Hey it’s Raj from 3CB Performance.
I’ve been asked numerous questions regarding COVID-19 aka novel coronavirus - general and
sport specific - but infectious disease is completely outside my scope of practice and
expertise. Therefore, I consulted with a trusted epidemiologist and infectious disease expert
for a two part video.
In this video, part one, I used his medical insight & expertise to explain COVID-19 and
answer frequently asked questions.
COVID-19 - CO standing for corona, VI for virus, D for disease, and 19 for the year
of discovery - is a virus within the general family of viruses termed “coronavirus”
that get their name from crown-like spikes on their surface. Corona is latin for crown.
COVID-19 is also known as “novel (new) coronavirus” because it hasn’t been seen before in humans,
with some researchers alleging that the virus was passed from bats to humans through an
intermediary host, pangolins, which are highly valued in China for their meat and scales.
Other examples of coronaviruses that spread from animals to humans include Middle East
Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS).
COVID-19 is spread through “droplet transmission”, typically when a carrier coughs or sneezes
within 6 feet of an unaffected individual or an unaffected individual touches a contaminated
surface and then touches one’s own nose, mouth, and/or eyes. Studies are showing that
COVID-19 can last up to four hours on copper surfaces, up to 24 hours on cardboard, and
up to 2-3 days on plastic and metal.
There are two keys to protecting yourself:
The first is to wash your hands with soap and water for at least 20 seconds, especially
after you’ve been in a public place or after blowing your nose, coughing, or sneezing.
Further, avoid touching high use objects like door handles. If you don’t have soap and
water, use a hand sanitizer that contains at least 60% alcohol.
The second is known as “social distancing”. Avoid going to large gatherings or crowds
and if you are out, maintain a 6 foot barrier between you and other individuals.
Both of these are incredibly important to break the chain of transmission especially
in the early stages of containment where even one less exposure and transmission can result
in exponentially less cases down the line. The research indicates that implementing strict
social distancing before 1% of the population acquires a virus during a pandemic can be
particularly impactful in the medium and long-run.
To help protect others, use a tissue or the inside of your elbow when you cough or sneeze,
clean AND disinfect frequently used surfaces daily (including phones and keyboards), wear
a facemask if you’re sick or have been exposed to a potential COVID-19 carrier (if you’re
neither of those, you don’t need a facemask as there’s no research showing it reduces
transmission to you and buying them for that purpose strains an already existing shortage
of facemasks for medical providers), and ideally, just stay at home.
If you don’t trust me, at least take Wu-Tang’s word for it.
The key symptoms of COVID-19 are fever, a dry cough, and shortness of breath. The dry
cough and shortness of breath speak directly to COVID-19’s impact on the respiratory system.
If you have symptoms, the best advice right now is to quarantine yourself at home for
at least 14 days in order to avoid potential transmission to anyone else. If you live at
home with roommates, spouse, or kids, separate yourself from them.
If you develop severe symptoms such as difficulty breathing, persistent pressure or pain in
the chest, confusion, severe lethargy, and/or bluish lips or face, seek immediate medical attention.
Even if you don’t have symptoms but find out that you’ve been around someone who
may have COVID-19, isolate yourself for 14 days in order to potentially stop the spread.
Ideally, individuals with symptoms would be getting tested and then quarantined in separate
housing - for example, China has quarantine hotels set up - but testing capacity is currently
woefully short in numerous countries, including the US which has the lowest per capita testing
of any country early in the outbreak.
Populations at the highest risk of becoming severely ill and dying include those who have
a compromised immune system, which includes people over 60 and those with existing illnesses
such as heart disease, lung disease, diabetes, or obesity (which is often clustered closely
with the first three). Each underlying condition results in cumulative risk.
To put that risk into perspective - nearly two-thirds of adults in the US have one underlying
health condition, 40% have two, roughly 25 million have diabetes, and nearly 33% are
considered obese.
In accordance with those risks, California has mandated at home isolation for those older
than 65 and/or those with chronic illnesses. A plan that may also go into effect in Britain
as well.
Additionally, there’s some evidence that frontline medical providers such as ER docs
and nurses are at increasing risk for infection, especially when overtaxed and over-fatigued.
This isn’t to say younger populations can’t become severely ill, they’re just less likely
to. Overall, death rates from COVID-19 are at nearly 1% compared to the .1% for normal
seasonal flu (influenza).
As with other viral infections, it’s likely that the body will develop antibodies to fight
off the virus and protect them from re-infection. However, we also know that immunity tends
to wane over time.
Even though researchers have recently been able to isolate COVID-19’s genome and human
trials are beginning, a vaccine is very likely still at least 1 to 1.5 years away from being
finalized, produced, and distributed.
Influenza subsides in the warmer months but we have no indication, information or knowledge
if that’s the case with COVID-19. Of course you hope that’s the case but it’s a fool's
errand to depend on an unknown or factor it into disease trajectory.
The hardest part about containing COVID-19 is that it has an extended incubation period,
meaning symptoms may take up to 14 days to appear - although in nearly 95% of cases,
symptoms appear in at least 10 days - whereas influenza has an average incubation period
of 2 days.
That’s potentially 12 extra days of going about your normal business and unknowingly
spreading the virus.
To that point, early research is showing that each person with
COVID-19 infects 2.2 other people, which is nearly double the rate of influenza.
If lower risk populations don’t take appropriate precautions, they can be carriers of the virus
that helps it spread to the high risk populations. Early data is showing that nearly 80% of cases
are mild or asymptomatic and data coming from South Korea - which has the most robust testing
of any country - shows the 20-29 year old demographic as having the highest proportion
of affected individuals.
Containment is critical because COVID-19 has an exponential growth curve, meaning there
are greater increases as time passes. This exponential pattern has been seen in nearly
every affected country thus far, characterized by a relatively low number of cases and deaths
early on - possibly creating a false sense of security - that eventually explode. The
reported cases are also very likely dampened by a lack of testing capacity.
Further - and this is the most critical piece to reducing the number of deaths - is reducing
sharp spikes in cases so hospitals aren’t overwhelmed and can actually meet the demand
for beds and needed equipment (such as respirators). You may have heard this called “flattening
the curve” and it simply means spreading the number of cases out over more time, preventing
the dire situation where MDs have to essentially begin choosing life or death for patients
as has been reported in some hospitals in Northern Italy.
That danger is a key reason why countries such as Italy, Spain, and France have mandated
a minimum 14 day country-wide shutdown and quarantine. Even Austria - which has only
8 million people - has banned gatherings larger than 5 people. The US and Great Britain are
tracking on the same pattern and I wouldn’t be surprised at all to see government mandates
at some point in the near future.
Social distancing in particular is critical RIGHT NOW in those countries because each
is currently in the asymptomatic phase where thousands and thousands of unaffected carriers
continue to spread the virus and cause exponentially more down-stream effects. Accordingly, certain
states in the US - notably Ohio, California, Illinois - are shuttering all non-essential establishments.
COVID-19 aka novel coronavirus has placed the health of the world population at the forefont.
It’s a situation that needs to be taken very seriously and we’re finally
seeing countries like the United States and Great Britain take the threat as such.
Prevention in those countries is out the window due to the lackadaisical preparation and response
time but we can still undertake containment measures and every single day counts in reducing
the number of cases, hospital workload, and deaths directly or indirectly attributed to the virus.
In addition to state and governmental mandates, each and every one of us can follow experts’
advice - hopefully this video is a useful primer for you but the Center for Disease
Control (CDC) and World Health Organization (W.H.O) are robust resources - and limit our
own exposure to COVID-19 and limit its spread to others, especially high risk populations.
Stay safe, stay calm, stop hoarding water and toilet paper, stay in control of what
you can control, and possibly use this relative downtime to reset and work on habits such
as sleep hygiene, fitness, nutrition, reading, reaching out to family and friends, and so on.
These are difficult times but we’ll get through this together and perhaps be better
for it due to the type of perspective that only seems to come from sobering global events.
Lastly, here’s a great clip from Dr. Michael Ryan, executive director of the W.H.O. and
leading global authority on the spread of infectious disease - that succinctly and matter
of factly sums up what we need to do to overcome this pandemic.
“What we’ve learned from the ebola outbreaks is that you need to react quickly, you need
to go after the virus, you need to stop the chains of transmission, you need to engage
with communities very deeply, community acceptance is hugely important. You need to be coordinated,
you need to be coherent. You need to look at the other sectors on impacts - the schools,
and security, and economic. So it's essentially many of those same lessons but the
lessons I’ve learned after so many ebola outbreaks in my career are: be fast, have
no regrets, you must be the first mover. The virus will always get you if you don’t move
quickly and you need to be prepared. I say this, one of the great things in emergency
response - and anyone who’s involved in emergency response will know this - if you
need to be right before you move, you will never win. Perfection is the enemy of the
good when it comes to emergency management. Speed trumps perfection. And the problem in
society we have at the moment is everyone is afraid of making a mistake, everyone is
afraid of the consequence of error, but the greatest error is not to move, the greatest
error is to be paralyzed by the fear of failure, and I think that’s the single biggest lesson
I’ve learned in ebola responses in the past.”
That’s a wrap for this video. Thanks for watching. My goal is to provide you with in-depth,
evidence based, narrative free analysis and you can always find me on IG and Twitter @3CBPerformance.
Make sure to sub to the channel and follow along on all social media for the latest updates.
Take care of yourselves and be cognizant of others, we’re all in this together.
3CB out.