SARS-CoV-2 & COVID-19: Prepare, Plan, Pause

It’s 2020. March. We are mid-pandemic. I feel a sense of urgency, however, I don’t feel a sense of distress. It is urgent that we act. Often in the face of an emergency, we panic. The panic stems from not knowing what to do. In order to use urgency to our benefit (rather than scare ourselves), we need to prepare. Preparation is the path out of distress and into problem solving.

Today’s discussion is about preparation, planning and hope. Hope for the future and information about what a pandemic means. We will recover from it. We will learn from it. We are ready. We have to be ready. Preparation is our best defence system right now and differentiating preparedness from panicking will determine the speed and success of our recovery. Prepare, plan and pause. That is our goal.

To be human

We have never been more ready for a pandemic than we are today. History has shown that our ability to fight infectious disease has improved steadily and drastically since early pandemics, such as the Black Plague (Bubonic Plague) and the 1918 H1N1 pandemic. Scientific innovation, particularly in the last 100 years, has drastically improved our ability to prevent and combat disease.

There are countries in complete disarray and countries just entering the uphill portion of the epidemic curve. Certain countries have experienced wide scale disease outbreaks in the past and learned a great deal about vigilance and public health measures. Other countries have never experienced a severe outbreak and were not prepared.

The outcomes vary greatly between these two polarities. The single most important factor is preparedness. Not fear, not turning on your neighbour. Being prepared from an individual, community and country-wide level, while maintaining strong communication on a global scale will be the key to our success. Taking care of the ‘me’ and the ‘we’.

A pandemic shows us who we are

Now is the time to realize we are all human. To see that no matter what differences you were focused on prior to the pandemic, we are all as frail and delicate as each another. We are all as uniquely ordinary as every other tree in the forest. No high ranking official will be immune to this virus; no billionaire or world leader can protect themselves any better than you can.

A pandemic illuminates that we are all human; we can all suffer, we can all feel fear and grief. All global emergencies do this; often bringing out the best and worst of our human nature.  We can come together as a stronger version of humanity than ever before by recognizing what a virus already knows. We are so much more similar than we are different. We are in this together. We need compassion during these times; compassion for others and a desire to help. No one is above anyone else when it comes to infectious disease. No one is superior; every human is human.

COVID-19 is the biggest news story ever

The news has made it clear that this is the apocalypse. Toilet paper seems to be the most important item for human survival. The doomsday voice is used by every news anchor and graphs portraying fatality rates are more popular than memes. I’ve been watching a comedy show that has followed the outbreak for many weeks in a segment called ‘This is How we Die’.

The panic in my own city has reached such high levels that Costco is probably going to sell out. Costco! People who buy from Costco don’t run out of anything, let alone Costco itself running out of industrial sized portions of everything. We’re preparing. The panic has not been dispelled yet, but we’re preparing.

Pandemic fail

The most staggering element thus far is the people who are capitalizing on the pandemic and selling toilet paper and Lysol wipes for a jacked up price on the black market. A man named Alex Jones who runs a TV show called InfoWars is purporting all sorts of terrifying information about the virus and selling what he calls ‘survival packages’ for thousands of dollars. He says it’s news; others say it’s fake news. It’s a bunch of either true or false news. Anyway.

The first package you see in his emergency preparedness section (now called ‘emergency reaction’) is a year’s worth of food. What message does that send? You will not have the Coronavirus for a year. My favourite is his Privacy and Security section which includes web cam covers, gun holsters and a $32 pen made of gun metal. I absolutely want a gun metal pen with me during this pandemic. Please send it with my full year of food. 

Capitalizing on fear

Alex Jones has opened three additional food plants in the last month so that he could capitalize on the pandemic. With his show to scare people, his store of water filtration systems, food packages and survival essentials like gun holsters, this pandemic is the best thing that ever happened to Alex Jones. Are we going to shoot the virus, Alex? Should I write to the virus with my gun metal pen? He is not the only one doing this; his story is one example.

To anyone who is using fear to hoard, steal or sell items like toilet paper, is that the story you want to tell your grandchildren about the pandemic? That you spread fear and used that fear to sell $374 single ply toilet paper rolls? A clean ass is not worth losing that much personal integrity. Not even the cleanest ass will get you friends after your toilet paper hoarding causes other people to use coffee filters.

*sips coffee*

Why have they started calling it SARS-CoV-2?

It has always been called SARS-CoV-2. That is the name of the virus. The first outbreak of SARS was a virus called SARS-CoV. That virus is what caused SARS (the illness). The virus SARS-CoV-2 is the strain of Coronavirus that causes the illness COVID-19. It’s really a semantics issue; the Coronavirus has multiple strains. When SARS was discovered (a strain of the Coronavirus), it was a novel strain. Now, a different strain is spreading. Can the current version cause SARS? Yes, it is literally the definition of SARS. Severe Acute Respiratory Syndrome. SARS is an illness. COVID-19 is an illness. Both are strains of Coronavirus. COVID-19 has about 80% identity to SARS. Not identical but highly similar.

What is a pandemic?

A pandemic is an outbreak of an illness that reaches a global threat. The organism is spreading throughout many countries, appearing in clusters and enough cases worldwide have been confirmed to call the outbreak a pandemic. Small outbreaks can be epidemics or endemics. A global outbreak is a pandemic.

A pandemic does not mean a deadly virus is spreading. It means a novel virus is spreading. It can be deadly, however, that is not the definition of a pandemic. I recently read a news article that stated we shouldn’t use the term ‘pandemic’ because it scares people. Lots of words scare people. The word ‘wasp’ is literally horrifying for me. Even if we called it the Healthy Virus Outbreak, people would freak right out. We should call it what it is and prepare for what it is. Losing sight of reality or denying it all together won’t help anyone. This is the time to educate ourselves, be proactive and intelligent.

Community in isolation

Simply put, just because a virus is spreading on a global scale does not mean ‘this is how we’re all going to die’. Quite the opposite. This is how we’re all going to learn. We will have to work together. Although self isolation and quarantines will be required to stop the spread, human beings have to remember we are one. We are all facing the same threat and it is our connection that will keep us hopeful. Our community.

We have phones, the internet, online communities and resources. Yes, we can see fear through these avenues but we can also see hope. We can refocus ourselves and take a role in stopping the virus by caring for our health and caring for our neighbours. Help one another; ask how people are doing. Be a part of the solution.

Will antibiotics treat the virus?

No. If a secondary bacterial infection occurs, such as bacterial pneumonia, antibiotics will treat it. If there is no bacterial infection and the illness is viral, antibiotics will not work. They are strictly for bacteria. A bacteria is similar to a little bug. It is an organism. A virus is a fascinating, confusing little organism that people debate whether it is alive or not. A virus cannot do anything without a host. A host is your cells.

This virus is spread through aerosols (coughing) and can remain active on a surface for a few hours. In order to proliferate in the body, the virus needs a cell (host). Basic hygiene practices such as covering your mouth when you cough, washing your hands and not touching your face will help protect you from the virus.

One reason a novel virus spreads so quickly is because no one has antibodies for them. The body does not recognize a new (novel) virus so the immune system takes a bit more time to launch an attack. Vaccines are what typically give our bodies a heads up to viral infections. No vaccine, no previous exposure to a virus; a perfect scenario for a novel virus to spread everywhere and anywhere.

Will the virus go away after the winter? Flu season will be over

It might. But likely not. Right now it’s 34 degrees celsius in the Philippines. There are a wide variety of temperatures on the planet, from -40 to +40, and it has not stopped the virus. It is reasonable to assume that this particular virus is not as temperature sensitive as Influenza (a completely separate virus).

Often during an emergency, people go into fight or flight mode without realizing it. They make impulsive decisions or become indifferent. They freeze and do nothing. Or run, stockpile and panic. Here is my quick pep talk for both kinds of people; both types (and all in between) are absolutely normal and welcome here in our TR community.

Over Reactions

Flatten the curve

An excellent article was published by the Washington Post on flattening the curve.  The article is very well done because it has cool graphics. It’s easy to understand and clearly depicts why health officials are encouraging strict social distancing. If we look at past pandemics, some were absolutely catastrophic. The 1918 H1N1 pandemic killed between 30 and 50 million people. Physicians advised many of the same things they are today; social distancing, avoiding touch, wearing a mask and they shut down public institutions. A full third of the European population passed away from the virus.

The same virus emerged again in 2009 for another pandemic. That time, just over 500,000 people died. Again, the same things were advised. The second time around, we had learned a great deal about science, hygiene, new medical treatments, vaccines, etc. In the grand scheme of things, we controlled the 2009 pandemic to an incredibly successful extent. We are now in another similar situation and again, we know more. We’ve learned more. We’ve never been more ready. Readiness has to come from the individual level all the way to the global level; take an active role in stopping the spread of this virus.

What if we aren’t ready for this?

We are. You are. You don’t need to panic. You need to prepare, plan and pause. Being prepared means looking at facts and making the best decision possible with the resources you have. It is being realistic. Compassionate. Proactive. Imagine you’re going on a trip. Let’s say it’s a two week camping trip. Perhaps we could even assume you’re staggeringly cool, you just bought a Boler and you have the resiliency of a Grizzly Bear. As you prepare for your trip, you start to come down with a cough. Because of your camping dedication and the new fairy lights on your Boler, you decide to go anyway. What would you need?

Yes, I know you need toilet paper. You’ve got it. We both know you’ve got enough toilet paper.

Gone fishin’

What else? If you had a cough, you might want cough medicine or other over the counter medication. You might want to ensure you have a full supply of any regular medication you’re on. You’ll need food and water to camp, which you know. But how will you cook? You brought your trusty Coleman stove and have extra propane. Good work!

What else? You have medication, TOILET PAPER (no I will not drop this because one day in the history books, they will talk about this outrageous toilet paper freak out), food, water and a way to cook the food.  Can you purify the water? What if the water is dirty; you’ll need to purify it. A thermometer perhaps? How will you know when to take your medication or go to a hospital? Your thermometer will tell you. Do you have your phone a friend card? A way to call for help? Plan for that, just in case.

My kid? Oh man…my dog too?

Are you camping with your kid? Your pet? They need food and medicine too. Two weeks worth. You could do your best to keep it from spreading to them by using a Kleenex to open and close your super cool Boler. What else would you like to camp with for 14 days?

Once you’ve created your list and you know you can survive for two weeks of camping, there is no reason to worry. You’re prepared. Replace panic with prepared. You have supplies, you’ve planned for multiple potential outcomes and you’ve got your loved ones covered (dogs, cats, kids, spouse).

Toilet paper theory

Pandemic preparedness

During the 2009 H1N1 pandemic, I felt extremely worried. Panicked, in fact. I had studied the 1918 H1N1 pandemic and all the most terrifying stories arose in my mind. I didn’t know enough about pandemic preparedness, emergency kits or what I could do. Having nothing to do in the face of panic is like gasoline on a fire. So we need to do something. That doing is the preparing and planning. I didn’t get sick from H1N1 but I did spend a week vomiting from anxiety. I imagine others are feeling that right now.

Now, I have learned. I am not sick or panicked because I am prepared. I am reading information on this virus, learning how to protect myself and my loved ones and using facts to make strategic decisions. So far, I’m crushing my response to this pandemic compared to the last (psychologically speaking).

Plan to be reasonable

We have people reacting to their panic and taking too much. When it reaches a point where essential supplies are running out and hospital staff cannot protect themselves, then we’ve taken too much. We have people like Alex Jones selling a year’s worth of food and that is going over the top. We need to be conscientious of our health and our community. When you take too much, others have less. Rationality needs to kick in here. It’s not Y2K. You’re not going into a bunker. This is a perfect time to move into our next topic – resolving the pandemic before you disappear for a decade into your bunker.

Often we can only see the panic; there is so much innovation and hope behind the scenes of Costco and gun metal pens. We have incredible research coming out in Canada, the United States, China, Europe and many more countries and institutions. We cannot give up hope that a treatment, vaccine and other medical counter measures will curtail the spread of the virus. We can each do our part and remain vigilant and hopeful. You have clear instructions right now on how to respond to this pandemic.

Science is the best

Scientists understand a lot about this virus and there is a global effort to more fully understand the mechanisms of it. We know that the virus has a receptor binding domain and that it uses a protein complex to recognize and fuse to our cell membrane. The recognition comes from a protein on the virus, the S protein, being in an ‘up’ conformation and recognizing a very specific receptor called ACE2. The complex is made up of three conformations; two ‘down’ and one ‘up’. In order to bind, the S protein (spike glycoprotein) needs to be ‘up’.

The receptor on our cells (ACE2) has other purposes, such as activation of angiotensin which regulates blood pressure. Just that knowledge alone can give hope as we have blood pressure medication that works on the ACE receptor. Further understanding of how to inhibit binding of the S protein to the ACE2 receptor could lead to treatments, new knowledge or any number of scientific innovations. Perhaps a decoy or suppressant could come from the research on the receptor binding domain. When the virus can’t bind to a host cell, it can’t infect it.

We have hope

Over 39,000 people in China have recovered and been discharged from hospital. This is the time for wisdom. Knowledge. Clear decision making and intelligent choices. This is not the time to panic. When we panic, we create stories in our mind and generally they are terrifying and include zombies. There is information available on government websites, through the World Health Organization and your local health departments.

Remember as we go through this that we have never been more prepared. We have never been as scientifically advanced as we are now and we have experience to draw on from a previous pandemic. We are ready.

In order to be ready at the community, city and country level (in any country), intelligent response is required. I mentioned that Alex Jones changed his ’emergency preparedness’ to ’emergency reaction’. What a perfect illustration of exactly what we should not do. Be reactive. There needs to be a global emergency response; responding with intelligence and steadiness. Reactivity comes from fear. Responsiveness comes from intelligence.

Prepare, plan and pause

Prepare yourself. Stay calm and breathe. Remember the news will tell you stories. Governments, health officials and the World Health Organization will tell you facts. Don’t get caught up in the stories; they are rarely helpful in staying grounded and maintaining perspective. We are living in a balancing act; prepare appropriately but not to the extent that you need a new mortgage for a building to hold your toilet paper. Be reasonable and rational. Rationality has always been a guiding light in times of turmoil.