Corona virus

[Charlene Marshall]

Hi John,

Thank you for writing to us and opening this topic – while I’m trying not to spend too much time thinking/worrying about this virus, I know it is hard not too and many patients with IPF likely feel worried about corona. I am just doing everything I can to ensure I protect myself from it – washing my hands as often as possible, hand sanitizer, etc. Part of me thinks of it like anything else: I got a cold that led to pneumonia in November and almost destroyed my lungs. I suppose we can get anything and it can go bad really quickly. Doing everything I can to protect myself and knowing that I am is the way I am coping with this new virus. What are others thinking about it?

Also, please remember: the most important thing for everyone to remember is that if you get symptomatic, you go to the doctor right away to prevent the spread of it.

[Mary Millwood]

…”if you get symptomatic, you go to the doctor right away to prevent the spread of it.”

The official response to this statement is that you DO NOT go to the doctor right away.  You call your PCP, emergency room, or other medical facility and ASK what you should do.  Going to the doctor immediately without their knowledge of the situation only spreads the disease (if you test positive for the coronavirus.)

[Joe Murray]

I have cut down on my outings and plan to self sequester once it appears in my area.  I have already stocked up on dry goods (Kleenex, paper towels/wipes, etc.), meds, and food – especially shelf stable food.  I have also keep some cash on hand in case it’s needed if and when the virus is detected in my community.  I can still go out for fresh air, sun, and exercise but not with or around large groups of people.  This is my way of coping with a unique challenge to my well being in a challenging time.

[Wendy Dirks]

Sadly, I think cutting down on outings is the only thing we can do. I haven’t worried too much about stocking up on things as I figure if I get it, I will almost immediately be hospitalised. The survival rate for people with chronic respiratory disease is 92% but I wonder if my lungs will be so damaged that even if I survived it, I’d be far more ill and far closer to the end of my journey than I would be without it. It hasn’t appeared here in my city yet, but the cases in the UK increase every day. We have been invited to a wedding at the end of May and sadly, I seriously doubt we will go.

[JillT]

We’ve had a completely ludicrous response by the public in Australia, given that there’s been only one fatality thus far. Panic buying with supermarket shelves stripped bare, etc.

I’ve made an effort to freeze a bit more food than usual, bought a few more cans and long-life milk so I can at least make yoghurt, but other than that, I don’t see what else we can really do. Self-isolation will be difficult, but not that much more onerous than how much time I already spend at home since going on oxygen. Avoiding crowds will be key, I think. If and when we get a lot more cases will be the time to stock up on medications etc. I’m sure we’ll get warnings if there are business closures beginning.

The “Keep Calm” posters are probably more appropriate now than ever.

[Terry Moriarty]

I’ve been monitoring very closely since I live 60 miles from Travis Airforce Base and UC Davis Medical Center, where they transferred the first community-transmitted patient, is only 20 miles away. But no cases reported here.

I’m more concerned about my son who lives near the outbreaks in Washington. I’m retired and can stay in if I need to, but most people can’t self-quaranteen.

There was another post about a person on oxygen being bullied while out shopping in the UK. I’d never thought that others would think of us as a threat.

[Charlene Marshall]

Hi @mary-millwood ,

Thanks for writing and yes, I agree with you: my statement should have said “contact” or “connect with” your PCP, ER, etc to advise on next steps, not necessarily going to the doctor in case it is positive. However, here in Canada they are encouraging people to seek a doctor for assessment (as opposed to calling) but I agree that calling in – if you can, we cannot call Emergency Rooms easily here, it is ideal to call to prevent any possible spread 🙂

[Charlene Marshall]

I am like you Joe! I’m still going out and enjoying my time in the sun, fresh air etc but I am very mindful of activities in close quarters with others…. especially when it isn’t necessary. When it is, I take all precautions I can. Sadly, it is very close to the city I am in and we’re keeping a close eye on its spread. Stay well!

[Charlene Marshall]

Hi Terry,

Thanks for writing about this important topic. Sorry to hear your son is near the outbreak in Washington! My friend is too, and it is quite scary isn’t it? Certainly not enough so where people are bullying others though. I read that too, and my heart broke. I think the media is contributing to our fear(s) about the virus, it is important to be as proactive and vigilant as possible but unfortunately that is about all we can do. Hope your son stays healthy!
Char.

[Kyle Stiegert]

Some basics to help incude:

1. Try to stay a few feet from other people.

2. Would not buy prepared meals (away from home or delivery). Cook your own food.

3.Recognize this as not much different than risk of a respiratory based flu.

4. Ebike or drive. Steer clear of public transit including air travel.

5. Really steer clear of people in health care buildings. Wear a mask.

6. Wash hands. Sanitize.

7. Sanitize home.

8. Spouse or others in house must also be vigilant.

9. Play cards and games online, not face to face.

10.

11.

 

[Charlene Marshall]

Good suggestions Kyle – thanks for sharing! It sure is tough because a lot of people are not following the precautions necessary to prevent the spread, but most importantly: wash those hands often! I appreciate your suggestions, and I hope others find ideas within them as well. Charlene.

[Terry Moriarty]

This just really became real for me. The first California death was at a hospital in my city. I cancelled my mani/pedi tomorrow, but have my annual CT scan scheduled for Monday (at a different hospital). My RN daughter-in-law says to cancel it. Have a message into my pulmonary doctor for advice. It’s so hard to get appointments here. Finally, my son and family from Washington are coming for a vacation on Saturday. I feel surrounded. Sigh.

And the rumors are flying. A kid in middle school here told his class that his mother had it and had to stay home. Messages were sent to parents because this was in the same city where the deceased patient lived. Turns out the kid thought his false claim would make him popular.

I’m lucky I’m an introvert and don’t mind avoiding people.

[Sue Schofield]

From what I understand, corona virus is a lung flu as opposed to upper respiratory flu, making it more dangerous to people with PF. In addition to above suggestions, I am asking visitors to wash their hands thoroughly as soon as they come into my house –we touch something everywhere we go and most of us are not thinking about sanitizing every time we push a door open or hold a railing on stairs. I am probably over-reacting but better that than ignoring possibilities.

[Wendy Dirks]

These are all excellent suggestions. We have our first case in the city where I live and I am worried. I expected it, to be honest. Great Britain is a relatively small island when it comes down to it. I have a CT scan scheduled at the same hospital where the patients are being treated in a special unit. I saw my consultant a week ago and raised the subject with her as part of the discussion of whether I should start MMF yet. I told her I didn’t want to start it until there was a vaccine for this disease – I need my immune system working at optimum! May we all stay well through this and hope this too shall pass…

[Wendy Dirks]

One more thing – I have washed my hands until they are raw! I have a thick cream that is prescribed for my legs – I have post-thrombotic syndrome on one leg and require thick paraffin based cream and a support stocking. But I have only recently started oxygen and was told to be very careful about flammable substances on my hands – like paraffin – and wash my hands thoroughly after I apply the cream – which sort of defeats the purpose of putting it on my hands to begin with! I’ve tried slathering myself up when I go to bed as I am on ambulatory oxygen only. It has helped a little bit but by the time I go to bed again tonight after a day of obsessive hand washing, my hands will once again be red, raw and burning. Ugh.

[Charlene Marshall]

Hi Terry,

Thanks for writing to us, although I am really sorry to hear this… I know the feeling of it being “a little too close for comfort”. Someone was just confirmed with it here too, and our city is pretty small in comparison to some of the other populated areas. Continue to do everything you can to prevent the spread and wash those hands often. I think cancelling appointments is a good idea if it’ll make you feel better. Let us know what your pulmonologist says about it, I think it is important we are getting information from credible sources as headlines are flying around everywhere. Have a good visit with your son but make sure he isn’t symptomatic when he visits, as I know poor Washington state is being hit hard right now.

Charlene.

[Charlene Marshall]

I think these actions are wise Sue! We often touch surfaces and don’t even think about it, so hand washing is such an essential part of our day now. I’ve also heard that the virus is particularly bad for those of us with lung diseases. Keep safe and do whatever you need/want to in order to help alleviate the fear or risks of picking up the illness. Thanks for writing, I know this is a topic on many of our minds.
Char.

[Charlene Marshall]

Hi Wendy,

Sorry to hear it has landed in the hospital near you too. It did where I am today too, and feels a bit too close for comfort but like you, I somewhat expected it. Unfortunately, I don’t know if we’re going to be able to contain it for awhile yet. We all need to be doing our best to prevent contracting it through the suggestions mentioned above and like you said, washing our hands frequently and for a long enough time. Unfortunately this does result in dry, red and cracked hands which can be very sore. I usually get this during the winter months here in Canada from frequent washing and it is unpleasant I agree.

What did your consultant say about not attending the CT scan until there is a vaccination for this disease? I am really curious about physician responses to COVID-19, especially for those of us with lung diseases. This is important information to have because so many rumors and headlines are circulating around. Stay safe all!
Charlene.

[Wendy Dirks]

Hi, Char – Sorry I wasn’t very clear. I’m going to go ahead and get my CT scan and attend all my hospital appointments as I normally would until the Chief Medical Officer tells us differently. I told my consultant that I didn’t want to start on MMF (CellCept) until there was a vaccine and she simply concurred. I think further discussion will come after she sees the results of the scan.

I have to say that I was disappointed in how little she had to say about the corona virus but that was in early days and I’m trusting that the team in the chest clinic are discussing things now that we have community transmission in the UK. The number of cases is jumping every day.

[JillT]

Has anyone thought about wearing surgical gloves when you leave your own house? Would it be effective? It occurred to me that it might be helpful for people having skin reactions to all the hand washing. Also would have the advantage of being a constant reminder to keep your hands away from your face. Then discard the gloves before entering your own environment again.

Also, wearing cotton gloves over barrier type creams can be helpful for protecting broken skin and keeping the skin moisturized.

Personally I’ve never been convinced that all the hand washing outside of medical settings is all that effective, especially as it’s disruptive to your protective skin microbiome as you’re also killing off good/protective bacteria that help keep pathogenic bacteria in check. Ditto for antibacterial products in general. The hygiene hypothesis makes sense to me. Might be an unpopular opinion, but <knock on wood> it’s served me well thus far, along with keeping up with regular supplementation of Vitamin D3, K2, C and zinc. Can’t remember the last time I had an upper respiratory tract infection, long may it continue 🙂

[Charlene Marshall]

Hi @wendy-dirks ,

Oh sorry – that was totally my misunderstanding! When I went back to read your original post, you were clear but my interpretation of it wasn’t. I suppose that is what happens when it is text/writing we’re dealing with 🙂 Glad you’re able to continue with all of your scans and appointments, I know being in the hospital right now is very scary. Hope all clinics are taking precautions to avoid contracting the COVID-19 virus… stay well.
Char.

[Charlene Marshall]

Hi Jill,

Thanks for writing and bringing up this topic. I’d be curious to hear what other patients think about the use of gloves and COVID-19. I did wear gloves while flying home this past week, but I suppose being on a plane is a unique circumstance, and I wasn’t the only one. I am really bad at leaning my hands on my face to rest my head or itching my eyes when I’ve had my hands all over things, so the blue gloves really helped remind me to keep my hands away from my face, as you mentioned. I saw the benefit as two-fold, but I don’t know if others feel the same, especially when not confined to a space like a plane. Would love to hear others’ thoughts though…

May you continue to avoid any type of respiratory infections for a long time to come Jill, I agree! Thanks as always for writing 🙂

[Lorraine]

I am afraid that Social Distancing will become my reality, especially if a 3′ distance, in public places is recommended … hopefully COVID-19 will burn out.

I just wrote a text to my pulmonologist, asking for guidance, given I am 61, have ILD and a heart PT.

In addition to the above postings, when in public places, I use a tissue or paper towel to open doors, depress elevator buttons etc. I have considered buying/wearing latex gloves.

I am trying to remember not to touch my face without a tissue, and doing pretty good in that regard. I am trying to remember not to lick my finger to turn a page. Other tings. As we know behavioral modifications take time.

I am drinking more hot tea and warm water, and getting as much sun as I can, since COVID-19 does not like heat!

I am sharing the below forward …

In closing, remember what our friends across the pond say, “Keep Calm and Carry on.”

Best wishes ALL!

Fwd:

“From another group that I am in. It is kind of a long read but well worth it.

My classmate’s nephew, graduated with a master’s degree, and works in Shenzhen Hospital.  He is being transferred to study *Wuhan pneumonia virus.*  He just called me and told me to tell my friends: If you have a runny nose and sputum when you have a cold, you cannot be a new type of coronavirus pneumonia, because *coronavirus pneumonia is a dry cough without runny nose*. This is the simplest way to identify.  Please tell your friends that if you know more about medical knowledge, you will have more *awareness of identification and prevention.*

This time, the *Wuhan virus is not heat-resistant and will be killed at a temperature of 26-27 degrees*.

Therefore, *drink more hot water.* You can tell your friends and relatives to drink more hot water to prevent it. *Go under the  Sun*. It has been cold recently, and drinking hot water is also very comfortable. It is not a cure and is good for the body. *Drinking warm water is effective for all viruses*. Try not to drink ice, remember!

Doctor’s advice about coronavirus:

1. It is *pretty large in size* (cell is about 400-500nm diameter), so *any normal mask (not just the  N95 feature) should be able to filter it out*. However, when someone who’s infected sneezes in front of you, it will take a great 3 meters (about 10 feet) before it drops to the ground and is *no longer airborne*.

2. When the virus drops *on metal surface, it will live for at least 12 hours.*

So remember if you come in contact with any metal surface, *wash your hands with soap thoroughly.*

3. The virus can remain active *on fabric for 6-12 hours*.

Normal *laundry detergent should kill the virus*.

For winter clothing that does not require daily washing, you can *put it out under the sun to kill the virus.*

About the *symptoms of the pneumonia caused by Coronavirus*:

1. It will *first infect the throat, so the throat will have the dry sore throat feeling which will last for 3 to 4 days*

2. Then the virus will blend into the nasal fluid and drips into the trachea and *enter the lungs, causing pneumonia*. This process will *take 5 to 6 days*.

3. With pneumonia, comes *high fever and difficulty in breathing*. The *nasal congestion* is not like the normal kind. You will feel like you are drowning in water. It’s important to go *seek immediate medical attention* if you feel like this.

About *prevention*:

1. The most common way of getting infected is *by touching things in public*, so *you must wash your hands frequently*. The virus can only live on your hands for 5-10 mins, but a lot can happen in those 5-10 mins (you can rub your eyes or pick your nose unwittingly).

2. Aside from washing your hands frequently, *you can gargle with Betadine Sore Throat Gargle* to eliminate or minimize the germs *while they are still in your throat (before dripping down to your lungs).*

Folks, *take extra care and drink plenty of water.*”

[JillT]

There have been several twitter threads by apparent medical staff on the front line of the Italian outbreak that are frankly terrifying. The hospital system seems to be collapsing under the strain of cases. The “triage” based on available treatment options is not at all reassuring to those over 60 or with other comorbid conditions. One doctor referred to CT results on affected patients as uniformly “bilateral interstitial pneumonia”, a term that has very strong and frightening associations for those of us with IPF/UIP. The other worrying aspect is that even if one manages to survive the virus, there is possibility of long term lung damage as can occur with other respiratory viruses.

I plan on keeping myself as isolated as possible for as long as possible. Online grocery shopping sounds safer than going out to shop. I’m even wondering about my weekly pulmonary rehab as the sessions take place in a community health centre where a number of people of all ages congregate and present for appointments for all sorts of medical conditions. I’m beginning to think the risks probably outweigh the benefits for the foreseeable future.

These front line stories have been a real reality check for me and I’m starting to get very afraid whereas up till now I was taking a more fatalistic approach to it.