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Opinion

JUST THE FACTS ABOUT THE CORONAVIRUS

SoVaNow.com / March 26, 2020
By Babita Patel,
MD, ABIM, NBPAS

Internal Medicine and Infectious Diseases, Halifax Internal Medicine
Special to the News & Record

Coronaviruses are a large family of viruses that may cause illnesses in animals and humans. Animals such as bats and birds are the ideal hosts for the coronaviruses. These are known as zoonotic diseases because the viruses can jump from animals to humans and cause infection. This virus primarily attacks the cells in the respiratory and gastrointestinal tracts. Antibodies appear after initial infection, which will eventually wane; however, it is possible that reinfection can still occur in the presence of antibodies.

In humans, several coronaviruses have been known to cause respiratory infections ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome, also known as MERS, and Severe Acute Respiratory Syndrome, also known as SARS. MERS was initially seen in Saudia Arabia in June 2012 with bats as the animal reservoir host and camels as the intermediate host. SARS originated in the Guangdong Province of Southern China in February 2003. The animal reservoir hosts were bats, and the intermediate hosts were civet cats eaten as culinary delicacies in China. The novel coronavirus, labeled by the World Health Organization (WHO) as COVID-19, has been spreading rapidly across the globe evolving into a pandemic.

This new virus and disease were unknown before the outbreak in Wuhan, China, in December 2019. Live animals sold at the Huanan Seafood Market are thought to be the source of this novel coronavirus with bats suspected as the animal reservoir host. It began with a rapid spread creating an epidemic in China and then spreading globally to all continents excluding Antarctica.

As of March 21, 2020, there have been more than 300,000 total cases worldwide with over 14,000 deaths. In the United States alone, as of Tuesday, March 24, there have been more than 44,000 positive cases and over 540 deaths.

The primary mode of transmission of the virus is from person to person through respiratory droplets from an infected individual who coughs or sneezes. However, contact with infected surfaces or objects is also possible as coronaviruses can survive on inanimate objects for up to nine days. Individuals are most contagious when they have symptoms, yet transmission can also occur before symptoms appear. COVID-19 is a highly contagious virus and is known to spread rapidly within communities.

Symptoms can appear 2-14 days after initial exposure and range from mild symptoms to severe illness and death. The most common symptoms are fever, cough, and shortness of breath. Other symptoms, although less common, are headache, sore throat, vomiting or diarrhea. This disease can progress to pneumonia and respiratory failure requiring mechanical ventilation. Those with heart and lung diseases, diabetes, and those who are immunocompromised are at higher risk for serious illness and complications.

There is testing available, however, we still have a limited capacity. Testing at this time is prioritized to those who are hospitalized, healthcare workers, symptomatic residents of long term care facilities, and people over the age of 65. The current COVID-19 test takes 4-7 days to receive results, yet there are new COVID-19 tests that take under 45 minutes to receive results which will soon be available.

Testing is not indicated for everyone. The public needs to be aware that if you insist on a test for a mild illness, then you are consuming critical personal protective equipment such as masks, gowns, and gloves. It is important to reserve these for healthcare workers who are treating patients with COVID-19 who are hospitalized and/or in the Intensive Care Unit.

As of now, there are no specific treatments for COVID-19. There are investigational medications that may be used for hospitalized patients which have not yet been approved by the FDA. These agents include Remdesivir, anti-malarial drugs such as Chloroquine and Hydroxychloroquine, and Lopinavir and Ritonavir commonly used to treat HIV infection, all have shown some antiviral activity against the novel coronavirus. Some additional agents are still being tested in clinical trials along with a vaccine that is not yet available.

The best way of prevention is to avoid exposure. It is important to emphasize the Centers for Disease Control (CDC) coronavirus guidelines to slow the spread of the virus:

If you feel sick, stay home. Do not go to work.

If your children are sick, keep them at home.

If someone in your household has tested positive for the coronavirus, keep the entire household at home.

If you are an older person, stay home and away from other people.

If you are a person with a serious underlying health condition that can put you at increased risk (for example, a condition that impairs your lung or heart function or weakens your immune system), stay home and away from other people.

Even if you are young, or otherwise healthy, you are at risk and your activities can increase the risk for others. You must do your part to slow the spread of the coronavirus.

Stay home if you feel unwell. If you have a fever, cough and difficulty breathing, seek medical attention and call your medical provider in advance. Please do not overwhelm our emergency department unless it is a true emergency. Some providers are using Telehealth services so you do not have to physically leave your home to seek medical attention. Call your provider and ask if they offer this service.

Frequently wash your hands with soap and warm water or use an alcohol-based hand sanitizer to protect yourself and others.

Practice social distancing to reduce transmission. Maintain at least 6 feet distance between yourself and anyone who is coughing or sneezing. Avoid touching your eyes, nose, and mouth. Sneeze and cough into a tissue or the inside of your elbow. And avoid social gatherings to prevent further exposure.

Please remember this is a community responsibility to contain this virus as we need to protect our elderly and those who are immunocompromised. Let’s do our part to contain COVID-19.





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