Is Coronavirus keeping you from booking liveaboard/overseas trips this year?

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Also posted another thread. I don’t necessarily agree with all his points but still an interesting perspective.


From an MD immunologist:

“I don't post a lot on facebook but I would like to give my perspective and context on the coronavirus outbreak. I hope I can be a more reputable source of perspective as a physician who specializes and is board certified in immunology (as well as pediatrics, allergy and dermatology).

1. Coronaviruses are a family of viruses. "coronavirus" is not unique to this particular strain. Everyone reading this has likely had another different coronavirus infection. This particular strain has been named COVID-19.

2. Every upper respiratory virus has the potential to be lethal. Patients unfortunately die from many upper respiratory viral infections every year - most prominently the influenza virus. 30,000 people died from the influenza virus in 2019. The media didn't report each one. They have reported all 11 coronavirus deaths. Not telling us about the people lost but rather keeping a death "toll".

Let me repeat that:
-Coronavirus: 11 deaths (US in 2020), 3300 deaths (China in 2020).
-Influenza: 30,000 deaths (US in 2019).

*Influenza pandemic of 1918: 675,000! (US), 20-50 MILLION!! (worldwide) <---These people I think would have been in favor of receiving their annual flu vaccine.

This is not meant to minimize any of these deaths but rather to give context and put some facts to the hysteria.

3. If you're healthy, there is no need to walk around wearing a mask. In addition to looking silly and most of the time wearing/taking them off wrong - which would actually make you more prone to acquiring an infection, they don't prevent you from getting sick. If you're actually sick stay away from people and then, sure, wear a mask so you aren't spreading respiratory droplets every time you cough/sneeze. In medicine we don't wear the masks you're buying and we wear other protective equipment - not just a silly looking mask you found on Amazon. When you see doctor's walking around the world wearing a mask then you should too. Until then, stop.

4. The symptoms are that of the flu. As doctors we don't test or know about most people with mild or moderate flu symptoms. That means most people will probably get it and just think they had the flu. That means you're only going to hear about the cases that get serious - not all the minor ones which will be the vast majority of cases.

5. When it is said that people who are older or have other medical conditions are most likely to die - that is equally true for EVERY upper respiratory virus. There is nothing unique about that to this particular virus. It does mean that the only cases we tend to know about are the severe ones. Once a case is severe it then makes sense to test the patient to find out what virus in particular they have. That means you can easily overestimate how severe or lethal the virus is because the only cases you end up knowing about are the serious ones.

In summary 30,000 people died from the flu last year. Another 30,000 died in car accidents.

I remember: H1N1 (2009), MERS (2012), Ebola (2014), Coronavirus (2020).

Take it from me: The poor resident who stood at the door of the ER to triage people in 2009's swine flu (H1N1) hysteria. The over reaction is exponentially worse than the actual problem and in 2020 the over reactions I'm seeing are remarkable. In cold and flu season you'll probably get sick once or twice for about a week each. You might even get this particular coronavirus and most of you won't even know it. I've seen people raiding supermarkets, major meetings and sporting events getting cancelled and fear/racism towards Asian people. These reactions are totally unnecessary and panic based. Just do what you've always done during cold/flu season. Stay away from other people when you're sick, wash your hands and keep them away from your face, and only go to the ER if you feel your symptoms are more severe than a bad cold/flu (shortness of breath, high fever, etc.). And also realize you can't live on earth and not get viral illnesses from time to time. It's a part of nature.

Please don't ask for antibiotics (those treat bacteria - not viruses). Thats like asking for a fire extinguisher when you're drowning. It can be a life saving device - but the wrong one for the problem at hand. Some doctor's don't want to fight about it when patients insist on antibiotics so they just prescribe them - but it doesn't mean its actually helping you and in some cases they can be harmful (resistance, infections, allergic reactions just to name a few). If you're one who asks for antibiotics every time you're sick, again, take it from me: ask for a flu shot each year and a doctor's note to stay home from work when you're sick instead. You will be much better off.

The government is very proud that testing will be available to every American. Remember, we don't test for any respiratory virus other than the influenza virus routinely. The reason is thats the only virus that has a treatment (pill) you can take to shorten the duration of severity of the illness. I suspect if we start testing everyone with cold symptoms for coronavirus we're going to find lots of it. It's not going to change the recommendations to stay home and rest. And its not going to predict the small percentage of people who may develop more severe symptoms. Essentially whether someone has coronavirus 19 or some other cold/flu virus isn't going to matter to your doctor. What it will do is slam urgent cares, ER's and hospitals with every patient who has a cold so they can be tested. It is much more sensible to reserve testing for patients requiring hospitalization or more advanced treatments. Even that wouldn't change their management but would be more to confirm the diagnosis and to not waste time looking for other causes of the patients symptoms.

In conclusion, yes there is a novel virus that our immune systems haven't seen yet so to get immune to it you will have to get infected - at least until a vaccine is developed to bypass the getting sick part and just jumping straight to immune. Most people's immune systems will do that effectively and be fine. A small percentage of unfortunate patients (primarily elderly, immune compromised etc.) will not be able to do that effectively and will need more advanced care. This is true of the cold/flu viruses we deal with every year. Follow normal cold/flu precautions and seek medical care if you feel your symptoms are severe. No need to get hysterical.

These outbreaks can be instructive for overall knowledge of public health. In particular showing your immune system the uniform of a potential invader (virus) so that if it ever sees a soldier wearing that uniform it will immediately attack and neutralize it without you ever getting sick. That is a wonderful thing and probably the single biggest achievement in medicine throughout human history. That is what vaccines are. The benefit to risk ratio of them are off the charts in favor of vaccines. If viruses like coronavirus scare you, then stay up to date on your vaccines and your immune system will be running the latest software.

If you still think you should be scared consider this: Doctors, nurses and other healthcare staff are going to hospitals every day. Crowded buildings with tons of sick people. They aren't walking around the halls of the hospitals wearing masks and they haven't stopped going to work. And they are all rolling their eyes at everyone else right now.

Marc Serota, MD”
 
Also posted another thread. I don’t necessarily agree with all his points but still an interesting perspective.
What do you take issue with?
 
Another perspective:

When I was facing a life and death procedure, I kept asking my doctor about my survival statistics. He replied: “In a population of 100, 40 will live, 60 will die. That is, from a scientific and medical perspective, you have a 40% survival rate. But you are not a population of 100. You are a population of one. You will either live or die. You are 100% dead or 100% alive. You will either end up in the 40% group or the 60% group. Do you I understand what I’m trying to say?”

That was a very harsh statement at the time and I never asked him about statistics again. Make of it what you will.
 
What do you take issue with?
I don’t really take issue with any of it I am just less willing to down play covid 19 in comparisons with influenza. There is just so much that we don’t know yet about covid 19..


Points that echo my thoughts, the seemingly over reaction by the public, especially on hand sanitizers but even more so for the face mask frenzy that has left the medical providers without access to needed supplies. And the media’s over emphasis on testing. I really appreciate his viewpoints on general public testing, useful at this point for surveillance but generally meaningless for management of the illness.
 
@uncfnp excellent post. and while yes there have been very few deaths compared to those infected worldwide, and yes the flu kills quite a few people every year. I think where most people seem to be having problems is this:

1. Several countries and governments are really freaking out about this. Today I get a news feed that the PM of Italy has pretty much shut down activity in Northern Italy.
2. Several business worldwide are really freaking out about this. Airports, vacations spots, etc. making it hard for people to function
3. The media (oh boy don't even get me started on them) is playing this off like the bubonic plague has covered the earth and we will see the Walking Dead soon.

While I am not making light of this - it stands to reason that they will work this out. What bothers me is all this "hype" is going to make people very paranoid. People need to be diligent about washing hands and not spreading germs (like always).

I went through hurricane Katrina and I guarantee you that I came into contact with more viruses, bacteria's and other nefarious infections than I care to admit...guess what...I am still here. What was the point of mentioning this...…..well its this...…..when a large group of people who become paranoid - they tend to act a bit crazy. That being said, if the hype keeps continuing to build, people are going to look out for number one (themselves) and that is when trouble really begins.

I can just see it now, someone on the subway feels that their space has been invaded and BAM -- someone goes postal. You get my drift.

On that note -- if I happen to be a person who thinks I may have caught this, I CERTIANLY hope my Dr. isn't rolling their eyes at me and thinking what a fool. Because it will be that one Dr. that doesn't take this as serious as they should and then it gets out of control.
 
Something that I find interesting is this: When the panic and the intense measures started in Italy (I think it was around the 22nd of February - that's just 2 weeks ago!!) Italy had something like 70-80 confirmed cases, and a couple of deaths. Today, Italy has 7000+ cases and 360+ deaths - that's just in 2 weeks time!!!
But look at the "irony": Today Germany and France (just 2 examples) have more than 1000 confirmed cases each (and France almost 20 deaths). That's more than an order of magnitude more confirmed cases than what caused the measures in Italy, but nobody talks about stopping flights etc to/from Germany or France. Isn't it strange how perspective can change in just 2 weeks time?
 
If you still think you should be scared consider this: Doctors, nurses and other healthcare staff are going to hospitals every day. Crowded buildings with tons of sick people. They aren't walking around the halls of the hospitals wearing masks and they haven't stopped going to work. And they are all rolling their eyes at everyone else right now.

Marc Serota, MD”
Well, I am not particularly scared. However in hour hospitals our doctors are actually wearing masks and protective dressing in areas where patients with Coronavirus are being treated:


Of course (and luckily) they have not stopped going to work, but are taking serious precautions attempting of not being infected.
Which does not always work, as the first spread of infection here in Italy was boosted by the fact that patients went to ER, and infected dozens of people, including the sanitary personnel...
Current recommendation is that people with symptoms do not go to ER or to their doctor, and ask for help by phone calling the special number for being visited at home by a MD (which of course will also wear similar protections).
And yes, also here in Parma (North Italy) everything has been shut down; schools, universities, public offices, cinemas, theatres, museums. People is invited to work from home with their computers.
Also here someone wonders if we are over-reacting, but we know really too little for understanding if we did exaggerate, or if instead we did take the best we could to slow down as much as possible the logistic epidemic curve.
 

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