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An informational column about COVID-19
dr. bob/silas bernardoni

Whether you have been identified as one of the people who are at higher risk for severe complications or death from COVID-19 or you have a loved one or friend who is, you are probably frightened and confused amid the myriad of information and misinformation that you read and hear. As we enter another week of the state’s safer-at-home order, I’ve been thinking about the amount of effort that my family and I have been putting into researching the novel coronavirus and the resulting respiratory condition COVID 19, because of health issues in our family.  Everyday science learns something new about what we’re all facing, and it’s exhausting to attempt to stay informed, so we can make good decisions about protecting ourselves.  Lafayette County can seem like a world away from big cities, but as of this week we now have our first confirmed case of COVID 19. 

     Over the course of the next few weeks and months, the situation in our country and right here in our community, will change.  We would like to use this column as a vehicle to educate the community on feasible and medically accepted ways you can protect yourself and your loved ones from this global pandemic.  We will do our best to cover the basics about what we are facing, how to manage your exposure, and how helping yourself will help the community as a whole.

     Last week, Memorial Hospital of Lafayette County’s Incident Command Team contacted me to see if I would assist the hospital if/when a surge of COVID 19 patients arrive at the hospital.  As a retired physician, with 30 years of serving this community, I decided that I had to decline.  Getting old is hard on everyone’s health, and I am no exception.  My pre-existing health issues make me highly vulnerable to COVID 19 and I decided that I should not expose myself or my family to the virus directly. After further discussion, I’ve agreed to help the hospital by sharing our research on the coronavirus and COVID 19, in an effort to help all of us better prepare for what has now entered our community, and threatens our well-being.

     Over the past few weeks, my son Silas and I have been sharing the frustration we have in our inability to serve the community in person.  Like many others, both he and his wife are working from home and need childcare support for their two young children.  Charlotte and I agreed to provide childcare and homeschooling at our farm on the condition that their entire family follow the same strict quarantine guidelines we have adopted to protect ourselves from the coronavirus.  The problem for Silas is that he is unable to respond to fire and rescue calls.  He has been a member of the Darlington Fire Department, serves on the Southwest Wisconsin Regional Technical Rescue Team as well as a Hazardous Materials Technician in the cooperative effort between Jo Davies County, Grant Count, and Lafayette County.

     The start of this column occurred 3 weeks ago when we were discussing what levels of protection we should agree to as a family.  I told the family how I had recently gone to Menards and how mentally draining it was to maintain a “sterile field”.  As a retired physician and surgeon, I tried to apply my surgical training, but in retrospect it was never going to work because you cannot control a retail store like an operating room.  Silas proceeded to tell the family about what his hazardous materials training had taught him about hazard control zones and he proceeded to provide an impromptu training.  We decided to make it a team effort to put together safety plans for controlling our exposure to the virus for each of our homes.  Silas went to work to provide the hazard control structure, and our medical professionals in the family provided the decontamination processes.  This effort soon caught the attention of our family and friends and Silas developed guidelines with his fellow hazmat technicians in the fire department that they shared on the DFD Facebook page. Comments came in about how we could best share the content more widely and that sparked the idea for this column.

     Our hope is that this column provides some insight into what we are facing and might provide ways for you and your family to channel some of your nervous energy and help minimize the impact this unforgiving virus will have on our community.

Let’s start with some basics:

What is coronavirus compared to COVID 19? Coronavirus is a virus that can cause a respiratory condition called COVID 19.

Why do people say “novel coronavirus”? Coronavirus is a “novel virus” because it appeared only 4 months ago.  The world’s scientists and medical professionals have only had a few months to learn how to treat and prevent its spread.  Humanity has learned a lot from previous virus outbreaks such as Ebola, SARS, and MERS, but every virus is different so we have to learn and adapt as fast as we can to best control it’s spread and treat those that become infected.

Why is coronavirus so hard to track and isolate?  When people are first infected, they start to spread the virus before they start to show symptoms.  Research is just coming out that says that some people might be carrying the virus without ever showing symptoms. People that spread the virus without showing symptoms are called asymptomatic carriers.  The onset of symptoms can start between 2 and 10 days after the person first comes into contact with the virus. 

Does this only affect the elderly?  No, this is unequivocally not true.  People of all ages can become gravely ill, often requiring being admitted to a hospital. It seems that older and people with underlying health problems tend to have a higher mortality rate, meaning that they are more likely to die.  Researchers do not understand why otherwise healthy people can quickly die from COVID 19.  In some cases, undiagnosed conditions may be found to have caused it.  Other research seems to think that the amount of viruses one comes into contact may have an impact.  Still others feel that something in an individual’s genetics may make them more susceptible to complications from the virus.  We will not know until this is all over and researchers have had time to collect information and study what’s going on.

If you are young and healthy, you still need to take precautions.  Even if you are not worried about yourself, you should be concerned about spreading it to your family and friends.  The more we can limit the spread of the virus, the fewer people will ultimately die from it.

What medical conditions seem to have the worst outcome? The top underlying medical conditions seem to be people over the age of 60, male, high blood pressure, diabetes, obesity and people who have a history of cancer, cardiovascular disease, or respiratory issues including smoking.  If you or someone you care about has one or more of these, they should be extra vigilant as to how to minimize exposure.

What does “flatten the curve” mean?  The main objective of social distancing and the statewide safer-in-place order is to limit the spread of the disease to prevent the hospital system from becoming overwhelmed.  There are a limited number of hospital beds available and if everyone gets sick at once, we will all need them at once. 

Will this impact rural areas like Lafayette County?  Living in a rural area is both an advantage and a disadvantage when it comes to coronavirus and COVID 19.  The impacts on our community will be delayed compared to the bigger cities, but unfortunately it can hit us even harder than what we are seeing in New York.  We have the advantage that there are less people living in rural areas and our everyday lifestyle usually results in less human contact than if we were riding the subway or bus in a city. The downside is that we have fewer medical resources per resident compared to that of a bigger city.  In normal operation, if the hospital has a patient that is severely sick or injured, they are transferred to a bigger hospital, such as UW-Madison.  The problem is that all of the small hospitals are in the same situation.  Once the big hospitals reach their capacity, they won’t be able to take patients from anywhere else.

How can I protect myself and my family? The best way to protect yourself and your family is to limit contact with other people.  This can seem simple but we all need to eat and the spring weather will soon start calling us outside.  You can make small changes in your behaviors like staying in to watch a movie, only having one person go grocery shopping, or letting packages sit in your garage for a few days before opening them.  Over the course of this series, we will discuss ways to better protect yourself and your friends and loved ones in our community.