BY LAUREN HANA MD – The novel (new) coronavirus, now called COVID-19, is a respiratory illness first detected in Wuhan, China in December of 2019. Initial cases were linked to a large open-air seafood and animal market. This virus is a relative of the coronaviruses that caused SARS (severe acute respiratory syndrome) and MERS (Middle East respiratory syndrome) outbreaks. All three are thought to have bats as the host of origin, followed by an undetermined intermediary host that then allows passage of the virus to humans. COVID-19 has also been named SARS-CoV-2, as it is most closely related to the previous SARS virus. There are several older strains in the family of coronaviruses, and man cause of the common cold.
COVID-19 is now known to be spread in humans by close contact and by respiratory droplets produced from coughing and sneezing. It is not yet clear if the virus may also be passed by touching surfaces contaminated with respiratory droplets, but it may be. Someone who has been infected with the virus is most contagious when they are the sickest, but it may also be possible to spread the virus prior to showing symptoms. Symptoms develop 2-14 days after exposure to the virus. These symptoms include fever, cough and shortness of breath and may include sore throat and diarrhea.
There is currently no vaccine to prevent COVID-19 and no medications to treat the disease. Treatment consists of supportive care and symptom relief. The National Institutes of Health (NIH) is working on vaccine development and trials of an investigational antiviral drug as possible prevention and treatment options.
As of this writing, there are 14 confirmed cases of COVID-19 in 6 states: Arizona, Illinois, California, Massachusetts, Washington and Wisconsin, 12 travel-related and two spread from person to person. An additional 39 cases have been confirmed in persons repatriated from high-risk areas to total 53 U.S. cases. The first U.S. case was confirmed on January 30, 2020. There are now cases on all continents except Antarctica, with Brazil reporting South America’s first case just today. The Centers for Disease Control and Prevention (CDC) has issued a Level 3 travel advisory for China and South Korea (avoid all nonessential travel to these areas) and a Level 2 alert for travel to Iran, Italy and Japan (practice enhanced precautions). These countries are experiencing sustained community spread of COVID-19 illness. Older persons and persons with chronic diseases should consider postponing nonessential travel. As several locations in Asia are experiencing outbreaks of COVID-19, the CDC is also recommending that travelers reconsider cruises to or within Asia.
The CDC is working closely with the Department of Homeland Security, and flights returning from China are being directed to 11 U.S. airports (Los Angeles International, San Francisco International, Seattle-Tacoma International, Honolulu International, Chicago O’Hare International, Dallas-Fort Worth International, Hartsfield-Jackson Atlanta International, Detroit Metro Airport, JFK International, Washington Dulles International and Newark Liberty International Airport), and travelers returning to the U.S. are being tested for COVID-19, placed under a 14-day quarantine if appropriate and monitored closely for symptoms. To date there have been no deaths in the U.S. from COVID-19.
Measures to prevent spread include those recommended for prevention of all respiratory viruses, including Influenza. Keep from touching your eyes, nose and mouth with unwashed hands. Stay home if you are ill. Cover your cough or sneeze. Wash your hands frequently. Stay away from others who are ill. Clean frequently-used surfaces with disinfectant regularly. The CDC also recommends getting an annual influenza vaccine to keep healthy.
Individual risk is dependent on exposure to someone ill with the COVID-19 virus. For the general American public, unlikely to be exposed, the immediate risk is considered low. If you have traveled to China in the last 14 days, have been in contact with anyone who has or have been in contact with anyone who has tested positive for COVID-19 and you develop respiratory symptoms such as fever, cough or shortness of breath, you should contact your health provider from your home for instructions on how to receive appropriate testing and care so as not to expose others.
More information can be found at the following websites:
Dr. Lauren Hana is the Boca Grande Health Clinic’s Medical Director. She earned her M.D. degree from the University of Illinois College of Medicine in Chicago and completed her residency training at Northwestern University’s Evanston and Glenbrook Hospitals. A full-time physician, she is board-certified in internal medicine and has been practicing for over 25 years.