Dr. David Price: Straightforward Rules to Protect Yourself from Covid-19
This video from March 22, 2020, featuring Dr. David Price of Weill Cornell Medical Center in a call to friends and family, provides straightforward advice directly from a doctor who is treating the disease on the frontline. Says Price, “We’re 3 months into this in the medical world, and we understand this disease.”
While nuanced findings have emerged since this talk, the video is worth watching because the practical guidance still holds. Here is a summary of the important points.
Keep your Hands Clean, and Don’t Touch Your Face:
Covid-19 is primarily transmitted by touching someone or surfaces that are infected and then touching your face (eyes, nose, mouth). So, Price’s main message is to make a habit of washing your hands, be aware of what you are touching, and use hand sanitizer if you touch objects outside the home.
Extended close contact is key to catching the disease. While transmission via airborne droplets is possible, the current thinking is that you need to be in a room with someone for a longer period of time, 15-30 minutes, without protection, to contract the disease. Price notes that throughout the world, spread of the disease happens mainly through home and family.
Masks Keep You from Touching Your Face:
The main reason for wearing a mask is to discourage you from touching your face, so a medical-grade mask is not necessary. In the hospital, Price and his colleagues typically wear a regular surgical mask when interacting with patients and use an N95 mask only when doing something that might cause the patient to spit (an “aerosolizing procedure”).
In fact, he cites that healthcare providers in Hong Kong and Singapore who followed this procedure incurred zero cases of the disease. The healthcare providers who became ill are those who did not know to follow proper precautions, many who, at the onset of the disease spread spent extended periods of time with patients unprotected.
Limit Your Interactions:
In public, keep a safe 3 to 6 feet away. Limit your regular contacts to a small group of people you isolate with. If you keep your hands clean and don’t touch your face, visiting the store is not a problem.
If a Family Member is Sick:
If a family member contracts the disease, the advice is the same: avoid sustained contact. Ideally, the sick family member would have their own room and bathroom, wear a mask when coming out, venture out for meals, clean the table area afterwards and go back into their room. Others should be safe with these precautions.
An exception: extra precautions should be taken if a family member is particularly vulnerable, in which separate living arrangements may be necessary.
Go to the Hospital Only if You are Short of Breath:
Shortness of breath is main sign to go to the hospital. In other cases, call or use telemedicine, and wait the disease out at home. In fact, many patients who come to Weill Cornell are sent home. Those short of breath might stay at the hospital for a week before going home.
The number of people who need to be put on a ventilator is remarkably low. Of those who contract the disease, only 10% need to go to the hospital. Of those 10%, only 1 to 3% need to be put on a ventilator. And most people come off the ventilator after about a week and half.
While many patients who come to the hospital are frightened, Price reassures that for a doctor, treating the disease is very predictable because the patients’ symptoms are all similar.
Highlights from the Audience Questions:
If you can’t tell whether you have Covid-19 or a regular cold, take precautions for about 2 days. If you are feel better, you don’t have Covid.
Whether to get tested right now depends on the availability of testing in your community. In a community with widespread testing, it makes sense to get tested. In a community with testing shortages, it is better to reserve tests for those who are short of breath, particular if testing would not impact your behavior.
Infants and children younger than 14 don’t seem to get the disease, but otherwise, the disease affects everyone else. It’s not clear whether children can carry it.
Transmission is primarily through droplets (vs. airborne), meaning that they land on surfaces and are then transmitted from hand to face.
If you go out for a run, wear a mask, even just a bandana—mainly to remind you not to touch your face—stay 3 to 6 feet away from others, and use hand sanitizer.
The incubation period is about 14 days. After contact with someone sick, if you don’t develop symptoms, you probably won’t get the disease.
Symptoms include aches, sore throat, cough and fever. If you have a fever use Acetaminophen or Tylenol rather than Ibuprofen.
It’s likely that people are spreading the disease a day or two before developing symptoms.
Patients are definitely developing immunity. Those who seem to have relapses likely have not fully resolved the infection.
Quickly working towards developing herd immunity doesn’t make sense at this point because this strategy will overwhelm the healthcare system. The strategy right now should be to “flatten the curve.”