Special Report On Coronavirus
A Personal Note: As most of you probably know by now, COVID-19 is the name of a disease caused by a newly identified coronavirus, which arose in China last year. But coronaviruses in general have been with us for quite some time – they’re a common cause of colds, along with rhinoviruses. In fact, COVID-19 seems to be behaving a lot like a condition most of us are all-too-familiar with: the flu. COVID-19 is estimated to be about as contagious as the flu and, like that seasonal illness, is most worrisome in older people and others who have weakened immune systems. This may be why, so far, children seem pretty resilient to COVID-19, often experiencing only mild symptoms.
Who’s at greatest risk? Probably someone like me who passed my 60th birthday several years ago, and who has an underlying infection – if you count a root canal gone bad and in need of yanking out. So, I decided to take a look at COVID-19, vowing that no sub-microscopic intruder is going to get me down for long, if it invades my system.
What follows is a question-and-answer with public health officials and the result of a medical literature search conducted this past week, which I thought might be helpful reading for others, too. The sources of the information are in boldface and links are provided. Call your healthcare provider if you suspect you may have COVID-19; You don’t want to rely on information from a writer in the higher-risk-group category who's currently suffering a toothache. However, here are some answers I found:
-- What is this thing called coronavirus, anyway? Under high-powered microscopes, it looks like a soccer ball with spikes. On some birds-eye views, the sphere is encircled by a crown – like the corona of the sun. That’s how it got its name. It isn’t named for a beer! (The National Institutes of Health has released photos at https://www.niaid.nih.gov/news-events/novel-coronavirus-sarscov2-images).
-- What has the local response been so far? According to clerks at stores that serve Independence, residents have been stocking up on hand sanitizer – clearing the shelves of one brand. But thorough hand-washing with soap and water is the recommended protective strategy, according Jonathan Modie, lead communications officer in public health at the Oregon Health Authority (OHA). For utilizing hand-sanitizer, use one with 60% alcohol content, he advised. (My own favorite hand-washing instruction so far is the one that went viral with a song by Mexican nurses. These nurses really nail it. Here's the link: https://www.pri.org/stories/2020-03-06/die-bacteria-die-mexican-nurses-croon-hand-washing-psa-video).
-- What will happen if a case is detected in Polk County? Polk County Public Health will conduct an investigation on any confirmed case that’s reported, following the protocol in place by the OHA -- and follow-up will include informing those who may have been in contact with the case, according to Kristty Polanco MPH, the director of public health for Polk County. Confidentiality is provided to those infected with COVID-19, but if the index case comes from a facility, that facility will be made public, she said.
-- How are schools in Central District 13J handling this? With vigilance, according to information imparted at the last school board meeting. Custodians are working intensively, making sure surfaces are wiped with effective reagents – even though that source of contamination is considered a far lower risk than person-to-person transmission, according to the OHA. It’s unlikely to stay viable on surfaces very long, said OHA’s Mr. Modie. How long? “You can count on two hours,” he said. Lysol and diluted Clorox are two solutions that seem to work well for disinfection, he said.
-- Is there a special treatment for COVID-19? Not yet, at least not for widespread use. A large majority of cases are expected to be fairly mild. However, for severe infections, treatment with certain anti-virals has been used in what is called “compassionate” circumstances in other countries. This is a situation in which a really sick individual is given a therapy that is not yet proven but, based on previous scientific study, is thought to be possibly helpful. One antiviral used this way, called Remdesivir, shows promise -- and now an American clinical trial on it is starting at the University of Nebraska Medical Center (https://www.nih.gov/news-events/news-releases/nih-clinical-trial-remdesivir-treat-covid-19-begins).
-- But isn’t likening COVID-19 to the flu comparing apples and oranges? It may seem that way, perhaps due to the fact that this coronavirus is new and will take more investigation and understanding, while influenza is anticipated every year -- with its very own name for winter, “Flu Season.” Transmission from both often comes from exposure to droplets carried in sneezes and coughs – but COVID-19 may be able to stay airborne even after the ill person is no longer nearby, according to Johns Hopkins University (https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/coronavirus-disease-2019-vs-the-flu)
-- What else is like COVID-19? A month ago, a team from the University of Texas, Galveston, and the University of North Carolina, Chapel Hill, published a commentary on the new coronavirus, concluding that it had “awakened the echoes” from an earlier era of the epidemic called Severe Acute Respiratory Syndrome (SARS) of nearly two decades ago. Like SARS, COVID-19 can cause severe respiratory symptoms. However, as the researchers observe in their recent publication, “with technological advances and important lessons gained from previous outbreaks, perhaps the world is better equipped to deal with the most recent emergent group 2B coronaviruses.” They note that most deaths from COVID-19 have occurred in people who have other chronic illnesses, and that’s one reason why elderly people are at greater risk. (Return of the Coronavirus: 2019-nCoV, published January 2020).
-- What about a vaccine? It’s at least a year away, but yes, testing a vaccine for COVID-19 appears to be on the horizon, according to Dr. Todd Ellerin, an infectious disease specialist who was the expert on a recent Harvard Health podcast on the emerging coronavirus (See Coronavirus Resource Center at https://www.health.harvard.edu).
-- What is this “social distancing” that’s suddenly being recommended? Well, we in the Willamette Valley can be a mighty friendly group. Watch people in downtown Independence greet each other along Main Street and you’re likely to see hugs, handshakes, arm grabs and high-fives. Try replacing this casual contact with just “hello” and a wave in the air. And keep in mind that certain people are more susceptible to complications; Pregnant women and the elderly, for example. You can read about why both groups need to exercise caution at: https://www.cdc.gov/coronavirus/2019-ncov/specific-groups/index.html
-- Is there a method to predict how much transmission will occur? The way this is done is to find the average number of infections one case can generate – and that’s variable because containment and control can have a powerful effect. When Canadian and Chinese researchers worked together to determine this, they found that the outcome could be heavily influenced by responsiveness with appropriate resources, like diagnostic testing, and with interventions, such as the ability to quarantine, (Infectious Disease Modeling 2020 5:248-255). For example, some companies have the ability to send staff home to telecommute – Amazon did this after one employee tested positive for the virus (https://www.cnn.com/2020/03/05/tech/amazon-seattle-coronavirus/index.html)
-- Does caring for a sick loved one mean COVID-19 will spread to the caretaker? This is where using sanitary precautions, like hand-washing around infected family members, may be paying off. Among early cases in the United States, the numbers of close contacts who seem to have been infected under these conditions hasn’t been as high as expected. “And I do think that’s good news.” said Nancy Messonnier MD, director of the National Center for Immunization and Respiratory Diseases. But the finding comes from a relatively small number of cases, compared with the global figures, she cautioned. “So we take that as optimistic but we still need to be cautious with these early cases and do complete investigations, which our state and local health departments are doing.” Dr. Messonnier made the statements last week, in a briefing at the Centers for Disease Control and Prevention (CDC).
-- Where can I get good up-to-date information? The OHA has a terrific Question-and-Answer page, which can be found at:https://www.oregon.gov/oha/PH/DISEASESCONDITIONS/DISEASESAZ/Pages/COVID19-FAQ.aspx
-- What's next? “Like everywhere in the country, we are recommending that people think through what they might do if there is a risk in their community,” the CDC’s Dr. Messonnier advised in her March 3 CDC briefing. General preparedness plans should be taking place, she said. “It is good to have those conversations in advance so that if you do need to act you are ready to do it,” she added. -end-
Who’s at greatest risk? Probably someone like me who passed my 60th birthday several years ago, and who has an underlying infection – if you count a root canal gone bad and in need of yanking out. So, I decided to take a look at COVID-19, vowing that no sub-microscopic intruder is going to get me down for long, if it invades my system.
What follows is a question-and-answer with public health officials and the result of a medical literature search conducted this past week, which I thought might be helpful reading for others, too. The sources of the information are in boldface and links are provided. Call your healthcare provider if you suspect you may have COVID-19; You don’t want to rely on information from a writer in the higher-risk-group category who's currently suffering a toothache. However, here are some answers I found:
-- What is this thing called coronavirus, anyway? Under high-powered microscopes, it looks like a soccer ball with spikes. On some birds-eye views, the sphere is encircled by a crown – like the corona of the sun. That’s how it got its name. It isn’t named for a beer! (The National Institutes of Health has released photos at https://www.niaid.nih.gov/news-events/novel-coronavirus-sarscov2-images).
-- What has the local response been so far? According to clerks at stores that serve Independence, residents have been stocking up on hand sanitizer – clearing the shelves of one brand. But thorough hand-washing with soap and water is the recommended protective strategy, according Jonathan Modie, lead communications officer in public health at the Oregon Health Authority (OHA). For utilizing hand-sanitizer, use one with 60% alcohol content, he advised. (My own favorite hand-washing instruction so far is the one that went viral with a song by Mexican nurses. These nurses really nail it. Here's the link: https://www.pri.org/stories/2020-03-06/die-bacteria-die-mexican-nurses-croon-hand-washing-psa-video).
-- What will happen if a case is detected in Polk County? Polk County Public Health will conduct an investigation on any confirmed case that’s reported, following the protocol in place by the OHA -- and follow-up will include informing those who may have been in contact with the case, according to Kristty Polanco MPH, the director of public health for Polk County. Confidentiality is provided to those infected with COVID-19, but if the index case comes from a facility, that facility will be made public, she said.
-- How are schools in Central District 13J handling this? With vigilance, according to information imparted at the last school board meeting. Custodians are working intensively, making sure surfaces are wiped with effective reagents – even though that source of contamination is considered a far lower risk than person-to-person transmission, according to the OHA. It’s unlikely to stay viable on surfaces very long, said OHA’s Mr. Modie. How long? “You can count on two hours,” he said. Lysol and diluted Clorox are two solutions that seem to work well for disinfection, he said.
-- Is there a special treatment for COVID-19? Not yet, at least not for widespread use. A large majority of cases are expected to be fairly mild. However, for severe infections, treatment with certain anti-virals has been used in what is called “compassionate” circumstances in other countries. This is a situation in which a really sick individual is given a therapy that is not yet proven but, based on previous scientific study, is thought to be possibly helpful. One antiviral used this way, called Remdesivir, shows promise -- and now an American clinical trial on it is starting at the University of Nebraska Medical Center (https://www.nih.gov/news-events/news-releases/nih-clinical-trial-remdesivir-treat-covid-19-begins).
-- But isn’t likening COVID-19 to the flu comparing apples and oranges? It may seem that way, perhaps due to the fact that this coronavirus is new and will take more investigation and understanding, while influenza is anticipated every year -- with its very own name for winter, “Flu Season.” Transmission from both often comes from exposure to droplets carried in sneezes and coughs – but COVID-19 may be able to stay airborne even after the ill person is no longer nearby, according to Johns Hopkins University (https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/coronavirus-disease-2019-vs-the-flu)
-- What else is like COVID-19? A month ago, a team from the University of Texas, Galveston, and the University of North Carolina, Chapel Hill, published a commentary on the new coronavirus, concluding that it had “awakened the echoes” from an earlier era of the epidemic called Severe Acute Respiratory Syndrome (SARS) of nearly two decades ago. Like SARS, COVID-19 can cause severe respiratory symptoms. However, as the researchers observe in their recent publication, “with technological advances and important lessons gained from previous outbreaks, perhaps the world is better equipped to deal with the most recent emergent group 2B coronaviruses.” They note that most deaths from COVID-19 have occurred in people who have other chronic illnesses, and that’s one reason why elderly people are at greater risk. (Return of the Coronavirus: 2019-nCoV, published January 2020).
-- What about a vaccine? It’s at least a year away, but yes, testing a vaccine for COVID-19 appears to be on the horizon, according to Dr. Todd Ellerin, an infectious disease specialist who was the expert on a recent Harvard Health podcast on the emerging coronavirus (See Coronavirus Resource Center at https://www.health.harvard.edu).
-- What is this “social distancing” that’s suddenly being recommended? Well, we in the Willamette Valley can be a mighty friendly group. Watch people in downtown Independence greet each other along Main Street and you’re likely to see hugs, handshakes, arm grabs and high-fives. Try replacing this casual contact with just “hello” and a wave in the air. And keep in mind that certain people are more susceptible to complications; Pregnant women and the elderly, for example. You can read about why both groups need to exercise caution at: https://www.cdc.gov/coronavirus/2019-ncov/specific-groups/index.html
-- Is there a method to predict how much transmission will occur? The way this is done is to find the average number of infections one case can generate – and that’s variable because containment and control can have a powerful effect. When Canadian and Chinese researchers worked together to determine this, they found that the outcome could be heavily influenced by responsiveness with appropriate resources, like diagnostic testing, and with interventions, such as the ability to quarantine, (Infectious Disease Modeling 2020 5:248-255). For example, some companies have the ability to send staff home to telecommute – Amazon did this after one employee tested positive for the virus (https://www.cnn.com/2020/03/05/tech/amazon-seattle-coronavirus/index.html)
-- Does caring for a sick loved one mean COVID-19 will spread to the caretaker? This is where using sanitary precautions, like hand-washing around infected family members, may be paying off. Among early cases in the United States, the numbers of close contacts who seem to have been infected under these conditions hasn’t been as high as expected. “And I do think that’s good news.” said Nancy Messonnier MD, director of the National Center for Immunization and Respiratory Diseases. But the finding comes from a relatively small number of cases, compared with the global figures, she cautioned. “So we take that as optimistic but we still need to be cautious with these early cases and do complete investigations, which our state and local health departments are doing.” Dr. Messonnier made the statements last week, in a briefing at the Centers for Disease Control and Prevention (CDC).
-- Where can I get good up-to-date information? The OHA has a terrific Question-and-Answer page, which can be found at:https://www.oregon.gov/oha/PH/DISEASESCONDITIONS/DISEASESAZ/Pages/COVID19-FAQ.aspx
-- What's next? “Like everywhere in the country, we are recommending that people think through what they might do if there is a risk in their community,” the CDC’s Dr. Messonnier advised in her March 3 CDC briefing. General preparedness plans should be taking place, she said. “It is good to have those conversations in advance so that if you do need to act you are ready to do it,” she added. -end-
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