By Russ Herring, DNP, FNP-BC, CSCS
Novel coronavirus 19, aka COVID-19 has already become a topic of intense media scrutiny, perhaps with some justification. One of my frustrations as a clinician, is the extent of sensationalist, trash news through which the average Joe on the street has to wade through. Please reference my previous blog on vaping versus cigarettes for an elaboration of this idea. The news media has a way of grasping onto a topic and wringing every last ounce of drama from the subject, and gone are the days of the calm, measured approach of the subject matter expert.
Thus, patients arrive with a diversity of questions. Some from left field and a little unusual, which is ok – we’re here to clear the air.
The common cold is caused, most generally, by rhinovirus, and yes, coronavirus (Rosenstein, et al., 1998). One of the first teaching points is that there are many coronaviruses. It is a family of similar viruses, like Pomeranian is a type of dog. There are many kinds of dogs, but they are still dogs. There are many coronaviruses, COVID-19 just happens to be the Cujo of the bunch.
Coronavirus is not the flu. COVID-19 has symptoms similar to influenza – fever, cough and shortness of breath (cdc.gov/coronavirus) but it is a different organism. The seasonal influenza vaccination provides no protection against coronavirus, but does offer ~45% protection against the circulating influenza viruses this year (Soucheray, 2020). A teaching point I use with my patients about the seasonal influenza vaccination is that it teaches your immune system the difference between dog and carrot, at a minimum. If the vaccine is not for the specific type of flu to which you are exposed, your immune system may not know the difference between Rottweiler and Labrador, but it at least has the head start of discerning between carrot and dog. If you’ve had the influenza vaccination for many years running, I tell my patients that their immune system will know the difference between Rottweiler, Labrador, Pomeranian, Poodle, and carrot. Your coverage improves as you continue to receive successive vaccinations, at least a little bit.
I have to observe that coronavirus is going to complicate initial diagnosis of causative agent, due to the similarities of the two infections. Currently, a local patient with cough and fever is likely to have influenza. That is about to become a more complicated issue, and soon. I’ve already had a friend from the Seattle area reach out with questions and, as my wife was telling our boys last night, there’s only a little piece of Idaho between us and Washington.
Now, to my short list of suggestions and recommendations.
First, get your flu shot. Make a responsible choice for yourself and your children. You complicate your own treatment if you’re equally likely to have influenza and coronavirus.
Wash your hands. I cannot guess how many times I wash my hands each day. I wash them at least twice with each patient. I wash them when I go to the bathroom. I wash them when I leave the gym. I wash them whenever I’ve touched a shared community item like a gas pump. I wash them. All. The. Time. Just wash your hands frequently, please.
If you have a cough with fever, don’t share it. Cough into your elbow. Stay home until the fever has been gone for a day without antipyretics (Tylenol/ibuprofen).
If you feel you need to be seen at the clinic, please request a mask at the desk and do not remove it until you are asked to do so. Masks need to cover both the mouth and the nose, and they need to remain on. Often, I’ll enter exam rooms to find patients with a mask only covering their mouth, or already removed entirely. It isn’t personal, but I can’t do my job if you cough in my face and I’m the next one to fall ill. Please and thank you.
Finally, if your particular reason for visiting the clinic is not immediate, you may choose not to. Sitting in a waiting room next to folks with potentially dangerous infections is not the right time to get your ears cleaned or to address that chronic, nagging complaint. Consider waiting until there is less scary stuff in the air and in our waiting rooms.
If you have questions, call your provider. Find out whether you need to be seen, and what precautions need to be taken if you are. We want to help you, but sometimes the best way to help is by telling you to wait for another day.
Finally, watch the news, yes – but please check out reputable online sources such as the Centers for Disease Control (cdc.gov) or the World Health Organization (who.int).
Stay safe and stay healthy.
About Russell Herring, DNP, FNP-BC, CSCS
Russell R. Herring, DNP, joined the Great Falls Clinic in 2018 and is among the newer healthcare providers in the State of Montana. He works alongside Drs. David Engbrecht and Dr. Carey Welsh in Family Medicine at the Great Falls Clinic Northwest location. Russell specializes in diagnostic, preventive, and therapeutic healthcare and treatment plans for acute and chronic illness, and in education and guidance of patients regarding disease prevention and health promotion. He is currently accepting new patients at the Northwest Clinic, 1600 Division Road, Great Falls. For more information or to schedule an appointment, please call 406-268-1600.
Nancy Rosenstein, William R. Phillips, Michael A. Gerber, S. Michael Marcy, Benjamin Schwartz and Scott F. Dowell
Pediatrics January 1998, 101 (Supplement 1) 181-184. Retrieved March 3, 2020 from: https://pediatrics.aappublications.org/content/101/Supplement_1/181
Soucheray, S. At midseason, flu vaccine yields 45% protection in US, 58% in Canada. Retrieved March 3, 2020 from: http://www.cidrap.umn.edu/news-perspective/2020/02/midseason-flu-vaccine-yields-45-protection-us-58-canada