To watch TV or listen to the radio, it appears as if coronavirus is a dire threat. Words like “pandemic” conjure up images of vast numbers of people falling victim of a virulent, out-of-control disease. Unfortunately, with COVD-19, this could happen.

The vast majority of confirmed cases are considered mild, involving mere cold-like symptoms to mild pneumonia. But the illness can be catastrophic for five percent of patients, particularly the elderly, especially those who smoke and those with impaired lung function and/or compromised immune systems.

Q: Why can’t my doctor diagnose it?

A: The symptoms of coronavirus look a lot like every illness that circulates this time of year. So it’s tough for doctors to make a diagnosis solely on the basis of the symptoms.

The only way to find out is to be tested. Unfortunately, the tests are hard to come by.

It’s important to be fast, but it’s more important to be accurate. When commercial tests are available, there will be  greater efficiency.

Q: If I’m exposed, how long before I develop symptoms?

A:  The period between exposure and symptoms is 5.2 days on average, but varies greatly among patients. A new analysis still supports a 14-day medical observation period for people exposed to the pathogen.

New England Journal of Medicine

Q: How sick would I get?

A: Across China, about 80% of cases are mild, involving mostly cold-like symptoms to mild pneumonia. Fourteen percent of cases have been “severe,” involving serious pneumonia and shortness of breath. Another 5 percent of patients developed critical respiratory failure, septic shock and organ failure.

Patients 80 years or older are most at risk, with 14.8 percent of them dying. Deaths occurred in every age group except in children under the age of nine.

For people with mild disease, recovery time is about two weeks, while people with severe disease recover within three to six weeks.

Chinese Center for Disease Control and Prevention

Q: Why are some people hit so hard?

A: Experts think it depends on a person’s immune response. It seems to trigger an overproduction of immune cells that flood into the lung, causing pneumonia.

Angela Rasmussen, a virologist at Columbia University’s Mailman School of Public Health

Q: How easily does it spread?

A: Each infected person infects an average of 2 to 3.1 other people. That’s higher than the seasonal flu (around 1.3) but much lower than the measles (12 or higher).

Maia Majumder, Boston Children’s Hospital 

Q: Can I spread it if I’m not sick?

A: Perhaps. In two patients, German researchers were able to isolate the virus from the nose and throat even before they showed any symptoms or had very mild symptoms.

— New England Journal of Medicine 

Q: Does a mask help or hurt?

A: The CDC does not recommend wearing masks unless you are a health care worker or have symptoms. Health care workers who care for care for patients with coronavirus should take all precautions. So should household members or close contacts of a known or suspected infected person. But in terms of day-to-day interactions, hand washing is far more effective.

A surgical mask is designed to keep the surgeon’s germs off the patient.

An ‘N95’ respirator mask is better in terms protecting you but can be difficult to fit correctly to the face. If a mask is ill-fitting, the virus can find a way in. If you wear that mask, it should be specially fitted.

— Virologist Dr. Warner C. Greene, professor of medicine, microbiology and immunology at UC San Francisco

Q: Can local hospitals treat patients?

A: Patients who require hospitalization can be cared for in any community hospital that is reasonably well prepared. Almost all hospitals already have trained for a flu pandemic — and should start practicing for coronavirus care now.

— Dr. Eric Toner of the Johns Hopkins Center for Health Security.

Q: What are my chances of dying?

A: The death rate — the percentage of known infected people who die — is about 2% in China’s Hubei province, where the virus first started, and 0.7% in other parts of China. The risk of death in those over age 80 is high, at 14%. For children and young people, it is very low.

That is comparable to the death rate of the 1918 Spanish Flu pandemic. It’s much higher than the 0.1 percent fatality rate for seasonal flu.  But it’s lower than SARS virus, at 9-10%, and much lower than the MERS outbreak, at 36%.

Dr. Bruce Aylward, World Health Organization

Q: There are no approved drugs to treat coronavirus. Are any being tested?

A: Yes. Trials already have started. The drug remdesivir, made by Gilead Biosciences of Foster City, is being tested on sick Americans at the University of Nebraska Medical Center in Omaha. While small, this is a rigorous study; it is ‘blinded,” with some subjects getting the drug and others getting a placebo. It is also being tested in China.

— Dr. Anthony Fauci, National Institutes of Allergy and Infectious Disease

Q: There’s no vaccine. What’s in the pipeline?

It is likely to be a year or 18 months before the vaccine is widely available. But things are moving quickly.

The company Moderna Therapeutics already has already shipped some doses of an RNA vaccine to the NIH. Those could be given to volunteers in a safety test starting as soon as April.

— Dr. Anthony Fauci, National Institutes of Allergy and Infectious Disease

Q: What’s happening in China?

A: Astonishingly, the number of new cases is declining, thanks to the country’s aggressive lockdown. The Chinese epidemic peaked between Jan. 23 and Feb. 2.

Fourteen other countries have not reported a new case in more than a week — and even more important, nine countries have not reported a case for more than two weeks.

Dr. Tedros Ghebreyesus, World Health Organization  

Q: Is it a pandemic?

A: It meets two of three criteria for a pandemic: illness resulting in death and sustained person-to-person spread. It’s moving closer but has not yet met the third criteria: worldwide spread.

— Dr. Nancy Messonnier, director of the CDC’s National Center for Immunization and Respiratory Diseases

This report is sourced from the Marin Journal.

2 Comments

  1. To put it in perspective, measles is probably a much worse disease, is highly contagious, and mainly affects young children. We have a very effective vaccine for measles that more and more people are resistant to having administered to their children, and measles is a disease that is increasing unnecessarily. I worked in public health for several years, and this still blows me away,,,

    Measles is worldwide. can compromise an immune system for up to three years, and it is still killing children. There are other contagious diseases that few take seriously (such as pertussis and influenza) that are out there as well.

    Be informed, and get to know your public health dept, as well as The CDC as sources of good information on contagious diseases.

    https://www.cdc.gov/globalhealth/measles/globalmeasles
    outbreaks.htm

    https://www.npr.org/sections/goatsandsoda/2019/12/05/785177595/measles-numbers-were-bad-in-2018-this-year-theyre-even-worse

  2. Great update. Thanks. Just wondering if the wide rage of symptom severity among COVID-19 sufferers in China could be due to the possibility that they don’t all actually have the same bug. Yes– the sick and elderly are always the most vulnerable, but this situation looks a little different from other flues, if coronavirus is in fact a flu. When a flu goes around, most people complain of the same types of symptoms and severity. Something’s just a little off about this whole thing. But then, it really is hard to tell what’s actually going on because the info is trickling down through so many unreliable sources– I’m not naming any names. I’m pretty sure this isn’t armageddon. Be well, y’all!

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