There's No Crying In A Pandemic...
Updated: Apr 24
Well, we’re back for a second round of Q&A. Hopefully this time we can move beyond a single issue (last time we never got past “to mask or not to mask”) but you just never know which rabbit hole this Dear Friend of mine might dive into….
Q: What’s today’s theme? A: What the hell are you talking about, theme? This is a global pandemic! There’s no crying in baseball and there are no themes in a pandemic. Q: I want a theme. Princess Bride was good, but you kinda beat that to the ground. A: Inconceivable! Q: Sigh. Nevermind…
Q: Ok. So based on our last discussion I know I should probably wear a mask, and… A: Wrong. Q: What? A: Not probably. SHOULD wear a mask. You should wear a mask in public. Every time. It’s how you protect your Gigi from YOU.
In FACT, I would argue that if we really are committed to re-opening America before its time to cook the Thanksgiving bird, we better all make the decision to start masking in public, 100% of the time. It is a very real risk-mitigation strategy that will allow for reduction of transmission. You don’t like it. I don’t like it. Get over it.
Q: so mask in public. Check. What about gloves? I see people walking around in the grocery store fondling all the produce with their gloved hands. Will gloves protect me? Will gloves help protect Gigi? A: Nope. You don’t need gloves. What you need are excellent handwashing strategies. Q: gloves are kinda cool, though. And they cover up the fact I’ve not had a manicure in 2 months. A: Cut your nails – they’re breeding grounds for germs, anyway – and skip the gloves.
It is just about impossible to get COVID from your groceries or your latest Amazon box or a piece of mail.
All this hype was borne out of a number of admittedly high-quality, peer-reviewed studies that demonstrated detectable viral RNA on a variety of surfaces days after Coronavirus first landed there. These studies have, understandably, generated a lot of concern about handling mail, groceries, etc. But here are the really important take-home points.
Viruses degrade rapidly outside of a cellular environment – they need our cells to live and replicate.
Without the right environment, their protein coat dissolves leaving just their core RNA, which will survive long enough to be picked up and amplified by enterprising young researchers with access to PCR.
When these experiments based on PCR – which amplifies the RNA – say they detect “viral RNA 10 days later” it does NOT mean they’re detecting infectious virus.
Q: No. Not really. A: Ya. I thought not. Let’s try another way.
COVID19 is a RESPIRATORY virus. It can only “dock” – aka invade – with certain cells in your body, primarily respiratory epithelium. It can’t burrow through your skin. It can’t infect you via an open cut on your hand. You can’t eat it and become infected. The only way this gets transmitted from an apple in the store to you is if someone sneezes ALL OVER the apples moments before you get there, then you handle the apples and stick your finger up your nose.
Pro-tip: don’t do that in the time of Corona.
Bottom line: aggressively, repeatedly, relentlessly washing your hands with soap is critical. Not touching your face is really important. Wear a mask – it is important for transmission prevention.
Do those things and don’t worry about the gloves. BUT, if gloves are giving you some sense of control, and you frankly need anything you can control these days, knock yourself out. Just don’t touch your face or adjust your mask until you’ve doffed the gloves and washed your hands with soap.
Q: Talk to me about Hydroxychloroquine A: No. Next
Q: Wait! Why? I hear it is the most promising drug we have! A: Sigh. That was magical thinking.
We now have some, you know, #Science (remember medical science?) that shows it not only is not helpful, in fact it poses a significant cardiovascular risk.
A preliminary study out of Brazil on the use of chloroquine diphosophate to treat patients with Covid-19 symptoms ended early after several patients died and researchers found that a high dose of the drug was associated with a severe type of arrhythmia.
There is a larger, randomized trial underway at the NIH, but to date there is little beyond anecdote. It’s a hail-mary.
A: I will however talk to you about blood donation and, in particular, about convalescent serum donation. Wanna know more?
Q: that sounds harder than taking a pill. A: All the best things in life are… Q: fine. Proceed. A: As you wish
First of all, let me just put a plug in for all our blood donors out there. If you’ve done this in the past, thank you. Please don’t stop. Just because we’re in the middle of a pandemic doesn’t mean we aren’t also having car accidents. Chemo patients (like my son at one point) still rely on your donation for packed cells and platelets. Your donation saves lives, and blood centers have done an excellent job getting up to speed in order to keep you and them safe while donating. Please do it!
Convalescent plasma for treating severe COVID19 infection shows promise. Essentially this means taking blood from people who are known to have had and recovered from Coronavirus. These folks fall into that “Recovered-Now-Immune” category and have antibodies in their blood – called convalescent plasma. Researchers hope that convalescent plasma can be given to people with severe COVID-19 to boost their ability to fight the virus.
If you have had and recovered from Coronavirus, talk to your physician about this type of donation, please. It shows tremendous promise.
Q: Ow. My brain. A: IKR?
Q: One more question. A: Of course
Q: (whispers) Are we going to be ok?
A: Absolutely. We can fix anything but dead, my dear.
Keep being brave, generous and kind, always.