Since the medical community became aware of the novel coronavirus known as COVID-19 at the end of December 2019, information about the nature of the virus and how to respond has evolved rapidly. Each week new data on transmission, symptoms, and more is gathered, but quickly changes as the pandemic continues.
For this reason, Dr. Jason Prystowsky, an emergency physician at Cottage Hospital, encouraged the public to pay attention to reliable sources.
“We’ll continue to get more and more information, and we have to be informed,” said Dr. Prystowsky. “The more informed our community is the healthier and safer we are.”
On Tuesday, Dr. Prystowsky hosted a webinar where he went over the latest studies and data sets coming out of medical institutions and hotbeds like Italy and New York.
“Ordinarily we wait for studies and research to be reviewed by our colleagues, and now everything is getting sent out on social media and electronically released prior to peer-review because we’re trying to get this data so fast,” said Dr. Prystowsky. “I’m going to do my best to try and filter through the data about the important parts of it.”
Over the last three months, doctors have begun estimating characteristics of COVID-19 like R 0, the virus’s basic reproduction number which tells doctors how contagious it is.
“For every one person who has the virus, how many people are they spreading it to?” said Dr. Prystowsky. “We think it’s somewhere between two or three.”
Initial descriptive data from places like China, Italy and New York have already begun to give doctors a picture of who is most at risk.
A study of 1,100 hospitalized patients in China that was published in the New England Journal of Medicine found that the average age of people hospitalized was 47.
“If you’re one of the types that’s going, ‘Oh, they’re saying if you’re not over the age of 65, you’re fine. It’s just the seasonal flu!’ that’s false. That’s wrong. I’m sorry if you heard that from any media sources,” said Dr. Prystowsky.
For those that ended up in an Intensive Care Unit on a ventilator or dead, the study found that these patients were over the age of 65, had chronic heart or lung disease, diabetes or were smokers.
In Italy, a study from Journal of the American Medical Association found that no patients under the age of 30 had died, while the New York State Department of Public Health said Tuesday morning that 9% of those hospitalized were aged 18 to 44.
A major takeaway from the data gathered thus far has been the issue of those that are infected but remain asymptomatic.
While data out of China shows that 14% of patients observed suffered severe symptoms and 5% end up in critical condition, information collected by the Japanese Institute for Infectious Disease from the now notorious Diamond Princess Cruise ship and released in a field report at the end of February shows the risk of spread by those who are asymptomatic.
“In 619 cases, 17% of those on the ship tested positive,” said Dr. Prystowsky.
“Half of everyone on the Diamond Princess were asymptomatic. Half. So there’s a lot of people and that’s why I’m telling the public: assume that you have it. Conduct yourself and behave in a way as though you have it and you’re keeping everyone in your community safe.”
Looking at countries like China, South Korea and Japan which have seemingly managed to “flatten the curve” and reduce the number of new infections compared to places like Italy and the U.S. that are still experiencing exponential growth, Dr. Prystowsky noted social differences as a factor.
“What do they all have in common? They have a very robust healthcare system, public health system, and civil defense. They have strong social safety nets, meaning when they tell people to stay home they have ways so the people at home can be fed and can continue to live their lives,” said Dr. Prystowsky. “In a lot of these countries there is a collective responsibility to put the village first.”
The United States does many things well, but we are an individualistic society, said Dr. Prystowsky.
“We’re going to have to change and we’re going to have to get over that, because communities that beat this thing are ones that do it together,” said Dr. Prystowsky.
Wearing masks in public may help and everyone should wash their hands frequently, but Dr. Prystowsky stressed the serious need for the public to practice social distancing and stay home, not only for their own safety, but for the safety of the healthcare professionals walking into harm’s way every day.
“We know the risks. We love what we do and we are committed to the health of our community. What we’re asking you to do as our community is to stay home,” said Dr. Prystowsky.
“Don’t be irresponsible with us.”
Dr. Prystowsky said he’s seen a lot of complaining and memes about how inconvenient the stay-at-home orders have been.
“We’re not asking you to compromise,” he said. “Behaving in a way that’s socially responsible is not a compromise, it’s an act of solidarity. It’s the ultimate act of civil unity.”
While Dr. Prystowsky warned the worst is yet to come and will probably last through August, he said the pandemic is drawing back the curtain of our character and that now is the time to show your kids, your neighbors and your community what you’re made of.
“Are you the kind of person that’s hoarding toilet paper and hand sanitizer and a bunch of guns and ammo? Or are you the kind of person that’s checking in on your neighbors saying, ‘Hey, I wanted to share my groceries with you’,” said Dr. Prystowsky.
“We’re entering a time when we need more heroes. We don’t need more selfish people.”