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NIAID Rocky Mountain Laboratories, U.S. NIH/Wikimedia Commons

This transmission electron microscope image shows SARS-CoV-2 — also known as 2019-nCoV, the virus that causes COVID-19 — isolated from a patient in the U.S. Virus particles are shown emerging from the surface of cells cultured in the lab. The spikes on the outer edge of the virus particles give coronaviruses their name, crown-like.

Voices / Viewpoint

Coronavirus: How much of a threat?

Basic respiratory disease transmission precautions will provide the best protection for most people

Richard Davis, a retired registered nurse and health-care professional and tireless advocate for access to health care, serves as Guilford’s health officer.

Guilford

We are being bombarded with information, misinformation, warnings, and all kinds of reports about the spreading coronavirus.

How do you know what information is factual, and how would you deal with an outbreak of the virus in your community or in your home? Should you be concerned, or is there just too much fearmongering and hype to take this new disease outbreak seriously?

The only accurate, factual, and up-to-date information is being provided by the World Health Organization (WHO), the Centers for Disease Control and Prevention (CDC), the National Center for Emerging and Zoonotic Infectious Diseases (NCEZID, part of the CDC), and infectious-disease specialists and clinicians who work for state health departments throughout the U.S.

The most unreliable sources of information about coronavirus are from politicians, policy bureaucrats, and media talking heads.

Unless a person is representing WHO, CDC, or a state agency, or is an infectious disease expert, then whatever they say should not be trusted.

It’s that simple.

* * *

One of the most important pieces of information people need to know (and it’s information that you can trust, as it comes from those aforementioned reliable sources) is why coronavirus is being taken so seriously when other communicable diseases continue to spread throughout the world.

According to the CDC, 10,000 Americans have died from this year’s flu, 19 million people have come down with the flu, and 180,000 people have been hospitalized for treatment of the flu and its complications.

We have 81,000 confirmed cases of coronavirus worldwide and 2,761 deaths (mostly in China) and 90 cases in the U.S.

While those numbers would seem to make coronavirus less of a threat than the flu, there are other considerations. Also keep in mind that expert reports about coronavirus characterize a moving target that is constantly evolving.

One of the most important reasons infectious disease experts are so concerned about the spread of coronavirus is because of its mortality rate. The mortality rate for the flu in the U.S. is 0.095 percent, while 2 percent who have contracted coronavirus worldwide have died, meaning that it is 21 times as deadly.

What also worries infectious disease experts is how easily coronavirus seems to spread.

These experts do not yet know the exact mode of transmission of coronavirus, whether it is spread by droplet transmission or airborne.

If it is spread by droplet transmission, as are cold viruses, it means that when people sneeze, cough, drip, or exhale, large droplets loaded with virus will settle within 3 feet.

If this is how it spreads, transmission occurs when people make contact with surfaces where droplets land. The virus can then enter a person’s eyes, nose or mouth. That is why handwashing is so important.

With the airborne mode of transmission, in diseases such as measles and chickenpox, smaller particles become airborne and stay suspended in the air, where they can more easily enter a person’s respiratory tract.

The CDC has indicated that coronavirus is likely primarily spread by the airborne route, accounting for its rapid spread.

“Two percent case fatality is still a tough case fatality when you compare it to the case fatality for the seasonal flu or other things,” Dr. Michael Ryan, executive director of WHO’s Health Emergencies Programme, told reporters recently.

“A relatively mild virus can cause a lot of damage if a lot of people get it,” he added. “And this is the issue at the moment. We don’t fully understand it.”

* * *

Infectious-disease experts writing in the Journal of the American Medical Association looked at the records of 44,672 people with confirmed cases of coronavirus. They found that 36,160 — or 81 percent — had mild cases; 14 percent had severe cases; and 5 percent of cases were considered critical. They also found a mortality rate of 2.3 percent, meaning that of those 44,672 people, 1,023 died as a result of the coronavirus.

Keep in mind that any figures presented are simply a point in time, that no one knows what the percentages will be in the future, and that no one knows how the new virus will affect populations of different countries.

People also want to know how to protect themselves if they are at risk of being exposed to the coronavirus. A vaccine is being worked on but will not be available for about a year; that means it will have little or no impact on the current outbreak but may help with future outbreaks.

Coronavirus symptoms are similar to any acute respiratory illness, including the flu, and the only way to accurately diagnose it is through testing.

Basic respiratory disease transmission precautions will provide the best protection for most people. Those most at risk of having a severe or critical case of coronavirus are people with weakened immune systems and people who suffer from chronic respiratory illnesses.

Frequent handwashing and containing individual coughing remain the best methods to prevent transmission of a respiratory disease. Most experts will tell you that face masks are not recommended for the general population. The only masks that will prevent transmission of respiratory illness are those that are individually fitted and that form an airtight seal. Those kinds of masks are best suited for use by health care professionals working within health care institutions.

If coronavirus begins to spread throughout the U.S., the best protection that can be afforded to people is to follow the above recommendations, maintain your health, and keep away from gatherings of large numbers of people.

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Originally published in The Commons issue #551 (Wednesday, March 4, 2020). This story appeared on page D1.

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