What You Need to Know about Coronavirus and Were Hesitant to Ask

The dateline on this article by MD Margan Zajdowicz calls attention to the rapid developments in the spread of the novel coronavirus. The importance of her advice prevails, and grows with time. Please read her recommendations and take them seriously.

March 5, 2020. I attended League Day today. The featured speaker was a bright, knowledgeable professor and attorney who discussed our national immigration crisis. The subject is important and the information she imparted was valuable. The surreal aspect of this League Day was that it took place while we are in the throes of a global pandemic, involving more than 60 countries including our own, more than 100,000 cases, and over 3,000 deaths—and the word “coronavirus” was never mentioned the entire morning. I saw no hand sanitizer anywhere. Astonished and puzzled by this, I asked an esteemed League friend why she thought this was. She looked at me quizzically and said, “We are hoping it doesn’t come to Pasadena.” My heart sank. Hope is not a strategy and denial doesn’t faze viruses.

Today, there are 50 cases of coronavirus infection in California, and the first California death was reported. As I write, there is a cruise ship idling off of San Francisco Bay whose 2,500 passengers are awaiting the results of testing, as it is likely that coronavirus is being transmitted onboard.

In 250 words or less, what should you do to help contain this epidemic?

• If you are sick, please stay home. Don’t come to League Day or any other event.
• If you cough or sneeze, please do so into a tissue or into your elbow if no tissue is available.
• Try hard to not touch your face, eyes, nose, or mouth. It’s not easy to do this.
• If you develop fever, cough, and shortness of breath, please seek medical care BUT first call ahead and let the healthcare facility or doctor’s office know you are coming.
• Wash your hands frequently and well. Use soap and water preferentially. If you use hand sanitizer, be sure the hand sanitizer is at least 60% ethyl alcohol. Otherwise it won’t kill the virus.
• Avoid large crowds and try to maintain a six-foot distance from others.
• Don’t shake hands. It’s a great way to transmit respiratory viruses. Use an elbow bump or a namaste greeting if you feel compelled to acknowledge someone some way other than with a smile.
• As much as possible, touch high-touch objects (elevator buttons, doorknobs, handrails, ATM buttons, etc.) with your elbow or a pen and not your fingers.
• We need to get prepared for the possibility that there might not be any League Days for a while since bringing people together in close proximity promotes viral transmission. We need to sharpen our skills and start thinking in terms of texting, email, Zoom, FaceTime, and Skype so we can still communicate while outsmarting the virus.

The case fatality rate (number of people who die divided by the number of people with symptomatic disease) for coronavirus disease isn’t trivial. It’s somewhere between 2.3% and 3.4%. It’s especially not trivial in older people (8% in people 70–79 years of age and 15% in people 80 years of age and older). So start cultivating good infection control habits now. They will help you avoid other respiratory illnesses, and when coronavirus is really at our doorstep you will have a better chance of avoiding this illness.

—Margan Zajdowicz, MD, MPH