Readers’ top 100 questions, answered

On April 5th, The Washington Post published a really nice guide to a handful of key questions here: https://www.washingtonpost.com/health/2020/03/13/if-you-feel-sick-are-worried-about-coronavirus-call-your-doctor-dont-rush-er/ (Although, now that I think of it, their second answer is horrible: No matter how old you are, even if you’re 101 years old, if you have a huge back yard, it’s perfectly safe for you to go outside! (If by “outside” you mean your back yard. The issue is going outside in a situation where you might be exposed to the coronavirus. So if you live in a retirement community, I guess you have a risk when you touch the elevator buttons and when you open or close a door…))

Vox has a nice feature, “11 questions about the coronavirus economic crisis you were too embarrassed to ask,” here: https://www.vox.com/coronavirus-covid19/2020/4/2/21201905/coronavirus-economic-crisis-recession-depression-stimulus-checks-covid-19 . As the headline says, these are economics questions — recession vs. depression, unemployment insurance, etc.

.

.

MEDICAL QUESTIONS

What are the symptoms of Covid-19 vs. the flu, a cold, or an allergy?

In short: (1) Covid-19 and the flu have coughs, whereas colds and allergies have sneezes. (2) Shortness-of-breath is a distinguishing symptom of Covid-19. (3) Loss of taste or smell is possibly a symptom of Covid-19 (but also some allergies). (4) Re: fever… [Finish writing this, then point to a couple of infographics.]

If I think I might have a mild case of Covid-19, do I need to get tested?

Good question! If the symptoms aren’t bothering you much, probably not. But if your symptoms worsen, be sure to consult your doctor. He or she will let you know whether you should be tested. Plus, you need a presciption from your doctor to get the test.

What’s the difference between Covid-19 and the flu?

Covid-19 is caused by what they call a “novel” or new coronavirus. You may have had a coronavirus before as some cause the common cold. But because this one is new, none of us have any immunity to it. And it can’t be prevented with a flu shot because there’s no vaccine yet.

Because some of us have had various strains of flu in the past and we can get a vaccine to prevent many types of flu each year, not as many people catch it. So while the flu is a very serious disease that kills many people each year, the hospitals aren’t overwhelmed with patients they way they are if everyone gets sick at once.

And while it’s too soon for conclusive statistics, there’s evidence Covid-19 may be more contagious and more deadly than the flu.

What’s the incubation period for Covid-19?

The median time to get sick after catching the virus is 5 days but it can be up to 14 days. This is another thing that makes it more dangerous than the flu. People typically show flu symptoms in 2 days so are more likely to stay home and away from other people while they recover.

Will this virus recede during the summer as is often the case with the flu?

It’s possible. But so far, the virus has been resilient in warm climates so we can’t count on it. In any event, a second wave of the disease in the fall could prove more deadly than the first, as was the case with the Spanish Flu in 1918. https://www.history.com/news/spanish-flu-second-wave-resurgence

What is “flattening the curve?”

How bad are ventilators?

They are bad. If you knew how bad, it’s likely you might not want your beloved elderly relative to be put on one. They would have to have a 10″ tube inserted down their throat into their lungs (“intubation”), put into an induced coma, and spend days in that fog (being, of course, confused and disoriented if they come out of it, possibly with paranoid hallucinations). In New York, estimates are 70-80% of Covid-19 patients die without ever coming off the ventilator. Furthermore, some survivors suffer physical setbacks like shortness of breath and PSTD-like conditions thereafter.

Some of the after effects of being on a ventilator are described here https://www.washingtonpost.com/health/2020/04/03/coronavirus-survivors-recovery/

(Add articles from STAT News, HERE and HERE)

STAT News (4/9/20): With ventilators running out, doctors say the machines are overused for Covid-19

[Write answer here]

Don’t we need clinical trials ASAP?

Yes! The National Institutes of Health’s ClinicalTrials.gov lists more than 100 clinical investigations focused on Covid-19 from around the world, with sponsors that include medical centers, pharmaceutical companies, and national research institutes.

One promising trial takes antibodies from the blood of those who have recovered from Covid-19 to see if the antibodies will help those with the illness currently. It’s called convalescent plasma therapy. This technique has proven helpful with other diseases but it may or may not work for Covid-19. The trials are just beginning.

Other treatments are being tested, including one heavily touted by the President – hydroxycholoroquine, along with the antibiotic azithromax. While the drug is approved for malaria, it can cause deadly heart arrhythmias. Therefore, many doctors are proceeding cautiously. A small trial of the drug in Brazil was cancelled after 11 patients died of heart arrhtythmias.

How far away is a vaccine?

Vaccines take a long time to develop and test to make sure they’re safe and that they work. For that reason, 12-18 months is about the quickest drug companies can come up with a vaccine. The WSJ on 4/10/20 says, “———–”

What if I need emergency care for something other than Covid-19?

If you have symptoms that could be life threatening, like chest pains or abdominal pain that could indicate appendicitis, call 911. Likewise for any serious injury. If your symptoms are not life threatening, many doctors offer phone or even video consultations.

Dentists are generally available to help in an emergency, even if their offices are closed for routine appointments.

What about a mental health crisis?

Being confined at home with others or by yourself can be extremely stressful. Likewise, many people have lost their jobs and are worried they won’t be able to pay the bills. If you’re feeling stressed out or need help with other psychological issues, there are many helplines available. Some can be found at https://www.psychiatry.org/psychiatrists/covid-19-coronavirus.

So, should I wear a face mask or not?

One of the big tragedies of February and March was the bad information that the CDC and the Surgeon General and top other sources gave us about the value of face masks.

For example, even as late as April 11th, the WebMD website says, “Are face masks really effective in reducing the risk of being contaminated? Generally, no. If you have Covid-19, then, yes, wearing a mask should reduce the risk of you giving it to someone else. But if you’re otherwise healthy, surgical masks provide little protection and the more sophisticated N95 masks are best left to health care workers, who are often fitted for them. Many people who wear either mask often do not do so properly — they continue to touch their face or adjust the masks, which can actually increase the risk of getting infected. You also have to dispose of it carefully. They are also not reusable, so as soon as you touch your face or adjust the mask, or take it off once you get inside somewhere safe, you can’t put it back on.”

As it turns out, that’s horrible advice! (A) The main benefit of everyone wearing face masks is so asymptomatic spreaders don’t unknowingly give it to others (see https://www.npr.org/sections/goatsandsoda/2020/04/13/831883560/can-a-coronavirus-patient-who-isnt-showing-symptoms-infect-others). (B) The secondary benefit is that of course it’s better than nothing at protecting yourself. (C) And the most logical reason that Hong Kong, Singapore, Japan, South Korea and China saw their infection rates decline faster than other countries is face masks are culturally accepted and worn by the vast majority of the population when needed.

Some observers speculate that the CDC and Surgeon General told us face masks weren’t helpful is because they knew they had failed to order mass quantities in the first few weeks of the year, and they didn’t want to look bad.

Should I also use disposable gloves?

Opinions are divided on this question. If you touch something contaminated with gloves on, then touch your face, you can still become infected, just as you would if you touched something contaminated with your hand. But wearing gloves and a mask may remind you not to touch your face. If you do choose to wear gloves or are required to wear them, as is the case with some grocery stores now, make sure you practice good sanitary habits. When you leave the grocery store, take them off by putting your finger on the inside (the clean side) and turning them inside out. Then immediately dispose of them in a trash can. If you touch the outside of the gloves, your hand can be contaminated with anything you touched with the glove. And if you leave them in a grocery cart or toss them on the ground, whoever touches them next can become sick.

Whether you choose to wear gloves or not, be sure t0 wash your hands with soap and water for a minimum of 20 seconds as soon as you get home.

What do I do if someone in my family gets sick?

If you believe someone in your home has Covid-19, even if you don’t have test results, that person must be quarantined away from the rest of the family. Ideally, he or she will stay in one room and use only one bathroom which others can avoid. If there’s only one bathroom in the home, it will have to be sanitized with a disinfecting cleaner each time the sick person uses it.

Meals should be served on disposable plates and cups and placed outside the door where the patient is confined. And this is where disposable gloves come in handy – after the meal is consumed, pick up the plate and cup with disposable gloves on, discard the trash, then remove the gloves, putting your finger inside and turning each inside out. Then dispose of them immediately and wash your hand with soap and water for 20 seconds.

Encourage the infected person to get plenty of rest and if he or she develops serious symptoms, consult your physician.

Can you get Covid-19 more than once?

Unfortunately, the jury’s out on this one. Some victims have appeared to have it more than once but it’s possible that the patient wasn’t fully recovered and the symptoms worsened after he or she seemed to recover.

According to Dr. Amesh Adalja of Johns Hopkins University School of Public Health in a recent interview with MSNBC’s Andrea Mitchell, if people are reinfected, their symptoms will probably not be as severe. People have become re-infected with other coronaviruses but those infections may be “clinically silent,” that is asymptomatic. We do not yet know if those individuals could spread the disease when reinfected.

Can you get Covid-19 from sex?

The concensus is Covid-19 is not a sexually transmitted disease.

STAY-AT-HOME QUESTIONS

If my city is under a “Stay at home” order, can I go outdoors for exercise or grocery shopping?

The answer varies by city and state. Chicago mayor Lori Lightfoot says you could get a ticket and fine for going out on a long run. In New Jersey, the governor has asked that citizens stay off the roads but compliance is voluntary. However, people obeying “stay at home” orders are generally permitted to go to the grocery or drug store as necessary, as well as traveling to take care of elderly or homebound relatives.

If you are running or doing other vigorous exercises outside, you might want to wear a face mask and.or stay farther away from others https://www.npr.org/2020/04/13/833242474/how-runners-can-keep-themselves-and-others-safe-during-the-pandemic

What is so dangerous about me going for a drive in my own car?

Excellent question! On its surface, it doesn’t seem like there’s any coronavirus risk to you or others from doing so. (Okay, maybe there’s a bit of a risk — either from you to others at the gas pump (either from you if you’re unknowingly infected-but-asymtomatic or to you from germs on the nozzle or on the touchscreen) — but, generally speaking, it would seem to be a safe, isolated environment.

However, local officials are understandably interested in minimizing the number of car accidents that would require help from first responders while dealing with the coronavirus emergency.

May I walk on the street with friends if we’re wearing masks and stay 6+ feet apart from one another?

Another good question! It’s acceptable to walk outside with friends if you’re maintaining social distancing. However, it may be hard to avoid other individuals and groups if you’re walking in a park or other popular location. Make sure you can maintain socal distancing with others in the area, too, or seek a less crowded place to walk.

Why do “President Trump’s 30 Days To Flatten the Curve” guidelines call for “Avoid groups of more than 10 people”? Shouldn’t I avoid ALL groups?

It’s only logical that the fewer people you encounter, the less chance there is of any kind of transmission. So, unless you have a family of 10 staying at home under the same roof, it’s a good idea to avoid groups of that size.

Does hand sanitizer go bad?

Yes. If you find some old hand sanitizer, it may have lost its potency. But it’s easy to make more even if you can’t find it in the stores.

How do I make hand sanitizer?

Use alcohol and either aloe vera gel or glycerin (the latter may be easier to find). The alcohol cleans and the aloe vera or glycerin helps keep the alcohol from being too harsh on your hands. Your mixture must be at least 60% alcohol to work. This is one simple recipe https://www.cbsnews.com/news/hand-sanitizer-coronavirus-make-your-own/

Where can I get instructions on how to create a homemade face mask?

Making a facemask is easy, even if you don’t sew. There are many tutorials online, for instance HERE https://www.youtube.com/watch?v=Kd54zrv8nSgor or HERE https://www.youtube.com/watch?v=X-OCwuiefzY

Try to use a densely woven fabric (one you can’t see through when you hold it up to the light) to prevent the virus from being expelled if you are infected and cough. Many times, people catch the virus from someone who doesn’t even have symptoms. As the saying goes, “Your face mask protects me, my face mask protects you.”

Once you have your mask, make sure you’re wearing it correctly https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/diy-cloth-face-coverings.html When you remove it, do not touch the front as you could contaminate your hands. Instead, remove it by the elastic or cord which fits around your ears.

How do I clean my mask?

You can put it in the washing machine with your other laundry. Of course, it will help to make more than one so you don’t have to do the wash each time you use it!

Why can’t I get toilet paper???

People tend to hoard critical items when they’re preparing for any extended stay home, as they do before blizzards. However, there are other factors. We all use more toilet paper if we’re home all the time vs. if we’re using the bathrooms at work or school.

There’s plenty of toilet paper available for public bathrooms, but it’s not in our stores because of distribution patterns. Commercial toilet paper is sold to corporations and school districts so the local Ralph’s store or CVS doesn’t get them. Plus, the product is often different, for instance 1 ply vs. 2 ply or on giant rolls. The industry is trying to adapt but it may take a while.

What about hand sanitizer and disinfecting wipes?

That’s easy. We’re using much more of it so demand exceeds the supply. Those manufacturers are increasing production and non-traditional entities are turning to production. Hand sanitizers are now being produced at breweries (they’re used to dealing with alcoholic products!) and in prisons.

Your local supermarket may not have them in stock because everyone looks for them there. Sign up for online flash sales as you may be notified of new stock. And check out of the way retailers. A friend of mine picked up hand sanitizer at an auto parts supply store.

What are the risks of abandoning social distancing too soon?

Other countries which have started to relax restrictions, like Japan and Korea which dealt with initial outbreaks aggressively have started to have rebounds as normal behavior resumes.

Articles here

“HOW CAN I HELP?” QUESTIONS

Do animal shelters need help?

[There’s a big demand for puppies, but staff for the shelters may be short supply…]

Would it be useful if I made homemade face masks and donated them? If so, to whom?

[Write answer here. Donate to neighbors? Storekeepers? A local nursing home or senior living apartment building? Your alderman?]

Is it true that blood donors are urgently needed?

Yes…

.

.

.

“GOOD NEWS” QUESTIONS

Can you give me some good news, please?

John Krazinski has a new online show on that topic. He joined “Big Papi” David Ortiz to announce some additional good news https://www.washingtonpost.com/sports/2020/04/13/john-krasinski-david-ortiz-surprise-boston-medical-workers-with-lifetime-red-sox-tickets/?utm_campaign=wp_post_most&utm_medium=email&utm_source=newsletter&wpisrc=nl_most

“Tiger King” is fun to watch… How about links to some webcams around the world? “Whatever Happened to Pizza at McDonald’s?” is an entertaining podcast… “Parks and Recreation” writer Alan Kang has a new movie dropping this weekend… New York magazine’s “Intelligencer” has writers from 35 classic TV shows describing what their pandemic episode would be like… Kurt has a great recipe for veggie chili that goes great with Skrewball peanut butter whiskey… The late-night hosts are broadcasting from their homes and maybe better than ever (especially “The Daily Show’s” Trevor Noah)… AccuRadio has a great channel called “Cocktail Jazz Trio” that you can summon on your Alexa device…

.

.

.

PERSONAL FINANCIAL QUESTIONS

When will I receive my stimulus payment — and how much will it be for, and for how long is it supposed to last?

[Write answer here]

How do I get a check if the IRS doesn’t have direct deposit info for me?

[Write answer here]

Do I have to make my mortgage or rent payment this month?

Good question!…

What are my options if I’m running out of grocery money?

Excellent question, because it’s not like you can start driving for Uber…. Are grocery stores or Amazon warehouses hiring?

.

.

.

SMALL BUSINESS QUESTIONS

Am I supposed to be paying my employees even if they’re not working?

[Discuss difference between furloughed, laid off, and fired — and how that affects unemployment insurance issues for employees (and the business)]

What am I supposed to do if I don’t have enough cash to make payroll this week?

[Write answer here]

What’s the current status of the PPP program?

[Write answer here]

.

.

.

QUESTIONS RE: ELDERLY PARENTS

What should I be thinking about vis-a-vis my elderly parents?

[Write answer here]

.

.

Questions about Kids

INTERNATIONAL QUESTIONS

What’s going on in Sweden with its no-lockdown policy? Is that working?

[The WSJ today says the jury is still out on that…]

What about third-world countries? Isn’t that a particular danger?

Yes, because social distancing is impossible in slums and the hospital systems are overloaded in even good times… What can be done to help them avoid suffering millions of deaths? Link to articles HERE and HERE.

.

.

.

QUESTIONS RE: WHAT WENT WRONG?

How did the CDC manage to send out a flawed test in January?

[Discuss executive staffing issues. Maybe also discuss our Attorney General and how he got selected…]

“Nobody could have ever anticipated this.” True?

No. This is not our first rodeo. Besides the Spanish Flu a hundred years ago, there have been threats from Ebola, the H1N1 “swine flu” and many other very contagious diseases. And we’ve all heard of The Plague, right?

Past administrations have had detailed plans on how to deal with pandemics because they are so likely and probably inevitable. The outgoing Obama administration conducted a briefing for the Trump team during the transition in January, 2017.

There were even concerns about the novel coronavirus as early as 2018. https://www.washingtonpost.com/opinions/2020/04/14/state-department-cables-warned-safety-issues-wuhan-lab-studying-bat-coronaviruses/?utm_campaign=wp_post_most&utm_medium=email&utm_source=newsletter&wpisrc=nl_mostArticles

There have been reports that our intelligence community warned about the outbreak in China as early as November, 2019.

More articles HERE, HERE, HERE, HERE, HERE, HERE, and HERE.

.

.

.

“HOW ARE WE GOING TO SOLVE THIS?” QUESTIONS

Who’s in charge? (Who should be in charge?)

[Discuss the strengths and weaknesses of Trump’s task force… The idea floated this week of a band of governors and experts (medical & economy) coming together to step into the leadership vacuum…]

When do things get back to “normal?”

It depends. It’s likely that some regions will resume normal activities before others. Also, activities which involve fewer people, like birthday parties, block parties, weddings and funerals, will probably be permissable before sports fans are allowed to attend games with thousands of people in the stands or music fans take in concerts at large venues.

Who makes the decision about when we go back to normal?

According to the U.S. Constitution, any powers not specifically reserved for the federal government remain with the states. The Constitution does not give the federal government any authority regarding quarantines. And the police departments needed to enforce social distancing are controlled by state and local governments. Posse Comitatus is a federal law dating back to 1878 which prevents the federal government from using the military to enforce laws within the U.S.

However, because controlling national borders falls to the federal government, it has the power to shut down travel into the country.

Don’t we need a national program of randomized testing, so we know the true prevalence of Covid-19 in the population?

Oh, yes, we do! Most experts believe it would be dangerous to go back to our usual activities without extensive testing that would enable us to identify infected individuals and make sure they quarantine themselves. That’s a problem because we still don’t have enough tests to test everyone. There are also backups at many labs which process even the number we’re doing now and the results aren’t always accurate. However, new tests are being created and manufactured, including a saliva test developed at Rutgers University https://www.youtube.com/watch?v=_A5TOhinXoU

Blood tests can determine who has already had Covid-19 and recovered. Those people would likely be able to go back to work without endangering others.

STAT News (3/17/20): A fiasco in the making? As the coronavirus pandemic takes hold, we are making decisions without reliable data

What’s the plan for getting our economy moving again — without overwhelming our hospitals?

[Write answer here]

What do we do if millions of people stay unemployed?

There’s no doubt that the crisis has cost many millions of jobs and unemployment is likely to be high for a very long time. But the coronavirus crisis has created some new opportunities. For instance, many retailers have closed, but Amazon and food delivery services need more delivery people.

Another opportunity might be hiring people to do “contact tracing.” That’s what epidemiologists do to find people who have come in contact with an infected person. It’s extremely labor intensive and some estimate it could take 100,000 people to trace them.

Also, the U.S. Census has been delayed because it wasn’t safe for people to go door to door. Some have completed this all-important head count informationo online but the Census may need more workers to complete the task.

Other federal programs like rebuilding our infrastructure could create many millions of good jobs if Congress can agree on a plan and authorize the funds to make it happen.

Could the November elections be delayed, the way some states have delayed primary elections?

.

.

.

=======================================================

Original “Top Ten Reader Questions”

1. How can I tell coronavirus symptoms from a cold or the flu?
2. Should I wear a protective mask?
3. What’s an appropriate supply of emergency food & beverages?
4. How long is this crisis likely to last?
5. What’s the recipe for homemade hand sanitizer?
6. Is outdoor exercise okay?
7. Is it safe to eat takeout and delivery food?
8. What can I do to best help the elderly, sick, and/or unemployed?
9. What does “COVID-19” stand for?
10. If I’m sick, how can I stay at home without putting my family members at risk?

“The most serious global health crisis in a century”

From The Globe and Mail:

https://www.theglobeandmail.com/canada/article-your-money-or-your-life-coronavirus-era-economics-makes-us-ask-grim/

What do I do now?

My job has been affected by the coronavirus pandemic. What do I do now?

Wherever you live and work, chances are your workplace has been affected by the coronavirus pandemic. Many businesses have closed, either voluntarily or under provincial bans on non-essential services, and those closings and layoffs have affected hundreds of thousands of people.

• If you have been laid off, the Canada Emergency Response Benefit will help you stay afloat. And: additional career advice.
• Here’s how to apply for EI and other COVID-19 emergency government income supports

Toronto employment lawyer Daniel Lublin answered frequently asked questions about COVID-19′s impact on the work force. Some questions include:

• If my employer shuts down because of COVID-19, am I entitled to severance?
• If I have COVID-19, am I entitled to my salary while quarantined?
• What types of questions can my employer ask me related to COVID-19?

Though the federal and some provincial governments have introduced income supports for workers that don’t qualify for EI benefits, many businesses have called for larger wage subsidies to prevent layoffs, as well as a broad freeze on payments to government.

Get a second opinion:

• What are the rules around temporarily laying off employees?
• My boss wants me to self-quarantine without pay. Is that legal?
• Is this a bad time to be switching jobs?

Have a question that you’d like answered? Send them to NineToFive@globeandmail.com. You can also check The Globe and Mail’s digest of the latest news about COVID-19′s spread around the world.