The Problem?

You want to get back to normal. OK, I get it … I understand. But, here’s the problem. COVID – 19 (C19) has created a “new normal” for our “modern” world. So, let’s carry on with “safety first” for ourselves and for others who are around us.

Tired?

Yes, we are all in the same boat and we are all tired of isolation, quarantine, social distancing, masks and washing our hands 100 times every day. But, it is the right, and safe thing to do, because it works. And, yes, continue hand washing, not hand sanitizers. Hand sanitizers are not sufficient to kill the germs. So, yes, we have to continue with all of these boring, ancient, inconvenient, but effective “back to basics” strategies, until The C19 Tsunami passes through. And, we have to be prepared for more ripples and waves from this and other emerging diseases and diseases of civilization for the short and long haul.

Frustrated?

Yup, I understand that you are frustrated, scared and sometimes immobilized by uncertainty, blunders and the ailment brought on by the COVID – 19 virus. Yes, the sickness, the hospitalizations, intensive care unit admissions, confinement, loss of work and income and, especially the loss of loved ones is very real and very painful.

Fear and Noise vs Fact

Fear and uncertainty conjure up all sorts of noises in human minds. Misinformation, wishful thinking, speculation, conspiracy theories, drama, hype and ghost hunting? None of this is helpful. So, let’s be sensible and continue to “Act on Fact”.

The Solution

ACT on FACT V2: “What The World Needs Now Is Love, is Love, Sweet Love”, Compassion, Mutually Beneficial Cooperative Action and “The C19 DeTERMINATOR”

What is the score with the C19 Pandemic? What’s your C19 score? What is the “The C19 DeTERMINATOR”?

Is it “SAFE” for me to go back to … ? For me? For those around me?

Building Applications and Games To Help Us Determine Our C19 Status and C19 Risk and ACTION OPTIONS with REAL TIME Tracking and Mapping?

What? You plan to save lives with games? Yes!

Track, Map and Terminate This Pandemic and Other Emerging Epidemics and Pandemics

I am sorry that “The C19 DeTERMINATOR” in not yet in operation. So, help us make it. How to help? Give us your support and feedback. Print this blog and figure your score as best you can. Let us know if you have any questions, or suggestions. With all the brainpower sitting around at home, we should be able to construct any manner of world class solutions. So, do jump in and help out. StepWisely(R) with us.

In this blog we share our framework and will take another look at your smart action options in light of current COVID – 19 (C19) facts and your current C19 status and risk. This time, we look through the lens, framework and checklists that we propose to use for the “C19 DeTERMINATOR”. Update your status as often as necessary. Have at it and let us know what you think.

SCORE 10 / COLOR GREEN / COVID – SAFE = GO: You are low risk*, have been exposed to the C-19 virus, may, or may not have been sick as a result of contracting the virus, have no evidence of the C-19 virus at this time and have documented immunity to the C-19 virus. (*Not elderly, not frail, normal immune function, no heart disease, lung disease or diabetes)

You are an able bodied adult, trained, certified, willing and able to go to work on the front lines of care, treatment and/or able to work support of caregivers and those who need care. You are an essential support service worker. (Continue isolation, mask, social distance, meticulous hand washing and decontamination of surfaces and objects)

SCORE 9 / COLOR GREEN / COVID – SAFE = GO: You are low risk*, have been exposed to the C – 19 virus, may or may not have been sick as a result of the virus, have no evidence of C – 19 virus at this time and have documented immunity to the C – 19 virus. (*Not elderly, not frail, normal immune function, no heart disease, lung disease or diabetes)

You are an able bodied adult, caregiver, willing and able to get training to help others and to work on the front lines of care treatment and support of others and willing and able to be trained to help in any way that I may be of assistance. (Continue isolation, mask, social distance, meticulous hand washing, decontamination of surfaces and objects)

SCORE 8 / COLOR GREEN / COVID – SAFE = GO: You are low risk* have recovered from documented C – 19 illness, have been in quarantine for 40 days and have no evidence of the C -19 virus at this time. You have NO DOCUMENTED IMMUNITY. (*Not elderly, not frail, normal immune function, no heart disease, lung disease or diabetes)

I am ready willing and able to go back to work as an essential service worker. I want to go back to my regular job. (Continue isolation, mask, social distance, meticulous hand washing, decontamination of surfaces and objects)

SCORE 7 / COLOR YELLOW / UNKNOWN = PROCEED WITH CAUTION: You are low risk and do not have confirmed contact, signs, or symptoms of C = 19 illness.

Proceed with caution. Isolation, mask, social distance, meticulous hand washing, decontamination of inanimate objects. Stay out of harm’s way and do not cause any harm.

SCORE 6 / COLOR YELLOW / UNKNOWN = PROCEED WITH CAUTION:

You are high risk (Elderly, frail, have heart disease, lung disease, diabetes, or immune dysfunction), do not have confirmed contact, signs, or symptoms of C – 19 illness. You have not been tested for the virus, or for immunity to the virus.

Continue meticulous isolation (mask when you go out, fresh air and ventilation when you can), hand washing and decontamination of inanimate objects and surfaces TO MINIMIZE YOUR CHANCES OF exposure and/or GETTING A LARGE VIRAL LOAD.

SCORE 5 / COLOR RED / HOT ZONE = STOP: You are low risk, do not have confirmed contact, no signs or symptoms of C – 19 illness.

Isolation, mask, social distance, meticulous hand washing, decontamination of surfaces and inanimate objects. Stay at home unless absolutely necessary to go out for essential items. You want to keep your viral load down and you don’t want to expose others, if you are one of the asymptomatic carriers of the C -19 virus.

SCORE 4 / COLOR RED / SICK WITH COVID – 19 SIGNS AND SYMPTOMS = STOP

Presumed C19 Illness Stay at Home

Isolation, Quarantine and early physician evaluation is required. High Risk and Low Risk Patients can try home care first, but this should be done under physician supervision. In other words, not all high risk patients are destined for Hospital, or ICU care due to Covid – 19 illness. And, on the flip side, some low risk patients do require Hospital and/or ICU care for Covid – 19 illness. In any case, when you have Covid – 19 symptoms, presume your illness is caused by Covid – 19.

Use symptomatic treatment, contact your physician (telemedicine and telephone is particularly useful here), get tested if you can (preferably at home), stay at home unless you meet criteria for hospital or Intensive Care Unit admission (see below). Isolation for 40 days, unless back to normal and you have two consecutive negative tests for the virus.

END OF LIFE CARE? C – 19 illness, or not, patients who are at the end of life, with advanced directives and established home care, should stay at home, if at all possible. The hospital and the ICU have little to offer that can benefit patients who need compassionate end of life care.

SCORE 3 / COLOR RED / SICK WITH C – 19 SEVERE SIGNS AND SYMPTOMS = STOP

Isolation and Quarantine. Possible Hospital, or ICU admission? Presumed Serious C – 19 illness with fever, abnormal mental status, trouble breathing, shortness of breath, turning blue, low blood pressure, or low oxygen levels will require physician evaluation. You will need further testing and may need hospitalization, or ICU care.

SCORE 2 / COLOR RED / SICK WITH C – 19 SIGNS, SYMPTOMS IN HOSPITAL = STOP

Isolation and Quarantine. Hospital admission. Presumed Serious C – 19 illness with fever, abnormal mental status, trouble breathing, shortness of breath, turning blue, low blood pressure, or low oxygen levels will require physician evaluation and testing. Early supportive care is likely to be effective, but some will need ICU care for more invasive therapies.

SCORE 1 / COLOR RED / VERY SICK WITH C – 19 IN ICU = STOP

Isolation, Quarantine and Early supportive care, including invasive ICU therapies are effective for most patients. This is not easy, but most patients will recover.

Why do we need “The C – 19 DeTerminator?

To get ahead of and stop the C – 19 wave.

By determining and mapping signs, symptoms, risk, confirmed cases, hospitalizations, ICU admission and deaths in real time, we can see the waves of this pandemic (and other epidemics) as they EMERGE in real time. By knowing the location of cases, we can target our preventive strategies and prepare for the actual cases ahead of the wave.

See Prior Blog Post, Act on Fact, V1 for background and facts.

Take The Best Careâ„¢ of yourself and those in your charge.

Together, we can beat this and any new, or old threat to our health and well being.

Wishing you many healthy and happy days.

Dr. Mike

Michael F. Mascia, MD, MPH

PS. Did you know that the first three-colored traffic lights were put to work 100 years ago in the City of Detroit.

PPS. We have the brainpower and the technology to build the “C – 19 DeTERMINATOR” to help us terminate this and other diseases. Let’s get on with it.