Sorry – this post has nothing to do with grief. I wear my doctor hat and put my mom hat aside with this topic.

Parents have asked me if they need to worry about coronavirus.

Let’s review what is going on:  A new coronavirus (2019-nCoV) started to cause infection in China, in the Hubei province. It is thought to have started in a food market and it was initially in an animal and infected a human. Since the infection was discovered, the Chinese government and now the WHO (World Health Organization) and CDC and other countries are actively working together to control the spread. The virus’ genomic sequence is known already and all countries and agencies are working together to test for the virus and share information on spread, control and care of patients with infection.

As of 2030 hours Jan 29, 170 deaths have been reported due to the virus. There are 71 cases in 15 other countries. Only 1% of cases have occurred outside of China and no deaths have occurred outside of China. The majority of cases are minor respiratory symptoms. 20% of cases are severe such as pneumonia, ARDS, and renal failure. 2% result in death.

It is an active outbreak and scientists are learning about this virus day by day, hour by hour. This is a fluid situation. Do not think this virus is going to overtake our world and we cannot stop it. The WHO is working diligently to control the spread. 

There is no specific treatment.  There is no vaccine. The virus is different than SARS – It takes approximately 2 weeks to show symptoms after exposure and during this time the virus can be transmitted. It is spread by close respiratory contact. It is by droplet (cough and sneeze) but could also be spread by fomite (the virus staying for a time on an object, then a person touches their eyes or mouth or nose and are exposed)

It is appropriate to be concerned. It is not time to panic.

So how do I answer the question a parent asks me– what can I do so I do not get this virus? How do I keep my family safe?

My suggestions:

• Avoid travel to China. Avoid as you can close contact to a person that has recently traveled to China.
• Keep up to date on news. It is changing every day. The knowledge of the virus is changing too. World, US and local news are all important. When we had a high numbers of measles cases in the US I wanted to know if any cases were in the Chicago area and I paid attention to where cases were in the US.
• Avoid the airport, train station, any areas where there is a great chance of exposure to people who are likely to be traveling internationally.
• Depending on the number of cases in the US we may have to avoid large groups of people in big cities
• Take care of your own health. Currently I don’t think we need to wear masks in the US but you can wash your hands often. Cover your coughs and sneezes. Get enough sleep and eat healthy.

Please understand – at this moment we have way more of a chance in the US of being exposed to influenza then this corona virus. We have seen a surge of influenza cases at our office. The last bullet point suggestion is most important to help prevent you getting the flu. Oh — and a flu shot – it is not too late!!!

 

Ahhh – the month of  January in pediatric medicine. Many people ask me “How do I stay healthy?” You can look at my dry red and painful hands and see I use hand cleanser, soap and water constantly. When you see 30-45 patients a day and clean before after and sometimes during the visit, your hands take a beating.

Do I take megadose Vit C? What else is my secret?

Twenty three years under my belt doing this – and unfortunately medical menopause is not kind in keeping my waistline from growing- but I have learned a few things.

I am under a lot of stress.

But I know I am not alone.

I have to say in the last years my stress load is considerably high. 

You see…. stress increases the chance of illness

In 1967, psychiatrists Thomas Holmes and Richard Rahe decided to study whether or not stress contributes to illness. They surveyed more than 5,000 medical patients and asked them to say whether they had experienced any of a series of 43 life events in the previous two years.

Each event called a Life Change Unit (LCU), had a different “weight” for stress. The more events the patient added up, the higher the score. The higher the score and the larger the weight of each event, the more likely the patient was to become ill.

Many people think a stressful event is always negative but as you see many are considered good events in our lives: vacation, child leaving for college, even retirement.

Note that the scale does not list death of a child. I would argue listing it as > 100 points and having it impact for more than the two years in scoring.  Let’s say… your lifetime.

I just did my assessment. I scored > 300. Congrats Dr. Gold!!! Proof of your assumption.

So what do I do to decrease my chance of illness? Can I decrease my stress?

Besides washing my hands and positioning my assessment of the 2 year old so the uncovered cough doesn’t hit my face – I do the following :

 

 

• Sleep- goal is 7 hours per night. 8 on weekends if I can
•  Eating healthy and hydrating- I drink 16oz of water before I leave the house. I try to get 64 per day but cannot always make that goal. We cook 90% of our dinners. I rarely eat out for lunch. Three meals is my goal. All of various size and plenty of veggies. A diet as mediterranean as I can do. Kale is my friend.
•  Exercise – wish I could get in more but running and spin and Tabata are my stress reducers
• Medical knowledge: I know my family tree and its medical history. I see my doc yearly, I do screening exams, I don’t smoke and I keep my alcohol consumption in moderation
•  Praying- taking care of my spiritual side. I pray every day. I read Daily Word and other writings. I say  “Let go, Let God”
• Talking with family and friends. I may not share all I feel to everyone, but I don’t hold things in.
• Fun time- I cook, write, read, and sing (in the car, usually 80’s alternative!) and occasionally do fun projects
• Cry time. I let it out. Let it go, right? Sometimes I cry so much I am tired from it.  But I don’t hold back. This is the time I don’t want to be around anyone.
• Loving my pets. When my day is too much, I get love from my cats. The best stress reducer is a cat who wants to play or curls up in your lap and does a megapurr session.

I want to say I stay free of illness but I can’t. Repeated exposure month after month and life events sometimes occurring too many and too often. (252 points alone for 4 aunts and uncles passing) make it a challenge to stay well in both mind and body.

I know illness is not just infection. Heart disease, cancer and dementia are all an increased risk due to stress.

I cannot change the past, I cannot predict the future. All I can do is live in the present and try to be as healthy as I can be.