I have included update recommendations from the CDC issued today. We all need to fully comprehend that as each day passes we learn more and more about this virus. I am witnessing lots of people totally misunderstanding this virus and as a result, it is close to spreading out of control. I can assure you the following is accurate:
1. COVID-19 is HIGHLY contagious and is being spread exponentially primarily by large crowds of people partying not social distancing and not wearing masks. Physicians are just as bad as the general population. This week close to 1/2 of the Anesthesia physicians in a hospital tested positive after an evening party in one of their homes. Talk about not leading by example. You continue to hear about the "R" value which is an indication of the AVERAGE number of people ONE person can infect. My estimation is that it eventually will be calculated at over 10. Seasonal flu is 1 or less. So COVID-19 to me is at least 10X more contagious than seasonal flu. The virus is contagious the first 14 days you have it, after 14 days for the most part people no longer spread it. That is normal and consistent with most viruses that are spread with the initial exposure and COVID-19 is no different from most viruses in that you are spreading them before you know you have them. Once you are sick, you generally no longer are infectious but even that is not 100% dependent on the virus. Ebola for example spreads from dead bodies days after death.
2. The death rate for seasonal flu hovers around at about 0.2% of the population. As of yesterday the death rate for the USA as a whole was 7% and for Florida was 1.4%. So COVID-19's death rate even with the best-case scenario in Florida is 7X the seasonal flu.
3. MASKS AND SOCIAL DISTANCING WORK PERIOD. There should be no discussion regarding this. I previously reported studies that said if only 60% of the population wore a mask in public and followed social distancing the virus would go away in weeks. In my opinion, if 100% of the public wore masks and conformed to social distancing the virus would be gone in two weeks. Italy for one has clearly proven it works. Yesterday there were only 5 deaths in Italy. Medical N95 masks are the best but truthfully any mask helps and is better than nothing. Masks, including N95, are now available online at reasonable costs. Seems like everyone is making them now.
Updated CDC recommendations based on new data are here:
Patients with confirmed SARS-CoV-2 infection DO NOT need to have two negative tests at least 24 hours apart to return to work, school, or receive medical care. CDC has reported that COVID-19 cases can continue to test positive for up to 12 weeks after their initial positive test, but that they are only potentially infectious to others for about 10 days.
As such, for most individuals with COVID-19 illness, isolation can be discontinued 10 days after symptom onset and resolution of fever for at least 24 hours, without the use of fever-reducing medications, and with the improvement of symptoms (changed from "improvement in respiratory symptoms" to address expanding list of symptoms associated with COVID-19).
The decision to discontinue isolation for patients with confirmed SARS-CoV-2 infection should be made using a symptom-based strategy, not additional testing:
· Individuals who had a mild or moderate illness and are not severely immunocompromised can return to work after:
o At least 10 days have passed since symptoms first appeared and
o At least 24 hours have passed since last fever without the use of fever-reducing medications and
o Symptoms (e.g., cough, shortness of breath) have improved
· Individuals who had severe to critical illness or who are severely immunocompromised can return to work after:
o At least 20 days have passed since symptoms first appeared
o At least 24 hours have passed since last fever without the use of fever-reducing medications and
o Symptoms (e.g., cough, shortness of breath) have improved
Asymptomatic persons with confirmed COVID-19:
· Who are not severely immunocompromised can return to work after
o At least 10 days have passed since the positive laboratory test and the person remains asymptomatic
· Who are severely immunocompromised can return to work after
o At least 20 days have passed since the positive laboratory test and the person remains asymptomatic
o Asymptomatic persons who test positive and later develop symptoms should follow the guidance for symptomatic persons above.
Definitions of mild to moderate and severe illness, and of severe immunocompromise, as well as more information about the science behind the symptom-based return to work can be found at: https://www.cdc.gov/coronavirus/2019-ncov/community/strategy-discontinue-isolation.html
Please note, the recommendation of 10 days is specifically for those who test positive for the coronavirus and have self-isolated. It does not apply to people who need to quarantine to keep from potentially spreading the virus. The incubation period for the virus is 14 days, so anyone who has been exposed to the virus still needs to quarantine and monitor for symptoms.
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