From Virology Down Under: So you think you’re about to be in a pandemic?

From Virology Down Under Go to their website!

Photo by Daria Volkova on Unsplash

We’re not in a pandemic now so let’s get ahead of what’s coming.

 

Assumptions and severity

This post is based on the assumption that a pandemic will occur at some point and that Wave 1 will impact us, wherever we live, in the coming weeks and months.

Planning now and doing something means we can control how well we cope with some of what may be coming.

While closures and cancellations are possible, they are by no means a sure thing. We don’t know how mild or severe SARS-CoV-2 will be, and each region will make their own – probably slightly differing – decisions about what is appropriate – and enforceable. Having a think now about how we might respond in these situations will help decisions come faster if we get to that point.

What we might see happen if many get sick

If we enter into a pandemic, large numbers of people will be sick. Even if that’s just staying home with a fever and bad cough for a week. If COVID-19 is more severe, that will have a greater impact.

Authorities will try to slow the speed of COVID-19 to prevent hospitals – which are essential to care for the sickest people – from being overloaded. Public gatherings – sports events and concerts – as well as schools and childcare centres, could be postponed or closed. All of which aims will be to keep people apart, making it harder for the virus to spread quickly.  Again, these decisions will differ between places, and may not even have to be made.

Measures which slow the peak (1) and “flatten the curve” (2) will delay and spread out the pressure on essential healthcare function and supply chains. [3]

Once we have a vaccine, we can mitigate the impact of SARS-CoV-2, but we’re quite some way from having a safe vaccine.

Planning for everything

It seems to take a while to get to around talking to the community about what they can do. Part of that’s because of how consumed with work many are right now because this epidemic is still only 8 weeks old; an infant, yet one that moves like a teenager who just discovered caffeine. And yet, late last week and over the weekend, the signal fires of pandemic awareness and increased communication started to light.

But what can we plan for and do?

Let’s break this into two main categories.

  • Reducing our risk of being infected
  • Reducing the chance we will run out of essential foods and goods

Reducing our risk of being infected

We can do a few things and we’ve probably heard them all before. They won’t guarantee to protect us from infection, but they can reduce our risk of infection. These are just as useful for avoiding influenza (flu) virus infection during flu season and for dodging SARS-CoV-2, once your local community is known to have it circulating.

These are things we can do to reduce our risk of SARS-CoV-2 infection.

  • Stay at least 2meters (about 6feet) away from obviously sick people.
  • We’re trying to avoid receiving a cough/sneeze in the face, shaking hands, or being in the range of droplet splatter and the “drop zone”
  • Wash your hands for 20 seconds & more frequently than you do now
  • Soap and water and then dry, or an alcohol-based hand rub, and air dry
  • Try not to touch your face.
  • There is a chance your unwashed fingers will have a virus on them and if you touch/rub your mouth, nose or eyes, you may introduce the virus and accidentally infect yourself. Practice this; get others to call you out when you forget. Make it a game.

While a mask seems like a good idea, and when used by professionals it does protect from infection, it can actually give inexperienced users a false sense of security. There isn’t a lot of good evidence (still!) that shows a mask to reliably prevent infection when worn by the public at large. They are useful to put on a sick person to reduce their spreading of the virus.

If you or a loved one becomes sick, follow the practices of the day.

Call ahead before going to a Doctor, fever clinic or hospital and get advice on what to do. Hopefully, this message is already out there and we’ll see it more once transmission of the virus is widespread.

Reducing our risk of running short of food and important goods – the 2-week list

What we’re looking at here is trying to minimize the impact of any shortages of goods we rely on having at the grocery store or at the end of an online ordering system.

Dried fruit. It lasts and is nutritious.

But don’t panic buy and don’t hoard!

 Don’t buy things you won’t eat later, don’t hoard and don’t buy more than you’ll need for a 2 week period. We’re not talking zombie apocalypse and we very probably won’t see power or water interruptions either.

Below we list things we’ll need to have in case of a more major interruption to supply; a stock that will last 2 weeks. Some of these things will last much longer and include items that may not be a top priority for authorities to keep stocked:

  • Extra prescription medications, asthma relief inhalers
  • Some of these may be a problem, so talk to your doctor soon.
  • Over-the-counter anti-fever and pain medications
  • paracetamol and ibuprofen can go a long way to making us feel less sick
  • Feminine hygiene products
  • Family pack of toilet paper
  • Vitamins
  • In case food shortages limit the variety in your diet
  • Alcohol-containing hand rub and soap
  • Household cleaning agents
  • Bleach, floor cleaner, toilet cleaner, surface cleaning spray, laundry detergent
  • Tissues, paper towel
  • Disposable nappies
  • Cereals, grains, beans, lentils, pasta
  • Tinned food – fish, vegetables, fruit
  • Oil, spices and flavours
  • Dried fruit and nuts
  • Ultra-heat treated or powdered milk
  • Ian is not drinking black coffee, no matter what
  • Batteries for anything that needs batteries, powerbanks
  • Think about elderly relative’s needs
  • Their medications, pets, pandemic stash, plans for care (see later)
  • Pet food and care
  • Dry and tinned food, litter tray liners, medicines, anti-flea drops
  • Soft drink or candy/chocolate for treats

The last-minute fresh list

In a more severe pandemic, supply chain issues may mean fresh food becomes harder to get. So this list is an add-on to the one above, and its items should be the last things to buy if you have a hint of when supplies might slow or stop for a (hopefully short) time.

  • Bread, wraps
  • Meat for freezing
  • Milk
  • Eggs
  • Yogurt
  • Vegetables, fruit
  • Fuel for your car

The elderly and COVID-19

To date, looking at data from China (below), most (94%) deaths from COVID-19 have occurred in those aged over 50 years of age, with more than half (51%) in those aged over 70 years. The age group most at risk for death are those aged over 80 years.

Older people with comorbidities have experienced higher proportions of death than those with no comorbidities. Most cases proportions of death than those with no comorbidities. Most cases identified in mainland China – 80.9% of them – even with the more severe case catching that China has favoured – have been classified as mild. This is good news although 20% is still a lot of “severe” disease. Mild cases recover in about 2 weeks from the time they showed symptoms, while severe cases can take 3 to 6 weeks to recover.

Infographic of the largest study of cases from China.[1]

Because of this, we may see a big impact on our elderly population, both in terms of hospitalisation and death. Residential aged care is likely to suffer and visits to loved ones may be restricted to keep them safe. If you have loved ones in an aged care facility, ask the facility about its plans for keeping their residents safe from flu (a similar situation) and whether they have thought about what they will do if SARS-CoV-2 is spreading widely.

Pandemic is a word, how we react to it is down to us

We all want to have some control over our lives but when a virus comes knocking as this one is, we feel the loss of that control. The lists above are something we can actually do.

 The lists have helped us all focus on how that “thing going on in that faraway country” will impact us when it comes to our neighborhood. This process has already made things a little more familiar and a little less unknown and scary. We’ve done some things that will help. We know there are still risks but we’ve talked about them, calmly, as a family.

Of course, this doesn’t remove the many unknowns, but we’re sure we’ll gradually reduce those as science gets us more answers. Hopefully, these answers will bring good news; lower death rates, effective antiviral drugs, and new vaccines.

We do have some experience of a pandemic and it wasn’t panic-worthy. The pandemic of H1N1 “swine flu” in 2009 had some unhappy consequences, but it was by no means a zombie apocalypse.

China has bought us time to prepare. Let’s not waste any more of it. Instead, let’s get our planning hats on and all work the problem together. This is one of those rare times when we’re unarguably all in this together.

SARS-CoV-2 doesn’t care about our beliefs, our sex or gender, our colour or our clothes – it just wants to make a home in our human cells.

It’s perfectly okay to be anxious about this.

But work the problem.

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