WINTER: Novel virus means new way of life

Published 5:19 pm Tuesday, March 17, 2020

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As the reality of our new normal is setting in, there is anxiety and uncertainty about how to proceed during this stressful time. As a professor of infectious disease epidemiology at the University of Kentucky and a parent of three young children I have been asked to share my advice based on the best information available to me today.

If your family is anything like mine, there is hardly a week where someone doesn’t have fever, cough or runny nose. Do not panic if this happens now. Remember that influenza is still widespread in Kentucky, strep throat is common, and seasonal allergies are just beginning. Current studies indicate that most children and young adults who are infected with COVID-19 have less severe symptoms and very few deaths have occurred in people under the age of 40.

If someone in the household does start to have symptoms like body aches, fever, or cough, they should stay home and distance themselves from others in the household. If the symptoms are severe, seek a medical evaluation, as you would normally do with any other infection, but do not run to the doctor just to get tested for COVID-19. At this point, availability to COVID-19 testing is still limited and many health care providers do not have highest levels of personal protective equipment needed to do the specimen collection, so it places them, as well as the other people in the office at risk. Until testing capacity is ramped up, it needs to be prioritized for hospitalized patients.

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Many are wondering why we are closing schools and canceling public events for COVID-19 when we don’t do this for influenza. This strain of coronavirus has never infected humans before, making it a “novel virus,” therefore no one in our community has any immunity and it can spread like wildfire. Disease transmission for seasonal influenza is different because there is already some level of community immunity due to vaccination and prior exposures, which reduces transmission. This coronavirus is also about twice as contagious as influenza, so it is both easier to spread and can spread at a faster rate than regular flu. Since no vaccine or treatment currently exists for COVID-19, we must rely on social distancing measures to help slow the spread.

So how socially distant do we need to be? Unfortunately, there is no definitive answer. Many do not have the privilege of paid leave or flexible salaried jobs and are unable to stay home with their children. No activity is without risk so the best we can do is make an informed choice when considering the situation. Here is some practical advice I’ve offered people. When sharing a babysitter or playing with other children, ensure everyone is healthy. Where possible, choose outdoor activities to further reduce the risk of spreading contagion. Smaller groups of healthy children doing indoor activities together is still more socially distant than a school classroom. If relying on friends and family for child care, try limiting to just a few additional households to keep your overall contact network smaller. At night, consider avoiding the prolonged close contact of co-sleeping and the nighttime creep of a toddler into your bed. There may be no better time than a pandemic to sleep train your child.

Household pets are now thought to be safe from contracting and spreading COVID-19. In terms of risk reduction, regularly cleaning frequently-touched surfaces and toys, laundering linens, keeping the air as fresh as possible with open windows and doors, and especially, just being outside (yes, even in the rain and cold) are great strategies. And, of course, practicing good hand hygiene and cough etiquette will further reduce the risk of disease spread.

It is older adults and those with preexisting conditions like diabetes, heart disease, or lung disease who are most at risk of being hospitalized or dying from COVID-19. It is especially important for all of us to limit close contact to anyone that is one of these risk groups. This may be the most challenging directive as many seniors already face social isolation, grandparents frequently have custody of their grandchildren, and nursing care for medically fragile family members often occurs at home. If someone in the household is higher risk, then all should be extra cautious about their symptoms and try to stay isolated if sick. Where possible, designate a bathroom and bedroom to be used only by the higher risk household member. If personal care is needed, try to designate those duties to just one or two others in the household.

It is also during times of crisis that we can so easily set our differences aside and unite in our shared humanity. Already neighbors are organizing to help out their elderly neighbors. Social service agencies are finding creative ways to deliver services to vulnerable clients. Teachers have frantically transitioned lesson plans online and school administrators have organized meal deliveries to Lexington’s neighborhoods. Even with just a handful of confirmed cases, our local medical providers, public health and government officials are working around the clock to slow the spread of this virus. Those around us are not to be feared, because our community is also our strength. So wave, not hug. Call instead of visit. Open your windows and clean your house. Go for a bike ride or walk and teach your kids to really wash their hands.

Kathleen Winter ais an assistant professor in the University of Kentucky’s Department of Epidemiology in the College of Public Health.