Coronavirus. How to roll with it.

By Chris Wolz

A letter of reflection on how to approach gaming in a COVID19 world. 

An excellent article was outlined by Mr. Reed on how this pandemic has affected the gaming community as a whole. I think it was well written and informative in laying out how this pandemic has affected the gaming industry and the individual gamer. The article got me thinking about how to get back to enjoying this wonderful hobby but still maintaining a good deal of safety and responsibility. 

About myself, I am currently both a licensed paramedic and a third-year medical student currently doing rotations in a large, community hospital system. I do not intend this article to be taken as personal medical advice, as I am not in a position of authority in which to give any personal medical advice. With that said I hope this article does lessen some anxiety and does allow some to make a better-informed decision.

This should be a starting step of gaining the knowledge needed to make the decision on whether to return to the gaming store, convention, or friend`s house. I do not stand in judgment of anyone’s opinion or choice when it comes to their own health. That is for you to decide, I merely want to offer some insights for you that may help you to make a well-informed decision about your own well being.  

First off the coronavirus is a positive-sense single-stranded RNA virus that appears crown-shaped and coated with protein spikes. This doesn’t mean a whole lot if all you want to do is game with friends, but I did spend a lot of money on textbooks so I had to put something virology related in here, but this article will stay away from that stuff from here out. What is important to know is that it is spread by respiratory droplets and some studies show it may remain infectious for days when deposited on objects. It is important to remember that this is new, and as such the studies released on it are at best, tentative, and at worst, misleading. A large portion of the studies first published on COVID 19 has been recalled by the respective journals due to either being unsound or having misinterpreted date.

This virus has differed from other viruses in its viral family in two major ways, first of all it is substantially less deadly than both MERS and SARS1, and second, is that both MERS and SARS1 produce symptoms and the ability of infectious spread to others at the same time, COVID does not.

These two differences mean that A) COVID is not a death sentence even if you do get it, and B) symptoms are not the best way to determine the risk of spread to the community. So keep in mind most people who get COVID recover, and that just because sick people are supposed to quarantine, that does not mean you are not being exposed.

At the hospital I am at, most of my COVID exposures have come from people asymptomatic and then test positive incidentally during pre-surgery workup. Also, understand the tests themselves have limitations. All tests have false positive and false negative rates, so the more you test someone, the more likely that person is to have a false positive or negative. I see people tested 9 or 10 times, and one of those tests comes back positive  They are still treated as positive for COVID even though they probably have had one false test result and do not actually have COVID.

The combination of the delay to symptoms, the fact some can be asymptomatic, and the issues with testing, monitoring for sick people in the community is incredibly unreliable, and as such community-based prophylaxis like masks and distancing are going to the best option to limit spread. 

 

First What’s the deal with Masks?   

First no masks, now yes masks. First N95 only, now any old piece of fabric will do. To break it down, there are guidelines for masks through the CDC. This is a great resource for masks selection and how to properly wear a mask. I recommend everyone check out the link provided below. A few highlights for masks, make sure your mask covers your nose, make sure you wash your mask, and most importantly make sure it does not restrict your breathing.

Furthermore, things that need to be thought about, is that while masks most likely lower your risk, they do not replace other measures. Social distancing is still more effective, so do not allow masks to give you a false sense of security. Also, it is my opinion that masks seem to make people more likely to touch their faces. Most people are not used to a mask and as such, they adjust their mask constantly throughout the day.

This allows the mask to become soiled faster and gives a greater risk of viral spread to your mouth and nose. This virus can stay in droplets on your hands and thus can be introduced to your respiratory tract through face touching. It is especially important to not touch the “T” zone, that is the area of your eyes, nose, and mouth, shaped like a T on your face. These reasons are why it is very important to limit face touching as much as possible so a more comfortable mask may be best because you will adjust it less often, and if you are going to adjust your mask, make sure to grab the corners of the mask and not the areas directly above or below your mouth and nose.

As far as mask care and cleaning, unfortunately, this is an issue without clear guidance. People are using masks over long periods of time in which they were never designed. Disposable masks were never made for long use and as such will not stand up to washing.

One thing that I do is I set my mask out in the sun, mostly on the dashboard of my car, my reasoning being that UV radiation from the sun damages the virus` genetic code.

There is evidence that UV light damages the virus, but no study has even been applied to cleaning masks this way. However, many hospitals are employing UV light for disinfection from COVID. Technically the windshield will block most UV light, but some UV gets through and that little bit does damage the virus. In this pandemic era where policies are made without clear evidence, it is not a bad idea to throw your mask on your dash when driving. Even better if you can expose you mask to sunlight through non-tinted windows or directly by placing it outside for 15 minutes.

Last, the composition of the mask. Realistically, most studies I have read boil down to 1) masks are somewhat effective and 2) we didn’t test which fabric is most effective. Most of the strong studies are large scale studies of virus-infected areas where the rate of mask-wearing is estimated, so the mask composition is going to vary in that population.

My advice, stick to medical or commercial masks, like those used in construction industries. I say that because there is a standard met with surgical and commercial grade masks that is not met with cloth masks but remember, some mask is better than no mask.

At work, I have different levels of mask. Generally, I just wear a disposable surgical mask. If I am in surgery or examining a patient, I wear an N95 with a surgical mask over it, and if I am with a known COVID patient, I wear a fitted, specially cleaned N95 or a supplied-air mask.

These really are overkill for just somebody going into public, but wearing a cloth mask over a disposable surgical mask will protect the disposable mask from large droplets and thus extend the life of that mask. That way the cloth mask on the outside can be easily washed, while the better filtering capacity of the non-washable, disposable mask is maintained.

Going the distance, socially. 

Social distancing is your best defense. It is important to think of a mask as a good adjunct if social distancing can not be maintained. Remember time, distance, and shielding. If you cannot maintain distance, then use shielding and limit time. If you are outside on your deck by yourself, do not wear your mask. If you are in your car by yourself, you do not need a mask. Both of these provide ample distancing. At the gaming table, try to space 6 feet apart and use a mask. A good tip that I follow, is to make the table a 6×6 foot table, that way, as long as you stand on opposite sides, you will never be closer than 6 feet. You can also use a 4×4 foot table as long as you remain diagonal to each other. 

Another form of distancing is isolating contacts. Keep your hands distant from other hands by avoiding contact with items touched frequently by other people. So bring your own dice and measuring tape. Gloves can be used, but remember the glove is not clean, so if you do wear gloves, you have to be careful to not touch your clothes or skin because that will just contaminate you.

I find it way more effective to wash my hands frequently, and only use gloves when at work actually touching a patient. I would not game in gloves because they are a contamination risk and will spread that contamination to my books, miniatures, and dice. 

Also, remember that part of this is to maintain good hygiene. Regularly showering and brushing your teeth lowers your chance of spread due to contamination. At a convention, you might want to do a head to toe clean up once you get back to your hotel room or house. This will limit any contamination of your clothes and body to your house or room. This is a form of limiting the amount of time that the viral particles will linger on you. Limiting this time limits the ability to infect.

Whole-body defense. 

Finally, in gaming terms, you need to increase your AC against COVID. This can be done by getting sleep, eating healthy, and exercising. These raise your constitution and so you ultimately lower your chance of becoming sick. Now, these are not quick changes to implement, but I think it is the worse part of quarantining and the aspect that is least talked about and in my opinion most effective in lowering mortality.

If you stay inside and watch TV all day, you’re most likely going to wind up being more susceptible to disease.  A lot of conditions are linked to low activity and poor diet, these conditions lower life expectancy even without COVID lurking around. Lately, multiple studies have even said that obesity, diabetes, heart disease, all greatly increase the chance of morbidity and mortality if infected with COVID and so limiting these will limit your risk.

Any current diseases you may have are also things you do need to be cognizant of. Approaching with increased caution is needed for any conditions that affect the respiratory system or immune system. And take steps to be more proactive. If you develop symptoms, be more aggressive in determining COVID vs non COVID because you do not want the serious illness to develop if you do have a compromised respiratory system already.

If traveling for a convention, make sure your medications are going to be adequate for your entire duration so you may not have an exacerbating event. Also, limit unhealthy practices that may cause a worsening of your conditions. Do not vape and do not smoke. Do not binge drink alcohol and do try to eat better when staying or traveling for a convention. Junk food is fine, a week of living on junk food is not.

Conclusion

Ironically, epidemiology is much like a tabletop RPG or war game. It boils down to percentages and modifiers, but at the end of the day, you still will have to roll the dice. Returning to a normal life will cause you to take a chance, but this is not new to life.

Risk vs reward is calculated into everything you do. Ever taken a ride in a car? Dice roll. Ever eaten food? Dice roll. Even going to a hospital is a dice roll. The biggest contributor to a person getting a hospital-acquired infection is that they were recently in a hospital.

Ultimately you are a person, and as a person, you are complex. Your overall health and susceptibility are multifactorial. A basic tenet of medical microbiology is the idea that a person becomes sick due to a combination of factors, these are factors of the infecting organism and the factors of the person being infected. So your goal should be to be well informed about risk which allows you to make decisions on how stacked you want your dice roll to be and how often you want to roll it. 

So I hope for all of you the dice roll always in your favor and that your fortitude checks are always successful. I also hope that this serves as a way of getting you comfortable with the idea of informed risk, lessening of controllable factors, and personal assessment,  because ultimately you need to do what makes you both healthy AND happy. COVID is a threat, but so is depression, isolation, and poverty. Mitigate risk and move forward towards the reward. And please remember life is for fun and adventure, not fear and apprehension. Thanks for reading and I hope you all stay safe, happy, and healthy.

Take-Aways From this Article  

Make the choices you need to make in a responsible manner to be healthy And happy. If you want to participate in gaming, be defensive and use time, distance, and shielding. For best protection always ensure you have two of these on your side. If you cannot shield, i.e. wear a mask, then limit the amount of time you have with people and maximize your distance to those people, i.e. greater than 6 feet.

If you are wearing a mask, then try to limit the time in which you are in close proximity or maintain 6 feet of distance. Remember to wash your hands. A good rule of thumb is wash your hands every time you change rooms.

If you go to the restroom, wash your hands. Go to eat, wash hands. Pack up to drive home, wash your hands. Practice full-body defense by maximizing healthy habits and good hygiene, and avoid bad habits, most importantly smoking and vaping. I don’t want to lecture on smoking or vaping, but if you do actively smoke or vape, do not visit flavor country every time you are about to go into a hall jam-packed full of people.

 

References

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