In December, 2019, a new coronavirus started infecting humans, first in China then around the world. By March, it was a global epidemic (pandemic), infecting and killing thousands and closing most public places, schools, sports, and many businesses around the world. It is spread from person to person, mostly directly and sometimes from contaminated surfaces.

Understanding coronavirus

Coronaviruses are a family of viruses that infect both humans and animals. They are so named due to the crown-like appearance of the outer spikes when viewed with an electron microscope. They were discovered as a cause of disease in animals in the 1930’s and in humans in the 1960’s. They tend to cause respiratory disease in winter and spring months. Several strains are known to cause the common cold, especially in young children. They are the second most common cause of colds and croup in children. Data suggest that about 90% of adults show evidence of having had these infections sometime during their lives.

History

In 2002-2003, there was a sudden outbreak of severe lung disease (SARS-CoV) associated with a new coronavirus in China, likely from bats. It lasted 9 months, with over 8,000 people infected and 774 deaths. Interestingly, the disease stopped and has not been seen since 2004. It affected mostly adults and was not common or serious in children. The mortality rate was around 10%. In 2012, another serious strain appeared in the Middle East (MERS) which spread to 21 countries and infected 2,400 people, 800 of whom died.

In December, 2019, a new strain appeared in China (SARS-CoV-2); the disease was dubbed COVID-19. By early March 2020, the disease had spread to 115 countries, caused over 125,000 infections and over 4,500 deaths. Like other SARS viruses, children appear to be relatively unaffected, at least by any serious disease.

The mortality rate appears to be around 1-3%. For the flu, it is usually around 0.1% in the United States. The influenza virus kills between 20,000-50,000 in the United States every year.

How is it transmitted

Like many other respiratory viruses, it is transmitted through small droplets from the nose or mouth, especially a cough or sneeze. These droplets end up in the air then onto another person’s face or hands. The germ can also land on counters, equipment, door handles, toilet handles, shopping cart handles, etc. then to the hands then to the eyes, nose, or mouth. The virus can survive for hours to days on surfaces.

What are the symptoms

Many people have no or very mild symptoms, especially in younger patients. Symptoms include cough, fever, and wheezing or difficulty breathing. Symptoms may also include runny nose, sore throat, congestion, muscle aches, and sometimes vomiting and/or diarrhea. Children especially may have diarrhea or runny nose. The symptoms are similar to the flu and other respiratory viruses.

Symptoms usually remain mild, but in a significant number of patients, especially those over 60, it can cause a severe lung disease about a week into the illness.

Why is it infecting so many people/so serious?

  • It’s new; no one has any immunity or partial immunity to it.
  • There is no vaccine, so no one is immune to it from that either.
  • Since no one is immune, it spreads more quickly and easily, and no one who is not immune is protected by immunity of those around him or her.
  • It is a more serious and deadly virus than many others.
  • Like other viruses, there is no treatment other than supportive care until the immune system can do its job. Some antiviral medications do slow viruses down and give the immune system a better chance. No one knows if any antiviral helps with COVID-19.
  • For this form of serious lung disease, supportive care is often not enough to prevent death.

How can it be prevented

  • Prevention measures are the same as those for other respiratory viruses; however, since the disease is much more serious, the prevention measures are greater.
  • Handwashing remains the number one way to prevent colds, flu, and coronavirus. Wash hands for at least 20 seconds with soap and water. Be sure to cover all surfaces and between fingers.
  • You can also use hand sanitizer (alcohol-based). Be sure to use enough and cover all surfaces and between fingers. This should take about 20 seconds as well.
  • Avoid touching your face, especially nose, mouth, and eyes. (You might be surprised how often you touch your face).
  • Be sure to wash hands or use sanitizer before eating or touching face and after touching frequently touched surfaces (door handles, shopping cart handles, etc.).
  • Some day we will hopefully have a vaccine (works for flu but does not exist yet for COVID-19, but it may in 12-18 months).

You help others by

  • Covering your cough or sneeze. Use your arm or a tissue, not your hand, and wash your hands afterwards if you use a tissue.
  • Other ways more specific to a serious pandemic: avoid close contact with people who are sick
  • Clean and disinfect frequently touched surfaces
  • Stay at least 6 feet away from other people
  • Stay home whenever possible