Thus far COVID-19 has dominated the health news in 2020. The entire media is focused on this. The storylines have covered the gamut. As a front line provider, I have been and will be, living the story. I forecast the COVID -19 virus will dominate the health news for a time to come. FYI, the Latin word for virus translates to “poisonous slime.”

    This piece of genetic material is very small. The virus ranges from 60-140 nanometers in size. There are 25.4 million nanometers in one inch. COVID-19 has spikes, which serves as a docking device and can mutate. Its purpose is to replicate and make billions of copies of itself by taking over a cell’s internal machinery. This action triggers the body to attack the foreigners, a cytokine storm.

    The COVID-19 virus is very contagious. One sneeze may contain as many as 200 million viral particles. Many can be without symptoms. The viral load peaks around 4 days after exposure and then dissipate over two weeks. Those with symptoms, cough, sneeze, fever, body aches, congestion, and gastric distress are the most infectious. The World Health Organization (WHO) has recently reported asymptomatic carriers are at low risk to spread the virus. The highest risk of spread is those with symptoms who, in a closed environment. This would include elevators, small rooms, buses, planes, and the like. The virus gains access to the nasal cavities and begins to replicate. A mere mask will not stop this extremely small virus.

    As I write treatment protocols are being investigated and research on a vaccine is underway. Testing has improved and can identify active infections and those who have been infected and now have antibodies. As we learn more, there will be more challenges and debates. There must be a balance. Which carries more risk, the virus, or the social isolation and economic consequences? How many will die from the virus versus the increased rate of anxiety, depression, suicide, alcoholism, domestic abuse, and avoidance of medical care out of fear of the virus?

    As we re-open society there are changing guidelines and multiple opinions. Many have asked me to comment on recommendations to re-open football, restaurants, and churches. What is a reasonable approach with the knowledge to this point? There is a distinction between knowledge and wisdom. Here are 7 suggestions.

    1. Ask yourself, “What is a reasonable risk for me”? We still have to live. Every decision we make carries some risk. Our liberty and freedom are important and without a vision, the people perish.

    2. Encourage those at greatest risk- 65 years of age or older, residents of assisted care, and those with compromised immune systems, diabetes, chronic lung, kidney, or heart disease to be the most careful.

    3. If you are sick- stay at home. If people must come together screen with some common sense health questions and a temperature.

    4. Avoid unnecessary contact. Practice social distancing, at least six feet away.  Avoid touching the face. Wash hands with soap and water after touching any surface. Keep frequently touched surfaces disinfected. Try to limit and distance face-face conversations, preferably less than 15 minutes. If you are not in a high-risk group, try to avoid those at increased risk. If you interact, wear a mask. 

    5. Try to limit time in confined spaces if you are in a high-risk group. This includes exposure to public transportation, elevators, and other closed rooms and buildings. Remember the air in a closed area is more conducive to spread. Eat outside. Have events outside if possible. If indoors, try to ventilate rooms, i.e. keep doors open when possible. Again, high-risk individuals need to be more careful. Again, low-risk individuals need to stay away from those at high risk.

    6. Avoid Crowds. This is very important for high- risk individuals. If you are low risk and feel bad in any way, stay home, no ifs ands or buts. If you feel well and must be in a crowd, wear a mask if you must sneeze or cough. Try to have open ventilation. Limit touch. If touched, wash or sanitize your hands. Spread out as much as the crowd will allow. 

    7. If possible, receive testing. If you have antibodies, you have been exposed and should be effectively vaccinated. We still have more to learn about those who have recovered and have antibodies.

    Daily, I make recommendations to not smoke, move, avoid stress, rest, and eat healthy. These lower risk of heart attack, the number one killer. Yet many choose not to follow these recommendations and increase their risk.

    Ultimately, each individual should make a personal decision about the level of risk he or she is comfortable with based on age, health status, life circumstances, and general level of risk aversion.

    Young healthy adults and children must consider the health of those around them. We need personal responsibility to shape our collective futures.

    Football in the fall – yes, if the above recommendations are followed and no new information surfaces.

    Restaurants – yes.

    Churches – Yes and pray for each other and the health of the world we share.