COVID-19/Coronavirus: a break down

Hello all, welcome back. Today's blog is slightly different from my usual writing of photography/travel related blogs. I'd like to address the COVID-19 pandemic, providing some useful information and suggestions. You're probably thinking, "pssht, what can you tell us that media hasn't already?", well for one I'm a nurse, and avoiding being sick, or managing sickness is literally my job. This is a bit of a read, so I'll provide a TL;DR at the bottom for anyone who wants it.

This blog will follow a structure like so; firstly I'd like to provide some information on the actual virus itself, secondly, I'd like to explain what happens in pandemics, thirdly, I'll explain what is your duty and how you can best avoid/prevent further spread of COVID-19 in your communities.

What is COVID-19?

COVID-19 is a virus that is more closely related to SARS or MERS rather than the flu. This is the first big point to get across. Many people feel like this is just another flu and it'll be manageable. Let me go in to a little more detail about this. COVID-19 is the specific name for this virus, but it comes from a family tree of "CoronaViruses", this family tree also includes SARS (Severe Acute Respiratory Syndrome) and MERS (Middle East Respiratory Syndrome).

So, if it's not the flu, what is it? CoronaViruses as described by World Health Organisation(WHO) (2020) are "...a large family of viruses that cause illness ranging from the common cold to more severe diseases...". This means different things for different components of our population, because to say something has the capacity to act like "common cold to more severe diseases" is a pretty broad description. But this is entirely true, for those of us that are relatively young to middle aged, fit, healthy, with few comorbidities we are likely to go about our lives relatively unimpeded. The highest risk groups for this disease are the immunocompromised, those with multiple comorbidities, smokers, and the elderly. But what does that all mean? It means for those fit and well, you might have a cough, and feel pretty miserable for a few days, for those at risk, there's a lot more at stake.

What are the symptoms for those who do contract the virus, who aren't lucky enough to have it but be asymptomatic (I'll address this specific group shortly)

WHO (2020) describes the symptoms to be:

Common

• Fever
• Dry Cough
• Tiredness

Less common

• Runny nose
• Aches and pains
• Sore throat
• Nasal congestion
• Diarrhoea (please stop panic buying toilet paper... it's very uncommon)

Uncommon (and bad)

• Shortness of breath/difficulty breathing

Looking at this list, doesn't seem too bad right? But currently the World Health Organisation is stating that roughly 1/6 cases diagnosed become seriously ill and may require hospitalisation. 1 in 6 cases.

On top of this, for us millennials and gen z'ers we're the highest bracket of being "lucky" and acquiring this disease but being entirely asymptomatic (meaning you have it, but don't feel ill at all and don't display any of the symptoms)(Statista, 2020). This is shown via statistics from South Korea (who've managed this pandemic incredibly well and have fantastic testing capabilities). As of March 20th, South Korea has tested roughly 316,000 citizens, that is huge. We can learn a lot from the results of these tests also, like the fact that 27.33% of diagnosed cases comprised of those from 20-29. Why has South Korea noticed a much higher trend of infection for younger groups opposed to the rest of the world? The rest of the world has limited capabilities for testing and is only testing those who are presenting with symptoms (and in certain countries, you can't get a test even if you have symptoms if you haven't had direct contact with a confirmed case or meet other requirements), whereas South Korea is testing as many people as they can, symptomatic or not (News Hub, 2020)(Statista, 2020). This means, if tested, we (20-29's) have a higher likelihood of having the virus, and not knowing, meaning we could be causing others to become sick/infected, making us the one of the main carriers and spreaders of this disease. But why is it a bad thing to have it, and not be sick? Let's talk about pandemics, and herd immunity.

Pandemics 101

What is a "Pandemic"? A pandemic, simply defined is a global outbreak of a disease. We are currently experiencing a pandemic, as Covid-19 is currently "world-wide". It doesn't mean that it's super deadly, or super bad, there is often a lot of associated fear with the title pandemic, but it just terminology used for the "spread" of an illness or disease. What is an issue with this disease though, is how easily it can spread. We addressed this lightly before, but we'll go into a little more depth this time.

So, as stated prior, fit and well, middle aged and lower don't tend to have adverse outcomes as a result of this virus. However, we want to be able to protect those individuals who are at risk, we also want to keep in mind the 1/6 adverse outcomes per diagnosed. This is where we'll experience the greatest challenge, protecting the vulnerable.

How does Covid-19 spread?

The spread of Covid-19 is mostly attributed to contact with the virus via nose, eyes or mouth. "But Justin, I don't lick handrails, or wipe my eyeballs on groceries at the supermarket, I should be fine". Correct, while it's great that we're not making that direct contact with our eyes, nose or mouth, our hands are a huge vector for this and the virus seems to have a surface life of up to 3 days on certain surfaces (The New England Journal of Medicine, Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1, 2020) . People supposedly on average touch their face 20+ times an hour subconsciously (Kwok, Gralton, McLaws, 2015). That's a lot of Covid-19 Russian Roulette over the course of a day, especially if you haven't maintained adequate hand hygiene. Not only that, sharing food or drinks with friends, partners, relatives can be a source of infection (they've touched said item with their mouth, then you've potentially touched the same spot with your mouth). Kissing is also a mode of transmission. Being in close proximity to others is also a mode of transmission, however, the virus isn't "airborne" in a literal sense. Close proximity could allow someone to accidentally sneeze/cough/spit(unintentionally (I'd hope)) in your direction, if any of those droplets land on you, there's a potential for infection (WHO, 2020, Q&A on Coronaviruses - How does Covid-19 spread?). It has a high mode of transmission, this is why it's an issue. Not only that, if someone is sick we can avoid them, but with Covid-19, it has an incubation period of roughly 4 days (the time it takes for you to get sick after it's in your body). You can infect people in this time before you know you're sick. Some of us can be "sick" and just not notice. That means even if you're "well", you could potentially infect others. It's speculated that each person who gets the disease will infect another 4 people on average. So droplets, or contact with a source then our mouth, nose or eyes, and everyone around you or even you, yourself could potentially be a time bomb... Fantastic...

What can we do about it?!

Remember before how we mentioned herd immunity? The general premise of herd immunity is if you have 10 people, and of those 10 people:

• 1 can get incredibly sick
• 2 can get sick and not care
• 7 are "immune" to the sickness

To protect the 1 person, it's up to the group to not spread the illness. As there are 7 people in the group who are immune, that means the sickness has less potential hosts and the 1 we are trying to protect has a lower chance of contracting the illness. This is a very basic general premise on herd immunity, it is the same concept supporting immunisations and vaccinations, reducing the total number of potential hosts to protect the vulnerable. However! We don't have a vaccine for this, we currently have 10 people that (hypothetically) includes:

• 2 can get incredibly sick
• 4 can get sick and not care (but unknowingly make the others sick)
• 4 that can get sick and might need some time off

How do we protect those that are vulnerable? Our "herd immunity" model doesn't work because it can go through all of us to make the others sick, also the more people that are sick around the vulnerable increases their odds of becoming sick.

So what can we do if we don't have this immunity or vaccine yet?

We can create the illusion of herd immunity by social/physical distancing. If we reduce the amount of contact we have with others, we reduce our potential to be infected and if we are infected we reduce our potential to infect others. This requires a large amount of disruption to our standards of social life though (unless you're a gamer, then you've been practicing social distancing since you started... so, good job...). But realistically we should be reducing our time around strangers, not going to large gatherings or anything that requires people to be in close proximity for any period of time, reducing physical contact with others, don't shake hands, don't hug friends etc. By doing this, we hopefully prevent the spread through the whole group, which also reduces the potential for those at risk to contract the virus. WHO currently advocates alongside all medical professions for Social Distancing as one of the best ways to reduce the impact of this disease. It is currently recommended that people maintain a distance of roughly 1.5-2metres between each other to reduce the incidence of infection (WHO, 2020, Q&A on Coronaviruses - What can I do to protect myself and prevent the spread of disease?).

What else can we do?

On this topic, the other pertinent strategy to staying healthy? Washing your hands, and not touching your face! I was living in pretty close proximity with a group of work colleagues in a hostel until about a week ago, I called them out on all the times where they were subconsciously putting themselves at risk. It requires a lot of effort and mindfulness, and sometimes it also means being uncomfortable (I don't care if your nose or eyes are itchy, don't scratch them). They mentioned that in the few days since I'd left, they were back to old habits and it was really difficult for them to not subconsciously touch their faces again. But it is about being aware of it. As a general rule, don't touch your face, especially if you haven't just washed your hands, and if you do touch your face, wash your hands afterwards.

It's great to wash your hands frequently, but not all hand washing is the same. Ideally it is for 20 seconds with soap and warm water, dried on paper towel for hygienic purposes, hitting all parts of your hands, not just your palms. Hand sanitiser can also work, however it needs to have a concentration of 60%+ alcohol otherwise it's useless (WHO, 2020, Q&A on Coronaviruses - What can I do to protect myself and prevent the spread of disease?). And realistically, you're washing/sanitising your hands after contact with anything that isn't clean if you're about to eat. This means if you open a packet of chips, you sanitise/wash before you eat your first chip, and you don't touch the packaging again as it is a "soiled" surface. Keep your cleans (inside of packing) away from dirties (outside of packing, hands, etc.).

Additionally, please don't touch your phone when you're eating... Phones are a huge breeding ground for these types of things and can potentially be a source of infection if you've touched a surface with the virus, then touched your phone. If you're handling your phone while eating, you are putting yourself at risk.

What about face masks?

Now, this is a hotly contended point. General public, I'm sorry, but I need to side with health care professionals on this point. You need to stop panic buying face masks. There's no confirmation that using a face mask reduces your incidence of exposure due to droplets (WHO, 2020, Q&A on Coronaviruses - Should I wear a mask to protect myself?). However, they do provide the tangible benefit of being a reminder not to touch your face. For this point I would recommend tracking down some reusable fabric face masks. As for the disposable medical masks, I urge you to please leave them where they are. Why? Because if your health care professionals get sick and can't work, what do you think happens to the medical system? It stops. Additionally, the public going out and panic buying masks, do you know how to use them properly? Especially people walking around with their N95's? They are uncomfortable to wear, and if you are comfortable, you're wearing it wrong and it's then a waste of vital resources. Grab some reusable masks, avoid disposable masks and please leave them for the professionals that desperately need them. There is a time and place for face masks, please be informed before wasting resources.

Well, that's about it, hopefully you've been able to take something from this blog. The key components are looking out for your health, we do this by good hand hygiene, social distancing, and not going out if you feel the slightest bit unwell. If you are symptomatic, most Australia is asking it's residents to phone their local GP to arrange a time to be seen rather than just going into the clinic and potentially infecting others. The disease itself is pretty manageable, but if it runs away from us, then we're in trouble. If our healthcare system gets flooded similar to Italy's we will run into issues of being able to provide healthcare. We may be in the same difficult spot where they are needing to choose who lives or dies as they allocate resources. Not just for people affected by Covid-19, but for anyone else that needs a hospital bed, had a heart attack? No bed? Good luck. Had a car accident? A friend took a bad batch of party drugs? Fell over and hit your head? Had a stroke? There's so many flow on effects that come from us not controlling this. Do the right thing.

TL;DR--

• Wash your damn hands
• Don't go out if you're sick
• Social distancing/less interaction around groups
• For the love of god, don't go out if you're sick
• Don't go out if you're sick
• Don't go out if you're sick

Once again, thanks for stopping by! It means a lot to be able to share something like this with you guys. - J

As always, if you've enjoyed this blog, or if you've found some benefit from this, feel free to share it around, drop a comment on the facebook post with this blog on my page, or if you're really feeling generous Vocal allows readers to leave tips. If you've found some benefit from this, please tip 😂 I'm currently on a 14 day isolation as imposed by our government for all that have returned from another country. A little goes a long way 🙏

References (forgive my lax use of APA6):

Q&A on coronaviruses (COVID-19) https://www.who.int/news-room/q-a-detail/q-a-coronaviruses

Coronavirus: New graph shows people in their 20s are more asymptomatic and not being tested for COVID-19 https://www.newshub.co.nz/home/world/2020/03/coronavirus-new-graph-shows-people-in-their-20s-are-more-asymptomatic-and-not-being-tested-for-covid-19.html

Age distribution of coronavirus (COVID-19) cases in South Korea as of March 20, 2020 https://www.statista.com/statistics/1102730/south-korea-coronavirus-cases-by-age/

2019 Novel Coronavirus (COVID-19) Outbreak: A Review of the Current Literature (Feb 11, 2020 (some data is old, such as surface life)) https://www.ejmo.org/pdf/2019%20Novel%20Coronavirus%20COVID19%20Outbreak%20A%20Review%20of%20the%20Current%20Literature-12220.pdf

Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1 (2020) https://www.nejm.org/doi/10.1056/NEJMc2004973

Kwok, Gralton, McLaws, Face touching: a frequent habit that has implications for hand hygiene. (2015) https://www.ncbi.nlm.nih.gov/pubmed/25637115