CORONAVIRUS FOR DUMMIES
My last two essays were, you guessed it, on COVID-19. That is all you hear on the radio or TV these days. In keeping with the trend, I am continuing to stir the pot. It has gone viral. Coronavirus, true to its name, is a virus that has gone viral!
Viruses grow exponentially (J-shaped growth curve), the fastest growth rate there is, the larger the growing population, the faster the growth, as long as the food holds out. When the food runs out, the curve then changes to a logistic curve (S-shaped growth curve). This curve shows a slowing down of growth. So what makes the curve slow down? There are only two things that make the curve slow down: #1 fewer in the susceptible herd are available (either through the susceptible making themselves less available or the process makes the susceptibles less available ). #2 the rate of growth slows down. This happens when it takes longer to infect the next person. This could be when people wash their hands more often, don’t go out to spread the virus, or at least sneeze into a napkin. Ultimately when the food supply runs out, both mechanisms are at work, reducing the susceptible and the rate of spread.
The number of new cases will slow down, guaranteed! But will we still be alive to talk about it? I think we will. There are several reasons I believe this. We are worried about it, in fact too worried! As evidenced by the stock market! The virus is not as dangerous as the news media tells us. The mortality rate is likely not 9% as SARS was, it is closer to 0.1% as the last flu outbreak was. The measures we are taking to reduce the number of people exposed, and the rate of spread will reduce the number of new cases. It is common sense not to go out and buy cruise trip tickets. It is common sense to limit your unnecessary exposure to large crowds. It is common sense to wash your hands often. It is common sense not to bring the virus close to the places the virus gains entry to your lungs, like your eyes, your nose, and mouth. The virus stays active for a couple of days on any surface, such as a door nob, so washing hands is not only hygienic but important.
I have been in the doctor business over two-thirds of my lifetime, and have washed my hands to the point that I have scrubbed off my fingerprints.
They always have trouble when I need to give a fingerprint for a passport or other ID, because I obliterated them off over the years. I first learned to scrub for surgery in my third year of medical school at UCLA from one of the icons of surgery. He put soot on our hands, then blindfolded us, gave us a brush and soap, and made us scrub our hands. You would be surprised how much soot stayed on our hands and the places that were most likely to remain black, the back of our hands, the webspace between the fingers, and the space between the wrist and the palm. For medical students, it was a minimum of ten minutes (first scrub of the day) to get our hands clean. But for our purposes, washing for 20 seconds is generally enough. I learned a nice little trick from my grandchildren’s primary school teacher, singing the “Happy Birthday” song twice (at regular speed) is precisely 20 seconds.
You get the virus from another person, either through direct contact or through a surface, the infected person has left some body fluids. Avoiding other people is one way to decrease contact. I believe that shaking hands was an ancient, rather strange custom. It goes back to the Middle Ages when you met someone in the forest. You extended your right hand, as did the other person, to show that they did not have a dagger in it. It was somewhat awkward standing there with both your and his hands extended, so grabbing and shaking seemed like the right thing to do. As we don’t carry daggers any more, this Middle Age custom has outlived its usefulness and needs to stop. I vote for the Mr. Spock handshake: right hand raised at your side with the index and middle finger spread form the ring and pinky finger in a V configuration. This is necessary because if you don’t spread your fingers, it looks like a “Heil Hitler.” And if you leave just your middle finger up, it changes the entire meaning.
Viruses, like white men, can’t jump. Therefore a yard distance between people should be enough although the CDC in an abundance of caution has now revised it to two yards unless they are coughing or sneezing. If they are, you need to get out of that room, because the sneeze generates particles that are as small as 5 microns in diameter that travel over 100 miles per hour, and can stay in the air indefinitely like any pollen sized or smaller particle.
Masks are not very helpful, except for the ill person who coughs and sneezes. It keeps the particles that are spewed out more confined. Regular masks, actually, are not very effective in preventing inhalation. For one thing, the sides allow fine airborne mist to enter the space behind the mask, which is inhaled. To be effective, it has to be a special mask fitted to the individual that allows only air that goes through the mask to get to the person using it. Those masks do not let fine mist or small particles to go through. These are called N95 masks.
Hugging is another one of those human customs that should go away. I won’t even discuss kissing. Hugging and kissing ought to go the way of arranged marriages and should be relegated to the XO on the written word.
Good Luck!! Gus Iwasiuk XOXO