Michael J Orlosky, MD, MMM, CPE is a physician with more than 20 years of experience with population health...

There will be time to talk about the failings of our elected leadership as it pertains to this disease, but for right now I want to use my platform to help make sure you get the RIGHT information to keep your your family and loved-ones safe. 

 

To that end, we've invited Dr Michael Orlosky, to directly address what you should and shouldn't be doing as we enter into this scary new-normal that we are all facing. Without further ado:

 

Michael J Orlosky, MD, MMM, CPE is a physician with more than 20 years of experience with population health. A graduate of USF College of Medicine, Dr. Orlosky also holds a Master’s Degree in Medical Management from Tulane University School of Public Health and Tropical Medicine. He serves on the Advisory Board of USF’s College of Public Health and is an Instructor at Yale University.

 

A sensible response to the Coronavirus pandemic

 

There are a number of responses happening due to the spread of the Coronavirus (officially called COVID-19) ranging from minimizing the danger (“It’s a hoax!) to panic (buying all the Purell and toilet paper you can find). The best and safest response is to do neither, but something else. This piece about that something else.

 

First, heed the advice of the National Institutes of Health (NIH) and personally observe the following recommendations:

  • Avoid close contact with people who are sick

  • Clean your hands often

  • Wash your hands often with soap and water for at least 20 seconds, especially after blowing your nose, coughing, or sneezing, or having been in a public place.

  • If soap and water are not available, use a hand sanitizer that contains at least 60% alcohol.

  • To the extent possible, avoid touching high-touch surfaces in public places – elevator buttons, door handles, handrails, handshaking with people, etc. 

  • Use a tissue or your sleeve to cover your hand or finger if you must touch something.

  • Wash your hands after touching surfaces in public places.

  • Avoid touching your face, nose, eyes, etc.

  • Clean and disinfect your home to remove germs: practice routine cleaning of frequently touched surfaces (for example: tables, doorknobs, light switches, handles, desks, toilets, faucets, sinks & cell phones)

  • Avoid crowds, especially in poorly ventilated spaces. Your risk of exposure to respiratory viruses like COVID-19 may increase in crowded, closed-in settings with little air circulation if there are people in the crowd who are sick.

  • Avoid all non-essential travel including plane trips, and especially avoid embarking on cruise ships.

 

If you have fever, cough, and are concerned you may have the coronavirus, keep calm and take the following steps.

  • Keep yourself at home and contact by phone your primary care physician for further instructions.

  • If you do not have a primary care physician, consider telemedicine where you can have a doctor visit over the internet. Even without insurance some companies, like Doctor on Demand, Teledoc, and MD Live can offer medical advice and treatment.

  • If you feel you need to be seen in person, whether at a clinic or at the hospital, try to remain outside the facility while the clinical staff are notified of your reason for being there. This will help ensure that proper precautions can be in place for everyone’s protection.

 

Also, this is a rapidly changing situation and you can find helpful regular updates at places like:

 

Be prepared for an extended period of time before the epidemic subsides. Many people are using the great influenza pandemic of 1918 as a model of what to expect, but this may not be a good example due to significant differences between the viruses that cause the “flu” and the coronavirus. 

 

First, we have lots of familiarity with diagnosing and treating the flu. With coronavirus, test kits are not easily available, expensive, and may be unaffordable for those without insurance. Next, there is a difference in incubation period before symptoms of the virus become evident. The average person is sick about 2 days before they start to show signs of the flu. In coronavirus, the incubation period averages 5 days, and of course during these extra days, more people are likely to be exposed to COVID-19 than the flu. Then there is a difference of mortality (death rates) between them. The mortality rate from the flu is about 0.1% (1 per thousand infected) whereas the mortality rate for COVID-19 appears to be about between 3%-4% (30 to 40 people per thousand infected). Finally, we do have specific treatments for the flu, but so far do not have proven treatments for COVID-19 beyond supportive measures of helping people breathe, reduce fever, isolate, and provide comfort.

 

What else can one do other than wash hands, wait, and be hopeful? Well there are a number of other things that we as a society can advocate to help us all get through this in the best possible way. We are all in this together and the more we can help our friends and neighbors stay well, the better our chances for staying healthy too. To that end consider supporting the following measures that go to the issue of public, not just personal health.

  • Practices and policies that allow rapid access to affordable testing for COVID-19

  • Practices and policies that allow for people with possible infection to stay home until recovered and not lose a paycheck for doing the safest thing

  • Public health measures that increase our ability to treat those without insurance in order to reduce the risk of infection within our own community

  • Funding to expand health resources (if needed) when there are not enough healthy doctors, nurses, EMTs, police, and fire rescue personnel to keep us safe

  • And long-term, continue to invest resources in the research for diagnosing and treating infectious diseases. No matter how exotic they may be today, they are the best candidates to become the next pandemic in our future.