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Wednesday, March 4, 2020

Public Gatherings vs. Coronavirus?

This week Grease opens!  (I'm also publishing this early in case YOU can come.)
I look forward to friends seeing a truly epic show.  It has a large cast complete with a rocking band at a very flexible facility.  If you saw the movie, you will enjoy seeing it live!  If you didn't see the movie, expect a delightful trip back in time.


Added to this I'm in another show, Godspell, the 2012 version, whose rehearsals must wait for some of us to get back to it.  

I limit my time involved in shows to stop it taking away from my storytelling business and, yes, it is a business and one where I frequently am a time traveler bringing "History as viewed by the 'average' person."  (Note to self: the slideshow on my Historical Programs page seems to have disappeared.  Re-do it with a new pictorial format a.s.a.p.!)

I strongly believe there's a HUGE difference in the impact of LIVE performance and recorded shows or storytelling.  It's because of this I'm taking seriously some of the ways Coronavirus is starting to impact our travel and gatherings in theatres, schools, churches, athletic events, and more.  I really don't want to indulge in scaring people, but even the Olympics may be affected.  Digital conferencing is taking the place of meetings and conferences.  The stockmarket, always reacting to any potential impact on business, has magically transformed Bulls into Bears.

On Storytell, the email list for storytellers, hosted by the National Storytelling Network, the discussion has begun with two interesting posts of articles by doctors.  As with anything potentially flat out fiction or misleading, I went to Snopes.com and searched Coronavirus.  The topic already has more pages than can show on one screen.  I strongly recommend using the Search feature there on whatever you may hear before spreading misinformation which can be the internet form of a pandemic. 

The pathologist whose information started the conversation was indeed correctly attributed to James Robb, "who described himself as 'one of the first molecular virologists in the world to work on coronaviruses.' "  The letter itself provides common-sense solutions to preventing disease transmission, but what garnered the most attention was his recommendation for zinc lozenges.  Snopes confirmed his writing it, but the intention was for close friends and family only and said:
His history with coronaviruses is accurately recounted. In the late 1970s, as professor of pathology at the University of California, San Diego, Robb published some of the earliest descriptions of coronaviruses. He also published a book chapter on this class of viruses for “Comprehensive Virology.”
While Robb does recommend zinc lozenges (of any brand, he told us), he would not describe the product as the silver bullet solution to the outbreak.
 Here is his letter:
Dear Family and Friends, as some of you may recall, when I was a professor of pathology at the University of California San Diego, I was one of the first molecular virologists in the world to work on coronaviruses (the 1970s). I was the first to demonstrate the number of genes the virus contained. Since then, I have kept up with the coronavirus field and its multiple clinical transfers into the human population (e.g., SARS, MERS), from different animal sources.

The current projections for its expansion in the US are only probable, due to continued insufficient worldwide data, but it is most likely to be widespread by mid to late March and April.

Here is what I have done and the precautions that I take and will take. These are the same precautions I currently use during our influenza seasons, except for the mask and gloves.:

1) NO HANDSHAKING! Use a fist bump, slight bow, elbow bump, etc.

2) Use ONLY your knuckle to touch light switches. elevator buttons, etc.. Lift the gasoline dispenser with a paper towel or use a disposable glove.

3) Open doors with your closed fist or hip - do not grasp the handle with your hand, unless there is no other way to open the door. Especially important on bathroom and post office/commercial doors.

4) Use disinfectant wipes at the stores when they are available, including wiping the handle and child seat in grocery carts.

5) Wash your hands with soap for 10-20 seconds and/or use a greater than 60% alcohol-based hand sanitizer whenever you return home from ANY activity that involves locations where other people have been.

6) Keep a bottle of sanitizer available at each of your home's entrances. AND in your car for use after getting gas or touching other contaminated objects when you can't immediately wash your hands.

7) If possible, cough or sneeze into a disposable tissue and discard. Use your elbow only if you have to. The clothing on your elbow will contain infectious virus that can be passed on for up to a week or more!

What I have stocked in preparation for the pandemic spread to the US:

1) Latex or nitrile latex disposable gloves for use when going shopping, using the gasoline pump, and all other outside activity when you come in contact with contaminated areas.

       Note:  This virus is spread in large droplets by coughing and sneezing. This means that the air will not infect you! BUT all the surfaces where these droplets land are infectious for about a week on average - everything that is associated with infected people will be contaminated and potentially infectious. The virus is on surfaces and you will not be infected unless your unprotected face is directly coughed or sneezed upon. This virus only has cell receptors for lung cells (it only infects your lungs). The only way for the virus to infect you is through your nose or mouth via your hands or an infected cough or sneeze onto or into your nose or mouth.

2) Stock up now with disposable surgical masks and use them  to prevent you from touching your nose and/or mouth (We touch our nose/mouth 90X/day without knowing it!). This is the only way this virus can infect you - it is lung-specific. The mask will not prevent the virus in a direct sneeze from getting into your nose or mouth - it is only to keep you from touching your nose or mouth.

3) Stock up now with hand sanitizers and latex/nitrile gloves (get the appropriate sizes for your family). The hand sanitizers must be alcohol-based and greater than 60% alcohol to be effective.

4) Stock up now with zinc lozenges. These lozenges have been proven to be effective in blocking coronavirus (and most other viruses) from multiplying in your throat and nasopharynx. Use as directed several times each day when you begin to feel ANY "cold-like" symptoms beginning. It is best to lie down and let the lozenge dissolve in the back of your throat and nasopharynx. Cold-Eeze lozenges is one brand available, but there are other brands available.

I, as many others do, hope that this pandemic will be reasonably contained, BUT I personally do not think it will be.  Humans have never seen this snake-associated virus before and have no internal defense against it. Tremendous worldwide efforts are being made to understand the molecular and clinical virology of this virus. Unbelievable molecular knowledge about the genomics, structure, and virulence of this virus has already been achieved. BUT, there will be NO drugs or vaccines available this year to protect us or limit the infection within us. Only symptomatic support is available.

I hope these personal thoughts will be helpful during this potentially catastrophic pandemic. Good luck to all of us.

James Robb, MD FCAP
Some of that, stocking up on masks, gloves, and sanitizers, is not currently being recommended, but Doctor Robb surely was intending the information for "close friends" who were in the healthcare field.  I also found it interesting Snopes says the common cold " is caused by a virus also classified as a coronavirus."  My own punctuation for that would be "!"  They also give this tip sheet from the Centers for Disease Control and Prevention for Prevention & Treatment, but the link has a sidebar that can take you to all aspects and summary of the latest information, yes, even travel information on this virus.

I mentioned two doctors were cited in the Storytell discussion.  Doctor Robb is retired, but Juliana Grant is currently working as an infectious disease specialist.  That link is to her full blog article on the subject, but she compares it to the 1918 Flu Pandemic.  None of us were around then but can recognize it as it's often called the Spanish Flu and Doctor Grant notes the critical difference between the two is the Spanish Flu particularly affected children and young adults, while Coronavirus is most severe for older adults.  (I would add also most severely affected is anyone with an immune system deficiency, a condition that can include, for example, people in cancer treatment.  I also recommend the full Wikipedia article on Spanish Flu as it points to more effects than the somewhat simplistic comparison Grant gives in a necessarily short article.)  Her summary is what is most important here:
What can we expect?
This is not the zombie apocalypse. Core infrastructure (e.g., power, water, supermarkets, internet, government, etc.) will continue to work, perhaps with some minor disruptions. 
There will be significant economic disruption: a global recession is very possible and there will probably be significant shortages of some products. The healthcare system will be hit the hardest. The number of people who are likely to get sick is higher than our healthcare systems can probably handle.  
Daily life will be impacted in important ways. Travel is likely to be limited and public gatherings will probably be canceled. Schools will probably be closed. Expect health departments to start issuing these orders in the near future, especially on the West Coast.
The acute pandemic will probably last at least for several months and quite possibly for a year or two.
What can we do?
We can’t keep COVID-19 from being a global pandemic but the more we can do to slow the spread of the disease, the less severe the impact will be. With that in mind, here are the things you can do:
Stay calm but take it seriously. This will likely be bad but it’s not the apocalypse.
Stay home if you’re sick or someone in your house is sick. 
Leave medical supplies for healthcare workers. You shouldn’t be stockpiling masks or other medical supplies. They are needed in hospitals to keep our healthcare workers healthy.
Wash your hands. Get in the habit of frequently washing your hands thoroughly and covering your cough.
Minimize your exposure. Now that we’re seeing community transmission in the U.S., it’s probably time to start cutting back on your exposure to other people. Depending on your circumstances, consider:
  • Canceling non-essential travel
  • Avoiding large-scale gatherings
  • Working from home if possible
  • Minimizing direct contact with others including hand shakes and hugs
  • Reducing your trips out of the house. If possible, shop for two weeks of groceries at once or consider having your groceries delivered. Stay home and cook instead of going to a restaurant.
Remember, keep calm and prepare. This is likely to be bad but if we respond calmly and thoughtfully we can handle it.
So why am I adding to what might seem hysteria?  That final minimal exposure section may affect the live and in-person aspects of storytelling and theatre.  A videoconference or YouTube performance does not equal live productions.  At the same time I find myself remembering the time a mother said to me after a program, while with two of her children, "I hope you don't mind that I didn't bring their brother, but he has mumps."  At the time I had never received a mumps vaccination (did it even exist then?) and my glands tended to be affected by my allergies.  I backed away and said, "Then I hope you don't mind if I don't get too close to your family."  Yes, she minded.

Frankly Dr. Robb's seven points for his initial precautions feels right for the present level, so I'll try them for now (they are common sense health measures even in the ordinary cold and flu season) and hope we don't have to change "large-scale gatherings."

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