This is a Medical and Legal Article about COVID-19 – the disease caused by the Novel Corona Virus of 2019.
As some of you may know, in addition to being a transportation lawyer, I am also a Medical Doctor, working for an urgent care and occupational medical group. As you can imagine, I routinely see patients with upper respiratory and pulmonary symptoms: People complaining of cough, fever, chest pain, shortness of breath; some who have chronic illnesses such as diabetes, lung disease, kidney disease, compromised immunity; and those who are elderly. In other words, people who may have COVID-19. I will share some basic information from the CDC regarding the Corona virus, what you should do to protect yourself, and when to go to your doctor, an emergency room or urgent care. While this is out of the ordinary for my articles, this is an extraordinary time and I want to share my experience as someone who is on the front line dealing with this.
Secondly, I will discuss the recent FMCSA order suspending certain safety rules in response to the COVID-19 outbreak.
What are the Signs and Symptoms of COVID-19?
COVID-19 ranges from mild disease with non-specific signs and symptoms of acute respiratory illness (like a common cold or mild case of the flu), to severe pneumonia with respiratory failure and shock (people who end up in an ICU on a ventilator). Frighteningly, there are people infected with COVID-19 who have NO symptoms and feel perfectly normal – scary because these individuals may pass off the illness to unsuspecting people. Needless to say, it makes diagnosing the illness a challenge and testing for COVID-19 is extremely limited.
Who is at risk for COVID-19?
Patients at greatest risk of infection are persons who have had prolonged, unprotected close contact with a patient with symptomatic, confirmed COVID-19 and those who live in or have recently been to areas with sustained transmission.
If I am concerned about COVID-19, I ask patients these questions:
-Any travel to mainland China (or other high risk areas) in the past 14 days?
-Any contact with a person diagnosed with, suspected to have, in evaluation for COVID-19?
-Any fevers, dry coughs, or shortness of breath?
At the clinics I work at, patients with suspected or confirmed COVID-19 are asked to wear a surgical mask as soon as they are identified and are evaluated in a private room with the door closed.
Who is at risk for severe disease from COVID-19?
Basically, older adults and people of any age who have serious underlying medical conditions.
According to the Centers for Disease Control, those at high-risk for severe illness from COVID-19 include:
People aged 65 years and older
People who live in a nursing home or long-term care facility
Other high-risk conditions:
People with chronic lung disease or moderate to severe asthma
People who have heart disease with complications
People who are immunocompromised including cancer treatment
People of any age with severe obesity (body mass index (BMI)≥40) or certain underlying medical conditions, particularly if not well controlled, such as those with diabetes, renal (kidney) failure, or liver disease might also be at risk
People who are pregnant should be monitored since they are known to be at risk with severe viral illness.
Many conditions can cause a person to be immunocompromised, including cancer treatment, bone marrow or organ transplantation, immune deficiencies, poorly controlled HIV or AIDS, and prolonged use of corticosteroids (like Prednisone) and other immune weakening medications. Ask yourself if you fall into any of these criteria.
How is COVID-19 treated?
Not all patients with COVID-19 will require medical supportive care. Treatment for hospitalized patients with COVID-19 is focused on supportive care of complications, including advanced organ support for respiratory failure, septic shock, and multi-organ failure. There are currently no antiviral drugs licensed by the U.S. Food and Drug Administration (FDA) to treat COVID-19.
Remember, the vast majority of patients require no specific medical treatment and will recover uneventfully. But don’t play Russian Roulette – take steps to protect yourself.
I work with patients to manage their underlying condition to the best of their ability, including ensuring that patients have sufficient medication and supplies. I encourage all patients, regardless of risk, to:
Take steps to protect yourself (see below)
See a doctor if you are sick with a fever, cough, or shortness of breath.
Follow CDC travel guidelines and the recommendations of your state and local health officials.
How COVID-19 Spreads.
The virus is thought to spread mainly from person-to-person.
Between people who are in close contact with one another (within about 6 feet).
Through respiratory droplets produced when an infected person coughs or sneezes.
These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs. It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes, but this is not thought to be the main way the virus spreads. However, the virus that causes COVID-19 seems to be spreading easily and sustainably. It’s going to get worse before it gets better.
Protect Yourself And Others With These Simple Actions
Clean your hands often:
Wash your hands often with soap and water for at least 20 seconds especially after you have been in a public place, or after blowing your nose, coughing, or sneezing.
If soap and water are not readily available, use a hand sanitizer that contains at least 60% alcohol. Cover all surfaces of your hands and rub them together until they feel dry.
Avoid touching your eyes, nose, and mouth with unwashed hands
Avoid close contact
Avoid close contact with people who are sick
Put distance between yourself and other people if COVID-19 is spreading in your community.
Stay home if you’re sick
Stay home if you are sick, except to get medical care.
Cover coughs and sneezes
Cover your mouth and nose with a tissue when you cough or sneeze or use the inside of your elbow.
Throw used tissues in the trash.
Immediately wash your hands with soap and water for at least 20 seconds. If soap and water are not readily available, clean your hands with a hand sanitizer that contains at least 60% alcohol
Wear a facemask if you are sick
If you are sick: You should wear a facemask when you are around other people (e.g., sharing a room or vehicle) and before you enter a healthcare provider’s office. If you are not able to wear a facemask (for example, because it causes trouble breathing), then you should do your best to cover your coughs and sneezes, and people who are caring for you should wear a facemask if they enter your room.
If you are NOT sick: You do not need to wear a facemask unless you are caring for someone who is sick (and they are not able to wear a facemask). Facemasks may be in short supply and they should be saved for caregivers.
Clean and disinfect
Clean AND disinfect frequently touched surfaces daily. This includes tables, doorknobs, light switches, countertops, handles, desks, phones, keyboards, toilets, faucets, sinks and gas pumps! See https://www.cdc.gov/coronavirus/2019-ncov/prepare/prevention.html for more information
The FMCSA issued an Emergency Declaration for motor carriers and drivers providing direct assistance in support of relief efforts related to the COVID-19 outbreaks.
The FMCSA ruled that due to the COVID-19 outbreak, an emergency exists that warrants an emergency exemption from Parts 390 through 399 of the Federal Motor Carrier Safety Regulations, excluding Drug and Alcohol Testing.
Specifically, the Emergency Declaration provides relief for motor carriers providing direct assistance in support of emergency relief efforts related to the COVID-19 outbreaks, including transportation to meet immediate needs for:
(1) medical supplies and equipment related to the testing, diagnosis and treatment of COVID-19;
(2) supplies and equipment necessary for community safety, sanitation, and prevention of community transmission of COVID-19 such as masks, gloves, hand sanitizer, soap and disinfectants;
(3) food for emergency restocking of stores;
(4) equipment, supplies and persons necessary to establish and manage temporary housing, quarantine, and isolation facilities related to COVID-19;
(5) persons designated by Federal, State or local authorities for medical, isolation, or quarantine purposes; and
(6) persons necessary to provide other medical or emergency services, the supply of which may be affected by the COVID-19 response.
The Emergency Declaration of 03/19/2020 is explained here:
https://www.fmcsa.dot.gov/emergency/frequently-asked-questions-related-fmcsa-emergency-declaration-03192020. See the actual declaration here: https://www.fmcsa.dot.gov/sites/fmcsa.dot.gov/files/2020-03/FMCSA%20Emergency%20Declaration%203.13.20.pdf.