Covid-19 information and advice from Dr. Bradly Bundrant

 

The most important thing to do if you are well, in order to remain well, is to wash your hands for 20 seconds before you touch your face or anything that goes into or around your mouth, nose or eyes. The most important thing to do if you are infected, in order to not infect others, is to wash your hands (for 20 seconds) after touching your face etc., before touching another person or anything that another person will touch. Sneezing/coughing into your elbow, or into tissue (then throwing it in the trash and washing your hands for 20 seconds) is also important. Since we cannot know if we are infected we must wash our hands before and after we touch our mouth, eyes or nose. Mask wearing and the other things that people talk about using the term social distancing; like keeping 6 feet away, or avoiding crowds will have little positive effect, if we don't get very good about washing our hands. Using alcohol based hand sanitizers may be substituted sometimes, if hand washing is impractical. However, washing after every few applications is critically important because sanitizers leave a little bit of residue to which dirt can adhere, and they don’t remove the dirt and grime to which germs cling and in which they survive.

Cleaning surfaces properly is another simple thing that is also important. All of the economic hardship that the country is being put through will be worth relatively little if we don’t do those simple things.

It is important to understand that there are certain things that we know about this virus that allow us to make very reliable predictions about the way it will affect our population. The 2 most important pieces of information are the answers to these questions:

1. Once a person gets infected how many people are they likely to infect?

2. Once a person gets infected, how long will they be infectious and how sick are they likely to get?

The numerical answer to the first question is know known as “R naught or Ro;” If the Ro for a given infection is less than 1, the infection will die out. That is exactly what happened with SARS, several years ago. For COVID-19 the Ro is said to be 2 to 3, and maybe higher. We know that one person often infects 5 or 6 people, and sometimes it is about a dozen or more. All of the strenuous social distance efforts, the emphasis on hand washing and wiping surfaces appropriately are all intended to reduce Ro to as small a number as possible. Less than one would be ideal. The answers to the second question actually affect the first question. If people remain infectious for a long time and don’t get very sick, they have the greatest chance of infecting a lot of other people. Unlike the first question, we don’t currently have any way of affecting the answers to the second question. The only things that we can do, in this particular case, is to give comfort (treating the fever with Tylenol, for example) and supportive care such as supplemental oxygen for severe cases or ventilator support for the most severe cases. That’s all.

As long as the answer to the first question is greater than 1, and there are no other factors involved, predicting the spread of the virus in a population that has no experience with it and hence no immunity, is simple. It will spread just like a bacteria introduced into a culture dish. There is some period of time during which the number of bacteria will double, so the growth in number of bacteria will be relatively slow at first, but the rate of increase will rapidly rise and the number will grow exponentially…. Until the population runs out of food. Then the number of bacteria will peak and rapidly fall off. It usually stabilizes at some level that is relatively low, compared with the peak. In this analogy the new coronavirus is like the bacteria, the world is the culture dish and we are the food supply.

Now, if you get sick with what may be COVID-19 you need to pay attention to your symptoms, and remember that we cannot do anything about the answer to the second question. There is nothing that a doctor can do for you that you cannot do at home by yourself, unless you need to be hospitalized for supportive care such as IV fluids, supplemental oxygen or ventilator support. So, if you are short of breath or you are vomiting and think you are getting dehydrated, seek medical advice or medical care.

Otherwise, don’t seek treatment or testing. It will be worse than useless to go get tested -- if you can find a test -- because you can’t change how sick you will get, and you can only increase the number of people you infect by going out to get tested. You may think,“I want to know what I have.” You won’t.

You likely won’tever know what you have unless you get very sick and stay sick for a week or more. If you are someone who is healthy and gets COVID-19, then goes to get tested, by the time the results come back they will tell you what you had. The test results typically take 4-7 days to come back, and by that time you will be feeling just about well again. What if it’s the flu? A very similar thing applies. If you are someone who is generally well, unless you are short of breath or needing supportive care for some other reason, stay home, even if you would have gone to the doctor with the same symptoms last year. Stay home this year, because the time and resources spent taking care of you will likely be better spent on someone who does need supportive care, and also because you might catch the COVID virus at the same time you are learning that you just had the flu. The same thing applies to having a cold and to most cases of bronchitis, which are really chest colds. Stay home unless you are really sick.

If you want to call someone, you can call 2-1-1, and use Option 6, 7AM-6PM Mon-Fri. Another choice is Shannon Medical Center’s telemedicine website at www.ShannonOnDemand.com.

Also, for general questions as well as information about specific situations, visit the Texas Department of Health (DSHS) site for coronavirus at: https://www.dshs.texas.gov/coronavirus

Here are other good sources:

CDC Coronavirus page:

https://www.cdc.gov/coronavirus/2019-ncov/index.html

CDC Coronavirus Guidance for School Settings:

https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/index.html

Johns Hopkins interactive map, one of the most detailed yet up to date sources of information and statistics:

https://coronavirus.jhu.edu/map.html

Here is a list of 274 surface cleaning and sanitizing products:

About 150 (those designated) can be relied on to protect against the virus that causes COVID-19 https://www.epa.gov/pesticide-registration/list-n-disinfectants-use-against-sars-cov-2

Dr. Bradly Bundrant is the Chief of Staff of Ballinger Memorial Hospital District and the founder of the Health & Wellness Coalition of Runnels County. You can reach Dr. Bundrant at Ballinger Memorial Hospital by calling (325) 365-2531.