• Yousef Zarbalian, MD

Coronavirus Pandemic, part 1: how to protect yourself and your community

Updated: Apr 25, 2020

Given widespread concern for the growing coronavirus pandemic, I want to share my medical advice as a physician who treats medical conditions that affect the immune system. As a rheumatologist who has seen conditions characterized by an immune system that is out of control, I am well aware of the kind of critical illness and lung inflammation that the coronavirus may unleash (also called ARDS = Acute Respiratory Distress Syndrome). To date, there is very limited research regarding interventions to prevent the immune system from having an auto-inflammatory response to the virus and therefore prevention is more important than anything else we do. For that reason, I want to emphasize the basics of prevention which I believe everyone has heard multiple times.

Let me re-emphasize that the evidence is quite strong for these preventative recommendations :

1. Wash your hands.

Soap/water is definitely preferred to hand sanitizer as it is more effective in general. In particular for this coronavirus which is covered by a lipid envelope, it makes sense that soaps would be most effective at dissolving it and removing it from your hand. When you touch a surface that other people touch often, you should definitely consider washing your hands again.

1a. Sanitize the objects you and lots of other people touch.

1b. Don’t touch your face unless necessary; don't pick your nose, etc.

2. Wear a mask when out in public -

Recently there has been conflicting advice on the effectiveness of mask use by the general public. I strongly believe that this layer of protection should be utilized by everyone in the population given there is sufficient evidence that it provides inward protection (moreso than outward protection).

This recent editorial cites a few studies demonstrating that the evidence for wearing a mask is just as strong as for physical distancing.

Given we are already facing major shortages of masks for healthcare workers throughout the country, making a mask for yourself rather than purchasing one would be great.

To that end, a video has been made showing how to do this. Some parts of this project use a sewing machine :

If you are experiencing fever, cough, or sneezing, you shouldn't leave home unless it is to get tested or to get medical care.

3. 'Social distancing.'

Others have pointed out that a better name is physical distancing. This means keeping people apart from one another (preferably 6 feet apart and sanitizing shared objects).

4. Limit nonessential movement.

Avoid travel, as you may not know that you are carrying the virus and could make someone sick at your destination. Air plane travel is commonly thought to be the highest risk due to the number of people that you are in contact with from the airport to the airplane cabin to reaching your destination (using rideshare, etc.).

Frequently asked questions:

When do I need to seek medical attention?

If you are sick with a stuffy/runny nose, sore throat, fatigue, and body aches you can stay home and keep well-hydrated, eat nutritious food (more on that in my follow-up post), and get extra rest. You should quarantine; In the unlikely case that your job requires that you be in contact with others, you should get the test to establish to your employer that you must self-isolate.

If you have shortness of breath or persistent dry coughing or chest tightness, you should seek medical attention.

If unsure of how to handle your symptoms, Dr. Zarbalian offers telemedicine visits for those who want further guidance or want to be tested for COVID-19. Register as a new patient here in order to access the portal and schedule an appointment.

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