THE INFORMATION ABOUT CORONAVIRUS KEEPS CHANGING VERY RAPIDLY AND BECOMES OUTDATED LITERALLY EVERY DAY. SO I AM NO LONGER UPDATING THIS BLOG POST. INSTEAD, WHAT YOU ARE LOOKING FOR CAN NOW BE FOUND ON THE HOMEPAGE OF THIS WEBSITE
ORIGINAL BLOG POST (NO LONGER UP-TO-DATE)
Disclaimer: I am sharing this for informational purposes, anything in this blog it is not meant to diagnose COVID-19 or offer treatment advice. Please contact your doctor if you are sick.
WHERE DID THIS VIRUS COME FROM?
There are many coronaviruses in nature, most cause infections in animals and humans (generally respiratory infections). This particular coronavirus is "novel" (new) - it was not known until December 2019 when it caused the first outbreak of a respiratory infection in Wuhan, China.
It appears that this particular virus comes from an animal (the exact source is uncertain), but it also appears that at this point, the virus is transmitted exclusively between humans.
WHAT IS THIS CORONAVIRUS ACTUALLY CALLED?
This new coronavirus is called “severe acute respiratory syndrome coronavirus 2” (SARS-CoV-2).
The disease that this virus causes is called “coronavirus disease 2019” (COVID-19)
Note, that most people may call the virus and the disease “coronavirus”, but the medical terms are SARS-CoV-2 and COVID-19 respectively.
WHAT ARE THE SYMPTOMS?
This particular coronavirus causes respiratory symptoms, fatigue, and not feeling well in general:
If you or someone you know have the following symptoms, those are symptoms to be concerned about:
The symptoms above are most typical, but other symptoms may also be present. Please consult a doctor for diagnosis.
HOW IS THIS DIFFERENT FROM A COLD OR A FLU?
Symptoms-wise, neither common cold, nor flu would normally give you shortness of breath.
Also, this coronavirus supposedly does not cause nasal congestion or sneezing - so if you have those symptoms it’s unlikely that you have the virus.
But it's not just about the symptoms. Please continue reading, and it will make sense.
WHAT SHOULD I DO IF I AM SICK?
CALL IN FIRST to your doctor's office or a designated phone number in your town/city/region. Don't go to see your doctor directly until after you call in. It will allow the clinic to take appropriate precautions.
If you are severely ill, Call 911 (or a specific coronavirus-designated emergency number in your area).
CLICK HERE for official recommendations from Centers For Disease Control.
HOW SEVERE ARE THE SYMPTOMS?
Most cases are mild. In mildest forms of the disease there are minimal to no symptoms.
In more severe form, the disease causes a serious lung infection / pneumonia that may be life-threatening to the point of requiring life-support in intensive care unit.
According to the World Health Organization, 1 out of every 5 infected patients requires hospital care.
HOW LIFE-THREATENING IS IT?
The exact mortality rates from COVID-19 may vary from country to country, but overall, the mortality rate is somewhere between 3 and 4% (out of 100 people infected with the virus, around 4 people may die).
Officially, as of 03/13/2020, World Health Organization is estimating the overall mortality rate at 3.4%. However, this number will depend on many factors - it will vary by region based on the overall health of the population, and on the preparedness of the local healthcare system. So far no children under age of 10 have died. I will keep this section updated as more information becomes available.
Time from first symptoms to death may be as short a few weeks.
Mortality tends to be higher in the older patients (age >70), smokers, people with multiple underlying health problems such as heart disease, diabetes, chronic lung disease, high blood pressure, cancer, and obesity among others. Mortality appears to be slightly higher in men comparing to women.
WHO CAN GET SICK FROM CORONAVIRUS?
Any person can potentially get sick from SARS-CoV-2
Based on the information available today (03/16/2020), our animals, including household pets, are not susceptible to this virus and should be safe.
HOW LONG DOES IT TAKE TO SHOW SYMPTOMS?
Symptoms may begin anywhere between 1 day to 2 weeks (and possibly even longer) from the time of being exposed to the virus.
In most cases, it takes about 5 days from the time one contracts the virus till the symptoms appear. In some cases it can take just a few days; however, it is possible for it to take longer to develop symptoms.
In 99% of people will have the symptoms appear in less than 14 days from the exposure. During this period of time (“incubation period”) the infected person may have no symptoms but may still be contagious infecting others.
There have been cases reported of symptoms developing even three-four weeks after known exposure; however, it is possible that this was due to double exposure, meaning that people were exposed twice during those three weeks.
Currently, anyone who has been exposed to the virus, should be in a 14-day-long quarantine/isolation in order to prevent potential spread of the infection.
HOW DOES THE VIRUS SPREAD? WHAT CAN I DO TO PREVENT THIS?
The virus spreads through cough, sneezing (so if someone is sick they should wear a mask to protect others).
When the virus lands on surfaces, it can be contagious through touch (if a person with the virus touches something, that object may be contagious for hours after). So if you touch the object with this virus on it, and then touch your face (eyes, nose, mouth), you can get the virus. That’s why it’s important to take various precautions such as hand washing, using hand sanitizers, and keeping everything clean - disinfecting surfaces. Also, it's important to avoid touching your eyes, nose or mouth.
So basically, it is important to use all the normal precautions that we should be using anyway in our everyday lives but often don’t. AND don’t touch your face! (which is easier said than done)
As far as hand washing it should be with soap and water and for at least twenty seconds (sing the “Happy Birthday” song twice for good timing). When soap and water are not available, use hand sanitizers with at least 60% alcohol.
You can use bleach-based disinfectants on surfaces, but NOT on your body.
WHAT SHOULD I DO IF I DON'T HAVE SYMPTOMS?
If you don't have any symptoms and have not been exposed to the virus as far as you know, and if you live in a region where there has been at least one case of COVID-19 (basically, if you live anywhere in the world), I would recommend the following:
Yes, this sounds extreme, I agree, but not only this would lower your risk of getting infected, but it will also slow down the spread of the disease in the community.
In Italy, people felt the same way (were not taking the virus too seriously), until the government finally put the whole country on lockdown. Unfortunately, it was a few weeks too late.
Let's learn from the mistakes of others.
Our governments have a tough job at trying to control this emergency - they are trying to prevent panic and may have other reasons to suggest only mild and partial restrictions at this time.
We, global citizens, don't have to wait for our governments to take extreme actions too late, we need to take responsibility, and do the right thing NOW to help slow the spread of this virus.
PLEASE DO THE ABOVE! TRUST ME ON THIS!
Don't worry about work, meetings, bills, birthday parties, credit cards, business, etc. - we are talking about hundreds of thousands of deaths that could be prevented if we do this before our governments have to force us to do it weeks from now.
PLEASE DO THIS NOW.
WHY SHOULD WE CARE ABOUT THIS VIRUS?
The issue with the virus is how fast it spreads, that we don’t have immunity to it, and that there is no treatment or vaccine available at this time.
Unfortunately, as a global community, we have missed a chance to prevent the spread of the virus. The prevention challenge lies in the fact that people with no symptoms could be infecting others and unless an extremely strict quarantine is followed (like they’ve eventually done in China and now in Italy) there is no way to monitor or control the disease outbreak.
The other challenge in the US is that until 03/12/2020 very few test kits and labs that can run the tests. So only sick patients who had either known exposure or known travel history to high-risk countries were tested, which likely means that many patients who did contract the virus but didn't travel and didn't have a known exposure were not diagnosed and were in the community as everyone else, potentially exposing others to the virus.
The other challenge is that most societies will not be able to create the environment where all citizens will stop contact with each other. Each government will have to make difficult choices regarding this and find a nearly impossible balance between several critical aspects of this pandemic:
CAN I BE TESTED FOR THE VIRUS?
As of 03/16/2020, in the US, testing for Coronavirus depending on test kit and lab availability.
Testing is done similar to a flu test - by using a long q-tip type swab in the back of the throat and deep in the nose (it may be a little uncomfortable but not painful). The swab is then placed in a test tube and sent to a laboratory for diagnosis.
Drive-through test centers are being established throughout the country.
www.CORONATESTMAP.com is a free private website that will be adding new drive-through centers daily. Please check them out, and spread the word (Please contact them if know of a location that they haven't listed yet.)
If a person tests positive by the local laboratory, it is called "presumptive positive". The test must be then confirmed by the CDC, at which point if it becomes "confirmed positive". (Based on the information available to me at this time, CDC no longer requires confirmation from local test sites; however, I do not know whether it is universally true across all of the United States.)
If you feel sick, please call your doctor's office (for severe symptoms/illness call 911.)
WHAT ELSE CAN I DO TO PREVENT THE SPREAD OF THE VIRUS?
In addition to washing hands, using efficient hand sanitizer, not touching your face, and disinfecting surfaces, I would highly recommend avoiding places with many people (especially enclosed spaces). In fact, minimize all nonessential contact. In fact avoid any contact as much as possible.
When greeting people, do not hug or shake hands - wave instead. (All touch contact should be minimized to decrease the risk of spread of the disease. This may sound extreme, but keep in mind, the disease is mild in the vast majority of cases, but we just need to do our best not to infect someone who might not do so well.)
Additionally, although I’ve seen a wide range of recommendations on how far to stay away from people who have respiratory symptoms. It appears that there is a possibility to get the virus even at a 6 foot distance of someone (please note that most precautions recommend only a 3 foot distance). Personally, I would recommend a 6-foot distance, if possible. So if you or someone is coughing or sneezing keep at least 6 feet away.
SHOULD I WEAR A MASK?
Wearing a facemask/surgical mask is mainly useful if you yourself have symptoms, but it does not fully protect you from others who are sick. So if you don't have any symptoms, you do not need to wear a mask unless you are taking care of someone who has COVID-19.
WHO SHOULD BE IN ISOLATION?
If someone has been exposed to the virus and is asymptomatic, it makes sense to quarantine (be isolated from other people) for at least 14 days.
If someone has tested positive for coronavirus, based on what I’ve read in the scientific studies of the virus, I would lean towards a longer quarantine - around 6-7 weeks. The authorities of each region and country will determine what's not only scientifically sound but also feasible and realistic based on how the pandemic is unfolding.
In my opinion, every attempt at minimizing contact with other people is essential in slowing the spread of the disease. Remember, people who have contracted the virus may be infectious to others without showing any symptoms. I believe that in addition to avoiding sick contacts and staying home if we have any respiratory symptoms (and being tested for the virus when appropriate and possible), we should do everything in our power to minimize any potential virus transmission. Many places, local governments have requested cancellations of large events (250 people or more); however, this may not be adequate. The longer we wait to self-isolate the more people will end up dying.
IS IT AS BAD AS IT SOUNDS?
Unfortunately, yes, it is. We are underreacting, not overreacting.
On March 11th, 2020, World Health Organization has called it a pandemic - a major global disease outbreak
As of the morning of March 12th, 2020, World Health Organization is still being hopeful that we can contain the pandemic. Personally, I believe that we are past that based on the slow response from the authorities in different countries, including the U.S. The challenge now is not to “prevent” the pandemic - we are already there, to slow down the spread as much as possible so that the healthcare system doesn’t get completely overwhelmed and so that hospitals are not overflowing with patients.
In Italy they are running out of intensive care and hospital beds and other resources to the point that doctors have to decide who they are going to treat and whom they will let pass (so those with low chance of survival are no longer treated). As far as I know, there is now a major shortage of doctors in the North of Italy, so they have to work even if they themselves are infected with the virus and only mildly ill. Note, that there are fewer doctors per capita in the US than in Italy - so will might be facing the same scenario (if not worse) in the US in the upcoming weeks (fortunately that’s probably not the case here in San Diego, but we need to be prepared).
No need to panic about any of this, but each person must do his or her part in minimizing the spread of the virus. It’s is critical that we do this (it will save many lives).
Epidemiologists estimate that if the virus continues to spread at current rates, that what we are seeing now is only a tip of the iceberg. From what I’ve read and the from the graphs I’ve seen in terms of infection rates, it would not be surprising that this pandemic will continue into 2021, and I would expect a rapid increase in cases in the upcoming weeks. I am not an epidemiologist, but from what I understand, these types of pandemics that have not been contained from the beginning (such as this one) only subside after a large percentage of the population has been infected at which point we will begin to build up immunity. The fall in the infection rates will begin at that point. So it will get worse before it gets better.
Again, no need to panic. Just prevent, prevent, prevent. As much as we can!
Please use the resources that are available - websites of World Health Organization and CDC, local healthcare and government organizations, your doctor and local clinic. We are all in this together. We should try to support each other.
HOW MANY PEOPLE ARE SICK?
As of 03/16/2020 people in 172 countries have been affected by the disease.
The issue is not how many people are sick right now, but how quickly the disease is spreading - the numbers of infected and dying are rising exponentially every day. That's why it is such a concern and that's why we cannot approach like we would a cold or a flu.
The data below reflects total cases and total number of deaths. Please note, a better way of looking at this information is by looking at the number of cases/10,000 of the population of each country as opposed to the total number of cases. But in any case, if you are following this blog, you will see how rapidly the numbers are going up and it is a HUGE concern.
WORLD: 216,994 cases (15,744 new). 7,965 (817 new deaths).
CHINA: 80,84 cases (13 new). 3,237** deaths (11 new)
ITALY: 35,713 cases (4,207 new). 2,978 deaths (475 new)
IRAN: 17,361 cases (1,192 new). 1,135 deaths (147 new)
SPAIN: 14,746 cases (2,920 new). 638 deaths (105 new)
GERMANY: 12,327 (2,960 new). 28 deaths (2 new)
FRANCE: 9,134 cases (1,404). 264 deaths (89 new)
S.KOREA: 8,413 cases (93 new). 84 deaths (3 new)
USA: 8,055 cases (1,644 new). 127 deaths (18 new)
. . .
* Countries are listed by total number of cases (top 8)
** The number of deaths in China which I posted on 03/16/2020 was incorrect. I apologize for the error. Current data is accurate.
*** I am doing my best to report the numbers as accurately as possible, but the actual numbers may be different based on testing availability and reported data, but this is as close as we can get. Source of data is Worldometer. Numbers last updated on 03/17/2020 at 11:50 AM PST. (TBA = to be announced)
WHAT DO THESE NUMBERS REALLY MEAN?
These numbers mean the following:
WE ARE ONLY DAYS BEHIND ITALY!
Based on the available information about the rate of spread of the virus, experts believe that the United States is only 16 days behind Italy.
Take a look for yourself using this Online COVID-19 lag tracker tool.
When we connect the dots in the graph below, we can see that the pattern of the spread of the virus is the same in the US as Italy and other European countries.
If we follow the path of the graph, we can see that the number of cases is rapidly going up! Look at the numbers in italy, and your will see where we are going to be in a few weeks.
No need to panic, but it's important to know the reality and to take appropriate actions.
Approximately 2 weeks ago, the number of cases in Italy were more or less what they are today in the USA.
If everything continues as is, in approximately 16 days, we will have similar numbers of new cases and new deaths as Italy does now!
The Italians are sharing with us what they should have done - more drastic measures and sooner. We can't ignore this, if we want to prevent as many avoidable deaths as possible!
Time is running out!
WHAT IS A GROWTH FACTOR?
Growth Factor is an important number which tells us how things are going - whether the infection is on the increase or the decrease. Growth factor should be less than 1 and eventually 0.
This is how growth factor is calculated Growth Factor = new cases each day / new cases the day before. For example, if yesterday there were a 100 new cases, and today there are 150 new cases, the growth factor is 150/100 = 1.5.
We want the number of new cases to be less each day than the day before.
You can calculate the growth factor for your region to know whether to be relieved or concerned.
Based on how [slowly/inadequately] the governments around the world are responding to this crisis (I am sure to the best of their abilities), I would expect that the growth factor will be above 1 for several months around the world with an exception of only a few regions, unless drastic containment measures are instituted world-wide immediately.
P.S.: I am sharing this in an effort to raise awareness and yes, concern, but not panic. The more aware the people are, the more we can do to contain the virus as humanity. Worry has never helped anything.
Let's work together to contain this! Please do your part! Minimize contact with others, wash your hands, if you are sick self-isolate and see a doctor.
COVID-19 NEWS IN CALIFORNIA
California: officially 598 cases, 13 deaths.
Current official data from 03/17/2020 06:00 PM PST from State of California Department of Public Health.
On 03/15/2020, California Governor Gavin Newsom has urged people with chronic health conditions and senior citizens over 65 years of age to isolate themselves.
There is an online COVID-19 screening survey which is intended to help California residents find out whether or not they need further testing (in an attempt to expand access to screening). Thes tool is currently available to residents of Santa Clara and San Mateo Counties: https://www.projectbaseline.com/study/covid-19/
I will continue keeping you updated!
COVID-19 NEWS IN SAN DIEGO
San Diego County Residents: 51 cases, 0 deaths
San Diego Federal Cases (at Miramar Base): 5 cases, 0 deaths
Non-San Diego County Residents in San Diego: 4 cases, 0 deaths
TOTAL: 60 cases, 0 deaths.
This is current official data is from 03/17/2020. San Diego County updates the official numbers of its website daily around 4pm.
Testing for COVID-19 is available in San Diego. Although the exact testing criteria may differ slightly between different institutions, one can most definitely be tested if he or she has typical COVID-19 symptoms and has had travel history to the "hot zones" such as China, Italy, or Iran.
Turn-around for test results can be as few as 4 hours for inpatient location, and up to 48 hours or more for most outpatient locations (clinics, doctor's offices).
SAN DIEGO BREAKING (GOOD) NEWS
From San Diego County News Center:
"To slow the spread of COVID-19, the following guidance is being issued and is effective from March 17 through March 31, 2020:
WHEN WILL THIS VIRUS GO AWAY?
Unfortunately, based on various predictions from the experts on pandemics, most likely the virus will continue its "disruptive work" into 2021.
Most definitely, it will not be "just a month or two".
WHAT ABOUT A VACCINE?
You can come across social media posts that claim that a vaccine against the virus has been found. In my opinion, those statements are entirely false.
It takes many, many months to develop a new vaccine. I highly doubt that we will have a vaccine before 2021.
SHOULD I STOCK UP ON THE ESSENTIALS?
The idea is to isolate yourself from other as much as possible. If you are standing in line to get toilet paper "just in case", chance are you could be exposing yourself to the virus.
In my opinion, it is wise to get the basic essentials, but conser doing it without major exposure to crowds of people who are trying to do the same. Realistically, chances are, most basic needs of the population (at least in the USA) will be met during this pandemic. So don't panic.
Here is what San Diego County recommends to help prepare for the pandemic.
ARE TRAVEL BANS HELPFUL?
Limiting travel is most definitely helpful. However, partial travel restriction will not solve the problem.
I would recommend NO travel, local and domestic, even if it is not restricted by the government.
Keep in mind, the government has to keep a balance between what's necessary to contain the virus vs. what's realistic. So we, the citizens of the world, can take on some of the burden off our governments' shoulders and self-restrict travel as much as possible.
Let's stop the spread of this virus!
NON-HEALTH "SIDE EFFECTS" OF THE VIRUS
Sadly, there are several predictable, and distasteful non-health-related "side effects" of this virus:
Please be mindful of this, and please help those who are not email or online new savvy avoid these traps.
WHAT ABOUT ALL THE CONSPIRACY THEORIES?
At this point it does not matter where the virus came from or who was responsible. At this point the only thing we should worry about how to contain it. Plain and simple. So don't add this extra worry to your plate. I am sure your plate is full as it is!
We can come back to this subject after the pandemic is controlled.
ARE THERE ANY POSITIVE NEWS ABOUT THIS VIRUS?
There are several positive things that are indeed happening in the world.
For one, China's outbreak appears to be more or less contained at the moment. That's a relief. So we know - quarantine and testing definitely work.
In Italy, where the virus has spread like wildfire, and extreme measures of nearly complete isolation of the entire country has been ordered, the people are creating new coping strategies. According my Italian friends, many people have been creating virtual social gatherings with friends like daily virtual happy hours or virtual workout parties. Also there are numerous balcony-singing flashmobs - people in different towns sing and playing musical instruments on their balconies, often creating beautiful neighborhood performances singing together from their windows.
Also, our pets appear to be safe :)
WHERE DOES ALL THIS INFORMATION COME FROM?
Everything above is my summary opinion based from what I’ve learned from the official sources, extrapolation from the available scientific research data, and from some of the perspectives of epidemiologists/experts in the field. Personal accounts come from communication with people I personally know in the "hot zones" (Italy).
WHERE CAN I LEARN MORE?
WHO (World Health Organization) - WORLD primary source of information
CDC (Centers for Disease Control and Prevention) - USA primary source of information
Worldometer (statistical website run by an independent company) - additional information
CDPH (California Department of Public Health) - CA primary source of information
San Diego County official government website - local information. In San Diego you can also call 211.
INTERVIEW WITH AN EXPERT - DR. BRUCE AYLWARD
HAVE OTHER QUESTIONS?
Please click on the "Comments" below to add your question or comment. Feel free to share as well!
Dr. Maria Danilychev, M.D., is a San Diego based medical doctor with 20 years of experience and board-certified in Internal Medicine, Geriatrics, Hospice/Palliative Medicine, and as a Hospice Medical Director. Dr. Danilychev also conducts clinical trials and was one of the first responders during 9/11.