Malecare Board of Directors member Vincent Santillo, MD, answers some of the coronavirus COVID-19 more curious questions.

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   Hello so I just swapped my first patient for potential covid-19.  There is very exciting lots of personal protective equipment which you can see in my embarrassing story — not really embarrassing — that’s just who I am but you gotta have a little bit of a chuckle — plus I’m actually also checking that the equipment doesn’t tare when I move around.  So if you can struck with personal protective equipment on, you should be fine.  


So let’s start with the questions: the first question why where is covid -18? one to eighteen.  Here’s how the name came about. COVID-19 is coronavirus disease the nineteen refers to the year in which the virus was identified which was December thirty first twenty nineteen.  So that’s right covered nineteen is actually way probably way more that nineteen coronaviruses out there — many of them just causing minor disease so that’s the first question. 

   And what are the symptoms? The symptoms are fever cough and shortness of breath there’s a lot of crossover with flu allergies colds but predominantly fever and cough in these patients and respiratory distress obviously the ones that are having a bad time of the illness. 

   How is it most likely to be spread? It is spread by respiratory droplets so the easiest way to get it is by spending a lot of time with somebody who has it and who is coughing so you want to stay at least six feet away from people I’ve seen other numbers like three feet but sixty is what’s on the NYC health website. What this social distancing is about which is preventing you from getting near people who might transmit it to you and to hopefully break the chain of infection. 

   And obviously, you also get the virus if you touch a surface where the virus is which my understanding can sometimes with three days on surfaces and then touch your mouth. That’s why we’re always saying wash your hands wash your hands wash your hands restaurants especially before you eat so that you don’t take the virus which is sitting on surfaces and place it into your mouth. 

   Another question was whether you can be re-infected with COVID-19?  the facts actually sort of out on that. 

   They don’t really know. There’s been some anecdotal reports that some people have been reflected in Asia after recovering came down with the disease again but we really can’t answer that question yet which is telling.  So we’re gonna have a lot more information in a couple of months about what this novel virus does and whether or not you can catch it twice. 

   Okay so who’s most at risk? It really seems to be age-dependent so the curve starts to move up above the age of sixty with the highest risk for mortality being about eighty also people who have chronic conditions lung conditions heart disease amino suppressed diabetes cancer these are all people who if they were to catch coronavirus might be one of the people have a very bad outcome. 

   It goes without saying that most of us would actually be very mild outcomes with this disease.  We’re trying to do two things we’re trying to prevent the disease. 

   Getting to the person who is going to have a really bad outcome and also an issue for a lot about this sort of flattening the curve. Here’s the real issue we’re facing — it’s not that the individual is in response to Mr g”onna do fine” it’s that as the disease spreads the number of people who may be severely ill at any one time and in need of ICU beds can become too large for our system to handle. 

   Some of the mortality differences that we’re seeing international sun article said there’s ten times the risk of mortality in countries which had overwhelmed health systems example given Italy. 

   And countries that had systems which were ready to absorb it. 

   Or at least were able to modify their systems to take care of people in mass numbers South Korea and China had much lower fatalities and you’re seeing in Italy. 

   What does that tell us that tells us what we have to do is prevent the health system from getting overwhelmed if we do that the mortality rate for this disease will approach a very bad flu. 

   But if we don’t do that if the number of cases increases too fast then we’re going to have capacity issues which can have really mortal consequences so social distancing what are we doing. We’re staying home. The city has closed venues above five hundred seats at venues with less than five hundred have been asked to cut their occupancy rates by half. Restaurants are closing.  What we’re trying to do is slow the spread. It’s going to spread. Its part of life on this planet is this coronavirus but if we can slow down the spread then the people who become severely ill will be able to slow the absorption it’s the health system get taken care of appropriately and have good outcomes. So you really are doing a public good when you decide to socially distance yourself. Okay well on social media use that for now this is going to be forever and thank you for thinking about others so when should I consult with my doctor according to the guidelines on the NYC health website. 

   You should consult your doctor if you have a fever cough shortness of breath or other colds or flu like symptoms and do not feel better after twenty four or forty eight hours.  Call your doctor don’t go into the office you’re over sixty. I visit the office and your doctor and talked on the phone and probably sending medication if you need it or talk about how testing can be accomplished safely. 

   Now if you have mild symptoms and any of the predisposing conditions like diabetes lung disease cancer immunosuppression, heart disease you may want to speak to your doctor earlier if you start feeling the symptoms they can help you decide what you need to do in terms of following up most importantly you should stay at home and avoid other people if you are feeling sick. 

   And then remember to call your doctor in twenty-four to forty-eight hours if you happen to feel better. 

   Stay home for at least three days after the symptoms and fever have resolved so you want to be a fever for if you get a fever and then yourself isolating you wanna stay home until you are fever-free for seventy-two hours three days while you are taking note hello no medicines to reduce your fear right so we want to have no fever. 

   No medicine for fever for three days after you have a febrile period K. that will tell you that it’s safe to go back outside legal but then again you should be doing that because they’re socially distancing anyway but you can go back from isolating to distancing. 

   Thank you so much for your patience and be safe out there — wash your hands — especially before you eat by.