My Fellow Wiffmericans,
As League Physician of the SWBL, I would like to take the time to briefly discuss the implications of the current pandemic to the health of our players and fans.
I am certain that by now we have heard the basics behind this outbreak deemed COVID-19, a novel coronavirus caused by the SARS-CoV-2 virus. As we face a time of unprecedented uncertainty, I hope to provide some facts, guidelines, and my professional judgement (please note, not individual clinical advice) in light of current events.
Personal Risk for Players:
The fact that this is a “novel virus” means it has never been seen or recorded before. The implications of this are that we have no immunity to it. For the vast majority of people, especially in the demographic that comprises the SWBL players, infection will range from asymptomatic, mild symptoms, or a flu-like illness with high fever and muscle aches that will resolve over approximately two weeks. Not to be an alarmist, but whereas “at-risk” populations are more likely to experience significant morbidity and mortality, people in their 20’s and 30’s are not “no-risk”, only “low-risk”.* I want to re-iterate: the individual risk is extremely low, to the point that we should not let fear for our personal health consume us (i.e. do not buy out the grocery stores. Even in the midst of a lockdown Italy is allowing citizens to go to the grocery store, and food-supply chains have remained operational). But for the personal well-being of our players and especially our loved ones, I urge you to take reasonable precautions TODAY.
Implications for Our Fans and Community:
On a population level, the most current data suggests that people in their 20’s are significant carriers for this disease, representing possibly the largest cohort of cases when separated by age group. Many of these cases are asymptomatic, as above, yet are still contagious. This poses a significant public health threat to the more vulnerable members of our society. As you may have seen, early estimates report a case fatality rate of 3.4%. While there is reasonable data to suggest the true case fatality rate is closer to, or below 1%, this still represents a figure ten times deadlier than the season flu - which kills thousands of Americans each year. This virus is estimated to have an incubation period of a little over 5 days, with 90% of patients exhibiting symptoms by 11 days. Furthermore, the early data on mortality out of China suggests that average length of time from exhibiting symptoms to death is just over 17 days, and patients generally do not require hospitalization until the second week of illness. That means that the precautions we take today will not be felt for nearly a month. As the number of cases and mortalities continue to rise, the fear from a public health standpoint is that healthcare systems will quickly become over-run with the burden from this disease. Below are several articles I have found helpful. In short: by taking these extreme precautions now, we hope to avoid a situation where death rates spike because our local hospital are out of equipment (ventilators, masks, etc) or healthcare workers (infection rate may be as high as 20% amongst healthcare workers in the most affected regions of Italy right now, and are also comprising a significantly disproportionate number of the mortalities). Patients who are sick, not just with SARS-CoV-2, but also from heart attacks, strokes, appendicitis, car accidents, during such a surge will not receive adequate care and outcomes will suffer as a result. We can do our part to mitigate this. A recent epidemiological study suggested that if we don’t take extreme measures now, the death toll in America will be 2.2 million people in the coming year. This figure does not take into account the deaths that will result from an overtaxed healthcare system that cannot provide adequate care for other patients, which will likely be many more. To put this into perspective, last year the all-cause mortality in America was 2.7 million.
What we can do:
Here are my recommendations for our players and fans. Again, this is not official clinical advice, or tailored to any individual, but my observations on the current situation as a physician.
Practice social distancing.
As we gather more information, it appears our demographic represents significant carriers. For the safety of others, consider having food delivered, buying goods online, watching movies in. Absolutely go outside if needed for mental health or exercise, but consider your backyard or a park where you can keep the recommended distance away from people, rather than a gym. Most studies suggest that this virus is spread through droplets, which in general do not travel further than 6 feet. So when at all possible, stay 6 feet away from others when out in public.
Wash your hands.
This is perhaps the single most effective measure we can take. As often as every 15 minutes is ideal (I understand less than likely), but certainly once on hour. A rule I try and remember is anytime I go through a doorway, I wash my hands.
Disinfect common areas
Door knobs, cell phones, TV remotes, kitchen counters. Bleach based disinfectants, alcohol based with > 70% alcohol, or ones that specifically report anti-viral are best for now.
Think about a new daily routine.
As our lives have dramatically changed, and it may be many months before we return to “normal”: think about ways you can remain sane, especially if restrictions continue to progress, or you are subject to quarantine. Do light exercise in the house. Read a book rather than watch TV. Consider meditation or prayer (if interested, I would consider the Psalms, particularly Psalm 23). Try to eat well.
Call and FaceTime loved ones
We will undoubtedly have loved ones who are subject to quarantine, and likely have loved ones in “high-risk” populations who will follow the advice of the CDC and self-isolate. This will likely be incredibly lonely and difficult times. Consider calling, texting, FaceTiming. Reminder: this is not a time to visit grandparents or take a spur of the moment vacation. If you have loved ones who are in higher risk groups, urge them to self-isolate as much as possible.
Be prepared for more closures and restrictions, and for this to drag on for months.
Most experts do not foresee a peak until April or May, and most suggest it will be a significant concern through June or July, even warning of the possibility of a second peak once restrictions are lifted.
If you are sick at all – stay home.
A good overview of the current scientific understanding
FAQ on Ohio State Medical Center’s website
UCSF on social distancing
Latest epidemiological data
As this situation continues to evolve, the league will continue to do what is best for our players and fans. Please reach out with questions or concerns, and again – do your part to #FlattenTheCurve.
Alex Heck, MD