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FARE Blog March 17, 2020

COVID-19: Why You Should Shelter in Place

Most COVID-19 infections are actually spread by infected people who have no symptoms. A study just published in the journal Science illustrates why we need to be very careful.

Authored by Thomas B. Casale, MD

Dr Thomas Casale

Dr. Thomas B. Casale serves as FARE’s Chief Medical Advisor for Operations. He is a Professor of Medicine and Pediatrics and the Chief of Clinical and Translational Research at the University of South Florida in Tampa. A former President of the American Academy of Allergy, Asthma and Immunology (AAAAI), Dr. Casale has participated in more than 250 multi-site clinical trials and has published more than 400 scientific papers, reviews and chapters on his research.

Many people have asked, “Why it is important to avoid contact with other people if I do not feel sick and neither do they?” A study just published in the journal Science illustrates why we need to be very careful. Most COVID-19 infections are actually spread by infected people who have no symptoms. I have quoted the important findings below:

“Findings indicate that a large proportion of COVID-19 infections were undocumented prior to the implementation of travel restrictions and other heightened control measures in China on 23 January, and that a large proportion of the total force of infection was mediated through these undocumented infections…that 86% of infections went undocumented and that, per person, these undocumented infections were 55% as contagious as documented infections….Due to their greater numbers, undocumented infections were the infection source for 79% of documented cases. For every confirmed case, there are most likely another five to 10 people in the community with undetected infections.”

Source: Li R et al. Substantial undocumented infection facilitates the rapid dissemination of novel coronavirus (SARS-CoV2). Science 16 Mar 2020.

What this means is you should avoid going out unless necessary. This includes going to restaurants, social gatherings, workout facilities, and so on. Keep your distance! Three feet is good, but 6 feet is better for social distancing. Keep washing your hands and using hand sanitizer with at least 60% alcohol.

New recommendations indicate that social gatherings should be restricted to no more than 10 people. However, based on the study quoted above, it would be best to shelter in place instead. If possible, have food and other essential items delivered to your door, especially if you are over age 60 and/or in poor health.

If you develop cough, fever and shortness of breath, call your doctor for instructions on what to do next. Do not visit the doctor’s office unannounced. Testing is becoming more available, but you need to protect others from whatever is making you sick. The best advice is to act as if you are infected and protect others with responsible actions.

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