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Covid-19 Bulletin #3: Travel & PPDs

Covid-19 Bulletin #3: Travel & PPDs

Thank you for the positive feedback that you’ve given us. Yes, we need to and can do more than wash our hands. Hence the last Bulletin #2: Scare yourself to Health was focused on boosting your immunity.

I’ve recently received some backgrounders and there are some valuable insights I’m going to share with you now. Also, many of you have reached out to me asking about three things:

  1. What should I do about travel?
  2. What should I do about masks?
  3. What else should be done?

Geographic Status Report:

Last week, I referenced a clinical epidemiologist who thought that 65% of the world’s population could be infected. The range now varies from 30-70% which makes sense given the hot vs cooler spots.

Many of us, including me, take US travel as an extension of our Canadian lives. No doubt, you have been watching the news, but two developments have surprised me last week in the USA.

1.CDC’s actions on testing. What I had assumed, when they said “X’ number (thousands) of people are under observation, was that they were all tested and pending test results. That turned out to be a wrong assumption on my part. For the past four weeks, less than 1000 people in total were tested. CDC was the only testing lab in America. It turns out the lab itself was shut down end of last week for contamination issues. This is in contrast to the 5000+ tests being done in Korea DAILY.

Therefore, we don’t know what is going on yet in the USA. Except we know that there are ‘community cases’ aka we are now out of control for containment because we don’t know who started being Case #1 in the community. Hence, expect to see a lot more (hundreds more is my guess) cases over the next several weeks. Testing is now coming online – thank goodness! CDC gave private labs in all States the go ahead to start testing if they are an existing FDA approved lab for viral testing.

2.There was a whistle blower who alerted the media (in fact sued the CDC) that they did not get Personal Protection Devices (PPD) to greet and process those returning from China from the chartered plane. While the CDC team was gowned head to toe, those processing had been exposed and subsequently went into the community. My suspicion for the cases in Southern California which came from the army base where the quarantine was in place. 

As it progresses in the USA this week and onwards, there is little redundancy to all hospital systems, though we often think American hospitals are far more equipped, compared to the full capacity Canadian ones.

No one in North America has the ICU beds ready in place, and in particular, the ventilators available for all those who need it. The next issue, as in SARS, is who gets priority to the limited number of ventilators. Sanjay Gupta, CNN Chief Medical Reporter, said that there are approximately 75,000 ventilators in play, but technically short 60,000. Heart attacks, strokes and cancers still occur, and these patients may also need ICU care too. Medical ethics will come into play yet again. Who do we save now and who do we ‘let go.’

Hence, stay healthy. Period. I don’t want any of us needing to make such difficult decisions.

Recommendation #1:

  • Travel now, if you need to, only in safe GREEN ZONES which includes all of Canada.
  • STOP travel to RED ZONES: China, Hong Kong, Japan, Korea, Italy, Iran.
  • On our personal YELLOW ZONES: Europe, Southeast Asia and USA, specifically Washington State and Southern California.
  • To be clear, I’m not saying that GREEN ZONES have no cases, just less so the probability of infection is at present, lower.

Here’s a live, in real time, link to a Johns Hopkins Covid-19 Dashboard globally.

What I’m doing:

  • I have travel plans booked for NYC, Chicago and Orlando every 4 weeks. It’s a week to week decision. NYC is next week for me and it’s now a day to day decision.
  • I’m not booking any new non-essential travel, anywhere.

Personal Protection Devices:

This virus is spread in large droplets by coughing and sneezing. This means that the air will not infect you (so far as we know now). However, all the surfaces where these droplets land are infectious. You will be at higher risk of getting infected if you are directly coughed or sneezed upon or bring the virus from a surface close to your face. This virus has an affinity for lung cells.

Many of you have asked about masks. There are two types at play:

  1. N95 masks – they are the gold standard and no longer available for sale – all sold to Health Systems (where they need it). If you need to wear one, you shouldn’t be where you are and wearing it.
  2. ‘Regular’ common masks, as mentioned last week, do not protect you from any Coronaviruses. However, what you don’t want to get is a regular cold/flu and then be compounded with Covid-19. 

Recommendation #2:

Given all of you now have resources to access your masks, if you decide to wear it, this is when you where it:

  1. If you are sick at home, don’t get the house sick
  2. If your family member is sick, they wear one and you too in the house
  3. Forget about wearing a N-95 mask – you shouldn’t need it

Here’s how to wear it:

  1. Once you put on the mask, don’t keep touching it! Defeats the purpose of not spreading germs from face to hand, hand to face.
  2. Pinch the nose area to make it SNUG. Yes, it’s hot and you feel you can’t breathe well. Pretend you are in the operating room as a doctor, you’ll feel empowered 😊. You’ll get used to it.
  3. Last but not least, you can’t keep re-using them. 
  4. Assume the masks last for about 5 hours once being used. In the operating room, we re-gown every 5-6 hours.

What we are doing in our office:

  1. Alcohol hand sanitizer for all who visit us
  2. Masks on for all who are coming in ‘sick’
  3. Wipe down a patient counselling room with Lysol and also spray with the same
  4. Spray and wipe down every surface at the start of day and as needed throughout the day

Maybe this protocol should now be implemented in your offices.

In general:

  • Consider the handshake a contaminant. If you continue, use hand sanitizer immediately afterwards
  • Think about wearing disposable gloves more often when attending public spaces eg. grocery carts, as it reminds you not to touch your face

What else you can do:

Recommendation #3:

  1. If you are on a prescription medication, reach out to your prescribing doctor to get your refills now.
  2. Get your immunity boosting supplements

We’ve started sporadic drug shortages as China has become a major manufacturer of raw materials and producer of drugs. Many of you understand the supply chain issues of this virus. Hence, manufacturers are also in India and Europe and are becoming impacted to fill in the gaps.

The recommendation of supplements in my last Bulletin #2 is now all on back order. We are in the process of awaiting more inventory for AHCC PLUS and Ultra-AO, both from Douglas Laboratories. If you are having issues sourcing, let us know and we will have you on our re-order list. We should get our next stock in a week. All of you who have sent us a note to date, we’ve been able to accommodate your immediate needs. In the meantime, we are offering some similar compatible alternatives.

Lastly, a bit of black humour to those of you who are warriors: if you do get the Covid-19 sooner rather than later, the good news – the hospitals still have capacity to take care of you. Things might change if we get into an overload situation. Let’s hope not.

Just a reminder, though highly infectious, the fatality rate is at 2%. It’s important to know that severe outcomes seem to impact people who are elderly and have other chronic conditions, such as diabetes, cardiovascular disease, and respiratory conditions.

All emails from you are welcomed. Thanks for keeping me up to date with very good sources of information as well. We will stay in touch with all of you as needed.

Link to Covid 19 Bulletin #2: Scare Yourself to Health

Link to Covid 19: Truth or Myths?

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