I moved to Walla Walla in 1997 to practice medicine at the Walla Walla Clinic. This community rapidly became my home for life. For 15 years my main work has been dealing with infectious disease in the community. COVID-19 has me worried.
The first SARS outbreak (caused by a coronavirus) was detected in China in November, 2002. It spread to 26 countries. But, it faded by July 2003 with fewer than 1,000 deaths. How? Aggressive quarantining of sick or exposed individuals and testing of all contacts.
This coronavirus pandemic will be far worse. The illness caused by the virus, COVID-19, is 10 to 30 times more deadly than seasonal influenza. Think of it. The 2018-19 Flu season resulted in 34,000 deaths in the U.S. This contagion could result in a million deaths. Why has this spread so aggressively and why have we been one step behind in containing it?
Here’s why — 80% of infected people have mild symptoms. In particular, younger, healthy people seem to recover just fine and may appear to have nothing more than a “bad cold.” In Washington state only 16% of positive tests have been on people under age 40. So, they go to school or work with their “cold” spreading it to others. It is spread mainly through large respiratory droplets, from people usually within six feet of each other, just like the flu.
For example: Dad returns from Seattle and develops a “cold.” His son in Walla Walla gets a “cold” or mild “flu” five days later. He goes to school while still coughing. He infects 3 others. Those 3 infect 3 more. Every five days the number of infected children triples. 3 to 9 to 27 to 81 in a total of 20 days. Some children have contact with a grandparent. A grandparent becomes ill and ends up in the ICU at Providence St. Mary Medical Center with pneumonia and on a ventilator. This is called “community spread,” and it can happen with stunning speed.
This may sound exaggerated, but it is not. On March 2, an attorney in New Rochelle, N.Y., presented for medical care and was found to have COVID-19. By March 7, five days later, 51 cases of coronavirus infection were detected with direct links to this patient. There is now a one mile emergency “containment” area in which schools, churches and synagogues are temporarily closed. Large gatherings are banned. The National Guard has been enlisted to help with cleaning of public spaces and providing for quarantined citizens.
So, how do we prevent the New Rochelle experience from visiting Walla Walla and College Place and Milton-Freewater?
Stay home if you are ill. And keep your children home if they are ill, primarily coughing or sneezing, with or without a fever.
If you are ill, stay away from more elderly friends and relatives.
Call your medical provider before just showing up in the waiting room with “cold” symptoms; you could infect the elderly person sitting near you who just came in for a sprained ankle.
Avoid tightly packed crowds. For example, do your shopping at less busy times of the day. If you are sick, let somebody else shop for you.
Wash your hands well after being in public and use a hand sanitizer with 70% alcohol.
If you are seriously ill, such as with a cough, fever and shortness of breath, go the emergency room. Procedures have been put in place to rapidly mask and isolate patients presenting with Covid-19 symptoms. Our ability to test for the virus at first was limited but has expanded rapidly.
This will be a burden for all of us, but we need, as a community, to band together and be vigilant. Employers need to be understanding and tolerant and generous. Businesses are already hurting. Support them when possible. Restaurants will be providing more take-out dinners.
Schools will have children staying at home much longer than normal when ill, until they are not coughing and well enough to return. But, this is about being good neighbors. We will get through this.