Making sense of COVID-19: Practical steps all of us can take

Our understanding of COVID-19 and its impact on our global communities is changing daily.

We recently spoke with Zohra Prasla, a pulmonary/critical care physician, to get the latest on the practical steps we can take to protect ourselves and our families – including why certain practices are recommended.

What exactly is the coronavirus?

• Coronaviruses are a family of viruses that can cause infections in people and animals. Most coronaviruses simply bring on the common cold. Some are more infectious. The viruses causing SARS and MERS outbreaks are also coronaviruses.

• The coronavirus strain that we are fighting now is SARS-CoV-2. The disease it causes is called COVID-19.

• What to look for: Cases can be mild to severe. Many experience fevers (often low grade), cough, shortness of breath, body aches, and headaches. Some present with gastrointestinal symptoms, like abdominal pain or diarrhea, in addition to one or more of the above symptoms. And less commonly, some people experience a loss of smell.

• Data from China and Italy show a greater impact on the older demographic. In the U.S., however, very early data from the CDC shows that while about half of the patients who were hospitalized are older than 65 years of age, 25-35% of patients ages 45-64 are also requiring hospitalization or ICU care, which is a higher portion than in most other countries. People with other medical problems, like high blood pressure, diabetes, and cancer, among others, are at high risk of getting sick from COVID-19, but healthy people can still get severe disease.

• There is a lot we still don’t know. China first reported the disease on Dec 31. Less than three months later, the disease is covering the world – a true pandemic. We don’t know how long it takes from exposure to exhibiting symptoms, but observational data shows that 97% of people show symptoms within two weeks, with a median time of five days. Some people never show symptoms but can still spread the virus. In general, a person can spread the virus to two to three others, which leads to the heightened focus on social distancing to limit spread. We have no randomized controlled trials yet to confirm characteristics of the disease and treatment.

Practical steps and why we should take them

• Those having more severe symptoms, including a high fever, shortness of breath, and weakness or confusion, should seek care immediately.

• Those with milder symptoms should avoid going to the hospital and should first call their local health department or their primary care doctor for guidance. Why? We have not seen this type of pandemic in our lifetime, and hospitals – particularly smaller ones – are easily overwhelmed.

• Wash your hands often with soap and water for at least 20 seconds, avoid touching your eyes, nose, and mouth, and maintain a distance of at least 6 feet from others. Why? The virus is spread through respiratory droplets, much like a cold. Droplets can travel up to about 6 feet.

• Wipe down surfaces frequently, especially common areas and things you touch often, like a phone, keys, and computers. Why? The virus can last from several hours to a couple of days on various surfaces. The data is still coming in. It’s an important precaution while we seek to better understand the virus’s behavior.

• If you have been exposed, or think you may have been, maintain isolation for a minimum of two weeks. Why? This is generally the amount of time it takes to exhibit symptoms and for spreading it to others. In the absence of a real treatment, we are hoping to keep people from getting sick.

• It is important to follow social distancing and to stay home as much as possible. Why? People can spread the virus even before they show symptoms. Cases start at different times, and shelter-in-place orders have been inconsistent, with varying start times from municipality to municipality. Given it is impossible to totally shut down the country, we need a minimum of two weeks just to see if we have flattened the curve (or seen a decrease in the number of new cases). Overall, we need more time to gauge impact.

Cooperation is alive and well

According to Dr. Prasla, we are seeing strong cooperation among healthcare providers and community groups across the world, who are all working hard to provide care to those who have contracted the virus. Groups of physicians are also providing helpful guidance to one another on social media. COVID-19 can be scary and while there is a lot of information out there, it’s important to follow the content of reputable sources. Here are a couple of our favorites:

1. CDC web site: https://www.cdc.gov/coronavirus/2019-nCoV/index.html

2. Harvard Medical School: https://www.health.harvard.edu/diseases-and-conditions/coronavirus-resource-center

Ultimately, we must all be logical and responsible, and take the necessary precautions to protect everyone.