First off, I want to take this time to encourage all of us, no matter what our health status, to focus on building our immune systems– individual resilience makes for collective resilience. With many locales on a “shelter-at-home” order,this is a great time to boost some of the pointers I highlighted in Brave New Medicine: getting extra sleep, cooking slow foods, and practicing pleasure.

The low-down from academic medicine

Highlights from UCSF Medical Center yesterday:

  • This outbreak is far more serious than anyone had predicted
  • The very best way for us all to keep ourselves and our loved ones safe, and, as importantly, to “flatten the curve” of this outbreak is to practice PHYSICAL ISOLATION and HAND WASHING.
  • Some findings show the virus can be transmitted by breathing, not just by coughing/sneezing – in addition to persisting on surfaces – so the 6-feet rule of social distancing is important if you’re out and about.
  • If you’re exposed to COVID, you’re likely to see symptoms in about 2-9 days, with median of 5 days.
  • The common symptoms are acute respiratory distress and fever, often high, which may be intermittent but can be persistent and last over 10 days.
  • Breakdown of cases thus far: About 80% of those who contract COVID only get mildly ill; 14% get hospital-ill, 6-8% critically ill. The mortality rate seems to be between 1-3%, but that needs to be adjusted for age. Mortality is 10-15% over 80, and drops lower for younger cohorts.
  • The bulk of those who fall ill are aged 40-55, with 50 being the median. But being young and healthy (zero medical problems) does NOT rule out serious illness or death; it may just delay the time course to developing significant respiratory illness by about a week or longer.
  • The virus spreads by air and in droplets (sneezing and coughing), but also via fecal-oral transmission. This is where hand washing with soap is key. And try to eat only cooked foods if you didn’t prepare them yourself.
  • COVID likely originated in bats. But for those sharing rumors that COVID came from Chinese people eating them, researchers now believe it went from bats to another animal species before jumping to humans, and that fecal-oral transmission was the likely vector. WASH YOUR HANDS.
  • There are no anti-viral treatments for COVID yet. One antiviral medicine has shown signs of reducing mortality but it is in still in tests, is in short supply and only available under restriction. Steroids, a common treatment for respiratory illness, may make things worse.

How long can the virus survive on surfaces? 

Findings from a recent study published in the New England Journal of Medicine:

  • in aerosols up to 3 hours post aerosolization
  • up to 4 hours on copper
  • up to 24 hours on cardboard
  • up to 3 days on plastic and stainless steel.
  • the median half-life estimate for Covid-19 is ~13 hours on steel and ~16 hours on polypropylene.

CLICK HERE for a great summary of a chemist depicting how and why soap disrupts the virus– by dissolving the envelope which encases it.

The latest from the medical fronts is to wash all produce with soap and water– either scrubbing hard produce like oranges or potatoes or, for soft produce like salad greens and blueberries, soaking in soapy water for 15 min. They’re also recommending wiping down all surfaces, like clamshell containers or juice canisters. 
COVID 19, while easily transmissible, is wimpy when it comes to soap and water. Soap and water dissolves the envelope of the virus and renders it disrupted (it can’t be “dead” because it’s not an autonomous living organism, as strange as that seems right now).
*And while you wash, shift your mindset to simply giving your foods a good bath :-). Can shift us from fight-or-flight to rest-and-relax! 

The good and simple news

We should all be able to stay relatively safe if we practice physical distancing — no friends or visitors. “Shelter-in-place” or “work from home” means no going to the gym or anything that involves exposure to crowds of any kind. 

BUT physical distancing does not equal social isolation. Our technology allows most of us to reach out by phone or video conferencing. Many neighborhoods here in the Bay Area also have online systems in place for neighbors in need of errands or food or other essentials. Schools are continuing through online platforms. Churches are alive and virtually connecting, too. 

My qigong teacher, Master Mingtong Gu of The Chi Center, has been holding livestream healing meditations for any and all interested. Last Sunday some 500 of us tuned in, and the healing and calming was palpable.

 

The primary thing we can do is simple: be mindful and wash our hands with soap and water!

In health and healing,