Alan Frischer, MD, MPH
One of my running buddies just informed me that the upcoming Tokyo marathon she had signed up for has been cancelled due to – you guessed it - the coronavirus. Another dear friend has planned a family vacation to Asia, and has been asking me repeatedly whether I think that they should cancel. This current health scare remains a global threat, and appears to be growing by the day. Let’s address the coronavirus.
It all started in late December in Wuhan, China, with a few patients suffering from a mysterious pneumonia. The numbers of cases and deaths keep climbing, and any numbers I report here will be inaccurate by the time you read this. The vast majority of cases are in China, although it is spreading around the globe, with quarantined cities now in China, South Korea and Italy. Experts just can’t predict whether this will become a global pandemic, like the influenza of 1918 and 1968, cholera, and Black Death, or will quiet down.
What is the coronavirus? Coronaviruses are a large family of viruses that cause illness ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS). A novel coronavirus is a new strain that has not been previously identified in humans. This new strain is thought to be less deadly than SARS, and most cases are quite mild. However, it has now infected and killed more people than SARS did.
Coronaviruses are zoonotic, meaning they are transmitted between animals and people. SARS was transmitted from civet cats to humans, and MERS from dromedary camels to humans. At first, the 2019 coronavirus was thought to have come from snakes, but more recent studies show that it is more similar to one found in bats. However, it now appears to spread person-to-person through respiratory droplets from coughing or sneezing, or through direct contact with contaminated objects.
Common signs of infection include fever, cough, runny nose, sore throat, and shortness of breath. Most cases are not severe. However, infection can cause pneumonia, severe acute respiratory syndrome, and kidney failure.
How can we protect ourselves? First of all, some perspective: Note that (at the time of writing!) there are 59 cases of coronavirus in the entire United States, with eight of them in California. Keep in mind that 40 million people live in California! Nonetheless, I urge you to practice these preventive guidelines (which are similar to those for avoiding the flu virus):
Wash hands frequently, thoroughly, and for at least 20 seconds.
Avoid touching the areas where viruses enter our bodies: the nose, eyes, and mouth.
If things get worse, or if you deem it necessary, wear a mask. Note that most masks do not completely prevent the tiny virus from entering our orifices. Rather, they keep us from touching our faces and bringing the virus into the body. Do note that if you wear a mask, the three-ply surgical mask is the only type that offers some protection. The most common one is the N95 mask, and they are in very short supply at this time.
Treatment of the coronavirus infection is supportive only, meaning that very sick people will be given IV fluids, medicine for symptom relief, and monitoring. There is no specific treatment for this infection, nor is there yet a vaccine to prevent it. Internet myths include the use of garlic for prevention, antibiotics for treatment, and pneumonia vaccination. They are useless, as is the myth about avoiding mail from China! (The virus does not survive long on objects.) And, even though the origin of the virus is from animals, our pets are not at any risk, nor can they transmit it to us.
Those of us most at risk are similar to those most at risk for the flu. Most cases are mild, and it is the very young and the very old who are far more likely to become seriously ill. If you have travel plans coming up, visit the Centers for Disease Control and World Health Organization websites for travel warnings and up-to-date information. Presently there are CDC travel warnings for five countries. This is changing rapidly. Because this is a new virus, we don’t know whether it will behave like other viruses and show a seasonal pattern as we enter the spring and summer months. See your doctor if you are concerned about your own symptoms.