3 + 2 + 1

Three tips to know if sick plus Two studies plus One did you know?

There are many well known symptoms associated with COVID 19. If you have ANY questions about your current symptoms, seek advice from your physician.  However there are three things you should know to help guide your decision for seeking care:

  • Symptoms may be mild initially, however, studies revealed worsening over the course of a week and a median number of 5 days occurred before shortness of breath developed and 7 days before hospital admission with diagnosis of pneumonia. Severe complications such as respiratory failure occurred a median of 8 days after symptom onset.
  • Warning symptoms to seek medical care include shortness of breath, confusion, and inability to eat or drink.
  • The tempo of symptoms should be watched closely as they may reflect development of pneumonia. For example, mild symptoms in the morning and worsening symptoms by mid-day.

Initial data from China and elsewhere described a virus that spared the young and could take the elderly or those with chronic illness. The world relied on this and began to protect those with chronic illness and worked to understand how old is in fact, old? With epidemiology studies much slower than the virus spread we had some comfort that in protecting these two groups we would have the greatest impact on mitigating the impact the mortality from the virus, and we have. In fact, mitigation in countries after witnessing the destructive path through countries such as Italy and Spain resulted in saving hundreds of thousands and perhaps millions of lives. However, epidemiology which is history  vs. models which are projections is still limited but is the most valuable information for us to know as a society and as individuals to understand our risks and how to mitigate them. 

The problem has been that in a rapidly progressive pandemic, history is reported slowly, possibly inaccurately, or incompletely. I have spent several hours now trying to find recent epidemiology for the United States and elsewhere. While newly diagnosed case rates and mortality data (without specifics) is very readily available, the specifics are not. This data would help identify those beyond the “very old” and “chronically ill” who may be at greater risk and those who are less so. I’m finding old, may not be so very old and perhaps young are not always spared of severe disease. The following is a chart with information for the United States:

Hospitalization status missing or unknown for 1,514 cases.

ICU status missing or unknown for 2,253 cases.

Illness outcome or death missing or unknown for 2,001 cases.

What is most worrisome to me in this chart is not the data, it is the lack of data. This chart reflects an estimateof what is happening and only reflects cases from February 12ththrough March 16th. In an era where hospitals have electronic medical records that can generate reports with a few clicks, we have to expect real time reporting in addition to statistical analysis. If data were available, then crowd sourcing statistics would provide for more rapid results. 

Also, this week and underscoring the importance of reporting epidemiology is a studycoming from China on pediatric cases (remember initial reports were no mortalities in younger age groups). There were 2143 cases reviewed in the study with known or suspected COVID 19. From this cohort there were 112 children with severe disease and two reported deaths. The majority of cases that were considered severe or critical were under the age of five with infants having the greatest risk. Most notable, however, only 731 of the 2143 were confirmed cases and authors note children could have had other respiratory based illnesses.

As a grandmother to children in this age range and unclear data that was initially reported, I take issue with these delays in reporting for all of our children and grandchildren, no matter where they live. We must also consider that suspected cases should be confirmed before reporting on them so that appropriate and accurate measures are taken. The bottom line is that every mitigating step that we take today will only bring us one step closer to effective therapies. While we may look to history for how we manage the future, we have today to know how we can make a difference.

Did you know that love results in chemical changes within your brain and body? That first obsessive, highly emotional kinds of love drop your serotonin levels and then over the first year they normalize followed by an increase in oxytocin. Oxytocin results in improved emotional bonds, raises immune function, and results in health benefits seen which includes fewer strokes, heart attacks and higher rates of survival from major surgery and cancer.

This photo depicts a moment of love, do you have a photo of your love to share?