COVID-19 Pandemic… Here’s the Latest for You to Know

April 4, 2020

On Monday, March 16, 2020, Christian Life Resources released its “Advisement on the COVID-19 Coronavirus.” With that communication I wanted to accomplish three things: 1) Update you on what we know about the virus; 2) Share ideas on what we, as Christians, can do at this time; and 3) Remind you to maintain perspective. [UPDATE (September 2021): It should be noted that a number of the links below are no longer current.)

UPDATE ON WHAT WE KNOW ABOUT THE VIRUS
PRACTICAL CONSIDERATIONS

UPDATE ON WHAT WE KNOW ABOUT THE VIRUS

Terminology

COVID-19 is the name of the disease that results from infection of a virus referred to as SARS-CoV-2. A virus cannot multiply on its own, but it infiltrates other cells and uses them to spread throughout a host.[1]

In this situation, the SARS-CoV-2 is called a “coronavirus” – hence the acronym “CoV.” A coronavirus is a type of virus that can infect your nose, sinuses, and upper throat. [2] There are many kinds of coronaviruses, most of which are not dangerous. Perhaps the most familiar coronavirus is the one that feels like the common cold.[3]

This “flavor” of the coronavirus is similar to the Severe Acute Respiratory Syndrome Coronavirus which broke out in China in 2002-2003 resulting in more than 8,000 cases and 774 deaths. Because of the similarity, you have the acronym, “SARS.” To distinguish between the two of them you have the suffix “-2.”

This is, therefore, a respiratory medical crisis that manifests itself by infecting the respiratory system as a spreading infection. We pick up the active virus either by inhalation or touching an infected surface and then granting access by touching our mouth, nose, or eyes.

Also, this is called a zoonotic disease, which means it was caused by the crossing of a virus from animals to humans. Some zoonotic diseases you may have heard of include rabies, Lyme disease, malaria, salmonella infection, E. coli infection, anthrax, West Nile virus, and Zika virus.[4] The World Health Organization (WHO) estimates that at least 61% of all human pathogens (those things which cause diseases) are zoonotic.[5]

Despite their commonality, zoonotic diseases are often referred to as “emerging infections” (EI) and remain a persistent challenge to the health and well-being of humans. It is often considered a leading cause of mortality in the world.[6]

Current Statistics

As of 7:30 am Central Standard Time, the United States and its territories have 277,607 diagnosed cases of COVID-19 and 7,406 deaths (2.7%).[7] The U.S. Centers for Disease Control (CDC) reports that its numbering does not represent all the testing being done around the nation.[8] For that reason, recent statistics are best obtained from an aggregate site that pulls all state information. The New York Times has created a “Daily Tracker” of the virus which can be seen by clicking on: https://tinyurl.com/wtkqprv

The first U.S. case was diagnosed on January 22, 2020. By March 1, the number grew to 76. On March 15 it totaled 2,952 cases, and now it has exceeded a quarter a million cases.[9] The highest number of cases are in densely populated areas. Yet, even more rural areas are experiencing continued and rapid growth.

An increasing number of municipalities have created local trackers to keep their constituents current on the spread of the virus. The national office of Christian Life Resources is located in a suburban/rural setting in Washington County, just north of Milwaukee, WI. The Washington/Ozaukee County Health Departments jointly have established this tracker: http://www.washozwi.gov/. Individuals in small rural communities have been infected with the virus.

The virus spreads exponentially, which means the numbers grow more rapidly with each passing day. In the United States, the number of diagnosed cases of COVID-19 double every four days.[10] You can see an illustration of how the virus spreads exponentially at the website of The Washington Post.[11]

In our March 15, 2020, advisement, we indicated the CDC showed a fatality rate from COVID-19 at 2.44%. The death rate now is at 2.66%. For comparison purposes, the far more common influenza death rate is less than .2% – which means COVID-19 is far more dangerous than the flu.[12]

Those Who Are Affected

Anyone can contract the SARS-CoV-2 virus. Anyone with an underlying health condition seems to be at greater risk of more dangerous symptoms from the virus that requires hospitalization.[13] The virus is no respecter of persons. The very young to the very old are all susceptible to infection. Being younger and in good health provides a greater possibility of not showing serious or life-threatening complications. Regardless of age or health, contracting the virus enables a person to pass on the virus.

Children generally show the least symptoms and recover the fastest. The most vulnerable are those with compromised immune systems, the elderly, those who have high blood pressure, those with respiratory issues, and most recently, it appears the African American segment of the population is experiencing a larger percentage of vulnerability to the virus.

Preventive Measures

Preventing the spread of the virus requires understanding in the manner it is spread. As noted above, the SARS-CoV-2 virus is spread by inhalation or contact with the virus on the hands which then touches the mouth, eyes, or nose. Simply stated, you can send or receive the virus in aerosol form (breathing, coughing, sneezing) and in a tactile form (coming in contact with the virus on a surface which then finds a way to enter one’s system through the soft areas of the mouth, eyes, and nose).

To prevent the aerosol distribution of the virus, the CDC recommends social distancing of at least 6 feet and, most recently, some sort of filtering mask to wear when in public.[14] The 6-foot social distancing standard is based on normal breathing and communication in a typical setting. The virus, contained in droplets of moisture expelled when breathing, generally falls to the ground within 6 feet of the person speaking or exhaling. Coughing and sneezing, however, accelerate the projection of the moisture droplets, as far as 27 feet.[15]

A recent video posted by the New England Journal of Medicine illustrates what can happen to a physician intubating a patient with ventilator support if the patient were to cough. That video can be viewed at: https://tinyurl.com/vbd6ero

While previous advice included sneezing or coughing into the inside of the elbow, it is hoped that the mask better contains projected moisture droplets. It would also have the benefit of helping discipline people not to touch their face so readily with their hands. Typically, we touch our faces as much as 16 times per hour.[16]

That brings us to the tactile spreading of the virus. The virus has what one might call a “life expectancy” during which it can infect another person. That “life expectancy” is affected by a variety of factors including propulsion (how hard it is breathed, sneezed, or coughed out), gravity (how far it travels before it falls), and the surface upon which it falls.

On March 17, 2020, the New England Journal of Medicine published a study comparing the “life expectancy” of the SARS-CoV-2 virus to the SARS-CoV-1 virus on a variety of surfaces.[17] In general, the authors found similarities. In fact, the report is alarming. The researchers measured the rate of virus decay as an aerosol (i.e., in the air), on a copper surface, on a cardboard surface, on stainless steel, and on plastic. Following is a summary of their findings:

Aerosol: It remained viable for at least 3 hours in a perpetually aerosolized environment
Copper: No viable virus was measured after 4 hours
Cardboard: No viable virus was measured after 24 hours
Stainless Steel: Viable virus was measured after 72 hours
Plastic: Viable virus was measured after 72 hours

Translating what this means for us practically: if a moisture droplet containing a viable virus is exhaled, coughed, or sneezed on these surfaces it could remain there at least three days later (in the cases of stainless steel and plastic surfaces).

Some have wondered if it is safe to accept a shipped package because of the possibility of it holding a viable virus. In reply to a similar question, the World Health Organization responded: “Yes.” The likelihood of an infected person contaminating commercial goods is low, and the risk of catching the virus that causes COVID-19 from a package that has been moved, traveled, and exposed to different conditions and temperature is also low.”[18] I suppose if the delivery person had the virus and sneezed on the package before handing it to you, it might still contain a viable virus, which is why the advice to avoid touching your face and frequently washing your hands have enduring value.

Because of the virus remaining viable on stainless steel and plastic surfaces, it has prompted some retail food establishments to provide wipes for customers to use before pushing grocery carts (which often have stainless steel or plastic handles), and to frequently wipe down door handles, scanning surfaces, and plastic counter mats with a disinfectant cleaner. The CDC has established a treatment protocol which can be found at this link: https://tinyurl.com/v9qzra5

There currently is no preventative vaccine. Based on global experience, the spread of the virus can be mitigated through social distancing (minimum of 6 feet), use of personal protection equipment (PPEs), such as masks and gloves, and responsible hygiene. Again, the CDC provides excellent instructions here: https://tinyurl.com/wb594ej

Treatment of COVID-19

There presently is no vaccine for the prevention or treatment of COVID-19. Most cases do not require hospitalization. For those with compromised immune systems and respiratory problems, it may require hospitalization and the use of a ventilator to oxygenate the respiratory tract to stay ahead of the disease until the body’s natural immune systems can catch up and overcome it.

Often it is heard that a person diagnosed with COVID-19 is quarantined at home for 14 days. A World Health Organization study shows that the median duration of viral detection is 20 days, with the longest case being 37 days.[19]

Flattening the Curve

Frequently the media reports that efforts are focused on “flattening the curve.”[20] This is what that means:

Those most at risk of severe life or health consequences from the disease need ventilator support to assist the body in staying ahead of the deteriorating effects of the disease on the respiratory tract, especially the lungs. Typically, ventilator support is part of ICU (Intensive Care Units) in hospital settings.

Every region has access to medical facilities with intensive care units that can handle ventilator support. More densely populated metropolitan areas have more of such facilities, while rural areas must travel greater distances to find such facilities.

Facilities with ventilator support ICUs establish the “capacity” in treating patients who need such support. The exponential rise in COVID-19 cases is projected to exceed the capacity of many medical facilities, especially in densely populated areas.

New Jersey Governor Phil Murphy and the New Jersey Department of Health provided a nice Q & A page and graph that illustrates current trajectory and benchmarks for “flattening the curve” in that state.[21] The graphs, in particular, illustrate why social distancing, good hygiene, wearing a PPE, and stay-at-home practices are primarily designed to “flatten the curve” and perhaps stretch out the number of COVID-19 patients needing ventilator support in a manner that does not exceed the capacity of the resources.

This is a very real situation. In Italy, for example, the number of new cases peaked on March 21, 2020.[22] Italy, however, had been known to have an exemplary medical system, with an average of 3.2 hospital beds per 1,000 people (compared with 2.8 beds per 1,000 people in the United States), and yet they overburdened their resources.[23] When you have more time, you can search out stories of the horrendous choices that had to be made about those to treat and those not to treat.

This has also been the concern expressed frequently by Governor Andrew Cuomo of New York, where there is the largest concentration of patients diagnosed with COVID-19 in the United States.[24]

The result is that the conversation has been raised involving the allocation of limited resources – which is a somewhat innocuous way of saying who does and who does not get treatment – or more pointedly, who lives and who dies. On March 23, 2020, the New England Journal of Medicine published an article entitled, “Fair Allocation of Scarce Medical Resources in the Time of COVID-19”[25] in which the discussion candidly pointed to establishing protocols for choosing between two patients for a single available ventilator. On March 25, 2020, The Washington Post reported on discussions relating to automatic “Do Not Resuscitate” orders on coronavirus patients as a means of addressing problems with limited resources.[26]

Not only are lives in danger, but medical professionals are increasingly placed in the horrendous position of having to choose who gets the care, and who does not; who lives and who dies; then having to communicate that message to the patient and the families; and finally going home and living with those decisions.[27]

Simply stated, making the sacrifices necessary to not overburden the health care system translates into protecting health and lives.

Close to Home

Generally, health crises become more meaningful when they become more personal. Anecdotally, more people have been telling me of acquaintances who have contracted COVID-19. Our daughter, living in Paris, France, told us her neighbor died from COVID-19. It is hitting closer to home.

Within the fellowship of our Christians both in the Evangelical Lutheran Synod[28] and the Wisconsin Evangelical Lutheran Synod[29] are those who serve in high profile positions and have contracted the virus. It appears in those instances, the people who contracted the virus were in good health and are now quarantined at their homes.

As Christians, however, the same impulse that prompts us to give to the community food bank or help those in other parts of the world who have been hit by natural disasters prompts us to be concerned for the well-being of our neighbors – and even to be more concerned about the well-being of our neighbors than ourselves (Philippians 2:3-5).

Practical Considerations

Stay Informed

There is a growing amount of information available on this pandemic. As you read the information, look for documentation and recency of the information. This is a new virus so what was written in February 2020 is already old news.

Look for sound, researched, and professional opinions. There are certainly plenty of opinions out there, but a lot of them are “gut feelings” rooted in suspicion rather than studies and experience.[30] Leading medical websites often post Q & A and myth-buster sections to help in rightly dividing rumor from truth.[31]

Your credibility is on the line when you speak about such things. If you are a pastor or an active layperson in the church, permitted to have a strong influence on the way things are done, be certain that “why” things are rooted in fact and not conjecture. That also means if you are steeped in a traditional approach to how things are done, there is nothing like a pandemic to turn your world upside down. Never compromise on your allegiance to Scripture, but take care not to venerate time-honored customs to a level of inspiration, just because of tradition and practice.

Dealing with Objections

I know all about objections. As the National Director of Christian Life Resources, I am always dealing with others who find cause to differ over the multitude of issues we deal with. The three objections I hear most often as they relate to the pandemic are that: 1) We are overreacting; 2) Restrictions infringe on our right to religious freedom; and 3) We must be careful not to burden consciences.

Let me handle the three objections in order:

Overreacting

Truth be told, initially, I was not alarmed by the virus. As you might imagine, January is a busy month for me in my work at Christian Life Resources. I had been traveling extensively in January and February, scrambling to stay caught up with countless commitments. I would receive the news stories about the epidemic. On March 11^th the World Health Organization declared it to be a pandemic (global outbreak). Even then I was not too alarmed until I heard the general description that it carried more than ten times the fatality rate of the common flu.

I often refer to this as the “Keillor Effect.” As Garrison Keillor concluded his “Lake Wobegon” stories on his “Prairie Home Companion” radio show, he would say “Well, that’s the news from Lake Wobegon, where all the women are strong, all the men are good-looking, and all the children are above average.”

The Keillor Effect is the notion that we are a little bit above average, a little bit healthier than others, a safer driver than others on the road, a better judge of how to do things, etc. It is, of course, a fantasy. We are part of the national average. The virus will affect us the same as it affects people in other places. Some of us would feel it worse, others not as bad. There is nothing about who we are or where we are that makes us immune or exceptionally endowed to weather the storm.

Overreacting is what happens when we react in a way that ignores the facts and not commensurate with the facts. For example, the most well-known zoonotic disease is arguably rabies. If a rabid animal infects a human being with rabies, death is almost certain. Rabies in humans, however, is extremely rare (1 to 3 cases a year).[32] Yet, if it is reported a rabid animal has been sighted in the area, we keep the children indoors and we often carry something to defend ourselves if we encounter the animal.

The SARS-CoV-2 is that “rabid animal” in the neighborhood. Its “bite” might not kill you, but it could. Worse, however, is that catching the virus gives you the incredible ability to pass it on to others without you even knowing you got it.

Accusations of overreacting in this regard ignore the facts of how easily the virus is transmitted, how ill-prepared we are to defend against it, how fast it spreads, and how it attacks and kills the most vulnerable. Generally, as I read social media posts and letters to the editor from those claiming we are overreacting, I do not see their suggestions on how to react in protecting the lives of the most vulnerable.

Infringing on Religious Freedom

Sadly, we easily become more “expert” on constitutional law than on the dictates of Scripture. We talk about freedoms, often harkening back to the Magna Carta and the Declaration of Independence. The Freedom to Worship or Freedom of Religion, though expressed generally in the First Amendment to the U.S. Constitution, is a right established by human beings – to be given, limited, and taken by human beings. While we very much wish to enjoy the freedom to gather, to worship, to share the Gospel, and to live our faith unencumbered by the interference of the government, the right is not absolute and not God-established.

In Biblical times the freedom to practice one’s faith varied greatly, and when restricted, violation came with grave consequences (Daniel 3 & 6; the passion of Christ; stoning of Stephen; etc.). Yet, even in those circumstances, the clearest dictate of Scripture is to obey those in governing authorities (Romans 13). Even in times of great religious persecution, Christians found the means to continue their worship life.

Today. the government’s restriction on group gatherings is not prohibiting the practice of our religion. We are still permitted to preach and teach through mailings, voice communications, and the Internet. If you want to grasp impediments involving the practice of your religious convictions, study what is done in communist China.

Instead, the government restrictions placed on us are for the health and well-being of the general public. Failure to grasp that puts us at odds with the command to obey (Romans 13) and the command to demonstrate love for God by loving others (Matthew 22:39).

Obviously, in a republic form of government, all of those in positions of authority are tainted with sin, as well as all of its citizens who may be critical of them. For that reason, we use our resources to view open records and to elect new representatives when we feel cherished freedoms are being threatened. There is, however, no Biblical foundation in challenging our government leaders who use their God-ordained authority to restrict communal gatherings to protect the health and lives of its citizenry. We may not agree, but we tread on dangerous ground to slander those in leadership and to cast dispersion on their motives. When we lack the facts, all we have are opinions – and are opinions are to be sifted by the Word of God.

Burdening Consciences

I have received only one criticism that in encouraging people not to meet communally, and to forgo any kind of communal reception of the Lord’s Supper is an unnecessary burden to consciences. This topic is deserving of its own theological paper. It is in reference to 1 Corinthians 8 which is a discussion of people who are ill-informed (1 Corinthians 8:7). The alternative to forcing ill-informed people to participate in something that they are unaware of is resolved by informing them. Until they are informed, the admonition is to not press them. The calling, however, is to inform them.

In the matter of suggestions about communion, worship services, and the sort, the challenge is to inform the membership that viruses can reside on the backs of pews, on the offering plate, on the communion cups, and can be transferred by the close proximity of the officiant to the communicant.

These are not points of conjecture but of proven medical science. The risks are established through testing and repeating the testing to prove the correctness. For someone to hear those truths and to then suggest they don’t believe it is no longer a matter of a weakened conscience but an obstinate spirit.

Spiritual leaders, whether pastors or the laity, are charged as are our governing leaders. They are to weigh the evidence and make judgments for the good of everyone – not to bring risk to everyone for the apprehensions of a few.

The Worship Service

Both the Wisconsin Evangelical Lutheran Synod (https://wels.net/) and the Evangelical Lutheran Synod (https://els.org/) have provided website messages and resources to help to weather the changes caused by the pandemic. Take time to become familiar with both church bodies’ resources.

Many of our congregations are diving headfirst into video streaming and posting recorded versions of the worship service, sermon, and Bible studies. It prompted someone to write, “Our pastors have now become televangelists. Now, if we can learn how not to make the videos look like Bin Laden hostage footage!” Hey, it is a rapid and unexpected learning curve for all of us. The Internet is a great means – and a great blessing for many – to stay connected.

Some of our churches just aren’t there yet. They lack the equipment, the skill, or the time to launch into streaming or recording video resources. If that is the case, Northwestern Publishing House has made available a wealth of free and discounted resources on its website to help families worship from home. Check out:

The Devotional Life

As a congregation, this is an unprecedented time to help our members establish personal and family devotional habits. As we well know, devotions often can be a foreign concept in many homes. In this day of school sports, club sports, long work hours, multiple volunteering opportunities, and church and the community, families lack the common time to conduct home devotions. For at least a few short weeks, that has changed. Today there are none of those distractions.

This is an excellent time for congregations to provide electronic or mailed material to the homes of its members, equipping them to conduct home devotions. This is a great time to share ideas and resources on how they can begin a devotional habit that remains after the pandemic has subsided.

Communicate

Not everyone is on the Internet. Not everyone on the Internet gets into video resources. For some of them, email is as far as it gets. Now, more than ever, resurrect the use of snail mail. Mail the membership once or twice a week – share your personal prayers and thoughts for them. Provide devotional and worship resources. Keep them current with what is happening with other members of the congregation.

During this time many of our members might be looking at other worship resources on the Internet that might be outside of our fellowship. Demonstrate your personal and heartfelt concern for each of them. Pastors and laity can network with the members, calling them, dropping them notes, etc. Keep the flock close during a time of potential wandering.

Support

Congregational and charitable agencies are taking a financial hit. While some members have moved to electronic platforms to ensure regular and consistent giving, most support comes from people who show up for the service. With no service, the need for support continues.

As a congregation, it is not wrong to remind members about the need to keep things moving. It still is costly to maintain the facility, to prepare the materials and communicate with the membership by mail and electronically. Unless there has been a decision to fold the operation, we all have to be minded towards keeping things going.

Closing Thought

A pandemic of this nature demands sacrifices. We have not been asked to put our lives on the line. Rather, it has been a test more of how we view our blessings that we have grown so accustomed to enjoying.

In my presentations, I talk about the challenges of raising children in the age of video games. After parents buy them their first video game, they love it. Before long, it becomes a part of their everyday life. You did not mean it to be that way, but that is what happens. You discover that when you tell them they can’t play the game until they finish their homework or clean their room, you have a meltdown on your hands. That is because they have learned to see the blessing as an entitlement.

At times like this, we face the same danger as adults. We live in the most prosperous nation in the world. Things we call necessities are unknown in other cultures. So now we have been asked to restrict our movement, change the way we do things, and make compromises – often for people we do not know. That is what it has been like at Christian Life Resources. We seek to help unborn children and their mothers that we often never meet. We provide resources for families who never meet us and can never say, “Thank you.”

The nature of Christian love is that it truly is selfless – performed not for personal benefit but as a reflection of the benefit we received by the selfless love of Christ. We love not because it is easy, or because it is deserved, or because we benefit from it. If we relied on that kind of love from God, we would all be in trouble.

Rather, we love because he first loved us (1 John 4:19).

I have always been troubled by the passage that says, “Because of the increase of wickedness, the love of most will grow cold” (Matthew 24:12). It has troubled me because it was spoken by Jesus in his instruction to the disciples. That means these words are meant for God’s people. “Wickedness” is a word that essentially means a disregard for the will of God. We, as God’s people, are in danger of increasing disregard for God’s will. The result is that it becomes more painful and more difficult to show love and to be loving – in the way God calls us to be.

Our source and strength in fighting the wickedness that may dull our senses are that we have God’s Spirit (1 John 4:13). It is the Holy Spirit that moves us to love as we have been loved and to sacrifice as he has sacrificed for us. It doesn’t take a pep talk to emotionally charge us. It takes a Spirit-moved experience of understanding of what happened during Holy Week, why it happened, and why it is important to us.

When Jesus ascended into heaven, he gave this promise: “I am with you always, to the very end of the age” (Matthew 28:20). Our lifeline in meeting these challenges is a prayer away. Christ committed to making even the worst of times work out for our good (Romans 8:28). Rest in his mercy, celebrate his victory over sin, and draw on the strength he provides. It is a lifeline that we have as his children. Use it and find the strength to persevere.

~ Pastor Robert Fleischmann, Christian Life Resources

April 4, 2020

[1] https://www.ncbi.nlm.nih.gov/books/NBK21523/ (accessed April 4, 2020)

[2] https://www.webmd.com/lung/qa/what-is-a-coronavirus (accessed April 4, 2020)

[3] https://www.cdc.gov/coronavirus/general-information.html (accessed April 4, 2020)

[4] https://www.medicalnewstoday.com/articles/320618#what-is-zoonosis (accessed April 4, 2020)

[5] https://www.who.int/neglected_diseases/diseases/zoonoses/en/ (accessed April 4, 2020)

[6] http://www.uvm.edu/pdodds/files/papers/others/2004/morens2004a.pdf (accessed April 4, 2020)

[7] https://www.worldometers.info/coronavirus/country/us/ (accessed April 4, 2020)

[8] https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/cases-in-us.html (accessed April 4, 2020)

[9] https://abcnews.go.com/Health/coronavirus-map-tracking-spread-us-world/story?id=69415591 (accessed April 4, 2020)

[10] https://ourworldindata.org/coronavirus (accessed April 4, 2020)