Coronavirus: Ask the Tri-County Health Care Experts

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States around the country have been taking drastic measures to help limit the spread of the Coronavirus, also known as COVID-19. Governor Tim Walz has issued an executive “Stay at Home” order for Minnesotans to significantly mitigate person-to-person contact.

While many people in the state will be staying home to help “Flatten the Curve,” Tri-County Health Care staff remain busy preparing for the Coronavirus to reach our communities. We know there are many questions circling this pandemic and our experts at TCHC wanted to take the time to answer questions on a wide range of topics. This week, our experts cover who is considered in the high-risk category, how children are affected, ways to clean and disinfect your home and alternative options to seek medical care during this pandemic.

Coronavirus Q&A ask the experts imageQ: What groups of people are considered in the high-risk category?

The reason so many experts stress the importance of social distancing is because it is crucial in reducing the spread of the virus to high-risk individuals in our communities. Ben Hess, M.D., explains who we are working to protect while social distancing.

Dr. Hess: When we talk about high-risk patients, we’re talking about two specific groups – people who have an increased risk of catching the Coronavirus and another group who may struggle after becoming ill with it.

The first group includes people who have problems with their immune system. This can be people who have an autoimmune disease or are on medication that suppresses their immune system. These people not only have a higher risk of catching Coronavirus, but are also more likely to become seriously ill.

The other group includes people with chronic conditions like diabetes or heart disease. Even if they have good control of their condition, we still want them to take precautions like they are in the high-risk group. While they may not catch the Coronavirus quite as easily, their chronic diseases can play a much larger role if they do become ill. For example, if a patient has a condition like diabetes under control, but then becomes critically ill, their body can no longer control the diabetes and their complications worsen.

Q: How does the Coronavirus affect children?

Dr. Hess: Studies show young children tend to tolerate and do much better with Coronavirus symptoms than adults. They are in the low-risk category and have a low chance of getting seriously ill or hospitalized from the Coronavirus. The risk isn’t zero, but it’s much lower than adults.

Q: What are ways to clean and disinfect inside the home?

Many people are wondering how to best clean and disinfect areas in their own households. This is important not only to prevent the spread of the Coronavirus, but also good practice for everyday germs. The Environmental Services team does this on a daily basis at Tri-County Health Care and has tips for how to best keep the household clean and free of germs.

Betty Klingaman, TCHC Housekeeping Supervisor: Using a bucket and rag, make sure to clean and disinfect frequently touched surfaces. These contact surfaces can include handles, desks, phones and keyboards. Make sure to clean all parts of the contact surfaces, including underneath tabletops and desks. If the surface is dirty, clean with soap and water prior to disinfecting.

Homemade disinfectant:

-Mix 5 tablespoons or 1/3 cup of bleach per gallon of water, or 4 teaspoons per quart of room temperature water.

DO NOT use hot or cold water – this minimizes the effectiveness of disinfectant.

-Mixed solution has a shelf life of 24 hours.

-Household bleach is effective against Coronavirus when properly diluted.

Tips:

-Contact surfaces should stay wet to ensure complete disinfecting.

-Be careful with solution – bleach can damage surfaces and discolor material.

-Follow manufacturer instructions for application and proper ventilation.

-Make sure product is not expired.

-Never mix household bleach with ammonia or other household cleaners.

 

Q: What if I need to see my provider but don’t want to risk exposure to the Coronavirus?

Jill Wilkens, MPAS/PA-C: We know that it is still necessary for us to provide care not only for the sick, but for our routine healthy patients as well. You may still need to be seen in certain situations. We are working out a process to find a safe alternative location to take care of our healthy patients. If you feel unsafe coming into our facility, please call and we will do whatever we can over the phone. You can also utilize MyChart and we will take care of you.

Patients also have the option to seek care online through the TCHC eClinic where providers can virtually diagnose, recommend treatment and prescribe medication. (Our eClinic also offers FREE Coronavirus screening)

 

Q: What news sources do you recommend to stay updated and informed on the Coronavirus? What should we do to be prepared?

Dr. Hess: Take care of yourself, eat healthy, stay hydrated, get plenty of rest, get good exercise, and keep an eye out for updated information here or visit Centers for Disease Control and Minnesota Department of Health.


The Coronavirus: Flattening The Curve

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As viruses spread, they tend to infect increasing numbers of people at high rates. The initial side of the curve over time, or rate of new infections, will naturally increase rapidly as more and more people are infected. If left unchecked, the total number people requiring health care will quickly rise well above the capacity of our US health care system.

By taking certain steps – canceling large public gatherings, for instance, and encouraging some people to restrict their contact with others – governments have a shot at stamping out new person-to-person transmissions, while also trying to mitigate the damage of the spread that isn’t under control.

The epidemic curve, a statistical chart used to visualize when and at what speed new cases are reported, could be flattened, rather than being allowed to rise exponentially. “If you look at the curves of outbreaks, they go into big peaks, and then come down. What we need to do is flatten that down,” stated Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. “That would have less people infected. That would ultimately have less deaths. You do that by trying to interfere with the natural flow of the outbreak.”

Stop the spread of coronavirus by flattening the curve

The notion that the curve of this outbreak could be flattened began to gain credence after China took the extraordinary step of locking down tens of millions of people days in advance of the Lunar New Year, to prevent the virus from spreading around the country from Wuhan, the city where the outbreak appears to have started.

The quarantines, unprecedented in modern times, appear to have prevented explosive outbreaks from occurring in cities outside of Hubei province, where Wuhan is located.

Since then, spread of the virus in China has slowed to a trickle; the country reported only 19 cases on March 9th. And South Korea, which has had the third largest outbreak outside of China, also appears to be beating back transmission through aggressive actions. But other places, notably Italy and Iran, are struggling.

On any normal day, health systems in the United States typically run close to capacity. If a hospital is overwhelmed by Covid-19 cases, patients will have a lower chance of surviving than they would if they became ill when the hospital’s patient load was more manageable. People in car crashes, people with cancer, pregnant women who have complications during delivery – all those people risk getting a lesser caliber of care when a hospital is trying to cope with the chaos of an outbreak.

“I think the whole notion of flattening the curve is to slow things down so that this doesn’t hit us like a brick wall,” said Michael Mina, associate medical director of clinical microbiology at Boston’s Brigham and Women’s Hospital.

“It’s really all borne out of the risk of our health care infrastructure pulling apart at the seams if the virus spreads too quickly and too many people start showing up at the emergency room at any given time.”

The U.S. has about 2.8 hospital beds per 1,000 people (South Korea and Japan, two countries that have seemingly thwarted the exponential case growth trajectory, have more than 12 hospital beds per 1,000 people; even China has 4.3 per 1,000). With a population of 330 million, this is about 1 million hospital beds. At any given time, about 68% of them are occupied. That leaves about 300,000 beds available nationwide.

Most people with Covid-19 can be managed at home. But among 44,000 cases in China, about 15% required hospitalization and 5% ended up in critical care. In Italy, the statistics so far are even more dismal: More than half of infected individuals require hospitalization and about 10% need treatment in the ICU. As cases spiked, Italian hospitals quickly couldn’t keep up with the patients coming in.

Countries and regions that have been badly hit by the virus report hospitals that are utterly swamped by the influx of sick people struggling to breathe.

Alessandro Vespignani, director of the Network Science Institute at Northeastern University, is gravely worried about what he’s hearing from contacts in Italy, where people initially played down the outbreak as “a kind of flu”. Hospitals in the north of the country, which the virus first took root, are filled beyond capacity, he said.

By limiting exposure to others, also known as “social distancing“, epidemiologists believe the curve could be meaningfully flattened. Social distancing means avoiding contact with others. This is crucial from a global health perspective. Limiting coronavirus cases not only has the obvious benefit of keeping the elderly and vulnerable safe, but it lessens the single biggest public health issue: overwhelmed hospitals.