This is a very important question for all of us today. Personally, I have a family member who has respiratory disease which makes it imperative that I not get exposed and bring it home. The disease is now in my backyard with citizens in quarantine and locally hospitalized. What to do and who do I believe?
To give some perspective here’s some information about COVID-19 and how it stacks up against similar epidemics. There are many types of human coronaviruses including some that commonly cause mild upper-respiratory tract illnesses. COVID-19 is a new respiratory disease and is rapidly spreading all over the globe. Many cases are not life-threatening but it is proving difficult to contain. If we look back at the SARS (severe acute respiratory syndrome) history, it was swiftly contained because it didn’t have the “fitness to persist in the human population”. SARS fatality rate was roughly 15%. People were isolated quickly because SARS was such a serious illness. They did not feel just a little under the weather while walking around seeding the virus among others and they were asymptomatic while carrying the virus for a shorter period of time. During the “Avian Flu”, the Chinese killed 1.5 million chickens to contain the virus. So what made the Avian Flu containment different from the COVID-19, the answer is its severity. Those who got it became extremely ill quickly and the fatality rate was approximately 60 percent. In other words, if you got it, you were likely to die.
The COVID-19 makes people sick, symptoms are becoming predictable and identifiable but the severity will definitely depend on each individual and their circumstances. At this point, we have a better understanding of how it is spreading and the symptoms to look for. Despite the efforts of quarantine in all the countries, the virus continues to spread. Some epidemiologists are forecasting that in 2020 there could be rates of infection as high as 40 to 70 percent of the world population.
CT scans are a prime tool for diagnosis of severity of respiratory involvement for COVID-19, but published studies have not agreed on when or if the disease can be diagnosed with CT early enough to be beneficial. Certainly, facilities should be ready to receive patients who will be scheduled for chest CT if they are involved with COVID-19 patients. The online version of the Journal of Hospital Infection states that some coronaviruses can be active for up to 9 days on an inanimate surface. CT scanners will be at risk. The good news is that household disinfectants will kill the virus. Common sense would dictate that if patients can be limited to a scanner suite, it would make disinfection somewhat easier. After each contact with a potential coronavirus patient, the CT and MR equipment gantries should be disinfected. Ultrasound probes, blood pressure cuffs, computer keyboards and mice should also be disinfected. Check your manufacturer recommendations for acceptable chemicals.
Precautionary personal protective equipment (PPEs) should be used with fluid resistant characteristics to repel any moisture or droplets. During transportation, patients should be asked to wear a mask with the protection equal to or better than the N95.
Portable x-ray units should be used for radiographs in patients’ rooms or the emergency department. They can be easily disinfected.
The most important part of the readiness process is the planning. We must make sure everyone is on the same page. Communication is key between departments and services, and training is a must in the proper infection-control techniques.
We cannot wait for the vaccine to be delivered to our doorsteps. Preparation is the key ingredient. The more the world enters a controlled access lockdown and self-preservation mode, the more difficult it will be to assess our risk. And what happens if this is a multi-year outbreak? We cannot survive by limiting travel, closing our borders, and hoarding supplies.
So, am I going to get the Coronavirus? Not if I can follow the recommendations. I have already expanded my normal 3 feet rule to six feet to observe “Social Distancing”. I am staying away from crowds, using hand sanitizer, and washing my hands with soap and water after every event I consider exposure. We are communicating with our team of heath care providers to get them on our Emergency Preparedness Plan. Other measures may be necessary as the infection spreads and we will be implementing those recommendations as necessary.
You take care and I hope you are also planning. This is a problem for everyone.