The WHO have said many times that governments can stop this disease by containing the virus swiftly and aggressively. Their most recent statement was the most blunt yet. They declared a pandemic, but one that we can stop. They said the question is not whether we can, but whether we will. Many governments have demonstrated this by doing it, including China, South Korea and Singapore. As Dr Tedros, Director General of the WHO put it:
The challenge for many countries who are now dealing with large clusters or community transmission is not whether they can do the same – it’s whether they will.
Meanwhile you can stop yourself from getting the virus and so can your relatives and friends, by following the same simple rules that Bruce Aylward and his team used. This international team of experts toured the worst virus hotspots in China (they didn’t speak to the sick patients or their contacts but they spoke to people who might have the disease and not know it). They did wear masks but this was only because it was Chinese policy - the masks are mainly to protect others from your coughs.
Updated version of this page here:
They came away again confident that they are not contacts for the virus and didn’t need to be quarantined before talking directly to the press. You can do the same by following the same instructions.
The flu viruses are airborne. This means that when you breathe out the minutest droplets of water, called aerosols carry virus into the air around you. If you are in a lift with someone with the flu you can get it just by breathing the same air (Seasonal influenza and influenza A(H1N1)). SARS is also airborne. In one incident, 20 people got SARS from one infected person on Air China Flight 112
But COVID-19 is only transmitted via the much larger droplets of coughs and sneezes or when you talk [or during certain medical procedures such as intubation]. This is why you can protect yourself from COVID-19 by standing 1–2 meters away. Those droplets fall to the ground in seconds. It is not a contact virus so the only way you can get it is if it enters your eyes nose or mouth.
Do you do these four things?
- Wash hands thoroughly
- Stay 1-2 meters from anyone coughing, sneezing or talking to you.
- Avoid touching eyes, nose or mouth [wash hands before touching]
- Cough or sneeze into your elbow
OR cough or sneeze into a tissue and put it into a bin immediately.
COVID 19 is not a microbe. It is a virus, just some genetic instructions mixed with protein. It can be destroyed totally with soapy water or an alcohol hand wipe.
Learn the proper hygiene instructions and make it into a habit so that you do it automatically, like brushing your teeth and you will be very safe from this virus.
Do this as thoroughly as the experts, and you can say:
"I don't have COVID-19 - I am very low risk".
Dr Bruce Aylward said that immediately after he returned from Wuhan. He knew he was safe because he did those things
Text on image: Dr Bruce Aylward after 9 days visiting China's worst COVID19 hotspots
"I don't have COVID-19 - I am very low risk"
- Wash hands thoroughly
- Stay 1-2 meters from anyone coughing, sneezing or talking to you.
- Avoid touching eyes, nose or mouth [wash hands before touching]
- Cough or sneeze into your elbow
OR cough or sneeze into a tissue and put it into a bin immediately.
and you too can be protected from COVID-19
If everyone does these things, it will stop it from spreading as well. These simple instructions save lives. They are not hard to do if you make them into a habit.
You might still get flus or colds following these instructions. If so don’t worry. Because flus and some colds are airborne, these instructions won’t 100% protect them, even with the social distancing.
However, these instructions are very effective against COVID-19.
You need to wash your hands thoroughly. This is one way to do it as demonstrated by Dr Tedros:
Try going through and copying what he does. Do it a few times and it will become automatic.
This is another video demonstrating the same sequence.
This video (of a slightly variation on the sequence) shows how it works.
Here Dr Maria Van Kerkhove, expert in coronaviruses and respiratory diseases and WHO technical lead for COVID-19 answering some of your questions on COVID-19
Those I help over the internet often worry about me because I am 65 and am in the UK. Don’t worry. I know what to do and would be safe even in Wuhan :). You all can be too if you do the right things rigorously.
I have done a tweet about this here:
This is a graphic about it from the BBC.
There are many other graphics and details of what to do at the WHO website here:
In a bit more detail:
- Wash hands frequently and thoroughly - that includes around the nails and between the fingers and the wrist.
You just need to use normal soap (or an alcohol wipe) because this is a virus, not a microbe. No need for anything antimicrobial. Soap completely destroys these viruses.
- Try to get out of the habit of touching your face, especially eyes nose, or mouth.
- Don't touch your face with unwashed hands after touching surfaces that could be infected.
If you can get completeley out of the habit of touching your face then you don’t need to wash your hands so often. It can’t infect through the skin. Make sure you wash your hands before touching your eyes, nose or mouth - that’s the main thing.
- Keep a distance of 1 -2 meters from anyone sick especially if coughing or sneezing
- Disinfect surfaces you work with - and wash hands before during and after preparing food.
Wash hands after going to the toilet .after you return from work, or school or shopping etc. and before eating.
This is another article I'm writing to support people we help in the Facebook Doomsday Debunked group, that find us because they get scared, sometimes to the point of feeling suicidal about it, by such stories.
Do share this with your friends if you find it useful, as they may be panicking too
Here I am talking about the basic instructions:
And here in a longer video covering most of this article:
ELEVEN STEPS TO WASH YOUR HANDS REALLY THOROUGHLY
Here is how the WHO recommends washing your hands to protect from COVID-19, demonstrated by Dr Tedros:
Dr Tedros is challenging others to do the same and upload videos of themselves doing it.
It may seem daunting at first - but humans are really good at learning sequences of events - do it a few times and it soon becomes automatic and you just do it as a habitual pattern not a remembered sequence. Make sure you include all the steps - there are videos on YouTube that leave out some of them. Might as well learn it properly.
It has 11 steps to thoroughly wash every part of your hands including between your fingers, thumbs, fingernails, back of hand etc.
- wet hands with water
- apply enough soap to cover all surfaces
- rub hands palm to palm-
- right hand over left interlocked fingers and vice versa
- palm to palm fingers interlaced
- back of fingers cupped in opposing palms (both ways)
- rotational rubbing of left and right thumbs
- rotational rubbing of palm with tips of clasped fingers (both ways)
- rinse hands with water
- dry thoroughly with paper towel.
- close tap with towel.
It's actually also quite a useful hand exercise as well, keep your fingers and hand flexible :).
Try to remember all the steps - after doing it a few times it becomes automatic.
If everyone did this the disease would stop quickly. Here is Bruce Aylward after he returned from China on the 25th February.
The press asked him why he wasn’t wearing a mask. He said that if he was a contact he wouldn’t be there, he’d be in quarantine, not talking to them with a mask on, it would make no sense (would not protect them adequately) He is a top expert on such things - he lead the campaign for almost complete eradicatio of Polio. He knows what he is doing.
If you do the same then even if you were in Wuhan you would be able to say, like him 72:58 in:
I don't have COVID-19 - I am very low risk ...
I never had any exposures. We are very careful, we run patient.
If the evidence changes and there is any reason that I was at risk, I wouldn't be wearing a mask, I wouldn't be sitting here.
The bigger picture can be overwhelming but by taking those measures you are protecting yourself and your community.
If you can get everyone in a housing estate or a village or street to do this, or some real world or online group of people - that community will be free of covid19 and create a gap where it can't spread.
Not only does this stop it spreading into that community - it also stops it spreading through its members to anywhere else.
If everyone did this then the disease would soon be extinct.
Also the WHO site
THIS DISEASE IS HARD TO GET
It is very difficult to get this virus. Even if you are in a tube crowded together with others - for things like the flu you need to be there for 15 minutes or so to get it. But for this disease - so far there is no evidence of it being passed on to anyone else in public transport.
That is why it is so easy to contain it. The people who get it are usually people who were in long prolonged or close contact.
Even with close contacts then between 95 and 99% of people don't get it and for people living in the same household as a family or couple, then between 90% and 97% of people don't get it - this is without taking any precautions to protect themselves.
Take those simple precautions and you won't get it. If we all did this then it would be extinct in the wild in 14 days. If three quarters of us did this then it would not last many weeks in the wild even if the governments did nothing.
MORE ABOUT BRUCE AYLWARD’S PRECAUTIONS
Bruce Aylward did wear a mask in China. He explained it was because it was Chinese policy so they had to do it - that is mainly to protect others from you. You can also do it by just coughing into your elbow, which actually works better for most people - if you cough into a mask and then touch the mask you transfer the droplets to your hands.
Of course he knew he didn’t have COVID19 but he did it anyway to comply with their policies. For instance he wore a mask for his press conference in China but he didn’t wear one for the press conference the next day in Geneva because he knew he didn’t need one.
He also goes into many concrete details about how they did the physical distancing, keeping 1 meter apart during meal times, for train journeys and so on.
He didn’t tour areas of hospitals where patients were being treated for COVID-19 or talk to patients or contacts.
He did visit areas where there could be people with COVID-19 who he talked to who didn’t know they had it.
This is how Bruce Aylward put it when interviewed by W2 in Canada:
This is a respiratory disease at the end of the day which means it can move very easily from me too you well not right now cuz you're too far away [1 meter away]
If your population knows how to protect itself you're gonna be very successful with this disease.
If I'm washing my hands, if I'm [doing] proper respiratory hygiene avoiding the others social distancing and know what to look for not just in myself but in others I'm going to be safe, or quite safe. There's no such thing as zero risk but you can really reduce the risk. I spent two weeks nearly three weeks in the epicenter of the biggest outbreak in history. I'm fine.
What I described is the WHO advice for people who are in the community not advice for e.g. sharing a house with a COVID-19 patient or visiting a ward with COVID-19 patients.
The WHO have separate advice if you are caring for someone in the same house with COVID-19 and it is more stringent. They say you should only do that with advice from a clinician who checks your house is suitable and can follow the instructions, and preferably then anyone with COVID-19 should be isolated in a separate facility from those without it and you only care for them at home as a last resort when you don’t have the capacity elsewhere. Patient and carer should both use masks if available and know how to use them properly.
IF 75% OF PEOPLE DO THIS THE DISEASE WILL SOON STOP
It doesn’t need everyone to do this.
To see how it works - if you take no precuations at all, on average each person infects two others and the numbers double roughly every 4 days.
Starting with 100 people:
- 100 infects 200 new cases (day 4) infects 400 (day 8) infects 800 (day 12)
12 days later you have 1500 cases (100 + 200 + 400 + 800)
Now suppose we can stop 3/4 of those infections. This means that 100 people infect 50 instead of 200 (because you have stopped 3/4 of the infections)
- 100 infects 50 (day 4) infects 25 (day 8) infects 12 (day 12)
Now 12 days later you have 187 cases instead of 1500 (100 + 50 + 25 + 12).
This is a huge difference. Soon this outbreak will be over.
This is why the WHO say that although this is a pandemic, it can be the first pandemic we stop.
For more about this:
MOST PEOPLE RECOVER
Also most people get a mild version of the disease and nearly everyone recover. The figures you see are misleading because it can take a really long time to recover. It would probably be better to label "recovered" as “discharged”. E.g. under: Coronavirus Cases
Some of the most serious cases who have been close to the point of death and been on a ventilator for weeks may not recover completely for months.
Even the mild ones, they may be over it within a fortnight, even some within a week. But they remain infectious for another 2 weeks. Those may not be recorded as totally “recovered” even though they feel fine and are fit, except that they still have the virus.
But there is more to this than that. The countries are variable in how well they count mild cases. In the UK they are only counting hospitalized cases now. They don’t even test anyone with mild symptoms.
In China in the early days of the outbreak they didn’t even know about the mild cases. Some countries like South Korea and Singapore, and China (now) probably catch just about all the mild cases. But other countries find hardly any of them. If you have a mortality rate of 1% but you are missing 80% of the cases because they are mild your rate will seem like it is 5%.
It is hard to find examples of people talking about recovery, because most people don't want to speak up because of stigma, and you have patient confidentiality. This is an example of a mild case - 80% are mild and some very mild This lady never really even felt unwell. Especially, young children normally get a very mild version and so far there are no deaths in the under 10s AFAIK and very young babies including days old newborns are least affected of all. Nobody knows why yet.
Here are a couple of examples from Singapore - of recoveries of the more severe patients who had trouble breathing.
Most never progress that far:
Make no mistake, this is a very serious disease.
However for younger people below 40 the mortality rate is low. Nevertheless if you have 1000 people below 40 who all get this disease, you can expect on average 1 or 2 of them will die and several more will need weeks of treatment on ventilators.
But there are many recoveries and you are most likely not going to die of it. Even at over 90 (most at risk age group), four out of five will survive.
THE WHO ONLY RECOMMEND MASKS IN TWO SITUATIONS - CARING FOR OTHERS WITH COVID19 OR TO PROTECT OTHERS WHEN YOU COUGH OR SNEEZE
The WHO say that medical gloves, gowns etc do not help the general public as they don't use them correctly.
Soapy water completely destroys these viruses. Wash your hands and you will be fine.
Masks DO NOT HELP if you don't know how to use them, and they also cause problems for the medical workers by increasing prices and reducing the supplies available in emergencies.
Surgical masks protect you if you care for someone with covid19 - but only if used correctly
Surgical masks can help protect others from a cough or sneeze. But you can just cough into your elbow or a tissue and bin the tissue instead.
You must use masks correctly or they are useless and can make things worse. See WHO advice on Masks.
Surgical gloves are useless to the general public as they don't use them correctly. Wash your hands and you will be fine.
You must use masks correctly or they are useless and can make things worse. See WHO advice on masks.
Both ways you discard temporary masks or gloves at the end of your session into a closed bin. Or you know how to sterilize them. Medical workers get through a lot of them and they are much more expensive now and also in short supply for health workers because of unnecessary panic buying by the public.
IT IS ACTUALLY REALLY HARD TO GET THIS DISEASE - NOT AIRBORNE
This disease is not airborne (this was proved early on) - no evidence even people sitting next to an infected person in an hours long plane journey will get it.
This is different from SARS. In one incident, 20 people got SARS from one infected person on Air China Flight 112
. This has not yet happened with COVID 19 despite all the people who flew back from Wuhan with the virus. They test passengeres within 2 meters of an infected case routinely.
This is an early study that showed this for a flight from Wuhan to Canada
From the big China report:
Airborne spread has not been reported for COVID-19 and it is not believed to be a major driver of transmission who-china-joint-mission-on-covid-19-final-report
I've had people comment mentioning a recent study that suggested that passengers in a coach could infect others more than 2 meters away. This was later retracted. The journal gave no reasons for the retraction. The original claim was that the droplets were carried further than 2 meters through air conditioning on the bus.
Studies like this are hard to do as you have to rule out the possibility that the passengers were infected elsewhere, before or after the coach journey.
Here Dr Maria Van Kerkhove, expert in coronaviruses and respiratory diseases and WHO technical lead for COVID-19 says that it is not airborne
TYPICALLY ONLY SPREADS TO CLOSE OR PROLONGED CONTACTS
Normally you will get it from someone you know well, have close contact with or spend a lot of time with. This is why the contact tracing has worked so well. You are not likely to get it from a stranger at a busstop or on a train or plane.
Also few people get it even with close contacts. Between 1 and 5% of contacts, for people in the same households it ranges from 3 to 10%
So, even if you live in the same house as someone, 9 times out of 10 you won’t get it.
Even couples don’t get it from each other usually. Many stories of couple who are surprised their partner didn’t get it - you may have seen some on the media.
This is why the Chinese have been able to contain it.
Here is a quote from the big report again:
In China, human-to-human transmission of the COVID-19 virus is largely occurring in families. The Joint Mission receiveddetailed information from the investigation of clusters and some household transmission studies, which are ongoing in a number of Provinces. Among 344 clusters involving 1308 cases (out of a total 1836 cases reported) inGuangdong Province and Sichuan Province, most clusters (78%-85%) have occurred in families.
Household transmission studies are currently underway, but preliminary studies ongoing in Guangdong estimate the secondary attack rate in householdsranges from 3-10%.
Between 1% and 5% of contacts were subsequently laboratory confirmed cases of COVID-19, depending on location
CAN YOU GET IT FROM SOMEONE WITHOUT SYMPTOMS?
The answer is - not likely. This is not a major factor for this disease - not a driver.
This is a major factor for flu but not for covid19
Sometimes someone may be unwell but suppressing their fever using paracetemol as happened with the Chinese lady who infected many colleagues in Germany. But genuine asymptomatic spreading is exceedingly rare for covid19.
You can detect the virus before symptoms and some have such a mild version that they don't even feel sick, these asymptomatic people don't seem to be infecting others.
If this does happen, it doesn't seem to be a major driver of the infection.
Asymptomatic infectionhas been reported, but the majority of the relatively rare cases who are asymptomatic on the date of identification/report went on todevelop disease. The proportion of truly asymptomatic infections is unclear but appearsto be relatively rare and does not appear to be a major driver of transmission.
There is a lot of evidence to confirm this. For insance, Singapore now tests any of its population of over 5 million people if they present with fever or pneumonia / respiratory symptoms.
All these tests have come out negative for covid19 apart from the known clusters.
There may be asymptomatic people with the virus, for instance many kids may have it without any symptoms or minimal symptoms - but if so they are not spreading it to others and not causing new outbreaks to arise.
ALMOST NO GENUINE COMMUNITY SPREAD
Although the Italian supermarkets are saying to stay a meter away from other customers - it's the experience of China, Singapore etc that it doesn't in fact spread this way.
They have found all the cases in Singapore through tracing close contacts all the way back to China.
Even in South Korea nearly all their over 7000 cases are from a few clusters.
The Italians are being hyper-cautious as it is a new disease and we are still learning about it. However there isn’t any evidence yet that this will make a significant difference to the spread.
As a personal guideline it is wise to keep a distance from anyone coughing and sneezing, and get out of the habit of touching your face if you can, wash hands frequently.
But even if someone coughs on you and they have covid19 in practice it is most unlikely that this infects anyone. Not just a single cough. It can't because if it did this contact tracing would never have worked as effectively as it has.
WHAT IF I HAVE HEART DISEASE?
The main risk is that your heart has to work harder once you get breathless to pump blood around faster which can tax your heart. This is only relevant if you were to progress to the more severe stages of the disease then you are more at risk.
Then some people with heart conditions have weakened immune systems.
Viral illnesses can also destabilize plaque leading to increased risk of a heart attack.
WEAKENED IMMUNE SYSTEM
If you have a weakened immune system for instance because of cancer treatment, or HIV etc, then you need to take extra care to prevent infection just as you do for flu.
Coronavirus (COVID-19) is a new virus. We are still learning how it works. But if you are immunosuppressed (have a weak immune system) you may be more likely to get infection.
There are many things that can cause a weak immune system, including:
- cancer treatment
- treatment for autoimmune diseases, such as rheumatoid arthritis, lupus, multiple sclerosis (MS) and inflammatory bowel diseases
- having an organ transplant or a bone-marrow transplant
Other lung viruses can cause severe illness in people who have a weak immune system. This is likely to be the same for coronavirus. This is why you should take extra care to prevent infection if you have a weak immune system. This is similar for other infections, such as flu.
WHAT ABOUT LUNG DISEASES
Chronic lung disease is a factor - there it is talking about chronic conditions that impair the function of your lungs.
Most will get only a mild version of the disease - this is still only a factor if you get a more severe version of it.
WHAT ABOUT DIABETICS?
For diabetes it is important to mange your diabetes well to reduce the risk.
Also most people get a very mild version of the disease and the risk of death is low.
Question 2: The NHS website says the symptoms and complications of coronavirus can be worse in people with diabetes. Would I be more likely to die?
Coronaviruses can cause more severe symptoms and complications in people with diabetes, as well as in older people, and those with other long term conditions such as cancer or chronic lung disease. The risk of death from coronavirus is quite low, and the majority of people with coronavirus will have a comparatively mild illness.
It is important that people with diabetes follow the sick day rules should they become ill from any illness. If you routinely check your blood sugar at home, you'll probably need to do it more often – at least every four hours, including during the night.
WHAT ABOUT ASTHMA?
This is an early study that said that asthma is not a risk factor, though it is based on only 140 patients, all hospitalized.
"Allergic diseases, asthma and COPD are not risk factors for SARS‐CoV‐2 infection."
However respiratory diseases like colds and flus can trigger a life threatening asthma attack in vulnerable people.
So use your preventer inhaler as prescribed and be sure to carry your reliever inhaler with you.
Also, the WHO's Maria Van Kerkhove said in a recent video interview that asthma does lead to increased risk.
Is it more dangerous for people with asthma?
So we do know from data from a number of countries that people who are most vulnerable for developing severe disease are people of older age so people who are over the age of 60 70 and 80 years old but also people who have underlying conditions like chronic respiratory disease like asthma or cardiovascular disease or diabetes so those individuals who do get infected have a greater chance of developing severe disease
WE CAN STOP THIS
We can stop it by any of these, or a combination:
- Case finding - e.g. testing anyone with flu / pneumonia symptoms with travel history with infected areas
- Contact tracing and isolation of all contacts of known cases
- Case finding rapidly - China can now find cases in 3 days from onset of symptoms. This requires you to have lots of testing capacity - and educate the public to report symptoms right away.
- Personal protection through washing hands etc.
Remember you only need to stop 3/4 of the transmisisons, or even just a bit over half would do.
For instance if we find all cases within 3 days of symptoms, instead of 14 days later, then they only have 3 days to infect anyone else and that alone could be enough to stop this virus in a few weeks.
South Korea are doing this. Italy is doing all the right things too. It is nerve wracking when the outbreak is still rising and shows no sign of stopping but there is always a delay of several days to a week.
You don’t see the effects right away.
Indeed all the aggressive case finding to stop an epidemic can lead to the number of cases rising fast early on in an outbreak because you are finding so many more of the mild cases.
Hopefully the Italian cases per day will start coming down in a few days.
GOOD NEWS IN CHINA AND SOUTH KOREA
No native covid19 cases in China outside of Hubei province on the 9th March. The 4 new cases were all imported from outside of China.
China are closing down 11 of their 16 makeshift hospitals because they are no longer needed - the largest of them with 2000 beds.
China are going to reopen schools this week and may lift the travel restrictions on Hubei province soon.
This underlines what the WHO have been saying - this virus can be contained. They only did lockdown of cities in Hubei province - in the other provinces it was mainly rapid case finding with their fever clinics, contact tracing, and public hygiene education and some other restrictions but not a total lock down.
A few weeks ago on 29th January all provinces in China were at level 1 "red" for risk the highest possible risk - the whole of China was red.
South Korea is close to containing their outbreak too, had less daily cases than they have had for two weeks.
Wuhan has now closed the last of the 14 hospitals that it built to treat the virus.
They are likely to start to permit some travel to / from Hubei province soon.
South Korea is close to contining it
However they had a recent cluster of 94 new cases all connected to a single call center.
It has a way to go yet to completely get over it but is well on its way.
See also my:
- Where to go for reliable sources on the Coronavirus COVID19
(also has a list of some of my posts at the end)
REMINDERS FROM THE WHO WEBSITE
These are from this page at the WHO Advice for public
These can be useful stickers to put on your door, or on your car dashboard or in other places where they will remind you and others around you what to do.
Stay healthy while traveling
- Avoid close contact with people suffering from a fever or cough
- Frequently clean hands by using an alcohol baed hand rub or soap and water
- Avoid touchign eyes, nose or mouth.
Protect yourself and others from getting sick
Wash your hands
- after coughing or sneezing
- when caring for the sick
- before, during and after you prepare food
- before eating
- after toilet use
- when hands are visibly dirty
- after handling animals or animal waste
WHO said today that 110,000 peole have contributed since last Friday when they stated the fund. They have contributed a total of nearly $19 million to be used to help buy diagnostic tests, supplies for health workers, and support research and development.
If you donate on Facebook, then Facebook matches your contribution dollar for dollar up to $10 million doubling your contribution. So far they are at over $8 million donated through Facebook.
You can also donate through the WHO website here
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Seven tips for dealing with doomsday fears
If you are scared: Seven tips for dealing with doomsday fears which also talks about health professionals and how they can help.
If in the middle of a panic attack, see
- Breathe in and out slowly and deeply to calm a panic attack by Robert Walker on Debunking Doomsday
- Tips from CBT - might help some of you to deal with doomsday anxieties
- STOPP skill
Facebook support group
Facebook group Doomsday Debunked has been set up to help anyone who is scared by these fake doomsdays.
Please read the rules pinned at the head of the group before posting - they help it to run smoothly, thanks!
If you need help
Do message me on Quora or PM me on Facebook if you need help.
There are many others in the group who are available to support scared people via PM and who can also debunk fake Doomsday “news” for you if you get scared of a story and are not sure if it is true. See our debunkers list
If you are suicidal don’t forget there’s always help a phone call away with the List of suicide crisis lines - Wikipedia