Coronavirus – Just the Facts

Posted Posted in Continuing Education, Homestudy, Seminars, Webinars

By Mary O’Brien, M.D.

Chances are good you have a lot going on this week. And there’s a lot to keep up with in the news. Bearing that in mind, here is a synopsis of the facts concerning Coronavirus.

  • Definition: Coronaviruses are enveloped RNA viruses which typically cause symptoms of the common cold. The name stems from the halo or corona-like appearance of the virus when viewed with an electron microscope.
  • Medical terminology: The current coronavirus causing illness will be referred to as 2019 nCoV (novel coronavirus 2019) in the medical literature.
  • Symptoms: Coronaviruses typically cause cold and flu-like symptoms such as runny nose, sore throat, headache, cough, fever, and malaise. Shortness of breath is often indicative of progression to a viral pneumonia.
  • Countries with documented cases of 2019 nCoV: China, South Korea, Vietnam, Thailand, Nepal, Hong Kong, Singapore, Malaysia, Australia, Japan, France, U.S., Canada.
  • Origins of current outbreak: Likely animal-to-human transmission with subsequent human-to-human transmission in Wuhan, China. Wuhan is the capital city of Hubei province and has a population of 11 million.
  • Current problems related to epidemic in China: Multiple hospitals in China are overwhelmed, with shortages of supplies including masks, gloves, goggles, disposable gowns; reports of patients being turned away. Food shortages are reported in various areas as a result of transportation bans and lock downs.
  • Containment measures in China: Travel bans now affect nearly 50 million people in China. Multiple tourist sites have been closed including some portions of the Great Wall, the Forbidden City, and Shanghai Disneyland. Movie theaters have been closed. Tour groups, cruises, and schools are closed. Many Chinese Lunar New Year Festivities have been cancelled. This week and next week comprise the busiest travel period in China and the resulting economic impact is expected to be significant.
  • Current medical measures in progress: The Chinese government is flying hundreds of physicians and volunteers into affected areas and two temporary emergency hospitals are under construction to provide an additional 2,000 beds.
  • Most vulnerable patients: Those at greatest risk include young children, the elderly, immuno-compromised patients, and those with diabetes, chronic heart or lung disease, and chronic renal disease.
  • Usual cause of death: Viral pneumonia with respiratory failure is the most common fatal complication of coronaviruses.
  • Appropriate workup in acutely-ill patients with possible exposure: Patients who have travelled in China, within the past 2‒3 weeks, or who have had contact with such an individual, who have fever, cough, headache, or shortness of breath may warrant a CXR, CBC, liver enzymes (especially LDH and AST). Coronavirus testing involves real-time reverse transcriptase PCR (RT-PCR) of lower respiratory secretions.
  • Historical perspective: Two other coronaviruses have caused serious respiratory illness in recent decades:
    • MERSCoV 2012 – Middle East Respiratory Syndrome
    • SARS-CoV 2002-3 – Severe Acute Respiratory Syndrome

MERS resulted in 2,066 confirmed cases worldwide with 720 deaths.

SARS resulted in 8,000 confirmed cases worldwide with nearly 800 deaths (a mortality rate of 10%). Deaths were reported in 37 countries.

SARS was eradicated in 2004 by rapidly identifying and isolating “super-spreaders” (patients who infect unusually large numbers of people in the general population.)

  • Prevention: Common sense and standard infectious disease principles are in order – frequent, thorough hand washing; avoid touching your face, nose, mouth, and eyes; do not travel, go to work, or socialize if you are ill; face masks can reduce transmission of virus-laden droplets from infected patients coughing or sneezing; avoid crowds; don’t share food, beverages, or utensils.
  • Current status: As of Monday 1/27 – 2,700 confirmed cases with 81 deaths. Mortality rate at present is about 3%. These statistics will evolve rapidly.
  • Recommendations:
    • Check for updates from the CDC.
    • Focus on facts, logic, and common sense.
    • Employ time-tested ID principles and protocols.
    • Realize similar outbreaks run their course (typically in winter) and eventually resolve with identification of the virus and isolation/containment of infection.
    • Get a careful history from patients. The vast majority of people with cold or flu symptoms have a cold or flu – not coronavirus from China.

Solomon and Churchill

Posted Posted in Continuing Education, Homestudy, Psychology, Seminars, Webinars

By Mary O’Brien, M.D.

Here we are – midway through January 2020.  Have you crystallized your vision of vitality for 2020?  Has anyone noticed you have a new routine or attitude?  Have you already given up?  Don’t be too hard on yourself.  Between coping with severe weather and assorted viruses, many people are doing well to be functional right now.  Fortunately, it’s never too late to focus on the future and take corrective action.  After all, ships and planes rely on constant corrective adjustments of their navigational systems to reach their destinations.  How much more do fallible, fatigued, and sometimes fickle human beings need to take corrective action if we’re to achieve our destiny?

Now there’s a word that gets far too little attention in our culture.  Destiny.  No doubt there are those who would roll their eyes and dismiss the concept as delusional and arcane.  But I really believe each of us has a destiny or at least a potential destiny.  The key is recognizing it and taking steady action to achieve it.  Andrew Roberts, the acclaimed biographer, describes Winston Churchill’s profound sense of personal destiny in his book, Churchill: Walking with Destiny.  An intense spiritual experience at the age of 16 implanted in the young Churchill a deep conviction that he would be called upon to save London and indeed, Great Britain, at some point in his life.

Churchill had some major failures along the way, as all great people do.  And, despite stunning successes, he was the target of relentless, vicious criticism from political opponents, pretentious journalists, and even people in his own party.  Many of Churchill’s speeches were greeted with ridicule and contempt by his detractors.  This should not surprise us.  Nothing fosters criticism more predictably than jealousy.  Those speeches would later be hailed as some of the most inspiring rhetoric in history.  Winston Churchill endured massive criticism at nearly every turn, but his sense of destiny allowed him to persevere.

The concept of destiny infuses the wisdom of the ages. Several thousand years ago, Solomon wrote a sentence in Proverbs that should be noted by individuals and nations alike.  He wrote, “Where there is no vision, the people perish.” Solomon was onto one of the great secrets of the universe.  Can there be much doubt that communism has largely collapsed because it tried to suppress the vision of its people?  Would inner city darkness and despair exist if people pursued a vision of future success?  Would many of us wallow in depression for long if a vision of great destiny propelled us forward?

If you were less than thrilled with the accomplishments and personal progress you made last year, make a change.  Change whatever isn’t working in your life.  Of course, that means changing the way you think.  It means daring to dream and develop a vision for the future.  Don’t dwell on your circumstances, change them.

The vision to see, the faith to believe, and the will to work can bring your destiny within reach.  Solomon and Churchill were onto something.  The question is, are we?

A Whole New Decade

Posted Posted in Brain Science, Continuing Education, Psychology, Seminars, Webinars

By Mary O’Brien, M.D.

Are you making New Year’s resolutions?  Are you worried about your weight or waistline?  The vast majority of New Year’s resolutions involve weight loss.  Unfortunately, most of those resolutions will fall by the wayside within the next few weeks.  There is a better approach.

This year, as we begin a whole new decade, it might be better to create a vision of vitality.  Vitality is the state of being strong, active, and energetic.  It’s a crucial factor in living a truly good life and a major part of success.  The thought of merely cutting calories is not exactly inspiring.  And a number on the scale will not magically confer health or happiness — at least not for long.  Sooner or later assorted stresses can undermine the healthiest intentions.  That’s called life on Planet Earth.  Most of us realize that, and yet, nearly all of us need a little jump start now and then.

Sustained success requires clarity of purpose, a burning desire, and firm resolve. Some sort of change will be necessary.  If you always do what you’ve always done, you’ll get what you’ve always gotten.  A couple of questions are in order:

  1. How badly do you want it?
  2. What sacrifices are you willing to make?

Pursuing vitality in life may not come naturally, and we all have different challenges.  The slightest lack of discipline begins to affect your psyche.  However, a few simple disciplines practiced every day lead to success.  As motivational speaker and writer Jim Rohn has said, “The price is easy if the promise is clear.”

So what would you be willing to do in exchange for greater vitality?  Could you be more active, eat more healthfully, or get more sleep?  Perhaps you need more time outdoors, greater inspiration at work, or a captivating, creative endeavor.  Does your family, personal, or social life need more attention?  Is your spiritual life what it could be?  Success without fulfillment is tantamount to failure.

Perhaps over the next few days a little self-assessment would be helpful.  Then create a vision of your future vitality.  Write it down in detail — and begin. Vitality:  The state of being strong, active, and energetic.  It’s not a bad way to begin a whole new decade.