Healthy Indoors Magazine
Issue link: https://hi.healthyindoors.com/i/1227696
22 | March 2020 dent responsible decisions on how to manage and prevent undue infection transmission. RECOMMENDATION FOR INDIVIDUALS Payattentiontothesymptomsyouget.Itiscoldandflu season. A common cold does not include fever. It also usually has upper respiratory symptoms — those of the nose and sinus — stuffy nose, sinus pressure, scratchy or sore throat. The seasonal respiratory flu is very similar to COVID-19. Fever, cough, aches and pains. If you have these symptoms, all public health all over isaskingyoutocallfirst!Callyourdoctor,thelocalpub- lic health department. They will tell you where to go and when and how. This is critically important to others. People with symp- toms should not walk into emergency rooms or waiting rooms where they might spread the disease to those oth- ers in the same rooms. FATALITY information is sketchy, even from WHO and CDC. But, if thebasicsarecorrect,a1-3%fatalityrate"could"bedev- astating to any country's health care infrastructure. Fortu- nately, proper containment and medical response, includ- ing large volume testing, will prevent mass infections. However, public health must consider the worst-case scenario and be prepared. Taking steps to avoid the worst scenario is critical. Understanding the worst-case scenar- io is required to design and implement proper prevention and containment. For example, if the transmission and infection rate are sameasseasonalflu,andiffatalityrateisbetween1and 3%,thetotaldeathswillbe10-30timesthedeathsthan fromseasonalfluandpneumonia. Thisisbecauseflufatalityrateisonly1/10thofone percent!(0.1%).TheU.S.hastensofmillionsofcases offlueachyear.Thetotalnumberofdeathscanrange from 18,000 to 60,000 per year. (Do the math: for every 10,000,000casesofflu,therewillbeabout10,000deaths. And worst years there can be as many as 60 Million cases oftheseasonalflu,with60,000deaths. The worst-case COVID-19 death total in the U.S. "could" be 180,000 all the way up to 1.8 Million in this initial outbreak year. InastatelikeOhio,whichhasabout3%oftotalU.S. population, that would be 5000 to 60,000 deaths IN OHIO. In a crowded large urban area like Greater Cleveland (about 1millionpeople,orabout10%ofOhio),that'could'beabout 500 to 5000 additional deaths in one year from COVID-19. Washington, to the business conference in Boston, the in- fected people with no symptoms, interacting in close quar- ters for prolonged periods of time, were the primary, and possibly only, cause of so many others getting sick. RECOMMENDATION The obvious solution is to simply not interact with others in crowds or groups. This is usually not an excessive burden ordifficulttodo.Itincludesnotattendingeventsaspartof a large audience, sports, concerts, rallies. Mass transpor- tationtoandfromjobsorschoolsismoredifficulttoavoid, but cautions can be taken, such as hand washing, wip- ing chair arms, rails, and perhaps wearing a simple mask when are closer than a few feet to each other, like on a bus or subway train. Importantly, the example is being made by several cautious, smart, and prudent Health Professional organi- zations who have not hesitated to cancel crowded, inter- active, close-quarter events. This includes The American Association for Cancer Research and The American Col- lege of Cardiology meeting, both of which had been sched- uled for later this month. VIRULENCE The risk to any average individual of getting incapacitat- ing symptoms is moderate to low. The virus primarily and most frequently infects the lungs. The typical symptoms include mild fever and coughing. Most people, perhaps one half to two thirds, will have mild symptoms, lasting several days to two weeks. However, a size-able fraction will end up getting severe symptoms,withasignificantnumberrequiringhospitaliza- tion. These symptoms include pneumonia and very high fever and the complications that go along with both. RECOMMENDATION FOR ORGANIZATIONS The most important risk assessment an organization can do is the consideration of which population subgroup is at highest risk for the incapacitating, dangerous, and life-threatening symptoms. It appears that for this illness, the most at-risk group are adults over the age 60, and worse for anyone with pre-existing respiratory or immune-system illness. These seem to be the groups at risk for many other illnesses of course, for obvious reasons. The responsible organization should also consider the likelihood and frequency of interactions as well as the re- quirement as part of the job or task to interact with poten- tially infected others. Once the organization understands who its member are, and what the interactions are, it can then make pru-