Spain and much of Europe is in near complete lockdown due to the novel coronavirus pandemic named COVID 19. As I’m sure you already know, the virus can cause a severe respiratory illness known as Severe Acute Respiratory Syndrome or SARS. People over 70 and those with pre-existing medical conditions are particularly at risk. People are being asked to sacrifice their liberty for public and personal health. Terms such as containment, isolation and social distancing are now part of our daily discussion. The three primary risks or challenges of infection, fear and quarantine are now in full swing and will remain our companions for the weeks and perhaps months to come.
How lethal is the virus and will the lockdown measures work?
Early estimates of the fatality rate for COVID 19 were up to 3.6% in China. This figure was artificially elevated due to only counting ‘confirmed’ cases. Many milder cases go undetected and uncounted and therefore the true fatality rate is much less. It may be closer to 1-2%. Don’t let the lower number of circa 1% reassure you though. If 80% of Spain’s population become infected and 1% die, that would still lead to 376,000 deaths and over 1.8 million severe cases needing intensive care support and ventilation! No health system has the capacity to withstand such massive demand in such a short space of time. That is why public health officials talk about ‘blunting the curve’ By turning off the tap and distancing ourselves from each other, we will reduce the spike in cases and smooth out the demand on hospitals and ventilators over a longer period. The earlier we adopt the measures, the lower the peak demand. As we are now painfully aware, such draconian measures as isolation come at a high price. People are being asked to sacrifice much of what makes us human beings for a time. Hugging and kissing and gathering together as friends and family to celebrate or to console each other are off limits. Children are not able to attend school or play organised sports or attend birthday parties. We are confined to home or work and left to wonder ‘will it ever be normal again?’. This level of intervention does work. In each pandemic over the last century we have good data confirming that by keeping people apart for a period of time, we can regain control over rapid spread and reduce the number of deaths. In basic mathematical terms, if on average an infected person transmits it to more than one new person, the pandemic grows. If on average each infected person infects less than one other person, the pandemic eventually burns itself out. Controlling the rate of transmission is only possible by a few methods. A vaccine is still many months away. Social distancing and temporary isolation for those at most risk is the best way we can all play a part to beat Coronavirus. It is essential we all adhere to government instructions on personal hygiene, temporary travel restrictions and home quarantine measures. It worked in China and South Korea. It will work in Italy, Spain and across Europe. A glimmer of hope - today is the first day when China reported no new cases. If we are brave and united, like China we will come through this public health crisis with as few deaths as possible.
What is it an essential versus a nonessential journey?
Right now, only trips to the hospital, pharmacy, grocery shop or to support an unwell or elderly family member should be considered essential. When attending to the needs of a elderly family member, physical contact should be minimised where possible.
What about work?
Some people are key workers and will need to continue work outside home. Nurses, doctors, police, pharmacists, supermarket workers, delivery people and some others are all critical to the frontline fight. Some employers are able to support people working from home. This is not available to many people in the hospitality industry in Spain and therefore there will be financial hardship and job losses as a result as small and large businesses run out of cash flow. Every level of government, local, national and EU is today discussing measures to support people who are affected financially. Financial stimulus packages have been announced. Each person and family should review their budgets and plan how to survive for at least the next 4 months with limited or even no income. For those who have already lost their job, I don’t have a platitude or a solution. It is not going to be easy. Reach out now to people or government institutions who may be able to help you and your family meet your needs. Do not despair and do not turn to unsustainable high interest loans or debt . Ask people for help.
How long can the virus survive?
The virus is killed by soap and water. Hand washing is essential to stopping this outbreak. If you are not washing your hands multiple times a day, you are not doing your bit. Droplets of respiratory secretions from coughing or sneezing land on surfaces or are seeded from one location to another by unwashed hands. On most surfaces the virus can survive for a few hours. On some surfaces such as stainless steel it may survive a few days. It is therefore very very important to increase hand hygiene and also the frequency of cleaning common surfaces such as handrails, lift buttons, door handles and all public transport internal surfaces.
Do masks work and should I be wearing one?
Masks are not necessary or useful unless you are a sick person worried about transmitting the virus or a health professional who needs to see people with potential COVID infection.
What will happen to the economy?
Your financial health is very important and is very much related to your mental and health. The effects of this outbreak will be deep and longstanding. Financial hardship can be just as fatal as Coronavirus. Almost 80% of the Balearic Islands gross domestic support or GDP is dependent on tourism. Many people already live paycheck to paycheck. Government support is likely to be helpful but not meet all the needs people have. To avoid the severe stress of not being able to pay bills, people need to act now. Identify the essentials in your life and negotiate your outgoing commitments. Share resources you do not need to own and give yourself a buffer if at all possible against the chance your job will not be there in a few weeks or months. If you have already lost your job, I am very sympathetic and you need to identify the government support available. Do everything you possibly can to reduce your outgoings while looking for work. It will be very tough. If you are finding the financial strain too hard to bear, talk to someone now. Don’t wait until you are either depressed or suicidal - reach out to a friend or health professional and work out how you are going to survive.
I have an elderly relative or a family member who has cardiovascular, diabetes or who takes immunosuppressive medication. When can I visit them?
Elderly people and those with pre-existing conditions are particularly at risk. In a sense the idea that there are certain groups more or less at risk is a distraction from the truth. We all know and love people in our families and communities who are either elderly or who have a chronic illness. Therefore their risk is our risk. It would be nonsensical and callous to go about our lives as younger people thinking our personal risk is low when lowering our guard could put someone else’s life at risk. Elderly people’s risk is therefore everyone’s responsibility. We need to act as a group to protect each other. With that in mind, all people need to adhere to the government instructions on home quarantine for as long as it takes. Stay at home and do not congregate in numbers where the virus will continue to spread. Wash your hand properly and regularly. Only visit older relatives if and when it is necessary for the next few months. Skype and Facetime were invented for this reason! It’s not the same, I know, but if you care about the grandparents and other more vulnerable people in your life you will make this sacrifice for the next few weeks and months.
What will happen next?
We will prevail. Things will get worse for the next while. Even more draconian measures may be necessary. Recurrent measures may be needed over months or even the next couple of years. People will suffer physically, mentally and financially but I am very confident we will win this fight. Treatments are already being tested. Vaccine trials have been started. Countries where people adhered to the tough public health measures that were imposed on them are now coming out the other side of the pandemic. Look at China and South Korea. Elements of normal life are already resuming after 4 hard months. People are once again able to enjoy each other’s company without fear of infection. Travel is resuming. Tourism will recover. Use this time to get to know your children, to plan projects for the future, to learn a new skill or enjoy a hobby you have been talking about for years. Stay physically fit. Even at home you can get some daily exercise by jogging on the spot for 15 minutes a day or by following a YouTube routine. Considering quitting smoking. Eat healthily - junk food reduces your ability to fight infection. Be strong, be brave and dig deep. Look after yourself, be kind to each other and support other people charitably. Keep calm, carry on hand washing and we will prevail.