by Julia Getzelman, MD

This flu season has recently gotten more “exciting” with the appearance of a novel coronavirus which at least a few experts now admit has morphed into a pandemic. COVID-19 was first reported to have emerged from a fish market selling wild animals in Wuhan, China in December 2019, and as the virus has spread beyond China and into other countries, including the United States, it has been getting more and more media attention. Even the stock market has experienced violent declines this week as investors increasingly worry about severe business risks.

I’ve been following the medical and scientific reports around COVID-19, analyzing and synthesizing the available information. I’ve written this article because I would like you to have the facts as well as my advice regarding this novel virus. As I explain below, I see every reason for you to be well-informed about COVID-19. You may be wondering how much of your own attention COVID-19 deserves at this point and what you can do to protect yourself and your family from it. Unfortunately, more questions than answers exist at this time, but I am sharing the best information available to me.

The good news is that currently young children appear to be less at risk than older adults, and about 80% or more of healthy adults without other existing chronic health conditions who become ill with COVID-19 can expect relatively mild sickness. However, heavy cigarette smokers and persons over 80 years old should be more alarmed (and careful) because the early evidence suggests that these groups have a significantly higher risk of severe illness and, possibly, death. The best thing you can do right now to protect your health and your family’s health is to continue to indulge in plenty of hand (and nose!) washing, as well as immunity boosting foods and appropriate supplements.

What is COVID-19?

COVID-19 is the most recently discovered coronavirus which causes respiratory illness. It’s also sometimes referred to as the 2019 Novel Coronavirus, 2019-nCoV, or SARS-coV-2. Coronaviruses are a large family of viruses that can cause illness in animals or humans. Their name comes from the crown-like spikes on their surface (“corona” is Latin for “crown”). At first glance, coronaviruses are unremarkable; they’re common among animals, and in humans cause illnesses similar to the common cold, which are usually not severe. Coronaviruses have one trait that makes them particularly hard to contain: they’re zoonotic, meaning they have the ability to jump between animals and humans, which appears to be the source of COVID 19. In humans, coronaviruses can cause respiratory infections that are mild, like the common cold as well as more severe disease like SARS (Severe Acute Respiratory Syndrome) and MERS (Middle East Respiratory Syndrome).[1]

How many people have it?

The number of people who have COVID-19 is changing every day. This map has the most up-to-date numbers. However, since China is an authoritarian state where much information also has a political component, it is reasonable to assume that China is actually underreporting the real number of persons who have contracted the virus. As of today, there are far more confirmed cases in the country of origin (China) than anywhere else, but pockets of uncontained corona virus are being reported in Iran, Germany, Italy, Japan and South Korea, among others. 

To be candid, it is very likely that the virus will soon be uncontained throughout most of the world including in the US. As an illustration, on February 26, the Centers for Disease Control and Prevention (CDC) announced that a person in Solano County, California, had contracted COVID-19 without any history of travel outside the United States or close contact with another person who had a known infection.[2] Subsequent reports indicate the person is an adult woman who first checked herself into at a hospital in Vacaville where she was treated for 3 days (without knowledge she was infected with COVID 19) before being transported to a hospital in Davis, CA.

Unfortunately, the CDC refused to test the woman for about 4 days and now more than 100 persons who were exposed to her in Solano County are self-quarantining. This case of COVID-19 shows us that we need strategies beyond closing our borders to detect, contain, and treat this illness within the United States. This episode and certain others suggest that even in the US, information from certain segments of the federal government (mainly the executive branch) also have a political overlay. So, take what you hear from segments of the federal government with a grain of salt. Listen more closely to medical experts known for their integrity like Dr. Anthony Fauci, a respected immunologist and the Director of the National Institute of Allergy and Infectious Diseases (aka “NIAID”).  

How does COVID-19 spread?

Our current understanding of how COVID-19 is transmitted is based on what we know about how other coronaviruses are spread. The virus is thought to advance mainly from person-to-person, between people who are in close contact with one another (within about 6 feet). When an infected person coughs or sneezes, the respiratory droplets that are produced can land in the mouths, noses, or eyes, or be inhaled by people nearby. It’s also possible that a person could get COVID-19 by touching an object or surface that has the virus on it and then touching their own mouth, nose or eyes, but this is not thought to be the main way the virus is transmitted. The incubation period for the virus is thought to be around 2-14 days, with people being most contagious while they have symptoms.[3]

What are the symptoms?

The symptoms of COVID-19 are a lot like a cold or the flu, including a fever, cough, and shortness of breath. The CDC also reports that for confirmed cases reported illnesses have ranged from mild symptoms to severe illness and death.[4] With such a wide range of severity of symptoms, it’s no wonder that this virus has captured our attention.

What is the mortality rate?

It’s hard to say for sure. Depending on the region of the world and the available medical care, the rate appears to be somewhere between 1-3%.[5] As mentioned above, if the actual number of individuals who have contracted the virus in China has been understated, it is quite possible the actual percentage will drop. We know that the illness is worse the older the person is, with the most severe cases in patients over the age of 80. Children, on the other hand, seem to be less susceptible to infection and from what we gather at this point if they become infected, they have more mild symptoms.[6] A recent report in Lancet indicated that mortality is also more likely for persons with other chronic health conditions such as heart disease and diabetes. Additionally, heavy smokers seem to be more at risk. 

How do you test for COVID-19?

The test is basically done as a q-tip swab of the nose and/or throat.[7] The test is NOT available in primary care offices, and GetzWell does NOT have these tests. They are available only in certain locations, including certain Public Health Laboratories.[8] Additionally, because swabs must be sent to the few certified laboratories, the length of time to obtain test results can be 3 – 4 days.

If your child has cold or flu-like symptoms, contact us so that we can give you specific, personalized advice. Don’t risk exposing your child or yourself to other viruses by visiting a hospital or public health clinic unnecessarily. Keep in mind that it is significantly more likely that your child has a cold or the flu than COVID-19. And remember that regardless of the illness, we’re here to support you and your child as they recover.

How do you treat it?

There is no specific treatment for COVID-19. Rest, hydration, as well as more intensive care if needed, are ways to support recovery. Gilead already had an antiviral drug known as Remdesivir which is now being tested in China. Remdisivir was used to treat a severely ill man with confirmed COVID-19 in Washington State who has since recovered. Remdesivir isn’t yet approved to treat any disease. According to Gilead, animal testing has suggested it is active against MERS and SARS, both of which are also coronaviruses. The drug has also been tested against Ebola. This is promising potential treatment option but only for severe cases where pneumonia or severe respiratory risks exist.

What about travel?

The CDC has issued the following travel advisories:

  • Level 3: Warning / Avoid all nonessential travel—China and South Korea
  • Level 2: Alert / Consider postponing nonessential travel—Iran, Italy, and Japan
  • Level 1: Watch / Practice usual precautions—Hong Kong
  • Other areas with community spread: Singapore, Taiwan, Thailand, Vietnam.

You can stay updated on COVID-19 travel advisories here.

The decision whether to postpone or cancel a trip is a highly personal one. But it’s really easy to catch an illness on a plane, so it’s probably worth thinking twice about whether you absolutely need to take that plane trip—domestic or international—right now.

How do you protect yourself and your family from COVID-19?

The best thing you can do is keep your immune system strong! Here are our top tips for boosting your immunity every day.

Should we wear masks?

As a member of the general public who doesn’t have a cough and is not treating infected patients, you shouldn’t bother wearing a mask for your day to day activities at this point. There are still only a very few cases of COVID-19 in the United States, and COVID-19, like all viruses, is so tiny that even Particulate Respirator Masks (like the N95 masks that have been recommended during the wildfires here in California) provide little protection unless the mask is perfectly sealed to your face. The rating N95 means that it can filter 95% of particulate matter. Additionally, this type of fit is nearly impossible with small children, so it isn’t a panacea. And even with a perfect fit, it’s still an open question whether N95 masks will be effective.

What about the State of Emergency that was declared in San Francisco?

Mayor Breed’s declaring a state of emergency is about mobilizing resources and being prepared at a city and county level for any wider spread of COVID-19. It’s about planning ahead, not about the current number of cases of COVID-19. This declaration will, among other things, help the city get reimbursed by state and federal governments for money it spends on preparedness.[9]

The situation regarding COVID-19 is still developing and we are learning more and more every day. We will keep you updated with important information as it becomes available. Meanwhile, we are always available at GetzWell to answer your questions and address any concerns. If you or your children experience flu like symptoms or respiratory ailments, please make certain to advise us when you communicate with us for appointments.  

Don’t hesitate to reach out to us with questions and to let us know how we can help!

[1] https://www.who.int/news-room/q-a-detail/q-a-coronaviruses

[2] https://www.cdc.gov/media/releases/2020/s0226-Covid-19-spread.html

[3] https://www.cdc.gov/coronavirus/2019-ncov/about/transmission.html

[4] https://www.cdc.gov/coronavirus/2019-ncov/about/symptoms.html

[5]https://www.newsweek.com/coronavirus-mortality-rate-covid-19-fatalities-ebola-sars-mers-1489466

[6] https://jamanetwork.com/journals/jama/fullarticle/2761659

[7] https://www.cdc.gov/coronavirus/2019-ncov/about/testing.html

[8] http://www.cidrap.umn.edu/news-perspective/2020/02/feds-allow-state-public-health-labs-test-covid-19

[9] https://www.mercurynews.com/2020/02/27/san-francisco-declares-state-of-emergency-over-coronavirus-heres-what-that-means/

For further reading and additional sources, see https://healthykidshappykids.com/2020/02/27/coronavirus-covid-19/