What should we be doing to prepare our families, workplaces, and communities for Coronavirus (COVID-19)?
I’ve been talking a lot with friends and community members about what to do to prepare, whether or not we should be worried, and how best to deal with the coming disruptions that will likely happen to our daily life across both family and business. I wanted to take the time to share what I would do and how I’m preparing for the next three to nine months, especially if you’re pregnant, giving birth, or a parent with small kids at home.
Some context: I am the executive director of Startup Pregnant, a company focused on pregnant women and working parents. In our online communities and in my email inbox, I’ve been fielding lots of questions about how to prepare for Coronavirus especially if you’re currently pregnant, what to do about school disruptions and small children, and how to prepare our families for the upcoming disruptions to our work and civic life. I hope this is helpful to many of you. Throughout and at the end, I’ll include links to articles and resources.
In this article I’ll cover:
What is Coronavirus (COVID-19)?
Why we should all prepare — my point of view
What we are dealing with
Social and civic reasons to prepare
Dealing with fear and worry and how to stay calm
Is this just media just hype?
How to prepare for coronavirus if you’re pregnant
Important preparations + my shopping lists
Our collective civic duties
The case for preparing even if it’s not that bad
DISCLAIMERS: I am a parent, a writer, and a researcher with degrees in psychology and biology, as well as a graduate degree in urban planning and landscape architecture. I like to plan ahead for things and tend to overthink, over research, and prepare. That’s my nature—I’ve been writing massive articles and blog posts based on my overthinking since I was a teenager. That said, I am not a doctor, a medical advisor, and I don’t work within healthcare systems. I am writing this from the perspective of a citizen and a parent—none of this should be construed as medical advice. Please heed your local community guidelines and governments, the CDC, and other sources as this outbreak progresses. You can find all all of my sources listed throughout and I’ll try to keep this as up to date with new information and corrections as I gather more information.
What is coronavirus (COVID-19)?
The novel coronavirus is a newly identified upper-respiratory tract illness that was first identified in Wuhan, China in 2019. The name “novel” means new, and the name COVID-19 stands for Corona Virus Disease, and the year 2019.
From the CDC website:
“On February 11, 2020 the World Health Organization announced an official name for the disease that is causing the 2019 novel coronavirus outbreak, first identified in Wuhan China. The new name of this disease is coronavirus disease 2019, abbreviated as COVID-19. In COVID-19, ‘CO’ stands for ‘corona,’ ‘VI’ for ‘virus,’ and ‘D’ for disease. Formerly, this disease was referred to as “2019 novel coronavirus” or “2019-nCoV”.”
“A novel coronavirus is a new coronavirus that has not been previously identified. The virus causing coronavirus disease 2019 (COVID-19), is not the same as the coronaviruses that commonly circulate among humans and cause mild illness, like the common cold. There are many types of human coronaviruses including some that commonly cause mild upper-respiratory tract illnesses. COVID-19 is a new disease, caused be a novel (or new) coronavirus that has not previously been seen in humans.”
You can read all of the developing and up-to-date information about COVID-19 on the CDC website. [Source: CDC]
I’m a planner and I am often an over-preparer. I like to be as prepared as possible for things and it calms me down—appeases my sense of control, I suppose. When I look at the landscape of what’s possible with the spread of a highly communicable disease, I think it’s a good idea to do some basic preparation. In the best case, we plan ahead and the virus outbreak is less intense than we think, we slow the rate of infection down so that our hospitals and medical providers can better handle the crisis, and/or a large percentage of the population is asymptomatic or has only a mild case. These would be great outcomes. Planning ahead—calmly and reasonably—is a great idea.
Here’s what we need to do to prepare, in a nutshell:
— Have 30 days of food, supplies, and medications on hand in the instance we have to self-isolate or quarantine. (The purpose of a quarantine is not just if you’re sick; it’s to prevent the spread of disease, see more below).
— Have a work-from-home plan ready for your business and your job; ask your supervisors to have one ready and prepared.
— Prepare for a disruption to your childcare and your workplaces over the next few weeks and months.
— Talk to your family members and check in with your neighbors who might need more help than you.
Before I get into the numbers and how a viral spread can be so potentially impactful, I want to say that we are dealing with several things all at once, each of which presents a different challenge:
— The spread of COVID-19 itself.
— A surge in the demand for hospital beds and an over-taxation on our healthcare and hospital systems, and the subsequent illness and death rates as a side-effect of hospital overcapacity. Of particular concern is that we are under-equipped when it comes to respiratory facilities in the United States.
— The impact on local economies and individual lives based on isolations, quarantine, and illness (or related school, work, and business shut-downs).
— Global supply changes and any related economic fallout.
— Additional impacts due to fear or widespread panic (runs on items, running out of supplies).
We can deal with and address each of these differently. The actions you can take to help today might be small, but they likely do matter. We need to do a combination of things: take pragmatic action, take care of our vulnerable populations, and also remember that many, many people will be okay is important.
As Zeynep Tufekci wrote in Scientific American on February 27, 2020, “Preparing for the almost inevitable global spread of this virus, now dubbed COVID-19, is one of the most pro-social, altruistic things you can do in response to potential disruptions of this kind.”
“We should prepare, not because we may feel personally at risk, but so that we can help lessen the risk for everyone. We should prepare not because we are facing a doomsday scenario out of our control, but because we can alter every aspect of this risk we face as a society. That’s right, you should prepare because your neighbors need you to prepare—especially your elderly neighbors, your neighbors who work at hospitals, your neighbors with chronic illnesses, and your neighbors who may not have the means or the time to prepare because of lack of resources or time.” [Source: Scientific American.]
The World Economic Forum published a piece about reducing the impact on hospital systems and why preventative action can help us stop one of the biggest issues—overwhelming healthcare systems. Here’s the chart, originally created by Esther Kim and Carl Bergstrom (published with Creative Commons, share widely):
I’ve heard some people say, “well, let’s just have everyone get sick all at once and get it over with, if we’re all going to get it,” (some epidemiologists think 40-70% of the world’s population will get it within the next year). I’ve heard other people who are healthy or low-risk say “well, I’m not going to let this disrupt MY travel; everyone’s overreacting.”
While it may not affect you personally as much, the real challenge here is preventing a sudden burst of everyone getting it at the same time. If everyone gets it all at once, we run the risk of overwhelming our healthcare systems. This is catastrophic because if we run out of hospital beds, the death rates increase tremendously because people who need to be hospitalized can’t get the attention they need. This is compounded by the fact that the hospitals will likely be understaffed because healthcare workers will also be getting sick.
The reasons to prepare, self isolate, and prevent the spread of the disease are so we can collectively slow the rate of infection and keep hospitals open for people when they need them. Further, it helps slow the rush on certain health items and extend the timeline we have to create tests, and potentially a vaccine.
There are different ways we each react to crisis:
Some people get scared and want to avoid the news. Some of us freeze, some of us run, some of us fight. Some people need to downplay the risks to stay calm. Some people over-prepare and read everything obsessively. Some folks, called “doomsday preppers” prepare for the worst possible outcome.
I think it’s worth saying that we all react and strategize differently, and for the most part—that’s okay. If you need to limit your media exposure or act as if life will go on as normal, I’m pretty sure that’s actually a healthy response for a lot of people that would otherwise get consumed by worry and over-prepare or panic, which isn’t helpful either. In my opinion, it’s not worth shaming or fighting with each other over the “right” response—remember to have empathy as we each react differently in each situation.
That said, I’ll make the case for a decent amount of preparation and why increasing your sanitization efforts and potentially increasing our social isolation efforts very soon are likely to be good moves. If it helps, plan ahead and prepare just enough—have a few weeks of food on hand, have a work backup plan, and consider your neighbors, parents, and friends that might need extra help. Being cautious and being prepared can be great, and in addition, it can be a civic kindness to those who are more vulnerable to help to reduce the spread of the virus. I’ll go over what I’m doing to prepare in part two down below, but first, let’s talk about how the virus works and what the effects will likely be.
For those of you caring for elderly parents or at-risk populations, remember that taking care of yourself and your mental state is equally important. Dealing with the worry and the fear is also something we will need to do. It is a good idea to increase self-care options: take walks in the forest, call friends and talk to them, reassure yourself that you’re doing the best you can, journal daily, talk to loved ones, and get plenty of sleep if you can. Take steps to make your life easier if you can and remember that stress is also a challenge, and so taking steps to decrease your stress is also wise.
It’s hard to understand and conceptualize these risks and really understand what they could potentially do to our daily life and the coming year ahead. Most of us haven’t been alive during a global epidemic or pandemic, and our brains are not wired to understand exponential rates of change. Let’s walk through a bit of it, although experts here will explain better than I can.
Adam Wren, a Geopolitical Analyst debunks why low current death rates, or arguments that “it’s just the flu,” or “the mortality rate is only 2%” are problematic.
“The main risk of the coronavirus outbreak isn’t that you’re going to get sick and die, it’s that so many people are going to get sick so quickly that our healthcare services and infrastructure are going to be completely overwhelmed.” When thinking about this, we need to look at R0, which is a measure of how infectious a virus is—how much it spreads. Because COVID-19 can last on surfaces for 9-27 days, and the incubation period (how long you can have the virus before you know you’re sick) can be anywhere from 2-14 days, people can be carrying and spreading the virus a ton before we even know where it is. The current best estimate of the R0 of COVD-19 is “assumed to be between 1.4 to 3.8, potentially much higher.”
I’ll share some of what he wrote:
“The worrying parts: The virus is highly infectious, potentially nearly twice as infectious as the flu. It might be far higher, there isn’t anywhere near enough data yet. Infected people could spread the disease for up to two weeks before showing symptoms. Some people don’t show any symptoms at all and could infect an enormous number of people.
“In The Atlantic, Marc Lipsitch, a leading epidemiologist at Harvard reported that “that within the coming year, some 40 to 70 percent of people around the world will be infected with the virus that causes COVID-19”. This was last week and while ridiculed at the time, his assumptions are now the generally accepted position among epidemiologists.”
Liz Specht, on Twitter, shared a few case examples of the how a contagious disease can spread quickly and the mathematics of disease spread, plus the fallout. You can read the entire thread here. I’ll recap a little of it, but the important things to note are that exponential rates are very hard for humans to understand, and we are predictably wrong in thinking about risk when it comes to situations like these. It may seem like there are a few thousand people—what’s the big deal?—but if a disease doubles in rates every six days, then it only takes a couple of months for most of the globe to be infection.
Let’s conservatively assume that there are 2,000 current cases in the US today, March 6th. This is about 8x the number of confirmed (lab-diagnosed) cases. We know there is substantial under-Dx due to lack of test kits; I’ll address implications later of under-/over-estimate. 2/n
— Liz Specht (@LizSpecht) March 7, 2020
We’re looking at about 1M US cases by the end of April, 2M by ~May 5, 4M by ~May 11, and so on. Exponentials are hard to grasp, but this is how they go. 4/n
— Liz Specht (@LizSpecht) March 7, 2020
What are the risks and could they be overstated?
We still don’t know a lot—we don’t know how the virus will behave during the warmer summer months, we don’t know the actual number of cases, and we don’t know how many people are asymptomatic or have mild cases, and we don’t know how long the incubation period really is, although we have guesses. A lot of this hinges on the fact that we don’t have enough testing kits and/or we haven’t been testing. Right now I think it’s best to prepare as though we will have a worst-case scenario.
Here’s the thing: we don’t know what to expect yet, and all indicators in terms of virility, spread, and projections for exponential rates of growth say we should prepare. When your more cautious leaders are saying to prepare, I pay attention.
In the best-case scenario, we see the virus stall in the warmer months (although remember that warmer months don’t happen everywhere—some people get warmer months while it gets colder in other parts of the hemisphere), and/or a greater percentage of the population isn’t affected for reasons unknown. In these instances, consider that you’ve now pre-purchased your summer camping supplies or emergency stores and have extra medicines and supplies on hand that you’ll use up in the next few months. The case for preparing versus the risks are very strong. Don’t sit out on this one.
Don’t panic, but do take steps to protect yourself—and your neighbors.
Okay, let’s talk next about how to prepare.
HOW TO PREPARE FOR COVID-19, PREGNANCY, AND BIRTH
With my first pregnancy, I got a really bad upper respiratory infection and coughed for weeks. I ended up bruising a few ribs and I was miserable. One of the things that’s so hard about pregnancy is that your immune system is weakened and you can’t take all of the regular cold and flu medications that you might normally take. If you’re getting sick with any cold this season, I feel for you—it’s so hard!
At this point, we don’t know a lot about how coronavirus affects pregnancy and unborn babies, or what the risks are. Let’s look at what we do know so far, what you can do, and why I would advise you, if you are pregnant, to try not to worry too much right now (if possible).
WHAT WE DO KNOW ABOUT PREGNANCY AND COVID-19:
First, what do we know? As of right now, from the CDC:
“We do not have information on adverse pregnancy outcomes in pregnant women with COVID-19. Pregnancy loss, including miscarriage and stillbirth, has been observed in cases of infection with other related coronaviruses [SARS-CoV and MERS-CoV] during pregnancy. High fevers during the first trimester of pregnancy can increase the risk of certain birth defects.”
This is alarming at first, but digging in deeper, the risks of miscarriage and stillbirth is just slightly higher. This has always been true—getting a high fever can be hard on a pregnant woman and occasionally have adverse outcomes in your pregnancy. Please remember, however, that most people who are pregnant, who get fevers, are still okay. This does not mean that getting this virus or another virus means you will automatically get a miscarriage or have a preterm baby. Your risk is slightly higher. There are a lot of things that can happen in pregnancy and it can cause a lot of worry.
Buzzfeed has a good article about pregnancy and COVID-19, and in it, Zahra Hirji writes:
“According to a Lancet study published last month, of the nine pregnant women reportedly admitted to the Zhongnan Hospital of Wuhan University in China in late January, seven had a fever, four had a cough, three had muscle pain, two had a sore throat, and two reported general discomfort.”
“None of the patients developed severe COVID-19 pneumonia or died, as of Feb 4, 2020,” per the study authors. Four of the nine women birthed their babies early, although beyond the 36-week mark. It’s unknown if this was due to the illness or not. The babies were born relatively healthy.”
So what can you do, given these potentials?
FIRST, PRACTICE GOOD HYGIENE
The first, most important course of action you can take are basic preventative health care measures. Try not to get sick. Wash your hands thoroughly, disinfect your doorknobs and basic surfaces, ask your other children to cover their mouths if they cough. Use social distancing measures if you can. But this can be challenging if people present no external symptoms or you have a job that requires lots of in-person interaction.
PRACTICE PRECAUTION AS NECESSARY
Use your own guidelines with your own comfort level for what to do next. If you feel like you need to be extra cautious and stay away from other people listen to yourself. You have permission to do what you need to do to keep yourself healthy, and if that means being extra-cautious, feel free to do this.
Personally, I used my doctor’s advice and asked for a note whenever I needed something that I wasn’t sure if other people would be on board with. “Ah, my doctor said I shouldn’t go out to social events right now, let’s catch up by FaceTime or set up a Zoom Call.” In the case of work, use the creativity strategy to help figure this out. “Love this, how can we get creative about solving for this while I work from home? Can we do a brainstorming session? My doctor recommends avoiding crowded places and workplaces for a while, and I figure it’s a good idea for me to be healthy and able to work versus sick and out for along time—I’ll get more work done this way.” Use a doctor’s note to keep quarantined if it’s what you need.
PLAN AHEAD TO MAKE YOUR LIFE EASIER
Next, prepare to make it easier on yourself if you do get sick—what foods do you love to have on hand? Can you create a list of your favorite foods, people to call in a pinch? Who can help you, what will make you feel better, and what are your favorite sick-time foods and comforts?
Have pain and symptom relievers on hand to help you navigate a bug if you do get sick. I’ll list them down below, but a steam inhaler, Vick’s vapor rub, epsom salts for baths, massage oils, eucalyptus oil, zinc and vitamin C, elderberry syrup, and other meds can help. Talk to your general practitioner or OBGYN about what to do if you feel ill.
PREPARING FOR BIRTH—WHAT DO YOU NEED TO KNOW? WHAT MIGHT CHANGE?
To me, my brain would triage in a couple of different ways. This is my opinion only—this is how I would prepare and think about it. A few broad-strokes questions to consider:
If you have an older child at home, who will watch them and care for them in the instances that their schools close?
If your birth partner or caretakers get sick, who do you want with you at the birth as a backup? Who can be a backup childcare provider?
If there is a surge at the hospital during the week(s) you are due with your baby, do you have alternative plans and places for birthing?
If you need to be quarantined during your postpartum period with your new baby, do you have extra supplies and food on hand for that period?
Please don’t let this overwhelm you—instead, take a few hours and think through who you know that you could call on in a pinch. Who are your friends and neighbors that you’d want to support you? Do you have additional family members? It might feel strange to do it, or you might not be that close, but in a twist, disasters or unexpected events are often catalysts for new friendships or increased rates of neighborliness. Make new friends or join an online parent’s group and talk about what’s coming up for you and ask what everyone’s doing to prepare.
More than likely, you will not have to switch your birth plan, but that wouldn’t stop me from reaching out to a few local midwives and doulas and asking to have their contact information on hand. If you go into labor and you need to call someone in a pinch, you’ll be glad to have their numbers.
YOUR PLANNING TO-DO LIST: Add two friends to your birth plan as a backup, write down the numbers of two local midwives or doulas you can call if this takes a turn for the worse.
PREPARING YOUR FAMILY FOR COVID-19: SHOPPING LIST AND QUARANTINE SUPPLIES
For parents with small children, one current relief is that this virus doesn’t seem to be affecting children as much as we expected. [Sources: JAMA article and study]Since we have seen that children have had mild to no symptoms so far, this might provide some solace to those of you with older children.
In addition, here are some resources:
- This podcast episode on preventing the spread of Toddler Germs on The Startup Pregnant Podcast — listen for tips on keeping toddler germs out of the house (including changing their clothes when they get home so their grimy shirts aren’t bringing more germs into the house)
- Winnie wrote an article about preparing for childcare backup plans.
- Most children don’t seem to be affected so far by COVID-19, which is wonderful news.
How to prepare your family for a disruption—Coronavirus prep list
In all likelihood, many of us will be asked to stay home or self-quarantine for a few days to a few weeks. In the worst-case scenarios you might have to do so for a month or longer; it’s not clear yet. Hopefully it’s on the shorter end, but it’s worth buying what you need so you can make it work.
I’ll also say that I have long-term asthma and have suffered from lots of bouts of bronchitis and other lung-related issues. I’m not looking forward to this particular virus, and so I’ve taken some extra precautions in addition to the ones below.
HAVE 30 DAYS OF FOOD, MEDICINES, AND SUPPLIES ON HAND
Have at least 30 days of food on hand in the event that your local government or community asks you to stay inside. Do this right away—don’t wait. The virus numbers are still very low right now, but they’re likely under-reported and will double every few days. Here’s what I purchased for our family:
Pantry items: Mac and cheese, shelf-stable crackers, canned tunafish, sardines, and anchovies, mayo, seeds and nuts, canned soups and broths, canned chili. Chia seeds, oatmeal, dried milk or boxed milks, chocolate bars. Pastas, rice, beans, lentils, quinoa. Peanut butter and other nut butters.
Frozen foods: lots of frozen veggies (I’m going to miss those if it’s a month away!), frozen meats, frozen fruits. Several packs of frozen butter, 3-4 bags of coffee stored in the freezer.
Household items: diapers, toilet paper, paper towels, bottle of bleach, bottle of alcohol (it works as sanitizer), tampons, feminine products, anything else you use in a regular month, like dish soap and laundry soap.
Health care items: any medications you use on a regular basis; get a refill as soon as you can. Jave a 30-day supply on hand.
Sick and wellness items: Zinc, Vitamin C, Elderberry, warm teas. Netipot, sinus rinse, steam inhaler, Flonase, lung inhalers in case you need them. Vick’s Vapor rub, cough drops, advil or anti-inflammatories and decongestants for you. We have humidifiers in both bedrooms and an air filter and run them while we’re sleeping.
Children’s health items: Have a full bottle children’s tylenol and children’s motrin. High fevers can cause febrile seizures in infants and young children, so one of the most important things you can do is keep their temperatures down if they get sick—children’s motrin can be great for this.
EXTRA PRECAUTIONS IF YOU ARE AN AT-RISK POPULATION
I called my regular doctor to chat with them about getting steroidal inhalers should I need them during this illness. I am also making a plan for my personal health given my history and what to do.
For those of you with more severe illnesses, or if you aren’t covered by health insurance and you’re scared of going to the doctor, call ahead to your local urgent care centers and ask if they have a cash option or if they’d be open to it. Many practices will take cash instead of insurance and not having insurance shouldn’t prevent you from being able to see a doctor. There are also telemedicine options available lately which could be useful. I’ll post more here as I learn more.
Right now, it seems like the virus is impacting men more than women, especially men over the age of 40 [Source—NPR].What does this mean? In general, take preventative health care measures however you can.Now is not the time to work even harder; sleep as much as you can. Rest up. Drink a lot of water every day. Eat your fruits and veggies. Cut back on sweets if you can (I mean, I’m eating toast with honey right now while I’m typing, so do your best.)
More seriously, do make sure you have life insurance policies if your family is dependent on a single man who is older and other people aren’t working.
The other thing to note is that this will affect different populations in very different ways. My job—at a startup!—is relatively stable, save some hits and turbulence, but I have some savings and means and can work flexibly. Not everyone has this ability. Thinking about people in various duties and jobs—bus drivers, delivery drivers, school teachers, doctors, hospital staff—and we can start to see how the ripple effects of getting sick will be very different for different populations.
In our building, we have neighbors that are 70, 80, 90. What do we do for them? I’m worried about some of my older neighbors because they will weather this virus differently. As a family, we are implementing some measures that are common sense and good hygiene: my kiddos aren’t allowed to push the elevator buttons anymore, and we’ll bring hand sanitizer and wipes to clean up their snotty finger trails as best we can. I’d like to put a bottle of hand sanitizer at the front of our building (if I can get a hold of one), just to help keep some of the germs at bay. I’m going to give my phone number to our neighbors so they can call us if they need a grocery run or they need to see a doctor if they get sick (honestly, I should have done this before).
What this means during a disaster is that people will be unable to prepare, and that will cause death rates to be higher. What we can hope our governments and local lending institutions do is make small business loans and small family loans accessible at very low to zero interest rates, as well as paid sick leave for people who otherwise wouldn’t be able to take sick leave from their jobs and stay employed or make enough money for their families.
Overall, these preparations, if done calmly as a precaution, aren’t a bad idea for every day life anyways.
Here’s where I fall on this, at the end of the day: preparing and taking steps to make you, your family, and your business as healthy as possible, and engaging in civic behavior to help our peers is always a good idea.
Things like staying in touch with our neighbors. Preparing a work-from-home plan and having backup childcare. Getting our businesses prepped for working remotely and flexibly. Staying agile and creative during recessions and downturns. Having life insurance and end-of-life plans. These are all beneficial skills to have in any situation, so I am in the camp of “prepare wisely, act cautiously,” because it’s our best case efforts here—and the best-case outcome—is if the virus slows down the spread, affects us less than we expect, and we have the space and cadence to be able to help everyone that needs help with hospitalization.
I see preparing as a civic duty. Don’t stockpile hand sanitizer (basically—don’t be a jerk), but do have enough supplies on hand to last a couple of weeks. Wash your hands and increase sanitization and health practices to help slow the spread of the disease—doing so will save lives. If you don’t have sanitizer, use soap and water: it works great. Remember, if you run out of toilet paper, you’ll be fine—create some rags and do extra laundry or use the shower to rinse off after you eliminate.
It’s like camping, for many of us. You’ll be okay. Also remember: constraints also ask us to think creatively. You will be able to think creatively as you need and innovate. Even if you can’t prepare today, you’ll be able to do what you need in a pinch. If the stores run out of Vicks’ Vapor rub, grab some eucalyptus essential oils or just take a steam bath whenever you can.
You’ve got this.
Sarah K Peck writes about parenting, gender, leadership, and the future of work. She is the founder and executive director of Startup Pregnant and the host of The Startup Pregnant Podcast.