Covid-19 Info

 

I compiled this Covid-19 disease information for use by family and wanted to share it with others, especially for those of us in the Greater New Orleans Metropolitan area. I retired from a public health career, and used those skills to find current information from relevant sources. Please inform yourselves and take care.

As of April 18, 2020 there are 23,580 known cases and 1267 deaths from Covid-19 in Louisiana. The death rate here in those 70 years or older is now at 19.6%. Black people make up about 33% of our population, but their current death rate is 59.29% (per the State Department of Health). Go here for an article about the national high mortality rates among black people.

 


Travel Restrictions

FLORIDA- Roadside checkpoints are set up on interstates to check for potential COVID-19 cases coming into Florida. Anyone traveling into Florida from Louisiana and other areas with substantial community spread of the virus will be subject to a mandatory 14-day self-quarantine. The checkpoints do not apply to commercial drivers or health workers. Click here for more information.

OKLAHOMA–  Governor Kevin Stitt issued a statewide “safer-at-home” order on April 1. Travelers arriving from New York, New Jersey, Connecticut, California, Louisiana or Washington must self-quarantine 14 days.

TEXAS- Executive Order (GA-12) mandates a 14-day quarantine for road travelers arriving in Texas from any location in Louisiana. (This follows GA-11, a previous order that mandates a self-quarantine of 14 days for individuals traveling by air to Texas as their final destination through certain airports, such as New Orleans, Louisiana. This order now includes travel from several states.) Texas state troopers will be stopping motorists and anyone entering Texas will be required to self-quarantine for 14 daysGo here for current info.

VIRGINIA–  All residents are under a stay-at-home order. Travelers arriving from “virus hotspots,” including New York, New Jersey, Connecticut, and Louisiana must self-quarantine for 14 days.

OTHER STATES- Some states are asking or requiring that all those entering from any other state undergo a 2 week quarantine.


 
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Nola.com page with current info includes breakdown of ages, showing cases under 18 to over 70.


QUESTIONS

What are coranaviruses? Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe respiratory syndrome diseases such as MERS and SARS (and now Covid-19).

 

What is Covid-19? Covid-19 is the name of this viral disease, first found in humans in December 2019 (so no one in the world has antibodies to it). The virus that causes this disease is SARS Cov-2 (or severe acute respiratory syndrome coronavirus-2). The 2003 SARS virus (SARS CoV) is related to this one genetically, but the diseases they cause are quite different. SARS was more deadly (9.6% fatality rate) but much less infectious than COVID-19.

 

Isn’t Covid19 just a flu? Influenza is not caused by coronaviruses. While both diseases can cause pneumonia in severe cases, severe cases of Covid-19 pneumonia can lead to acute respiratory distress syndrome (ARDS) which can require prolonged mechanical ventilation in a hospital. This equipment is in short supply, especially in the US. The current mortality rates for Covid-19 (3.4% globally per WHO) are from 10-30 times greater than that for influenza. Unfortunately, recent death rates from Italy is coming in at around 6.6%, a number nearing the rate of the 2003 SARS epidemic. Flu illness that results in hospital admissions is spread out over a long period of time (3-4 months) compared to Covid-19 which is sending patients to hospitals in 3-4 weeks. This huge surge in demand can lead to collapse of medical systems, as is currently occurring in Italy.

         Current info on death rates compared to flu:

         

 

How is Covid-19 spread? CDC- The virus is thought to spread mainly [emphasis added] from person-to-person.

  • Between people who are in close contact with one another (within about 6 feet).
  • Through respiratory droplets produced when an infected person coughs or sneezes. (These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs.)

It may [emphasis added] be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes, but this is not thought to be the main way the virus spreads.  Transmission of novel coronavirus to persons from surfaces contaminated with the virus has not been documented [note: yet]. Current evidence suggests that novel coronavirus may remain viable for hours to days on surfaces made from a variety of materials. There is interim guidance on cleaning homes.

 

Is Covid-19 circulating in the New Orleans area? Yes, we have community spread of Covid-19 in and around New Orleans. Our Covid-19 disease rate is high and comparable to New York. (NY, WA, and CA have the most total cases so far.)

 

Won’t Covid-19 go away when it gets warm? Covid-19 is not caused by a cold virus (which is affected by the seasons), nor is there any information yet for how weather will effect this new Covid-19 virus.

 

Who is most at risk for severe illness? Some people are at higher risk of getting very sick from this illness. CDC general guidance states this includes:

  • Older adults
  • People who have serious chronic medical conditions like:
    • Heart disease
    • Diabetes
    • Lung disease

However, the CDC  Interim Clinical Guidance for Management of Patients with Confirmed Coronavirus Disease (COVID-19) under ‘Clinical Management & Treatment’ states- “Possible risk factors for progressing to severe illness may include, but are not limited to, older age, and underlying chronic medical conditions such as lung disease, cancer, heart failure, cerebrovascular disease, renal disease, liver disease, diabetes, immunocompromising conditions, and pregnancy.” [Emphasis added.]

Note: the CDC removed earlier language saying those over 60 were ‘older adults’ when it comes to this disease (as did some early studies). Those with auto-immune conditions, smokers, asthma, and others may also at high risk regardless of their age. Studies are also indicating that asymptomatic people are as contagious as those with symptoms, and in some cases can have more of a virus load and be more contagious.

 

What is the treatment for Covid-19? There is currently no vaccine to prevent Covid-19, and no specific treatment for COVID-19 is currently available. People who are mildly ill with COVID-19 are able to recover at home:  do not leave, except to get medical care, do not visit public areas, stay in touch with your doctor, call before you get medical care, and be sure to get care if you feel worse or you think it is an emergency.

If pneumonia  occurs standard treatments are used. Approximately 20-30% of hospitalized patients with COVID-19 and pneumonia have required intensive care for respiratory support, where treatments include high-flow oxygen therapy,  mechanical ventilation, and advanced organ support, and others . Acute respiratory distress syndrome (ARDS) developed in 17–29% of hospitalized patients.  (Interim Clinical Guidance for Management of Patients with Confirmed Coronavirus Disease, CDC)

 

 

What’s being done to fight Covid-19? So far, response has been state by state or by local jurisdictions. Federal testing is not yet available, and the previous kits sent out to states were incomplete.  In a March 16, 2020 conference call with US governors President Trump advised states to find their own respirators and ‘materials’. On the ground Federal support does not appear to be forthcoming, and Louisiana does not have resources to out-compete other states in buying respirators to meet this crisis.

 

CNN’s very good compilation of questions and answers.


CDC HEALTH INFO

NEW- CLOTH FACE COVERINGS– when and where to wear them, how to use, make, and clean (launder)

SYMPTOMS (from CDC)

Reported illnesses have ranged from mild symptoms to severe illness and death for confirmed coronavirus disease 2019 (COVID-19) cases. The following symptoms may appear 2-14 days after exposure.*

  • Fever
  • Cough
  • Shortness of breath

*This is based on what has been seen previously as the incubation period of MERS-CoV viruses. [Editorial comment- so this is a guestimate– some case studies have shown longer incubation periods.]

 

WARNING SIGNS (from CDC)

If you develop emergency warning signs for COVID-19 get medical attention immediately. Emergency warning signs include*:

  • Difficulty breathing or shortness of breath
  • Persistent pain or pressure in the chest
  • New confusion or inability to arouse
  • Bluish lips or face

*This list is not all inclusive. Please consult your medical provider for any other symptoms that are severe or concerning.

 

PROTECT YOURSELF (from CDC)

 

SOCIAL DISTANCING TO CONTROL PANDEMICS

CDC Guidance as of 3/15/2020- CDC recommends that for the next 8 weeks, organizers (whether groups or individuals) cancel or postpone in-person events that consist of 50 people or more throughout the United States. Read full recommendation.  On March 16, 2020 the White House advises public to avoid groups of more than 10, asks people to stay away from bars and restaurants– for 15 days. Download the Coronavirus Guidelines for America from the White House.

Image result for covid-19 cdc curve


RESOURCES

 Check often for updates

National Covid-19 page- CDCvery good information  [Note: their count of US cases is behind and inaccurate. Go to the LA Dept of Public Health page for our stats.] The White House states that CDCgov has and will continue to post the latest guidance on #COVID19. #coronavirus.

LA Dept of Health– good count & locations of LA cases, otherwise not very up to date. Dial 211 or text the keyword LACOVID to 898-211 for the most current information about the outbreak as it becomes available.

City of New Orleans– good info. Their Assistance for Residents page includes utilities, housing, unemployment, crisis counseling, etc. New Orleans will open drive-thru coronavirus testing– New Orleans is one of four cities chosen for a pilot program by the federal government offering drive-thru testing for people that meet the criteria for testing and are most at risk.

World Health Organization Covid 19 Info

Coronavirus COVID-19 Global Cases (CSSE- Johns Hopkins University) international map of cases

Cities & Parishes– check to see if they set up resources

 

General

First 2 LA Deaths– aged 53 and 58, both from New Orleans. LA has one of the highest rates of positive Covid-19 cases per capita in the nation. As of the evening  of March 16th  there are 136 known cases of of Covid-19 in Louisiana

STUDIES  – Many studies- people without symptoms are causing substantial amounts of infection. One study- viral load of asymptomatic patients was higher than those with symptoms.

Covid-19 Joint Update– article with good information.

Louisiana hospitals to restrict entry, most visitors will be stopped at the door– WWLTV, 3-15-20

Coronavirus Can Live in Patients for 5 Weeks After ContagionChina detected the viruses RNA in respiratory samples from survivors for a median of 20 days after they became infected. So a period of social distancing may be even more important.

Expert estimates reveal that US hospitals may run short on life-saving ventilators as the coronavirus outbreak ramps upCNN, 3-16-20. This expert states we have about 170,000 ventilators, but 1 million patients may need one with the Covid-19 outbreak.

Study from The American Journal of Gastroenterology Reveals Diarrhea is a Prominent Symptom of COVID-19 (3-28-20)

Loss of taste and/or smell to be added to COVID-19 symptoms (

Note: research is ongoing

 

 

A message from concerned physicians: 

“EVERYTHING WE DO BEFORE A PANDEMIC WILL SEEM ALARMIST. EVERYTHING WE DO AFTER WILL SEEM INADEQUATE” 

Michael Leavitt

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