Some of the views expressed here are controversial. Please consult with your family doctor before following the advice provided below.

In these uncertain times, it is common to feel a little lost and unsure of our choice. Dr. Jane M. Orient has compiled a list of “do’s” and “don’ts” concerning the Coronavirus. Let’s begin with the “don’ts”:

Don’t panic. That is always good advice. If you, like the world’s economy, operate on just-in-time inventories and did not take advice to stock up 3 weeks ago, do not join a mob at a big-box store. Somebody there is no doubt infected. Plus, there’s the risk of getting trampled or injured in a fistfight over the last roll of toilet paper. Most of the world survives without that luxury good. If you have no rice or beans or pasta in the pantry, that is more serious, but you should still avoid mobs if at all possible. Take-out and drive-through places are booming.

Don’t treat a fever without a doctor’s advice. Fever is not a disease. It is an important defence mechanism. Very high fevers (say 105 degrees) can cause brain damage, and children can have seizures. But don’t pop Tylenol or ibuprofen at the first sign of fever. Many of the casualties in the 1918 pandemic might have been caused by the heavy use of aspirin. Like aspirin, popular nonsteroidal anti-inflammatories (NSAIDS) such ibuprofen also have detrimental effects on blood clotting. Try lukewarm sponge baths for comfort.

Don’t rush out and get a flu shot. I know, a lot of doctors and public health authorities urge everybody to do this. Influenza can kill you, and the flu shot decreases that risk by 30% to 60%—but there is evidence that it can make COVID-19 worse, both from the earlier SARS epidemic and lab research. Like with so many things in medicine, we have to play the odds.

Don’t waste. Expired medications are probably still good. Most drugs or essential ingredients are made in China, and supplies are running out. Masks (also mostly made in China) are meant to be disposable, but likely can’t be replaced (see below).

Don’t touch your face or your eyes. That is very hard—preventing that is one function of a mask and eye protection.

Don’t fall for internet scams, or malware. Scammers will always be around to try to profit from panics. A new type of malicious virus is embedded malware in sites that come up on a search for information. (If you want to find the Johns Hopkins University dashboard of cases and deaths, go to the university’s website, don’t Google “coronavirus map.”)

Now for some dos:

Do prepare to take care of yourself and your family. Be sure you have a fever thermometer, disposable gloves, plastic garbage bags, and cleaning supplies. A pulse oximeter, available in many places for around $40, is good to have to check oxygen levels.

Do clean and disinfect surfaces such as doorknobs, telephones, computer keyboards, toilets, and countertops often. Virus can persist there for days.

Do remember that sunlight is the best disinfectant. If you don’t have a pocket ultraviolet lamp, try putting things like masks or paper currency out in the sun. The idea should be rigorously tested, but in times of need, you may have to guess.

Do wash your hands often and use hand sanitizer. With SARS-CoV-2, most disinfectants work, including 70-percent-alcohol-based sanitizers.

Do put a mask on sick people if you can. For protecting yourself you need a minimum of an N95 mask and eye protection.

Do take your vitamins. Most people may be vitamin D deficient. Your need for vitamin C escalates with infection. Some 50 tons of vitamin C was shipped to Wuhan, and studies of effectiveness are underway.

Do get your essential prescriptions refilled for 90 days—the supply chain depends on China. If your managed-care plan won’t pay, consider paying cash. You may be able to get a good price with a coupon from goodrx.com.

Do protect your immune system, with adequate sleep, exercise, fresh air, and diet, especially avoiding sugar if you feel ill.

Do help your neighbours, and be responsible about protecting others as well as yourself from contagion.

 

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ane M. Orient, M.D. obtained her undergraduate degrees in chemistry and mathematics from the University of Arizona in Tucson, and her M.D. from Columbia University College of Physicians and Surgeons in 1974. She completed an internal medicine residency at Parkland Memorial Hospital and University of Arizona Affiliated Hospitals and then became an Instructor at the University of Arizona College of Medicine and a staff physician at the Tucson Veterans Administration Hospital. She has been in solo private practice since 1981 and has served as Executive Director of the Association of American Physicians and Surgeons (AAPS) since 1989. She is currently president of Doctors for Disaster Preparedness. She is the author of YOUR Doctor Is Not In: Healthy Skepticism about National Healthcare, and the second through fifth editions of Sapira's Art and Science of Bedside Diagnosis published by Wolters Kluwer. She authored books for schoolchildren, Professor Klugimkopf’s Old-Fashioned English Grammar and Professor Klugimkopf’s Spelling Method, published by Robinson Books, and co-authored two novels published as Kindle books, Neomorts and Moonshine. More than 100 of her papers have been published in the scientific and popular literature on a variety of subjects including risk assessment, natural and technological hazards and nonhazards, and medical economics and ethics. She is the editor of AAPS News, the Doctors for Disaster Preparedness Newsletter, and Civil Defense Perspectives, and is the managing editor of the Journal of American Physicians and Surgeons.

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