A message from our Chief Medical Officer Troy Brennan, M.D. to CVS Health colleagues with helpful guidance for all

Monday, March 16, 2020

As we move into the second full week of changes in our personal and professional lives as a result of the coronavirus outbreak, we thought it might be helpful to share a few epidemiological and clinical insights.

There is still a lot that is not known. We will learn more as testing increases and as more patients with significant disease from the virus are treated. However, radical social distancing is working. It worked in China with very stringent approaches, and in Korea with more measured ones. Neither country has eliminated the virus, but there is some sense of control.

In the United States, things have changed significantly in a week and, as a result, I suspect that viral spread must be down helping to relieve pressure on our health care system. We also hope that the warming weather will help prevent spread although we cannot guarantee that it will.

One of our health centers distributed tips regarding self-care and suggested that we consider the following when thinking about symptoms of the common cold vs. the coronavirus:

  • If you have a runny nose and sputum, you likely have a common cold.

  • Coronavirus pneumonia presents as a dry cough with no runny nose, often accompanied by a fever. If you experience these symptoms, you should call your doctor.

  • Stay hydrated and get plenty of sleep.

  • You should wash your hands frequently. The virus can only live on your hands for a period of time, but a lot can happen during that time: you can rub your eyes or touch your nose or mouth unwittingly.

  • Most importantly, remember that this illness is very mild in 80% of people who have it, and our children do not appear to be getting sick at all except in very rare cases.

If your job requires that you go into a workplace, practice good respiratory etiquette and hand hygiene. The CDC provides guidance for those who are in the workplace and encourages the use of non-contact forms of greeting. They also suggest that you regularly clean and disinfect frequently touched surfaces like doorknobs, tables, handrails and desks.

It’s important to maintain the steps we’ve recently taken regarding our hygiene and begin to follow new social distancing guidance when working from home or after you leave the workplace:

  • No playdates, parties, sleepovers or families visiting each other's houses. This sounds extreme because it is. The idea behind social distancing is to create distance between family units and between individuals across those family units. It is uncomfortable, especially for families with small children or for kids who love to play with their friends. But even if you choose only one friend to invite to your home, you are creating new links and possibilities for the type of transmission that all our school/work/public event closures are trying to prevent. The symptoms of coronavirus take four to five days to manifest. Someone who comes over looking well can transmit the virus.

  • Take walks/runs outside, but maintain distance (ideally six feet between people outside your family).

  • Try not to use public facilities like playground structures as coronavirus can live on plastic and metal for up to three days, and these structures aren't getting regularly cleaned.

  • Do not visit nursing homes or other areas where large numbers of the elderly reside, as they are at highest risk for complications and mortality from coronavirus.

  • Reduce the frequency of going to stores/restaurants/coffee shops for the time being. Trips to the grocery store will be necessary but try to limit them and go at times when the store is less busy.

  • Take-out meals and food delivery is riskier than making food at home given the links between the people who prepare food, transport the food, and you. It is hard to know how much that risk is, but it is certainly higher than making meals at home.

The wisdom of early and aggressive social distancing is that it can flatten the curve of viral spread, prevent the overwhelming of our health system, and eventually reduce the length and need for longer periods of extreme social distancing later (evidenced by what has transpired in Italy and Wuhan). We all need to do our part during these times, even if it means some discomfort.

We will get through this. It is important to practice healthy habits by aiming for the recommended eight hours of sleep, drinking plenty of fluids and eating a well-balanced diet. Be calm, take care of yourself and your family, and follow public health guidelines.