the cutoff of a positive test.
2)The swabs are not obtained correctly. This can happen by using the incorrect swab type, or not swabbing deep enough in the nasopharyngeal or oropharyngeal cavities where the virus tends to congregate.
3)The test kit itself having problems. This happened with the first batch of swab tests in the US, leading to inconclusive results. This is much less likely to be a factor now as the first two on this list.
4)If someone has a medical condition or is taking medication that suppress antibodies, the blood test can be negative.
Both the swab test and the blood test suffer being falsely negative early in the disease. This is why using 𝗯𝗼𝘁𝗵 tests and 𝗿𝗲𝗽𝗲𝗮𝘁𝗶𝗻𝗴 negative tests after a few days may be beneficial.
There are 𝗻𝗼 recommended medications right now for SARS-CoV-2/COVID-19. All medications currently being used are being used on an experimental and compassionate-use basis and do not have robust clinical trial data to show efficacy against COVID-19.
This includes treatments that have been touted in the media to be effective against SARS-CoV-2 such as chloroquine/hydroxychloroquine, remdesivir, and IL-6 blockers like tocilizumab.
Many medications have shown potential to stop the virus in laboratory settings, but this does not always reflect how well a drug will do at stopping an infection in the body.
Additionally, hoarding of these medications has occurred, limiting the ability to use them on severe COVID-19 patients for clinical trials. Some people using these medications without physician guidance have developed toxicities or died.
As treatment guidelines are developed, I will update the guide with their recommendations.
The first vaccine against SARS-CoV-2 went into human testing on 3/16.
However, this vaccine has to be tested extensively for safety and manufactured on a large scale. The earliest a vaccine is expected is in the first half of 2021.
If you were either:
You may be eligible to enroll in a medication study conducted by the University of Minnesota in which you are sent hydroxychloroquine or placebo.
For details and to sign up for this clinical trial, please visit UMN Clinical Trial
Medication trials like this one are how researchers will determine which treatments are effective for COVID-19.
Early in the pandemic, the risk of family members getting COVID-19 was about 10%. However, by utilizing social distancing, mask wearing for the sick, and cleaning surfaces, the risk of a family member getting COVID-19 drops to about 3%.
This is why it is absolutely critical to have a plan ready based on guidance from the CDC, WHO, and NIH on how to care for sick individuals in case a family member gets COVID-19.
This result depends on your employer's guidelines and advice from your physician.
Guidance on criteria for returning to work will update based on testing availability, particularly if the rapid blood testing is widely available and if it is shown we develop protective immunity after exposure.
The CDC does provide some guidance on this, but please note, the link below is intended for healthcare providers as the intended audience.
Soap and water is very effective against the virus and can be used for hand hygiene and for cleaning surfaces.
Additionally, you can make your own bleach wipes at home using the following recipe: Mix 1/3 cup of bleach per gallon of water. You can then use paper towels soaked in the solution to make your own disinfectant wipes. Always remember to use gloves and wear eye protection for splashes, and to only use in well-ventilated spaces.
This is very unlikely to occur.
Level 2 Pets
Researchers recently have been exposing dogs and cats to the virus to see what happens. Current data suggests dogs are resilient to the virus. Cats may be able to be infected, but don't develop disease symptoms and are unable to infect other cats.
This suggests cats and dogs aren’t good at spreading the actual infectious virus.
If you want to be extra cautious while this is still being researched, if you are sick, try to abstain from close-up time with pets and wash your hands frequently.
Certain pets like ferrets and rabbits are more likely to get sick with this virus.
Yes. Those under 20 years old typically only develop a mild flu-like illness, and are much less likely to progress to severe disease or die. This may be due to how their immune system responds to infections.
The most important thing to remember if you are in a household with anyone under the age of 20 is that they are just as likely as adults to get infected with the virus. They can then spread the virus to people that have a higher likelihood of getting severe disease. It is important 𝗲𝘃𝗲𝗿𝘆𝗼𝗻𝗲 learns proper hand hygiene and social distancing.
There have not been cases of babies being delivered that have been sick with this virus.
A few cases have raised questions for in-utero transmission, although this is not conclusive at this time.
Level 2 Pregnancy
Transmitting an infection from mother to a developing baby is called “vertical transmission”. A recent set of two case reports showed that mothers who had the virus in their 3rd trimester delivered babies that had certain types of antibodies to the virus in their blood that could not have been passed from the mother to the baby. This suggests the baby was infected in the womb. However, both of these babies tested negative to the virus. So more information is needed before we know for sure.
Pregnancy is a risk factor for developing severe disease if you get the virus, so social distancing and hand hygiene is extremely critical for pregnant individuals. Also, if a mother is sick with COVID-19, she can transmit it after birth by coughing, kissing, or breathing on her baby.
Because this disease has only been recognized since December 2019, data only exists for mothers in the 3rd trimester, with 1st and 2nd trimester data expected later.
There is no evidence of this occurring at this time.
While the virus has been detected in the stool rarely in severe disease, it has not been shown to be a method of transmission at this point.
However, there are certain practices you should be doing anyway to reduce the possibility of spreading 𝗮𝗻𝘆 fecal-oral diseases:
It is unlikely that one can get COVID-19 from food. The FDA and other international food safety organizations have stated that food is NOT thought to be a method of transmission of SARS-CoV-2. However, until fomite transmission is better understood, it may still be theoretically possible.
To reduce this possibility, order foods served hot or reheat them after you receive in an oven or microwave. Also, consider supporting restaurants that are asking employees about symptoms, checking for fever, and providing paid sick leave for those who get the virus.
Fomite transmission, as I mentioned above, is thought to be a distant secondary form of transmission to droplet transmission. That being said, one can never completely eliminate all risk of acquisition, and if excessive surface-disinfection measures being taken are causing wasting of limited resources and mental strain, it may not be worthwhile to do these things.
The lab studies of how long a virus remains viable on surfaces need to be interpreted with caution as these scenarios may not be applicable to real-life conditions. The studies do not reveal if the virus can still cause infections in people if they touch these contaminated surfaces and their face hours or days after an the surface was contaminated.
Focus your disinfection of surfaces to those most likely to be contaminated with high amounts of virus. These would be surfaces that someone with COVID-19 might have gotten respiratory secretions on or touched with their hands. Cleaning repeatedly-touched surfaces like door handles, elevator buttons, hand-rails, keyboards, and telephones are the highest priority.
If you are concerned about surfaces you have contacted potentially being contaminated, remember, the simplest and most effective tool in your arsenal is to wash your hands for 20 seconds and abstain from touching your face.
No.
From the NIH: “There is no scientific evidence that any of these alternative remedies can prevent or cure the illness caused by this virus (SARS-CoV-2).”
This is unknown at this time. We do form antibodies (proteins made by your immune system that fight infections) against the virus as I mentioned before in the Level 2 section on testing. We still don’t know how effective they are for fighting the disease and how long they stay in the body.
Early data in monkeys re-challenged with the virus show that monkeys didn't get sick on a second exposure if they had antibodies.
Pragmatic tips for things you can do to keep yourself from becoming sick and save lives!
These numbers mean absolutely nothing to your overall safety and do not need to be repeated on social media. Why do the numbers not matter?
Knowing these numbers on a moment-to-moment basis will do nothing to help you if you or a loved one are exposed to SARS-CoV-2, they will simply increase existential dread and panic.
Assume the virus it is in your community even if you have no reported cases, and use social distancing at all times. The lack of reported cases in your specific community may be due to a lack of testing availability or those with mild symptoms not presenting for testing.
Consider abstaining from coronavirus news outside of international reputable medical sources including the NIH, WHO, CDC, or your local health department.
Think about this question for a moment: In all of the time you spent watching or reading news coverage about coronavirus, and checking social media for updates, how much have you actually learned what you should be doing in the pandemic?
This is the purpose of this guide---education, not alarm, is the key to reducing cases of COVID-19 and saving lives.
Understanding this disease, and developing a plan on how you can help yourself and your community, reduces anxiety of the unknown.
Some news organizations continue to focus on cases and deaths and political failings to stop the virus for good reason: you will keep watching and returning to them if you feel uninformed, scared, confused, or filled with vitriol. This generates views, clicks, and advertising revenue. These incentives do not align with the public good of reducing harm from this disease.
If you feel disconnected by not reading the news, limit yourself to your local city paper, which will likely focus on how coronavirus is affecting the community around you, and point to ways you can help your community.
Alternatively, if anyone reading this guide has a suggestion for a news source that is providing pragmatic information, and not focusing on political failures and cases/deaths, please let me know in the comments.
Due to the coronavirus pandemic, many hospitals are facing severe blood shortages. Blood donation facilities are taking special precautions to keep you safe from coronavirus exposure. There have been 𝗻𝗼 cases of giving or receiving a blood transfusion causing COVID-19. Please consider donating blood so others do not die from conditions requiring transfusions.
Currently, less than half of those living in the US can donate blood. However, it is worth checking for changes in the FDA guidelines for blood donations regularly if you are restricted from donating.
As of 4/2/2020, the restriction on men who have sex with men (MSM) and women who have sex with MSM has been reduced by the FDA from a 12-month restriction since last sexual act to 3-months for blood donation.
For more information on if you are eligible to donate blood please see the link below. At the time of writing, this link has not been updated to reflect the recent change in FDA policy on MSM.
Red Cross Donation CriteriaThis is important even if you are alone to reduce the chance of surfaces in your environment being contaminated with the virus.
If you are at home sick, put on a mask anytime a caregiver is within 6 feet of you.
When you are cleaning surfaces that may be contaminated, pay attention to the chemical contact/kill time of the product you are using against SARS-CoV-2. This means that once you use the disinfectant, be it a wipe or a spray, you must leave it on the surface and visibly wet without wiping, rinsing, or touching the surface for the duration of the contact time before it is safe to use.
If the information is not on the product label, there is an easy short-cut to determine the contact time:
Simply bookmark the following link on your phone:
Disinfectants for Use Against SARS-CoV-2
Now look at the label of the product in question and find the “EPA Registration Number” which is on the back of all disinfectants. Type that number (including the hyphen) into the search box and you will see the contact time as well as recommended surfaces to use it on.
For example, if you are wiping down a grocery cart handle with a Lysol wipe, punching the EPA number (777-114) into their database shows a contact time of 10 minutes for SARS-CoV-2. This would mean you would have to wipe your grocery handle and wait 10 minutes before touching it to ensure the surface is clean for SARS-CoV-2. Waiting 10 minutes for your shopping cart is probably something you don’t want to do, so check your products before you buy them in this database.
When in doubt about if you contacted a contaminated surface, wash your hands as soon as possible, and don’t touch your mouth, nose, or eyes.
Do not spread photos of empty store shelves on social media. What starts as someone posting a photo of an empty toilet paper shelf, prompts others to simultaneously go out and wipe store shelves clean out of fear of shortages. Posting the photos creates a self-fulfilling prophecy. The grocery supply chain has not been disrupted, and shortages are simply due to unnecessary overbuying exceeding expected demand.
Additionally, do not post news stories about new and unproven medications against COVID-19 or new routes of transmission.
UCSF has compiled a very good website/guide with pragmatic and proactive steps for addressing the mental health implications of this pandemic:
Resources to Support Your Mental Health During the COVID-19 Outbreak
If you have health insurance, call the member-services number on the back of your card and ask for a list of in-network mental health providers providing telehealth services. For a better idea what changes to allow you to access mental health services have taken place with your insurance carrier or your state, please see this website: