Older Bolder Mark

There’s been a fair amount of water under the bridge since I first posted a few thoughts about the COVID-19 story unfolding with ever increasing speed and vigor around the world two weeks ago.

While not intended in any way to be a comprehensive primer on the COVID-19 outbreak, here’s a quick rundown of key points I’ve been sharing with friends, family, and clients this past week in response to questions that keep rolling in.

There’s Still a Lot We Don’t Know (and for a Variety of Reasons)

One of the hallmark features of this COVID-19 story has been the lack of hard data available for public perusal, beginning from the earliest days in January when eyes and ears around the world began to pay attention to what was happening in Wuhan Province.

The authorities in China have a long and checkered history of not disclosing information which shines a revealing light on life there, and there of course has been and continues to be extensive criticism of early management of the COVID-19 outbreak and the lack of critical and accurate information provided the rest of the world as the virus has advanced beyond China’s borders.

To be sure, there’s much, much more information available today than two weeks ago, for example, the genome has been well mapped and tracked as the virus mutates (typical viral behavior) as it migrates through new hosts.

Vital information detailing the actual disease process induced by the viral infestation, how truly infectious the particle is, the impact of various co-morbidities on the natural history of the resultant illness, and even testing protocols have yet to be fully developed and dispersed.

Digging into the clinical details takes time; hard data is coming, but it’s simply not available at the granular level we’ve all come to expect in North America.

Hello, I’m Here from the Government, and I’m Here to Confuse You About COVID-19

Sadly, and impressively, the Chinese authorities haven’t been the only agency withholding information. The debacle unfolding in Washington State is a stunning example of such – it’s becoming clear that at least one of the early infections among the nursing home patients and staff was identified as early as six weeks ago, and not explored and addressed with purposeful intent and care in its earliest stages. (References: 1 2 3 4 )

Impressively, the mis-handling of the nursing home nexus in Washington has exposed thousands in the community unnecessarily; heads should roll once the relative crisis there has been averted.

Several states are withholding numbers and locations of patients under monitored or isolation protocols, and the frank – and let’s be damned honest about it – overt politicization of the issue by many at the national level is absurd, inflammatory, distracting, and harmful. RUN from anyone attempting to make this a political game – it is most certainly not – and you can be damned sure that any politician, regardless of stripes or tenure, doesn’t have your or the nation’s best interests in mind if they’re playing the COVID-19 politics card. RUN, and don’t look back.

Who Should Genuinely Be Concerned About COVID-19 Today?

As to who should be genuinely concerned about the COVID-19 outbreak today, those with preexistent lung and / or cardiopulmonary disease, especially if symptomatic, remain at the very top of the “should I really worry list”. By the relatively limited available data, most fatalities related to COVID-19 have occurred in this group, and those older than 80.

I’m hearing some chatter among physician friends that those with T1DM appear to be at higher risk, and of course anyone with impaired immune function for what ever reason needs to exercise due caution.

Another issue you won’t hear discussed in main stream media venues is a probable fecal-oral vector; this is very likely part of the nursing home catastrophe in WA, and would raise the potential for critical issues in locales such as San Francisco, where you need an app to navigate city streets to avoid current defecation sites. Cities with large homeless populations – LA, SF, Portland, Seattle, Austin, etc. – will need be watched carefully, and if they’ve not yet disclosed outbreaks by now, count me among those betting it won’t be long.

So What’s a Prudent Family to Do This Week to Deal with COVID-19?

So what’s a prudent family to do this week?

You’ve no doubt heard much of this same stack of advice from many other sources, and you’ll hear it / read it again and again this week as well. There are of course easy points to add to a list like this – don’t travel to high risk countries, cruise ships aren’t a great choice right now (at least in the Orient), and it’s worth keeping an eye on outbreaks as they develop around the country – at least as they’re reported – using your local health department or the John Hopkins mapping tool here.

Standard, time-tested and proven protocols for managing flu season risk are good to brush up on. Even better – simple hand washing and avoiding touching your face (especially around the eyes) – lower flu season risk dramatically and are available to everyone.

Might you have to sequester yourself in your home for a short time? Perhaps, if you live in the epicenter of a community eruption such as the one very likely coming in Kirkland, WA (the nursing home story we’ve been talking about) or have someone in the family with very high risk factors.

In many locales it’s probably too late for a full-on “prepper” stock-up, though putting together two weeks of food, water, personal hygiene items, medications, and home care products isn’t a complex game. As I write this late yesterday afternoon, there are reports across media outlets of runs on grocery stores (Costco in particular for some reason) all day yesterday.

I agree with those who suggest the supply chain disruptions caused by this event may be more seriously impactful on daily life than the risk of the actual infection, which for most will most likely be a flu-like event. Supply chain problems are just beginning to develop now, and will worsen down the line; having a store of food and supplies offers a buffer for these issues as well.

Still smoking? The data suggests that smokers are at particular risk for COVID-19 infection and more serious clinical syndromes – it’s past time to stop. Get it done, and now.

Have a potential option to work from home? It might be a good idea to chat about options and work through a few details with your employer before the (potential) sh*t hits the fan at some point down the road.

And finally, if you’re overweight, have the metabolic syndrome, are carb-dependent, and out of shape, any effort you expend starting NOW to overhaul your nutrition plan and begin to rebuild your fitness will pay off in the months to come, regardless of what issues this viral syndrome brings to your own neighborhood.

Pay attention, plan well, get moving.