Let me be really blunt here. PAY ATTENTION!
I'll put this in terms of Trump's earlier tweet.
"We are in very close communication with China concerning the virus." YES WE ARE - both officially (full of PC lies) and unofficially (in direct contact with researchers and family members of researcher that are in this country.)
"Very few cases REPORTED in the USA, but strongly on watch." Reported by the political CDC. They are SCUM - they will do anything not to create a panic. I know they lie specifically due to the "boots on ground" work my boss has done on ebola and SARS. "Officially" there are few confirmed nCoV cases publicized in the US. There are a whole bunch of people being investigated. There are even MORE secondary contacts. Case in point, in my own town we have an individual who came in on the same flight as the first positive in Washington state. NO ONE has officially contacted him or his family. (We are feeding him facts and recommendations at a distance.)
"We have offered China and President Xi any help that is necessary." We have University links to several research facilities in China and directly with personnel there. The Fake News reports and the clinical reports we've received so far are dramatically different. There is a lot of high-quality information coming in directly to and from researchers. Chinese politics will "save face". Researchers are saving lives and getting the technical information out.
"Our experts are extraordinary!" Absolutely! My boss has a 200+ IQ (tested). He has US patents out the ying-yang. He has spoken directly with the President in the past. His team is just as extraordinary. I am responsible for the medical health of that team (Don't ask how this dumbass Emergency Physician got linked into this group - I just consider it a privilege to know these people that make a profound difference in the world EVERY DAY.)
HERE ARE THE FACTS AS I KNOW THEM:
1. They have traced the virus back to "Patient 0" (I can't find anymore unclassified information about him.) .
2. The original virus contains gene sequences from a "Civit" (cat like), "Krate Snake" and "Horseshoe Bat". There is a great argument about who ate/got infected by whom first. The exotic meat of all three were sold at the Meat Market at WuHan. The possibility of a weaponized/engineered virus has NOT been ruled out.
3. There is a HIGH suspicion this can be transmitted to/from snakes, domestic cats and bats though that is unproven at this time.
4. The virus has evolved TOWARD better human to human transmission and IS continuing to do so.
5. The PUBLIC numbers from China are EXTREMELY LOW. (Direct information to researchers in the US from family of researchers that are in the field themselves. You can dispute all the videos and statements coming out of China, but that fact remains they are reacting much more aggressively in response to this than the seasonal flu that kills thousands times the current "official" nC0V numbers.)
6. The current OFFICIAL rate of sustained infection (R0) is 1.4 to 2.6. Anything over 1 is considered to be self-sustaining. (I suspect that number is much higher due to undocumented infections, whether hidden, self-quarantined, mis-diagnosed or unable to see a documenting health professional. )
7. Current (well documented) incubation is 1-14 days.
8. Infected can shed virus 2-5 days BEFORE showing symptoms of their infection.
9. Surface survival of the virus is approximately 15 minutes (Exposed to sun and chemicals) and up to 7+ days when not exposed to high moisture and UV radiation. (WuHan is a big manufacturing area for the world - Budweiser Beer has been produced there since the mid-90's. Think of all the exports. Think of the contact spread of the virus.)
10. You have to get a certain number of viri to produce an infection. That number is unknown. Avoid areas where people/germs can concentrate (planes, trains, autos, meeting rooms, etc.)
THINGS TO DO:
- Stay home.
- Don't allow visitors.
- Wash your hands, wash your hands, wash your hands - for 20 seconds at least, and with soap (Don't depend on hand sanitizers - some are not effective and people don't always use them properly).
- Wash your hands before putting anything in your mouth.
- Nothing in mucus membranes (Eyes, ears, nose, mouth, vagina, anus). Sorry Ladies and Gentleman, you are going to have to put away your toys for the duration.
- Don't touch your face.
- Avoid crowds, gatherings, clinics and ESPECIALLY hospitals.
- If you have to go out as this develops, mask, gloves, whole body clothing - then launder/shower when home.
- Prep for sheltering-in-place for a minimum of 2 weeks.
- Get it done!
HERE IS WHAT I AM DOING:
Yes, I have to work.
For simple masks we only use N-100s. Anything less is insufficient (will leak during normal activities and are uncomfortable to wear for an extended period of time - read you will touch the outer surface repeatedly to adjust it - BAD) and in the case of surgical masks - those ear loop pieces of cloth/paper, can enhance the spread of the infection when they get wet from regular respirations (20 minutes). BTDT
We use clear wrap around protective lenses generally and goggles for bad stuff. The goggles work well as I can keep my glasses on.
The house has several HEPA air filters, both floor units and high-grade AC filters in the forced air unit (pain in the butt to replace every 3 months).
We wipe everything with Clorox Clean-ups (switches, door handles, railings, anything your hand touches). We wash is as high as temperature as permissible - bodies, clothing, dishes, etc.
We are now experimenting with UV-C hand wands for non-wipe-able items.
RETURNING FROM A DAY AT THE CLINIC:
I come in the basement door and drop my clothing in the laundry or directly into the washer. Doctor bag stays in the basement. (We are experimenting with UV-C lighting for the laundry when we are not there). Shoes/Doctor bag get sprayed with Lysol or UV wanded. From there, I head directly to the shower and redress in clean clothing. The wife wipes everything I've touched down with Clorox Cleanups. Only then do I kiss the wife, play with the dogs, get something to eat, and check my e-mails. After that, its time to drag the wife off to bed for some fun. Since the AIDS epidemic way back when, we agreed to share any lethal bug I might contract in my job - personal choice.
This procedure of stripping and showering got my physician Grandfather through the Spanish Flu without infection as he saw patients in their homes daily. We actually read it in my Grandmother's diary and adopted the practice here.
I will provide more information as it becomes available. Please don't hit me with PMs or open questions. I don't have the time and get really snarky when I get exhausted.
Good luck and Godspeed.
Blizzard, MD, FACEP