Coronaviruses are a large family of viruses that can infect birds and mammals, including humans, and is traditionally associated with the common mild cold in people.
Sometimes coronaviruses that infect animals, including camels, bats, cattle, cats and snakes, can evolve and make people sick then become a new human coronavirus.
Some examples of animal coronaviruses that crossed over and spread person-to-person are the severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and now the new 2019-nCoV (a.k.a. COVID-19.)
As of 17-Feb-2020, authorities in China say the death toll from COVID-19 is over 1,700 (well surpassing the deadly 2003 SARS outbreak), with most deaths occurring in the Chinese province of Hubei (esp. Wuhan city) where the coronavirus was first discovered.
Globally there are (now) about 693,282 confirmed cases of the virus so COVID-19 (formerly 2019-nCoV) has over a 4% mortality rate as of 30-Mar-2020 globally (and about 2% in the U.S. as of 30-Mar). And this outbreak is far from over as millions of Chinese returned to work after the extended Lunar New Year break ended. But realize the Spanish flu of 1918, which was the last true global pandemic, had a “case fatality rate” or CFR of 2.5%, and it killed an estimated 50 – 60 million people.
The fatality rates for MERS was about 35% and SARS was around 14-15% which is why those coronaviruses were very concerning, but countries were able to contain things in both cases so thankfully neither became a pandemic.
Interestingly Live Science says one group has escaped with minimal damage so far: children. Other coronaviruses, including SARS and MERS, also showed this pattern. Currently the median age of 2019-nCoV patients is between 49 and 56 years old, according to a recent JAMA article.
Symptoms and Complications
COVID-19 infection can range from mild, with no symptoms or minor symptoms, to severe or even deadly. The symptoms usually start between 2 to 14+ days after you get infected and can include:
- Sore throat
- Runny nose
- Shortness of breath or breathing difficulties
It can also cause pneumonia and progress to multiple organ failure or death in some severe cases.
There is a test for 2019-nCoV [COVID-19], but there’s no vaccine or specific treatment yet other than medical care to help relieve symptoms, although Gilead’s experimental drug called remdesivir is being trialed in some cases.
As Dr. Sircus reports, some patients who at first appeared mildly or moderately ill then took a turn for the worse several days or even a week into their illness. The median time from their first symptoms to when they became short of breath was 5 days; to hospitalization, 7 days; and to severe breathing trouble, 8 days. Experts say that pattern means patients must be carefully monitored, and it is not safe to assume that someone who seems to be doing well early on is out of the woods. But, as Dr. Sircus says, “remember at least 95 percent of people survive it! Cancer patients should be so lucky.”
At a time when many are rightly concerned about coronavirus — of which there are just a handful of cases in the U.S. so far — the CDC is also warning Americans not to drop their guard about influenza, which has caused at least 19 million illnesses, 180,000 hospitalizations, and 10,000 deaths so far this season.
What is being done
On Jan. 30, the World Health Organization declared a Public Health Emergency of International Concern about the current epidemic of 2019-nCoV in mainland China. The following day, HHS Secretary Alex Azar declared 2019-nCoV a public health emergency domestically and ordered any U.S. citizens returning from China’s Hubei province to be quarantined for up to 2 weeks to provide proper medical care and health screening.
The immediate risk to the U.S. is currently low, and a presidential proclamation in place suspends entry of foreign nationals who have visited China within the past 14 days into America. The CDC has also put into place measures to detect this virus among those who are allowed entry into the U.S. who are entering the country within 14 days of having been in Hubei province or mainland China.
All of these passengers are being directed to 1 of 11 U.S. airports where American citizens and exempted persons who have been in Hubei province will have an additional health assessment. They will be screened for fever, cough, difficulty breathing.
- If symptomatic, American citizens and those who are exempt will be transferred for further medical evaluation. They will not be able to complete their itinerary and will be isolated for 14 days.
- If asymptomatic, American citizens and those who are exempt will be subject to a mandatory 14-day quarantine at or near that location.
The list of 11 airports are…
- San Francisco International Airport, California;
- Los Angeles International Airport, California;
- Hartsfield-Jackson Atlanta International Airport, Georgia;
- Daniel K. Inouye International Airport, Hawaii;
- O’Hare airport, Illinois;
- Detroit Metropolitan Airport, Michigan;
- Newark Liberty International Airport, New Jersey;
- JFK, New York;
- Dallas/Fort Worth International Airport, Texas;
- Washington Dulles International Airport, Virginia;
- and Seattle-Tacoma International Airport, Washington.
The Department of Defense has identified housing support at 4 bases for up to 1,000 people who may need to be quarantined upon arrival from overseas travel. Currently DOD is housing 198 people at March Air Reserve Base, California, but DOD is not involved with treatment or observation of those at the facility; Health and Human Services is doing that.
The 4 bases are…
- Marine Corps Air Station Miramar, California;
- Travis Air Force Base, California;
- 168th Regiment, Regional Training Institute in Fort Carson, Colorado;
- and Lackland Air Force Base, Texas.
So what can people do?
First – don’t panic since Americans are still currently low risk and the focus right now is on travelers returning from places where this disease rate is growing.
And as mentioned above, it is still active flu season here in the U.S. which has sickened millions and killed 10,000 people so far. Use the below common sense tips from both CDC and our preparedness and first aid manual to help reduce the spread of germs and infectious diseases.
- If you haven’t already, consider getting a flu shot and take flu antivirals if prescribed.
- CDC does not recommend that people who are well wear facemask to protect themselves from respiratory viruses, including COVID-19.
- Facemask should be used by people who show symptoms of COVID-19, in order to protect others from the risk of getting infected. The use of facemasks (and eye protection!) is also crucial for health workers and people who are taking care of someone in close settings at home or in a health care facility.
- Take everyday preventive actions to stop the spread of germs.
- Wash your hands often with soap and water for at least 20 seconds – especially after going to the bathroom; before eating; and after blowing your nose, coughing, or sneezing. An easy way to mark the time is to hum the “Happy Birthday” song from beginning to end twice while scrubbing.
- Use an alcohol-based hand sanitizer that contains at least 60% alcohol.
- Avoid touching your eyes, nose and mouth with unwashed hands.
- Avoid close contact with people who are sick.
- Stay home when you are sick or becoming sick.
- Cover your cough or sneeze with a tissue (not your hands) and throw the tissue in the trash.
- Clean and disinfect frequently touched objects and surfaces.
- Do not travel while sick.
- Seek medical care right away if you have both symptoms of fever, cough and shortness of breath and have either recently returned from China or have direct exposure to others diagnosed with a coronavirus.
- Before going to a doctor’s office or emergency room, call ahead and tell them about your recent travel and your symptoms.
- Cover mouth and nose with tissue or sleeve (not your hands) when coughing or sneezing.
- Keep cuts and scrapes clean and covered until healed.
- Boost your immune system.
- Clean counters, doorknobs, fixtures, phones, remotes, nurse call buttons, linens, etc. often with a bleach solution.
- Don’t share silverware, razors, clothing, towels, or bedding and wash objects with soap and hot water.
Doing your part
- It’s currently flu season. Take everyday preventive actions to stop the spread of germs and infectious diseases as listed above.
- Health care professionals:
- Maintain awareness of people with travel history to China as well as fever and respiratory symptoms.
- When caring for a COVID-19 patient, follow recommended infection control procedures.
- People who may have COVID-19 infection:
- Follow CDC guidance on how to reduce the risk of spreading your illness to others.
- Stay up to date with CDC’s travel health notices.
CDC: Coronavirus site
World Health Organization: Coronavirus site
Dr Sircus: Treatments for Viral Infection
The Survival Mom: The truth about disinfectants: Q&A with an expert