Chapter 1: The Nature of COVID-19

When officials at the CDC announced that the spread of the novel coronavirus (COVID-19) was unavoidable, I felt a sense of relief. To effectively manage pandemics, we require data, preparation, and realistic perspectives, rather than false reassurances.

The inevitability of spread became evident as details about transmission emerged. In certain illnesses, individuals only become contagious when they exhibit symptoms, making it theoretically feasible to curb the spread by isolating those affected. However, when a virus can be transmitted by individuals who show no symptoms, controlling its spread becomes nearly impossible once it has begun. The most effective viruses often leave their hosts only mildly ill or entirely asymptomatic.

Infection can propagate unnoticed.

This appears to be the case with COVID-19, which first emerged in China in 2019 and has since spread across numerous countries. We have learned that individuals can carry the virus for up to 14 days (or longer) before symptoms manifest, all while being contagious. There are even reports of a 20-year-old transmitting the virus without ever exhibiting symptoms.

Once a virus can be spread before the appearance of symptoms, managing its transmission poses significant challenges. The exact rate of asymptomatic spread for COVID-19 is still undetermined, but its existence raises concerns about the White House's claims that everything is under control. Even if all flights into the United States were halted, the virus would likely continue to circulate.

The limited number of cases in the U.S. can be attributed to the fact that only 445 individuals had been tested as of February 26, 2020. As testing increases, we can expect the number of confirmed cases to rise.

To be adequately prepared, one must rely on facts, systematic scientific evaluation, and realistic expectations.

Unrealistic expectations lead to panic, which has its own detrimental effects and can exacerbate any existing problems. How severe will this situation become? The truth is, we cannot predict it, and the fear of uncertainty can be unsettling.

It may be helpful to contemplate a worst-case scenario, a best-case scenario, and then consider the likelihood of a moderate outcome, as an intermediate scenario is most probable.

The most alarming scenario people envision is reminiscent of the 1918 Spanish Influenza pandemic, which infected a third of the global population and had a mortality rate of 2-3 percent (keeping in mind that medical care has advanced significantly in the past century). Conversely, the most optimistic scenario would involve rapid containment, seasonal changes halting contagion, effective antiviral treatments, and the swift development of a vaccine before subsequent waves of the disease arrive.

Let’s remain hopeful—optimism is beneficial—but also cautious.

Stay Informed

Consult reliable sources, such as the CDC and WHO websites. Avoid overwhelming yourself with the constant flood of news regarding the virus, particularly on social media. Much of what circulates online consists of anecdotal accounts and sensationalized coverage that incite anxiety rather than clarity.

Be wary of myths surrounding the virus: there are currently no approved treatments, vaccines, or antibiotics for COVID-19. Letters from China do not transmit the virus, and spraying disinfectant on your body is ineffective and can be harmful.

Prepare

Channel your concerns into practical actions: stock up on non-perishable food items (emergency preparedness is always wise) and ensure you have a sufficient supply of any necessary medications. The CDC does not advise healthy individuals to wear masks for protection.

Develop a contingency plan for possible disruptions to daily life (such as school closures or public service interruptions) in the same way you might prepare for a snowstorm or hurricane.

Mentally prepare yourself by remaining calm. After taking these precautions, continue with your life unless advised otherwise.

Maintain Good Health

While the advice to wash your hands may seem tiresome, it remains crucial. Wash your hands thoroughly and frequently—especially before meals, after using the restroom, after sneezing, and after touching shared surfaces. Use soap and water for at least 20 seconds, and avoid touching your face. Cover your mouth and nose when you cough or sneeze, and maintain distance from those who are coughing or sneezing. Regularly clean frequently-touched surfaces.

Though this guidance may feel repetitive, it is vital for preventing the spread of respiratory viruses and other contagious diseases.

Take care of your health: every illness, particularly infectious ones, is an interaction between the host and the pathogen. COVID-19 tends to have more severe effects on individuals with pre-existing health conditions. Prioritize self-care: eat nutritious food, stay active, ensure adequate sleep, and consider getting the flu vaccine if you haven't yet (influenza can be a serious illness, and the combination of it with COVID-19 is concerning).

Stay Calm

Life has always been precarious, and if you ever felt entirely secure, now is the time to recognize that your sense of control may have been overstated.

Challenging situations require composed minds, accurate information, positivity, and mutual support. We are truly all in this together.

Stay safe,

Dr. Ayala