What COVID-19 Means for our Members

WHAT COVID-19 MEANS FOR OUR MEMBERS

Hello everyone!  There has been a lot of recent discussion about the Coronavirus (COVID-19 (the disease)/SARS-CoV-2 (the virus)).  Some of it is fact, and some of it is fiction. Therefore, we at Harper Health wanted to write to our members and followers explaining the spread and symptoms of this new virus, what you can do to protect yourself and loved ones, and what unique options are available for Harper Health members during this time.

Please keep in mind that information on this pandemic changes daily. We will aim to keep you informed, however there are excellent resources available at the:

CDC (https://www.cdc.gov/coronavirus/2019-ncov/index.html)

NIH (https://www.nih.gov/health-information/coronavirus)

Illinois Department of Public health (http://www.dph.illinois.gov/topics-services/diseases-and-conditions/diseases-a-z-list/coronavirus)

Chicago Department of Public Health (https://www.chicago.gov/city/en/depts/cdph/provdrs/health_protection_and_response/svcs/2019-novel-coronavirus--2019-ncov-.html)

And resources from local institutional partners such as:

Northwestern (https://www.nm.org/conditions-and-care-areas/infectious-disease/novel-coronavirus)

University of Chicago (https://www.uchicagomedicine.org/forefront/prevention-and-screening-articles/wuhan-coronavirus)

WHAT IS COVID-19/SARS-COV-2?

SARS-CoV-2 is a respiratory virus from the family of viruses called coronaviruses. Coronavirus is one of the many virus families that can cause the common cold, yet SARS-CoV-2 is a new species of coronavirus that started causing disease in humans this year. Because it is caused by a virus similar to those causing the common cold, the symptoms are similar to other seasonal “colds” and include fever, cough, wheezing and shortness of breath.  SARS-CoV-2 usually DOES NOT cause sinus congestion, ear pain, sore throat, or gastrointestinal symptoms.  Cases of SARS-CoV-2 infection in about 8 out of 10 people who are infected are mild and last about a week. Two out of 10 people get really sick and require hospitalization. Some people can die from SARS-CoV-2 infection.

AM I AT RISK FOR MAJOR COMPLICATIONS?

The concern about COVID-19 is that in certain groups it can cause severe illness requiring hospitalization, and in some cases COVID-19 is deadly. Those at risk for severe complications from SARS-CoV-2 infection are the elderly (folks over the age of 70ish) and those with other conditions that weaken the immune, respiratory or cardiovascular systems.  This includes people with chronic lung disease (COPD, asthma, emphysema, etc.), chronic heart disease (history of congestive heart failure (CHF) or history of coronary artery disease treated with medicines, stents, or bypass), diabetes Type 1 or Type 2, or immune suppression due to disease or medications (steroids, Humira, Cimzia, or the like).

HOW DOES ONE GET INFECTED?

Some infectious diseases are spread by insects, others are spread through food, and still others are transmitted through close, intimate contact. In order to get COVID-19, though, the virus needs to get from an infected person’s lungs into yours. One way is through respiratory droplets: if someone who has the infection coughs or sneezes without covering their nose or mouth, respiratory droplets are produced into the air. If you are nearby—within six feet or so—and breathe in the virus-infected droplets you are at risk for getting the disease.

Another way one gets infected is through fomites: the airborne droplets that are expressed through a cough or sneeze land on a surface and stay there, ready for you to come by. Or an infected patient coughs or sneezes onto their hand and then touches an object putting the virus there. If we touch a fomite and then touch our mouth or nose, there is a risk that we can inhale the virus into our lung. SARS-CoV-2 can live on a fomite for around a week, yet it’s not clear how long it remains able to infect us after being on that surface.

Overall, though, it seems that it is not all that easy to get infected with SARS-CoV-2. A person who has COVID-19 on average passes the disease on to about 2 (actually 2.3) people, which is more than influenza (1.3) but significantly fewer than measles (18! Yea for vaccines!). With this infectivity rate (a.k.a. R0 or R naught), the chance of significant fomite transmission is likely low, but still important to guard against.

HOW IS COVID-19 TREATED?

This is the challenge. Medications that treat influenza don’t work. Antibiotics work on bacteria not viruses, so those aren’t effective. For now, there is no direct SARS-CoV-2 virus treatment that we can offer our patients, so if the COVID-19 illness is mild to moderate the disease will just need to run its course. The 20% of patients who are really sick will need to be treated in the hospital with extensive high-touch support and measures that have been tried in other settings.

WHAT CAN I DO TO PROTECT MYSELF AND OTHERS?

1)      Avoid close contact with people that are sick, and stay home if you are not well so you don’t transmit your illness to others. Person to person contact seems to be the main way the disease is spread

2)      Wash your hands! Please handwash with any type of soap (doesn’t need to be “antibacterial”). Be thorough – sing Happy Birthday twice! You can also use alcohol-based hand sanitizer frequently throughout the day as long as the sanitizer is at least 60% alcohol. With supplies being low, there are methods to make your own hand sanitizer, but there is risk attached to that.

3)      Avoid touching your face—if you happen to get the virus on your hands, it needs to make it’s way into your nose/mouth; if you don’t touch your face, this should reduce that risk. Easier said than done!

4)      If you need to cough or sneeze, cover your nose and mouth with a disposable tissue OR the inside of your elbow. If you sneeze or cough into your hand, immediately wash! Don’t make fomites, even if they aren’t SARS-CoV-2 fomites!

5)      Clean and disinfect frequently touched objects and surfaces such as phones, tables, and doorknobs. This is a list of CDC-approved disinfectants.

6)      Currently, the CDC does not recommend asymptomatic people wear a mask. However, wearing a mask can serve as a reminder to you to avoid touching your nose and mouth. Sick people with concern for COVID-19 entering health care facilities like ours will be offered masks to limit the spread of the virus.

CAN I GET TESTED FOR COVID-19/SARS-CoV-2?

Most testing for SARS-CoV-2 up to now has been done on patients that are ill in the hospital setting. As of this week, our partner labs (LabCorp and Quest) have made testing for SARS-CoV-2 available. If you are feeling sick, or have come into contact with a known case of COVID-19, please call our office so we can assess if testing is needed for you.

As of now (March 10, 2020), based on the number of cases in the Chicago area, where most of our patients live, we do not plan on testing very many people. If the number of cases rise and the risk of COVID-19 goes up, we may test more people in order to help contain the outbreak. For right now, if you’re sick it is likely a common cold or influenza and we recommend you stay home and practice “social distancing” until you’re well. With social distancing, you avoid congregated settings and limit public activities, a good habit anytime you’re sick with a cold or flu. If your symptoms progress, as do 20% of the cases of COVID-19, we will send you to the hospital where they are better equipped to diagnose and treat the illness.

Also, it is not helpful to test a person with no symptoms to “check if they’re okay” before seeing a sick friend or aged relative. We will not be offering tests for this reason.

SHOULD I TRAVEL?

Currently the CDC recommends that everyone avoid non-essential travel to countries with high rates of infection, so called Watch Level 3 countries. Right now these countries include China, Italy, South Korea and Iran. In addition, the high risk adults outlined above should not travel to Japan, the CDC’s only current Watch Level 2 country. Hong Kong is Watch Level 1, where travel isn’t restricted, but there is an outbreak. This list of countries is likely to change, so check back.

It is our recommendation that we should all do our part to limit the spread of the infection by avoiding getting the infection, ourselves. It is particularly important for at-risk people to avoid infection. So, while domestic travel has not been curtailed in any way, any travel does put us at risk. Why? We are exposed to crowds of people, some of whom may have SARS-COV-2 infection. In busy airports there are also more fomites. Third, we are trusting the HEPA filters on airplanes to clean and disinfect the circulated air. If you do choose to travel by air here is what we recommend:

1.      As much as possible keep a six-foot-radius person-free zone around you, so if a fellow traveler does cough or sneeze, the virus will likely hit the ground before it reaches you.

2.      Obsessively sanitize your hands with hand sanitizer. Keep a 3 ounce bottle in your pocket. Anytime you touch something after washing your hands, say to yourself, “my hands are dirty” and re-sanitize ASAP.

3.      DO NOT touch your face! If you have an itch that needs to be scratched, sanitize first and use a tissue as a barrier between your hand and your face

4.      After boarding the plane and taking your seat, fully sanitize your area with disinfectant wipes. Again, here’s the list of products that work

5.      Wash your hands again!

Since the main method of transmission is most likely person-to-person spread, the six-foot zone of relative safety is much more difficult on planes and cruises as well as in theaters, concerts and ball games. One extreme of prevention is self-quarantine, the other is to do nothing. You must find YOUR comfort zone along this continuum. We can help you find it. Contact us.

WHAT CAN HARPER HEALTH OFFER?

We can offer our counsel and care. Our team is taking multiple calls per day, and hopefully this document helps answer many of the questions you may have. We will send out updates if significant updates become available.

The team at Harper Health alongside our supplement partner Xymogen has put together two vitamin packs that are available only to our members. While no research has yet to prove any benefit against the SARS-COV-2 virus, the first, called “IMMUNITY BOOST”, is a blend of supplements that may help boost your immune system and may help prevent you from getting sick when you feel like you’re at risk (i.e. when you are beginning to feel run down, when you are traveling, visiting relatives, etc.)  The second, called “ANTI-VIRAL,” is a blend that has some evidence to support a reduction in symptoms of certain viral illnesses, like colds and flu. We’d recommend taking these for a few days at the onset of a cold or flu. In no way do these vitamins replace care from our team and hospital partners if you become seriously ill.

If you are interested in learning if our supplement packs are right for you or have any further questions or concerns, please do not hesitate to reach out to your provider directly.  We are always here for you.

Your team in health,

Dr. Meg

Dr. Will

Dr. Dan

Steph

Priscilla