Coronavirus advice from Dr. Michael Mellman
Editor’s Note: Dr. Michael Mellman is a longtime Hermosa and Manhattan Beach resident and an internist in private practice in El Segundo. He is also a team doctor for the Los Angeles Kings.
What are the symptoms?
The core symptoms are fever, cough and often fatigue and body aches. The cough may initially be dry and precede the other symptoms. It can be a minor cold/flu-like feeling, as well as much worse. Some people/children can be asymptomatic, meaning that they do not feel sick at all.
When is an infected individual contagious?
Certainly, when they have symptoms, but also when asymptomatic. How soon after exposure is unclear.
Many people were caught by surprise by the COVID-19 pandemic and were away from their families. If possible do not reunite ill members into the household. If you must reunite, isolate them in their room and maintain social distancing.
Is testing desirable?
Yes, for symptomatic and/or high-risk individuals. There are some qualifications due to the backlog of testing Tests for COVID-19 will only be performed on sick individuals where a treatment decision will be impacted. Why? Tests remain at a premium. Whether you test positive or negative, the advice remains the same — keep a mindset as if you were infected to protect both yourself and others. The penetrance of COVID-19 into the community may reach as high as 50-plus percent.
Do not ask for a COVID-19 test just because you want to know if you have been infected by the coronavirus. Testing on a broader front will be implemented when we have the testing capacity and adequate personal protective equipment (PPE) for the testers which is not currently the case.
This is a national disgrace but I will save politics for a time once this is in our rear view mirror.
Can children become infected?
Yes. Their illness if they are otherwise healthy and over 5 years old is usually mild. They can however transmit the illness to others. Thus the concern for them coming into contact with grandparents and others who are in the at risk group.
What does at risk mean?
“At risk” individuals are at higher risk for severe, even life-threatening infections. Anyone over the age of 65. Anyone who is taking immunosuppressive medications — you know who you are. Medical conditions such as diabetes, cancer, lung disease, smokers/vapers, heart disease especially heart failure. If you are unsure if you are at risk consult your personal doctor.
I remain concerned about pregnant women and infants because of their reduced immunity.
What the numbers mean
The reported number of infected individuals in the U.S. is going up rapidly due to new infections and to broader testing of already infected individuals. Better indicators of the severity of the pandemic, though, are hospitilization and/or the death rate due to COVID-19, which are more accurate number at this time.
Social distancing and hand washing are the best tools we have. When you enter your residence, or anyone else’s, leave your shoes outside and wash your hands. The COVID-19 virus can exist on nonporous surfaces, such as stainless steel for days and porous surfaces like cardboard for hours. Work from home if possible. The Chinese data shows 4 of 5 people infected were infected by individuals who did not know they were infected/contagious and were mostly household contacts.
CDC (Center for Disease Control) surveillance numbers show a significant percent of hospitalizations in the young and middle age groups due to serious illness but still a low death rate compared to the elderly.
There is some discussion regarding medications that may work against COVID-19. We are waiting for further info from the FDA. ER