How to prepare for Coronavirus

[DocSnowball]

This thread courtesy @ReadTheFootnotes

 

Goal: Curate the best evidence-based information on how to prepare:

1) to not get Coronavirus in the first place

2) to survive it if you get it (focus on this thread is curating information about self-care at home not medical care)

 

Two quick links to start, more can be posted using our collective wisdom.

https://www.cdc.gov/coronavirus/2019-ncov/prepare/index.html

 

https://www.cdc.gov/coronavirus/2019-ncov/faq.html

 

Once we have enough good information, we can try to make a checklist

CDC checklist here:

https://www.cdc.gov/coronavirus/2019-ncov/prepare/checklist-household-ready.html

 

Disclaimer: This is not professional medical opinion, only general information on a discussion board.

[Read the Footnotes]

Thank you, DocSnowball.

 

Several board members I respect have been following John Campbell. He seems to be capable of explaining ideas well to the general public.

Some of these ideas could keep us safer and help us do a better job of building or updated our models whether a mental model or an explicit model of this pandemic. Here's John's YouTube channel:

 

https://www.youtube.com/channel/UCF9IOB2TExg3QIBupFtBDxg

 

One idea I got from John Campbell is to get a thermometer, pulse/oxymeter, scale with % body fat. Combine that with a SPREADSHEET and you can track the DATA. If hospitals are overwhelmed, the odds of getting help early in the disease progress could be low.

 

In many parts of the world the system is so inadequate, that the recommendation is basically that you should stay home until you get to the point you can't breathe for yourself anymore. I have heard from board members that they are being turned away from the hospital to care for themselves and that tests are not available to them in north america. If you find yourself in this situation, this information could help you track your vitals and perform a function that might be performed for you by a nurse in better times.

 

**Importantly, the time to start this in my opinion is BEFORE you get sick. The reason is that it could serve as an early warning system that your body is fighting something.**

 

Further information here:

 

 

 

That's right. Spreadsheets and data, this should be right in your wheelhouse!

 

John Campbell on the importance of not taking NSAID's

 

 

If you want to lay in Supplies:

Expectorant and cough suppressant-this was recommended as the most likely early treatment back in January and that has not changed

Gatorade

Interesting assortment of things to drink: tea, propel, seltzers, etc

Tylenol (acetomenophen)

 

[Jurgis]

John Campbell on the importance of not taking NSAID's

 

 

His advice against taking acetaminophen/tylenol is somewhat controversial. I've heard this theory (i.e. don't reduce fever, your body fights disease better when in fever) before. It is not what most doctors suggest although it is possible that anti-fever medications are overprescribed and overused. Do more research or follow what your doctor says. Also:

 

https://www.thejournal.ie/ibuprofen-cuh-coronavirus-whatsapp-5047311-Mar2020/

[Read the Footnotes]

Has anyone heard of good practices for those who are treating at home? I just spoke to yet another board member who has it. He goes way back on the board and at the Fairfax meetings. Please share reputable sources.

 

I have now spoken to several board members. Be VERY careful. All of them say it started so subtly that they didn't realize what was happening. The expected progression is that it will get much worse about day 7-9. If you are having mild symptoms it could be COVID-19 in the early days. People are also reporting feeling very anxious especially at night and they had difficulty sleeping. They and/or their healthcare providers dismissed it as anxiety surrounding the trouble events in the world, but eventually it became clear it was much more. I am having to communicate by text with one of them because he is too breathless to speak, but he can text.

[Jurgis]

These people are officially tested and diagnosed or just suspecting that they have CoVid but not tested?

 

Best well wishes to all of them.

[Read the Footnotes]

These people are officially tested and diagnosed or just suspecting that they have CoVid but not tested?

 

Best well wishes to all of them.

 

Still nearly impossible to get tested for COVID-19. Two of them were telling me it takes hours to even get tested for flu and impossible to get the COVID-19 test.

 

Yesterday afternoon I didn't know anyone, now I am losing count of how many friends and their immediate family members are being effected by this.

[LongHaul]

I am not a doctor but happy to put my 2 cents in.

 

Evidence Based solutions for Combating Viruses in the Human body

 

Take Sambucol (Elderberry Extract) - Antiviral properties have been shown in multiple studies including reduced flu symptoms and with Coronavirus'.  Not yet the Covid 19 but to

me worst case it wont help, best case could help significantly. 

 

Gargle with Salt Water and Salt Water in Nose (3x per day) - Less time sick according to 1 study and less chance of transmission.

 

Have Chicken Soup - Salty broth, hot liquids down throat and other beneficial nutrients appear to have a beneficial effect.

 

Get Plenty of Sleep and Rest - Enhances Immune Defense and minimizes chance of getting sick in the first place.

 

Drink More Liquids - Good hydration helps keep mucous loose and helps your body function at the optimal level.

 

Minimize Stress - Stress can weaken the immune system

 

Good Nutrition - Helps immune system function. If missing micronutrients Immune system may not be optimal.

 

Articles and Studies

https://www.sciencedirect.com/science/article/abs/pii/S1756464619300313

https://www.dailymail.co.uk/health/article-6654291/Gargling-salt-water-cure-common-cold-body-produces-anti-viral-BLEACH.html

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3256323/

https://health.clevelandclinic.org/what-happens-when-your-immune-system-gets-stressed-out/

https://www.nature.com/articles/1601819

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3899428/ (S. Nigra (elderberry) rendered a coronavirus less infectious) from 2014)

 

I would also ask for the most recent drugs that could help.

 

Also - I have seen mentioned before that fever which is your body's natural immune defense helps lessen sickness length.

I read today this which seems to confirm it.  https://www.theguardian.com/world/2020/mar/14/anti-inflammatory-drugs-may-aggravate-coronavirus-infection

If you can best to let the fever run its course it looks like.

 

FYI - I am on personal lockdown.  Absolutely minimal contact with non-family and trying to keep a safe distance 6ft + from people.

There is no upside for anyone to getting or spreading this.  You can resume normal like when normality hits.

 

Wishing everyone in the world to stay safe, be careful and be vigilant.  Get well to those who have it.

[DocSnowball]

A nice 25 minute webinar from Johns Hopkins, available for free on youtube. If you're just starting to learn about COVID, this is a good place to learn the technical side of it.

 

CDC recommendations on how to prevent COVID from spreading to another household contact (it's long I know, needs to be converted to a checklist by someone who has time). Please know this happened quite a lot in China.

https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-prevent-spread.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fguidance-prevent-spread.html

 

 

[DocSnowball]

 

"Covid 19 Protecting Your Family"

Take a listen, excellent practical explanations. Well worth your time!

 

[DocSnowball]

New model published in Lancet ID based on China, Diamond princess and those who came out of China to the rest of the world, revising fatality rates down. Attached fatality rates table by age groups.  See Table 1 for fatality rates and Table 3 for projected hospitalization rates by age group (does not go deeper into those with high risk conditions). Time will tell!

 

https://www.thelancet.com/action/showPdf?pii=S1473-3099%2820%2930243-7

 

A state by state healthcare system and population based projection here from IHMI:

It models the burden on hospital resources and deaths for the US and for each state.  NY is predicted to peak on 6 April, and the US as a whole in mid-April.  Although there are wide confidence intervals, the number are sobering.  They predict about 80K deaths.

 

The IHME has been the lead on the global burden of disease study – the definitive ongoing study of disease burden (mortality & disability) for more than 350 diseases and 84 risk factors in 195 countries (https://vizhub.healthdata.org/gbd-compare/).

 

https://covid19.healthdata.org/projections 

Lancet_ID_Table_1.pdf

[Guest Schwab711]

New model published in Lancet ID based on China, Diamond princess and those who came out of China to the rest of the world, revising fatality rates down. Attached fatality rates table by age groups.  See Table 1 for fatality rates and Table 3 for projected hospitalization rates by age group (does not go deeper into those with high risk conditions). Time will tell!

 

https://www.thelancet.com/action/showPdf?pii=S1473-3099%2820%2930243-7

 

A state by state healthcare system and population based projection here from IHMI:

It models the burden on hospital resources and deaths for the US and for each state.  NY is predicted to peak on 6 April, and the US as a whole in mid-April.  Although there are wide confidence intervals, the number are sobering.  They predict about 80K deaths.

 

The IHME has been the lead on the global burden of disease study – the definitive ongoing study of disease burden (mortality & disability) for more than 350 diseases and 84 risk factors in 195 countries (https://vizhub.healthdata.org/gbd-compare/).

 

https://covid19.healthdata.org/projections

 

Thanks for posting this!

[Dalal.Holdings]

My recommendations would be as follows (if not infected or if infected). If you are infected with URI symptoms, remember the goal is to prevent spread to your lungs (i.e. a lower respiratory tract infection). If you keep it as URI (in your nose, throat/pharynx), over time you will build antibodies (IgG in particular) to defend your whole body including lungs. Stop spread to the lungs however you can/optimize defenses by:

 

1) Humidify indoor spaces: mucociliary clearance (MCC) is the lung's primary innate defense mechanism (innate immunity, does not require prior exposure to a pathogen). Patients with impaired MCC (cystic fibrosis) are prone to frequent pneumonia. Studies show MCC is optimized at 100% relative humidity, adequate hydration, and avoiding cold temps (Pubmed ID: 27864314, https://www.researchgate.net/figure/Mechanisms-involved-in-respiratory-epithelial-innate-immunity-Inhaled-pathogens-such-as_fig1_304577962, https://www.ncbi.nlm.nih.gov/pubmed/25361567)

 

2) Maintain hydration. If dehydrated, hydrate with fluids consistent with oral rehydration therapy (water + some sugar + salts) which allows H2O to be absorbed optimally via osmosis in GI tract. This keeps your airways moist, optimizes MCC, and increases mucous layer on respiratory epithelium (PCL) which prevents viral attachment and allows for clearance (Pubmed ID: 27864314)

 

3) Avoid cold temps (MCC/beating of the cilia is optimized when you are at core body temp/you don't breathe in super cold air) (Pubmed ID: 27864314)

 

4) Vitamin D at least 2000 IU a day has been shown to reduce URI frequency/severity, particularly in those who are Vitamin D deficient (increased deficiency in low sunlight places) (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3543548/)

 

5) Avoid close contacts (there may be a correlation to viral load and disease severity, but a lot of uncertainty at this point)

 

6) Light/moderate exercises (only if you are not sick, can help overall immune function)

 

7) Daily multi vitamin, fruits/vegetables

 

 

Obviously some of these depend on if there is no contraindication in the individual/underlying conditions that would preclude doing these

[LongHaul]

My recommendations would be as follows (if not infected or if infected). If you are infected with URI symptoms, remember the goal is to prevent spread to your lungs (i.e. a lower respiratory tract infection). If you keep it as URI (in your nose, throat/pharynx), over time you will build antibodies (IgG in particular) to defend your whole body including lungs. Stop spread to the lungs however you can/optimize defenses by:

 

1) Humidify indoor spaces: mucociliary clearance (MCC) is the lung's primary innate defense mechanism (innate immunity, does not require prior exposure to a pathogen). Patients with impaired MCC (cystic fibrosis) are prone to frequent pneumonia. Studies show MCC is optimized at 100% relative humidity, adequate hydration, and avoiding cold temps (Pubmed ID: 27864314, https://www.researchgate.net/figure/Mechanisms-involved-in-respiratory-epithelial-innate-immunity-Inhaled-pathogens-such-as_fig1_304577962, https://www.ncbi.nlm.nih.gov/pubmed/25361567)

 

2) Maintain hydration. If dehydrated, hydrate with fluids consistent with oral rehydration therapy (water + some sugar + salts) which allows H2O to be absorbed optimally via osmosis in GI tract. This keeps your airways moist, optimizes MCC, and increases mucous layer on respiratory epithelium (PCL) which prevents viral attachment and allows for clearance (Pubmed ID: 27864314)

 

3) Avoid cold temps (MCC/beating of the cilia is optimized when you are at core body temp/you don't breathe in super cold air) (Pubmed ID: 27864314)

 

4) Vitamin D at least 2000 IU a day has been shown to reduce URI frequency/severity, particularly in those who are Vitamin D deficient (increased deficiency in low sunlight places) (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3543548/)

 

5) Avoid close contacts (there may be a correlation to viral load and disease severity, but a lot of uncertainty at this point)

 

6) Light/moderate exercises (only if you are not sick, can help overall immune function)

 

7) Daily multi vitamin, fruits/vegetables

 

 

Obviously some of these depend on if there is no contraindication in the individual/underlying conditions that would preclude doing these

 

Very helpful.  Thanks Doc!

[Jurgis]

3) Avoid cold temps (MCC/beating of the cilia is optimized when you are at core body temp/you don't breathe in super cold air) (Pubmed ID: 27864314)

 

OT.

 

Ahh, so this might be an explanation for a belief that you get cold/flu/pneumonia from being cold (or in the cold). It's just the MCC - and maybe some other parts of immune system? - work worse when a person is cold (is outside in the cold), so they are more likely to get infected?

 

Thanks for insight.

[Dalal.Holdings]

3) Avoid cold temps (MCC/beating of the cilia is optimized when you are at core body temp/you don't breathe in super cold air) (Pubmed ID: 27864314)

 

OT.

 

Ahh, so this might be an explanation for a belief that you get cold/flu/pneumonia from being cold (or in the cold). It's just the MCC - and maybe some other parts of immune system? - work worse when a person is cold (is outside in the cold), so they are more likely to get infected?

 

Thanks for insight.

 

Most definitely. And remember--cold air is also drier (less humid), so it may dry out mucous lining in airways as you breathe it in (esp if you are a mouth breather vs nose breather) which impairs MCC/allows viruses to attach and gain entry into cells. Studies also show respiratory droplets (containing influenza for example) travel shorter distances in humid air vs dry air which may explain why Flu is seasonal towards cold/dry seasons (https://jvi.asm.org/content/88/14/7692).

 

As COVID also spreads via respiratory droplets, humidifying indoors spaces and maintaining warmer temps is a low risk, potentially high reward action you can take to protect yourself.

 

Influenza virus transmission is dependent on humidity and temperature.Using the then newly developed guinea pig model of influenza virus transmission (4), we tested directly the impact of ambient temperature and relative humidity (RH) on the efficiency of viral spread between hosts. When inoculated and exposed guinea pigs were housed in separate cages, transmission was found to be dependent on both temperature and RH (5, 6). Transmission was highly efficient at 5°C but was blocked or inefficient at 30°C. Dry conditions (20% and 35% RH) were also found to be more favorable for spread than either intermediate (50% RH) or humid (80% RH) conditions (Fig. 1A). These results were obtained initially using a seasonal human strain, A/Panama/2007/1999 (H3N2), and were subsequently confirmed with a 2009 pandemic isolate, A/Netherlands/602/2009 (H1N1). Transmission at low (5°C) versus intermediate (20°C) temperatures was also tested with two influenza B viruses and found to be more efficient under colder conditions (7). Thus, transmission of human influenza viruses by a respiratory droplet or aerosol route in the guinea pig model proceeds most readily under cold, dry conditions.

[LC]

Drink warm/hot liquids (tea, honey, maybe a pinch of salt!)

[Spekulatius]

I know Dalal.Holdings  mentioned this before, but there is more and more evidence that Vitamin D is protecting against COVID-19 or at least the severe progression:

https://www.marketwatch.com/story/new-study-claims-vitamin-d-deficiency-may-impact-coronavirus-mortality-rates-2020-05-08

 

Anyways, cheap insurance with very little downside if it doesn’t work. So take in some sun when you can or some Vitamin D gel tablets.

[Spekulatius]

Risk know them - avoid them seems like a good

https://www.erinbromage.com/post/the-risks-know-them-avoid-them

 

It’s quite shocking to read the case studies about how one person in a choir could infect many people in the church after a couple hours of exposure for example.

On the other hand the risk to contract COVID outdoors seems to be vastly overrated, so politicians really should open parks and beaches.