On this special episode of The Nurse Keith Show (one of many to come), I discuss the social and economic ramifications of COVID-19; our responsibility as healthcare providers; how the coronavirus hijacks your cells; my thoughts on the response so far; and how young people can play an active part in keeping everyone safer and healthier by not feeling invincible and unnecessarily putting vulnerable populations at risk.
I will be regularly publishing episodes related solely to the COVID-19 pandemic. There will be no corporate sponsors of these episodes and no advertising of my coaching business. This is solely about education and information as a public service. Please share far and wide if you feel these episodes are a valuable approach to the virus.
Topics covered today:
Social and Economic
- Concerns for frontline healthcare providers
- Concerns for the poor, the working poor, the homeless
- Children missing their school meals which may be their only meal of the day/
- Parents who can’t afford childcare and cannot afford to not work
- People being laid off who have no access to credit cards and live paycheck-to-paycheck
- Hoarding of food and household supplies
Physiology and Medical
New York Times article regarding how the coronavirus hijacks your cells
The coronavirus is named after the crownlike spikes that protrude from its surface. The virus is enveloped in a bubble of oily lipid molecules, which falls apart on contact with soap.
The virus enters the body through the nose, mouth or eyes, then attaches to cells in the airway that produce a protein called ACE2. The virus is believed to have originated in bats, where it may have attached to a similar protein.
The virus infects the cell by fusing its oily membrane with the membrane of the cell. Once inside, the coronavirus releases a snippet of genetic material called RNA.
The virus’s genome is less than 30,000 genetic “letters” long. (Ours is over 3 billion.) The infected cell reads the RNA and begins making proteins that will keep the immune system at bay and help assemble new copies of the virus.
Antibiotics kill bacteria and do not work against viruses. But researchers are testing antiviral drugs that might disrupt viral proteins and stop the infection.
As the infection progresses, the machinery of the cell begins to churn out new spikes and other proteins that will form more copies of the coronavirus.
New copies of the virus are assembled and carried to the outer edges of the cell.
Each infected cell can release millions of copies of the virus before the cell finally breaks down and dies. The viruses may infect nearby cells, or end up in droplets that escape the lungs.
Most Covid-19 infections cause a fever as the immune system fights to clear the virus. In severe cases, the immune system can overreact and start attacking lung cells. The lungs become obstructed with fluid and dying cells, making it difficult to breathe. A small percentage of infections can lead to acute respiratory distress syndrome, and possibly death.
Coughing and sneezing can expel virus-laden droplets onto nearby people and surfaces, where the virus can remain infectious for several hours to several days. The C.D.C. recommends that people diagnosed with Covid-19 wear masks to reduce the release of viruses. Health care workers and others who care for infected people should wear masks, too.
A future vaccine could help the body produce antibodies that target the SARS-CoV-2 virus and prevent it from infecting human cells. The flu vaccine works in a similar way, but antibodies generated from a flu vaccine do not protect against coronavirus.
Soap destroys the virus when the water-shunning tails of the soap molecules wedge themselves into the lipid membrane and pry it apart.
The best way to avoid getting infected with the coronavirus is to wash your hands with soap, avoid touching your face, keep your distance from sick people and regularly clean frequently used surfaces.
Thoughts on the response
- Too little testing
- Mixed messages
- China built a 1,000-bed coronavirus hospital in 10 days; in Seattle, they’re commandeering motels and RVs (what’s wrong with this picture)
- What about mutations, just like in HIV?
Newsweek opinion piece from MD in Europe: Young people thinking they’re safe and simply want to have fun
We are still awaiting the peak of the epidemic in Europe: probably early April for Italy, mid-April for Germany and Switzerland, somewhere around that time for the UK. In the U.S., the infection has only just begun.
But until we’re past the peak, the only solution is to impose social restrictions.
And if your government is hesitating, these restrictions are up to you. Stay put. Do not travel. Cancel that family reunion, the promotion party and the big night out. This really sucks, but these are special times. Don’t take risks. Do not go to places where you are more than 20 people in the same room. It’s not safe and it’s not worth it.
But why the urgency, if most people survive?
Here’s why: Fatality is the wrong yardstick. Catching the virus can mess up your life in many, many more ways than just straight-up killing you. “We are all young”—okay. “Even if we get the bug, we will survive”—fantastic. How about needing four months of physical therapy before you even feel human again. Or getting scar tissue in your lungs and having your activity level restricted for the rest of your life. Not to mention having every chance of catching another bug in hospital, while you’re being treated or waiting to get checked with an immune system distracted even by the false alarm of an ordinary flu. No travel for leisure or business is worth this risk.
Now, odds are, you might catch coronavirus and might not even get symptoms. Great. Good for you. Very bad for everyone else, from your own grandparents to the random older person who got on the subway train a stop or two after you got off. You’re fine, you’re barely even sneezing or coughing, but you’re walking around and you kill a couple of old ladies without even knowing it. Is that fair? You tell me.
My personal as well as professional view: we all have a duty to stay put, except for very special reasons, like, you go to work because you work in healthcare, or you have to save a life and bring someone to hospital, or go out to shop for food so you can survive. But when we get to this stage of a pandemic, it’s really important not to spread the bug. The only thing that helps is social restriction. Ideally, the government should issue that instruction and provide a financial fallback—compensate business owners, ease the financial load on everyone as much as possible and reduce the incentive of risking your life or the lives of others just to make ends meet. But if your government or company is slow on the uptake, don’t be that person. Take responsibility. For all but essential movement, restrict yourself.
This is epidemiology 101. It really sucks. It is extreme—but luckily, we don’t have pandemics of this violence every year. So sit it out. Stay put. Don’t travel. It is absolutely not worth it.
It’s the civic and moral duty of every person, everywhere, to take part in the global effort to reduce this threat to humanity. To postpone any movement or travel that are not vitally essential, and to spread the disease as little as possible. Have your fun in June, July and August when this—hopefully—is over. Stay safe. Good luck.
Our Responsibilities as Healthcare Providers
- Protect ourselves so that we can be effective and productive healthcare providers, educators, etc
- Educate, educate, educate
DISCLAIMER: All information in these episodes about COVID-19 uses the most up-to-date information we can access, as well as some personal opinions and reactions. Please note that the situation is changing by the moment, and any information shared in any episode may not apply once that data has been updated. Please also note that nothing shared in the course of any Nurse Keith Coaching COVID-19 podcast is intended for diagnosis or treatment; please consult your healthcare provider or your local Department of Health.
If you hear or read something I have shared that appears to be erroneous, if you can, please leave an evidence-based comment or email me directly at firstname.lastname@example.org. Thank you for understanding, stay safe, and keep informed.