Here’s what we know about new coronavirus, what we don’t and how to protect your family
As King County public health officials have learned more about local transmission of the novel coronavirus, they alerted the community Tuesday via Twitter that “what we’ve seen with the level of community spread has raised the level of concern about the immediate threat of #COVID19.”
For weeks now, the Centers for Disease Control has told Americans to expect more cases of coronavirus, but the steady drumbeat of new findings over the last seven days has sparked some anxiety across the nation. Jeff Duchin, the health officer for Public Health Seattle & King County, said this was bound to happen as states got the capability to do their own diagnostic testing.
“Because of our national testing criteria, because of the limited availability of tests has focused on more severely ill people, we are not aware of whether or not there are people in the community who have mild illnesses that look just like the common cold or a mild flu that may be due to COVID-19,” Duchin said. “People shouldn’t be scared of (new diagnoses). People should understand that this disease is likely to increase, as it has in other countries.”
The public needs to understand, Duchin and others said, that there won’t be capacity to test every suspected case, and the onus for preventing the spread of COVID-19 will fall upon individuals, schools, employers and communities.
So far in Washington state, 27 people have been confirmed to have the illness, and nine of them have died. No one can say how large an outbreak Washington or the nation will have, Duchin said, but public health officials are doing all they can to slow the progression of the new coronavirus.
“We want to have fewer infections if we have a choice,” he said. “We want those infections to be spread over a longer period and not happen all at once.”
Travel restrictions, airport screenings, and aggressive work by local health agencies to identify the sick and isolate them are all measures intended to give U.S. citizens, schools, businesses and workplaces a chance to take actions that will lower the risk of anyone becoming ill, Duchin said. They can also prepare for the possibility that schools, events and businesses may be shut down.
“We may get to a point where we recommend canceling large public gatherings, social events, sporting events, entertainment until we get over what might be a large outbreak,” Duchin said. “We don’t know what to predict at this point. ... We want to have fewer infections if we have a choice. We want those infections to be spread over a longer period and not happen all at once.”
Certainly, there are plenty of unknowns when it comes to COVID-19, and local, state and federal leaders have all acknowledged that the situation is still evolving. So, let’s sort through what epidemiologists know, what strategies they are using to blunt the impact of the disease in the U.S. and what they will be working to find out over the coming weeks and months.
You may have heard this virus referred to as a new coronavirus, a novel coronavirus, COVID-19 or 2019-nCoV, but they all refer to a zoonotic disease that at some point spilled into the human population. Public health officials first took note of the respiratory illness in December after it infected several dozen people who had visited a public market in Wuhan, China.
Viruses are not living things, epidemiologists said, and they cannot live long outside a host. Certainly, they say, they could not survive a trip on goods or packaging from China. Rather they said, they are spread when people cough or sneeze, spraying droplets packed with the pathogens into the air. Those pathogens land on other people’s skin and on surfaces.
“Don’t touch your eyes, don’t touch your nose, don’t touch your mouth unless you’ve cleaned your hands first,” Duchin said. “Please have consideration for your community members. Do not go to school or work if you’re sick, especially if you’re a health care provider. If you know other people are ill, stay away from them.”
COVID-19 causes coughing, fever and shortness of breath, and the symptoms are so severe in some people that it caused pneumonia and ultimately death. Although it originated in bats, epidemiologists studying its genealogy say it appears the virus infected another animal that then gave the illness to humans.
One of the people found to have the disease in December had no known ties to the Wuhan market. That case — and models of the virus’ genealogical development — have led epidemiologists to say that COVID-19 likely had infected people before the Wuhan market outbreak.
Coronaviruses are a hugely diverse, big family of viruses, and most mammals have coronaviruses, said Christine Kreuder Johnson, an epidemiologist at the University of California, Davis, who has built a career on studying exotic zoonotic diseases. Until COVID-19 came along, she said, there were only six coronaviruses that infected humans.
SARS and MERS, for example, are members of that family. Those two diseases have proven far more challenging to beat than COVID-19. Severe acute respiratory syndrome has killed roughly nine of every 100 people infected with it, and the Middle East respiratory system claims the lives of 30-40 out of every 100 people who had it.
Roughly 80 percent of the people who get the new coronavirus will experience no symptoms or mild symptoms, according to public health officials.
“You get anywhere from 15 to 20-some percent who are going to go on to require advanced medical care — hospitalization, possibly intensive care,” said Dr. Tony Fauci, the director the National Institute of Allergy and Infectious Diseases. “For the most part, the people who get in trouble and tragically who die from this are people who are elderly and/or have underlying conditions — heart disease, chronic lung disease, diabetes, obesity.”
But there also will be deaths that defy that norm, Fauci said.
“Every once in a while, you’re going to see a one-off, you’re going to see a 25-year-old person who looks otherwise well who is going to get seriously ill, but the vast majority of the people who get into trouble do have these underlying conditions,” Fauci said. “That’s why it confuses people because they say, ‘Well, you just said that,’ and then there’s a report of a 40 (year old) physician from China who died. That’s going to happen. That happens with influenza. Most of the time, influenza kills people who are at advanced age and underlying conditions, but you hear in the media every once in a while of a college student who got infected and ultimately died.”
Of course, the first U.S. case of coronavirus was announced Jan. 21 in Seattle. As of Tuesday, 124 people had been diagnosed with it in the U.S., and nine Washington residents have died. Globally, the disease has claimed the lives of more than 3,100 and has been diagnosed in more than 93,000.
The mortality rate from coronavirus is not yet known because so many people never seek medical care, but Fauci has said the mortality rate may turn out to be less than 1 percent, no worse than the percentage who die during a bad flu season. In an article in the New England Journal of Medicine, Chinese researchers noted a mortality rate of 1.4 percent among 1,099 patients they studied.
Until last week, leaders at the CDC had limited testing for coronavirus to travelers who had been to China and their close contacts who showed symptoms, but after a California woman tested positive for the disease, despite no known connection to a traveler, the CDC expanded testing to people hospitalized with severe acute lower respiratory infections that had no explanation. On Tuesday, Vice President Mike Pence said the CDC would allow doctors to order tests on any American.
Washington’s public health leaders have broadened the criteria, allowing county public health officers to recommend testing when clinical findings or epidemiology of an illness is unresolved. And, because tests can now be done by Washington’s state lab, the results often are available the same day.
Public health officials are not out to test every single case, Duchin said. Rather, they are using testing now to evaluate where problems lie and to allow clinicians to better guide treatment of severely ill people that are hospitalized.
Duchin and others said that, while there have been cases where asymptomatic people transmitted the disease, the greatest risk is when a person is coughing and sneezing, shedding the coronavirus all around them. Health departments simply will not have the manpower to implement containment around all the people with mild cases of COVID-19.
That’s where an educated public comes in, he said, so people need to go to the CDC site that provides nonpharmaceutical interventions that individuals, schools, employers and communities can make. At some point, Duchin said, the public must focus on alternative means of doing business and adopting healthy habits such as hand-washing.
How to prevent the spread of new coronavirus
- Wash your hands frequently with soap and water. If you cannot get to soap and water, use alcohol-based hand sanitizer with at least 60 percent alcohol.
- Do not touch your eyes, nose, or mouth with unwashed hands.
- Do not get too close to people who are sick.
- Stay home when you are sick, and see a doctor immediately to be evaluated for COVID-19. And employers should insist workers fully recover before returning to work.
- If you have traveled to areas with heightened levels of exposure, inform your employer immediately.
- Businesses should avoid sending staff on business trips to areas where there have been outbreaks. Currently, the U.S. State Department is advising against all travel to China.
