The COVID-19 virus has spread to all 50 states – some more deeply than others, but none has been spared. The virus has also spread worldwide. Currently, the U.S. has the most documented cases of COVID-19 infection of any country in the world. Here are the numbers as of April 26, 2020, according to Johns Hopkins University:

• Global cases confirmed:   2,920,660
• Global deaths:                   203,670
• U.S. cases confirmed:       941,628
• U.S. deaths:                        54.001

The data changes daily, so these numbers will have increased by the time you read this.

The point is, the COVID-19 pandemic is serious business. It must be taken seriously by all of us as well as by our municipal, state and federal governments – and the decision makers who are supposed to establish rules and guidelines that must be observed if we’re to have any hope of getting this pandemic under control and safeguarding ourselves and our families. We are all responsible for following these rules and guidelines. Not doing so puts people at risk. We have seen people marching on their state capitals demanding that their states be reopened so that they can resume their normal lives and go back to work. They crowd together in total violation of stay-at-home and social distancing guidelines. By doing so they are inviting a surge in COVID-19 infections and deaths – possibly even their own.

We know this to be a likely outcome because of our history with pandemics – the most severe being the 1918 Spanish flu that killed over 50 million people worldwide including over 675,000 in the U.S. alone – far more than the 20 million who died in World War I. What’s scary is that this pandemic hit in three waves – in the spring, fall, and winter of 1918. Granted, medical science and technology weren’t then what they are now. There were no flu vaccines or diagnostic tests. A few cities did close schools and ban public gatherings, but there was no coordinated national effort by the federal government to do likewise across the country, and a lot of people died as a result. You know the old saying that those who do not learn from history are doomed to repeat it. Well, the history of the 1918 Spanish flu pandemic is one we do not want to repeat with regard to COVID-19.

It is imperative that we implement comprehensive testing and contact tracing in every state and community in the country and contain the spread of the virus as much as possible to ensure maximum safety BEFORE we even consider reopening any state or community. This is not a political stance on my part, but a medical statement based on science and the data. We know for example that countries that have tested as many people as possible have the lowest per capita infections because they caught instances of infection sooner.

Unfortunately, right now, the U.S. is a long way from implementing testing on the comprehensive level that is needed. Critical equipment and materials are still in short supply and not getting to the doctors and hospitals and health care personnel who need them fast enough or in sufficient quantities. We are also a long way from COVID-19 hitting its peak across the country. Some places are doing better than others, but those others have yet to experience the surge of infection that has taken place elsewhere. We as yet do not have a COVID-19 vaccine or medicine or any treatment that is confirmed as effective. We also don’t know for sure whether someone who gets the virus and recovers from it does indeed develop an immunity. We need more studies and trials, and those take time. We cannot and must not take any shortcuts. The good news is that we are making some progress. We certainly know more about how COVID-19 behaves than we did at the outset of this pandemic. But we have a long way to go.

As a doctor working in a hospital every day, I have seen far too much illness and mortality, as well as the extreme strain felt by my fellow health care professionals who put themselves in harm’s way every day to treat and save as many people as possible. Through it all, one thing is absolutely clear:  We must respect the virus, and so far not enough people are doing so.

Therefore, my intent with the rest of this article is to give you information you need to know about COVID-19 and cut through the misinformation and confusion that’s out there so that you are better able to protect yourself and your loved ones.

With that in mind, here are answers to the most common questions about COVID-19.

What is the coronavirus COVID-19?

COVID-19 is an acronym that stands for Corona Virus Disease 2019, 2019 being the year in which it originated. COVID-19 is a new type of corona virus. Corona viruses have been around since the 1960s and have caused colds and the flu. This virus was first present in Wuhan, China and has since spread worldwide. This particular variety of virus normally stays with animals, but it has since been transmitted from humans to humans, which is most alarming.

Why is COVID-19 so dangerous?

The COVID-19 virus obstructs respiratory pathways with thick mucus which solidifies and blocks the airways and lungs, making it extremely hard to breathe and, in the most severe cases, makes it impossible for an individual to breathe on his or her own. Hence the need for ventilators which are still in short supply compared to the demand.

How do people become infected with COVID-19?

COVID-19 is airborne, and COVID droplets can last in the air up to three hours, which is scary. The most recent literature on the subject also says that the virus sticks around on surfaces a lot more than we initially thought. The virus can live on cardboard for up to 24 hours, on stainless steel up to 2 days, and on plastic up to 3 days. If someone who is infected sneezes or coughs into the air and you’re in the vicinity, you could become infected. If someone with the virus touches plastic, stainless steel or cardboard surfaces, and you then touch those surfaces, you might also become infected.

What are the symptoms of COVID-19 infection?

Fatigue, body aches, shortness of breath, and a dry cough are among the most common symptoms – along with fever, which is present in about a third of COVID-19 cases. But that last fact also means that you could have the virus but not know it because you don’t have a fever. Diarrhea is another symptom, and I single that one out because, according to the most recent findings, diarrhea along with loss of the senses of taste and smell often precede fever, so take note if you or a family member exhibits those symptoms.

Who are most at risk?

According to the most recent studies, primary co-morbidities and mortality rates associated with susceptibility of contracting the COVID-19 virus are hypertension (high blood pressure), obesity and diabetes in that order. Just to be clear, morbidity refers to illness. The term co-morbidities refers to multiple disorders afflicting the same person. Mortality is related to risk of death. Morbidity and mortality are not the same thing, though chronic illnesses such as heart disease, cancer, diabetes and others are leading causes of death. The point is, a great many people have hypertension, or diabetes or are obese, and they are all at risk. Some people have all three conditions, thereby raising their risk of COVID-19 infection considerably. In addition, because the COVID-19 virus often leads to acute respiratory distress, someone with a pre-existing respiratory condition such as asthma is especially vulnerable. Also on the high-risk list are cardiac patients, whose hearts may not be able to withstand the added stress of viral infection, cancer patients whose treatments often lower their bodies’ immunities, plus anyone else taking immunosuppressant drugs. People 65 and older have a higher mortality rate than other segments of the population, but younger people should not assume that they are safe. In fact, ABC News reported that, in New York City, 45% of their cases are people from 18 to 44 years of age and, nationwide, 48% of patients in ICU are ages 20 to 64. Unfortunately, young children are also vulnerable. I know of a 10 year old COVID-19 patient who was hospitalized in New Haven, Connecticut not long ago. More recently, the 5 year old daughter of two Detroit first responders died from complications associated with COVID-19. So did the 5 month old baby of a New York City firefighter. Age aside, we know that the mortality rate of COVID-19 is disproportionately higher among Black and Hispanic populations and, regardless of race, is much higher among men than women. There may be a number of lifestyle, environmental and economic factors contributing to these disparities, but we don’t know for sure. All we know for sure is that COVID-19 does not discriminate. It will attack anyone regardless of age, gender, ethnicity or geographic location.

Are we as sports officials more at risk because of what we do?

Absolutely. At a basketball, baseball, soccer or football game, multiple athletes are handling the ball which you, too, are handling. An organism could live on that ball’s surface and infect you. When you break a sweat, how often do you wipe your face with your hands? How often do you put your whistle in your mouth? These actions put you at risk. Granted, for the time being, sports at all levels – from youth to the pros -- are currently suspended, so you won’t be in those risky situations for a while. But if and when play resumes, think about how to protect yourself and be conscientious about taking preventive actions before, during and after every sports contest you officiate. If and when we get to return to the field, court or rink, we may have to operate differently. For example, will we have to wear gloves and face masks and, if so, could such masks enable us to have whistles in our mouths? Incidentally, Smitty – a supplier of officials’ apparel and accessories – now offers a black and white striped washable/reusable face mask with or without the IAABO logo. Masks or no masks, it’s going to be a strange new world for sports officials.

If you experience symptoms or are around people who are infected or you suspect are infected, should you get tested and, if so, how can you get tested?

While we definitely need more comprehensive testing nationwide, not everyone should get tested. If you do not in fact need to be tested but get a test anyway, the health care professional administering the test is using up test kit materials which are in short supply and which should go toward testing someone more at risk or symptomatic. What’s more, despite wearing personal protective gear, that health care professional is in harm’s way the more people he or she comes close to in order to administer a test. So unnecessary tests have potentially harmful consequences. That said, if you are symptomatic, you should call your doctor and tell him or her about your symptoms. If your doctor prescribes a test for you, you can get tested at one of the various sites open for testing, including drive-through test sites. Depending on where the test material is sent, it could take several days or more to get the results because of the overwhelming number of tests sent to labs that cannot quickly process them. However, new testing technology is available or in the works that can deliver a result within a few minutes, without sending the test sample to a lab. While that technology could be a game changer, the reliability of such tests has yet to be confirmed.

How can you protect yourself against COVID-19 infection?

• Wash your hands several times throughout the day -- especially if you have been outside or handled cardboard packages delivered to your home, or packaged grocery products, or even your daily mail – or if you have touched surfaces that may be housing the virus.  DO NOT skimp on this preventive measure. And remember that soap and water are more effective than hand sanitizers such as Purell. Those sanitizers are only useful if you do not have access to soap and water. Also, after washing your hands, use a moisturizing lotion, because frequent hand washing can dry and damage your skin, causing cracks and fissures that could make you susceptible to infection.
• Wear protective gloves when you’re out and about, especially when shopping. Dispose of the gloves after each single usage.
• When you get home, remove your clothes and get in the shower. That’s because the COVID-19 virus attaches itself to hair and clothes.So when you get home, don’t just sit anywhere while still dressed in the clothes you wore outside your home.
•      Launder your clothes in hot water immediately if possible after you’ve been out. Detergent can kill the virus. If you can’t wash your clothes right away, at least hang them in sunlight which also helps neutralize the virus.
• Slip into a different pair of shoes when you get home and then wash your hands. The COVID-19 can be spread on shoes.
• Keep your home’s hand rails, door knobs, and other metal objects clean. Try not to touch them before you clean them.
• Drink lots of hot liquids such as coffee, soup, and tea. In addition, take a sip of warm water periodically because this keeps your mouth moist and washes down any of the virus that’s entered your mouth. If the virus goes into your stomach, your gastric juices will neutralize it before it can get to your lungs.
• Get lots of sleep. You need to be as well rested as possible to fight infection.
• Hydrate, Hydrate, Hydrate. Constant hydration is good for your health in general and helps fight viruses. When you’re sleeping, your body tends to dry up, so keep a bottle of water near your bed. That way, if you wake up dry and thirsty, you can grab a sip of water before going back to sleep.
• Gargle daily. Use an antiseptic or warm water with or without salt or lemon.
• Eat fruits and vegetables. Try to elevate your zinc levels.
• Wash all fresh fruits and vegetables before eating them.
• Don’t smoke. COVID-19 aside, you should never smoke (or you should quit now if you do smoke), as smoking is hazardous to your health.
• Attack any throat soreness or discomfort immediately. Use the above precautionary methods to do so. Remember that the virus can enter your system through the throat and could sit in your throat for 3 to 4 days before it passes into your lungs.

Here are some critical measures to take -- especially when you leave your home:

• Wear a mask, period!! No exceptions! You can purchase masks from a variety of sources online and locally. If you’re lucky enough to be able to buy some N95 medical grade masks then get them, as long as you’re not adversely affecting supplies to healthcare providers and first responders. These masks offer the best protection, but other masks can help, too. Consider double-masking to increase your level of protection. Remember that wearing a mask does not just help protect you against becoming infected by others but also helps protect others against becoming infected by you. But don’t rely on having just one mask. Try to acquire 4 or 5 and use different masks on different days.
• If you cough or sneeze, do so into your arm to prevent spreading possible COVID-19 droplets. That’s important. Consider that a sneeze comes out of your body at 100 miles per hour! You want to do everything possible to prevent that sneeze from traveling fast and far.
• Keep your distance from other people. You’ve all heard the recommendations to practice “social distancing.” Do it. Remain at least 6 feet away from other people. We know that social distancing works. We’ve seen places where people have ignored social distancing and the COVID-19 virus has struck these people with a vengeance and spread dramatically. In fact, as recently as April 19^th, Kentucky experienced 273 new confirmed cases of COVID-19 -- their highest single day increase to date – after protesters hit the streets without keeping their distance from each other to try and get their state reopened.

ABOVE ALL, RESPECT THE VIRUS

Take the precautions I’ve noted above and act as if your life depends on it – because it does. So do the lives of your family, friends, neighbors and colleagues. Unfortunately a lot of people think they can break the rules. No, they cannot – not without endangering themselves and everyone around them. Some people believe that the restrictions that have been put in place around the country are violations of their civil rights. They aren’t. These restrictions are there to help protect people from contracting or spreading the COVID-19 virus. Obeying these restrictions is simply the right thing to do. As a doctor, I’ve seen the heartbreak and tragedy caused by the insidious COVID-19 virus. I’ve seen otherwise perfectly healthy people get knocked down by it. I’ve seen people whose health was already compromised suffer greatly because of the virus. I work side by side with doctors, nurses, medical technicians and others who put themselves in harm’s way every day to protect you and people like you. They deserve our thanks and admiration. More than that, they deserve having you do the right thing so as to not make their jobs any more difficult or dangerous. Put simply, respect the virus and do everything you can to protect yourself, your family, and your community. If we all do so and work together, we will save lives, including our own, and hasten the day when COVID-19 has run its course and we can return to our normal daily lives, including the avocation we love -- sports officiating.