COVID-19 coronavirus - Stay informed & protect yourself from infection

by Tom Cloyd - reviewed 2020.03.21:2157 PDT

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CRITICAL SUMMARY: COVID-19 is rapidly spreading across the world, with infection hot spots currently in the USA, Iran, and major western European countries. Entire countries are self-quarantining1. The USA hot spot is now New York state, with New York City especially hard hit. Most at risk are older people - males more than females - with chronic diseases. Protect yourself by touching your face as little as possible and washing your hands frequently and vigorously for 20 seconds. Protect yourself AND others by seeking help early if you have symptoms, and by self-quarantining if you suspect you might have the virus or if you are infected or ill.

I apolgise for the fact that this page is in dire need of updates. This past week, with the WHO’s declaration of a pandemic on March 11, has been more than a little frantic for some of us here in the USA.

Page Updates - most recent -2020.03.14 ^

Introduction - about this page ^

This page synthesizes and shares vital COVID-19 information. Updates about the COVID-19 disease incidence (new cases) and prevalance (existing cases), as well as crucial information about risk and personal protection strategies will be posted here as soon as I encounter it. I have a serious personal interest in this threat2 and so read a wide range of materials during the day. I use this page to organize and share the best information I find.

This page will be a unique source of reliable information for many people. In my sustained efforts to better understand this threat and to stay healthy, I’ve found information and resources that you probably have not seen. For that reason alone a quick survey of what’s here well may benefit you. And unlike what you read in any news outlet’s print or Internet article, key statements here are footnoted3. In addition, I subscribe to several news outlets that restrict access, beyond a certain point, to subscribers. I can read material not always available to the general public.

This page is NOT complete! “Complete” will always be a relative thing, but at this point I am rushing to get this material out to people, so there are important things that should be here which I have not yet had time to write up. At this time, this work is the major thing I’m doing, but it still takes time adequately to cover all major topics. I apologize to my international friends and visitors for a bias seen in certain sections toward the USA and the Pacific Northwest region of the USA. Limited times for work on this project necessarily limits my geographical coverage.

Comments wanted! As I am working fast to produce this page, errors may escape my editorial review. If you see something needing correction, or if you want to suggest an addition, or just have a comment or question, please contact me - tc@tomcloyd.com.

About “COVID-19” - name, origin, and dateline ^

“COVID-19” is the name of a new coronavirus which has caused a level of infection worldwide justifying the declaration of a pandemic.4 “Coronaviruses are a family of viruses most often associated with the common cold in humans.”5

“Coronaviruses are a large family of viruses that are common in people and many different species of animals, including camels, cattle, cats, and bats. Rarely, animal coronaviruses can infect people and then spread between people such as with MERS-CoV, SARS-CoV, and now with this new virus (named SARS-CoV-2)…. All three of these viruses have their origins in bats.”6

As announced by the World Health Organization (WHO) February 11, 2020:78:

The disease caused by the coronavirus of current interest is called COVID-19. This name, chosen by WHO, places the disease in the ICD (International Classification of Diseases).

The formal name of the virus itself is severe acute respiratory syndrome coronavirus 2 or (SARS-CoV-2).

Key dates:6

  • 2020.01.30 - “The International Health Regulations Emergency Committee of the World Health Organization (WHO) declared the outbreak a ‘public health emergency of international concern’”.
  • 2020.01.31 - “Health and Human Services Secretary Alex M. Azar II declared a public health emergency (PHE) for the United States to aid the nation’s healthcare community in responding to COVID-19.”
  • 2020.03.11 - “WHO publicly characterized COVID-19 as a pandemic.”
  • 2020.03.13 - “The President of the United States declared the COVID-19 outbreak a national emergency.”

Managing the risk of becoming sick with COVID-19 ^

“Preparedness equals self-sufficiency.”

Self-protection ^

Key recommendations for protecting yourself - full version ^

*Some people do better with a simple version of these recommendations. I have prepared one here.

  • Avoid touching your face, especially your eyes, nose, or mouth, to avoid introducing the COVID-19 virus into your body. 9 If you must touch your face, use a paper tissue or clean cloth, or wash your hands first.
  • Wash your hands frequently. When visibly dirty, use soap and water. If not visibly dirty, wash with soap and water or use alcohol-based hand cleaner. This kills most viruses and bacteria. 9
  • Maintain social distance of at least 1 meter (3+ feet) between yourself and anyone who is coughing or sneezing. People with the virus will spray many small liquid particles into the air with a cough or sneeze, whether or not they are clearly ill. People nearby can inhale these particles and thus acquire the virus.9
  • Do not touch people you are greeting (no hand shakes, hugs, etc.). Instead, wave, bow, or nod.9
  • Manage your coughs and sneezes correctly: Cover your mouth and nose with your elbow, or a paper tissue. (Then dispose of the tissue immediately and wash your hands if possible.)9
  • Respond early to indicators of respiratory illness: If you have a fever, cough, and difficulty breathing contact medical authorities right away for advice. This will give you and others people the best protection from COVID-19 if you have it.9 And know that getting tested won’t cost you anything.10
  • If you are aged 60+ or have preexisting medical conditions, such as cardiovascular disease, any respiratory condition, or diabetes, avoid crowded areas or any areas where you might become sick.9
  • Stay informed by regularly consulting reputable authorities and sources; help others by sharing what you learn.9

Key recommendations - simple version ^

  • Avoid touching your face, especially when away from your home. The virus infects you through your eyes, nose, and mouth. If you must touch your face, use a tissue or clean handkerchief, or wash your hands first.
  • Wash your hands often. Washing with soap and water is best. Wash vigorously for 20 seconds - count slowly to 20 or sing “Happy birthday to you” twice while washing.
  • Stay away from other people as much as possible. Avoid large groups. If you go to a store, try to stay 3 feet (one meter) away from other people, especially if they are sneezing or coughing or look sick. After leaving a store or meeting, use hand sanitizer if you have it. Wash your hands when you return home.
  • Avoid touching other people, as we usually do when greeting them. Nod and smile at them instead.
  • If you cough or sneeze, whether you are sick or not, always do it into the inside of your elbow. Or use a paper tissue, discard it right after using it, and then wash your hands.
  • Be especially careful if you are already dealing with any kind of lung disease or problem, or heart problem.
  • Call a doctor if you have a fever, a persistent cough, or difficulty breathing. Always call before going to any medical office or hospital.

Hand washing - what you should know ^

  • Hand washing with soap and water is generally more effective than using hand sanitizer or disinfectants.11
  • It reduces the amount of “…all types of germs and chemicals on hands”.12
  • Any time you cough or sneeze and cover your mouth with your hand, you must immediately wash your hands.13

There are specific, research-based steps to correctly washing hands to reduce and prevent disease:14

  1. “Wet your hands with clean, running water (warm or cold), turn off the tap, and apply soap.” Soap improves water’s ability to remove germs. People using soap also tend to scrub their hands better. Use of antibacterial soap has not proven to improve hand washing results in community settings.
  2. “Lather your hands by rubbing them together with the soap. Be sure to lather the backs of your hands, between your fingers, and under your nails.” Vigorous rubbing of hands increases removal of dirt, oil, and germs. Attention must be paid to all parts of the hand and especially the nails.
  3. Wash your hands for a full 20 seconds, for maximum effectiveness. (See this note15 for a simple trick that makes this easy to do!)
  4. “Rinse your hands well under clean, running water.” Clean rinse water is the critical factor here.
  5. “Dry your hands using a clean towel or air dry them.”

Hand sanitizer - what you should know ^

  • Hand washing with soap and water is generally more effective than using hand sanitizer or disinfectants.11
  • Hand sanitizers can quickly reduce the number of germs on hands, in certain situations, but do not kill ALL sorts of germs.12
  • Hand sanitizer should contain “at least 60% alcohol” to be maximally effective.12
  • For hand sanitizers to work well, hands must be free of dirt, oil, and grease, which can be difficult in real-world community settings. 12
  • Children should be kept from having free access to them to risk of alcohol poisoning due to swallowing them.12

Who in the workforce faces the greatest risk of COVID-19 disease?

In a compelling interactive graph, NY Times writer Lazaro Gamio shows who has the greatest risk and why.16

In brief, health care workers of all sorts, from dentists to home care workers, are at greatest risk.

“At a nursing home in Washington State linked to 25 coronavirus deaths as of Saturday, at least 70 employees have fallen sick.”

Also at high risk: teachers, food service and retail workers.

Here’s the problem that you may not see: “Workers in a number of professions facing elevated risk earn less than the national median wage. Many of these workers in low-paying jobs do not have paid sick leave, and many could still go to work sick to not lose income.”

Pre-existing conditions indicating need for extra care in preventing COVID-19 infection ^

High blood pressure, diabetes, and cardiovascular disease are “the ‘underlying conditions’ most associated with severe cases of COVID-19, in all age groups. “…The underlying condition most connected with COVID-19’s worst outcomes are afflictions of the heart.”17

Pre-existing bacterial or viral conditions both worsen heart conditions and weaken one’s immune system. For this reason, “the U.S. Centers for Disease Control and Prevention, and the American Heart Association recommend that cardiac patients take extra precautions as the coronavirus outbreak grows, which includes getting vaccinated for the flu and bacterial pneumonia.”17

People with high blood pressure or atherosclerosis (plaque-clogged arteries) are vulnerable to potentially lethal inflammatory side-effects of COVID-19, as are individuals with diabetes - who also tend to have suppressed immune systems and thus increased vulnerability to viral infection.17

Also seriously vulnerable to COVID-19 related complications are “chronic respiratory illnesses such as cystic fibrosis, chronic obstructive pulmonary disease, asthma, or allergies, as well as for people with lung damage linked to smoking.”17

Cancer treatment, including bone marrow transplants and chemotherapy, often have damages immune systems, and thus can make a person “more prone to catching pneumonias, including the viral versions.” Such immune system damage can persist past the end of such treatment.17

When should you tested for COVID-19? ^

When you have symptoms - this is the advice of Dr. Anthony Fauci,18 director of the National Institute of Allergy and Infectious Diseases – and a doctor for the National Institutes of Health for more than 50 years.19

Protection of others ^

“Elderly members of the household and those with chronic medical conditions risk severe complications, even death, if they become infected. Pregnant women may also be at particular risk, although the data aren’t clear.”13

  • When experiencing cough or a fever, avoid other people. 9 (This includes traveling or going to work!)
  • Keep your hands clean by washing with soap and water or alcohol based hand cleaner or when caring for the sick.9
  • If you have a fever, cough, and difficulty breathing contact medical authorities right away for advice.9
  • Do not spit in public.9

Self-quarantining ^

If you become ill and have symptoms that suggest COVID-19, or are tested and found to have the virus, you well may end up living at home, either by personal choice or because you were ordered to.13 “You’ll be so lonely,” according to one woman who was required to quarantine for 6 months due to tuberculosis exposure.20

“If you come down with (or are exposed to) certain communicable diseases, including cholera, diphtheria, infectious tuberculosis, plague, smallpox, yellow fever, viral hemorrhagic fever, SARS or a pandemic influenza, the state and federal governments can force you into quarantine and isolation. Often you will be told to hole up in your house or apartment until you are no longer deemed a threat.”20

Local governments have considerable power not just to advise this but to order it. However, the conditions under which they may do so vary, depending upon many factors. Also, technically, quarantining is for individuals who are not yet known to be ill but who are considered at risk for illness. For those actually ill, the practice of living along is “isolation”. It is risky and requires some kind of monitoring in case the illness worsens.13

While either practice is primarily to protect others from infection risk, it also reduces the risk of your becoming infected with opportunistic secondary illnesses to which. If infected, you may be more susceptible to such illnesses, and their consequences may be more severe for you.

Self-quarantining for the COVID-19 virus is currently most often for the two-week period recommended by the CDC and validated by a very recent analysis of data from the Wuhan, China region.21 This period of time becomes problematic when you have roommates or housemates or you have children or elderly to care for.13

For individuals actually exposed to the COVID-19 virus, about half of those who are going to show symptoms will have done so by about 5 days, and between the eleventh and twelfth days 97.5% of those going to show symptoms will have done so.5

If you are quarantined for long periods you should active seek support from others.20]

  • Avoid other people, period. Have no visitors.
  • If with other people, you should stay 3 to 6 feet away. You should wear a mask (N-95) and so should they. If none are available, cover your mouth and nose with anything you can improvise.
  • Do not go to a health care provider or agency without calling first.
  • The CDC recommends also avoiding pets. While they are not likely to catch COVID-19, they might carry the virus to others.
  • You should have your own room, and ideally your own bathroom. Don’t share towels.
  • Don’t share with anyone (including pets) “dishes, drinking glasses, cups, eating utensils, towels or bedding.”
  • If you must go out, wear a mask. Do not take public transportation.
  • Avoid touching your face, and especially your eyes, nose, or mouth. If you must, use a tissue, or wash your hands for a full 20 seconds first.
  • Wash your hands often, for a full twenty seconds. Use soap and water preferably. If not available, use hand sanitizer - as directed by its label. Always do this immediately after coughing or sneezing into your hand.
  • A cough or sneeze should be done into a disposable paper tissue, after which it is disposed of in a lined trash can. Then immediately wash your hands for a full 20 seconds.
  • Disinfect often all frequently touched surfaces - things we grab or hold with our hands or on which we lay things we hold with our hands, including parts of furniture or appliances, key parts of doors and windows, food preparation surfaces and bathroom counters, bedside tables, toilets, phones, and computing hardware.
  • Disinfect especially anything that has contact with bodily fluids.
  • Do not reuse masks, gloves, or any other item used for viral isolation. Discard these items safely so they will not be encountered by others, including animals.
  • Watch your health closely. Seek medical advice if it starts to deteriorate.
  • Advise all health care providers of your condition relative to the COVID-19 virus.

Disease characteristics ^

Symptoms of COVID-19, & when to see a doctor ^

Based on what has been seem previously with the MERS-CoV viruses, a person exposed to the COVID-19 virus will show symptoms of the illness within 2 to 14 days. The core symptoms are:

  • Fever
  • Cough
  • Shortness of breath22

Contact a doctor if the key symptoms of COVID-19 appear.13 Do NOT just go to a health care office or facility without calling first.

Morbidity (infections - new and existing cases) ^

Current prevalance (number of cases) can be seen on this excellent, frequently updated

Mortality (lethality) ^

(Under development; to appear very soon.)

Disease management and treatment ^

Masks

Reuse of masks

CDC recommendations

**

Current news ^

All times given in 24-hour (military) format and reflect the d.

International ^

“…Research and recent experience shows screening of departing or arriving passengers will likely do very little to slow the spread of the virus as it’s exceedingly rare for screeners to intercept infected travelers.”

A range of experts express pessimism that the virus can be controlled. “The fight now is to mitigate, keep the health care system working, and don’t panic….This has a range of outcomes from the equivalent of a very bad flu season to something that is perhaps a little bit worse than that.”

National (USA) ^

“The coronavirus is out of control of in Northern Italy. As of 6 p.m. local/1 p.m. EST on March 10, there were 15,113 total cases in Italy, with 12,839 active cases, 1,016 deaths and 1,258 recoveries. And there were 162 total cases here in Rome.”

“The hardest-hit region around Milan has had to improvise as its health system has been deeply stressed by the sheer number of patients. In Milan and Brescia, field hospitals have been set up in the fairgrounds as the local hospitals have been drowned in patients.”

“Because the demand for respirators and intensive care has been beyond any previous planning, doctors have been forced into the kind of triage thinking developed for intense battlefield casualty situations. There are reports that emergency room doctors are allotting respirators to those with higher life expectancy due to the limited equipment in the hardest hit areas of the province. If you are older or have other illnesses, you may simply not be eligible for treatment.”

“The package includes free coronavirus testing for all, but its two weeks of paid sick don’t apply to many workers. The Senate is expected to take up the measure early next week….The legislation includes a series of measures intended to bolster the safety net for families and workers whose livelihoods and health are affected by the virus.

“The measure gives some workers two weeks of paid sick leave and up to three months of paid family and medical leave, equal to no less than two-thirds of their pay.”

“…Those benefits only apply to employees of businesses with fewer than 500 employees, or the government, who are infected by the virus, quarantined, have a sick family member or are affected by school closings. Large employers are excluded, and the Labor Department will have the option of exempting workers at any company with fewer than 50 employees, if it determines that providing paid leave ‘would jeopardize the viability of the business as a going concern’.”

“The bill also limits benefits to workers who are sick, subject to a quarantine or caring for a family member; it stops short of what some public health experts have called for — effectively paying any worker to stay home, in order to reduce the spread of the virus….Those exemptions could potentially exclude nearly 20 million workers.”

“The bill includes about $1 billion for food security programs aimed at helping those who may struggle to get access to meals during the pandemic.”

Many factors may explain Washington’s high numbers, but then high levels “…can also be attributed to the simple fact that the state diagnosed its first case before the rest of America and was forced to jumpstart its testing and surveillance response.”

Numbers of tests done in Washington is about to increase dramatically. The University of Washington’s virology lab has led the way in attempts to increase testing, The lab “…can currently handle about 1,000 samples a day, and by next week may be able to process as many as 4,000 samples.” Their goal is to be able “…to test 10,000 samples a day.”

“…The bill guarantees sick leave only to about 20 percent of workers. Big employers like McDonald’s and Amazon are not required to provide any paid sick leave, while companies with fewer than 50 employees can seek hardship exemptions from the Trump administration.”

“Sick workers should stay home, but there is no guarantee in the emergency legislation that most of them will get paid.” This failing was the price of the bipartisan support necessary to pass the bill.

Local (Pacific Northwest, Washington, Spokane region) ^

  • 2020.03.16, Monday
    • (no timestamp) COVID-19 in Spokane County - As of March 14, the Washington State Department of Health (DOH) has confirmed three cases of coronavirus disease 2019 (COVID-19) in Spokane County residents

Major public health emergencies in recent history ^

  • 2019 - Ebola virus. “A second emergency was declared …in DR Congo.”23
  • 2016 - Zika virus. “…Declared…a public health emergency…after the disease spread rapidly through the Americas.”23
  • 2014 - Ebola virus. “The first emergency…lasted from August 2014 to March 2016 as almost 30,000 people were infected and more than 11,000 died in West Africa.”23
  • 2014 - Polio. Close to eradication in 2012, “…polio numbers rose in 2013.”23
  • 2009 - Swine flu (H1N1 virus). This virus spread from Central America “…across the world…, with death toll estimates ranging from 123,000 to 575,400.”23

Disinfecting - how and when to do it and what to focus on ^

HOW

(Under development; to appear very soon.)

WHEN

(Under development; to appear very soon.)

FOCUS ON

(Under development; to appear very soon.)

Essential terms and definitions ^

CDC (Centers for Disease Control and Prevention) ^

(Under development; to appear very soon.)

Incidence ^

An incidence statistic gives the rate or number of new occurrences of a phenomenon of interest in some time period, and excludes the number already present. (Often confused with prevalence).

Example: If someone says ”Women are no more or less likely than men to experience any mental disorder over their lifetime“, the statement refers to events, not persistence over time. If it takes men twice as long to recover, then for any period of time less than a lifetime, prevalence in men will be greater than in women, even while incidence is the same. For an entire lifetime, prevalence always equals incidence.

”The rate of new cases; e.g., the number of infants born with a condition divided by the number of live births in a given population in a given period of time“.24

Compare Prevalence.

Prevalence ^

“The number [of individuals] with a specific condition in a given population at a particular time”.24

Often confused with incidence, prevalence presumes incidence - a condition must occur (thus becoming an incident) before it can prevail.

Given a period of time, a prevalence statistic counts both new occurrences and those already existing at the beginning of the period. This gets tricky: Lifetime prevalence statistics will always equal lifetime incidence statistics for a given population. This will NOT necessarily be true for prevalence rates given for some period of time within a lifetime.

Example: The 12-month prevalence rate for diagnosable mental illness (DSM-IV criteria) in the USA was 18.9, in 2017.25 That means that during any 12 month period on average about one person in five will have a formally diagnosable mental illness.

Compare Incidence.

Resources websites you can trust ^

International resources - suitable for everyone | National (USA) | Local (Pacific Northwest, Washington, Spokane region)

NOTE that most, if not all, nations and subdivisions of nations (states, provinces, regional departments, etc.) have Health Departments which are working to address this current pandemic. Most of them have some kind of web presence which may be accessed to get current regional iformation and advisories. What is listed here is what I think is likely to be most useful to the majority of people accessing this page. At the least, it offers examples of the kinds of information that may be found by those who look for it.

International resources - suitable for everyone ^

World Health Organization (United Nations)

National (USA) ^

Coronavirus (COVID-19) - Centers for Disease Control and Prevention

The front page for the CDC COVID-19 information pages.

Coronavirus Disease 2019 (COVID-19) in the U.S - Centers for Disease Control and Prevention

“This page will be updated regularly at noon Mondays through Fridays. Numbers close out at 4 p.m. the day before reporting.” Offers summary counts of cases, maps show infection level by state, and “COVID-19 cases in the United States by date of illness onset”, among other things.

Watch How the Coronavirus Spread Across the United States

An animated map and graph showing the exponential growth of reported cases in the USA.

Local (Pacific Northwest, Washington, Spokane region) ^

The focus here is Washington state. Similar resources surely exist in Oregon and California.

Washington State Department of Health - 2019 Novel Coronavirus Outbreak (COVID-19)

“The Washington State Department of Health has established a call center to address questions from the public. If you have questions about what is happening in Washington, or how the virus is spread, please call 1-800-525-0127. Phone lines are currently staffed from 6 a.m. to 10 p.m, seven days a week. Please note that this call center can not access COVID-19 testing results.”

Washington State Employment Security information for workers and businesses affected by COVID-19 (coronavirus)

“Employment Security has programs designed to help individuals and employers during this unprecedented time. If you are affected by COVID-19, Employment Security has programs that may be able to help. We adopted a series of emergency rules to relieve the burden of temporary layoffs, isolation and quarantine for workers and businesses.”

Spokane Regional Health District - Coronavirus Disease 2019 (COVID-19) Information

Excellent coverage of health care topics relevant to COVID-19 in the Spokane region, including cases reported, medical providers, and insurance providers.

Translate this page ^

Follow this steps to translate this (or any) webpage into any of a large number of languages:

  1. Select the page URL (web page address) above, and copy it into your operating system scratch pad. (Ctrl+C in a PC)

  2. Browse to http://translate.google.com to access Google.com’s free translation service.

  3. You will see two boxes, side by side, each with the names of a very few languages at the top. The left box should have “English selected”; if not, select it. Then paste the URL of this page into the box below. It will appear almost instantly in the right box.

  4. At the top of the right hand box, select the language you want the page translated into. If necessary, click on the dropdown arrow to get a large list of languages you may choose.

  5. Click the webpage address that appears in the right box. Your browser will go to a translated version of the original page. You can browse the entire site, translated, as long as you stay in the Google Translate interface.

References ^

Akpan, N. (2020-03-10). These underlying conditions make coronavirus more severe, and they’re surprisingly common. National Geographic. https://www.nationalgeographic.com/science/2020/03/these-underlying-conditions-make-coronavirus-more-severe-and-they-are-surprisingly-common/.

A detailed, well-sourced long-form article about vulnerability to viral infection and COVID-19 infection in particular secondary to a surprisingly diverse group of chronic illness, most of which are common in older people while also found in other age groups.

Bowser, A. D. (2020.03.09). Some infected patients could show COVID-19 symptoms after quarantine. MD Dredge, Internal Medicine. Retrieved from https://www.mdedge.com/internalmedicine/article/218655/infectious-diseases/some-infected-patients-could-show-covid-19.

Cole, E. (2020.03.15: 11:53 AM EDT). Why Dr. Anthony Fauci says he’s not getting tested for coronavirus. CNN. Retrieved 2020.03.15 from https://www.cnn.com/2020/03/15/politics/anthony-fauci-coronavirus-test/index.html

Coronavirus declared global health emergency by WHO. (2020.01.31). BBC News. Retrieved 2020.03.11 from https://www.bbc.com/news/world-51318246.

Coronavirus disease (COVID-19) advice for the public. (n.d.) World Health Organization. Retrieved 2020.03.12 from https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public

Coronavirus test is covered by Medicare Part B (Medical Insurance) if ordered by medical professional. (n.d). Medicare.gov. Retrieved 2020.03.12 from https://www.medicare.gov/coverage/coronavirus-test.

COVID-19 in Spokane County. (2020.03.16). Spokane Regional Health District. Retrieved 2020.03.16 from https://srhd.org/covid19

Gamio, L. (2020.03.15). The Workers Who Face the Greatest Coronavirus Risk. NY Times. Retrieved 2020.03.15 from https://www.nytimes.com/interactive/2020/03/15/business/economy/coronavirus-worker-risk.html

Kaplan, H. I., Sadock, B. J., & Grebb, J. A. (1994). Kaplan and Sadock’s synopsis of psychiatry: Behavioral sciences, clinical psychiatry (7th ed). Baltimore: Williams & Wilkins.

Kopecki, D., et al. (2020.03.11, 1227 EDT). World Health Organization declares the coronavirus outbreak a global pandemic. CNBC. Retrieved from https://www.cnbc.com/2020/03/11/who-declares-the-coronavirus-outbreak-a-global-pandemic.html.

Mental Illness. (2019, February) National Institute of Mental Health (NIMH). Retrieved 2020.03.12 from https://www.nimh.nih.gov/health/statistics/mental-illness.shtml.

Mettier, K., et al. (2020.03.14, 1:27 PM PDT). Spain announces nationwide lockdown; U.S. will suspend all travel from U.K. and Ireland. Washington Post. Retrieved 2020.03.14 from https://www.washingtonpost.com/world/2020/03/14/coronavirus-latest-news/.

Naming the coronavirus disease (COVID-19) and the virus that causes it. (n.d.). World Health Organization. Retrieved 2020.03.13 from https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/naming-the-coronavirus-disease-(covid-2019)-and-the-virus-that-causes-it.

New York Times. (2020.03.21: 2104 - updated frequently). Coronavirus Map: Tracking the Global Outbreak. Retrieved 202.03.21 from https://www.nytimes.com/interactive/2020/world/coronavirus-maps.html.

Rabin, R. C. (2020.03.12). *How to Quarantine Yourself. New York Times. Retrieved 2020.03.14 from https://www.nytimes.com/2020/03/06/health/self-quarantine-coronavirus.html

Show Me the Science - How to Wash Your Hands. (2020.03.04). Centers for Disease Control and Prevention. Retrieved from https://www.cdc.gov/handwashing/show-me-the-science-handwashing.html

“…Guidance for effective handwashing and use of hand sanitizer [which] was developed based on data from a number of studies.”

Show Me the Science – When & How to Use Hand Sanitizer in Community Settings. (2020.03.20). Centers for Disease Control and Prevention. Retrieved from https://www.cdc.gov/handwashing/show-me-the-science-hand-sanitizer.html

“…Guidance for effective handwashing and use of hand sanitizer in community settings [which] was developed based on data from a number of studies.”

Situation summary. (2020.03.15). Centers for Disease Control and Prevention. Retrieved from https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/summary.html

Spokane Regional Health District - Coronavirus Disease 2019 (COVID-19). (2020.03.16, 1200 PDT). Spokane Regional Health District. Retrieved from (https://srhd.org/news/2020/learn-more-about-coronavirus-disease-2019-covid-19)

Suthivarakom, G. (2020.03.12). Coronavirus Has Caused a Hand Sanitizer Shortage. What Should You Do? Retrieved 2020.03.12 from https://www.nytimes.com/2020/03/11/smarter-living/wirecutter/coronavirus-hand-sanitizer.html.

Symptoms. (2020.03.14). CDC (Centers for Disease Control and Prevention). Retrieved 2020.03.15 from https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html

Vazquez, M. (2020.03.14: 9:24 AM EDT). How Dr. Anthony Fauci became Trump’s coronavirus truth teller. CNN. Retrieved 202.03.14 from https://www.cnn.com/2020/03/14/politics/anthony-fauci-trump-coronavirus/index.html

WHO Director-General’s remarks at the media briefing on 2019-nCoV on 11 February 2020. (2020.02.11). World Health Organization. Retrieved 2020.03.14 from https://www.who.int/dg/speeches/detail/who-director-general-s-remarks-at-the-media-briefing-on-2019-ncov-on-11-february-2020

Wollan, M. (2020.02.25). How to Quarantine at Home. NY Times. Retrieved 2020.03.15 from https://www.nytimes.com/2020/02/25/magazine/home-quarantine.html

Notes ^

For full information on sources cited here, see References, above.

  1. Mettier, K., et al. (2020.03.14, 1:27 PM PDT). ^

  2. As a male in his early 70s, with a history of asthma, I am in a high risk group for this disease. See pre-existing medical conditions mortality, above. ^

  3. This means you can verify claims made here, as well as pursue additional information by reading the sources I’ve consulted. ^

  4. Kopecki, D., et al. (2020.03.11, 1227 EDT). ^

  5. Spokane Regional Health District - Coronavirus Disease 2019 (COVID-19). (2020.03.16, 1200 PDT). ^ ^2

  6. Situation summary. (2020.03.15). ^ ^2

  7. Naming the coronavirus disease (COVID-19) and the virus that causes it. (n.d.). ^

  8. WHO Director-General’s remarks at the media briefing on 2019-nCoV on 11 February 2020. (2020.02.11). ^

  9. Coronavirus disease (COVID-19) advice for the public. (n.d.). ^ ^2 ^3 ^4 ^5 ^6 ^7 ^8 ^9 ^10 ^11 ^12

  10. Coronavirus test is covered by Medicare Part B (Medical Insurance) if ordered by medical professional. (n.d). ^

  11. Suthivarakom, G. (2020.03.12). ^ ^2

  12. Show Me the Science – When & How to Use Hand Sanitizer in Community Settings. (2020.03.20). ^ ^2 ^3 ^4 ^5

  13. Rabin, R. C. (2020.03.12). ^ ^2 ^3 ^4 ^5 ^6 ^7 ^8 ^9

  14. Show Me the Science - How to Wash Your Hands. (2020.03.04). ^

  15. A personal suggestion: While you can just count slowly to 20, or sing “Happy Birthday” silently, to pass the 20 seconds, I find it easier to count from 1 to 3 as I wash each of these - my palms together, back of my left hand, back of my right hand, between the fingers of both hands, back of left hand fingers, back of right hand fingers, then hands all over to finish. That equals 21 seconds, and they fly by. But the best idea of all is whatever works for you! ^

  16. Gamio, L. (2020.03.15). ^

  17. Akpan, N. (2020-03-10). ^ ^2 ^3 ^4 ^5

  18. Cole, E. (2020.03.15: 11:53 AM EDT). ^

  19. Vazquez, M. (2020.03.14: 9:24 AM EDT). ^

  20. Wollan, M. (2020.02.25) ^ ^2 ^3

  21. Bowser, A. D. (2020.03.09). ^

  22. Symptoms. (2020.03.14). ^

  23. “Public Health Emergency” declared by WHO. See Coronavirus declared global health emergency by WHO. (2020.01.31) ^ ^2 ^3 ^4 ^5

  24. Kaplan, et al., 1994, p. 149. ^ ^2

  25. Mental Illness. (2019, February) National Institute of Mental Health (NIMH). ^