Update: 4/23/2020
As weeks have passed with the shutdown for the coronavirus ongoing, more information seems to show a few unchanging facts: this virus remains very contagious, asymptomatic spread is real, widespread testing is not yet available, certain groups are at higher risk for a poor outcome when infected, and there is no vaccine or widespread effective treatment. The worsening of the economic situation must be met by re-opening very shortly. This virus will not go away; the warmer months may give a brief respite, as it doesn’t appear to thrive with sunlight very well.
Some recommendations from the Health Department have met with acceptance, and some have not. The current strategy continues to be one of mitigation. We still do not want to have a large upsurge in ICU admissions or deaths when we go back to work. How to lower the risk of that happening? Continue social distancing, cleaning of countertops between individuals, frequent hand washing, and not reporting to work if you any symptoms of illness. Taking employees’ temperatures upon entry into the workplace is not perfect, but it can be an additive measure, to then advise the employee to not enter the workplace if their temperature is elevated. The vulnerable groups have been identified, and if it is possible, seriously consider having younger employees age 64 or younger return to work first. The health care provider could help those with the chronic health conditions (heart disease, pulmonary disease, lowered immune status, and diabetes) decide if they are increasing their likelihood of serious outcomes when they are infected.
Wearing a facial covering will protect others if you are an asymptomatic spreader of this. That means you don’t even know you have this virus because you don’t feel ill, but can shed the virus by coughing, talking, and sneezing and infect others.
If I am in a more vulnerable group, I would frequent businesses that had employees wearing facial coverings. They are lowering my risk to acquire the virus from their employees. If I am in a vulnerable group, I need to not expose myself any more than is necessary to obtain essential items. I would have myself to blame if I did not take personal responsibility to limit my risk. The rest of the country needs to get back to work to avoid a depression.
This shut-down does need to stop. The limitation of testing cannot delay this re-opening. The testing will help with contact tracing efforts and mitigation efforts in the Health Department’s required duties. We can live and work differently for a while to protect the vulnerable groups. I believe we do need to acquire so -called "herd immunity" to, hopefully, prevent the large numbers of infections occurring all at once, again this fall. The United States, in most areas, can do this because much of the country does not rely on public transportation nor live in close cramped housing.
The Miami County Health Department will continue to follow the Executive Orders which will likely be updated next week.
Christi L Redmon, M.D.
Health Officer
Miami County Health Department
Miami County has had two new positive cases reported from the ISDH for our county. The individuals are at home in self-quarantine and being followed by their health care providers, as well as daily by the Miami County Health Department. As testing availability increases, we will see more positive cases throughout the United States.
It remains critical that each individual remain engaged in all CDC and ISDH guidelines and public updates found on the government websites. www.cdc.gov/COVID19 and www.in.gov. Indiana has an opportunity to avoid a surge of cases if everyone understands how widespread this outbreak may become and follows those guidelines.
To review:1) maintain the 6 feet social distancing at any grocery store, pharmacy, gas station, take out food service line that remains open as an essential service or business that falls under Governor Holcomb’s executive order found at www.in.gov/gov/2384htm from last week. Do not be in any large gathering at this time
2) hand washing for 20 seconds with soap and water frequently during the day and particularly after returning home and before eating. An alcohol based hand sanitizer is used if you do not have soap and water available 3) do not leave your house if you feel ill 4) self-isolation of the household if one individual is ill is needed to avoid spreading this virus to someone else’s household; this should continue for 14 days 5) avoid elderly individuals, those with chronic illnesses, those with weakened immune systems. Younger individuals with asthma would also fall in this category 6) disinfect non-porous surfaces with a commercial disinfectant, or one may be made from dilute bleach, with instructions for use on the back of the bottle. Commonly touched surfaces such as countertops, door handles, bathroom and kitchen fixtures, and car handles are especially important when you re-enter your house 7) "cough hygiene" is using your elbow and not your hand if you had to cough 8) Call your health care-provider if you develop symptoms and need advice- Lutheran Triage is one local number that can give good screening advice, 260-435-5050 or again the ISDH website has guidance to begin with.
With this new health challenge ahead, so much of our lives has changed very quickly. That is likely to continue for some time. Don’t neglect your underlying well-being. The stress of being home daily with children is not easy. Finding ways to engage with them while avoiding too much television or media time is possible. So many websites provide good family interaction suggestions now because we are all in this together as a nation. The YMCA has very good resouces for health and exercise on their website. Take a walk together, read together. Ask neighbors if you can drop off any necessities if they are isolated or elderly.
It is a time to work together and meet this crisis very quickly and effectively. Do the right things for each other.
Dr. Christi Redmon