COVID-19: Serious Action Against a Novel Virus

by Glenn W. Wortmann, Section Director, Infectious Diseases
March 30, 2020

Taking cues from how other countries are managing COVID-19, government and healthcare leaders have implemented dramatic and necessary steps to slow its spread. Because there is not yet a cure for this new virus, we’ve seen schools and non-essential businesses in many regions close, and Americans are encouraged to stay inside and avoid contact with others in a sweeping effort to contain the virus’s spread.

MedStar Washington Hospital Center began preparing for the potential onset of the virus last December, when it was first reported in China. We have been working aggressively and proactively to educate the community, carefully manage resources, and protect the members of our healthcare team who are committed to serving our patients.

COVID-19, a Coronavirus With a Serious Twist

Here’s what we know about the virus:

COVID-19 is a flu-like illness that can cause a severe respiratory reaction, especially in the elderly and those with respiratory problems and other underlying conditions.

Although it is caused by a novel coronavirus, coronaviruses themselves are nothing new—in fact, this same family includes viruses that cause the common cold. But COVID-19 is much more serious—similar to the viruses that have caused Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS).

At the end of 2019, this new coronavirus began causing severe respiratory illness in China, where it affected more than 81,000 people with nearly 3,200 deaths. With study, scientists determined it to be a new coronavirus, officially known as SARS-CoV-2. The illness it causes was named COVID-19.

On March 11, the World Health Organization declared that the virus had reached global pandemic proportions, which means it is continuing to spread as opposed to being an endemic disease with a stable number of infected patients.

Signs and Symptoms

Every day in the Washington, D.C. metro area, as in most regions across the U.S., we’re seeing rapid increases in patients stricken with the virus.

Overall, globally, about 80 percent of those infected experience respiratory illness—dry cough accompanied by fever and feeling sick and achy for a week or so. Some people will show mild symptoms, feeling only a little under the weather before bouncing back quickly. Others can be infected and not realize it, displaying no symptoms.

Most children, quite fortunately, seem to do very well with COVID-19. We don’t know exactly why just yet, but that’s been a piece of good news.

However, for some infected people, the disease can be life-threatening. About 15 percent of patients require hospitalization for the severe respiratory problems they experience, including pneumonia. It’s this group we’re most concerned about, and it’s for them in particular that we’ve taken nationwide infection control measures.

It’s still too early to know an accurate death rate globally, although it was declared to be as high as three percent in China. Better news comes from countries like South Korea, which—although initially hard-hit—was able to move quickly with testing and early diagnosis. There, they’ve tested 250,000 patients, and experienced a fatality rate of around 0.6 percent.

Until Medical Treatment, Social Distancing

So what can we do?

Although we are still learning a lot about the virus, we know it poses a measure of danger, especially to older people who contract it. The scientific and medical communities worldwide are working hard to develop treatments and a vaccine, but those will take time.

Until those tools are widely available, the most effective way to slow the progress of the virus is via social distancing. We’re dusting off the playbook from how we dealt with the measles, polio and smallpox outbreaks of the 1940s and 50s, and applying those lessons now.

Washing your hands correctly and frequently is always important, and especially during an outbreak of a contagious disease. However, it’s important to understand that COVID-19 is mainly spread through droplets in the air—usually within about a six-foot radiusthat can occur when infected individuals sneeze or cough.

And lab experiments show us that this virus can survive on surfaces. So, again, it’s imperative to wash your hands and keep your home environment as clean as possible. Hand sanitizer is useful when you’re not near soap and water. But, because the virus spreads so readily in the air, handwashing isn’t enough. Social distancing helps us avoid coming into close enough contact to spread the virus.

Protecting Those Most at Risk

Social distancing is as much about protecting yourself and your family as it is about protecting the whole community.

As with flu and other viral infections, people with impaired immune systems—such as those undergoing chemotherapy or with auto-immune disorders—may be hardest hit by COVID-19. Also at risk are patients with chronic respiratory illnesses, such as Chronic Obstructive Pulmonary Disease (COPD), asthma, or emphysema.

And as we age, the immune system weakens. So, similar to what we see with flu, those over age 70 are at higher risk of developing pneumonia.

Staying put helps protect everyone.

#SocialDistancing is as much about protecting yourself and your family as it is about protecting the whole community from #COVID-19, says infectious diseases expert Dr. Glenn Wortmann. #TogetherApart https://bit.ly/2UmtJGG via @MedStarWHC

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If You Have Symptoms

Remember, fever is your main warning sign, along with a dry cough and shortness of breath. If you have these symptoms but they seem mild, or if you don’t have difficulty breathing, you should ride it out at home. Get plenty of rest and fluids, and self-quarantine to avoid infecting others.

Reach out to your healthcare provider if or when you feel severely sick, have trouble breathing, or have a fever of 100.4 F or higher. Take your temperature two or three times over the course of an hour. If it is consistently above 100.4, it’s time to do the following:

  • Call for advice, first. This cannot be overemphasized. It keeps you at home and reduces your risk of spreading the illness. And it helps your healthcare team manage very limited resources during a time of unprecedented demand
  • That first call should be to your primary care doctor to determine the best course of action. If you cannot reach your primary care provider or don’t have one, you can have a virtual consult via MedStar Health eVisit
  • If your provider recommends a visit to the hospital, call ahead, so the team can prepare properly for your arrival
  • Not everyone can or should be tested—there are not enough test kits for widespread testing yet. But certainly, if your provider recommends it, MedStar Health Urgent Care locations are equipped for testing. Please call ahead before seeking care at one of these locations

Decisive Action Can Save Lives

The fast spread of COVID-19 is outpacing medical science. We know the virus can survive on surfaces, but we don’t know for how long. We don’t know if those infected will develop immunity. We don’t know how long the virus will persist in the community, or if warm weather will make it better or worse. And we don’t know how long social distancing will be recommended.

The important takeaway is that we are all in this together. Following guidelines from healthcare organizations could save your life and others—your elderly friends and relatives, those with underlying conditions, and others you’ve never met.

It’s inconvenient at a minimum. It can be scary. But other countries are making progress—the curve of infection is flattening, with fewer total cases. If we take similar precautions and avoid repeating mistakes, we can expect to see a decrease over time.

Category: Healthy Living, In the News     Tags: corona virus social distancingcovid-19Id-1qinfectious-diseasesProtecting yourself from coronavirus