I have received several questions asking is there anything neuropathy sufferers should specifically worry about with COVID-19, which is quickly sweeping the world. The best way to answer this would be in two parts, direct and indirect effects. I want to also touch on some of the common myths that people just keep talking about that involve the COVID-19.
Direct Effects
While COVID-19 has shown itself to be a respiratory disease marked by cough, fever, and shortness of breath, and in a small number of cases it can lead to severe respiratory problems and death. While the full understanding of COVID-19 is still unfolding, there are indeed hints that they may also be a neurological component in certain instances. Exactly what, we do not know however. Kenneth L. Tyler, MD, FAAN, Louis Baum Endowed Professor and chair of neurology at University of Colorado School of Medicine, noted that earlier this year a report from three COVID-19-designated hospitals in Wuhan, China, indicated that more than one-third of coronavirus patients had some type of neurologic symptom, including altered consciousness, evidence of skeletal muscle damage, and acute cerebrovascular disease. Dr. Tyler said it makes sense that COVID-19 would have neurologic manifestations because other coronaviruses that affect humans can invade the central nervous system.
There are published articles on another coronovirus, Middle East respiratory syndrome (MERS), having some neurologic complications. Dr. Tyler said "We should be vigilant to see if we are going to see that occur (with COVID-19) as more cases and experience accumulate,"
Indirect Effects
The much bigger issue facing us presently is that many of the underlining medical conditions that have lead patients to get peripheral neuropathy place them squarely in the "at risk for complications category." Those that have undergone cancer treatments and have weakened immune systems, diabetes sufferers, and anyone with heart or respiratory issues whether related to their neuropathy or not, is in this "at risk" category regardless of your age. Many neuropathy sufferers are over 60 which also lends to another risk factor. What all this means is that it would be prudent for neuropathy sufferers to practice social distancing wherever the can and take other precautions as seen fit.
Myths
Claim 1: Face masks do not work
Wearing a face mask is certainly not an iron-clad protection against the virus as it can also transmit through the eyes and tiny viral particles known as aerosols, can penetrate masks. However, surgical style masks can be effective at capturing droplets, which is the main transmission route of COVID-19. Some studies have shown that masks have a estimated five fold protection versus no barrier at all. Masks with ratings of N95 or higher (commonly used to protect people during tasks such as painting and sanding) can keep out even many smaller aerosols. Even more important, if you are showing signs of having the virus, a mask can protect others around you from getting the virus passed on. There is a definite shortage of masks currently and they need to be available to health and social care workers first, but if you have some and are in the above high risk category, your odds with a mask in public are better than without.
Claim 2: It is mutating into a more deadly strain
All viruses mutate over time and COVID-19 is no different. How widespread different strains of a virus become depends on natural selection – the versions that can propagate quickest and replicate effectively in the body will be the most “successful”. This does not necessarily mean most dangerous for people though, as viruses that kill people rapidly or make them so sick that they are incapacitated may be less likely to be transmitted. While scientists in china had already identified two strains of COVID-19, one was a much smaller strain and found to be the ancestral version.
Claim 3: COVID-19 is no more dangerous than the winter flu.
For many individuals, they will experience nothing worse than the symptoms that they would feel with the flu. However, the overall profile of the virus including its morality rate looks more serious. Bruce Aylward, a WHO expert, who led an international mission to China to learn about the virus and the country’s response, said the evidence did not suggest that we were only seeing the tip of the iceberg. If borne out by further testing, this could mean that current estimates of a roughly 1% fatality rate are accurate. This would make Covid-19 about 10 times more deadly than seasonal flu, which is estimated to kill between 290,000 and 650,000 people a year globally.
As of March 12, 2019, of the more than 147,000 people who have been infected and tested positive (meaning as Mr. Alyward stated above many without testing positive recovered) worldwide, more than 5,500 have died. That's a death rate of about 3.7%, and the WHO has previously estimated the rate at about 3.4%. The death rate, however, varies widely based on age, health and geographic location. A February WHO study of more than 55,000 cases in China found that the highest morality rate was among people over 80 years of age (21.9%).
Claim 4: You need to be around an infected person for 10 minutes to contract it.
For flu, some hospital guidelines define exposure as being within six feet of an infected person who sneezes or coughs for 10 minutes or longer. However, it is possible to be infected with shorter interactions or even by picking the virus up from contaminated surfaces, although this is thought to be a less common route of transmission.
Claim 5: A vaccine is on the way
Scientists were quick out of the gates in beginning development of a vaccine for the new coronavirus, helped by the early release of the genetic sequence by Chinese researchers. The development of a viable vaccine continues apace, with several teams now testing candidates in animal experiments. However, the incremental trials required before a commercial vaccine could be rolled out are still a lengthy undertaking – and an essential one to ensure that even rare side-effects are spotted. A commercially available vaccine within a year would be quick.
Claim 6: I should get tested now
As you may have seen on the national news the roll out of tests in the United States has been slow. Mostly because more accurate tests had not been developed until vary recently. As a national emergency has been declared and funding will be voted on shortly, expect to see the roll out of tests much quicker. Many of the available tests are going to places where the spread of the virus has been confirmed. Yes, testing positive means that you have the virus, but it does not mean that you will develop symptoms. Some people who have the virus do not have any symptoms at all. At the same time, testing negative does not necessarily mean that you don't have the virus. The best thing to do is If develop symptoms, call your primary medical provider for further instructions on what to do next. It is important that whomever you talk too knows about your high risk categories.
Claim 7: Mosquitoes and other animals can pass the virus
As far a scientists know, COVID-19 cannot be passed by mosquitoes. However, Hong Kong’s Agriculture, Fisheries, and Conservation Department (AFCD) has indicated that a pet dog whose owner had contracted COVID-19 had been tested for SARS-CoV-2 and that multiple tests over several days’ time had come back “weak positive.” Experts from the School of Public Health of the University of Hong Kong, the College of Veterinary Medicine and Life Sciences of the City University of Hong Kong, and the World Organization for Animal Health (OIE) believe the consistency and persistence of the results suggest the pet dog may have a low-level of infection with the virus. While officials have said this may be a case of human-to-animal transmission, this is still speculative and further testing is being conducted. The CDC, WHO, and other organizations are investigating this further, but if you have contracted COVID-19, you may want to consider quarantining your four legged loved ones away from you until you are better, just to be safe. But as of now, pets cannot get sick from the virus nor pass it.
Claim 8: COVID-19 is like the flu, you can only get it once.
A protective antibody is generated in those who are infected. "However, in certain individuals, the antibody cannot last that long. For many patients who have been cured, there is a likelihood of relapse," said Li QinGyuan, director of pneumonia prevention and treatment at China Japan Friendship Hospital in Beijing.
Poland agreed, saying the chance of reinfection is "very likely."
However, Eng Eong Ooi, a professor of emerging infectious diseases at Singapore's Duke-NUS Medical School, said the data is too new to determine definitively whether the immunity will last for a very short period of time, for years or for life.
Claim 9: The virus can only live for a matter of minutes on surfaces.
Depending on the type of surface, the virus can stay on surfaces for a few hours or up to several days, according to the WHO. A recent study found that viable virus could be detected up to three hours later in the air, up to four hours on copper, up to 24 hours on cardboard and up to two to three days on plastic and stainless steel.
It's possible that you can become infected if you touch your face after touching a surface or object that has the virus on it, according to the CDC. But scientists do not think surfaces are the main way that the virus spreads; the most common form of infection is from respiratory droplets spread by a person's cough or sneeze, the CDC reports.
Meanwhile, the WHO says it is very unlikely that the virus will persist on a surface after being moved, traveled and exposed to different conditions and temperatures. That means the virus cannot spread through goods manufactured in China or any country reporting coronavirus cases.
At the same time, the WHO is reportedly encouraging people to use as many digital payment options as possible. Viruses can survive on hard surfaces like coins for days in some cases. U.S dollars, a blend of fabric and paper, are harder for viruses to stick to.
Claim 10: We will run out of basic necessities such as toilet paper and hand soap.
Sadly this is one of the biggest purely panic driven myths at the moment. Sadly for those who are their last roll of TP, you may currently have trouble finding your toilet paper in the store, but basic necessities like these are not in fact in a shortage and will be replenished throughout the normal supply chains throughout the country. Many stores are already getting new stock as this is written. See an update on this Claim here.
Final Advice
Bunker down, we hopefully just need to make it the next month or two until that time of the year when all viruses normally quiet down. The best thing we can do as neuropathy suffers is stock up on our medications (many insurances have lifted the 30 cap on medications so you can get one fill-up to last you throughout this time period. Practice social distancing meaning if you do not have to be in a group of people, don't be. High risk individuals may want to go ahead and self quarantine as much as possible. Wash your hands whenever coming inside the house, and before and after all meals, using soap and warm water for at least 20 seconds (sing happy birthday to yourself twice). You can track the virus in your area by going to our tracking page here.
"Health is not valued till sickness comes..."
-Thomas Fuller
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