COVID-19 Coronavirus

Mar 20, 2020

What You Need To Know About COVID-19 Coronavirus

Last Update – 3/11/20

COVID-19 coronavirus is a novel coronavirus that originated in Wuhan, China, and has spread to more than 30 countries in Asia, Europe and the Middle East. The World Health Organization and the United States have declared public health emergencies because of the virus’s spread.

What is a coronavirus?

Coronaviruses have been with us for a long time. They were first discovered in the 1960s, and frequently cause the common cold. It’s very likely that at some point in your life, you have had a coronavirus infection. So, what is different about SARS-CoV-2, the coronavirus causing the COVID-19 infections that started in Wuhan, China, and have spread throughout the world? This particular coronavirus (like SARS and MERS) has some unique characteristics that mean it causes a more serious infection from time to time.

The coating on the outside of a virus dictates the location in the human body to which the virus can attach. A coronavirus with a particular exterior that is predisposed to attach to the lining of the nose will cause a common cold, an upper respiratory tract condition. In the case of COVID-19, the virus has an exterior that can attach to tissues in the lungs. This means that in some patients, COVID-19 can cause pneumonia, which is a lower respiratory tract problem and potentially more serious.

What are the symptoms of COVID-19 coronavirus?

The first symptoms of COVID-19 coronavirus are very similar to cold and flu, and generally include sore throat and runny nose. In fact, many people who are infected with COVID-19 coronavirus appear experience very mild symptoms or no symptoms at all. (This is what makes the virus so hard to contain. If people don’t really know they are sick, they are more likely to infect lots of other people.)

In a small percentage of cases, the virus can cause pneumonia. If that happens, the person infected with COVID-19 coronavirus will have shortness of breath and fever. If these symptoms are present, it means that you are dealing with more than just a common cold, and you should seek medical attention.

How do I get tested for COVID-19 coronavirus in Texas?

Public health departments are not currently testing for the COVID-19 coronavirus unless you meet one of the following criteria:

  1. You are exhibiting symptoms consistent with COVID-19 AND have had close contact with a laboratory-confirmed COVID-19 patient in the last 14 days.
  2. You are exhibiting symptoms consistent with COVID-19 that are severe enough to require hospitalization AND you have traveled to China, Iran, Italy, Japan, or South Korea in the last 14 days.
  3. You are experiencing symptoms consistent with COVID-19 that are severe enough to require hospitalization AND you have been tested to rule out alternative diagnosis (e.g. Influenza.)

I’m worried I might have COVID-19 coronavirus. What do I do?

If you were traveling, or think you may have been exposed to COVID-19, the most important thing you can do is STAY HOME. If you are out and about, you could be exposing more people to the disease. If you need care, use telemedicine or a virtual care service. Your employer health plan may have a telemedicine benefit, or you can book a Remedy video visit, which is covered by most major insurance plans. If it is suspected that you have the virus, you will be expected to self-quarantine at home for 7-14 days until you are no longer infectious to others.

How worried should I be?

The COVID-19 coronavirus causes mild symptoms in most people. This is a bit of a double-edged sword. On the one hand, COVID-19 is not something to worry about too much, because in the vast majority of cases, it is mild. On the other hand, because it is mild (and in some cases asymptomatic,) it is likely that it will spread fairly easily.

How is the COVID-19 coronavirus spread?

Like influenza and the common cold, COVID-19 coronavirus spreads through respiratory droplets. This means that an infected person generates potentially infectious droplets when they cough, sneeze or even talk. You can become infected with COVID-19 if these infectious droplets come into contact with your eyes, nose, or mouth, or if you touch a surface where these infectious droplets have landed and then touch your face.

How can I protect my family from the COVID-19 coronavirus?

  1. Avoid contact with people who are sick.
    Whenever possible, avoid contact with friends, family, and coworkers who are experiencing cold or flu-like symptoms.
  2. Wash your hands.
    Wash your hands frequently with soap and warm water for a minimum of 20 seconds.
  3. Don’t touch your face.
    Avoid touching your eyes, nose, and mouth after touching any surfaces in a public place, or after coming into contact with someone who is experiencing cold or flu-like symptoms.

What about masks? Do they help?

Not really. The masks available at local pharmacies don’t form fit to your face, and still allow air to enter your respiratory tract from the outside. Masks may help you remember not to touch your face so might be helpful in that regard. In healthcare facilities, we will mask people who are symptomatic. That helps prevent them from sneezing and coughing the virus into the air around them.

How severe can COVID-19 coronavirus get?

Recent data from China indicates that about 80% of infections from this virus are actually quite mild. “Mild” means that the lungs are not involved, so no pneumonia. Or if there is lung involvement, it is often not serious. The remainder of the infections were categorized as “severe” or “critical”. Severe infections had lung involvement and produced shortness of breath. These accounted for about 14% of infections, leaving about 5% as “critical”.

The fatality rate is not clear yet. In China, the above study showed that the fatality rate was around 2.3%, or about half of the critical cases. But many experts feel that this is being skewed high by the fatality rate in the Hubei province (where Wuhan is) of 2.9%. The fatality rate outside of Hubei province has been closer to 0.3%. Globally, almost 114,000 cases have been reported, with 4012 reported deaths. Of those roughly 33,000 are in China, which accounts for 3140 of the attributed deaths.

As of this writing, there have been 938 reported cases in the US, with 29 reported deaths.

The mortality of the seasonal flu, caused by the influenza virus, is close to 0.1%. So it may be that COVID-19 is more lethal than the flu, but not much more. Also, it is key to remember that these infections (like influenza) are more serious in the elderly, the very young, and patients with multiple medical problems. Most young, healthy people are going to fight off the infection easily, but should be careful not to infect others in these high risk groups.

How is COVID-19 coronavirus treated?

There are no antivirals or antibiotics for the COVID-19 coronavirus. It cannot be treated with medicine, so the treatment available is what is called “supportive care”. This means that we can supply oxygen and even put patients on mechanical ventilation if the pneumonia is really bad. But ultimately, we have to let the virus run its course and let the body fight it off. Unlike influenza which can be treated with antivirals like Tamiflu®, there is no medicine that specifically treats COVID-19. So, management consists of drinking plenty of fluids, rest, and fever-reducing medicine like Tylenol® as needed.

What will happen with this pandemic?

The situation is evolving rapidly, and public health officials and infectious disease experts are learning more about this new novel COVID-19 coronavirus every day. Most experts agree that there are two possibilities at this point….

One possibility is that the virus could become less and less transmissible as it spreads, and eventually die out. This is what happened with other coronavirus infections like SARS and MERS.

Alternatively, it could become well-established in its new host (that’s us… humans). Basically, constantly and periodically infecting us, ramping up seasonally during the winter months as the current influenza virus does. We would learn to live with it like we do the flu, and it’s likely that the coronavirus would lose some of its potency in that process. Also, previous infection would result in antibodies that protect a person from future infections. That is, as long as the virus doesn’t evolve and change like the flu virus does.

The Bottom Line

Don’t panic. Practice hand washing frequently, and minimize touching your face. This will keep you safe not only from coronavirus, but the seasonal flu as well. If you are sick, stay home, and encourage co-workers or fellow students to do the same if they are sick. Whenever possible, use virtual care such as telemedicine, or at-home care where a provider comes to you. These may be available to you through an employer-sponsored plan, or you can use Remedy which is in-network for most major insurance carriers.

Last Update – 3/11/20

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