Things everybody should know about Covid-19. Plus some ideas.

Idaho has 42 cases of Covid-19 as of this morning. It feels like nothing, but that's because very few people are being tested and we are on the leading edge of the exponential growth curve. Some of us feel bad for feeling happy because these are serious times, some people feel sad in expectation of feeling sad in the future and others are just scared. It feels a little like a snow day, though, and we are knee deep in possibilities. Young people who never cook are learning to cook. People are doing crafts and hunkering down. I've heard from friends who I'd lost touch with. Much of my day is eaten up by learning more of what's known and what's known today may be wrong tomorrow.

Things you should know which are likely to be true:

• The coronavirus has a median incubation period of just over 5 days and nearly everyone who gets it will get it within 12 days of exposure. This is from China's data, reported in the Annals of Internal Medicine. 
• Symptoms can be variable: muscle aches, sore throat, fever, chest tightness, cough, runny nose, fatigue, nausea, vomiting, diarrhea, loss of sense of smell (later in the disease). There can be no symptoms at all! Symptoms can be long lasting and can get better and then worse again for weeks. This is from a combination of the New England Journal and self reports from physicians I know. 
• The nasal secretions of patients in China who show no symptoms have the same number of viruses in them as those who do show symptoms. If they aren't coughing and sneezing they probably aren't transmitting it as much, but that's the only difference. Source: NEJM. (Please note: Senator Rand Paul is reported to have tested positive but has no symptoms. He was reported to have then gone to the gym and attended a lunch with other people. That was foolish and very risky for other people.) So: just because a person has no symptoms does not mean they will not give you Covid-19. They definitely can.
• Around 15% of Chinese children who were infected had no symptoms. None at all. A proportion of these showed some sort of viral pneumonia when they were scanned. It is very hard to know what the spectrum of disease is in asymptomatic patients in the western world because we are testing very few people without symptoms. So Covid 19 infection is real even if the person carrying it feels OK. This is from the NEJM.
• It appears that virus survives on dry surfaces for longer than you might think but not forever. A recent US study shows a range of a few hours to about 3 days (NEJM). This means that it might survive on the package handed to you by a sick UPS driver. The surface of that box, though, will have fewer and fewer infectious viruses as time goes on and 3 days after its last exposure to live viruses all of the virus that might have been on its surface will be dead. Your package will not create aerosols so you could open it and then clean your hands after throwing away the packaging. This goes for takeout boxes, cardboard coffee cups etc. The coronavirus does not go through your skin so in order for you to be affected it has to get to your nose or other respiratory mucosa. Clean your hands after handling things that others touch. Keep your hands away from your face, especially your nose.
• The nasal and pharyngeal swabs miss some patients who are infected. This is Chinese data, so could be different in the US. For the test to detect infection, it must be an accurate test and the sample must be good (that swab goes WAY up your nose and maybe not everyone is doing it correctly.) We may be missing 30-40% of patients who are infected even if they get the test (JAMA).

Things to do (when you can't do much): You may be suffering financially already, but maybe not. Helping people out now may not only be good for them but will likely blunt the devastation that will follow this great experiment in stopping everything.

• If something you were planning to do is canceled, consider not asking for a refund.
• Buy gift cards at restaurants, bookstores, anywhere that is hurting right now. Either throw the gift cards away or save them and use them when the business is back to thriving.
• Give big tips when you get take-out.
• Start turning money into real value by helping your friends and family pay off loans or bills. You may have to bring this up. They may not ask. 
• Start giving to charity again. Some people have stopped because the tax bill that congress passed in 2017 has made it harder to deduct charitable donations. Think it through. What charities are going to really make an impact? Food banks. Churches with a strong commitment to helping the poor. Homeless shelters and drug and alcohol recovery centers. Arts organizations. Really. Arts organizations are hurting, will get very little federal support and employ vulnerable gig workers. 
• Support your local artist. Buy something cool online from an actual artist. Check out Etsy perhaps.

The great reset:

We are going to be slowing down for awhile. This is a marathon not a sprint. Correction. This is a very long and challenging walk on the Appalachian trail, without all the company. It may seem hard but we're going to get better at it and it will change. Oh the things we're going to know in a month that we don't know now! That was always true but we were too busy to notice. Pay attention and remember. These will be good stories to tell eventually.