Re: nCoV 2019-2020 Outbreak
An email blast from a WA epidemiologist who is a friend of a relative:
Hi Friends,
Some of you have started to email and ask about the coronavirus and how our family is doing in the thick of it all in WA state. We live in Snohomish County (where the first case was identified) and Kirkland is right next to us (where most of the deaths have taken place, albeit in elderly already ill individuals). The grocery store shelves are empty in the hand sanitizer, bleach, and toilet paper sections. Schools just started to announce 2 week suspensions of all activities, though the health department is not recommending this yet. [Husband] is putting in the hours and then some at his work place where he specializes in infectious respiratory diseases. Though he usually tackles the flu this time of year, which is still peaking as well, his flu research has been impacted and most of his attention has been diverted to coronavirus. Below is his synopsis of it as of 2 days ago, keeping in mind that there is a lot they don't know about the virus still that might change some of these answers in the future.
Sincerely,
[Wife]
As of Sat, 3/2/20
Dear family (and friends),
We've been getting requests for an epidemiologist to weigh in on all the coronavirus news, so here is some information in Q&A format. Right now, we still have a lot that is unknown about this new virus, but hopefully this helps you navigate some of the uncertainty.
Can you help me understand the different terms being used in the media?
Some of the terms have been changing, but most public health groups seem to be settling on these definitions:
SARS-CoV-2: The name of the new coronavirus
COVID-19: The disease caused by infection with SARS-CoV-2
Pandemic: a new virus/bacteria that spreads worldwide (a term for spread, not severity).
Should I panic? Is this the apocalypse?
No. We might see some disruption to our daily lives (schools and businesses closing temporarily, events cancelled, lots of people sick at home), but this is not something to panic over.
Are you sure? I really feel like panicking.
SARS-CoV-2 is something to take seriously, but not something to take fearfully.
How is SARS-CoV-2 spread?
SARS-CoV-2 is a respiratory virus, similar to influenza. It is mainly spread when an infected person coughs, sneezes, or blows her nose. You can be infected by breathing in droplets created when an infected person coughs or sneezes (generally, this happens if you are close to them, typically <6 feet away). You can also be infected touching something that has SARS-CoV-2 on it, and then touching your eyes, nose, or mouth. For example, if an infected person blows their nose and then opens a door, you could be infected if you touch the doorknob and then put your fingers in your mouth. We don't know specifically how long SARS-CoV-2 can survive on surfaces, but other respiratory viruses typically survive for several hours.
How serious is COVID-19 disease?
Most people infected with SARS-CoV-2 are going to have a "mild" respiratory illness - meaning, they'll be sick, but not so sick they need to see a doctor. Some people will have more severe disease that may put them in the hospital, or even kill them. We don't know right now how likely it is that infected people will be hospitalized or die. Currently, approximately 3% of people with confirmed COVID-19 have died. But this death rate is higher than the true rate will be, because SARS-CoV-2 infections are mostly being detected in people who are more severely ill - people with milder respiratory disease aren't being tested to see if they have SARS-CoV-2 .
To compare this with influenza, approximately 0.1% (1 in 1,000) of people infected with influenza die. So, at the moment, SARS-CoV-2 looks like it is more dangerous than influenza, but not as dangerous as diseases such as ebola (50% death rate), meningitis (10% death rate), or MRSA (5% death rate).
Who is at high risk for severe COVID-19?
Most of the people being hospitalized or dying from COVID-19 are elderly and/or have chronic lung or heart disease.
How can I reduce my risk of being infected?
Strange as it sounds for a respiratory virus, the most effective thing you can do is be careful with your hands: wash them often (soap and water, scrub for 20 seconds, or use alcohol-based hand sanitizer), especially before eating, and try not to touch your nose, mouth, or eyes with unwashed hands.
Face masks are not an effective way to protect yourself. Most people don't know how to properly wear them, and it's easier than you think to contaminate your hands or your face when you take the mask off. Face masks are most useful for people who are already sick, to help trap droplets from coughing or sneezing from spreading to others.
You can also reduce your risk of COVID-19 by avoiding contact with infected people. One way to do this is to avoid unnecessary gatherings of large groups of people, such as a basketball game or a big meeting at work. As of March 2nd 2020, most people in the US do not need to avoid large gatherings, since SARS-CoV-2 is not yet widely circulating in most communities. As SARS-CoV-2 spreads further, your local or state health department may start making recommendations about large gatherings. However, even in the Seattle area, where SARS-CoV-2 is starting to circulate, the health departments are not yet recommending that people consider avoiding big meetings.
[My personal opinion: If you are in the Seattle area and are at high risk due to age or chronic lung/heart disease, you might consider avoiding unnecessary big gatherings. So, go to church, but maybe skip the high school basketball game.]
What are the symptoms of SARS-CoV-2 infection?
Unfortunately, there is nothing unique about SARS-CoV-2 symptoms that distinguishes it from other respiratory viruses. The main symptoms are fever and cough, possibly with shortness of breath.
What should I do if I have these symptoms?
First, stay at home if you can. If at all possible, don't go to work, or school, or other gathering places. This will protect other people from getting infected. Even if you have some other respiratory virus like influenza, your friends and family will thank you for not sharing it with them.
Doctors' offices and emergency department (ED) could start to get overwhelmed by "worried well" - people with mild disease who are scared and are looking for treatment. If you can, contact your doctor by phone rather than going to the doctor's office or ED. This will ease the burden on the medical system. If your doctor has any kind of phone or web consultation, they can tell you how to care for yourself at home, and can also let you what symptoms to watch out for that may need you to go to the doctor or ED. And of course, seek medical care if you get more seriously ill (high fever, severe coughing, difficulty breathing).
They just closed my school / office / church! What's going on?
Businesses, schools, or other gathering sites may be closed in response to SARS-CoV-2 in the coming weeks. There are two reasons for doing this:
1) Early in the pandemic, schools (or workplaces) may close if they have one or more infected students, with the goal of decontaminating the school and then opening again. This is not likely to happen much once SARS-CoV-2 becomes widespread.
2) Gathering sites may close to try and slow down the transmission of SARS-CoV-2. In theory, reducing people's contacts early in a pandemic can delay the time until the peak occurs, and can make the peak last longer but with less intensity, so the medical system and other businesses don't get overwhelmed.
I feel like doing something. Is there anything else I can do?
In the worst-case scenario (not the most likely, but the worst-case), enough people could be sick during the peak of SARS-CoV-2 that some normal services get disrupted. If you don't already have a basic disaster kit (food, water, essential medications, etc) to get you through a couple of days, you could put that together. (And really, you should already have that!)
What are some good sources of information?
I've found that the Washington State Department of Health's page on SARS-CoV-2 is one of the best:
https://www.doh.wa.gov/Emergencies/Coronavirus
The CDC's page will be accurate, but they are often too afraid of assuming too much that their facts end up being bland to the point of being trivial:
https://www.cdc.gov/coronavirus/2019-ncov/index.html
If you want COVID-19 case counts by country:
https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6