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A Quick Guide to the Coronavirus

Kelsey Tyler

Coronavirus information changes quickly, so please take note of this story’s publication date. You can find current recommendations and national outbreak data on the CDC website. Or, if you want local coronavirus updates and stats, check out the department of health website for your state or your city. Enjoy reading and stay safe. Let’s flatten that curve. 

The coronavirus is a quickly evolving public health crisis, and new information is coming out all the time. Here’s a breakdown of the basics. 

What is the novel coronavirus, and is it the same thing as COVID-19?

Coronaviruses are a large family of viruses that cause respiratory infections. The name comes from the ring of crown-like spikes encircling the viruses (“corona” means “crown” in Latin). Most coronaviruses only infect animals. Of the seven coronaviruses known to infect humans, four of them are very common and cause only mild illness. Two of them, MERS and SARS, are severe. The seventh is the novel coronavirus that’s currently spreading around the world. It’s technically called SARS-CoV-2, and the illness it causes is called COVID-19.

We still don’t know exactly where COVID-19 originated, but experts suspect bats in China are to blame. The virus was first detected in humans a few months ago in Wuhan City, China, and has since spread to almost 70 countries. This interactive map, from the Johns Hopkins Center for Systems Science and Engineering, tracks the number and location of all COVID-19 cases. The Centers for Disease Control and Prevention posts updates here.

How does the virus spread?

While experts are still learning about COVID-19 transmission, the virus seems to spread primarily from person to person. When someone who has the virus sneezes or coughs, they produce small respiratory droplets that can travel through the air and infect people within about a 6-foot radius. It’s also possible that someone could get COVID-19 by touching a surface or object with the virus on it and then touching their face, although this isn’t thought to be the primary mode of transmission.

The virus appears to be able to survive on a surface for between a few hours and a few days, depending on the material. A study published in the New England Journal of Medicine found that the coronavirus lives longest on plastic and steel, where it lingered for up to 72 hours, compared to 24 hours on cardboard. Researchers also found the virus to last in aerosols (tiny droplets suspended in the air) for about 30 minutes, calling into question the WHO’s determination that the coronavirus isn’t an airborne illness.

How contagious is COVID-19?

COVID-19 appears to spread very easily, based on the growing number of people who are contracting the virus without knowing how or where they could have gotten infected. This is called community spread

To understand how contagious a virus is, epidemiologists determine the average number of people a sick person will go on to infect, within a group that has no immunity. That average number is called RO. Early data suggests that COVID-19 has an RO of between 2 and 2.5. The flu’s is 1.3. But experts will need a lot more data before they can say, with any certainty, exactly how transmissible the coronavirus is.

What symptoms should you look out for?

The most common symptoms of COVID-19 are similar to those of other lower respiratory tract infections, such as the flu: fever, cough and shortness of breath. But there are also reports of less common symptoms. For example, research shows that some COVID-19 patients experience vomiting, diarrhea or nausea prior to developing the hallmark respiratory signs.

Symptoms of COVID-19, experts say, take between two to 14 days to show up. But people may be able to transmit the virus before they become symptomatic. COVID-19 appears to be an indolent illness, meaning it typically starts mild and worsens gradually. The flu, by contrast, tends to go from 0 to 60 fairly quickly.

What does a “mild” case of COVID-19 look like?

The WHO classifies “mild” cases as those that don’t require hospitalization, explains Dr. Douglas M. DeLong, chief of the division of general internal medicine at Bassett Medical Center in Cooperstown, New York and the chair of the American College of Physicians’ Board of Regents. So, a mild case would probably involve a cough and a fever. A younger, generally healthy person could develop more severe symptoms and still be considered only mildly ill as long as they don’t need to go to the hospital. 

A fever is typically defined as a temperature of at least 100.4 degrees. Although, Delong says, the CDC lowered the threshold to 99.6 degrees to account for older adults, “who may not mount a robust temperature like children or young adults.”

What should you do if you have respiratory symptoms? What about less common symptoms?

If you develop respiratory symptoms, contact your primary care provider. Do the same thing if you’ve been in close contact with someone who’s sick or have another reason to believe you’ve been exposed to the coronavirus, whether or not you have symptoms. If you don’t have a doctor to contact, you can also reach out to your local board of health.

Dr. Michael Chang, an infectious disease physician at UTHealth in Houston, says reports of gastrointestinal symptoms are definitely becoming more common among confirmed patients across the country, and that guidance for less common symptoms remains the same: If you’re mildly symptomatic and don’t feel you need medical attention, then self-quarantine as you would for respiratory symptoms.

“Generally speaking, right now for most people testing or not, social distancing, self-quarantine, minimizing contact is recommended,” Chang says. “For example, if you have GI symptoms, but say you actually tested negative for [the coronavirus], it still wouldn’t be a good idea to go out, regardless of what the infection is.”

For higher-risk patients, more vigilance about watching symptoms and seeking care may be necessary. “However, if you have some established patterns like environmental allergies, then you can probably still chalk up your symptoms to what’s normal for you,” Chang says.

Who should be tested?

The CDC permits doctors to order testing for any patient exhibiting COVID-19 symptoms. Initial testing guidelines were more restrictive, limiting testing to symptomatic people who’d also been in close contact with an infected person or had recently traveled to an outbreak region. 

How much does testing cost?

The cost of testing might depend on a few factors. If you have health insurance through Medicaid, Medicare or a private carrier, testing will be covered. (This is a new requirement.) That means you won’t be responsible for the full cost. Some states are going further, and making testing entirely free for residents. There’s a push for the federal government to follow suit. Here’s more information on coronavirus care costs.

How can you protect yourself from getting sick?

  • First and foremost, wash your hands. Here’s the proper way to do it, according to the CDC: Use soap and water (warm or cold), lathering up and scrubbing the entirety of both hands (including underneath your nails) for at least 20 seconds. Dry your hands afterward, as studies show that wet hands transfer germs more easily. Hand-washing is especially important before eating, after using the restroom, and after blowing your nose, sneezing or coughing. When running water isn’t available, use alcohol-based hand sanitizer or wipes with at least 60 percent alcohol. The soap-and-water method is preferable because it removes certain types of germs more effectively than sanitizer does, especially when hands are greasy or dirty. 
  • Avoid touching your face (specifically your eyes, mouth and nose).
  • Disinfect your phone as often as you wash your hands; dampen a microfiber cloth and add a small amount of regular soap to wipe down your device and its case, then gently pat them dry. The chemicals in disposable wipes or sprays may strip protective treatments from a smartphone’s screen, making it harder to read. “Phones present an extra risk because we keep them so close to our faces, so I recommend using a Bluetooth headset as much as possible,” says Dr. Georgine Nanos, a family medicine doctor in San Diego. 
  • Avoid shaking hands unless you know you can wash or sanitize them immediately, says Nanos. 
  • Get your seasonal flu shot if you haven’t done so already. You’re more susceptible to catching viruses when your immune system is down. While the flu vaccine won’t protect you against the coronavirus, it can help you stay in fighting form.

Here’s a longer list of tips from the CDC. 

Should you wear a face mask?

Healthy people shouldn’t wear face masks unless they’re caring for infected people, according to public health officials. There’s no strong evidence that wearing a mask in public, as a precaution, makes someone more resilient to infection. Additionally, many people wear masks improperly, and end up touching their faces more often with them on.

If someone is — or even might be — infected with the coronavirus, however, the CDC says they should wear a mask in order to lessen the chance of infecting others. 

How is COVID-19 treated?

We don’t have a specific treatment for this novel coronavirus yet. Antiviral drugs (like Tamiflu) are currently undergoing clinical testing, but it will take months for any treatment to become widely available for use in the general public, according to Dr. Chad Sanborn, a pediatric infectious disease specialist in West Palm Beach, Florida. For now, patients who need clinical care receive “supportive” treatment, such as supplemental oxygen.

When will there be a coronavirus vaccine?

It will take at least 12 to 18 months before a vaccine is ready for widespread use, according to public health officials. An experimental vaccine is currently in the hands of US government researchers, with clinical testing set to begin as early as April. But safe, effective vaccines take time to develop, and rushing the process is too risky.

Should pregnant women be particularly concerned about COVID-19?

The American College of Obstetricians and Gynecologists says there’s not enough information about the coronavirus yet to issue specific guidance for pregnant women.

During pregnancy, the immune system, lungs and heart undergo changes. As a result, pregnant women are often especially vulnerable to getting respiratory infections, as well as becoming severely ill once they’re infected. That’s the case for the flu, as the CDC explains here. Nanos says that “pregnant women with asthma or other chronic lung diseases are at even higher risk for respiratory complications and should always have inhalers or necessary medications for these conditions.”

But while the flu and the coronavirus can cause similar symptoms, they are different viruses. So far, based on extremely limited research, the WHO says there’s no evidence that pregnant women are more likely than anyone else to exhibit severe coronavirus symptoms. There’s also no evidence that the coronavirus causes birth defects, like the Zika virus can.

There has been no documented transmission from mother to fetus, nor has the virus been found in breastmilk or amniotic fluid,” says Sanborn.“That being said, as with more common viruses, it is better to not get sick with anything when pregnant if you can avoid it.”

The CDC recommends that pregnant women take standard preventive measures, like frequent hand-washing, to avoid infection. With so little information available, it makes sense for pregnant women to be cautious and consult healthcare providers immediately if they have any concerns about coronavirus symptoms or exposure.

Who’s most likely to get severely ill from the coronavirus?

While experts stress that anyone can contract COVID-19, some people are especially vulnerable to developing complications, such as pneumonia, from the virus. The main higher-risk groups, per the CDC, are older people and those with underlying health conditions, such as diabetes, COPD and other heart and lung diseases. Although it’s not clear why, preliminary data reported in JAMA also shows slightly higher rates of coronavirus transmission, and resulting hospitalization and death, among men.

The CDC has updated its guidance for higher-risk populations, advising them to stay home as much as possible, stock up on supplies (medication, groceries, household items), steer clear of crowds and avoid cruises, in addition to taking the same precautions we all need to take.

By contrast, very few cases of the coronavirus have been reported in children so far. In China, per the WHO, no one under 9 years old has died from the virus. The prevailing belief, experts say, is that children are most likely contracting the coronavirus (and thus able to spread it), but rarely becoming ill as a result. At this point, it’s not clear why young children appear to be less vulnerable. 

Are “higher risk” groups more likely to contract the virus, or just more likely to get sick from it?

In the context of the coronavirus (and other infectious diseases), “high risk” could mean two things. There’s the risk of becoming severely if you contract the virus. That’s what the CDC means when it talks about higher-risk groups. There’s also the risk of infection itself. These risks are distinct, says Denis Nash, a professor of epidemiology at the CUNY School of Public Health. Members of higher-risk groups are more likely than other people to have bad health outcomes from the coronavirus, but they aren’t inherently more likely to contract the disease in the first place. 

Risk of infection really means risk of exposure to the virus. Factors that make someone high risk for exposure are situational and (at least theoretically)  modifiable. Initially, for the coronavirus, those factors were recent travel to China or another country with a sustained, severe outbreak, and close contact with an infected person. But with more (and more severe) coronavirus outbreaks, exposure risk is becoming harder to identify and control.

“In many places, including in the US, we’ve moved from a situation where all the cases that we learn about are among people who’ve traveled from a place where there’s a larger coronavirus outbreak to a situation where people in communities who have not traveled are becoming infected by people in that same community who have also not traveled,” says Nash. “So, in that situation, like with the flu, the risk of becoming infected can be significant.”

The best-case scenario is for members of higher-risk groups to maintain a low risk of exposure. We should all do our part to make that happen.

If you’re healthy, what else should you be doing now?

Practice good hygiene, take social distancing seriously and prepare for the possibility of more restrictive limits on what you can do and where you can go. A “shelter in place” order is already in effect in parts of California, and other areas of the country may follow suit. Depending on your medical needs, preparation might include stocking up on extra refills of any medications you regularly take or asking doctors how you’ll get any routine care you need.

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