COVID-19
The Biology


What is difference between "Coronavirus" and COVID-19?:  
Coronaviruses are a whole family of viruses that can infect many different animals.  The common cold in humans is caused by several other strains of coronavirus.  COVID-19 is a new type of coronavirus that has not ever infected humans before, so none of us have immunity.

How did this virus get into humans?:  The COVID-19 virus jumped from animals (probably bats) to humans in Wuhan, China, probably sometime in November.  It is very likely it happened at a market that was known for selling exotic animals in Wuhan, but we won't likely ever know the exact point for sure.

Has something like this ever happened before?:  Yes, in terms of the whole world population, something like this happens every several years.  In 2002, a new coronavirus started in China and jumped to humans.  It was called SARS and it killed about 800 people worldwide (it killed about 8% of people it infected).  It was stopped by aggressive quarantining in the three main countries it spread to, which were China, Taiwan, and Canada.  In 2012, a coronavirus called MERS jumped to humans in Saudi Arabia.  It was much more deadly and killed about 35% of the people who were infected, but it didn't spread between humans very well, so it thankfully didn't spread very far. COVID-19 kills around 3% of the people it infects (but this can be much higher or lower depending on whether good medical care is available.)

How is the virus spread?: It is spread either by breathing in tiny droplets from the air after a person with the infection coughs, or by the infected person touching something and leaving some virus particles on what they touched, and then someone else touches it and then touches their hand to their eye or mouth.

What medical treatments are available?:  There is one treatment that is far more effective than any other.  It is the treatment that stopped the SARS epidemic of 2002.  It is quarantine.  If the infected person is kept away from other people until they get better, they won't pass the infection on and the infection will die out.  Most people who catch COVID-19 (around 85%) won't need to go to a hospital.  They will have a nasty cough for a couple of weeks and then will get completely better.  But about 15% will become much more ill when the virus inflames their lungs to the point they can't breathe. They need oxygen and IV fluid.  And if they get worse, they need a ventilator.  With excellent medical care, most will recover but some will die no matter what we do.  There are some tiny case studies that have suggested some other treatments like hydroxychloroquine or high dose Vitamin C -- and we are trying those on patients in Utah today because we have nothing else to try -- but we don't yet have any solid studies showing how often or how much they help.

I am happy to try to answer any other questions you may have and there are some good resources on the internet as well.  Here is the CDC website on Coronavirus.


       COVID-19
Where does the USA stand as of today?


Yesterday, March 26, 2020 was not a good day for us.  Yesterday, the USA passed up both China and Italy to become the country with the highest number of COVID-19 infections in the whole world. (About 85,000 as of the time of my writing).  The other thing that is very bad is that, as of today, the number of cases in the US is still growing exponentially.  It has been about two weeks since we closed schools and started "social distancing," so hopefully that will bend the curve down soon.  As of today, Utah has around 400 known cases (which is how many New York had 2 weeks ago.)

Here are two graphs, showing the daily number of total infections in the United States and the number of deaths. (These graphs and the other graphs below are from a site that is tracking numbers every day around the globe called worldometer coronavirus.)


The worst thing about both of these graphs is that so far they are showing exponential growth, increasing by a factor of 10 about every 8 days.  This means that unless our social distancing is successful in slowing down the growth, in 8 days we will have 10 times as many infections, and in 16 days we will have 100 times as many infections.

Many other countries in the world are suffering from exponential growth of new cases and deaths similar to these graphs.

But not all countries in the world are still experiencing exponential growth.

China was experiencing exponential growth in cases in late January, but they imposed a harsh quarantine on hundreds of millions of people for 4 weeks.  This brought their economy almost completely to a halt temporarily, but it worked.  They have almost completely eliminated new cases of the disease (for now) from their country, and they are back to work.  Here is the graph of new cases in China:

Note how in February, their graph was also going up exponentially, but turned more and more flat after the quarantine.  You could say the the Chinese government is likely to lie about their numbers (which is probably true), but if the cases were going up exponentially, there would be hundreds of millions of people sick and they wouldn't be able to conceal it, so the numbers are largely correct.

China is an authoritarian country that can (and did) lock people up in their own apartments against their will for those 4 weeks, but they are not the only country to have success. South Korea (a free country with a democratically-elected government) has also managed to block exponential growth.  Here is their curve:

They did this with extensive testing very quickly of many people, and tracing and isolating all of the individuals who were infected and all the people that they came in contact with.  They kept their economy largely going the whole time.

In the United States, we have been very slow to produce enough test kits.  Last week we were testing very few people.  This week we are testing a lot more. And hopefully by next week, we will be testing as many as we need to be.

I am hoping, also, that by next week, we are better organized to trace every single sick person and their contacts and help them get the care they need while making sure they have a place to quarantine where they won't have to worry about infecting their family and friends.  Helping people quarantine so they don't get the next 10 people sick is much better than trying to quickly buy more hospital ventilators.

There is currently still a debate raging in the United States about whether the quarantine and social isolation will hurt the economy more than the disease itself.  Clearly it is true that shutting down large parts of the economy is very damaging to all of us, but it is my belief that blocking the spread of infection before it gets 100 or 1000 times as many more people sick is the fastest way to get through this difficult period.  The day will come when we will be able to open the economy and all of our social interactions back up -- and I believe that the sooner we block the spread of the disease, the sooner that day will come.

COVID-19
What is our personal responsibility?

These are difficult times.  The next couple of weeks will almost certainly see a large increase in the number of cases in the United States -- and how fast and how large that increase is will determine what our options are after that.  Hopefully the Social Distancing that we have been practicing these last few weeks will help our curve bend down away from exponential growth before the infection becomes very widespread throughout the community.

Here are what I see as my own personal responsibilities -- and I hope you will take a minute to think through what you regard as yours.

* To care for patients at my medical clinic in a way that meets their needs without putting them or my staff or myself at any unnecessary risk.  To this end, we have almost completely stopped in-person visits and are doing almost everything over video connection.  When patients do require in-person contact (such as being tested for the COVID-19 virus), we carefully follow medical protocol for personal protective equipment. We have already had 2 cases of COVID-19 come to our clinic -- one of whom, unfortunately, has died.

* To keep myself and my family at home except for obtaining basic supplies such as food until it becomes more clear what will happen with the number of cases in our community.

* To keep in touch with neighbors and friends and make sure they have what they need.  And as cases become more common, to make sure that people in quarantine have a place where they have food and basic necessities met and won't run the risk of infecting family and friends.

* To remember that now more than ever, we are all in this together.  The collective choices that we make regarding whether we put ourselves at risk of getting sick, and then -- for those who do become sick -- to do everything possible to avoid getting anyone else sick, are what will determine how quickly we are able to recover from this.

* To remember that we will recover from this.  Our community is strong and, come what may, we will find ways to help each other as we get through this.  The day will come when we are back to school, back to work, and back enjoying each other's company in 1000 positive ways.

Thank you for the kind things that so many of you have done for me and my family.  If there is anything I can to do be helpful to you as we go through this, please let me know.  As always, you can reply to this email, or call me at 801-440-8765.
Contact:
Ray Ward Representative House District 19
email: rayward@le.utah.gov
cell phone: 801-440-8765