Coronavirus - What Should You really worry about?
After a surge in cases tied to international travellers, China, Hong Kong, Singapore and other places that seemed to have the epidemic under control have imposed stricter measures.
With a growing number of cases of the new coronavirus confirmed across the United States, having a sore throat or some sniffles might feel like a cause for concern. But in most cases, there is no reason to worry, experts say.
If you have symptoms of the coronavirus, which include fever, cough and shortness of breath, here are the steps that doctors and public health officials recommend you take.
In recent weeks, a new coronavirus disease called COVID-19 has spread from where it was first detected in China to dozens of other countries. Now, several U.S. states have confirmed cases.
As the outbreak hits closer to home — and the news coverage becomes more alarming — you might wonder what this means for you, your family and your community.
"Like any novel infection that's reported, it's certainly a public health concern," says Steven Gordon, MD, Chairman of the Department of Infectious Disease. And there is still much to learn about this new coronavirus disease.
The U.S. Centers for Disease Control says that "the immune response to COVID-19 is not yet understood." Because this is a new strain of coronavirus, scientists are still collecting information and research on the virus.
As the situation continues to evolve, infectious disease specialist Frank Esper, MD, encourages people to stay informed and follow common-sense practices like proper hand-washing to reduce the spread of viruses.
At the time of writing this article, the coronavirus(COVID-19) has taken the world by a storm. What seems to be a deadly disease as portrayed by most of the media have illicit fear and irrationality among many citizens and netizens alike.
At this point, the coronavirus is not just an epidemic, and it is also a numbers game. Global news media is waiting for the numbers to hit a milestone and spice it up with good, attention-grabbing titles so that people will click and read their articles. Because more readers give them more revenue, right?
That is not to say these outlets should immediately be accused of fake news. On the contrary, most journalists are trained to report facts, but that doesn't mean they can't season their articles with a dash of emotion.
Take the above headlines as an example. To them, 100,000 cases is a milestone worth reporting and grabbing the attention of the readers. What follows in these articles are probably just new numbers of the highest this and the highest that.
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What is coronavirus?
Coronavirus is a family of viruses that are common in people and animals. They can cause a variety of illnesses, ranging from the common cold to severe pneumonia.
Coronaviruses spread from person to person through droplets released when people who are infected cough or sneeze. These infected droplets can land on people nearby, who can then become infected if the virus gets into their body through their eyes, nose or mouth.
So you could get COVID-19 from coming in close contact with an infected person who is coughing and sneezing, Dr Gordon says. Experts also suspect that you can get it from touching a surface that has been contaminated with virus-containing droplets.
Because of this, the C.D.C. recommends that people who have or might have COVID-19, or anyone caring for someone who has it, wear face masks to prevent the spread. However, you do not need to wear a face mask if you are not sick.
It is caused by a member of the coronavirus family that has never been encountered before. Like other coronaviruses, it has transferred to humans from animals. The World Health Organization (WHO) has declared it a pandemic.
What are the symptoms this coronavirus causes?
According to the WHO, the most common symptoms of COVID-19 are fever, tiredness and a dry cough. Some patients may also have a runny nose, sore throat, nasal congestion and aches and pains or diarrhoea. Some people report losing their sense of taste or smell. About 80% of people who get COVID-19 experience a mild case – nearly as dangerous as a regular cold – and recover without needing any special treatment.
About one in six people, the WHO says, become seriously ill. The elderly and people with underlying medical problems like high blood pressure, heart problems or diabetes, or chronic respiratory conditions, are at a higher risk of serious illness from COVID-19.
In the U.K., the National Health Service (N.H.S.) has identified the specific symptoms to look for as experiencing either:
- a high temperature - you feel hot to touch on your chest or back
- a new continuous cough - this means you've started coughing repeatedly
As this is viral pneumonia, antibiotics are of no use. The antiviral drugs we have against flu will not work, and there is currently no vaccine. Recovery depends on the strength of the immune system.
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Symptoms are what one would expect from a typical upper respiratory infection, including cough and fever. Some people also have other symptoms that mimic the flu, such as muscle aches, sore throat or diarrhea, Dr Esper notes.
"Unfortunately there is no truly identifying feature of this coronavirus that separates it from other viruses out there," he says.
Most people who contract the virus will have mild symptoms and can recover on their own at home. But people over age 50 and people who have heart disease, lung disease or weakened immune systems seem to be more at risk of severe infections that could lead to pneumonia and difficulty breathing, Dr Esper says.
The only way to confirm that someone has COVID-19 is through a swab test. Efforts are underway to make testing more widely available in U.S. hospitals and healthcare facilities. Because of this, Dr Esper expects to see an uptick in the number of cases of COVID-19 being diagnosed and reported.
However, the C.D.C. currently considers the immediate health risk to the American public to below.
Coronavirus infects the lungs. The symptoms start with a fever followed by a dry cough, which can lead to breathing problems.
This is a new, continuous cough and means coughing a lot for more than an hour, or having three or more coughing episodes in 24 hours (if you usually have a cough, it may be worse than usual).
It takes five days on average to start showing the symptoms, scientists have said, but some people will get symptoms much later than this. In fact, the World Health Organization (WHO) says the incubation period lasts up to 14 days.
Ear, nose and throat specialists in the U.K. have also noticed rising reports of anosmia - the term for loss of smell.
And increasing numbers of people on social media have been reporting a lost sense of smell and taste. Some have tested positive for coronavirus.
However, the evidence so far is only anecdotal, and viruses behind the common cold often lead to lost senses of smell and taste.
How deadly is coronavirus?
The proportion dying from the disease appears low (between 1% and 2%) - but the figures are unreliable.
Thousands are being treated but may go on to die - so the death rate could be higher. But it may also be lower if lots of mild cases are unreported.
A World Health Organization examination of data from 56,000 patients suggests:
- 6% become critically ill - lung failure, septic shock, organ failure and risk of death
- 14% develop severe symptoms - difficulty breathing and shortness of breath
- 80% develop mild symptoms - fever and cough and some may have pneumonia
Older people, and those with pre-existing medical conditions (such as asthma, diabetes, heart disease, high blood pressure), are more likely to become severely ill. The data from China also suggests that men are at slightly higher risk of dying from the virus than women.
Treatment relies on keeping the patient's body going, including breathing support, until their immune system can fight off the virus. Work to develop a vaccine is underway.
What are the main concerns?
High medical costs make the virus particularly problematic - many Americans avoid doctor's visits because of unaffordable charges.
On 10 March, Vice-President Mike Pence - who is leading the U.S. response - announced that a group of major health insurance companies covering almost 240 million Americans have agreed not to charge patients for coronavirus testing.
They have also vowed to extend coverage for COVID-19 treatment in all benefit plans - but it's unclear what this extended coverage will entail, and it could still leave insured Americans with thousands of dollars in medical bills.
Taking sick leave is another concern. Not all employers offer paid vacation, and workplace culture often pushes employees to go to work ill. President Trump's claim that coronavirus patients may get better "by sitting around and even going to work" drew widespread criticism from health experts.
This could contribute to the virus spreading, as infected people may not show significant symptoms for up to 14 days.
We don't have enough ventilators and I.C.U. Beds if there's a significant surge of new cases. As with Italy, the health system could become overwhelmed.
The ability of the American healthcare system to absorb a shock — what experts call surge capacity — is much weaker than many believe.
As a medical doctor who analyzes health issues for The Upshot, I strive to place your fears in context and usually tell you that you shouldn't be nearly as afraid as you are. But when it comes to the nation's response to the new coronavirus, I cannot be so reassuring.
A crucial thing to understand about the coronavirus threat — and it's playing out grimly in Italy — is the difference between the total number of people who might get sick and the number who might get sick at the same time. Our country has only 2.8 hospital beds per 1,000 people. That's fewer than in Italy (3.2), China (4.3) and South Korea (12.3), all of which have had struggles. More important, there are only so many intensive care beds and ventilators.
It's estimated that we have about 45,000 intensive care unit beds in the United States. In a moderate outbreak, about 200,000 Americans would need one.
In China, international flights have been cut back so severely that Chinese students abroad wonder when they will be able to get home. In Singapore, recently returned citizens must share their phones' location data with the authorities each day to prove they are sticking to government-ordered quarantines.
In Taiwan, a man who had travelled to Southeast Asia was fined $33,000 for sneaking out to a club when he was supposed to be on lockdown in his home. In Hong Kong, a 13-year-old girl, who was spotted out at a restaurant wearing a tracking bracelet to monitor those in quarantine, was followed, filmed and subsequently shamed online.
Across Asia, countries and cities that seemed to have brought the coronavirus epidemic under control are suddenly tightening their borders and imposing stricter containment measures, fearful about a wave of new infections imported from elsewhere.
Even when the number of new cases starts to fall, travel barriers and bans in many places may persist until a vaccine or treatment is found. The risk otherwise is that the infection could be reintroduced inside their borders, especially given the prevalence of asymptomatic people who might unknowingly carry the virus with them.
While researchers are still learning about the new coronavirus, most people sickened by it appear not to get all that ill.
"The one thing we don't need is mass hysteria," said Dr Robert Murphy, executive director of the Institute for Global Health at the Northwestern University Feinberg School of Medicine and an infectious diseases professor. "Eighty per cent of people have such minor symptoms, and they don't require any medical care at all. The 20 per cent who do feel quite ill need to be evaluated, and some of them will require hospitalization and some of them will require intensive care."
Those most at-risk for severe symptoms include senior citizens and people with underlying medical conditions, such as cardiovascular or lung disease, cancer or diabetes, he said.
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As of Friday evening, there were more than 300 confirmed cases of the coronavirus across the United States. Some have already recovered.
The priority: Prevention
While there is no specific treatment for COVID-19, the best way to protect against it and any other upper respiratory infection are to practice good cold and flu season hygiene, Dr Gordon says.
Actions to prevent the spread of viruses include:
- Washing your hands thoroughly with soap and water, or using an alcohol-based hand sanitizer.
- Properly covering your nose and mouth with a tissue or your sleeve when you cough and sneeze.
- Staying home from school or work if you're not feeling well, whether you think you have something extraordinarily contagious or not. Wear a mask if you are sick.
- Disinfect surfaces that are frequently touched, like doorknobs and handles.
- Avoiding close contact with people who are sick.
- Avoid touching your face to prevent the spread of viruses from your hands.
- Follow travel guidelines from the C.D.C.
If you are worried you might have the coronavirus, pick up the phone before you seek medical treatment. The reason for this is twofold: In very mild cases, your doctor might be able to give you advice on how to treat your symptoms at home without needing to see you in person, which would reduce the number of other people you expose.
"The vast majority of cases are going to be mild, and people are going to recover just like they do from a cold or flu-like illness," said Dr Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security and an infectious diseases doctor.
In more severe cases, where medical treatment might be necessary to assist with breathing issues or other problems, an urgent care centre or a hospital emergency department will benefit from advance notice of your arrival. They may have a special entrance they want you to come in through so you don't expose other patients on your way in or a mask they want you to put on, Adalja said.
Not everyone needs to be tested, experts say. If you have been in close contact with someone diagnosed with the coronavirus or have recently travelled to an area where the virus is spreading, and you develop a fever, a cough or difficulty breathing, the Centers for Disease Control and Prevention recommends you call a health care professional for guidance on whether to be tested.
You should wash your hands regularly - using soap and water for at least 20 seconds, avoid contact with people who have respiratory illness symptoms and stay away from animals.
The C.D.C. does not recommend wearing a face mask if you are not sick or taking care of someone who is ill.
It may be useful to ensure you have enough supplies - like extra water, non-perishable food and medicines - in case you need to self-quarantine.
You might want to discuss work-from-home options with your employer and plan for child care if schools need to close.
We have enough fear of going around the world as it is. Spreading fear and irrationality have proven to be a lot faster than the coronavirus itself.
From panic-buying and even brawling for toilet rolls, short-term stock market crashes and wearing surgical masks when healthy out of fear, we are starting to see the surface of the dark side of humanity.
Based on your geo-location, you should be able to assess the likelihood of actually catching the virus roughly. If you're staying in a location with really high existing cases, do your part and stay away from crowded areas and practice personal hygiene with diligence. This applies especially to individuals with existing health problems that will definitely escalate if you contract the virus.