Update: Thursday, March 26, 2020 – The U.S. now has more confirmed cases than anywhere else in the world and we still haven’t hit our peak yet according to NIAID Director Dr. Anthony Fauci. Read this article from Vox news for more details and what to do next. Hint: Continue to practice social distancing and self-isolation. Otherwise, this will drag on longer than it should.

UPDATE: Friday, March 13, 2020 – President Donald Trump declared a National Emergency to free up Federal funding to battle this pandemic. Currently, his travel ban only restricts foreigners coming into America, but not Americans traveling out of the U.S. Track latest case numbers as more testing is made available here or scroll down to bottom list of resources and view Johns Hopkins University interactive map.

As of Wednesday, March 11, 2020, the World Health Organization (WHO) declared the novel coronavirus a “pandemic.” This simply means that the disease it causes known as Covid-19 has spread globally affecting more than 118 countries and territories including the U.S. since it’s outbreak in Wuhan, Hubei Province, China from December 2019. They have since recovered and have returned to their daily lives as of the first week of March, per my in-laws in Shanghai. China recovered quickly because their government took extreme, but necessary, measures to contain the virus by prohibiting any social gatherings and imprisoned anyone and their families who broke self-quarantine or isolation. We know this because my husbands family has ties to military in China. His family worries for our lives now as the virus spreads quickly across America with over 30 cases in Los Angeles county alone as of March 12, 2020. *Note: Check CDC.gov or Johns Hopkins map for daily rates of cases.

For those who don’t care to read, watch and share this animated video from Kurzgesagt.

Check Facts to Ease Panic

This article is meant to serve as a point of reference for factual resources. As Health Officials advised weeks prior to the writing of this post, don’t panic, and for crying out loud – we are NOT going to run of toilet paper or our water supply. This is not the zombie apocalypse. However, I really want to stress to those who think Covid-19 isn’t any big deal: CHECK YOUR FACTS in the resources listed below. If you don’t like to read much, follow @who @nihgov @niaid and @cdcgov on Instagram or Twitter. Covid-19 is deadlier than the seasonal flu (2-3.4% vs 0.1-0.2% as of this writing) especially to those who are high-risk with “underlying health conditions, diabetes” and compromised immune systems including my Type 1 diabetic five year old daughter (oldest of two). New research regarding how the coronavirus affects those with Type 1 diabetes is still underway. As of March 12th, I decided to keep Coral home from school until CDC updates the public with a decline in cases in LA regardless of LAUSDs lack of prompt action.

Learn more about how Covid-19 compares to the seasonal flu here. Note: There is a multitude of information but researchers are still gathering data on a more accurate mortality rate of the novel coronavirus as the days go by. The article I’ve linked from Live Science was thorough and pulled sources from Health Officials I’ve mentioned earlier.

Be considerate of your community and stay in self-quarantine as advised by your physicians and the Department of Health. Don’t be a foolish a-hole and put other people’s lives at risk. Practice social distancing now to prevent further spread and deaths within your community.

Coral demonstrates how she does the #safehands challenge initiated by @who on Instagram.

Follow Health Officials Guidelines

It’s important to note that we can still change the course of this respiratory disease by taking steps listed out by WHO as some of you might have seen in past weeks if you’ve been following
Coronavirus on your Apple news feed like me:

  1. Stay home if sick and experiencing flu-like symptoms – call your physician asap. Do not head directly to the hospital or ER until you receive further instructions from your healthcare provider.
    • Avoid touching face
    • Cough or sneeze into your elbow or tissue
  2. Wash your hands and tell your kids to do the same – especially if still at school. Be vigilant with good hygiene and sanitizing surfaces with frequent contact.
  3. Follow health officials and physician’s orders to self-quarantine if you’ve traveled out of the country in the past 30 days primarily Iran, China, South Korea. Check CDC.gov for more level 3 zones and travel restrictions.
  4. Be considerate of those with compromised immune systems and the elderly – they are at highest risk of Covid-19.
  5. Educate yourselves – per CDC, people may be asymptomatic for days or weeks and still contagious. So stay the f*ck home and don’t spread the disease. Unlike, China, America’s democracy and bullshit politics prevents imprisonment for those who fail to self-quarantine. To those selfish butthole’s, you better pray locals don’t retaliate. I won’t be surprised if it gets to that point especially in Los Angeles given the already present plethora of self-entitled ignorant pricks and transients living here.
    • National Guard Activated in Florida, Iowa, New York, Louisiana, Rhode Island, and Washington already called in the National Guard earlier this week. California and Maryland are expected to do the same.
    • Break the Stigma – Just because we’re [part] Asian doesn’t mean we have the coronavirus and stop calling it the “Chinese Virus.” Learn the basics here.
  6. #Flattenthecurve – the only way we’re going to be able to control the rate of speed this disease is spreading is to do all the above AND practice #socialdistancing, per Dr. Anthony Fauci of the National Institute of Allergy and Infectious Diseases (NIAID).
    • We need to stop social gatherings until if and when things stabilize again – use apps like Zoom, Facetime, Skype, WhatsApp or WeChat.
    • Stay 6ft away from other people even if you’re asymptomatic – you could still be carrying the virus and be contagious.
    • If you must go out for vital essentials (not limited to Prosecco), then go during off-peak hours before 9am or after 8pm. Check your local grocer for hours of operation and Google it for peak times prior to leaving your home. Ladies, take pepper spray with you or send a male friend or your spouse in the evenings.
    • Order in dinner or non-perishable groceries with apps like DoorDash, Grub Hub, Amazon Fresh, or Pavilions (AKA Vons). Use your own discretion as to how safe you think the food is from the restaurant to the driver then to you receiving it. If you haven’t stocked up your freezer and pantry of a minimum two weeks worth of food by now, then you’re way behind the rest of us proactive peeps. So far, according to the CDC, there is still no data that proves the coronavirus can be transmissible through foods. Fingers crossed. Update 3/26/20: We haven’t been able to place an order on Amazon Fresh or the Pavilions app for the past two weeks. Costco.com delivery has worked out better but we must place our order a week in advance and keep checking our order status daily for updates. Watch this YouTube video of a doctor’s advice how to sanitize your groceries or takeout food (only order hot foods).
    • If available, order all medication and insulin through an online pharmacy like OptumRx Even though they’re absolutely clueless about Dexcom, it’s more convenient than physically picking it up at a major pharmacy where the lines will be hectic with a bunch of sick frantic people. Check with your insurance provider to see what’s available in your area. When we had Kaiser living in the Valley in 2016, we were able to request the pharmacy mail us our insulin and they’d place it with gel ice packs in a well-insulated box with padding and/or styrofoam.
      • Have endo rewrite your prescriptions to the max allowed covered by insurer. Even if you get denied by insurer, then have your endo send a pre-auth for a higher quantity of medication so you don’t run out of life-saving insulin or medication during these hectic times. Be persistent and resilient.

Be Prepared

DiaTribeWhat you need to know about diabetes and the Coronavirus, 5 minute read. Bottom line: the more chronic conditions one has, the higher the risk. Also, read Coronavirus Preparation Strategies and see their Diabetes Shopping List.

I posted some immune boosters we usually stock up on and have used before this outbreak on Instagram. Also, shop our Low Carb Goodies and typical T1d Supplies on Amazon (not sponsored). You may also refer to our Quick Referrals and Good Glucose Snacks pages for more of our favs.

Top Resources for Coronavirus Facts and Updates

Centers for Disease Control and Prevention (CDC) – This is the main resource for facts and updates on the novel coronavirus. Read carefully asap! Stop the spread of misinformation especially on social media. CDC.gov should be everyone’s first go-to for current factual information about the novel coronavirus.

World Health Organization (WHO) – cross-reference data and resources on this site and above-mentioned CDC.gov. The top four I’ve listed will often reference each other because they all work together to combat the spread of viruses and diseases. Download and share WHO’s free infographics like some of the ones below on how to protect yourself.

National Institute of Health (NIH) – A valuable resource of must-read information and news of a clinical trial for vaccine. If there are any medical journals within the U.S. regarding new research findings of how the coronavirus affects T1ds, this will be one of those main sources.

National Institute of Allergy and Infectious Diseases (NIAID) – See factual and realistic approach by Dr. Anthony S. Fauci, MD, Director of NIAID here.

Johns Hopkins Coronavirus Resource Center – Take 15-20 minutes to explore and navigate your way through this site, but don’t let all the news feeds distract you. View their interactive map for live updates of cases around the globe. Be aware of the spread within your community.

California Department of Health – Update: As of March 13, 2020, 8 a.m. PDT, there are a total of 247 cases and five deaths in CA (including one non-resident).

As of March 12, 2020, 7 a.m. Pacific Time, there are a total of 198 positive cases and four deaths in California: 24 cases are from repatriation flights.

The other 174 confirmed cases include 60 that are travel related, 43 due to person-to-person transmission, 44 are community acquired (map of community transmission by county in California- PDF) and 27 are from unknown sources. Of all the confirmed positive cases:

  • Age 0 – 17: 4 cases
  • Age 18 – 64: 113 cases
  • Age 65+: 79 cases
  • Unknown: 2 cases

Approximately 11,100 people are self-monitoring, across 49 local health jurisdictions, after returning to the U.S. from travel. Google your state’s department of health for updates on daily cases and measures your state officials are taking to minimize the spread of Covid19.

CNN Audio: Coronavirus Fact vs Fiction – Listent to this series of podcasts. Share with friends and family or those misinformed Facebook groups who are too lazy to do their own research.

Type 1 diabetes and Covid-19

Dr. Bernstein’s take on diabetes and Covid-19 – watch YouTube video or see blog from A Sweet Life. Bottom line: Avoid the novel coronavirus and social distance or self-isolate as long as possible.

Beyond Type 1 – a brief 5 minute read of the coronavirus and how to prepare for it as a diabetic. Emphasis on difficulty of managing and controlling BGs once contracting the virus still needs to be addressed on all medical journals, research, and by diabetes organizations. Possibility of DKA remains a threat similar with the seasonal flu. Bottom line: Have tight control over glucose levels before actually getting sick and you’ll have better immune response to a virus.

American Diabetes Association – Read their articles covering Covid-19 before JDRF’s. Bottom line: Everyone with any type of medical condition should take proper precautions and stock up on medication and supplies. Practice social distancing and stay at least 6ft away from other people even if they are asymptomatic.

Parents, scroll down to the part where ADA mentions children with diabetes protected under Section 504. Emphasize to your school faculty and nurse(s) that your child is considered “high-risk” per the CDC and health officials recommend social distancing. Ask your child’s teacher for homeschool materials or a packet to be sent with you or mailed to you. As of today, 3/12/20, over 39,000 concerned parents have signed a petition requesting the closure of all LAUSD schools. I signed it.

Update: Friday 3/13/20, 9AM, PDT – LAUSD Superintendent Austin Beutner finally announced closure of all schools for two weeks starting Monday, 3/16/20 after a tremendous amount of pressure from concerned parents across all demographics. See that announcement here.

JDRF – As of 3/13/20, I received an email from CEO, Aaron Kowalski like many of you have, stating the “risk of contracting Covid-19 does not increase with T1d.” However, I stress the point, again, that there is still not enough conclusive medical research that proves whether or not this is true. I will post an update once I finally do find valid research from reliable medical sources (so closer to 6-12 months from now). See their guide here.

NOTE: My request on social media for anyone who knows of someone with T1d who has recovered from Covid-19 was met with a few different articles of the same one guy who went skiing in Italy and returned to the UK with coronavirus symptoms and later tested positive. So, please, speak out to your public health officials and medical researchers if you are T1d or a parent of a T1d child who has recovered from Covid-19. You will be doing a great service to the diabetic community. Thank you in advance.

American Association of Clinical Endocrinologists (AACE) – Type 2 diabetics or anyone averaging higher glucose levels are more susceptible to additional and severe complications once contracting Covid-19. Learn more here. Contact your endo or CDE for managing your diabetes.

Download a Medical Alert Stop Sign I designed. FREE for personal use only. It took me about three unpaid hours to design this on Adobe Illustrator. Please follow and credit @type1diabetic_life if reposting on Instagram or @typeonediabeticife on Facebook and mention my blog, Typeonediabetic-life.com in your caption. Mahalo!

Further Reading & Education

MedCram – Medical lectures explained clearly by Dr. Seheult. If you can’t understand him, then read all the other resources I’ve listed for you in this blog post thoroughly. Otherwise, there’s no hope for you.

Live Science – “Can People Spread Coronavirus After Being Infected?” Good 3 minute read and actually gives a positive outlook.

New York Times – Possible source of outbreak came from the rare pangolin at a wet market in Wuhan, China. Now, President Xi Jinping of China banned trade of exotic animals.

National Health Commission of People’s Republic of China – all in Chinese, but you can use the translator feature in your Google Chrome browser and it’ll translate some of it.


Questions About T1d and Coronavirus Remain

Even after all the research I’ve dug up from Beyone Type 1, JDRF, and the ADA, I am still wondering how exactly does Covid-19 affect those with Type 1 diabetes. We all know BGs are extremely difficult to manage with a regular cold or seasonal flu. I would like some answers from endocrinologists and epidemiologists as more research develops regarding the following:

  • Once a person with T1d contracts Covid-19, how severe does it affect blood glucose? Does it make the person more resistant or sensitive to insulin? Depending on the type of virus, Coral typically becomes insulin resistant the first few days and then super sensitive as her cold subsides. It requires constant monitoring with her Dexcom CGM more often than usual and basal adjustments even with Loop. Note: We make all changes to her insulin needs without endo’s help and have done so since first several months post-diagnosis.
  • If a T1d typically has overall well-controlled BGs or an a1c below 7%, then will they A) have any symptoms at all and B) will they have a higher chance of a full and quick recovery after contracting Covid-19?
  • How does Covid-19 affect younger populations under the age of 12 who also have T1d? Or using immunosuppressants likely due to kidney or any other organ transplant?
  • How does Covid-19 affect those with other autoimmune diseases such as celiac, hashimotos, rheumatoid arthritis or lupus? This a huge population of over a million strong individuals who would like some answers once more research is available.

Due to this being a novel or new coronavirus transmitted from an animal to humans, medical researchers are still gathering more information as the days go by. Therefore, we cannot expect to see the answers we seek for another few months to a year. We can continue to check for any clinical trials requesting group studies for T1d-Covid19 patients. In the meantime, use good judgement, pray your CGM continues to work accurately, and monitor closely especially when ill as advised by your endo.

Spread Awareness Not Stupidity

Please help spread awareness and educate those that are willing to listen. Use credible sources like what I’ve listed above and share to social media with your friends and family. Please encourage them to do their part in society by social distancing to #flattenthecurve. We must stay informed, remain calm and listen to health officials. I will try my best to keep this page updated as the weeks go by. Malama pono (live well in Hawaiian).

Warmest aloha,

Shelsea


Disclaimer: Nothing I say or do on this Blog or my social media accounts @type1diabetic_life on Instagram and @typeonediabeticlife on Facebook is meant to be taken as medical advice. Do not literally follow us. Always seek counsel from your healthcare provider like your endocrinologist or certified diabetes educator. Make educated decisions for your and/or your child’s safety. Call 911 for an emergency. I am not an epidemiologist, but I wish more people would listen to them and Health Officials regarding this pandemic. Also, I do not make a profit from this blog, social media accounts, or my Zazzle.com/t1dife shop. I actually have to pay a subscription for this blog on WordPress. An average of 15% of royalties I make from my Zazzle shop designs all goes back to maintenance and supporting my family. I am in no way compensated for sharing products and educating others on my platforms. Mahalo for reading and please subscribe to my blog or follow us on Instagram.

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