Simone Harvey @solistens put together this brilliant summary on COVID-19 to help folks who are still struggling to connect the dots.
1. What is COVID-19?
In COVID-19, ‘CO’ stands for ‘corona,’ ‘VI’ for ‘virus,’ and ‘D’ for disease. Formerly, this disease was referred to as “2019 novel coronavirus” or “2019-nCoV”. The name of the actual virus is “Sars-CoV-2.” There are many types of human coronaviruses including some that commonly cause mild upper-respiratory tract illnesses. Severe Acute Respiratory Syndrome (SARS) and Sars-CoV-2 are related to each other genetically, but the diseases they cause are quite different. However, there are many types of corona viruses. Coronaviruses have caused two other recent epidemics – severe acute respiratory syndrome (Sars) in China in 2002-04, and Middle East respiratory syndrome (Mers), which started in Saudi Arabia in 2012. In both cases, work began on vaccines that were later shelved when the outbreaks were contained.
2. What does symptomatic/asymptomatic mean?
There are symptomatic (you can tell they have it: coughing, fever, etc.) and asymptomatic (you can’t tell they have it) folks with the virus. Being asymptomatic only means you’re not displaying or feeling any symptoms; you can still infect other people. Being asymptomatic means you will never develop symptoms. Being pre-symptomatic means that you are not showing any symptoms yet but will develop them later.
3. Why are some people asymptomatic?
We don’t yet know why some people are symptomatic or asymptomatic. The reason may be genetic or environmentally based or both. The latest number I read was somewhere between 25-50% of infected are asymptomatic, depending on who you ask. Some proportion of asymptomatic folks are actually just not sick YET (i.e. pre-symptomatic). There are also some articles that say your susceptibility is influenced by blood type. However, this research has not been peer-reviewed or published in a medical or academic journal, which means other experts in the field have not analyzed its research methodology, citations or significance. That means, for now, it is a hypothesis (or a GUESS), not fact. It appears that most children are asymptomatic but as you now know that doesn’t mean they can’t get you sick.
4. How do you know if you are in the symptomatic or asymptomatic group?
You don’t. Can you get a test that tells you which group you are in? No, tests confirming whether you are immune to the virus — identifying and measuring the COVID-19 antibody — have not been developed yet but I believe are underway. The only tests we have so far are those that confirm you have COVID-19 when you already have it.
5. What is an incubation period?
Viruses are typically spread before a person has any symptoms. The time period from when you first contract it (get it) to when you exhibit symptoms is called the “incubation period.” It’s the time the virus infects your cells and replicates inside of you without you noticing anything. This coincides with when the so-called viral load — the amount of virus being emitted from an infected person’s cells — may be the highest. In other words, when you are most infectious. For COVID-19 it is ~5 days. That means you could have it for 5 days before you display any symptoms. If you are asymptomatic (showing no symptoms) you will never display any symptoms. This is when you infect other people, unknowingly.
6. If there hasn’t been a case in my community, I should be ok, right?
No. The only way we know who has it and who doesn’t is if EVERYONE is tested. We neither have enough tests nor do we have tests that are always effective. Plus, you could get tested today and get infected tomorrow but someone who hasn’t been tested yet. The virus spreads very rapidly due to the estimated number of asymptomatic and untested people so you don’t know how far the virus has reached. And because of the incubation period you will not find out until much later.
7. The numbers of infected people published are a good reflection of where we are in terms of infections right?
No. The numbers published are a result of the number of people TESTED and the local, state governments BEST GUESS, the reality is likely to be 20-50x higher. If no one has been tested there are no known cases, get it?
8. Will a mask protect me?
A mask can reduce your likelihood of getting infected if you use it correctly. Think of the virus as blue paint people are spraying on you by sneezing, coughing or breathing on you. The size of the paint droplets make a difference but we only have guesses as to how much. Once the paint is on you and you touch it, you’ve been painted. So if it lands on any part of you, including your mask and you keep touching it, you’ve been painted. If you take off your painted mask and then touch your face, you’ve been painted, etc. Masks are pointless if you don’t avoid touching them, wash them or clean them when you get home.
9. What is a comorbidity?
The simultaneous presence of two chronic diseases or conditions in a patient. Conditions considered comorbidities are often long-term or chronic conditions. So for example, if someone has depression and heart disease or high blood pressure and diabetes. Some comorbidities often come together like high blood pressure, heart disease and diabetes. They are separate chronic conditions but are physiologically related because they influence each other. But that’s for another day.
10. What is the relationship between a comorbidity and COVID-19?
Among lab-confirmed cases of COVID-19, patients with any comorbidity yielded poorer clinical outcomes than those without. A greater number of comorbidities also correlated with poorer clinical outcomes. Translation: People who have additional chronic conditions like hypertension (high blood pressure) and diabetes are going to be sicker and have a harder time recovering than those who do not. This also means that if have other chronic conditions your likelihood of dying from the virus will be higher.
11. Is it true that only the elderly are most at risk for cover-19?
It is true that COVID-19 leads to hospitalizations and deaths more frequently in those who are middle-aged or older. But a significant number of otherwise healthy adults can develop a more severe form of the disease. Data from the Centers for Disease Control and Prevention found that among those age 20 to 44 with coronavirus in the U.S. from Feb. 12 to March 16, 14% to 20% were hospitalized. Although that’s a lower percent range than those above age 65, which ranges from 28.6% to 70.3%, it’s still a large chunk. 2-4% of those in the 20-44-year-old age category required admission to an intensive care unit. You don’t objectively know how healthy you are and how your body is going to react to this. Best not to gamble. Also, see #10, 11, 12.
12. What’s this “flattening the curve” business?
In epidemiology (the study of how disease spreads), the idea of slowing a virus’ spread so that fewer people need to seek treatment at any given time is known as “flattening the curve.” It explains why so many countries are implementing “social distancing” guidelines. Because of the asymptomatic folks, the 5 day incubation period and the lack of large scale testing, we are always only going to find out how many people are sick at a delay. The present will never be an indication of where we actually are. (See #7) Our healthcare systems can only treat so many people at once and so if more people need treatment than we have space or staff for we will overwhelm the system. That’s what’s happening in NYC. As a result, both folks who are very sick from the virus as well as other folks (car accidents, heart attacks, etc.) are less likely to get the care they need as fast as they need.
13. What’s all this talk about ventilators?
In the most severe manifestation of COVID-19, people’s ability to breathe is severely reduced to the point where they can’t breathe on their own or get enough oxygen to survive. If your organs don’t get a minimum amount of oxygen they will shut down. So in order to save people’s lives they are put on ventilators. Ventilators breathe for you if you can’t do it yourself. If the number of sick people, needing ventilators is higher than the number of ventilators available, we will have to start choosing who gets to live and who doesn’t based on ventilators available. This is a huge ethical issue. Some efforts to manufacture more ventilators are underway.
14. How does a vaccine work?
All vaccines work according to the same basic principle. They present part or all of the pathogen (disease causing agent) to the human immune system, usually in the form of an injection and at a low dose, to prompt the system to produce antibodies to the pathogen. Antibodies are a kind of immune memory which, having been elicited once, can be quickly mobilized again if the person is exposed to the virus in its natural form. As a result, you can fight off a new infection of a pathogen “known” to your system faster and with less damage. Kinda like “Oh I know what kinda bs this is and what to do about it.”
15. Why don’t we have a vaccine yet?
Vaccine development is a complex and drawn out process. About 35 companies and academic institutions are racing to create such a vaccine, at least four of which already have vaccine candidates they have been testing in animals. Clinical trials, an essential precursor to regulatory approval, usually take place in three phases. The first, involving a few dozen healthy volunteers, tests the vaccine for safety, monitoring for adverse effects. The second, involving several hundred people, usually in a part of the world affected by the disease, looks at how effective the vaccine is, and the third does the same in several thousand people. This process takes time and a lot of resources. Phase 3 alone typically lasts 1-4 years. So you see, it’ll be a while.
16. Once you have contracted the virus and have recovered you’re safe right?
No. We don’t yet know if people who have contracted the virus 1) can get re-infected by the same strain 2) are equally as vulnerable to another strain or 3) have any advantage as compared to someone who never had it. Once we can identify the COVID-19 antibody and test for it we will know who’s immune naturally (asymptomatic) or who has developed immunity as a result of having contracted the virus and recovering.
17. What is herd immunity?
Herd immunity is a form of indirect protection from infectious disease that occurs when a large percentage of a population has become immune to an infection, whether through previous infections or vaccination, thereby providing a measure of protection for individuals who are not immune. The tricky thing is that herd immunity requires that ~70% of the population have to have contracted and recovered from the virus (including asymptomatic carriers.) At such a high proportion of infected folks its likely that millions of people will die not just due to the virus’ mortality rate but also due to an overwhelmed healthcare system unable to care for the most severely ill in time no matter what they’re sick with.
18. What needs to happen for social distancing to relax?
Widespread testing to figure out who has it and who doesn’t
Definitive way to identify those who are immune either naturally or after recovery
Herd immunity but this would come at a cost of millions of people dying.
A vaccine
Any of these would allow for some people to go back into the public sphere safely.
*Doctors, biologists, biochemists, epidemiologists – feel free to correct if any of this is factually incorrect.
When it is dark, you can see stars.
Epidemics of the past have changed the way we lived and inspired innovations in infrastructure.
For example, Tuberculosis was the leading cause of death toward the end of the 19th century. I in 7 people around the world had died of the disease ranked as the third. While the medical community recognized TB was caused by bacteria, most people in the general public gave little attention to the behaviors that contributed to transmission. It was common for family members, or even strangers, to share a drinking cup, even when it was clear one coughed and expectorated.
The “War on Tuberculosis” public health campaign discouraged cup-sharing. States banned spitting in public spaces including inside public buildings, transit, sidewalks, and other outdoor spaces. Soon spitting in public spaces was considered uncouth, and swigging from shared bottles frowned upon too. These changes in public behavior helped successfully reduce the prevalence of tuberculosis.
Many infrastructure improvements and healthy behaviors we consider normal today are the results of past health campaigns that responded to devastating outbreaks.
In many large cities, rot and horse waste were commonplace. For example, city streets in London and New York overflowed with filth. People tossed their trash, chamber pots, and food scraps out their windows onto the streets below. The horses pulling streetcars and delivery carts also contributed to the squalor, putting pounds of manure and urine on the streets every day. When a horse died, it became a different kind of hazard. Children would play with dead horses lying on the streets. A carcass would be left to rot until it had disintegrated enough for someone to pick up the pieces.
There were also no sewer systems. When people would come to live or work in the city you had 25 to 30 people sharing a single outhouse. The privies frequently overflowed and folks would damp barrels dripping with feces into the nearby harbor. The frequent outbreaks of typhoid and cholera made cities recognize the need for organized systems to dispose of human waste. Filtration and chlorination systems were introduced to clean up municipal water supplies. Water closets became popular, first among the wealthy, and then among the middle-class. This led to plumbing and house reform.
Builders started adding porches and windows to houses as physicians said good ventilation and fresh air could combat illness. This fresh-air “cure” partly incited the study of climate as a formal science. People began to chart temperature, barometric pressure, and other weather patterns in hopes of identifying the “ideal” conditions for treating disease. Today ventilation, access to outdoor spaces, and parks still entice homebuyers.
For example, during the 1793 yellow fever epidemic, there was no formal crisis plan. Philadelphians selflessly stepped up to create a makeshift hospital, and build a home for 191 children orphaned by the epidemic. Volunteers collected clothing as well as food and monetary donations. Members of the Free African Society were particularly altruistic, providing two-thirds of the hospital staff. They also transported people, buried the dead, and performed numerous other medical tasks.
The diphtheria outbreak hit Nome, Alaska, in January 1925. This small region inspired national support and innovation. While there was an antitoxin serum available to combat the disease, the region was in short supply and the town was inaccessible by road or sea in the winter. This led to the creation of the Iditarod, the famous dog sled race. The dogsled teams and mushers carried a supply of the serum 674 miles from Fairbanks, in record time, facing temperatures of more than 60 degrees below zero. The challenges of delivery by dogsled also sparked an investigation into the possibilities of medical transport by airplane.
The polio epidemic of 1952 sickened more than 57,000 people across the United States, causing 21,269 cases of paralysis. In response, the National Foundation of Infantile Paralysis (NFIP), which had been founded in 1938 by President Franklin D. Roosevelt distributed around $25 million through its local chapters. The March of Dimes, as it later came to be known, provided iron lungs, rocking chairs, beds and other equipment to medical facilities, and assigned physicians, nurses, physical therapists, and medical social workers where they were needed. The success of this campaign has served as the gold standard in public health education and fundraising since its heyday in the 1940s and 1950s.
Disease can permanently alter society. Public health emergencies have inspired innovations in education, information circulation, and civic debate. The cycle continues today, as media powers and regular citizens flock to social media to discuss COVID-19—disseminating information and collaborating to create solutions.
What will we create in this pandemic?
When this unprecedented plague is over, we may never again take for granted, each deep breath, a handshake with a stranger, close conversations face-to-face, a crowded theater, Friday night out, a roaring stadium, the taste of communion or a shared cold beer, a routine checkup, rush hour traffic, coffee with a friend, a touch, a hug, a kiss…
Coronavirus has:
Let’s celebrate the silver lining, make each moment matter, and thank our essential workers.
Remember, every breath is a gift. With each breath, we have the opportunity to be more. A crisis can spark creativity in remarkable ways.
To laugh often and much;
To win the respect of intelligent people
and the affection of children;
To earn the appreciation of honest critics, and endure the betrayal of false friends;
To appreciate beauty, to find the best in others;
To leave the world a bit better,
whether by a healthy child, a garden patch, or a redeemed social condition.
To know even one life has breathed easier,
because you have lived.
This is to have succeeded.
– Ralph Waldo Emerson
The love you deserve will peek into the most profound parts of who you are, and cradle you there. It will not cower, or run away.
The love you deserve will clap for the parts of yourself you always used to hide, it will cherish the twists within your soul that others always tried to untie.
The love you deserve will be your best when you’re feeling broken. It will show up for you in the dark and love you, even when you think you don’t deserve it.
It will love you unapologetically, and inspire you to believe in the human being that you are becoming.
The love you deserve will support you. It will ruthlessly believe in your brilliant mind and celebrate your depth.
The love you deserve will be your voice of reason. It will see you – your beauty, softness, and the stars in your eyes. It will strengthen your resolve when doubt starts to steep in, and build your restless heart a safe place within itself.
The love you deserve will teach you how to trust in the timing of your life and show you that it will always find you.
The love you deserve will fight for what you have when difficulty hangs heavy in the air. It will insist that you are stronger together, that you are capable of beating the odds, that you are filled with the potential to turn your losses into lessons — into seeds that will make it stronger.
The love you deserve will teach you how courageous it is to simply have faith in the heart of another, how beautiful vulnerability can be after years of hurt.
The love you deserve will teach you that you were never too much for those you always tried to give yourself to. You were always enough. You were just giving your heart to the wrong people.
The love you deserve will show you that you are truly deeply loved.
You are always worthy.
Imperfection is part of life.
It is part of humanity. It is all around us and within us.
Trying to force perfection can be tough on the psyche. While striving to achieve more, we will fall short far too often.
Instead of focusing on your imperfections look at the special qualities that make you uniquely you. Think of how far you’ve come and notice simple moments worth celebrating.
In a fast-paced and often chaotic society, many women tend to put their own needs on the back burner.
As women we often spend much of our lives nurturing others and struggle with giving ourselves permission for self-care.
It’s hard to remember that we, as much as anybody else in the entire universe, deserve our own love and affection. In order to design a more complete and fulfilled life, I’m learning that I need to prioritize self-care, which ultimately nourishes and flourishes every other aspect of life.
Taking care of my well-being and health first is the best way to ensure I will be able to care for all of my love ones. Self-care reduces the stress, worry, anxiety, tension, fear and overwhelm which bury our dreams and weigh us down.
Rest and reflection enable us to tap in the power within and tackle life with more ease.
Toxic work environments, chronic complaining friends, or doom-and-gloom days deplete energy. I’m finding that eliminating these type of triggers allow space for more positivity and abundance.
A calms state of mind opens up a bridge to our unconscious world and is the conduit to realizing what’s possible. When we take time to acknowledge our dreams, we allow ourselves to become more consciously aware of our thoughts, feelings and experiences we may have either repressed, forgotten about, or never been really aware of.
What is weighing you down?
REMEMBER…
When well-being and health is absent, wisdom can’t reveal itself, art can’t manifest, strength can’t strive, wealth becomes useless, intelligence can’t be applied.
Walking is the best exercise!
This year, walk away from arguments that lead you to nowhere but anger. Walk away from people who deliberately put you down. Walk away from any thought that reduces your worth. Walk away from failures and fears that stifle your dreams.
The more you walk away from things that poison your soul, the happier your life would be.
Walk towards joy and peace of mind. Walk towards loving relationships. Walk towards an attitude of gratitude, laughter, action, inspirational experiences, and self-love.
Don’t try to explain yourself to everyone. If they don’t accept you shake it off and keep on walking – don’t try to make them understand. Walk!
Wish you a Happy New Year filled with joy, fulfillment, new dreams, new hopes, new experiences, new joys and a truly prosperous year!
A huge part of being human is the emotional turbulence we all face from time to time, from exciting emotional highs to those unbearable low moments. A recent gallup poll showed that a whopping 55% of people in the US experienced stress on a daily basis. If not dealt with aggressively, these stresses can lead to despair, dejection and despondence.
As someone who has suffered from a bout of stress that left me feeling depleted and depressed, I know that every person going through this is trapped in a tragic cycle of self-blame, self-pity and a lack of will to live life fully.
I came to the realization that the most significant step you can take towards recovery is changing your internal dialogue. Most depressed people will beat themselves up with a myriad of questions in a bid to understand why they are going through such an experience. If we flip the script on the questions we ask ourselves, we have a much higher probability of thriving through it.
Why me?
Think of the challenge as a setup rather than a set back.
Invariably we all must suffer some hardships in life. Instead of falling into the abyss of self-pity and despair, ask how this hardship will help you grow. Rather than asking the question ‘what did I do to deserve this?’ get excited and ask ‘what I’m I being prepared for?’
Why now?
Just as opportunity and good fortune meets us unexpectedly, so can calamity and misfortune. Life is known to throw complications our way when we least expect them. Timing does not matter. Always be prepared to hold the bull by its horns.
Remember, how you react to what life throws your way makes all the difference in determining whether your problems will overcome you or you will overcome them. Determination and perseverance is key if you are to defeat hopelessness and depression. With every obstacle you overcome, you are better prepared to take on more domain.
Ignoring problems doesn’t make them go away. It just makes them fester and grow into bigger, messier problems. Face the problem, learn what it has to teach, grow from it and turn that adversity into a positive benefit. The hard things in life are most definitely the best teachers. In every adversity is the seed of an equal or greater benefit. We just have to open our minds and open our hearts to see what we are being taught.
Where do I go from here?
Some calamities like the loss of a loved can leave one feeling too lost to move on with life. Understandably, some people are unable to pick themselves up. Holocaust survivor, Viktor Frankl reminds us that even in the midst of the most unimaginable horror and daily pain, we can opt not to stay trapped in hurt and loss. By focusing on something worth living for, we can find a way out of the most harrowing turmoils. As devastating as they can seem, often life’s tragedies can bring our biggest breakthroughs.
While psychology is not my field of expertise, my own life experiences led me to share my thoughts on this issue which affects us all. I would like to share these tips as a summary of how to fight the stress and fear which can ultimately lead to despair, dejection and despondence:
In conclusion, when you find yourself overwhelmed, gripped by guilt, lost and confused, stressed and challenged, choose faith over fear.
Both are figments of our imagination. While either can drive you forward, fear often paralyzes, prevents you from taking action and leaves a trail of pain. Faith let’s you live with expectancy and work with a wide open heart. Isn’t that so much more fun?
The disappointing thing about heartbreak warfare is that, once you begin, no one really ever wins. And yet the truth is that in matters of the heart, there’re only two things we all really want – to feel like we’re enough and to be loved.
Heartbreak Warfare is a song by John Mayer, an American blues-rock musician. It’s the opening track on Battle Studies, his 2009 fourth studio album. John Mayer wrote and produced the song. It was featured in the movie Date Night. Here are the lyrics:
Lightning strikes inside my chest to keep me up at night
Dream of ways to make you understand my pain
Clouds of sulfur in the air, bombs are falling everywhere
It’s heartbreak warfare
Once you want it to begin, no one really ever wins
in heartbreak warfare
If you want more love why don’t you say so?
If you want more love why don’t you say so?
Drop his name, push it in, and twist the knife again
Watch my face as I pretend to feel no pain, pain, pain.
Clouds of sulfur in the air, bombs are falling everywhere
It’s heartbreak warfare
Once you want it to begin, no one really ever wins
in heartbreak warfare.
If you want more love why don’t you say so?
If you want more love why don’t you say so?
Just say so…
How come the only way to know how high you get me is to see how far I fall?
God only knows how much I’d love you if you let me but I can’t break through it all.
It’s a heart… heartbreak
I don’t care if we don’t sleep at all tonight
Let’s just fix this whole thing now
I swear to God we’re gonna get it right if you lay your weapon down
Red wine and Ambien
You’re talking shit again, it’s heartbreak warfare
Good to know it’s all a game
Disappointment has a name, it’s heartbreak, heartbreak.
It’s heartbreak warfare
It’s heartbreak warfare
It’s heartbreak warfare
June 3, 2018: Escape
June 3, 2019: You’re on your own
June 3, 2020: Goodbye, my love