By now you’ve been inundated with news about the new coronavirus respiratory disease that began in China at the end of last year. We looked at it through the lens of a woman in her 60s and above to learn how it might affect us and what we can do to protect ourselves.
First, some background.
The “coronavirus” circulating now is a new strain of other known coronaviruses. It is closely related (89% similarity) to a group of SARS-like coronaviruses that had previously been found in bats in China.
It has a name now, or rather, two names. Knowing which is which will help you follow the news coverage of disease spread, a public health issue, vs. the science of understanding the disease.
- The disease is called COVID-19.
- The name of the virus is SARS-CoV-2 (or 2019-nCoV).
Here’s what else you need to know.
The shape of the virus allows it to enter human cells easily.
Coronaviruses are shaped like a sphere with “spikes” covering the surface (see below). “Corona” in Latin means “crown.”
Coronaviruses invade cells through these “spike” proteins, which lets the 2019-nCoV coronavirus pierce and invade human cells and the genome of the virus to enter human cells and begin infection.
Coronaviruses as a family are not new. Some common colds are caused by coronaviruses. The SARS pandemic of 2002-2004 was caused by a coronavirus.
It’s dangerous because it’s new.
The reason for the current freak out is because it’s a new virus to infect humans and no vaccines or medications exist to treat it as of now.
Figuring out the shape of the spike protein in SARS-Cov-2 (the current coronavirus in circulation) is the key to figuring out how to target the virus and develop treatments, according to an article on livescience.com.
Fortunately for us, Chinese researchers mapped the virus’s genome in February, opening the door for medical treatments to be developed.
Coronaviruses are transmitted from animals to humans, then human to human.
The SARS-CoV-2 most likely started with a bat, which passed the disease to a pangolin—a scaly, ant-eating mammal that is considered a culinary delicacy in China.
Both were sold at a fresh meat and seafood market in Wuhan, in the province of Hubei, China. Coronaviruses are zoonotic diseases, meaning they jump from animals to humans. China banned the consumption of wild animals in January, but the horse has left the stable, so to speak.
Can you get it more than once?
This is such a new disease little is known about the likelihood of reinfection.
Unlike the influenza virus, coronavirus antibodies do not last for a long time. The body produces antibodies to protect from subsequent exposure, but over time the body’s response wanes. How long the immunity lasts isn’t known yet.
With another human coronavirus known as Middle East Respiratory Syndrome (MERS), the antibodies were gone in as little as six months.
How does it spread?
COVID-19 is primarily spread through respiratory droplets. To become infected, people generally must be within six feet of someone who is contagious and come into contact with these droplets.
It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes, but this is not thought to be the main way the virus spreads.
It also may be spread through blood and feces, although research has not confirmed this.
Symptoms of COVID-19 appear within two to 14 days after exposure. (The Cleveland Clinic)
Is there a vaccine?
Not yet. But now that the genome has been mapped pharmaceutical firms have accelerated development of a vaccine, with clinical trials expected in April. Approved vaccines may be available by the end of the year.
What’s being done to stop the disease from spreading?
In the absence of a vaccine countries, states, and municipalities are adopting a three-part strategy to limit spread: preparedness, containment, and mitigation.
For example, New York City has 1,200 hospital beds ready in case they are needed and is setting up testing facilities to test locally rather than waiting for results from the Centers for Disease Control. Public transportation will undergo more rigorous cleaning and disinfecting.
Containment measures include personal social isolation on the community level, such as staying at home or keeping children at home if they feel sick. Several international ports of entry–Los Angeles, New York and Hawaii–are screening incoming international travelers.
Travelers from countries that have coronavirus cases are being tested and quarantined if necessary. Some people are self-quarantining upon return from overseas travel by staying at home for a few days.
In extreme cases, community mitigation measures recommended by the CDC include cancelling large public gatherings like concerts and sporting events, dividing classrooms into smaller groups or giving students some days off, postponing face-to-face meetings and conferences, and arranging for people to work from home.
The symptoms are similar to cold and flu.
COVID-19 is a respiratory illness that is clinically indistinguishable from a bad cold or flu. The symptoms are:
- Sore throat
- Dry cough
- Runny nose
Unlike a cold, the virus infects the tissues and airways deep inside the lungs rather than the nose. Additional symptoms include:
- Shortness of breath
- Muscle ache
- Loss of smell or taste
The disease can progress to pneumonia and organ failure.
Most cases are mild.
A February 18th article on the BBC website looked at a report by the Chinese Centers of Disease Control of more than 44,000 confirmed cases of the disease. It showed:
- 81% developed mild symptoms
- 14% developed severe symptoms
- 5% became critically ill
Those who are 50 years and older have a greater chance of becoming sick.
The latest information from China based on 72,313 patients indicates the older the age, the more dangerous–the mortality rate of patients over 80 years old reached 14.8%. The mortality rate is significantly higher among men than women.
WHO reports total mortality rate for all patients is now 3.4%, but this may decrease significantly once nonsymptomatic cases are identified and included in the count.
By contrast, SARS had a mortality rate of around 10%; the MERS mortality rate is closer to 30% to 40%. (Harvard Health)
Individuals who have underlying illnesses or conditions like those below are at greater risk.
- Cardiovascular disease
- Chronic respiratory disease
Researchers note that many men in China smoke, which could account for the higher figures coming out of that country.
Scientists don’t know what exactly happens in older age groups.
Based on research on other respiratory viruses, experts theorize that whether a coronavirus infection takes a turn for the worse depends on a person’s immune response.
“The virus matters, but the host response matters at least as much, and probably more,” says Stanley Perlman, a virologist and pediatric infectious disease specialist at the University of Iowa.
In an article on TheScientist.com, author Katarina Zimmer explains that some people—especially the elderly and sick—may have dysfunctional immune systems that fail to keep the response to particular pathogens in check. An uncontrolled immune response can lead to a “cytokine storm” which floods the lungs with fluids and immune cells, blocking off the airways.
What to do if you start to have symptoms.
Stay at home if you begin to feel unwell, even with mild symptoms such as headache and slight runny nose. Use over-the-counter medications like acetaminophen, ibuprofen, or naproxen to treat aches and an expectorant to calm a cough. Get plenty of rest and fluids.
Seek medical attention sooner than later.
If you develop a high fever, persistent cough, and difficulty breathing, seek medical advice promptly.
Call your primary-care doctor first. They will ask if you recently traveled or been in contact with anyone who has. However, now that the virus is spreading in the community this may be less of a factor so don’t let yourself be brushed aside if you don’t have a travel connection.
As a woman over 60 you have a higher risk of developing more serious symptoms so contact your doctor early in your illness. “The older you are, the shorter the fuse you should have for seeking care,” Dr. George Rutherford, a professor of epidemiology and biostatistics at the University of California, San Francisco, told Live Science in a Feb. 27 interview.
Mild symptoms can develop into serious symptoms quickly. The chart below shows the progress of COVID-19 in a 50-year old man in China. He had a cough for seven days before he had trouble breathing. He suffered from acute respiratory distress syndrome within two days. He refused an oxygen mask because he was claustrophobic; he died two days later.
So don’t mess around with this.
How to protect yourself.
- Avoid shaking hands with other people or kissing on the cheek, European style. (You can adopt the Wuhan Handshake)
- Don’t touch your eyes, nose, and mouth.
- Wash your hands often with soap and warm water for at least 20 seconds. The CDC lists five simple and effective steps–wet, lather, scrub, rinse, dry.
- Nothing beats soap.
- “Soap dissolves the [virus’s] fat membrane, and the virus falls apart like a house of cards and ‘dies,’ or rather, it becomes inactive as viruses aren’t really alive, explains Palli Thordarson, professor at the School of Chemistry at the University of New South Wales, Sydney, in an article on MarketWatch.com. (Read the article–it’s fascinating.)
- The virus detaches from the skin and falls apart readily in soapy water.
- Use hand sanitizers–correctly. If soap and water are not available, use an alcohol-based hand sanitizer with at least 60 percent alcohol.
- Apply the product to the palm of one hand (read the label to learn the correct amount) and rub the product all over the surfaces of your hands until they are dry. Distribute the sanitizer between your fingers, under your nails and jewelry, on your wrists and on the backs of each hand.
- Never rinse your hands with water or wipe them with a towel after using a hand sanitizer because it will counteract the effect of the product.
- Hand sanitizers do not work well on dirty or greasy hands.
- Your hands must be dry for hand sanitizers to work. Otherwise the water will dilute the alcohol and render the sanitizer ineffective.
- Note: Washing your hands removes the virus from your body. Using hand sanitizer kills the virus but it remains on your skin.
- Close the toilet lid. The aerosol spray from flushing can contain germs. Toilet plume can travel up to 15 feet and the particles can remain in the air for several hours. If using a public toilet—or even if you’re waiting for a friend in a public toilet, wash your hands thoroughly afterwards.
- Stay away from crowds. If there is an outbreak in your area stay away from crowds and crowded places. There are numerous services that will deliver groceries to your home. Many pharmacies deliver. And there’s always Amazon.
- Maintain social distancing. The World Health Organization explains why. “When someone coughs or sneezes they spray small liquid droplets from their nose or mouth which may contain virus. If you are too close, you can breathe in the droplets, including the COVID-19 virus if the person coughing has the disease.” A six-foot distance is recommended.
- Forget the face mask. Most face masks will not protect you from the virus and can give you a false sense of security.
- Avoid close contact with people who are sick. If a family member is sick and you are caring for them, both of you should wear a mask. But also follow the other steps.
- Clean and disinfect frequently touched objects and surfaces like doorknobs and phones.
- Make your own sanitizer. Business Insider has a formula for making your own hand sanitizer and wipes. The key is to ensure the formula is at least 60% alcohol because alcohol is the active ingredient.
Avoid spreading the disease.
- Cover your cough or sneeze with a tissue, then throw the tissue in the trash. Wash your hands.
- Sneeze into your elbow, not your hand.
- Stay home when you are sick
Where can I get the latest information?
Information about and understanding COVID-19 is in its early stages and is evolving rapidly.
The best resources for keeping track of the disease are the U.S. Centers for Disease Control, which tracks the disease in the United States, and the World Health Organization, which monitors the disease worldwide.
What is the takeaway?
- We are in a higher risk group but there is no need to panic. Be careful and practical and take reasonable protective measures.
- Follow good health practices–eat right, exercise, get plenty of sleep.
- If you drink water from your tap you can continue to do so. There’s no need to stock up on bottled water–although it’s always a good thing to have some on hand for emergencies.
- It’s a good idea to stock up on some pantry foods in case you get sick and can’t or don’t feel like cooking.
- Call your primary-care doctor if you suspect you’re infected. Because we’re in a higher risk group don’t wait until you’re very ill.
- Most states and municipalities are taking the measures needed to contain the spread of the virus, lessening the chances that you’ll get infected.
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