"My friends, you can’t get obese by standing next to someone. You can’t kill an elderly neighbor by eating Doritos (but) you can contribute to people’s deaths by going about your regular business. We live in a world where we all just care about ourselves."
That is one ER nurse's plea to the general population as to why they should stay home in the coming weeks due to the coronavirus. Greek-American Stef Dimi then goes on to clarify, "if you are under 50, don’t smoke, or don’t have multiple comorbidities this virus probably won’t affect you (but) your response to this matters. You become infectious before you show symptoms. You don’t want to give this to your parents, or grandparents, or anyone for that matter."
Dr. Lisa Kennedy, a chief economist specializing in health economics with a PhD focused on respiratory infectious diseases explains why Stef's pleas for people to stay home really does matter. "We don’t want the U.S. to face the same capacity problems as Italy. We don’t want our elderly and vulnerable showing up to hospitals but receiving a ‘reverse triage’ like in Italy, we don’t want folks arriving at hospitals that are full – that’s everyone’s nightmare. Avoiding this scenario is what we mean when we say ‘flattening the curve.’"
Some people have questioned why this coronavirus makes it so important to stay home and "flatten the curve" when the flu and other sicknesses don't get nearly the same attention.
Dr. Anastasia Bendebury who has a PhD in microbiology from Columbia University and research experience in infectious disease and human health explains the difference.
"Coronaviridae are relatively new viruses that are more deadly than the flu. Final case fatality rate for SARS was 9.6%, final case fatality rate for MERS is 34.5%. We don't know how dangerous SARS-CoV-2 is going to be in the end, we can only figure out the real numbers retroactively. What we do know is that it spreads way easier than either one of these other viruses.
Dr. Bendebury is a co-founder of the science blog Demystifying Science and writes about why "flatten the curve" is being stressed by government officials especially in NY where Stef is an ER nurse. https://demystifyingscience.com/blog/2020/3/11/flatten-the-curve.
"The current modeling forecasts predict that 40-70% of the world's population will be infected with COVID-19. The virus spreads exponentially, meaning that there will quickly be more infected people than hospital beds. Say 50% of the (American) population gets infected - that's 150 million people. 10% of those people will need hospitalization – which is 15 million people. 50% of them, 7.5 million, will need serious care – ventilators, etc. In the U.S. we have only 3 hospital beds per every 1000 people, which comes out to about 1 million hospital beds.
The 1 million hospital beds are usually filled at 65% capacity, which means that there will be nowhere for 7.5 million folks that need hospitalization to be treated – let alone the ventilators to treat them.
Flattening the curve through hand washing, social distancing, and minimizing travel allows us to slow the spread of the virus so that people who are infected early can be treated, discharged, and the net wave can be helped."
Dr. Kennedy echoes a similar sentiment saying, "everyone’s learning about this virus – we’ve only seen it for about 10 weeks and in that time its devastated countries at a pace we couldn’t even imagine last year. At first we didn’t know if the projections from other countries and epidemiologists would apply to us, but we are seeing country after country brought to its knee by this virus – we need to learn from these lessons and act now."
She continues, "the evidence from other countries plus what we know historically from infectious diseases suggests that once the virus takes hold in a region, it’s hard to stop it – with a lack of any immunity, a virus like this can just sweep through a community with no resistance. This is happening fast – things are changing day by day. By staying home we will see a few things – the first is a little more information on the magnitude of the problem – how much is this circulating and where. Secondly, this will also buy us time to get more testing, training, and infrastructure up and running in the U.S. Thirdly, and most importantly, it will help stop the community transmission of the virus – social distancing, plus greater public awareness and education on how the virus moves and how to avoid infection.”
Michelle Constant of Constant & Associates has more than 20 years of experience in health security and emergency management and has provided consultation on H1N1, ebola, and anthrax to all levels of government and the private sector. She also founded Women in Homeland Security Southern California.
"It is not those who are affected in the next few days that will be the ones most at risk, but those who catch the virus from them in the next ten days. Self-quarantine can prevent the spread that would overwhelm hospitals and force them into making decisions on treatment based on survival rate," says Constant.
Dr. Nicholas Morrissey, Associate Professor of Surgery at Columbia University, talked about how this survival rate is crushing Italy. "If you have a really huge spike in a short period of time, you will overwhelm the medical system and a lot more people will die. This is what happened in Italy, it’s why the mortality rate is so high. The cases spiked so quickly that the ICUs and the hospitals couldn’t handle them. The advantage of social distancing and staying away from groups is that you can slow the spread. You may still get a large number of cases, but the number of cases at any one time won’t overwhelm the healthcare system."
To use a vivid example of how toilet paper can help explain the need for social distancing, Dr. Shikha Jain, Assistant Professor of Medicine at Rush University told us, "in order to prevent the spread of Covid19, it is essential to social distance. The concern with this particular virus is people who have no symptoms could be unknowingly spreading the disease just by coming into contact with more vulnerable individuals. The purpose of ‘flatten the curve’ is to decrease the number of individuals who are infected and critically ill in the initial wave of those who get the illness. If we can spread out the time period during which people get the disease, there is less of a chance for our hospital systems and ICUs to become overwhelmed. An excellent example is this: everyone went to buy toilet paper at the same time because of concerns regarding the pandemic. So now stores are out of toilet paper. If a huge chunk of the population is infected at the same time, hospitals will reach capacity and very sick people will not be able to be treated in the intensive care units. This is the problem Italy is currently facing. The purpose of flatten the curve is to give the best chance for all of those people who end up critically ill to survive.
"Please stay home and help flatten the curve. By staying home you may save a life."
Joseph Welfeld from SUNY Empire State College's Healthcare Administration & Management faculty underscores the goal of flattening the curve is "to avoid a huge peak that would impact the need for healthcare resources (hospital, physician, respirators) on a short term basis that might result in the lack of availability of resources to some patients. This “rationing” of care would result in decisions as to who and who will not receive required services as has occurred in Italy."
Stef finishes her plea saying "we are going to run out of space in hospitals, this is inevitable. Your actions matter. You can help slow this down and give us a fighting chance if you STAY HOME."
How you can stay home and still be safe:
"Flattening the curve, is an important concept in epidemic management, currently coming to the forefront of Coronavirus pandemic planning. Delaying cases of the coronavirus will help prevent our health care systems being overwhelmed by a rapid increase in cases – and potentially delay and decrease the volume of coronavirus illnesses to allow for vaccine development. Social distancing is one way to potentially flatten the curve. Digital health is another; virtual care can provide increased access to screening, earlier diagnosis, and easier dissemination of disease education on self- quarantine – all of which can help flatten the curve.
Using digital health for COVID-19 concerns or another appropriate health care issue allows patients to stay at home for their health care and avoid spreading infections throughout clinics and waiting rooms – or getting exposed to infections themselves. Patients with mild illness can be diagnosed and treated in their own home, which opens up urgent cares and emergency departments for patients that truly need in-person care," says
Zipnosis' Chief Medical Officer, Dr. Lisa Ide.
Manhattan-based, Dr. Nieca Goldberg, a pioneer of cardiac care and Medical Director of NYU Women’s Heart Program says, “one way to reduce stress is to be proactive.”
The general tips for hand washing are important. soap and water have been used by doctors for a long time to prevent transferring infections to patients. Hand sanitizer with 70% alcohol or alcohol are good options when soap is not available. Stay home and practice social distancing.
Food shopping tips:
- Frozen fruits and vegetables are a healthy option. Have the same nutrients as fresh fruits and vegetables.
- When buying canned vegetables and soups choose the low salt option.
- Oatmeal has a long shelf life and with added cinnamon and vanilla make a nice breakfast is full of fiber.
- Pasta choose whole grain or whole wheat- toss in vegetables.
- Tasty and healthy canned tomatoes and dried herbs to make tasty and healthy sauces
- Home exercise if your gym is closed or reducing the number of participants. There is always home exercise. Exercise bands do not take up space and are good for upper and lower body strengthening exercise. Maybe you have a treadmill or bike at home that is collecting dust. Dust it off and use it to get aerobic exercise. You can also take a walk outside as long as you keep your distance from others.
- To reduce stress try meditation or relaxed breathing.