(AND WHAT TO DO IF A FAMILY MEMBER GETS SICK)

By Dr.Jim Harris

(Harris Translation of the FABULOUS first article below from the NYT. You may remember it, but I’ve simplified it a bit for old folks in a hurry. Notice the colors. The final article is from Vandy.)

To read the New York Times article: Charting a Coronavirus Infection By Katherine J. Wu and Jonathan Corum Updated October 5, 2020- click here

Charting a Coronavirus Infection

1. Exposure and Incubation

The time between initial exposure to the virus and the appearance of symptoms is known as the incubation period. This period is typically four to five days, although it can last up to 14 days, or perhaps even longer in rare cases.

Most people who come down with Covid recover within a couple of weeks and do not require hospitalization. Severe cases, however, may take far longer to resolve. And a growing cohort of coronavirus survivors, called long-haulers, has reported symptoms and side effects — including fatigue, impaired memory and heart problems — that can linger for months.

People who develop severe cases of Covid tend to be hospitalized within two weeks or so of the emergence of symptoms. Older more obese people are at high risk of more severe disease.  People with diabetes, kidney disease, COPD, and other chronic diseases as well as those with some genetic types and blood types are more likely to develop severe cases. 

2. Viral Load

After an initial exposure, the number of virus particles in a person’s body, or viral load, takes time to build up as the pathogen infiltrates cells and copies itself repeatedly. The amount of virus usually  peaks before symptoms appear, if symptoms appear at all, and starts to decrease fast in the days following the first signs of illness.

To repeat: People are more likely to be contagious when their viral loads are high.  The peak infectiousness might be only a few days long, beginning a day or two BEFORE symptoms appear, and closing within a week thereafter. Remember, however, up to 40% of infected, contagious  people have no symptoms or fever and do not know they are sick. 

This also means that people can be highly contagious during the so-called presymptomatic stage, in the days before they develop symptoms. 

Asymptomatic carriers of the coronavirus have also been repeatedly pinpointed as the source of transmission events.

3. Testing for the Virus

 Many of these screenings are rapid tests, delivering actionable results within minutes without needing to send samples to a laboratory. Such speed and convenience can come at the cost of accuracy: Rapid tests are worse at picking up on low viral loads and very recent infections, and more often produce false negatives or false positives. Some experts argue that true positives from rapid tests might coincide with the period in which people are most contagious, although this has not yet been confirmed.

Rapid tests with negative results does not rule out an infection or contagiousness.

People with known exposure to an infected person  or who have already developed symptoms may need to take a more sensitive test. Experts often recommend laboratory tests that rely on a technique called P.C.R. (polymerase chain reaction) that can detect very small amounts of the virus, but that usually takes several hours to run on sophisticated, expensive machines.

Because a P.C.R. test is more sensitive to low viral loads, it may be able to detect a coronavirus infection very early on. But the diagnostic test can also pick up harmless bits of the virus that linger in the body after symptoms have resolved, and perhaps after a person stops being contagious.

Antibodies are produced by the body in response to an invading pathogen, starting about a week or so into an infection, and can persist in the blood for months. 

Another type of test, called a SEROLOGY test, looks for these antibodies instead of the virus. Serology test show that you have had Covid-19 in your body. However, you may not still be contagious. It is not a good test to show if you are infectious. The presence of antibodies (positive Serology Test) may or may not mean you have some immunity. 

4. Preventing Infection

Public health measures to combat its spread. While no single tactic can confer complete protection, combining actions like mask-wearing, physical distancing, frequent handwashing and avoiding crowded spaces significantly lowers risk.

Masks and face coverings that fit tight and  a cover the nose and mouth can block much of transmission  from contagious people and also block nearby people wearing masks from inhaling some if not all viruses. The lower the number of viruses in the exposing dose, the less likely infection is to be transmitted, and, if it is, it will be milder.

Infected people can also reduce the chance of passing on the virus by isolating themselves for at least 10 days after symptoms appear, as long as they continue to improve. 

Those who have been exposed to someone with a known case of the coronavirus should quarantine for two weeks and seek a test. Unfortunately, 40 percent of infections might lack symptoms, although some estimates have been even higher. 

CDC says infected individuals  are unlikely to be infectious for more than 10 to 20 days after their symptoms start.

J. Harris: In summary, to prevent getting sick or making others sick:

1. Protect yourself, protect your family; protect your friends and your community. Don’t go anywhere  you can avoid — until the virus is again checked and vaccinations are available.
2. Avoid crowds, gatherings, celebrations — even avoid family members who don’t live with you. Avoid bars, restaurants, parties, weddings, funerals, unmanaged churches, sports events, doctors offices, barber shops, dental offices, buses, airplanes, automobile travel with people other than your family. For sure, don’t go on a cruise.
3. When forced to be out or when  at essential work, or at the grocery store,  keep at least 6 foot spacing and don’t let others crowd you.
4. Wear the best mask you can find anytime you are around people other than your immediate family with whom you live.
5. Wash your hands (or sanitize) every time you think about it, especially when coming in or going out. Wear gloves when you are handling things others have touched or been close to. 
6. Assume that anyone you encounter outside your personal secure area is contagious. Protect your space. 
7. Pay attention to good medical advice from physicians and scientists who are reliable; avoid medical people or quacks are selling something or bragging about their unscientific “cures,” or who acting outside of recognized historically reliable organizations such as the CDC and NIH and your doctor, your county and state health authorities, and those of  your local officials who you know to be trustworthy. 
8. Avoid medical advice given by politicians, especially those in the heat of an election. Generally, avoid medical advice on Facebook and similar publications.

 AND FINALLY: WHAT DO YOU DO IF A FAMILY MEMBER HAS COVID:

Transmission of SARS-COV-2 Infections in Households — Tennessee and Wisconsin, April–September 2020” (J. Harris: You might want to keep this mailout?).                                                                 “…..persons who suspect that they might have COVID-19 should isolate, stay at home, and use a separate bedroom and bathroom if feasible. Isolation should begin seeking testing and before test results become available …. Concurrently, all household members, including the index patient, should start wearing a mask in the home, particularly in shared spaces where appropriate distancing is not possible…. Close household contacts of the index patient should also self-quarantine, to the extent possible, particularly staying away from those at higher risk of getting severe COVID-19…An important finding of this study is that fewer than one half of household members with confirmed SARS-CoV-2 infections reported symptoms at the time infection was first detected, and many reported no symptoms throughout 7 days of follow-up, underscoring the potential for transmission from asymptomatic secondary contacts and the importance of quarantine. Persons aware of recent close contact with an infected person, such as a household member, should quarantine in their homes and get tested for SARS-CoV-2. …..

AND FINALLY, A FEW OLD TV JOKES:

Q. When you pat a dog on its head he will wag his tail. What will a goose do?                                                                                                                               A. Paul Lynde: Make him bark?

Q. According to Ann Landers, is there anything wrong with getting into the habit of kissing a lot of people?

A. Charley Weaver: It got me out of the army.

Q. If you were pregnant for two years, what would you give birth to?

A. Paul Lynde: Whatever it is, it would never be afraid of the dark..

Q. According to Ann Landers, what are two things you should never do in bed?

A. Paul Lynde: Point and laugh.