How to Survive the Coronavirus (With Your Sanity Intact)

Hello readers —

We’ve got an important update for you about the coronavirus, and what you can do to prepare yourself. Please read to the bottom, or you can listen on our podcast of the original post right here. This post has been occasionally updated to address the broader situation, but will never reflect an update in daily numbers.

That’s not the point.

So let’s get to it:

The coronavirus started late 2019 in China. It’s thought to have an animal origin, probably bats, maybe by way of a goddamn ant-eater—

—you know what?

None of that really matters for you, as (despite our highly-qualified readership) you’re probably not on one of the teams trying to find a treatment or vaccine for it.

If you are, good luck!

For everyone else:

Your sole job is to operate with relative stoicism: educate yourself, prepare for what’s coming, and remain calm, with perspective.

Know that what happens now is inevitable. You can only choose how to respond to it.

So this piece is not intended to serve as breaking news. In fact, it’s the antitheses to that. We’re doing what we do best, providing context and direction, so you can take informed action, and let go of the rest.

We’ll tell you how it works, and the symptoms, so you don’t have to spend time imagining how it will feel or what you’ll do.

Though many will get ill, and some folks will die, for the vast majority of us — and specifically as far as we can tell with this virus — we nearly always suffer more in imagination than reality.

So at the end of this, you will know what’s coming, and you will know everything you can do about it — and everything you can’t. Our job as regular humans is to let go of the latter to focus on the former.

More than anything, please, please seek like never before to get your information and direction from reputable sources.

On that note, many thanks to our friends at the CDC and elsewhere who helped compile and verify this piece. Our words do not, of course, represent an official statement or assessment from them. We have included more first-hand sources down below.

So. Here’s what you need to know:

What is it?

“It” is a virus. In this case, it’s a virus that causes a respiratory disease. The virus is named SARS-CoV-2, but the disease it causes is called COVID-19. This naming mechanism is like HIV, and AIDS.

Quick question. What is a virus?

Viruses are actually microscopic parasites, and usually much smaller than even bacteria. For example, the polio virus is 10,000 times smaller than a grain of salt.

Important note: viruses lack the capacity to thrive and reproduce outside of a host body. In this case, that’s you.

Viruses try their hardest to survive. Which means, coronaviruses like this one, or the 4 that cause the common cold, probably evolved in humans to maximize their own spread.

They don’t try to kill as many people as possible, because people are their hosts, and then they die, too. So, instead, they try to make as many people sick as possible.

Which is what separates this virus from, say, the incredibly lethal H1N1 (“bird flu”).

Back to it. How contagious is it?

Calculating transmissibility requires considering the probably of infection, duration of infectiousness, and the number of direct contacts you’ve got.

On average, this baby seems to be more contagious than the flu. As far as we can tell, an infected person will probably transmit it to 2 additional people, versus 1.3 for the flu. But that will become more specific over time, and for what it’s worth, it appears one stays contagious for a few days longer with coronavirus than with the flu.

What are the symptoms?

So far, the majority show fever and a dry cough.

The rest, in order of presentation reporting: fatigue, shortness of breath, sore throat, headache, muscle or bone pains, chills, nausea or vomiting, possibly diarrhea.

Note: runny nose is on the list, but it's very far down the list. It’s not a leading indicator of COVID-19, so far.

Do antibiotics help?

Nope. Antibiotics do not work on viruses.

How is it transmitted?

By the transmission of very small droplets from infected individuals when they breathe or cough. And to a lesser extent, by you touching something that has the virus on it, and then touching your mouth, nose, or maybe even your eyes.

What’s the incubation time?

As far as we can tell, 2-14 days.

Can you be sick and not show any symptoms?

Yes, there are a fair number of asymptomatic cases so far. We don’t know how many, but it’s making diagnosis assessments complicated.

Is that good or bad?

It’s good and bad. Good because most people aren’t devastatingly sick, and bad because it makes it harder to get people to get diagnosed if they’re not actually feeling or looking sick, and so also more difficult to contain, as those people will continue living their every day lives, spreading it to their close contacts.

Is it deadly?

Yes. But it’s complicated.

What? Why?

The current fatality rate is about 2%. This is pretty damn deadly.

But let me note — this number is, so far, heavily complicated and skewed by a number of factors.

How?

First, because over 80% of known cases so far are very mild. Across China, about 14% of cases are severe, and 6% become critically ill.

The median time from initial symptoms to death for those folks is currently about 14 days.

So the fatality rate in Hubei (HooBAY) province, where it started, is between 2-4%, and for the rest of China, it’s just .7%.

This lower rate is partly because China locked down that province so heavily, preventing a wider domestic spread. More on that later.

So — because most of the cases are so mild, many people might think they have bad colds and — here’s the kicker — not get diagnosed.

And because they’re not getting diagnosed, the infected number remains artificially low, inflating the “fatalities per infected” percentage.

Maybe.

For example, Iran and Italy are showing extremely high fatality rates — even higher than China — but in all three cases, it’s expected that either the governments aren’t reporting the full data for whatever reason, or they just haven’t diagnosed everyone that has it, so, again, those numbers may very well be inflated.

Or they may be counting close to everyone, in which case that complication goes out the window.

But it goes deeper, and this part is important:

The virus seems to be affecting older people and those with previously or currently compromised immune systems far more heavily than younger and/or healthier people, often leading to pneumonia, organ failure, and possibly death among that group — driving up that segment (and the overall) fatality rate.

Next, China and Italy feature a full generation of older men that still smoke heavily. They are, in particular, suffering the greatest fatality rate. Correlation does not imply causation (yet), but anyways kids — don’t smoke.

Finally, but not comprehensively, it’s far easier — especially for countries without sound medical systems — to report deaths than the infected. One report is, shall we say, black and white, the other is not.

Venturing out into cities, or even villages, to diagnose every one of the possibly infected, when most symptoms are mild (or even not showing at all), is a herculean task for any developed country, much less one that is less so.

Counting the dead is much easier.

To be clear, for perspective, this thing is deadly. If the overall rate remains between 2-4%, that’s exceeds the Spanish Flu. If it, by chance, is closer to .7%, that’s still about seven times the fatality rate of the seasonal flu.

OK. Fun. How do I prevent getting it? How do I protect my family?

Global health organizations recommend measures similar to that for SARS, MERS, and the flu:

1. Stay home

2. Avoid travel and public activities

3. Wash your hands with soap and water (count to 20!)

4. Cough and sneeze into your elbow

5. Don’t touch your eyes, nose, or mouth

What are the symptoms again?

Fever, dry cough, and then fatigue, shortness of breath, sore throat, headache, muscle or bone pains, chills, nausea or vomiting, possibly diarrhea.

I’m feeling some of those symptoms. Where can I get diagnosed?

If you feel sick, the CDC would like you to call your doctor before going in and possibly infecting others.

Basically: stay home. Please.

Call, and then quarantine yourself for the good of others unless otherwise directed. There is no unique coronavirus, on-site or prescribed treatment or cure the doctor can give you, anyways, unless you are drastically ill.

Should you be asked to come in, in that case: you will most likely be tested in real time on a respiratory sample, and get results in a few hours to a few days.

Many countries and more rural areas in other countries do not yet have access to this testing infrastructure, so this might be contributing to the smaller infected rate.

Fun story: in the United States, we haven’t even rolled out CDC-sanctioned test kits everywhere here, yet.

They are, to date, very hard to come by, even in the biggest, fanciest hospitals, and when doctors do have them, they are complicated to use.

But these will get further distributed, and easier to use, and importantly, there’s nothing you can do to make either of those happen faster. You know what to do (nothing).

What about the children?

Great news here (so far): like SARS and MERS before it, children are faring remarkably well with COVID-19, and often showing no symptoms at all.

That’s not to say they’re immune, but by far the most resilient to the disease, or they’re somehow getting a more mild version.

Is there a specific treatment?

No. Current management includes treatment of symptoms. Most cases, because they are so mild, close in time.

The CDC recommends sick individuals, barring necessary medical care, to remain at home and wear a facemask, for the benefit of others. Quarantine yourself to a single room and single restroom, not to be shared with others.

So I should get a bunch of facemasks!

Updated:

Studies have shown that 40-70% of cases were transmitted from asymptomatic or pre-symptomatic infected people. Because of this, our recommendation has been updated:

Assume you’ve got the virus. If you have to go out in public, and you already have a mask, wear it, for the benefit of others.

However, because health care workers need masks the most, and we have a truly incredibly shortage of them already, the very last thing we need is more of our health care workers going down (see: Italy), so don’t go buying more until there are many more to buy. Just stay home.

Second, the virus can probably squeeze through standard surgical masks, and honestly, humans can’t resist touching their face in some way, anyways.

What about fancy masks?

Updated: N95 masks are useful. But we are short millions of them. If you have one, keep it. If you have more than one, donate it to a healthcare provider, immediately.

Know this: most people don’t wear these masks correctly, defeating the purpose, and even medical professionals admit that wearing them correctly for more than 30 minutes or so is stifling, so people...take them off.

Again: medical professionals desperately need millions more of them, so do the right thing.

What SHOULD I do to prepare, and stock up on?

At some point, it may feel, as we progress through this, like the walls are closing in. But you are reasonable, and you will know what’s coming, and you’ll be prepared for it.

So, besides reason and empathy, you should remembering there’s other people out there trying to do the same for their families — stock up on:

1. Any prescription medications you and your family are currently on (you’ll want to call your insurance, first, to see if that’s possible)

2. Adult and child pain medications

3. Adult cold, cough, and flu medications

4. Children’s cough medications

5. Benadryl

6. Immodium

7. Pepto

8. Dramamine

9. Pedialyte or other electrolyte replacement drinks

10. Dry foods

11. Ready-to-eat meals

12. Soups you can freeze

13. Board games

14. Card games

15. Books

Basically, you should gradually begin self-quarantine procedures whether you’re sick, or isolating yourself from people that are. Have a plan. Go over that plan, share it with your family and friends, start doing the plan.Run a company? Begin teleworking, now.

Work at a company? Ask what the telework plan is, and whether you can start now.

Have a family? Think about how you're going to handle your kids being home for weeks at a time.

Be ready, and then go about doing what you can do, and letting go of what you can’t.

You should also definitely consider:

1. Turning off alerts that send your cortisol levels through the roof day and night

2. Scheduling a limited time each day — preferably not right when you’ve woken up, and not before bed — to check the news, the live maps, to discuss what’s going on. And then leave it alone, knowing you’ve done all you can do.

3. Scheduling time for exercise outdoors, for meditation, reading, sex, etc.

Mental health is going to be a big part of us making it through this moment. We need you.

Is there a vaccine?

No. Otherwise we wouldn’t be in this place. We didn't exactly keep working on them after SARS, but that’s another story.

But — there are many good people worldwide working on one. To be clear, as of today, it’s estimated it’ll probably take another 12-18 months, at best, before a human trial were to begin. Science is hard.

But: it’s 2020, and we live in a fairly advanced technical society, we learned a lot from SARS and MERS, and this virus resembles those somewhat closely (they’re about 80% the same genetic code) — so we have a bit of a head start.

Have some perspective: most vaccines take two to five years to develop, at best. The process is half-science, half-alchemy. See, the flu shot.

But there’s nothing you can do to make it come faster, so let it go, and be in the moment.

Is there anything coming sooner that could make this not get real bad?

To be clear: there will not be a vaccine in time to prevent a pandemic in the US. That’s not just going to happen. So we need to live for that, and prepare for it, with perspective, and reputable, up to date information.

Also, and it’s 2020, so this isn’t a surprise: much of our pharmaceutical supply chain comes from China, and they’re a bit under the weather. So it’s not going to go very smoothly, regardless.

But — there’s quite a bit of work going on antivirals, with some already entering clinical trials, but to be clear: those will not prevent you from getting the disease.

And they’re not ready yet anyways, so — let go. Be in the moment. Operate from reality, and do what you can.

Fine. So what is the government doing?

To be sure: there are good people in the CDC and elsewhere — affiliated labs, biotech companies, pharmaceutical companies, and university labs — who are working day and night to build this virus from scratch, to analyze it, and to develop treatments and potential vaccines.

But as if it isn’t clear by now, we shouldn’t rely on the federal government’s primary decision makers to direct efforts with any...well...direction, or strategy.

They are late and they don’t believe in science. They have spent a half decade more or less gutting the CDC from the inside-out. And there really isn’t a person on earth less trustworthy or qualified to oversee this thing than Mike Pence, who doesn’t believe condoms work. So.

In time, we will discover that they may very well have completely maligned or hindered the roll-out of early testing across America. That’s not great.

BUT ANYWAYS. You can’t do anything about any of that, can you?

The best we can do to change the power structures is go vote, don't touch anything while you’re there, and then write these idiots off. It’s almost easier that way. Wishing it were different any earlier than January 2021 won’t help.

Be in the moment, do what you can, let go of everything else.

Won’t this go away with warm weather, like the flu?

We don’t really have any idea yet. It's making the rounds in Singapore pretty widely, and it’s in the 80’s there on the daily, so....we’ll see.

Don’t rely on it, you can’t control it, move on.

What can I expect, society wise?

If you’ve read to this place you understand that there’s very little we — as a society — can do, at the moment, to stop the spread of this virus. Except, of course, containment.

But the mostly agreed-upon bottom line, at this point, is: we haven’t been able to fully contain it, so you should stop hoping that’ll be the next alert you get from the NYT.

You will probably get COVID-19. Deep breath.

The virus is spreading in America the way it’s spreading elsewhere, and there’s little reason at this point to assume it won’t continue to do so. We are beginning to face significant disruptions to our daily life, most of which we’ve never dealt with before.

America has very clear laws that forbid much of what China did to quarantine and lock down millions upon millions of people, however late to the party they may have been.

China is now going door to door in some provinces, testing everyone, but otherwise (and virtually everywhere else we’re talking about “otherwise”) this is the thing with diseases that, at times, cause no symptoms: they’re impossible to contain.

But: our federal and state and local governments can, and will, pressure organizations, companies, schools, and the citizenry in general to cancel virtually any and all vehicles for the virus to spread.

These things are happening now, and they will absolutely shake our comfort levels, patience levels, and the definition of every-day life over the next weeks and months:

1. You should fully expect, and be prepared for, air travel, internationally, and domestically, to become scarce.

2. You should expect to be told to work from home, as offices are closed.

3. You should expect schools and daycares to be closed for weeks, if not months.

4. You should expect a further and considerable market crash.

5. You should expect sporting events and concerts and conferences to be postponed, if not cancelled entirely. You should not go to those, regardless.

6. For example, and I know this sounds farcical, but I would not be surprised to see a remainder of the NBA season and at least the beginning of the Major League Baseball seasons to be cancelled, same with the Premiere League, for Euro 2020 soccer to be cancelled, the Olympics to be postponed or cancelled, and more.

Have no doubt, this is all going to be incredibly stressful stuff.

The best we can do as individuals is take the measures we can for ourselves and our families, to operate with empathy in considering the bigger picture and society as a whole, and be in the moment.

If you have health insurance, and can take time off of work, consider yourself one of the lucky ones.

The virus, as of so far, is so mild for many, that it’s like we are under going a worldwide stress test for something much more deadly down the line.

That’s not to say people won’t die, because a small percentage already have and even more will, especially if this thing is allowed to scale as much as it’s seemingly capable of. A very small percentage of everyone on Earth — or even in the US — is a very large number. It brings me no joy to report this.

Control what you can control. Be a leader, for your children, and your communities.

Here’s the good news.

All of these modern day societal things will rebound — the market will come back, in time, games will be played, schools will open again (thank christ), and further, and most importantly, because the interruptions to these things, and our lives, will be so unique, impactful, and far-reaching, we can only become far better prepared than we currently are.

I wish you well, and as always, thank you for reading, and thank you for giving a shit.

— Quinn