Monday, March 2, 9:05 AM

March 2, 2020

Dear A&S Faculty and Staff,

   Hello everyone. First, the official update: Last week the university put out an official COVID-19 novel Coronavirus web page, that information is in the email below. (which includes links to county, state, national and world health organizations):

We have no word on any closures or event cancellations as of right now, 9:00 am on Monday, March 2 but please check that web page regularly for updates. It may also be a good time to begin thinking about how you might be able to use online tools in the event there is a disruption in class meetings (either through cancellation or student/faculty/staff illness).

Next, an unofficial update. Dr. Michael Myint is an epidemiologist and personal friend who is deeply involved in the COVID-19 response in the region. He has been posting information via social media that I thought you may find helpful, I offer his thoughts from the past two days below:

 From March 1, 2020:

An update on Coronavirus as of 03-01-2020.  Seattle, WA unfortunately seems to be the place where we are first seeing increased cases of Coronavirus in the US.  Evergreen hospital reported the first death in the US yesterday.  They also have another positive case from a nursing home in Kirkland, WA where several patients and the nursing home staff are also showing symptoms and are under investigation. 

All the preparation recommendations in my prior post takes on increased importance if you are in this region.  Usually these very sick cases are the "tip of the iceberg."  Further assessments are occurring, but public health and the healthcare systems in the area are continuing to evolve our response. 

 I want to add one more point after seeing some conspiracy theories on the news.  Our public health and healthcare professionals are ALL trying to do the right thing and protect the health of the public.  The CDC and the DOH for each state are the experts.  My posts will always be apolitical because this is not a political issue and I feel we should focus most of our energy in keeping each other as safe as a community.

 Bottom Line

  1. Don't Panic, be prepared - this is the natural progression of this type of disease, but take the following precautions 2. Continue to prepare your home for "social distancing" and follow public health recommendations as they are changing quickly.  Right now there are no recommended local travel or gathering restrictions.  If you do participate in group gatherings (eg Church, school), practice excellent respiratory and hand hygiene.  Do not touch your face in public areas without sanitizing your hands.
  2. Stay home if you are sick.  If mild, the current recommendation is not to seek immediate testing.  Recall that 80% of patients with COVID-19 patients have mild symptoms and recover like other viral upper respiratory infections.  If you are feeling like you need to see someone because your symptoms are worsening such as shortness of breath, high fevers, or inability to keep hydrated, then call your healthcare provider before coming in as they will give you triage instructions on whether to come in and where to go.
  3. Follow the news, sources like this one are meant to be a supplement to public health in your area (especially if you are outside of the Puget Sound).
  4. Always use trusted sources of information - I like the World Health Organization and the Centers for Disease Control and Prevention. These may not be your sources, but find consistent sources of information that you can use.  Note that both the CDC and WHO do their best to post the latest information but even with the best scientists in the world, they can occasionally disagree.  This is not reason to distrust them, but evidence that both are run by very smart humans and very smart humans can disagree as well as make mistakes.  Though even during this epidemic, I have disagree with their recommendations, these two organizations, in my opinion do the best job and are committed to improving their recommendations over time.  Choose your sources and always be a critical reader.  I am asked frequently about multiple prevention or cures for COVID-19.  The bottom line is that in the age of the internet, you can find "evidence" for any solution a human can dream up and post.  in lieu of further research on natural/naturopathic interventions, medications, and vaccines is that there is not currently a "magic cure" for viruses like this one, though many are touted.
  5.  

    As I get asked, our practice for myself and my family is to take the CDC/DOH recommendations as a baseline and then make informed choices about non-necessary public gatherings and travel.  We have decided to not plan any travel (as my daughters China Trip was cancelled by the school) and keep our itinerary open as we know this is a changing situation.  We have stocked up on sundries and snacks at home, and supplemented and renewed our already present 2 week "earthquake" supplies. 

 From March 2, 2020:

03-02-2020

Mike Myint, MD

To start, I acknowledge and understand the level of anxiety out there around the novel coronavirus called COVID-19.  There is much unknown but a the same time there is also an accumulating body of knowledge.  This piece is not meant to review the latest information. I will continue to post information that I feel is actionable in future posts.  I also use the framework that many of the interventions are simple.  The actions I will recommend are not technically difficult, but they do defy any "silver bullet" solution at the present time and are therefore not easy.

 I also have recently had discussions with people who are really scared immediately followed by others who write off COVID-19 as hysteria.  The reality, as it often is, is in between and I want to also acknowledge that objective truth such as estimates that 80% of people with COVID-19 have mild disease doesn't mean that two people can differ on what this data point means and how it makes them feel.  Does this prove that there is nothing to worry about or does this prove we should be worried?  This piece is meant to try and frame how a community of people is interdependent and how public health is really more about how we treat ourselves and each other than about the particulars of COVID-19. 

 Step 1 - "Always" activities - These are things I think are reasonable for everyone to do, all the time.

Always take care of yourself and your families.  Being at Costco and seeing how much toilet paper they were selling makes me acknowledge that it's the simple things that make us feel secure at home.  Having basic supplies and increasing stock reasonably for preparation makes sense.  Eating well, sleeping well, and exercising are the simple, but not easy "always" events we should continue to do.  Further, addressing anxiety and fear goes a long way in improving one's physical health.  Wash/sanitize your hands, cover your cough, and get recommended vaccinations.  Social distancing is part of this.  All social distancing means in the time of an outbreak is minimize exposure to large groups of people when you can.  Though  health officials will either ban or not ban events of certain sizes, close schools etc, on a personal basis these decisions are more subtle.  Do I go to a concert?  Do I go to the mall?  Do I go to a school event?  There is not "right" answer, but each event we think about as a family we do a pro/con analysis.  At minimum, I follow public health recommendations to help weigh these choices.  My philosophy is "public health plus."  In addition to what Public Health recommends, I add on reasonable precautions as I know that public health recommendations sometimes can move slower than an epidemic.  One of my kids loves Comicon and if allowed to proceed, will be a game-time call before the event.  We will weight the enjoyment we get from going with the real risk of being in a crowded group who has travelled from large distances.  And the lines would be shorter…

Step 2 - "Never" Activities - These are things I would not do  • Do not harm yourself or your families - the "cures" on the internet can be absolutely hazardous to your health.  Humans, even really smart humans can create myths they believe to their core.  When fear and anxiety are present, people are more susceptible to solutions posited as simple AND easy.  Life, in my experience, doesn't work that way.  Simple AND easy solutions are generally people trying to sell me something.  Harm can also be financial including spending large amounts of money to buy protective equipment or "cures."

Step 3 - Community focused actions

 We are both individuals as well as part of a community.  Caring for ourselves can get us so far, but caring for others helps our communities stay healthy.

Try to stay home when sick - this part of social distancing is very effective as I have emphasized for COVID-19.   If you have health concerns, especially for respiratory infections you might think compatible with COVID-19, call your healthcare providers office first to prevent potentially unnecessary contacts.  Most people with COVID-19, as I mentioned will have mild disease and the current recommendations are to treat this like you would other cold/flu.  If you feel like you need evaluation, call first and follow your healthcare providers advice.  There are people in the community who need ongoing medical care for chronic diseases as well as other acute conditions.   Preventing the spread of disease helps our communities stay healthy, especially those who are vulnerable such as the elderly and those who are ill with other chronic diseases.  We have one box (yes only one) of masks in my house purchased a few years back.  We only plan to use these masks if we are sick and need to go out for some reason to protect others.

Help each other.  My opportunity is to write articles like this one and help my organization prepare for epidemics.  Everyone has a way to help their neighbors and communities get through this epidemic.  What can you do to contribute?

 Thanks everyone, let’s work to stay informed and respond thoughtfully through the next few weeks.

Best regards,

David