Coronavirus - I'm too anxious, right?
March 5, 2020 3:13 PM   Subscribe

I went with a relative to their surgery appointment yesterday. The surgeon "had a cold and so he wouldn't shake hands". He did not wear a mask when he talked to us, although I assume he wore one during surgery. My relative said he coughed a little. Today, we had to call the clinic and the surgeon is out sick. I...am not doing well with this information.

We are in Minnesota, where there are no diagnosed cases, but we all know that's bullshit because so little testing is being done. I am worried that this doctor got it from a patient or on an airplane or something.

Is this likely? Both the relative and I would have underlying conditions but we're still mid-forties. What medical reasoning would you use around this question?

Secondarily, what can I do to manage my anxiety around this? I keep thinking that the surgeon, who was in his thirties and looked ultra-healthy, is just going to be sick for a week and we're going to get it and have really bad things happen.
posted by Frowner to Health & Fitness (19 answers total) 4 users marked this as a favorite
 
1) The surgeon probably knows pretty well how to distinguish between Coronavirus and a cold.

2) The doctor probably decided that freaking people out wasn't worth it and has started staying home from work, which he should have done a long time ago.

3) There are no diagnosed cases in Minnesota, and he would likely have access to diagnosis if his symptoms were in any way likely to be related.

4) Nevertheless, you have my permission to call the clinic again and raise holy hell. Ask why he is sick, ask how, ask if he has a fever, ask if you need to alert the health authorities, call his boss, and so on. Ask and keep asking until you have answers that will allow you to make personal health decisions, or until they credibly threaten to call the police, at which point I would "ask" a local yellow journalist.

5) I'm sorry, this sucks. You are almost certainly going to be fine, but it still sucks. I would reassure the relative as much as you can and let them recover from surgery, and I would channel my anxiety into giving the doctor a reasonable amount of hell.
posted by internet fraud detective squad, station number 9 at 3:24 PM on March 5 [4 favorites]


When I was struggling with severe anxiety about a similar thing (potential exposure to something I could do nothing to prevent, but no obvious symptoms at that time), I eventually found some peace with the sort-of mantra "don't borrow trouble." I told myself repeatedly that if I saw symptom X or symptom Y then I had permission to start worrying and catastrophizing, but until then, nope. In my situation the thing I was exposed to never materialized.
posted by needs more cowbell at 3:25 PM on March 5 [5 favorites]


Think of it this way. If a doctor lies to you, and then adverse consequences occur because of said lie, that doctor is opening himself up to a MASSIVE malpractice lawsuit. He has zero incentive to lie, and he knows the difference between a cold and the flu; it's OK to trust he was telling the truth in this case.

He might give you his cold, but that's pretty much the end of it. The bigger issue, for me, is why a doctor with an active and probably somewhat contagious cold was seeing patients, regardless of the existence of coronavirus.
posted by pdb at 3:26 PM on March 5 [4 favorites]


I posted some links in a recent Ask that also seem relevant to your question:
Coping with stress during the 2019-nCoV outbreak (WHO) via Coronavirus disease (COVID-19) advice for the public (WHO)

And from Psychology Today: Why Your Doctor Is Not Panicking About Novel Coronavirus, Coronavirus: Countering Your Fears, Covid-19: What Is the "Right" Amount of Scared?, and Our Brains on Coronavirus (a psychiatrist's tips for staying calm and focused)
There's also this overview from WaPo: Should I get tested for coronavirus? Here’s when to stay home or see a doctor.
[...] It’s a good idea to call your primary-care doctor if you have both a fever and a cough, said Maria Raven, chief of emergency medicine at the University of California at San Francisco. And if you have shortness of breath, unremitting fever, weakness or lethargy, it’s definitely time to get in touch with a health-care professional, according to Adalja. [...] Wherever you go, Adalja said, you should call ahead and tell them that you’re experiencing respiratory symptoms. That enables them to be ready to protect other patients when you arrive, such as by quickly outfitting you with a face mask or directing you to a separate section of the waiting room.
And I doubt that you can obtain private health information about the doctor, and I implore you to avoid making any threats towards the medical practice, or taking any actions that might lead them to call the police, or any other irrational behavior that will do nothing to help protect your health. It is understandable to be afraid right now, but please do not bully or harass anyone, including medical providers.
posted by katra at 3:33 PM on March 5 [35 favorites]


I'm not going to shame your anxiety, because I've been there. Hell, I had the beginnings of a cold this past weekend, and even though I've not come anywhere near any potential exposure risk, I still took my temperature just in case to see whether it was just a cold or if it was....something else. (No temperature. I was fine. I had several zinc lozenges and slept in all weekend and was just fine on Monday.)

What has strangely seemed to help me with anxiety is just to overload myself with Facts And Statistics, to put things into perspective. Invariably, one of those facts ends up being enough of a Security Blanket that I can cling to that. For example:

* The World Health Institute says that the death rate from Covid-19 is only 3.4 percent on average.

* The rate changes DRAMATICALLY depending on your age - those at greatest risk are people over 80, for whom the mortality rate is 14 percent. Those in their 70s are only half as much at risk, with a mortality rate of 8 percent; those in their 60s are half again at risk, with a mortality rate of 3.6 percent. Those in their 50s are again half as likely, with a morality rate of only 1.3 percent. And for those in their forties - the mortality rate for the Coronavirus is only 0.4 percent.

* At present, medical professionals say that keeping yourself at only a four-foot distance from an infected person is enough to keep you safe. That's about average for two people meeting in an office. So even if the surgeon was infected, your seated distance from him alone most likely kept you safe.

* This year's flu is transmitted exactly the same way and shows very, very similar symptoms - and there have been one thousand times as many deaths from the flu in the United States as there have been from the Coronavirus.

* Finally, it's much more likely that the surgeon was staying home with a cold, out of caution. He might have only just started to notice symptoms prior to your visit, while he was in the office (I know I've had cold symptoms only start to show up mid-day), which would explain why he was there meeting with you instead of at home; he'd just realized it was happning, but you were about to walk in for your meeting in only a half hour and he didn't want to screw you over. He might have done the same thing I did - took his temperature to check just in case, saw that his temperature was normal, and said "okay, good, no fever, this is likely just a cold."

So you have the distance he sat from you in the office working in your favor, you have the sheer raw numbers of flu vs. Coronavirus pointing to Coronavirus being unlikely, and you have your extremely low mortality rate for 40-somethings all working in your favor to point to things being okay.

If none of those Facts And Statistics do it for you, though, there may be others. Try sticking to official channels, of course (the World Health Organization as opposed to, like, someone's wordpress blog "HippieHealth.com" or something). I have a hunch that one random statistic will suddenly smack you over the head and make you realize "Oh. Okay, that's convinced me that this is going to be unlikely."

Good luck.
posted by EmpressCallipygos at 3:36 PM on March 5 [11 favorites]


Yeah, doctors also have a right to privacy when it comes to their health, and also a right to not be threatened (can’t believe those two things even need to be said???) Physicians in hospital systems are getting multiple emails daily with updates about COVID-19 and hospitals are setting up their own data-driven guidelines for employees, which he is likely following. As another comment said, he’s probably staying home out of an abundance of caution.
posted by namemeansgazelle at 3:43 PM on March 5 [17 favorites]


It is way, way more likely to be a run of the mill cold than coronavirus, seeing as though we’re smack in the middle of cold-and-flu season.

I just sympathize with you, though. It is so hard for anyone to avoid being anxious about what’s going on. Even though you probably are 99% sure that it’s not coronavirus, you’ll worry about it anyway. Please keep in mind that for you—and nearly everyone else—anxiety is a far worse enemy than COVID-19.

It’ll be all right. Internet hugs.
posted by vitout at 3:52 PM on March 5 [2 favorites]


Please do not call the clinic to "raise holy hell". The doctor had a cold.
posted by no regrets, coyote at 4:04 PM on March 5 [56 favorites]


Nevertheless, you have my permission to call the clinic again and raise holy hell.

Don’t do this.
posted by mhoye at 4:23 PM on March 5 [39 favorites]


Here's what I'm trying, in case you find it helpful.

I noticed that I keep thinking, What if I get COVID-19? Running over plans in my mind, imagining scenarios, stressing.

So now I'm asking myself, What if I don't get COVID-19? What do I want my life to be like in a month if I don't have it? And trying to focus on that because it is likely.
posted by medusa at 4:27 PM on March 5 [4 favorites]


Oh, I do feel your pain on this issue. I have the same thought patterns, a couple of underlying conditions and am convinced everyone will shrug the virus off except me.

What is helping (a little) at the moment is some fairly naive thinking around the fact that :

- transmission rates are still extremely low in most countries and among people who haven't travelled to places like Italy or East Asia;

- people are taking genuine notice of the media reports and bulletins that are circulating, and are talking about handwashing and self-isolating - i.e. they are actually paying attention to the guidance and need for containment should the virus start to spread;

- this is effectively a new virus but in a form that is familiar to researchers, clinicians and scientists and so they are not starting from scratch in sourcing a vaccine;

- the weather could become drier / damper / cooler / warmer / sunnier / frostier - basically, external factors could play a currently unknown role in helping to manage the virus by creating an inhospitable environment for it;

- among the people who have already been exposed, developed symptoms and / or become ill, there must have been a significant number of diabetics, people with asthma, people with heart problems and the like who haven't all become seriously ill or died, especially if you consider that it's likely the actual number of cases is probably much higher than has been reported, or even recognised by the patients themselves.

I'm diabetic and every time I hear about underlying conditions, I automatically assume it's me personally they are talking about. But if I can stop to think it through as rationally as I can, I'm a reasonably active type 2 diabetic with not terrible blood sugar levels, in her 50s and not older, with no other serious illness. So even with my underlying conditions, I'm still in all probability not the most likely to succumb. Neither are you, I'm pretty sure.

I'm sorry I can't offer you more compelling reassurance, but I hear your anxiety and recognise your fears as my own.
posted by Martha My Dear Prudence at 5:22 PM on March 5 [2 favorites]


If you leave Covid19 out of it, a doctor or any health care provider with a cold should probably wear a mask, because patients having surgeries need extra protection As we have all read, surgical masks are for contagious people to limit the spread of any disease. I'd call and speak to a patient advocate and express concern. If the doc ends up with Covid19, people should be notified, but you can ask, to be certain.

The news is concern-inducing, but if people were getting Covid19, some would get pretty ill, get diagnosed and tested, so there really may not be any in your area. Relative may want to take a multivitamin and be extra vigilant. I've had to reduce my news exposure a bit because it's too intense.
posted by theora55 at 5:31 PM on March 5


An issue with trying to turn public health recommendations into worry levels is that the right thing to do on a population basis is to take precautions way out of proportion to your actual risk as an individual. So even though a very very very small percentage of people are actually likely to be infected with this particular virus at this time, without widely available fast testing very many other people with perfectly ordinary colds will need to stay home from work, to avoid close contact and handshakes, etc. in order to make sure that ALL the novel virus is contained. But most of them actually will just have ordinary colds.
posted by Lady Li at 5:31 PM on March 5 [2 favorites]


--While I totally understand your concern, I don't think it's at all likely that the surgeon had COVID-19. I live in the PNW near where it's thought to have been running free for six weeks, and they still only estimate that a thousand or fewer people here have it. The chance that this particular individual in MN had it yesterday are statistically very, very low.

--And even if the surgeon did have it, the likelihood is still that he wouldn't have transmitted it to you. It's contagious, but not "everyone you meet gets it" like norovirus.

--As far as coping with anxiety, two things that I find most personally useful in this situation are lovingkindness meditation (it seems difficult for the mind to run its fear processes simultaneous to its goodwill-towards-people processes), and watching dumb television. When I feel anxiety I try to be compassionate towards the anxiety, without letting it run the show.

--I also get some comfort from the "serenity prayer" thing. You have a limited amount of control in this situation. You can do stuff to make your mind and body as currently resilient as possible (i.e. sleep, eating well, etc) and you can be watchful of your health over the next two weeks, but that's about it.

I'm sorry this happened! Hang in there.
posted by hungrytiger at 5:42 PM on March 5 [3 favorites]


This is stressful, I'm sorry. I work in a hospital so I anticipate likely eventual exposure. All I can do is lots of hand hygiene and I have reduced my time in group spaces. But we are going to have to live with uncertainty and risk on this unfortunately. Not sure if it's helpful to think of it this way but, the coughing doctor is not that relevant. The truth is the virus is circulating in our communities now even when we don't see it. So we reduce risk where we can and live with some of this.

On the reassuring side, it's definitely much, much more likely that the surgeon has a cold than COVID19. Also the best available evidence points to COVID being droplet borne, so not easy to get in a short interaction from a distance.

Know also that fortunately you are not in a high risk age group for serious illness, and by far most cases are mild or asymptomatic.

So chances are small that you've been exposed, smaller that you caught it, much smaller yet that you would get seriously Ill from it.
posted by latkes at 9:55 PM on March 5 [1 favorite]


I often check in with my worry levels by measuring my worry level for others.

Did you see, or could you visualize, other patients that the surgeon saw yesterday? Are you feeling concern for their possible exposure to COVID-19? What about a person working at the deli counter where the surgeon may have gotten lunch yesterday? Or the person who delivered a signed package to the surgeon's house? Are you as worried for them as you are for yourself and your relative? Why or why not?

I find it really helpful to imagine and test different scenarios for people other than myself who might be facing the same "threat." It works particularly well on an airplane: I look at some random passenger three rows ahead and ask myself if I think they're going to die in a plane crash today. The answer is almost always "obviously not."

Also, a fact I'm comforted by is that, with the majority of cases being mild and untested, the mortality rate will likely end up being far lower than the 2-3.5% figures you see in the news. Sometimes I like to hit refresh on this page and see that the number of mortalities has increased by just a few, while the number of recoveries has grown by the dozens or hundreds. The graph of recoveries vs. total cases looks encouraging, also.
posted by witchen at 10:22 AM on March 6 [1 favorite]


Just checking in to see how you & relative are.
posted by internet fraud detective squad, station number 9 at 8:53 AM on March 19


We're okay, but we have a non-missable follow-up appointment today, so I'm gearing up for that. Clinic says they are only seeing 30% of the usual patient load, doing the rest by telemedicine, and that staff are all using masks (where they got them, I don't know). We have a small supply of masks which I am using, I'm taking Lysol wipes and hand sanitizer with us to use as we go, and we are driving in a friend's car which I'm going to wipe down with bleach shortly.

Minnesota case numbers are misleading - the state has switched to testing hospitalized patients only to conserve tests.
posted by Frowner at 9:57 AM on March 19 [2 favorites]


Thanks, and thanks for checking in, I know it's a bit of a hassle and I appreciate it. Thinking of both of you <3
posted by internet fraud detective squad, station number 9 at 1:01 PM on March 19 [1 favorite]


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