Easter Sunday, April 12, 2020, 16:18 New York Time

What you can do for yourself and those in your charge?

What is your COVID -19 action plan?

Transparency, Truth, Teaching, Training, Triage, Treatment: T6 Action Planning

Face the facts. This is an unprecedented global crisis and an unprecedented global opportunity to help each other get through it. The COVID – 19 Tsunami has directly, or indirectly struck each and every human across the globe. Chances are pretty good that, if not already exposed, all of us will be exposed to the COVID 19 virus at some time during this pandemic. Sure, fear is common especially on account of the uncertainty and vortex of moving parts that surround this novel coronavirus. But smart decisions about your life and health must be made on the basis of fact, not fear.

We now know enough about this bug to help prevent the spread of serious infection & fear, and to get best care and treatment for the folks who need it. So, let’s start with helping you Determine Your COVID – 19 STATUS, RISK and Best Prevention and Treatment Action Strategies and End with Facts, Resources and References that you can use to back up your actions and help keep you up to date on facts and on target with best action. We expect to update this blog on a regular basis, while continuing to develop tools and strategies with members, friends and partners to help everyone get through COVID -19 and beyond. We will talk more about new C19 Solutions as they emerge, but for this edition of C19 Act on Fact, we focus on solutions for individuals and families.

A. WHAT’S YOUR COVID STATUS and RECOMMENDATIONS?

KEEP YOUR VIRAL DOSE LOW & IF YOU GET IT, TRY NOT TO SPREAD IT

GENERAL RECOMMENDATIONS

NOT SICK / LOW RISK? Young, healthy people are unlikely to get a serious COVID – 19 infection. However, large doses of the virus can harm and sometimes kill anyone. So, keep the viral load low. Many of the young and healthy patients who have COVID -19 infection have minimal, or no symptoms. Even though you are “not sick” you can spread COVID – 19. So, presume you are infected, until proven otherwise.

HOW TO STAY OUT OF HARMS WAY AND CAUSE NO HARM TO OTHERS? General Recommendations: Isolation, Quarantine, Hand Washing with soap and water, decontamination of hard surfaces and inanimate objects with dilute chlorine bleach, alcohol or peroxide. Stay in well ventilated spaces, stay away from crowds, eat well, sleep well, meditate, pray and play. Pull out all your Stress Management stops. Find ways to help and work with others while avoiding increasing risk to yourself and those in your family. (Think Virtual and other forms of communities and communication)

1. ISOLATION: Stay away from folks who may be carrying and spreading the COVID-19 Virus. We presume that many who do not have symptoms are able to spread the disease, even if they are not known to be sick. Home made masks may help here. (see # 5 below)
2. QUARANTINE: SICK? THINK YOU HAVE MAY HAVE COVID – 19? 40 DAYS QUARANTINE, if you are sick with COVID-19, or think you may be sick with COVID-19, or you have been exposed to COVID-19, UNLESS, OR UNTIL YOU CAN BE TESTED TO PROVE THAT YOU DO NOT, OR NO LONGER HAVE COVID – 19. The virus is easly spread by those who are ill as a result of COVID-19, through exhaled air and secretions. To date, shedding of the virus by infected individuals has been documented for up to 38 days.
3. DECONTAMINATION WITH DILUTE CHLORINE BLEACH, ALCOHOL, or PEROXIDE: This kills the virus rapidly. The virus has been documented to live in the air around infected individuals for several hours. On hard surfaces the virus has been documented to live for up to 9 DAYS.
4. HAND WASHING WITH SOAP AND WATER: This kills the virus rapidly and prevents spreading from person to person.
5. MASKS: N95 masks should be saved for professionals and caregivers. Homemade masks can help infected folks, including those who have no symptoms, keep the virus to themselves.
6. NOT SICK / HIGH RISK: Elderly, feeble and those who have heart disease, lung disease and other conditions that lower immunity are at high risk for serious infection. Not to worry. Be meticulous about your preventive actions (1 – 5 above) to keep the viral load low.
7. NOT SICK / HIGH RISK AT END OF LIFE: Line up proper advanced directives and be sure to develop a proper home care plan. The worst place to go for end of life care is a hospital. Worse yet, is the hospital ICU.
8. SICK / LOW RISK: QUARANTINE AND SYMPTOMATIC TREATMENT at home should get you through this. If you need help from your physician, try telephone, telemedicine, or, perhaps a house call. If necessary, some physicians do make house calls. Chances are pretty good that you don’t need any special treatment and you should be able to stay at home. Do your best to stay home to avoid spreading the germ to others. Ideally, testing for the virus and for antibodies to the virus will be done at home. That’s in the works, but not yet readily available.
9. SICK / HIGH RISK: QUARANTINE AND CONTACT YOUR PHYSICIAN AS SOON AS POSSIBLE. The best bet is to stay at home, if possible. But your physician may want to start some therapeutic agents early. Yes, there is some evidence suggesting that zinc and certain antimicrobial agents will help reduce the severity of illness. Plasma from patients who have recovered from COVID – 19 patients has been infused into a few critically ill patients and was determined to be helpful. The availability of this treatment is limited, but likely to become more readily available.
10. VERY SICK / Shock, Abnormal Mental Status, Shortness of breath, Turning blue, Abnormal Oxygenation and Low Oxygen Levels: Call 911, or your physician, or local emergency services. High risk, or not, certain pathological conditions and complications require hospital care, or care in an intensive care unit and may require invasive therapy. Get help as soon as possible, unless you have previously determined that you are NOT A HOSPITAL CANDIDATE and/or have a home care plan in place.

B. PHYSICIAN CONTACT: contact your physician early, if you get sick. Chances are pretty good that your physician will want to keep you home and away from the hospital, if possible. If you need hospital care, or critical care, chances are that you will do well if you start treatment early.

C. COVID – 19 Facts: Facts are being updated frequently because this is an EMERGING and NOVEL INFECTIOUS DISEASE. In other words, it is new to the human population and we are learning as we go through this, together. Keep up to date with reliable sources. Here are some useful facts.

1. The Origin of The Covid 19 Virus: Where did C19 come from and how did it get to humans? https://www.nature.com/articles/s41591-020-0820-9
2. First Covid 19 Case in China: https://www.scmp.com/news/china/society/article/3074991/coronavirus-chinas-first-confirmed-covid-19-case-traced-back
3. First Covid 19 Case in the US: https://www.nejm.org/doi/full/10.1056/NEJMoa2001191
4. COVID 19 MAPS and DATA: These NYT maps are updated daily. https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html
5. COVID 19 TRACKING: The New York Times is doing a good job of tracking this disease.
6. COVID 19 FACTS & BACKGROUND: References and Resources, documentation and science to support the facts. https://www.cdc.gov/coronavirus/2019-ncov/publications.html
7. COVID 19 GENERAL READING AND PODCAST: EASY READING AND EASIER PODCAST TO GIVE YOU THE GENERAL IDEA OF WHAT THIS EMERGING INFECTIOUS DISEASE IS ALL ABOUT https://www.newyorker.com/science/elements/from-bats-to-human-lungs-the-evolution-of-a-coronavirus
8. GENERAL STRESS MANAGEMENT HELP: https://veritashc.org/wp-content/uploads/2019/11/Complete_SMW_WithCover_WithBack_WithIntroContents.pdf.pdf
9. GENERAL DISASTER PREPAREDNESS HELP: https://veritashc.org/wp-content/uploads/2019/11/DPCombinedforCD-PDF.pdf

D. Coming soon

Real Time C19 Mapping & Tracking: This next generation epidemiology is in the works and we will keep you updated as soon as we have something to show

Telemedicine: Coming soon for our VHC members

OPEN ZOOM MEETING FOR TEACHING, TRAINING and TRIAGE: To start soon

Have questions, or need guidance?

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Call, or Text 315-491-3634

Email mfmascia@gmail.com

Be Healthy, Happy and Safe,

Dr. Mike

Michael F. Mascia, MD, MPH