The following article was submitted by Dr. Bradly Bundrant, the Local Health Authority for Runnels County.


As I write this at noon on Sunday April 12, 2020 Texas has had 124,533 tests for COVID-19 performed, and resulted with 13,484 confirmed cases; 1,338 of these are currently in hospital. The number who have died of the disease is 271, and 2,014 are said to have recovered (from Texas Case Counts at https://dshs.texas.gov/coronavirus).


Each of these figures tells a story. The number tested is a reflection of two things: the number of tests available is one, and the number of people that had a credible presentation (history plus clinical findings) suggesting that they might actually have the disease. Almost exactly 10% of the people tested were positive for the disease. This is a number that is pretty consistent in places where there is low or negligible community spread (as opposed to places like New York City, where at the height of their epidemic the rate of positives was 30% or more).


Of the confirmed Texas cases, less than 11% are in the hospital, and 2% of those infected have died. Looking at it another way, of the people who were legitimately worried and got the test, only 0.2% have died. That may be the most important number of all, for most of us.


For someone in Texas who is sick with a COVID-like illness, the chance of death is about 0.2%. Of course it is more if you are older and have underlying illness, and less if you are young and healthy, but those odds are not much different from the chance of death if you have the flu.


The numbers are a little worse if you look at the country as a whole. There are 2,688,766 people who have been tested, with 532,339 positives and 21,418 deaths. So not quite 20% of the tests have been positive, and the rate of death is 4%, for those infected.


Of the people tested the death rate is 0.8%. The reason I say that the rate of death among those with a COVID-like illness is the most important number is this: By now we all know the signs of COVID, and they are fever, cough, shortness of breath, fatigue and may include GI symptoms such as nausea or diarrhea in addition to runny nose.


No test is required, you know if you have this. If you do, your chance of something serious happening (if you live in Texas) is almost exactly the same as if you had the flu. Two important differences, at this point, is that there are prescription medications (such as Tamiflu or Xofluza) that you can take which may shorten the duration of flu symptoms by a few hours, or at most by a day, and also there is a widely available vaccine to help reduce or prevent illness from the flu.


These differences aside we can think about COVID-19 and flu in exactly the same way. If you knew that you had the flu you would (should!) stay home until you are no longer contagious, drink plenty of fluids and take Tylenol (acetaminophen) for the fever and body aches. Then, if you got sicker and had a hard time breathing, were vomiting and getting dehydrated etc. you would call your doctor or go to the ER. It is exactly the same with COVID, with one exception.


Please don't just show up at the ER. Call first. If you need more information, the CDC has terrific tools to use if you are sick at:


https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/steps-when-sick.html.


Unless you are a person at higher risk for death from COVID-19, if you do get a COVID-like illness (or CLI), and don't get very sick, you don't need to be tested. That's important in one sense because, on average, the more people tested in any one day the longer it will take for tests results. And people who DO need to be tested may have lots of other people whose peace of mind, or even whose livelihood may be threatened while waiting on those results. It won't be very long, I suspect, before we will have antibody tests that will let you know whether you had COVID or not. So, if you have a CLI and stay home and get well, then what? If you are one of those workers who must get back to work, the CDC advises that you wait until:


· At least 3 days (72 hours) have passed since recovery defined as resolution of fever without the use of fever-reducing medications and improvement in respiratory symptoms (e.g., cough, shortness of breath); and,


· At least 7 days have passed since symptoms first appeared https://www.dshs.texas.gov/coronavirus/docs/NonTestBasedStrategyForReleasingHomeIsolation.pdf


If you have not been sick, but have been exposed to a suspected or confirmed case, see


https://www.cdc.gov/coronavirus/2019-ncov/community/critical-workers/implementing-safety-practices.html


I leave you with one final thought. We have succeeded in "flattening the curve." What that means is that we have lowered the peak number of infections at any one time by lengthening the time during which we will have a significant number of infections. When you hear. "flattening the curve," think, "lengthening the curve." That means for many months we will need to remember and follow the guidelines for hand washing, not touching the face with unwashed hands etc. That includes wearing a mask in public if there is a chance you could have a CLI -- even in an asymptomatic phase…. But we will get through this, and will likely be better for having been through it.


Dr. Bundrant is the Local Health Authority for Runnels County and a physician at Ballinger Memorial Hospital. Previous articles listed Dr. Bundrant as the Chief of Staff, but that position is now held by Dr. Hardwicke. We apologize for the error and for any confusion.