Dr. David Dausey: Covid-19 thoughts from an epidemiologist

I am a Yale-trained epidemiologist who spent years working around the world to help countries prepare for pandemics. Coworkers, friends and family have asked me for my thoughts and advice on what is happening in the world right now. Here is what I tell them.

The threat from covid-19 is real. For some reason, opinions on the threat posed by covid-19 are split along party lines. Covid-19 kills Republican and Democrat alike. Don’t be fooled. Take precautions now to protect you and your family. The case fatality rate for covid-19 is at least 10 to 20 times greater than that of influenza. Influenza kills approximately 30,000 to 50,000 Americans per year. Basic math suggests that covid-19 has the potential to kill hundreds of thousands of Americans, if not more.

Covid-19 can be spread by asymptomatic people. Covid-19 can be spread by people who are infected but not sick. These “silent spreaders” of the disease don’t realize they are making others sick. Thus, trying to stop the spread of the disease by telling people to avoid going to work if they are sick won’t work. This is why many employers have moved to remote work options, why some governors are ordering all but non-life-sustaining businesses to close and why many K-12 schools and colleges and universities across the country have moved online.

Covid-19 may be airborne and lasts long on surfaces. Recent research suggests that covid-19 can be traceable in aerosols for up to three hours and can survive on some surfaces for up to three days. This means it will be very difficult to contain. This is why federal, state and local authorities are scrambling to enforce social distancing measures. Simply put, washing your hands alone might not be enough to keep you and your loved ones safe. You need to avoid crowds of people — even people who don’t appear sick.

Covid-19 kills the elderly and people with chronic illness at alarming rates. The case fatality rates for covid-19 for people ages 60 and over are alarming. Current data suggest that nearly 5% of people 60-69, nearly 10% of people 70-79 and nearly 20% of people 80-plus who get the disease could die. People with common chronic illnesses such as heart disease and diabetes are also at increased risk for mortality or morbidity if they get covid-19.

Covid-19 can still be terrible for young adults. Even if covid-19 doesn’t kill young adults, it can still make them very sick. Young adults are responsible for a big proportion of the covid-19 hospitalizations in the United States. Reports from Europe point to young and healthy people needing to be put on mechanical ventilators to save their lives (if they were lucky enough to have access to one by the time they got sick). If that happens to you, you could find yourself in physical therapy for months. Worse than that — even if you get the disease and have no illness or mild illness, you could unintentionally spread the disease to a parent, grandparent, friend or coworker who could die as a result.

A vaccine for covid-19 is far off. An NIH trial of a vaccine for covid-19 began a few days ago. While this is a positive development, don’t get your hopes up. It will likely take another 12 to 18 months before there will be a vaccine ready for mass distribution for covid-19. During that time, the disease will have free rein to spread throughout the world, and the only real defense we have is social distancing and the possibility of drugs being fast-tracked for approval by the FDA for off-label treatment or prophylaxis.

This could go on for months — if not longer. We are faced with a stark choice right now: Engage in social distancing or let hundreds of thousands of Americans die. The reality is that we could be dealing with covid-19 for a year or more. During that time, the disease has the ability to completely overrun our health care system if extraordinary measures aren’t taken to slow its spread now.

Given all of this, my advice to my friends, family and coworkers has been threefold.

First, avoid crowds of people and follow the social distancing guidelines established by your state and local authorities. Your leisure time until this clears up may have to be Netflix and taking your dogs for a walk. If you can’t work remotely, at least ask whether you can teleconference into meetings rather than gathering in groups. As painful as this is, vacations, birthday parties, weddings and other events need to be canceled and rescheduled. If you are elderly and retired — stay home.

Second, if you need to go out, try to keep at least 3 feet between you and other people, and use an alcohol-based hand sanitizer regularly.

Third, love one another and take care of each other. Since this mess started, I have seen the very best in so many people. Practice compassion. If you are upset about the disruption to your life, be thankful to be alive and take actions that will help others to stay healthy and well.

David Dausey, Ph.D., is provost and vice president of academic affairs at Duquesne University and a professor in Duquesne’s John G. Rangos School of Health Science. He is also a distinguished service professor of health policy at Carnegie Mellon University.