Notes: I originally wrote this to share with my family and close friends. It’s now getting passed around so I’m posting it publicly. I have revised the language slightly a few times. This is the most current version.

Hi folks,

A number of you have asked me what I think is going to happen with coronavirus (COVID-19) and what we should be doing to prepare. I have a few thoughts about what’s likely to happen and what you can do about it. For those of you who don’t know me well, I am a preventive medicine physician and infectious disease epidemiologist. I graduated from the CDC’s Epidemic Intelligence Service and have over 17 years of experience in the field, most of that with CDC.

Wishing everyone good health,

Juliana

Who should you listen to?

The CDC and your state health department are your best place for information about COVID-19. (Listen to them before you listen to me.) Be cautious about other sources of information - many of them will not be reliable or accurate.

How bad is this going to be?

It’s possible that COVID-19 will be similar to a bad flu year but there are a number of indications that it will be very much like the 1918 Flu Pandemic. To put that in perspective, the 1918 flu did not end civilization as we know it but it was the second-deadliest event of the last 200 years. It is likely that people you know will die from COVID-19.

However, there is one critical difference between COVID-19 and the 1918 flu - the 1918 flu virus hit children and young adults particularly hard. COVID-19 seems to be most severe in older adults. Children and young adults generally have mild infections and we are grateful for this.

What can we expect?

This is not the zombie apocalypse. Core infrastructure (e.g., power, water, supermarkets, internet, government, etc.) will continue to work, perhaps with some minor disruptions.

There will be significant economic disruption: a global recession is very possible and there will probably be significant shortages of some products. The healthcare system will be hit the hardest. The number of people who are likely to get sick is higher than our healthcare systems can probably handle.

Daily life will be impacted in important ways. Travel is likely to be limited and public gatherings will probably be canceled. Schools will probably be closed. Expect health departments to start issuing these orders in the near future, especially on the West Coast.

The acute pandemic will probably last at least for several months and quite possibly for a year or two.

What can we do?

We can’t keep COVID-19 from being a global pandemic but the more we can do to slow the spread of the disease, the less severe the impact will be. With that in mind, here are the things you can do:

Stay calm but take it seriously. This will likely be bad but it’s not the apocalypse.

Stay home if you’re sick or someone in your house is sick.

Leave medical supplies for healthcare workers. You shouldn’t be stockpiling masks or other medical supplies. They are needed in hospitals to keep our healthcare workers healthy.

Wash your hands. Get in the habit of frequently washing your hands thoroughly and covering your cough.

Minimize your exposure. Now that we’re seeing community transmission in the U.S., it’s probably time to start cutting back on your exposure to other people. Depending on your circumstances, consider:

Canceling non-essential travel

Avoiding large-scale gatherings

Working from home if possible

Minimizing direct contact with others including hand shakes and hugs

Reducing your trips out of the house. If possible, shop for two weeks of groceries at once or consider having your groceries delivered. Stay home and cook instead of going to a restaurant.

Remember, keep calm and prepare. This is likely to be bad but if we respond calmly and thoughtfully we can handle it.

Feel free to share this email as you see fit.