Coronovirus: What It is, How to Prevent It, and What to Do If You Become Sick

Coronaviruses are a large family of viruses which can cause respiratory infections in humans, ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS). SARS and MERS had mortality rates of 9.5 and 34.5%, respectively. The most recently discovered coronavirus causes coronavirus disease COVID-19 which appears to be more easily spread and therefore harder to contain.

CURRENT MORTALITY STATISTICS

(Percent of people with laboratory verified COVID-19 who died from the disease)

· average overall mortality rate worldwide 3.42%

· pre-existing medical conditions (such as high blood pressure, heart disease, lung disease, cancer or diabetes) 5-10%

· no history of chronic disease <1%

· overall men 2.8%

· overall women 1.7%

(Source:https://ncov2019.live/data, https://www.medscape.com/viewarticle/925681)

COVID-19 mortality is generally due to acute respiratory distress syndrome (ARDS) and/or pneumonia

By age (Source: T. Tibbitts; Source: China CDC Weekly):

· over 80 years old 14.8%

· 70-79 years of age 8%

· 60-69 years of age 3.6%

· 50-59 years of age 1.3%

· 40-49 years of age 0.4%

· 10-39 years of age 0.2%

· 0-9 years of age ~0%

On a positive note, very few children have been diagnosed with it. In China children only account for 2.4% of all reported cases. Only 2.5% of children who did contract the virus experienced severe symptoms. Only 0.2% who experienced severe symptoms became critically ill. Even newborns seem to be tolerating the virus fairly well. One study found that in China only nine infants were hospitalized with it between Dec. 8 and Feb. 6. None had severe complications or required intensive care. Worldwide, there have been no deaths reported so far in young children. This does not mean that children can't transfer the virus to other more vulnerable members of the community.

Young, relatively healthy people may experience just a sniffle and so it's easy for it to go unnoticed and unknowingly spread it. For this reason, it's especially important for people of all ages to take the following PREVENTIVE MEASURES to protect people of all ages:

· Washing your hands often, under water for more than 15 seconds, is the best and most effective preventative measure.

· Avoid touching your eyes, nose, and mouth, especially with unwashed hands. Pathogens enter our body through the eyes, nose and mouth.

· Avoid close contact with people when you are sick and don't send your kids to school when they may be contagious. For the common cold, doctors typically advise 5-7 days of avoidance, but when kids feel better after 2-3 days, many of us send them back to school anyway. Keep in mind that even if your child's nose runs clear and their cough is mild, they can still pass the virus on to somebody else that is vulnerable to more serious disease and complications.

TESTING

At this time the CDC is only advising testing for patients with cold symptoms who are hospitalized with unexplained symptoms or who have travel history or who have been in contact with a known case. The CDC is working to increase the availability of tests to allow testing of symptomatic people with no known exposures.

Local clinics and private labs do not have a test for this yet. If your provider suspects COVID-19, they will work with the local health jurisdiction to arrange testing at Kittitas Valley Healthcare and the collected samples will be sent to the Public Health Laboratory in Shoreline. The Public Health Lab is not charging patients for these tests; however patients can expect to accrue a charge from KVH for the collection of the samples.

TREATMENT

Currently there are no known specific treatments for COVID-19 other than supportive care. If you develop cold symptoms (runny nose, fever, mild cough), you should take the following measures:

· Isolate yourself from others

· Contact your CompassDirect Healthcare provider. If your cold moves into your chest, your provider will want to see you here at the clinic to rule out pneumonia

· Treat fever with Ibuprofen and/or Acetaminophen as directed

· Address congestion with nasal saline, humidifiers, steam showers, Vicks, cough and cold remedies (if age appropriate)

· Increase fluids

Early supportive care will improve outcomes. Treatment options include:

· Steroids to slow the immune response that can lead to ARDS

· Inhalers to improve lung function and ease breathing

· Antibiotics to address and or prevent secondary bacterial complications

· Inpatient care when extreme/necessary (diuretics, vents...)

TRAVEL

The CDC is advising against non-essential travel to China, South Korea, Iran, and Italy. For older adults and those who have chronic medical conditions, the CDC recommends postponing travel to Japan.

Don't forget there are other illnesses out there. Flu activity in Washington State is currently elevated. 74 lab-confirmed deaths, including 6 children, have been reported in our state since October 1, 2019. Influenza deaths in adults are not tracked nationwide; however the CDC estimated that 18,000 adults have died from influenza this season. We are currently seeing Influenza A (H1N1) and Strep circulate in our community.

If fevers are high see your doctor to rule out influenza - Tamiflu/Xofluza work best when started within the first 48 hours of the onset of symptoms.

If you have a red sore throat with or without fever or an upset stomach see your doctor to rule out strep.

In conclusion, please remember that for the vast majority of us, Coronavirus is just another cold. Please let us help if you have any concerns.

Adapted from a Facebook post shared on 2/26/2020 by Westside Pediatrics, Inc