COVID-19
How do we get the economy going? The choice of the economy versus COVID is a false dichotomy as noted by Nicholas Taleb (author of Black Swan)
the video
the transcript
as well as this article from Technology Review
https://www.technologyreview.com/2020/04/08/998785/stop-covid-or-save-the-economy-we-can-do-both/
First physical distancing is needed to avoid the spread of COVID-19
But I feel OK, why should I stay home?
The problem is by the time you feel sick, you have been shedding the virus ( been contagious) for several days (Presymptomatic spread). This is what makes this virus more difficult to contain.
https://www.cdc.gov/mmwr/volumes/69/wr/mm6914e1.htm (from the CDC 4/1/20)
We can't sort out who is not contagious from who is contagious so everyone needs to stay home. Once testing is more widespread and available, we should be able to change this policy.
Why do I need to cover my face/wear a mask?
At first folks thought that the virus was not spread through the air and gave recommendations to that effect.
Unfortunately the virus is spread via the air. You may have heard the sad story of a church choir that spread the virus through singing despite physical distancing
https://www.latimes.com/world-nation/story/2020-03-29/coronavirus-choir-outbreak
As of 4/3/20 this is the CDC recommendation
https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/cloth-face-cover.html
As a neuroradiologist I am familiar with wearing surgical masks to protect my patient from droplets from my mouth just from normal talking (never mind sneezing)
This CDC page is from 2011. Doctors who did spinal injection procedures and did not use a mask gave patients meningitis!
https://www.cdc.gov/injectionsafety/spinalinjection-meningitis.html
An article from 2012 that documented spread from healthcare workers to patients during myelography
https://www.jacr.org/article/S1546-1440(11)00554-0/pdf
Sadly we did a survey and half the respondents did not follow this guideline as noted in this 2014 publication
https://www.academicradiology.org/article/S1076-6332(14)00050-6/fulltext
This is the basis of my "mask protects you , your mask protects me."
n95 masks are used by healthcare workers and are currently in short supply.
After natural disasters such as Katrina, The department of homeland security recommended that citizens prepare an "Emergency Kit"
This includes a "dust mask" for everyone in your household! A dust mask may be an n95 mask. So those who have made an Emergency Kit, may have a mask that will be useful for the pandemic.
Other things:
This crisis should be another reminder to have a healthy diet (and be at a healthy weight)
Reference:
An opinion piece article from 4/13/20 New England Journal of Medicine Journal Watch essentially stating "better safe than sorry when it comes to wearing masks".
An article from the New York Times (4/17/20):
https://www.nytimes.com/interactive/2020/health/coronavirus-best-face-masks.html
What this article does not state is that a masks blocks droplets from the wearer. Surgeons wear masks to protect the patient! (They should also protect their eyes from droplets, but that's another story)
We should wear masks to protect each other!
A good summary of what went wrong.
https://www.medscape.com/viewarticle/947316#vp_2
Stay safe!
Nolan Kagetsu, MD, FACR
you can follow me on Twitter @nkagetsu
I answer my DMs