Weill Cornell Medicine ICU Doctor David Price Offers Advice On How To Protect Yourself And Family From Coronavirus Covid 19 - Follow The 4 Rules, Disease Strikes All Ages Over 14, Take Tylenol For Fever And Go To Hospital If You Have Shortness Of Breath

@Rooseveltisland @RIOCny @BenKallos can anyone answer? What's the protocol on Roosevelt Island if you think you have COVID-19 and need to go to urgent care or Emergency if, like most people in Manhattan, you don't have a car or access to one?

— Catee (@Cateenyc) March 28, 2020

Roosevelt Island is a short distance across the East River from where seriously ill Coronavirus patients are being treated by health care professionals at NY Presbyterian/Weill Cornell Medical Center.

One of those health care professionals, Dr David Price a critical care pulmonologist and recent Fellowshiip grad caring for COVID-19 patients at NY Presbyterian/Weill Cornell Medical Center, offers some very practical advice in video below on protecting yourself and family during the Coronavirus Covid 19 Pandemic.

Here's an excerpt from the video with Dr Price:

...  What is Covid19?

 I mean it's  now every single news story it's political its economic but what is this disease? So this is a virus. It's from what we would colloquially think of as a common cold family the Coronavirus family but what's unique is that the human body has never seen this virus before.

And so this obviously started in Wuhan. The thought is that it came  probably from an animal and then made its way into the human body for the first time and so one of the common questions I get is what does this disease look like?

So what commonly people have is they have fever and they have cough and then they have sore throat and when they get this the virus goes through their entire body and what we have found is that the most likely place that this will affect is your lungs. So people will commonly have cough but for about 80% of people you just don't feel good is the most common thing.

You have a mild cough maybe you have a little headache. The disease lasts from what we're seeing between 5 to 7 to 14 days is probably the best accurate description. Some people who have a mild disease by about day 5 are starting to feel better and then people who aren't feeling better usually start to get short of breath around a 3 to 5 and then start to feel better around that 7 day mark.

So what is the first kind of big topic we're going to talk about and I think the reason I wanted to have this call is how to protect your family. I think we've learned a lot and I want to kind of share all the stuff that I've learned so far with you guys,

So I think the first thing is how do you get Covid 19? I think that this is really important and we've really learned a lot over the last couple weeks, two months about how you get this disease. The overarching theme is sustained contact with someone who has this disease which the vast majority is people with fever and aches or someone who is about to get the disease. So someone in the next one to two days who's going to develop symptoms of this disease.

The way that you get this is the transmission of the virus almost exclusively from your hands to your face and so it's either into your eyes, into your nose or into your mouth. There's a lot of talk about contact or getting it through contact hands to face there's also a small thought that it can be aerosolized, that it can kind of exist a little bit in the air.

The thought at this point is that you actually have to have very long sustained contact with someone and I'm talking about over 15 to 30 minutes in an unprotected environment meaning you're in a very closed room without any type of mask for you to get it that way.

But to very simply state the overwhelming majority of people are getting this by physically touching someone who has this disease or will develop it in the next one to two days and then touching their face and so that actually I think is incredibly empowering and that's as I think in the hospital the last two days the thing that makes me smile a little bit is that I actually know now that I won't get this disease because I know how to protect myself and so I just want to give you guys a few very very practical tips to how to protect yourself...

and the full video.


Dr. David Price COVID-19 Information Session March 22, 2020 from Laura Seay on Vimeo.

More excerpts:

... The first step which i think is incredibly clear is to become a Hand Nazi, Know where your hands are and know that they're clean at all times. Very simply what this means for me in the city is that I walk around with Purell. When I leave my apartment, everything I see that I'm going to touch I make sure that I Purell first so when I leave my apartment door and I go to the elevator it's okay that if I touch it with my hand but then I Purell.  When I go downstairs and I open the door, it's okay to touch the door. You can open it with your elbow but if you touch the door, I make sure to Purell it. So we know that if you keep your hands clean that you're not going to get this.

The second point is that this is not a disease that we're getting because someone is sick and touched something and then an entire community of ten people get it because they touch that. It's mostly from sustained contact with people who have Covid 19. Out of an abundance of caution we also make sure that everything we touch we're cleaning our hands so that's the first thing, become a Hand Nazi. Everything you know about your hands, just keep them clean and you will not get this disease

The second thing is you have to start psychologically working on the connection between your hands and your face. I'm terrible at this. I touch my face all the time literally all the time. You don't even realize that you move your hand, you know you scratch your nose and so the virus has taken advantage of this and the reason why everyone gets this disease is because you have sustained contact with someone. So someone at a party has this and you shake their hand and then you touch your face. It's that simple that is how you get this disease

I think there's two practical things that you can do. One is just to start to be aware of when you touch your face. Atul Gawande, a Harvard trained surgeon I think is very famous actually has a recommendation for people to just start wearing masks and the idea here is not that the mask is going to prevent you from getting Covid  because as I said it's not a disease that you're most likely getting from the air but the reason to put on a mask is because, and I do this in the hospital, you just stop touching your face.

I would recommend when you're leaving your house is to wear a mask.  I think those two things combined is incredibly powerful and will prevent the transmission of disease into your family in 99% of cases. To know your hands are clean and to not touch your face, period. There are going to be an obscure 0.01 percent of patients who get it and will just never know but I think for you that is an incredibly important way to to protect yourself.

Three,  you don't need a  medical mask. These masks that people are wearing are not protecting them from getting the disease and front care health line workers need these masks right now. That's not to say don't wear a medical mask if you have one that's great put it on but it doesn't mean you to have a wild supply of masks or N95s or anything like that.

The general community has zero need for an N95 mask, zero.  In the hospital where all I do is take care of patients with Covid 19 I only wear a N95 mask if I'm in the room with that patient doing something that's going to make them have aerosolization of the virus. That is no one in the community

So to summarize -  always know where your hands are and what I mean by that is when you leave just become aware of when you're touching stuff that's not from your protected home environment so if you're going to go to the grocery store if you're going to touch the cart just clean the handle if you go into the store and you see people around don't touch them it's incredibly simpe

The fourth thing that I'll say which is the thing that the government is talking about and kind of is the same principle this distance yourself. This is incredibly fascinating in New York City now is that nobody is going within three or six feet of each other and it actually has not changed their life that much and so I think when you go to the pharmacy because people are going to the pharmacy now you don't have to wait directly in line with someone you can stand a couple feet back.

So the four things I think I said:

• Always know where your hands are and have Purell when you touch stuff that's outside your home just make sure that you're washing your hand. 
• Start to learn how to not touch your face. A really good way to do that is to start wearing a mask when you're out and if you want to practice wear a mask when you're home.
• You don't need a N95 mask or a medical mask. Any mask will do because this is not preventing the disease this is training you and
• then the fourth thing is just stay away from people. that's the nitty-gritty of how not to give yourself this disease or get it from your community.....

... Please listen to what I'm going to say. This disease affects everyone who's not in the age group of 0 to 14, so 23 year olds 35 year olds 45 year olds with zero medical problems are getting this disease.

People like that are coming to the hospital, people like that are going on ventilators. There is a very evil narrative early in this disease that said that this is only a disease of old people and people who have hypertension or people who have diabetes. That is not true. I can tell you because all I do is take care of patients.

It hits the entire spectrum of ages so that includes older people who do worse, We see a little bit more older people. We see a ton of 35 year olds and we will understand it someday but we don't understand it right now and so it's not to scare. you

You just follow the rules. If you can get this disease from age 20 years old maybe 16 years old all the way up to age 105 and you can get sick and end up on mechanical ventilation on a ventilator. The younger you are the less likely that is to happen the older you are the more likely that is to happen but we see young people who get really sick and we see old people who do just fine and so I think it's a great question.

I don't think we know exactly why young people are also getting sick but it's just to say follow the rules. If everyone does it you're going to be fine you're not going to get to the disease. If you get the disease follow the rules. You can protect your family. Most people will be fine. If you're short of breath go to the hospital so I'm just trying to make it as simple as possible.

What are the symptoms, what to do if you have them? Is it okay to use ibuprofen with fever? So I think I touched on what the symptoms are the vast majority of people are going to feel body aches they're gonna have a sore throat and they're gonna develop fever. Upwards of 90% of people are gonna have fever so I think that's what it looks like. Very interesting question about Ibuprofen. We're not using it in the hospital anymore. There's really good data from Germany that there's worse outcomes and people more inflammation and people who use Ibuprofen so that's simple answer which is if you have a fever take Acetaminophen Tylenol so don't use Ibuprofen use Tylenol it's very simple....

... I think probably the question that a lot of people are asking is if I get Coyid 19 and I feel short of breath am I just going to go to the hospital and die. This is where I'm probably the most qualified person in the country to comment on what it looks like when people are coming into the hospital sick.

So first who should go to the hospital? If you're feeling short of breath. come to the hospital. that is the rule, that is the clearest thing. It's not I have a fever, it's not I think I have COVID 19, it's not I can't stop having those body aches.

It's I feel short of breath when I get up to go to the bathroom. Those are people that should come to the hospital and be evaluated. At Cornell right now what we're doing is a lot of the people that come to the emergency room, we're sending home to live out the the 4 or 5 days of their disease so that they can feel better and we say oh you look completely fine go home.

But we're also seeing is that people that feel short of breath who comes into the hospital some of them go on to the floor and just are short of breath for five to six seven days and then they go home.

So of the entire population of people who get Covid 19, about 10% need to go to the hospital because they get short of breath. Of the 10% who are coming to the hospital, about one to two to three percent of those are required admission to the ICU and to be put on the ventilator.

So what happens when people get put on ventilators? The vast majority of people, overwhelming majority of people come off the ventilator and they usually come off the ventilator seven to ten days later. But I think the important thing for you guys to know is going to the hospital is not a death sentence it's a safe place for you to be. Go to the hospital when you're short of breath  Don't go to the hospital just because you have Covid19....

Also, an interesting Twitter thread from patient and caregiver's perspective:

I was mildly sick for a few days w/ covid symptoms. Then my 29 yr old healthy boyfriend got really sick. 13 days later, after a relentless fever, awful nausea, pneumonia in both lungs + a reluctant trip to ER, he is finally turning a corner today. Some things I learned:

— Eliza Shapiro (@elizashapiro) March 26, 2020

Stay well and Follow The Rules.