Unless you have been meditating in a cave or made a decision to avoid the news over the past couple of months, you have no doubt heard about the new coronavirus that is rapidly spreading across the world. The disease it causes has been named COVID-19, short for Coronavirus Disease 2019. Coronaviruses are a family of viruses named for the spikes that protrude from the surfaces of the actual virus, as seen under an electron microscope. In humans, coronavirus illnesses cover a wide spectrum, ranging from the common cold to the headline-grabbing SARS (Severe Acute Respiratory Syndrome) epidemic in 2003 and MERS (Middle Eastern Respiratory Syndrome) outbreak in 2015. COVID-19 is an illness ranging from mild, cold-like symptoms to very serious lung infections that can lead to death, especially in vulnerable populations such as the elderly and those with other medical problems.
While humans have lived with various types of corona virus for years, the specific one that causes COVID-19 is new to humans. What makes the COVID-19 newsworthy is its mortality rate and how quickly it spreads.
The World Health Organization reports there are now almost 90,000 confirmed cases globally with the vast majority- about 80,000- in China. Of those Chinese cases, 2,900 died. This 3.6% mortality rate is extremely high – about 36 times that of the common flu – but I think it will to drop after we better study the disease. The basic reason: quite probably many people who have COVID-19 aren’t diagnosed.
This lack of diagnosis happens for a couple reasons. First, some people have mild symptoms that mimic a cold, or no symptoms at all, so they don’t get tested. Second, until very recently, testing could only be done through the The Centers for Disease Control and Prevention in Atlanta (C.D.C.), and the criteria were very restrictive, so likely many who had the infection weren’t tested.
The disease has mushroomed to more than 67 countries with significant numbers of cases in South Korea, Italy, Iran and Japan. Because of this, there are screening procedures and travel restrictions in many countries around the world. The C.D.C. is advising against all non-essential travel to China, South Korea, Italy and Iran, and has warned older and at-risk travelers to avoid Japan.
Symptoms of COVID-19 include fever, a cough and in the more serious cases, shortness of breath. If you have a fever and/or respiratory symptoms and have been in one of the 5 high-incidence countries in the past few weeks, or if you have been in close contact with someone who has or who might who have COVID-19, you should contact an urgent care clinic or your primary care physician and arrange to be evaluated.
But please don’t just show up at the clinic or your doctor’s office- call first so you can be evaluated without exposing others. The clinic or your PCP can then prepare for your arrival, and will contact the Nevada County Public Health Department, which will arrange for the appropriate testing and public health measures.
COVID-19 is getting worldwide attention and is making headlines daily. But the reality is that while it constantly in the news, currently it is nowhere near as great a risk to your health as influenza- the common flu. The number of cases of COVID-19 is increasing daily, but as of this writing, there were 88 cases and 6 deaths in the US. To put this in perspective, the C.D.C. estimates there have been 14,000 deaths from influenza so far this season, with over 250,000 people hospitalized more than 25 million infected. And this has been a relatively mild flu season- there were 62,000 deaths in 2017-18.
The initial symptoms for COVID-19 and influenza are similar. But there are some significant differences between the two infections. Unlike influenza, little is known about COVID-19, there is no vaccine to prevent it and no anti-viral medication proven effective against it. Research is just starting on COVID-19, but it appears that people can pass the virus before they have any symptoms, and that some people have the infection and never develop any symptoms.
Officials think the virus may have been spreading undetected in the Seattle suburbs for the past 6 weeks while the federal government resisted calls for more widespread testing. This led to a reported delay in diagnosis of the first community acquired case in the US, a woman from Solano County who was hospitalized at UC Davis. In addition, test kits have been in short supply as the first test kits sent to state public health departments were defective. There is now a limited supply of tests in California available through the California Department of Public Health, with that supply expected to ramp up soon.
The chance of becoming infected with COVID-19 if you are not travelling outside the country is still low. That being said, there are steps to take to reduce your risk. As with most respiratory infections, wash your hands frequently with warm water and soap, scrubbing for 20 seconds, then rinsing. Avoid close contact with people who are sick and stay home if you are feeling ill. Cover your mouth when coughing and disinfect surfaces in your home and office. These same steps will reduce your chances of getting the common flu. And there is a vaccine to help prevent influenza, so if you haven’t had one yet this season, please get one!
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