The Coronavirus Disease
The current novel coronavirus has been named SARS-CoV-2. SARS stands for severe acute respiratory syndrome. The disease that it causes has been named Covid-19 (coronavirus disease 2019). The virus first appeared and was identified as the cause of a cluster of pneumonia cases in late 2019 in the city of Wuhan, China. Within about 30 days, the virus had spread throughout the entire country and has now become a global health emergency with cases identified in over 60 countries.
Coronaviruses are a family of viruses that are found in many species of animals. Human coronaviruses are a common cause of colds and most of us have antibodies to these viruses so when they cause illness, it is typically very mild. Rarely, an animal coronaviruses will infect people and then spread amongst other people resulting in an epidemic, as is the case with the current SARS-CoV-2. These viruses are new to our immune system; thus, we have difficulty stopping its invasion of our cells which allows them to propagate and cause more severe illness. Also, because our immune system doesn’t recognize the virus, it is highly contagious and easily transmitted from person to person. Officials do not know what animal caused the Wuhan coronavirus, although it is linked to a market that sold wild animals as food products.
Viral particles have protein appendages that attach to host cells and this process allows the viral particle to enter the cell and highjack the nuclear material of the host cell. Obtaining this genetic material from the nucleus allows the virus to replicate producing many more viral particles. The host cell dies releasing the viral particles into the environment of the tissue allowing them to invade many more host cells. If the immune system is able to respond appropriately, antibodies are produced which block the attachment of the viral proteins to the host cell stopping or slowing progression of the viral illness. Interestingly, viral proteins have varying affinity for certain organs or tissues of the body. For example, viral hepatitis occurs because the hepatitis viral proteins have an affinity for liver cells. It has been determined that the current coronavirus, SARS-CoV-2, has an affinity for cells in the lungs. Thus, typical presenting symptoms of Covid-19 infection are cough, shortness of breath and fever.
It has been determined that person-to-person spread of SARS-CoV-2 is mainly via contaminated respiratory droplets, resembling the spread of influenza. There is also some evidence that infectious viral particles can be found in urine and feces. It is likely that infective viral droplets can survive for several hours, or possibly days, on inanimate objects, just as influenza.
Our skin is a very effective barrier to viruses entering our body, but viruses can gain entrance through the mucous membranes of the nose, mouth and eyes. Therefore, touching an object that had previously been touched by an infected individual, and then touching the face can lead to infection.
The incubation period for an infection is the time between when a person contracts a viral illness and symptoms appear. The incubation period for Covid-19 appears to be on average 5 days but can be as long as 14 days. There are case reports of people testing positive for the virus and not developing symptoms for 21 days. This is significant because an infected person can spread the disease many days before they develop symptoms and realize that they are infected. Therefore, screening people for fever to determine if they are infected is less than ideal.
The most serious complication of Covid-19 is pneumonia which can progress to acute respiratory distress syndrome (ARDS). ARDS causes the lungs to fill with fluid and the body cannot obtain oxygen. This leads to organ failure, shock, and death. ARDS can be treated, but the mortality rate is between 30-50%.
Thus far, there has not been a true outbreak of the infection in the US which currently is reporting about 60 cases. So, what should you do to prepare for a potential outbreak? The precautions to take are not new and have been recommended for years to prevent respiratory infections:
· Frequent hand washing with warm water and soap for at least 20 seconds before eating, after using the bathroom, and after sneezing or blowing your nose. If dining out, hand washing should be done after handling money or a charge card. When washing hands, be sure to cover the areas between fingers and the back of the hand up to the wrist.
· When using a public bathroom and after hand washing, use a tissue when touching the door knob to exit the facility.
· If you do sneeze or cough, do not cover up with your hand or elbow. Use a tissue, fold it, and dispose of it in a closed container.
· Avoid shaking hands and simply use the ‘fist bump’.
· If soap and water is not available, use a hand sanitizer containing 60-90% alcohol. Keep hand sanitizer throughout your house, place of work, and automobile.
· As for the surgical mask, if you are not sick, you do not need to wear them. The purpose of the mask is to keep someone who is infected with the virus from spreading it to others. The common surgical mask blocks droplets coming out of a sick person from getting dispersed into the air, but they are not effective in preventing what is already in the air from getting inside the mask.
Since there is currently no medical treatment for this coronavirus, preventive measures and awareness are the best tools at your disposal. Until it can be determined where this illness is heading, we think it is wise to currently avoid large congregations of people (sporting events and concerts) and defer air travel and cruises for a later date.
If you do become ill with fever, cough and shortness of breath, isolate yourself and contact your healthcare provider for further instructions.
Original article by Dr. James Tippett, MD, founder of Comprehensive Quality Healthcare Providers, a concierge internal medicine and geriatric practice located at 1210 Commerce Dr. Suite 106, Greensboro, Ga. 30642. He can be reached at 706-510-3659. Visit his webpage at www.drtippett.com