Coronavirus (SARS-CO2 causing COVID-19 disease) is now all anyone is talking about and thinking about. This does not mean panic, it means be prepared and be realistic. It means be aware of potential contacts and know what symptoms to look for. It means listening to authorities and the medical community to help contain the spread of the virus.
Coronaviruses are not new. In fact every winter many colds we all get are from coronaviruses. This one in particular IS new. That means it is just now being understood and none of us have immunity to it. We also do not have proven therapeutic interventions or a vaccine. Therefore it will spread very easily in the population.
For many people, COVID-19 will cause nothing more than a common cold, or maybe no symptoms at all. The most common symptoms are dry cough, fever and shortness of breath. For about 20% of the population, the infection will result in respiratory distress leading to hospitalization, potential intubation (ventilator) and ICU care, or potential death. Many people may not even notice they are sick for several days after they are already spreading the infection. This, in addition to the lack of community immunity, is why public health measures are important now. If you or your child has mild cold symptoms, fever, cough or shortness of breath AND have been to one of the countries listed by the CDC as Level 3 risk or has been or in contact with someone who has confirmed COVID-19 within the past 14 days, call your doctor or health department for instructions. Please DO NOT show up at the doctors office if you meet the above criteria, they are unlikely to be equipped to deal with isolation and they may be unable to test you due to unavailability of test kits. Testing ability is constantly changing so checking with your local health department is helpful if you have questions about testing in your area. Once testing becomes more readily or commercially available, it’s still important to avoid overwhelming the labs and try to reserve tests for symptomatic people. Ideally, widespread testing when available will help identify patients so their contacts can be quarantined and monitored, which will significantly decrease spread.
Why such an uproar about this virus if most cases are mild? Why don’t we behave this way every cold and flu season?
As stated above, this virus is new and no one has pre-existing immunity to it. Again, this means spread through all communities will be easy. What will happen if we don’t heed current warnings? We will see more rapid spread, especially in dense populations, which will not only negatively affect the most vulnerable in our population, but will also overwhelm our healthcare system. Don’t forget, if your doctor gets sick or exposed, they are out of the pool of doctors to help you if they must be in quarantine for 2 weeks. We can learn a lot from the experience in China and South Korea. Social distancing and use of quarantines have helped in decreasing spread. On the other hand, we can also learn a lot from the experience in Italy. They are experiencing an overwhelmed hospital system in which there aren’t enough doctors and resources. So if large gatherings are canceled to halt the spread, it’s what needs to be done to avoid overwhelming the system. It’s called #FlatteningTheCurve.
What are symptoms of COVID19 and how does it compare to the flu?
I’ve heard many say this infection is like a bad flu. SARS-CoV2 is a different virus than influenza and appears to be more fatal than the flu at this time. However, influenza IS STILL BAD. Millions get the flu every year and thousands die. And not just people in vulnerable populations, the flu kills healthy kids and adults every year. Also the onset of symptoms of the flu are different from COVID-19. Influenza will cause a sudden onset of high fever, fatigue and body aches while COVID-19 will cause a more gradual onset and is mostly going to cause fever and cough. Worsening symptoms of COIVD-19, like pneumonia or acute respiratory distress syndrome, are not likely to occur until the second week of illness. Usually there will not be a runny nose with COVID-19 and the cough will be a dry cough. Shortness of breath or trouble breathing is a sign that the infection is getting worse and it’s time to seek medical attention. If you are not experiencing shortness of breath but have mild symptoms, please call your doctor before arriving at their office as stated above.
The spread of both infections is very similar; they spread through droplets. That means the virus lives in drops that come from coughing, sneezing and talking and will live on surfaces where they land, can land on your face directly or can be transferred from your hands to surfaces and then from those surfaces to someone else’s hands and then face. While influenza lives on surfaces for up to 48 hours, we know that this new virus can live on some surfaces for many days. Because of this, personal precautions (see below) are extremely important all of the time. Also, you should be getting your flu shot.
So what can you do right now?
- Wash your hands for 20-30 seconds with soap and water or use alcohol based hand sanitizer and rub it in until it is dry. Cough or sneeze into your elbow. Do not touch your face or eat without washing your hands first. Regularly clean surfaces with disinfecting wipes. Stay home if you are sick.
- We are now (edited on 3/15/20) seeing more cases pop up in communities throughout the United States. This is not unexpected with more testing being done. Therefore, now is the time to stay home to decrease spread. The least affected people in the population, children and young adults, are most likely to have no symptoms of infection and still spread it. The virus can be spread for several days before any symptoms appear at all. That means keep your little germ spreaders at home! No play dates, no group sports, no sleepovers.
- Avoid large gatherings and be prepared when things like conferences, sporting events or concerts are postponed. Avoid non-essential travel. (As of 3/15/20 most schools, museums, large events, sporting events, and theme parks have been closed or canceled.)
- Listen to local authorities if you end up needing to quarantine and be prepared with medicines and prescriptions you may need, as well as food and other essentials. However, do not stockpile items like masks and sanitizer that your healthcare system may need. Standard surgical masks will not keep you from getting disease although it can help prevent spread if you are sick.
- Stay home if you are sick and talk to your employer now about options for working form home or paid time off.
For frequent updates, please check back to the links above to the CDC. I won’t always have the time to update this blog post, which is why I have included these links. You can also check my company website, which is being updated regularly at Children’s Primary Care Medical Group. Finally, I hope this helps everyone understand how public health works and will go on to not only have better hygiene all of the time, but will understand how their actions may affect others in their community.