Coronavirus 2020 Q&A

18115_lores[1]Learn how to protect your friends, your family, and yourself from the coronavirus.

The coronavirus is big news throughout the world, with over 90,000 cases and 3,000 deaths so far. It does not show many signs of abating. I have corresponded with journalists writing articles on this topic for the Huffington Post, Rolling Stone magazine, and other venues. But since I am most concerned for (and praying for, even last night), our readers and subscribers at the MD Harris Institute, I want to share important coronavirus information with you.

US and world public health authorities, such as the US Center for Disease Control and Prevention (CDC), are developing and following scientific protocols for quarantine, isolation, and personal protective measures. Hospitals are ramped up for detection and treatment. Top scholars are researching the virus and searching for treatments and vaccines. Many people have died, and more will, both in the US and abroad, but we want to minimize that number. The coronavirus is a serious challenge to all of us, as individuals and as nations, and we must face it as individuals and as nations. As with every other threat in life, governments can only partially protect us; we must protect ourselves and our families.  

Where did the coronavirus come from? Coronaviruses are part of a large family of viruses found in animals. The best evidence suggests that COVID-19, the specific virus responsible for this outbreak, came from bats. The epicenter was a large live animal and seafood market in Wuhan, Hubei Province, China. Most of the disease spread now is person to person.

How is it transmitted? Can it be transmitted via pets? What about packages from China or other impacted countries? At this time, transmission is primarily person to person via respiratory droplets in the air or on the surface of an object. Coronaviruses of various types come from animal reservoirs (as noted above), but pets do not transmit COVID-19 to humans. Under optimal conditions, COVID-19 persists in the environment up to nine days. Since packages are exposed to heat, cold, dryness, and other conditions that can kill COVID-19, packages are unlikely to transmit the disease.

How do you know if you’re infected with coronavirus? 

There are three criteria to look for in making the diagnosis of COVID-19 disease:

  1. Traveled to China recently (14 days) or
  2. Close contact with someone known to have 2019 nCoV sickness
  3. Fever and/symptoms of lower respiratory illness (cough, shortness of breath), especially if your symptoms are getting worse.

If a person meets these criteria, they should wear a face mask and see his or her doctor. If a diagnosis of COVID-19 is confirmed, your doctor will report the case to the local public health authorities.

What is the testing process here in the US? Where can you go to get tested? As with many novel infections like Ebola, local health facilities take a sample and then send the sample out to the specialized lab at the CDC. The CDC has issued clear guidelines for specimen preparation. Specimens are respiratory – swabs of the nose and throat – or samples of fluid from the lungs. People should get tested if they have symptoms and a link to someone who may have the disease, or if their doctor recommends it.

If you are infected, how do you avoid passing it on to others? Wear a face mask, wash your hands, and avoid coughing or sneezing on others. Stay home from work and avoid groups of people while you have symptoms. Sleep in a bedroom alone if available. Avoid people with chronic medical conditions such as immunosuppression and heart, kidney, or lung failure. COVID-19 infections in people with these problems are much more likely to be fatal.

How long is the incubation period? Are you contagious during this time? The average incubation period is 6.4 (5.6 – 7.7, 95% CI) days, ranging from 2.1 to 11.1 days (2.5th to 97.5th percentile). People are contagious when they have clear symptoms and may be contagious even if they have minimal symptoms.  

What are some signs that you need to be tested, if symptoms do not appear for a while? Muscle pain and fatigue are common. Headache, coughing up blood, and diarrhea can occur. Since these symptoms can occur with many other diseases, a link to China or to a person with confirmed COVID-19 is important.

What is the treatment protocol? There is no specific treatment unless a patient develops a complication such as an overlying bacterial infection. Avoid corticosteroids. Supportive care is important, especially for severe disease.

Any other lifestyle changes/tips you can try to feel better faster? Adequate sleep, hydration, healthy diet, and gentle activity are best.

What about diet? Certain foods cause inflammation in the body and could conceivably worsen infections such as COVID-19, though this is not proven. Pro-inflammatory foods include sugars and high fructose corn syrup, artificial trans-fats, refined carbohydrates, alcohol, and refined meats. Anti-inflammatory foods include most seafoods, whole grains, and vegetables. No drink is better than water – in generous amounts.

What about exercise? Moderate exercise, up to 60 minutes aerobic at moderate intensity (like brisk walking), improves the immune system. Strenuous exercise impairs the immune system for up to 24 hours after exercise. If you have mild symptoms of a coronavirus or other significant respiratory disease, avoid exercise except for slow walking and gentle range of motion.  

Is there anything that can be done to prevent infection? Is there anything we can/should eat or take or do to prevent infection? Healthful habits such as good hydration, sleep, and moderate exercise are the best. Wash your hands and avoid groups of people when you are having symptoms. Don’t smoking or vape and stay out of high particulate environments. Eschew any other activity or setting that can increase inflammation in your respiratory system. Launder any fabrics with second or third hand smoke. Do not drink alcohol.

How can I use my environment to protect against coronavirus? Coronavirus lives up to nine days in the environment, and like all microorganisms, survives in mucous, other body fluids, or water better than in dry conditions. Keep surfaces, especially kitchen, bedroom, and bathroom, clean and dry. Soap and water are most important but disinfecting with commercial cleaners is useful. Encourage ventilation in your house and other areas.

Should I wear a face mask? Is there really a shortage of masks? Masks are helpful but wearing them consistently and getting the right fit is difficult. Any type of mask is better than no mask. You should wear a mask if you have symptoms or if you are exposed to others who have symptoms. The area between the nose bridge and the cheeks is most likely to be left open or fit poorly, so make sure that this area is as small as possible. Some companies that make surgical masks are reporting a shortage.

What is the prognosis for a relatively healthy person in the US? What types of people are more susceptible to coronavirus? Healthy patients with COVID-19 infection usually recover without difficulty. The elderly, the very young, and those with severe underlying health problems have the highest risk of death. Thus far, about 50% more men than women have died from the disease, but it is not clear why.

What are the signs that it may be progressing toward something more serious / potentially deadly? Worsening symptoms such as severe difficulty breathing or blood in the sputum or urine.

How do I wash my hands?

The single most important thing that any of us can do to minimize our risk of getting coronavirus, or influenza, or most infectious disease, is to wash our hands. Many of us don’t wash, and even those who do wash don’t do a good job. How should you wash your hands?

  1. Turn on the water and get some soap. Wash for 20 to 30 seconds.
  2. Start by washing your fingertips. Wash around the fingernails and fingertips.
  3. Keep your hands above your elbows so that the dirty water runs down your arms instead of back to your fingertips.
  4. Wash the rest of your fingers and proceed down to your hands. Once you wash an area, like your fingers, don’t go back to it, and don’t let soap and water run from dirty areas to clean areas.
  5. Wash your wrists and lower arms, keeping your elbows below your hands and your hands below your fingers.
  6. Turn off the water with your elbow, if possible. Otherwise, use a paper towel.
  7. Dry your hands from fingertips to wrists and lower arms with a paper towel or heat dryer. Keep hands up and elbows down, and do not let water from wrists and elbows run back over your hands and fingers.
  8. Use a paper towel to open the door to leave the room.

The music video that I posted on February 4, the Ballad of the Coronavirus, has useful information, and reminds us that the vast majority of people who develop symptoms from the coronavirus recover completely. The MD Harris Institute is keeping up to date on COVID-19 and providing education and resources to combat the threat. Check out our Disease and Disaster Updates for current information on coronavirus and other timely threats.

References

  1. www.CDC.gov
  2. https://www.medrxiv.org/content/10.1101/2020.01.27.20018986v2.

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