COVID-19 is a nasty disease. All the nastier if you are over 60. While treatment options and techniques have improved since the beginning of the outbreak, avoiding the disease altogether is the optimal strategy. But how?
The graph above is both encouraging, very flat number of deaths, and alarming, significant rise in number of cases. It reflects increased testing. Number of hospitalizations and admissions to ICU remain pretty flat. However, the increased case count certainly made me reassess my situation and my family’s.
Everyone’s situation is different and, with the best will in the world, public health people have to deal with people in aggregate giving general guidelines. I have been saying since the beginning that each of us needs to deal with our own situations and take what measures we can. Here are a few ideas which may work for you. So far they have worked for me and my family.
Get your Vitamin D level up: Right from the beginning I have made a point of getting out in the sun (with no sunscreen) for at least 20 minutes a day. And I have been taking 1000 IU a day in supplement (2000 on rainy days). Can’t hurt, might help, was my reasoning. Turns out this was correct. “Vitamin D deficiency increases a person’s risk for catching COVID-19 by 77% compared to those with sufficient levels of the nutrient, a study published Thursday by JAMA Network Open found.” (source) Vitamin D supplements are cheap and, well, having sufficient Vitamin D levels is good for you on all sorts of levels.
Zinc: I recently started supplementing with 50mg of zinc daily. The science is all over the place on Zinc and COVID but there are virtually no downsides. In general, Zinc is an immune system booster and I have taken it for years during cold and flu season. It’s cheap and, after initial shortages in the early spring, readily available.
Vitamin C: Every year about Labour Day I begin to take 1000 IU of Vitamin C and I keep taking it until May or June. Again, this is about supporting my immune system rather than about COVID specifically. Again, cheap, available and beneficial. Why not?
Live where the virus isn’t: More by accident than design, I live in a semi rural location at the south end of Vancouver Island. Vancouver Island in general has had a minimal number of cases of COVID – at the moment there are 7 active cases.
What this means to me and my family is that our risk of contracting the virus is substantially lower than if we lived in a community with higher numbers of cases. That, in turn, means we can be less concerned about day to day interactions with others.
Limit exposure to higher risk situations: This is really about risk assessment and balance. Susan and I are well past the age where going to a rave is a live option; but the fact is that any large gathering presents a significant risk. Such gatherings are effectively banned in BC and will remain so for some time.
But what about the rest of life? Here having some sense of the overall infection rate in your area is important. I would not take the subway in Toronto or New York, I would be fine taking the bus in Sidney.
It is not obvious to me that social distancing – whether 1 meter or 2 – is particularly effective but I am perfectly willing to keep my distance in the grocery store. What I wish public health officials would recommend along with social distancing is social “speed”. I suspect there is a greater chance for viral transmission in the lineup to use the hand sanitizer than there would be if that lineup was eliminated. Simply being a bit organized when you shop reduces the time you are actually in the store.
You can also socially “schedule”. Most of the stores in my community are open until 9:00PM and are pretty empty from 7:00PM onward. Taking advantage of that emptiness costs nothing and cuts risk.
Staying at home: Our family is lucky. I work from home, the kids are home schooled and Susan prefers to be at home. There is no lock down in BC but people have re-ordered their lives to stay at home far more than they did before COVID.
People who used to work in offices are now working from home and that means they are not exposed to everything from public transit to dirty elevator buttons to their co-workers. Again, how useful this is depends on how much virus is in your community; but staying at home more often than not will improve your chances of avoiding COVID.
Masks: As a general rule I do not wear a mask because I live in a low virus area and make a point of limiting my social interactions. I am able to control my life to the point where I am virtually never in a situation where it is impossible to socially distance.
(As a matter of science I am pretty convinced that masks outside a high contact, long duration setting – think Emergency Waiting Room – are unlikely to be very useful. But the science is very ambiguous.)
Hand Sanitizer: I suspect hand sanitizer will become a permanent fixture in stores. We have very nice spray sanitizer in both our cars and it is now simply routine to spritz when we get back to the car. Low cost, might help, why not.
Hand Washing: Public Health Authorities have been all over the place on many COVID issues but they are united on proper hand washing. This is not surprising, proper hand washing is key to any number of public health concerns. Flu and cold season could be reduced in severity with proper hand washing. (It will be interesting to see what happens to flu and cold season this year.) The thing about hand washing is that it is a very simple thing to do and it takes all of 20 seconds after you use the washroom or come in from any activity.
Vaccination: We do not have a vaccine as yet though we are promised that something maybe ready this year. Thanks but no thanks.
I am a huge fan of vaccines for things like polio, mumps, diphtheria and a variety of other diseases. If I were travelling to a place which had a specific endemic disease for which there was a vaccine, I would almost certainly take it. However, I don’t take the flu shot and I would be very reluctant to take the first rounds of the COVID vaccine.
No, I don’t think Bill Gates is trying to microchip me. My reluctance is based entirely on the standard risk reward analysis I use in the rest of my response to COVID. Yes it is a nasty virus. But if you are under 70 and have no pre-existing conditions, it is very unlikely to kill you. And if you take the basic measures outlined above, there is every chance that you will not catch the damned thing at all.
The risk profile of any new vaccine is initially unknown. It has to be tested and, most importantly, its effects have to be observed over a decent length of time and over a substantial population of test subjects before a risk profile can really be developed. Until that is done it is pretty much impossible to assess what risk a vaccine poses. (But don’t take my word for it, here is an excellent thread from a pharmacology PhD.)
Reducing my already slim chances of contracting the virus at an unknown cost is not a chance I am ready to take.
Self Monitoring: All the accounts I have read about COVID suggest that its onset is characterized by all manner of symptoms. From coughing to loss of the sense of taste or smell and on down the line. What has also emerged is that people can have COVID and barely notice it.
Without being obsessive about it, I take a minute when I wake up to simply see if there are any notable changes in how I feel. Not very scientific. I don’t take my pulse or blood pressure or temperature; I just sit on the side of our bed, breathe normally and take a mental inventory. Does it do any good? I have no idea. But taking a moment to be aware of how you actually feel seems sensible to me.
Hydroxychloroquine: What a mess. If you are unlucky enough to contract COVID and are hospitalized, don’t think for a second that HCQ is going to help much, if at all. That science is pretty well established.
Unfortunately, HCQ has become a political football rather than a discussion between doctor and patient. Given its long history as a safe drug in the treatment of other diseases, I think HCQ should be an option. Get the politics out of it.
That said, whether or not you need to take a drug prophylactically is, once again, a matter of risk assessment. Were I a front line health care worker dealing with COVID cases day in and day out, I would want HCQ as a condition of showing up for work. I’m not. And, as mentioned above, I live in a low virus intensity area, can control my social interactions and keep my immune system in decent shape.
Now, if one of those conditions changed. If Vancouver Island suddenly had huge case numbers as the much discussed “Second Wave” hit or an unrelated illness compromised my immune system, then I would want HCQ to be an option.
Like many things on this blog, this was written to order my own thoughts on COVID. To first time readers, nope, not a doctor or epidemiologist or virologist. Like the rest of the laity, I am trying to figure out what best to do for my family and myself in our particular situation.
We’ll see what happens.
Jay Currie 
A US doctor, said take one zinc tablet, and 3 to 4 oz of Schweppes tonic water a day. It has quinine in it. I continue to do that. I am 71. Have no idea if it works, but so far so good
I find the tonic water is ever so much more effective with about two ounces of Tanq 10 gin, a bit of lemon (Vit C) and ice (hydration).
Here’s the thing. How many of the positive cases are admitted to the hospital? We have around 1650 active cases and all of 31 people in the hospital. This has become a case pandemic without sick people it seems. Well, not sick enough to be admitted to the hospital. Watch the numbers this week if you don’t believe me.
Recall early in this pandemic, the public health officials were concerned about overwhelming the health care system. They closed up everything, cleared all “non-essential” health care, and in BC opened up over 3000 beds. They filled around 160 of those during the peak. And now, the peak is higher and the hospital count and death count is lower!
Here is a really good video from a guy in Ireland that I have been following. Sums up the facts quite well.
Very good video.
I take your point as to a case pandemic without serious illness. That said, my own strategy is to take reasonable measures not to get the damn thing.
Cost benefit, risk assessment, ounce of prevention and all that. I fear that I cannot follow Dr. Tam to glory holes and masked sex; but I am more than willing to stand six feet away from the masked Karen with the hand sanitizer pendant (really, not making it up) as I buy my deli meat.
Having my morning coffee in the sun is no great hardship and boosts the D.
If the numbers of hospitalizations and deaths stay down the case count won’t matter. Except politically and that is a topic for another day.
I was taking a multi vitamin daily before this started, Kirkland Silver old man version 🙂 I added 2000 IU of vit D3 and 1000 mg of Vit C in March. I believe that the Flu is real, I just don’t see the point in freaking out the way the media and public health did. I am still amazed at the lack of risk awareness of the people running the world. They must be doing this on purpose because they just can’t be that stupid, can they?
As for masks, only wear one when they make me. We flew to Winnipeg for a wedding, so we bought the light weight paper ones at Costco. They don’t do a damn thing, but everyone feels better, and there is no reason to fight it.
I will throw my 2 cents worth into the mix (while 2 cents is still worth something). My postgraduate education is in the area of fluid dynamics so when it became clear that this was a fluid borne transmission (i.e. air) then I became much more interested.
As with everything there is a trade off. Not all infectious droplets from an infected person are the same size. The larger droplets have more virus which increases the chances of catching the disease but they also drop out of the air quicker. The whole idea of social distancing is to allow a space for these drops to fall. With that established it is only a question of your risk tolerance as to whether you stand 1 meter away or 10 meters away. I heard (but can find no scientific reference for it) that the 2 meters is the 90% threshold.
The issue of masks has been confusing because at first WHO and the CDC said it would not protect you so don’t bother wearing one. That statement is true, but it is not the whole picture. While they don’t protect the wearer, they do reduce the speed of particles coming from the mouth when coughing or talking. By reducing the speed of these particles they tend to travel less and drop out of the air faster. So you don’t wear a mask to help yourself, but to protect everyone else around you. In my opinion social distancing and mask wearing are even more important than hand sanitation.
Finally, I will actually stick up for the federal government and say that they – for the most part – handled this well. Looking back I can see a hundred things they could have done better (and looking back on my life – I am over 60 myself – I can see a thousand things that I could have done better). But this was unprecedented and there was no guide to go by. The pandemic had a significant impact on my work when it hit and we basically had to make up everything as we went along, balancing our needs with client needs with schedules was challenging to say the least.
Thanks John.
Mask wearing in areas where there is a relatively high likelihood that you may, asymptomatically, be carrying the virus makes some sense. If you are lucky enough to be in a low case area and have not left that area the case for mask wearing weakens. (One of the reasons why good and fairly localized COVID information is important.)
As to the federal government, as you know, the public health decisions in Canada are made at the provincial level. About the only thing the feds could do directly was to close the national borders which they still have not really done. The closure of the US border took forever. Where I do think the feds did well was getting $ out the door very, very quickly. And not just CERB, the loans to small businesses were well done.
Provinces have responded with varying degrees of competence. The West and the Maritimes seem to have done well, Quebec and Ontario, less so.
You are right, there was no guide. Making it up as they went along Canadian public health officials seem to have got it mostly right. The only big, and I think foreseeable, blunder was in not realizing how at risk our senior seniors were and taking action proactively to protect them. We knew that senior seniors were vulnerable to bad flu seasons and, at a minimum, that should have alerted us to the risk.
We are some distance from the finish line of this whole mess – I am not optimistic about when or even if an effective vaccine will appear. Where we may actually beat it is more likely to be the way we have learned to manage AIDS with a set of prevention and treatment protocols. But we may also simply get lucky and the virus will burn itself out.