Courtesy Dr. Ming Wang, M.D., PhD (laser physics)
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I am a practicing ophthalmologist in Nashville taking care of patients with eye diseases, including infections. The following information is from my colleagues from around the world and from medical literature, as recommended by experts.
What is the situation worldwide, and where are we as a nation?
Regarding time, we are behind China by 4 to 6 weeks, behind Italy by 2 to 3 weeks. China is getting out of it, Italy is peaking, so the U.S. should peak in mid-April.
Why is this virus so deadly?
Most viruses are either very infectious, but not as deadly, or very deadly, but not as infectious. This coronavirus is both very, very infectious and also quite deadly.
Why has this virus killed so many young and healthy people with no immune deficiency or underlying medical problem at all?
This has to do with the initial viral load at the time of initial infection. A 30-year-old, completely healthy doctor can die from COVID-19 if he has initially inhaled a large amount of virus.
If you have been infected with only a small amount of the virus (single, and remote exposure, for example), then, since viruses do take some time to replicate, your healthy immune system thus does have the sufficient amount of time to ramp up its activity gradually, and generate enough antibodies to kill the virus.
However, if you have been infected with a large amount of virus (repeated exposure or close encounters, such as in many healthcare workers) to begin with, then the virus starts its replication from a very big initial base number, and they can hence quickly overwhelm your system. In this case your healthy, active immune system then has no choice but to sound the alarm to the highest level to try to, ASAP, kick up the immune reaction into the highest gear possible, from the get-go, in a very short period of time, to try to catch up with the huge viral load that has come on so quickly and suddenly. Such a huge immune overreaction (cytokine storm) itself is often the main reason why these young and healthy COVID-19 patients die.
What are the two means of transmission of this coronavirus?
Though surfaces: this coronavirus travels with regular bacteria, so on any surface which is not clean and has bacteria, this virus can be there. So, that means all surfaces!
Suspended in the air: this coronavirus has the unique ability to suspend itself in aerosols. It can stay in the air for eight hours. So, that means if you walk into a space that in the previous eight hours was walked in by someone who is infected, the viral particles could still be in the air and you can still breathe it in and get infected.
What are the eye conditions associated with this coronavirus?
Pink eye, conjunctivitis. Pink eyes are associated with an upper respiratory viral infection, and this coronavirus attacks our respiratory system. One percent of the coronavirus patients have been found to have the virus in their tears.
What should I do if I have viral conjunctivitis?
Make sure that you do not touch your eyes, they are very infectious. It can go to the other eye or infect others. Generally, the viral conjunctivitis is self-limiting and they resolve in 1 to 2 weeks and no eye drops are needed.
What country has done the best? Why?
South Korea. They have by far the lowest number of infections and the lowest number of deaths among the first wave of countries infected.
Because:
– Social distancing, staying home, quarantining, wearing masks.
– Testing, testing, testing! South Korea tested nearly everyone. If you don’t test, you have no idea where the enemy is.
– Digital contact tracing, using the cellphone of the infected, of all people who have been in contact with that infected person in the past two weeks, and quarantining all of these specific people.
What country has done the worst, in terms of percentage of the population infected and the total number of deaths? Why?
Italy! For a small country of only 60 million people, they have the highest percentage of the population infected and the total number of deaths.
In the early weeks of the infection in Italy we saw:
– Delay in and insufficient testing (we had, and still have, the same problem here).
– No consensus and order from the government to stay home.
– People were not social distancing, restaurants were still open and public transits were still running.
– People did not wear masks early on.
What is the benefit of staying at home?
Keeping our hospitals from crashing (if too many infected come in too quickly).
Keeping the total number infected and total death low (which many Asian countries have successfully done through staying-home orders).
How can I keep myself from being infected?
Cellphones: wipe often with an alcohol pad wipe, since you are constantly touching the cellphone.
Gas-pump handles: use a paper towel or tissue when grabbing the handle and avoid direct contact with the handle. Push the buttons using the paper towel or tissue. Discard the paper towel or tissue before you go back into your car.
Hot water: the virus can be inactivated in high temperatures, higher than 77 degrees F. Drink hot water. Wash your hands with soap and hot water.
Sunbathing.
What is the most important thing for me to do now?
Stay home. When you go out, wear masks.
People in the US must start adopting masks. Masks do not block the virus in the air, just the droplets. The main benefit of masks is that they block the accidental touching of our faces with our hands. Cloth masks can be washed and reused. If they are made of cloth, then multi-layer masks are best.
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If you have any questions, please feel free to contact drwang@wangvisioninstitute.com.
