In this #COVID19 pandemic, EVERYONE’S health is interconnected. We ALL have a responsibility to follow precautions & protect the well being of others. If others get sick it WILL affect u. Don’t believe it? Let's go on a COVID field trip:4⃣Reasons to follow precautions (thread) 1/
Reason1⃣: Follow precautions because you don’t want to get sick. This one is easy and self explanatory to most. To limit your own risk of getting sick: wash hands often, avoid crowded places, practice social distancing, work from home if you can.

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Reason2⃣: Follow precautions to protect others.

Some have refused to take precautions or social distance for the benefit of others, citing that its their right to "do what [they] want". Others don’t believe the gravity of the situation. And some just want to profit.

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Even if u feel you're invincible or aren't worried about getting sick, social distancing & staying home could save someone else's life. Though u may be young/healthy, u still can carry #COVID19 to someone not as healthy as u are, someone who won't have the same good outcome.

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In fact, you may not even know you've been infected. Time from infection to symptoms can be 14 days, tho average is ~5 days. With 3 day turn around on test kits so far, it can take 8 days for diagnosis (if you can even get a kit). This is plenty of time to spread the virus.

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People are dying & more will die. Mean time-to-death is ~18 days. This means many deaths today are related to infections from ~2.5 wks ago. Deaths related to today's infections will happen in ~2.5 wks. New cases are rising exponentially & we're not even NEAR the peak.

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Increased infection severity & death occur with increased age & other chronic medical conditions (such as diabetes, heart disease). Tables show deaths related to age & to chronic diseases for 44,672 cases in China. Subsequent studies in Italy & the US show similar results.

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A recent @JAMA_current article reports that compared to overall cases:
🔴70-79 yrs olds➡️3.5x higher fatality rate
🔴80+ yr olds➡️6.5x higher fatality rate

Though the young tend to do well, w/ milder course, they can STILL greatly harm others by transmitting #COVID19.

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Perhaps you don't care about other people's grandparents. If that's the case, you STILL should follow @CDC precautions bc (while its the right thing to do) it also happens to be the selfish thing to do. Yes, u read correctly, there's STILL something in it for you. Read on.

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Reason3⃣: Social distance, stay home if sick, follow precautions to reduce RATE of infection in others. Many of you have seen this graph and the label #FlattenTheCurve.

What does this mean?

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It means that if too many people get sick at once, the healthcare system will be overwhelmed & medical resources will RUN OUT (pink curve). If infection rate is reduced (flattened), the # of sick people can be handled w/ available resources (gray curve). #FlattenTheCurve

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Why does any of this matter to u if you are not sick? Let's take a closer look.

This is a graph of the number of #COVID19 cases in Italy versus the US over time. Italy is perhaps ~1-2 weeks ahead of the US, but so far, the US is closely following a similar trajectory.

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On day 12 school shut in Italy.

You may have noticed that many schools across the US ominously now have closed.

Also cancelled:
-Professional conferences (all sectors)
-All major league sports
-March Madness
-Disneyland!
-Many other things
*National Guard is in NY!

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And now its US national emergency w/travel restrictions. Why is this happening? Lets consider Italy...

Without a flattened curve, #COVID19 infection RATE was too high for Italy's resources:
2/22/20: 79 cases
3/1/20: 1,701 cases
3/7/20: 5,883 cases
3/14/20: 21,157 cases

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As a result, the Italian College of Anesthesia, Resuscitation and Intensive Care (SIAARTI) has published guidelines to decide which patients receive life-saving measures (such as ventilators and ICU beds) because there isn't enough to go around. https://theatlantic.com/ideas/archive/2020/03/who-gets-hospital-bed/607807/

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"Distributive justice" in allocation of limited health resources is a fancy way of saying that some people are chosen to be saved & others aren't. How do you determine the relative worth of a life? This is a situation no country, community, system, or individual ever wants.

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If there's only 1 ventilator but 2 people need it, what do you think happens to the person that doesn't get the ventilator? If the US doesn't #flattenthecurve, Americans may be faced w/ the same situation as in Italy, where those needing life saving measures won't get them.

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This means that if you or your loved ones contract #COVID19 down the line, there may not be enough resources to take care of you.

Tho what if you or your loved ones never get COVID19? That would be great! But you must still help stop others from getting sick. Why? Read on.

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Reason4⃣: If hospital systems & medical resources are stretched beyond capacity and you or a loved one have ANY medical need (car accident, appendicitis, heart attack, stroke, cancer), resources won't be available. Non-COVID19 patients make demands on overlapping resources.

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Many medical centers are already limiting or shutting down elective inpatient & outpatient procedures & imaging. These are just a few of MANY societies guiding institutions, hospitals, and healthcare providers as they prepare for the worst:

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To Recap: EVERYONE has a responsibility to follow #COVID19 precautions & protect the health of others. Its not just about u, what u feel like doing, or if u feel well or invincible. Do it bc its the right thing to do, or if nothing else, bc it is still in your best interest.

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Four Reasons Why:
1⃣You don't want #COVID19

2⃣Protect those who are not as strong as you

3⃣Reduce COVID19 infection RATE so resources don't run out for anyone, including you #FlattenTheCurve

4⃣Conserve resources for non-COVID19 patients; this could be u or your family

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You can follow @GayatriJoshiMD.
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