Important Information on COVID-19 (aka coronavirus)
North Coast Family Medical Group wants to emphasize to our community the importance of staying informed about the spread of COVID-19 (aka coronavirus).
North Coast Family Medical Group wants to take this opportunity to further educate you about this virus. The below is a “data dump” because it is important that we are all informed, there is much competing and confusing information that is being transmitted in the media, by the government, on social media, and by friends and family. More is known about this coronavirus that has taken over the news and public discussions. There are many coronaviruses in the world, you likely recall SARS, or might have heard about the lesser known MERS, both of which are coronaviruses. These originally were viruses of animals, often bats. The viruses transferred to another type of animal (often domesticated), which was then able to jump from that animal to humans. Now it can pass from human to human. It is primarily passed like colds and flus, respiratory secretions (cough, sneeze, saliva, nasal secretions), but is also thought to be in feces and vomit.
This virus can cause a wide range of severity of infection, mostly dependent upon age and health status. In general, the younger one is, the less severe the disease known as COVID-19. The older one is, the more likely for more severe symptoms, or even respiratory failure which could lead to death. Much of the information that the medical community has learned has come from those patients who’ve been hospitalized. Incubation of the virus before the onset of symptoms is about 4 days (ranging from 2-7 days), but other coronaviruses may take up to 14 days, thus the reasoning for the 14 days of quarantine. Unfortunately, it is estimated that infected people are contagious during the 2-3 days prior to exhibiting any symptoms (asymptomatic virus shedding), thus the reasoning to limit social gatherings, even if one feels well, you might have the virus and pass it on to others.
Frequently reported signs and symptoms of patients admitted to the hospital include fever (77–98%), cough (46%–82%), muscle aches or fatigue (11–52%), and shortness of breath (3-31%) at illness onset. Less commonly reported symptoms include sore throat, headache, cough with sputum production and/or coughing up blood. Some patients have experienced gastrointestinal symptoms such as diarrhea and nausea prior to developing fever. Older patients and those with chronic medical conditions may be at higher risk for severe illness. Higher rates of death have been reported according to patient ages (60-69 years: 3.6%; 70-79 years: 8%; 80+ years: 14.8%). Patients who reported no underlying medical conditions had an overall death rate of 0.9%, but it was higher for patients with chronic medical diseases: 10.5% for those with cardiovascular disease, 7% for diabetes, and 6% each for chronic respiratory disease, hypertension, and cancer. Advancing respiratory symptoms haven’t been noted until the second week of illness (shortness of breath most often occurring around day 8). Of those hospitalized for breathing difficulty, 20-30% required intensive care and ventilator/breathing machine use. Studies are showing that it is uncommon for someone with COVID-19 to have other infections at the same time (Strep, bacterial, influenza, etc.).
Since this is a new disease to humans, we don’t have antibodies or immunity against it. It is expected that many people, estimates go as high as half the population, will eventually contract this virus. If one makes a graph of how many people get infected, and plot it over time, then if many people get infected at the same time, then the curve on the graph will be very high. Given the numbers in the prior paragraph, the medical system (hospital beds, ICU beds, ventilators) will quickly be overwhelmed. Thus, you might have heard about “flattening the curve”. This means to limit how many people contract the disease at once, so that there are fewer people ill at the same time. This also means that the virus will likely be active for many months. It is not known how the virus will react to the summer months, influenza commonly is not active in our hemisphere. Based on the 1918 Spanish flu epidemic, it is estimated that COVID-19 will blossom again next fall and winter, if we aren’t able to get a handle on the spread of this disease. This is why social distancing and social restrictions have been engaged across the country and the world. Also something to consider, the number of cases reported in the news are only those who have tested positive for this coronavirus, there is no way to know how many other people have the virus, suffered mild symptoms, and yet were contagious and spread it to their social network.
People who are mildly ill with COVID-19 are able to isolate at home during their illness. While ill, restrict activities outside the home, except for necessities like medical care. Utilize food delivery services from restaurants and grocery stores. Do not go to work, school, or public areas. Avoid using public transportation, ride-sharing, or taxis. Also, avoid contact with pets, including petting, snuggling, being kissed or licked, and sharing food. It is not clear if pets can catch this virus, but the virus can get on the pet and transfer to other people in the home. If one must care for the pet or be around animals while sick, wash hands before and after interacting with pets and wear a facemask. Call ahead before visiting the doctor, and use a mask or handkerchief over nose and mouth while out in public. Make sure that shared spaces in the home have good air flow, such as by an air conditioner or an opened window, weather permitting.
As mentioned previously, there is no vaccine or treatment for COVID-19, only supportive measures. However, the vast majority of people will have flu-like symptoms for 2 weeks and then be fine. The goal is to protect those most vulnerable to this virus, the older people (this is why family are discouraged from visiting at nursing homes or senior communities) and those with chronic medical conditions. Testing for this virus is helpful in those with symptoms in order to help contain the spread of infection to other people, meaning to quarantine those who actually have the illness and limit how many other people will get sick from that one person. However, testing has a relatively slow turn-around (several days) at this time in the outpatient community.
Be safe, wash your hands frequently, try not to touch your face, practice social distancing, stay informed. The Johns Hopkins website for Center for Health Security, CDC, and The New York Times have accurate information.