In general, viruses thrive when people live through them and are passed from person to person, allowing the virus to spread wildly and flourish among us humans suffering with runny noses, coughs, fevers, and muscle aches. Coronaviruses are extremely common – most of us have experienced them multiple times in the form of our common colds. Sometimes they cause more significant symptoms, and thus, they are on the panel for viruses we commonly test for. Typically, if we get a diagnosis of a Coronavirus, we are pleased – we know that patient will recover well. Every once in a while, though, there occurs a virus so virulent it causes an increased fatality rate in humans. The “Avian Flu”, or Influenza H5N1 is such a virus. The mortality rate is 60%! But it has killed less than 500 people since 1997 due to the fact that it is easy to isolate and contain the virus due to its severity. Other similar dangerous viruses include the Coronaviruses that cause SARS (severe acute respiratory syndrome) and MERS (Middle East respiratory syndrome), which similarly have high mortality rates, so the virus dies with the victims, causing little spread of the virus itself.
This is where COVID-19 is different from its other virulent relatives. It appears that it has an overall mortality rate of around 2%, although that rate is changing as new data keeps coming in. To put that rate in perspective, Influenza has an overall mortality rate of about 0.1% in the United States. Tens of thousands of people die from the Flu every year because millions are infected seasonally. Like Flu, COVID-19 appears to have mortality rates that vary depending on age. Thus far, the data (from the CDC) shows that for those over 80 years of age, the mortality rate is 15%, and it goes down from there to a rate of 0% (thus far) for children 0-9 and .0018% for children 10-19. At this point, children appear to have low death rates from this virus. While this is very relieving and reassuring, it will make containing the spread of this virus extremely difficult. On the Princess Diamond Cruise ship recently, there were 14 Americans that tested positive for the virus with little to no symptoms. Herein lies the problem: this virus will be extremely difficult to contain due to its tendency to cause common cold symptoms in so many. In other words, it appears, according to the experts, that this virus will spread and will likely become a routine virus we need to manage.
COVID-19 symptoms are very similar to the common cold or flu-like illnesses. Patients may get fever, upper respiratory symptoms, and a cough. A small percentage will get diarrhea as well. More severe cases cause shortness of breath and difficulty breathing. This is worse and more likely in those who are older, have asthma or other lung diseases, or diabetes or cardiovascular disease. As I mentioned above, most will recover well from this virus, and may not even know they have it.
At this point, the treatment is supportive care, including acetaminophen (Tylenol) or Ibuprofen(Advil or Motrin) for fever and discomfort, fluids, and rest. For those who have more significant symptoms, oxygen may be needed or mechanical ventilation. There are no anti-viral medication or vaccine yet for COVID-19, but there will be in the future if the virus persists seasonally.
- Wash your hands! I cannot stress this enough. Washing your hands with soap and water well and often prevents the spread of viruses and bacteria. Please teach your children this as well!
- Avoid work or school if you or your child is sick. China has shut down schools and places of business, which would desperately hurt our economy. To avoid this, we need people to stay home when they are sick.
- Avoid unnecessary travel to high risk places. The CDC website has up to date information on travel warnings and case numbers in varying countries. Please remember that aside from potential infection and spread, quarantines may occur and leave you and your family stuck somewhere. As of now, we are not restricting travel in the country for our patients, but discouraging international travel for the above reasons. Again, this is a changing situation, so check the CDC site for updated information
- If you have traveled outside the country or to high risk areas and have FEVER, COUGH, and/or SHORTNESS OF BREATH, please call your doctor. If you are going to the doctor or the ER, a face mask/surgical mask should be worn to help prevent viral particles from spreading. The CDC does NOT recommend face masks for healthy individuals.
- General offices currently do not have the ability to test for the virus, so the Public Health Department is needed. Your doctor will help you navigate this. Currently they are only testing those that have traveled to China or has had exposure to a person diagnosed with the virus. This may change…
Remember that we are still experiencing fairly high level of Influenza cases as well as many other winter viruses. We do have testing for these viruses so call your doctor if you are unwell. New information is coming in daily, so I will try to update this info as often as I can. While these are scary times, I am hopeful that the world will work together to contain and control this new virus. There are thousands of researchers currently working on testing kits, vaccines, and anti-viral treatments to help prevent loss of life. In the meantime, wash your hands, eat well, and be well.