Easing the COVID-19 Restrictions

I read an article written by an infectious disease physician in the state of Georgia. She was quite critical of her Governor Kemp opening the society prior to the state of Georgia meeting the very minimal guidelines for reopening the economy set down by the Trump Administration.  She believes it is a mistake and will be followed in 14-21 days by an increased rate of infection and death.  I next read an article on the CNN website about the reopening of Wuhan, China for business.  Wuhan is a big industrial manufacturing and commerce center of 11 million people who were ground zero for this pandemic.  Businesses are staying closed. Restaurants that could open for takeout are closing because consumers are still afraid and staying home. They fear a second wave of infection and death.

I say this as an introduction to my trip south down to Palmetto Bay, Florida south of Miami in Dade County.  It is a residential community of single-family homes in a reasonably well-to-do and well -educated diverse community.

My daughter and son-in-law moved into that community this past summer. We have not seen them face to face in over six weeks of our self-isolation and stay at home sequestering and miss our 2-year-old grandson desperately.  We had a ton of supplies at our home for them that just never made it south due to the disruption of the pandemic.

My daughter is pregnant and isolated because she too is considered “high risk.”   The trip reminded me of the sci-fi apocalypse series Mad Max Road Warrior. Traffic was light on the Florida Turnpike as I creeped along doing 75 miles per hour in the right-hand lane with SUVs roaring past me at 120+ mph. At certain times, I would see an auto in the left lane doing 80+ mph with the middle and right lanes empty and a faster driver would pull up behind them and tailgate them for miles. It was unclear why they just did not change lanes and safely whiz on by.

When I exited the turnpike for the Palmetto Expressway west the amount of traffic was incredible.  We dodged speeders and creepers and made it to the end on US-1.  The streets south were jammed. As we turned off onto 152nd Avenue, we noticed the young homeowners of Palmetto Bay were all out in their driveways and streets with their children, no masks on and weren’t the social distancing guidelines recommended by Public Health Officials.

Three homes north of my daughter’s home a pool party was in progress with multiple vehicles in the driveway and people of all ages attending.   We dropped off the supplies in my daughter’s driveway, talked for 20 minutes through their impact windows and then headed home.

When I turned into my community and passed our children’s playground, still closed per executive order of the County and Governor, a high school graduation party was in progress.  Multiple vehicles from outside our non-gated community were parked at the park entrance and a large crowd of diverse ages was congregating and celebrating at distances far less than the suggested six feet.

While I am not a registered fortune teller, I do not need a crystal ball or Tarot cards to predict that 14-21 days from now there will be an increase in COVID-19 cases and deaths in Dade, Broward and Palm Beach Counties due to the reopening of the society.  No one seems to care about how highly transmittable this pathogen is and its devastating effects on the older population.

We are approaching off season in Florida. Traditionally the snowbirds or seasonal visitors go home, and the economy is supported by year-round residents most of whom are older Americans. Each newly infected Coronavirus victim, with or without symptoms, will transmit the disease to an average of 5.7 individuals before they know they are ill.

With the rush to open the economy in Florida championed by the Governor, following the President’s lead, if the over 60 crowd is sick or dead, who will financially support the economy this coming off season?

Immune Boosting Foods – Lessons from a Dietitian on the Front Lines

Allison Pingel is a registered dietitian working with the Moffit Cancer Center to provide patients with the nutritional knowledge they need to stay healthy. As we know, COVID-19 is a severe threat to those individuals with an impaired immune system. Allison talks about building a strong immune system by eating correctly on a consistent basis.

The construction of this strong immune response does not occur overnight but occurs over time when you give your body the correct nutrients. She is quick to point out that there are no scientific studies that document or prove that vitamin supplements are a good substitute for foods which provide these building blocks naturally. “Fruits and vegetables are a more economical and nutritious way to obtain your necessary vitamins and minerals as well as other nutrients that are helpful including fiber.”

“Foods high in Vitamins A, C D, E and zinc support the immune system.” She cites broccoli, berries, garlic, ginger and spinach as products containing high amounts of these vitamins which assist the body in fighting infections. She encourages yogurt and nuts as plentiful sources of probiotics and zinc, which she considers essential for building a strong immune system. Additionally, she is a strong advocate of fruits and vegetables. One and a half cups to two cups of fruit per day, plus 2-3 cups of vegetables per day, are helpful for building a strong immune response.

While eating correctly to build your immune system is essential, so is some regular exercise and activities that are social and put you in touch with others in a safe manner. As spring descends on our country, it’s a fine time to take a walk or ride a bike and say hello to your friends and neighbors from a safe distance. Just make sure you adhere to your community’s stay-at-home restrictions.

The COVID-19 pandemic is frightening but with healthy eating, regular exercise and safe social interaction we will prevail and come out of this crisis stronger.

When Can I See My Grandchild? Social Distancing – Today’s Norm

I have a neighbor down the block who is a talented internist, administrator and teacher. On his resume is a stint as the Chief Medical Officer at a large urban hospital and director of the medical doctor training program as well. We walk our dogs at a safe social distance daily and update each other on the latest news on the Coronavirus in Florida.

We are also both relatively new glowing grandparents of two-year-old boys living in Dade County. Both boys brought home a viral illness 10 days ago and, quite frankly, with no testing available, we do not know what they had. The only important item is that they both recovered, and their parents are not sick.

“Do you have any idea when I can safely see Hank,” he asked rhetorically? “The CDC told me he needs two negative Covid-19 tests at least five days apart to make sure it is safe for someone over 60 years to safely take that risk. It’s difficult enough to obtain testing for acutely Ill patients so why would I waste them in this situation”?

Initial papers out of Wuhan, China demonstrate that when a sick person recovers from this infection, they continue to shed live virus for days or even weeks. Researchers either are not sure, or do not yet know, if those viral pieces can cause illness in some other susceptible host. They are not sure how someone is still contagious after recovering?

Hopefully this information will be available soon. Until we know for sure I would advise high risk patients to stay away from recovered Covid-19 patients for a few weeks.

Tonight, my wife and I will drive down to South Miami for a family BBQ. My son-in-law, daughter and grandchild, plus their dog Mia, will be on one side of a fence in a covered area. We will be across from them separated by a fence using our own gas grill. We will stay separated by a minimum of 10 yards and prepare our own food.

We will talk in person, tell some stories, sing some songs and then make the long drive home.

 

Hugs, kisses and rides on my shoulders will have to wait for another time.

Life’s New Reality with Coronavirus aka COVID-19

We are bombarded daily with news about the spreading infections with CoronaVirus or Covid-19. With television, the Internet and other news mediums; the quantity, quality and accuracy of information can be overwhelming.

This single stranded RNA virus has managed to invade most of our populated continents and is now moving into communities. There is more we do not know about this pathogen than we do know.

Public health officials which include the Trump Administration, the CDC, the NIH and local health departments have been extremely tight-lipped on the clinical course of the hundreds of US citizens evacuated from infected areas and quarantined for 14 days.

We do not know if there are any telltale historical or clinical markers to tip us off as to whether the patient in front of us with a cough and low grade fever might have a run of the mill seasonal viral infection or Covid-19.

And, it is still unclear,

  • How long the virus stays alive on a surface and remains infective.
  • How long the incubation period is and how long in advance of demonstrating signs of infection asymptomatic patients can transmit the disease.
  • What role, if any, children, who seem to be less vulnerable to the disease, play in the transmission of the disease as asymptomatic carriers?
  • How a relatively healthy nonsmoking adult in their 30’s to 50’s will do if they catch the disease?

The recommendations on testing from the administration and CDC have been unrealistic based on the lack of availability of the testing labs and kits in affected states. This will improve with time, but will it improve to the level of the “quick, never get out of your car, drive-through testing” being done in South Korea? That story, covered by CNN, was both enlightening and disheartening. Enlightening by illustrating how government can institute a plan quickly and efficiently.   Disheartening realizing that with all our wealth and expertise in the United States we are not doing something similar.

The recommendations about prevention are commonsense. Do I really need to log onto the CDC website to learn that I need to wash my hands, avoid touching my face and stay home if ill?

The selfishness and entitlement of the American public make even asking these minimal changes in our pattern to be a major inconvenience and intrusion into our privacy. I see the Ultra Rock Festival in Miami and the Calle Ocho street festival have been cancelled smartly to prevent infection. At the same time restaurants are jammed, servers and food preparation individuals without sick leave and health insurance still show up at work ill, to serve and prepare food, and many chronological adults balk at giving up their restaurants, bars, clubs and shows to prevent the spread of disease.

Posters suggesting we stay six feet away from others are plastered on buses and train platforms of mass transit systems where if you can stay 6 microns away from another transit passenger it’s as if you are travelling in the First Class section.

If we are all fortunate, Covid-19 will ultimately be an annoyance in the low risk population. We will develop fast and effective ways to detect it and then, with knowledge of how it spreads, we will be able to provide advice on how to protect others.

I am just not sure today’s American public has the will, the determination or the sense of community, altruism and sacrifice of lifestyle needed to prevent a major health and economic crisis.

INFORMATIONAL RESOURCES: