Right now the world is experiencing a rapid rise of the SARS CO-V2 virus, which causes the disease COVID-19. The advice I'm sure that you're all hearing right now is to practice social distancing. This means that everybody should be working from home as much as possible, limiting exposure to other people, avoiding groups as much as you can and washing your hands more thoroughly and more frequently than you may have been doing in the past. So SARS CO-V2 is a coronavirus. There are many different corona viruses circulating worldwide right now. Some caused a very mild, almost unnoticeable infection, and some, like SARS or MERS, are extremely dangerous. One of the things that makes this virus so dangerous is that it spreads rapidly through droplets both in the air and on surfaces.

The R-Naught Number

This is where I'd like to explain to you what the reproduction number or R-naught number, means. This is an ever changing number for an infectious agent that represents how quickly it's spreading an R-naught of one means that every infected person is infecting one more person. This number tells us how the virus is spreading and whether it's going to balloon in the population or if it's going to slowly go away on its own.

An R-naught less than one means that statistically, people are recovering faster than they're spreading the virus, and an R-naught greater than one means that statistically infected people are infecting even more people. So right now, the best estimates are that the R-naught for SARS COV2 are between 1.4 and 3.9. This means that the virus is actively spreading and capable of exponential growth in the population. So there are two things to take away from this. The R-naught is a dynamic number, we can lower it through hand washing, social distancing, and self quarantining. Number two, the virus is going to infect a lot of people.

“The WHO estimates that 30 - 70% of the planet will be infected with the virus.”

Mitigating the Danger of Coronavirus (COVID-19)

The WHO estimates that between 30% and 70% of the planet is going to get infected with this virus. However, we can mitigate a lot of the danger by slowing the rate of transmission. If everybody goes about their daily routine as normal. The virus is going to spread hot and fast through our communities, and this is a big deal, as most states have 1 to 2 hospital beds per 1,000 people. If everyone is sick at once, we will not be able to treat everyone using all the tools of modern medicine. In Italy right now, people are dying because there are just not enough resources to go around, and hospitals are overwhelmed with sick people. We don't have the infrastructure to treat everybody all at once.

But if we slow the rate of infection and spread out the course of this virus over a longer period of time, the health care system will be better able to treat every person. This is called "flattening the curve." The same number of people get sick, but over a longer period of time, and they're treated instead of overwhelming the health care system. So let's talk for a second about risk. One of the things that makes this virus so hard to eradicate is that it has an incubation period that could be anywhere from 2 to 14 days, though for most people it's 4 to 6 days.

This means that people can be exposed, feel perfectly healthy, traveled to another area of the country that doesn't have any cases, and then develop this very contagious disease. Most of the people who contracted COVID-19 are middle aged adults, though there are likely many more infected children who are going unreported since they experience a more mild form of the disease. The severity of the illness also correlates with age. The older the patient is, the more likely they are to die from this virus. Risk is fairly mild for people under the age of 40.

What’s Causing Fatalities from Coronavirus

However, the case fatality rate starts to rise rapidly after that. People in their sixties have a 4% risk of dying. That's 1 in 25 people. For people in their seventies, the risk is 8% about 1 in every 12 or 13 people. For people 80 and older, the risk is about 15%, or about 1 in 7 people. These numbers get even higher for people who have chronic diseases like diabetes, heart disease, and lung disease. I want to stress that these numbers are very recent and they're likely overestimates most people who get tested early on in an outbreak have more severe illness. So we're probably missing a lot of people who are infected but didn't feel so poorly that they went to the hospital.

The mortality rate is also highly dependent on the amount of care available to a patient. Deaths will be higher for people who can't access needed supplemental oxygen or ventilators. Our best estimate right now is that the case fatality rate for COVID 19 is likely between 0.5% and 3.5%. That means that in our best case scenario, this is only five times more deadly than the seasonal flu. But it could be up to 35 times more deadly. So another thing I want to talk about is testing. Right now, the U. S is reporting about 1,200 cases of COVID 19.

It's my opinion, though, that this number is substantially lower than the actual rate since our testing capabilities are abysmally low right now. This testing failure has been political in nature as well as logistical and sick people around the country are going untested.

Taking Steps to Prevent Coronavirus

So what can you do about it right now? If you're relatively healthy and under 40, and you get infected, then you might get a fever, cough and maybe some muscle pain. But you'll likely be able to weather it at home. The problem is that people are shedding the virus, i.e. they are infectious before symptoms start, and they continue to shed virus for up to 18 days after onset of symptoms. If we want to drive down the replication number to end this pandemic, we need to keep our distance from one another and wash our hands thoroughly. This is a global problem that has to be solved by individuals.

The virus is relatively easy to kill with soap. You don't need to go nuts with heavy duty cleansers or anything like that. But you do need to wash your hands with soapy water for at least 20 seconds, multiple times per day, and every time you come home. People should also sterilize their phones as they represent a potential reservoir of virus. So please stay home as much as possible, do not congregate, and avoid unnecessary travel. Stop touching your face, wash your hands, and let's save some lives. Hand sanitizers are okay, but studies clearly show that soap and water are more effective. People are dying from this virus, and they're gonna continue to die but we can save lives by practicing some extra hygiene.

Recommended Coronavirus (COVID-19) Wellness Tips

To help protect yourself and to decrease the spread of COVID-19 within the community, I recommend to adhere to the following guidelines and wellness tips:

Clean doorknobs, toilets, cellphones, countertops, refrigerator handles as often as you can. The virus could live on certain surfaces for 4-72 hours.
Work from home if you can.
No tournaments, no sports events, no soccer, baseball, dance, gymnastics, concerts, gym, etc. No matter how much they claim that they will clean the equipment.
Cancel vacation travel. You will be saving many lives by doing so.
Cancel birthday parties, conferences, and so on.
If you are over 60 years old, you should stay home. Use a delivery service for groceries.
If you have family members in a nursing home, consider moving them home for now.
If you feel sick, stay home. It doesn’t matter if you don’t feel "too sick." Going to work will put countless other people at risk.
Cancel all business travel.
Check on your medications, try to get a three month supply of prescription medications.
Many grocery stores have order ahead options with either pick up or delivery. There are online grocery delivery services available in many areas.

Additional Coronavirus (COVID-19) Tips

Wash your hands with soap and hot water for at least 20 seconds, and then dry them. If it resonates with you, pick a healing prayer or mantra for your 20-second timer.
Avoid touching your face, I know it’s hard to do, but please start being mindful of it.
Use hand sanitizer when soap and water are not available. The local stores are out of hand sanitizer and rubbing alcohol, but the liquor store still has Everclear at 75% alcohol (brands vary in strength). Put the Everclear in a small spray bottle and add 10 drops of essential oil. On-guard or Germ fighter are good choices. Alcohol of any variety is drying, so you'll want to apply oil or lotion as well because dry skin weakens a barrier to infection.
Honor social distancing guidelines and any other public health directions. Social distancing is not just about keeping you healthy. It's also about not infecting others who may be more vulnerable and about keeping our healthcare system from becoming overwhelmed.
Take Vitamin D3, 2,000 IUs per day. Vitamin D functions as a hormone as well as a vitamin. Current research shows that it is important to immune function. Supplementation is necessary because we do not get enough sunlight exposure, especially this time of the year, for our bodies to make adequate quantities.
Use a Neti-pot. Do it in the evening before you go to bed and in the morning when you wake up. The neti pot is effective at rinsing out mucus from the sinuses. It is very important to use clean filtered water and a clean pot. Neti can be drying, so you may add a little bit of cooking oil to the neti pot when sick. You can also add one drop of peppermint or eucalyptus essential oil to the neti pot.
Gargle with warm salt water two or three times a day, it may help to rinse out the oral cavity as well as your sinuses.
Start your day with a cup or two of hot water, it's important to stay hydrated. If you like, add fresh lemon or lime.
Use herbs and spices that improve the digestion. Some of them also have been found to have antiviral properties. E.g., black pepper; turmeric; ginger, fresh garlic.
Take a good probiotic (we recommend: Align probiotic supplement )
Take a good omega oil supplement (we recommend OmegaAvail TG1000, also available through the office)
Use a humidifier, Denver is very dry. Aim for 40% relative humidity. Dry air is associated with increased rates of infection from pathogens.
Diffusing essential oils at night or if you work at the office desk, with antiviral properties, such as eucalyptus, holy basil, clove, or cinnamon. Planttherapy.com or Doterra have great quality essential oils (On-guard from Doterra or Germ Fighter from plant therapy are good choices, Breathe from Doterra is a great respiratory blend)

Contributors: Uri Bulow, an MD,PhD candidate at Tufts University

How to Prevent & Prepare for Coronavirus (COVID-19)