COVID-19 Latest Updates
Figure 1: Estimated deaths by calendar date. From University of Washington.
What you need to know
U.S cases: 6,999,985 cases | 203,723* deaths, 14 September, 2020.
- 1 week ago: 14 September: 6,690,859 | 198,157.
- 1 September: 6,202,705 | 187,927.
- 1 August: 4,726,234 | 157,041.
- 1 July: 2,748,902 | 130,273.
- 1 June: 1,851,951 | 106,622.
- 1 May: 1,132,201 | 65,592.
- 1 April: 217,540 | 4,723.
- 1 March: 30 | 1.
- 1 February: 8 | 0.
- First case 22 January, 2020: 1 | 0.
Sources: Johns Hopkins, 1Point3Acres
* Includes probable deaths.
(Figure 1) APRIL IS GOING TO BE 👉🏽👉🏽👉🏽 BAD 👈🏽👈🏽👈🏽
As many as 90,000 dead by May 1
On a single day of April 15, we expect 2,271 COVID-19 deaths.
By May 1, there will be a shortfall of by 61,509 beds and 26,753 ventilators (see Figure 2).
Figure 2: Estimated shortfall of hospital and ICU beds by calendar date. From University of Washington.
Map of US showing predicted case burden by state from New York Times
What you need to do
Stay at home and continue social distancing
Expect pandemic to be a marathon like World War II. But we’ve got this: 100 things to do during social distancing, good art vibes from art community, 🆕👉🏻👉🏻👉🏻 Learn from an astronaut how to survive isolation👩🚀🚀. 🆕Understand grief. See our mental health tips.
Exercising before becoming infected can improve outcomes. Healthcare system in current overhaul to enable patients to visit doctor remotely. Gratitude journals improve mental health. See how to quarantine or what to do if you are sick.
Create a 90 day financial plan to stay at home for 90 days. See financial health section for ideas.
Best online source for what to do during COVID-19: Consumer Reports. They accept no advertising and have great articles.
Must read links related to the pandemic
What is COVID-19
COVID-19 (Coronavirus Disease 2019) is a pandemic coronavirus that is similar to virus that caused the SARS outbreak in 2002. It is a respiratory virus not related to the viruses that cause flu. COVID-19 did not come from a bioterror lab.
There are signs that COVID-19 causes heart damage. The CDC has great COVID-19 resources.
Why this outbreak isn’t “like flu.”
RISK TO YOU
COVID-19 has a case fatality rate (CFR) of 7 in 1000 (0.7%) overall—almost 10 times more than flu. But this is when the healthcare system can provide a good care to all patients. See below “Risk to the Healthcare System” below to see how a burdened healthcare system affects the CFR.
If you have COVID-19, you have approximately 15% risk of being hospitalized and 5% risk of requiring ICU care.
Mortality risk increases with age, chronic illness, and being immunocompromised (see bar chart to right). Pregnant women don’t seem to be at direct risk, but should use similar caution as at-risk groups.
This only describes your risk of dying if you catch COVID-19. People discharged from critical care and ICUs often have health that is permanently changed for the worse. This is a particular concern for high risk patients.
RISK TO THE HEALTHCARE SYSTEM
Virus spread occurs exponentially. One person infects 2-3 others, and the spread doubles every 3 days. Monday could have 5 cases, Thursday 10, Sunday 20, and so on. Seattle has experienced almost an entire 6 month season of flu deaths in the span of 1 week.
There aren’t enough hospital beds for COVID-19 and other illnesses. The approximately 95,000 ICU beds in the U.S are mostly filled with non-COVID illnesses—only 29,000 are available.
Conservatively, 1 out of 3 Americans will become infected with the virus (105 million infections). About 15 out of 100 require hospitalization. This amounts to 14.4 million hospitalizations, and about 5 in 100 of these will need critical/ICU care. That is 720,000 admissions to the ICU 25 times the capacity that we have.
The healthcare system cannot handle these admissions all at one time. Remember the run on groceries and toilet paper? Imagine that, but for hospital and ICU beds. The CFR of COVID will increase with burden to the healthcare system. This is seen in other countries. Italy is currently overburdened, increasing the CFR approximately 11 times to 8%. Singapore and South Korea acted swiftly, and the CFR is approximately 0.7%.
To decrease the rate of infections, i.e. “flatten the curve” (see figure), practice social distancing and hygiene (see below). This will spare our hospital capacity and give us time to develop a vaccine.
Social distancing has worked in democracies like Hong Kong, South Korea, and Taiwan who all learned from SARS in 2002.
Animated figure showing how social distancing can “flatten the curve” to prevent overburdening of the healthcare system.
Social distancing lowers the rate of COVID-19 infections so that hospitals don’t get overwhelmed and start rationing care for all diseases.
One person transmits COVID-19 to 3 other people. Social distancing saves lives!
The degree of virus spread in the U.S. is unknown. Testing has not been widespread due to regulations at the federal level. These regulations have been changed and testing expected to rapidly become more widespread.
Animals and pets do not seem to become infected. It is unknown if they can transmit disease. See this FAQ from the American Veterinary Medical Association.
What are symptoms & what do I do if I have Covid?
Figure showing common symptoms of COVID-19 compared to cold and flu symptoms
Check the CDC’s COVID-19 symptom checker. Most people will not have symptoms. The most common symptoms are fever, cough, and shortness of breath. Rarely diarrhea, stomach upset, and loss of smell can occur. It is hard to tell what’s COVID-19 versus some other cold or flu.
If you have symptoms, presume that you are sick and see below for a summary of the CDCs recommendations.
- Relax. You will very likely be o.k. Treat symptoms like the flu or any other cold.
- Use acetaminophen (tylenol), not ibuprofen (advil) or other NSAIDS for symptoms.
- Call your doctor to see if you should remain at home, be seen in clinic, or go to the emergency department. Your physician can tell you how long you need to self-isolate.
- See your state department of health to see if there is a testing center near you & that you are up-to-date for the latest info in your area.
- Self-isolate. Stay home if you’re sick and have people deliver groceries and meds for you.
- Don’t share food.
- Wear a mask when you are around others.
- Get medical attention immediately for:
- Difficulty breathing or shortness of breath
- Persistent pain or pressure in the chest
- New confusion or inability to arouse
- Bluish lips or face
- Make sure you read the CDC’s recommendations.
What to do if you are not sick
Practice social distancing (more in depth link) and prepare for an outbreak. Consumer Reports is a great resource.
- Stay 6 feet away from everyone except for those you’re sleeping with.
- Avoid large gatherings of people. go to supermarket and use public transportation at off-peak times. Refrain from shaking hands and hugging. Schedule errands at off-peak times.
- Wash your hands often with soap and water for at least 20 seconds especially after you have been in a public place, or after blowing your nose, coughing, or sneezing.
- Use hand sanitizer with 60% alcohol if you are unable to wash your hands.
- Avoid touching your face with unwashed hands.
- Cover your mouth when coughing or sneezing by coughing into your elbow.
- Prepare for extended time of social distancing. Get prescriptions and food necessary for 2 weeks in case shortages occur.
- Exercising before becoming infected can improve outcomes.
- Masks worn by well people at home does not prevent getting COVID-19 from a sick person. Only infected persons should wear masks. Proper use of masks requires training.
If you have diabetes or problems with your lungs, heart, or blood pressure, you are at higher risk. See the CDC’s recommendations.
Medical Myths Corrected
There is currently no preventative or therapeutic medication for COVID-19.
No change to outpatient blood pressure medications recommended.
Avoid NSAIDs like ibuprofen/Advil for symptoms and use acetaminophen/Tylenol instead.
Viral shedding after recovery from COVID-19 is not currently thought to be transmissible. Generally patients are thought to be unable to transmit virus 3 days after symptoms resolve or are improving. See “when to discontinue home isolation.”
Caring for mental health during the outbreak
Stress can show up in a variety of ways. See American Psychological Association recommendations to maintain sanity and good spirits during social distancing. This non-medical article is a great to-do list for establishing routines and activity suggestions. See therapist’s James Guay’s COVID-19 Survival guide.
- Limit checking in with news/social media to twice daily
- Eat healthy, stay hydrated.
- Communicate with friends and colleagues via telephone or videochat. This is better than texting for mental health.
- Volunteer and continue your hobbies.
- 👉🏻👉🏻👉🏻 Learn from an astronaut how to survive isolation.
If you are thinking of harming yourself, please contact the National Suicide Prevention Hotline at 1-800-273-TALK (8255).
How banks, lenders, and landlords will handle the COVID-19 cash crunch is rapidly evolving. See FDIC and SBA resources below.
Expect to stay in place for 3 months.
Create a 90 day financial plan:
- First assess your necessities.
- Create a budget of income vs. expenses.
- Consult government resources.
- Federal resources:
- FDIC.gov 👉🏻👉🏻👉🏻 FAQ and list of resources for insight into status of loans and mortgages
- U.S. Small Business Administration
- State resources: For ideas consult the financial resources for impacted businesses and individuals for State of Washington and City of Seattle. Even if you live in another state, they can provide ideas for what’s available in your state.
If by 2021, “only” a few people die
It will be one of the finest hours of America, as the public healthcare system worked. Asian countries are ahead of the U.S. on COVID-19 because they learned from SARS in 2002. Because of COVID-19, we will be able to learn from this and apply to pandemics in the future.
For healthcare providers
Coronavirus disease 2019 (COVID-19) from Up To Date
CDCs guidelines on reusing masks
COVID-19 from Internet Book of Critical Care
A Seattle Intensivist’s One-Pager on COVID-19
Critical care medicine for the non-intensivist from SCCM.
UCSF Algorithms for COVID-19 management
U Washington Emergency Med COVID-19 Guide
COVID-19 Pages at top authorities: CDC, BMJ, Lancet, JAMA, Nature, NEJM, Science
Specialty Specific COVID-19 Sections: Am Assoc Fam Practice, Am Assoc Pediatrics, Am Acad Otol, Am Coll Surg
Social Media Resources: Facebook Critical Care COVID-19, Twitter #covid4mds, Reddit /medicine subreddit
Telemedicine resources: Otolaryngology