Coronavirus

Today the government has imposed restrictions, including restriction of travel from one province to another. Not sure exactly how that will work, eg as Manilva is on the edge of Malaga Province, whether we shall be allowed to travel, for example, to Sotogrande which is in Cadiz Province or even to Gibraltar. Might be best if you fly into Malaga rather than Gibraltar, that is if your flight is flying. Citizens must stay at home, other than going to work or to buy food. All shops, bars, cafes and restaurants to be closed from Monday other than food shops and pharmacies. No visits to family or friends. If you get here there's no guarantee you will be able to return when you want so perhaps best to stay at home.

This is a very long  post but worth the read from a doctor in the US:

REMEMBER THAT REGULAR EXERCISE IS GOOD FOR YOU!! Make sure you keep moving.

A thought that might ease your concern...a little note from a doctor's facebook post....

This is worth the read thanks to Dr Eric M DeYoung. ‎Marc Serota, MD immunologist, posted this on facebook. I think it is the clearest statement regarding Coronavirus I have seen.

From an MD immunologist:

I don't post a lot on facebook but I would like to give my perspective and context on the coronavirus outbreak. I hope I can be a more reputable source of perspective as a physician who specializes and is board certified in immunology (as well as pediatrics, allergy and dermatology).

1. Coronaviruses are a family of viruses. "coronavirus" is not unique to this particular strain. Everyone reading this has likely had another different coronavirus infection. This particular strain has been named COVID-19.

2. Every upper respiratory virus has the potential to be lethal. Patients unfortunately die from many upper respiratory viral infections every year - most prominently the influenza virus. 30,000 people died from the influenza virus in 2019. The media didn't report each one. They have reported all 11 coronavirus deaths. Not telling us about the people lost but rather keeping a death "toll".

Let me repeat that:

-Coronavirus: 11 deaths (US in 2020), 3300 deaths (China in 2020).

-Influenza: 30,000 deaths (US in 2019).

*Influenza "pandemic" of 1918: 675,000! (US), 20-50 MILLION!! (worldwide)

This is not meant to minimize any of these deaths but rather to give context and put some facts to the hysteria.

3. If you're healthy, there is no need to walk around wearing a mask. In addition to looking silly and most of the time wearing/taking them off wrong - which would actually make you more prone to acquiring an infection, they don't prevent you from getting sick. If you're actually sick stay away from people and then, sure, wear a mask so you aren't spreading respiratory droplets every time you cough/sneeze. In medicine we don't wear the masks you're buying and we wear other protective equipment - not just a silly looking mask you found on Amazon. When you see doctor's walking around the world wearing a mask then you should too. Until then, stop.

4. The symptoms are that of the flu. As doctors we don't test or know about most people with mild or moderate flu symptoms. That means most people will probably get it and just think they had the flu. That means you're only going to hear about the cases that get serious - not all the minor ones which will be the vast majority of cases.

5. When it is said that people who are older or have other medical conditions are most likely to die - that is equally true for EVERY upper respiratory virus. There is nothing unique about that to this particular virus. It does mean that the only cases we tend to know about are the severe ones. Once a case is severe it then makes sense to test the patient to find out what virus in particular they have. That means you can easily overestimate how severe or lethal the virus is because the only cases you end up knowing about are the serious ones.

In summary 30,000 people died from the flu last year. Another 30,000 died in car accidents.

I remember: H1N1 (2009), MERS (2012), Ebola (2014), Coronavirus (2020).

Take it from me: The poor resident who stood at the door of the ER to triage people in 2009's swine flu (H1N1) hysteria. The over reaction is exponentially worse than the actual problem and in 2020 the over reactions I'm seeing are remarkable.

In cold and flu season you'll probably get sick once or twice for about a week each. You might even get this particular coronavirus and most of you won't even know it. I've seen people raiding supermarkets, major meetings and sporting events getting cancelled and fear/racism towards Asian people. These reactions are totally unnecessary and panic based. Just do what you've always done during cold/flu season.

Stay away from other people when you're sick, wash your hands and keep them away from your face, and only go to the ER if you feel your symptoms are more severe than a bad cold/flu (shortness of breath, high fever, etc.). And also realize you can't live on earth and not get viral illnesses from time to time. It's a part of nature.

Please don't ask for antibiotics (those treat bacteria - not viruses). Thats like asking for a fire extinguisher when you're drowning. It can be a life saving device - but the wrong one for the problem at hand. Some doctors don't want to fight about it when patients insist on antibiotics so they just prescribe them - but it doesn't mean its actually helping you and in some cases they can be harmful (resistance, infections, allergic reactions just to name a few). If you're one who asks for antibiotics every time you're sick, again, take it from me: ask for a... doctor's note to stay home from work when you're sick instead. You will be much better off.

The government is very proud that testing will be available to every American.

Remember, we don't test for any respiratory virus other than the influenza virus routinely. The reason is that's the only virus that has a treatment (pill) you can take to shorten the duration of severity of the illness. I suspect if we start testing everyone with cold symptoms for coronavirus we're going to find lots of it. It's not going to change the recommendations to stay home and rest. And its not going to predict the small percentage of people who may develop more severe symptoms.

Essentially whether someone has coronavirus 19 or some other cold/flu virus isn't going to matter to your doctor. What it will do is slam urgent cares, ER's and hospitals with every patient who has a cold so they can be tested. It is much more sensible to reserve testing for patients requiring hospitalization or more advanced treatments. Even that wouldn't change their management but would be more to confirm the diagnosis and to not waste time looking for other causes of the patients symptoms.

In conclusion, yes there is a novel virus that our immune systems haven't seen yet so to get immune to it you will have to get infected - at least until a vaccine is developed to bypass the getting sick part and just jumping straight to immune. Most people's immune systems will do that effectively and be fine. A small percentage of unfortunate patients (primarily elderly, immune compromised etc.) will not be able to do that effectively and will need more advanced care. This is true of the cold/flu viruses we deal with every year. Follow normal cold/flu precautions and seek medical care if you feel your symptoms are severe. No need to get hysterical.

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If you still think you should be scared consider this: Doctors, nurses and other healthcare staff are going to hospitals every day. Crowded buildings with tons of sick people. They aren't walking around the halls of the hospitals wearing masks and they haven't stopped going to work. And they are all rolling their eyes at everyone else right now.

Marc Serota, MD