This is a rapidly changing situation with frequent federal and local updates as the knowledge about the disease evolves. Check the Centers for Disease Control and Prevention (CDC) for the latest updates at
cdc.gov/coronavirus
. Questions? Contact AAHPO at
info@aahpo.org
.
AAHPO board member
Tsoline Kojaoghlanian, MD
, a pediatric infectious diseases specialist, is helping us sort through the flood of information.
There is currently an outbreak of COVID-19 that originated in China in December 2019, with ongoing outbreaks now also in Italy, Iran, Japan and South Korea, and cases have spread to 55 other countries as of today, including the US.
Q. What is the novel coronavirus?
A. The novel coronavirus is a virus that has not been previously identified in us, human beings. It is thought that it is an animal virus that somehow infected a few humans, and now humans are passing it on from one person to another. Because humans have never been infected by this virus before, the medical and scientific community does not yet know the full extent of the disease caused by the virus, and all the ways it may be transmitted; we are learning at a high speed as we go along. This novel virus has been named SARS-CoV2 because it looks similar in structure to the virus that caused the SARS (severe acute respiratory syndrome) epidemic years ago.
Q. How serious is this virus and what are the range of symptoms?
A. Disease due to infection with novel coronavirus SARS-CoV2 has been named COVID-19. COVID-19 has ranged from mild to severe. The most common symptoms include fever, cough, shortness of breath and other breathing difficulties. Some have had diarrhea. A small but substantial percentage of people have progressed to pneumonia, and when pneumonia is severe, it has necessitated stay in an intensive care unit, with some of those people dying. So far, those who have died tend to be older in age, and/or with other chronic medical problems putting them at risk for severe disease. There is a possibility that many infected people are mildly ill and haven’t gone to doctors and haven’t been tested for the virus.
Q. How does COVID-19 spread?
A. Much is still unknown about how novel coronavirus spreads. Person-to-person spread is occurring, but it is not clear how easily the virus spreads between people. Person-to-person spread is thought to occur mainly via respiratory droplets produced when an infected person coughs, similar to how the influenza virus spreads. Whether it also spreads by touching surfaces touched by infected people or by other methods remains to be determined.
Q. How long before symptoms of the virus appear?
A. Symptoms may appear anywhere between 2 and 20 days after exposure to the virus.
Q: Are children more susceptible to COVID-19?
A: There is no evidence so far that children are more susceptible; most confirmed cases of COVID-19 have occurred in adults. A small percentage of reported infections are in children, and these limited reports suggest that children have generally presented with milder symptoms of COVID-19.
Q. What is the current status of COVID-19 in the US?
A: As of today, there are at least 66 cases of COVID-19 in the US, none in the Tri-State area. There is one death reported today. Until this week, the infected persons had acquired it abroad, or had acquired it from a close contact who acquired it abroad. This week, we learned that there are at least 6 infected individuals in the West Coast who have no connection to travel, indicating that we are seeing spread within the US. This was expected and inevitable, and the number of infections is expected to rise.
Q. Why is there talk of schools closing and people working from home?
A: Health department and medical institution measures of isolating and treating patients as well as tracing and isolating their contacts should help control and avoid potentially large outbreaks within communities in the US. However, if a community has a significant number of infected patients, then efforts will expand from containment to mitigation which include social distancing measures to avoid further spread. Such measures may include closing schools, canceling large public events, asking people to work from home- all intended to reduce person-to-person transmission.
Q. What happens if a person exhibits symptoms of COVID-19?
A. Remember that the symptoms can include fever, cough or shortness of breath – symptoms similar to the flu (influenza) or even the common cold. If anyone develops symptoms suggestive of COVID-19 after returning from any travel abroad in the past 3 weeks, they should call their health care provider and keep themselves isolated at home if the symptoms are mild. They should follow instructions the health care provider gives about whether they should visit them. CDC has developed guidance to help in the risk assessment and management of people with potential exposures to COVID-19 (see below). If anyone develops severe symptoms such as shortness of breath and/or difficulty breathing, regardless of travel, they should seek medical attention immediately.
Q. What should the general public do about COVID-19 today?
A. For the majority of the US population today, the risk
for COVID-19
remains low but that is expected to change in the next few days and weeks. The CDC does not recommend that people who are well wear a facemask in their daily lives to protect themselves from respiratory diseases, including COVID-19.
Q: What can I do to protect myself and my family from COVID-19?
A: People of all ages should engage in
preventive actions
to avoid infection:
- Wash your hands often with soap and water for at least 20 seconds (singing “Happy Birthday” twice), especially after going to the bathroom, before eating, and after blowing your nose, coughing, or sneezing. Dry your hands thoroughly after washing
- If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol. Allow the sanitizer to dry/evaporate. If you are allergic to soap, use sanitizer, and vice versa
- Avoid close contact with people who are sick- keep a distance of 6 feet between you and a sick person who is coughing and sneezing
- Avoid touching your eyes, nose, and mouth
- Avoid shaking hands with people if unnecessary
- Avoid crowded, enclosed places
- Cover your cough or sneeze in your elbow sleeve or with a tissue, then throw the tissue in the trash immediately. Teach the same to your children
- Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe. Throw the dirty wipe in the trash
·
Stay up to date with your vaccinations, including the influenza vaccine
- Avoid stress- stress reduces immunity and may make you more vulnerable to infections
- Eat healthy and drink plenty of fluids
Q: Are there any treatments available for COVID-19?
A: There are currently no drugs being used in patients to kill SARS-CoV2. However, there are drugs being tested for their efficacy in both severe and mild forms of COVID-19. One such drug, named remdesivir, is advancing quickly through the clinical trial process. Until then, treatment is supportive- hydration by drinking fluids, Tylenol if necessary for fever, adequate nutrition and rest.
Q: Will this outbreak end when the winter season ends in the US?
A: As the virus is novel, its behavior is unknown, so we don’t know if it will stay year-round and cause infections, or it will be infecting in winter months only.
Q: Is there a vaccine we can take to prevent COVID-19?
A: There are unprecedented efforts to make safe and effective vaccines for SARS-CoV2 as soon as possible, but in the best-case scenario, the vaccine will not be available for use until 2021.
Q: Should we cancel travel plans abroad?
A: As of today, there are certain countries- China, Japan, South Korea, Italy and Iran- that should be categorically avoided but the list of such countries is expected to grow, thus keep yourself up to date. Until we know more about this new virus, hold-off non-essential travel abroad, not for the purpose of avoiding getting infected, but for the purpose of avoiding potential hospitalization away from home.
Q. What are good websites health care providers can use to counsel their patients and take care of infected patients?
A: See below:
Tri-state Department of Health phone numbers:
New York state 518-473-4439, New York City 866-692-3641, New Jersey 800-222-1222
,
Connecticut 860-509-8000
