Coronavirus: How Worried Should You Be?

For weeks, the global outbreak of the new coronavirus — also known as COVID-19 — has dominated the news. More than 100,000 cases — and over 3,300 deaths — have been reported worldwide, the vast majority of them in mainland China. In the U.S., 17 states have confirmed their first cases, pushing the nation’s total to more to 400, with 14 deaths linked to the virus as of March 8. As the U.S. ramps up testing for the virus, the number of cases is expected to grow rapidly.

Fueling fear are reports of person-to-person spread of the virus — one of the factors that have prompted the CDC to declare that “the potential public health threat posed by COVID-19 is high, to the United States and globally.” The CDC also cautions that older people and those with certain medical conditions, such as heart disease, diabetes and lung disease, seem to be at higher risk for serious illness, while the disease is likely to be mild in most healthy people. Here is the latest on the virus, including the answers to frequently asked questions and the best ways to protect yourself and your family.

What is the new coronavirus and where did it come from?

Coronaviruses are a family of viruses that cause respiratory illnesses ranging from the common cold to more severe infections, such as Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS). COVID-19 is a new strain that has not been previously detected in people. The name “coronavirus” comes from crown-like projections on the viruses’ surface.

Coronaviruses are zoonotic, meaning that they can be spread between people and animals, including camels, cattle, cats, rats and bats. Initially, people at the epicenter of the outbreak — Wuhan, China — had some connection to a large seafood and live animal market, suggesting that the virus may have started through exposure to infected animals, the CDC reports.  Later cases have shown that COVID-19 also spreads from person to person.

What are the symptoms of COVID-19 and how likely it is to cause serious illness?

Symptoms vary considerably, and some people who get it may have few or no signs of illness. Common symptoms are fever, shortness of breath and cough. More severe cases can cause pneumonia, severe acute respiratory syndrome, kidney failure and even death. 

On February 17, 2020, the Director-General of the World Health Organization (WHO), Tedros Adhanom Ghebreyesus, presented the following information on the severity of COVID-19, based on an analysis of data from 44,000 confirmed cases in China: 

• More than 80 percent of people with COVID-19 experience mild illness from which they can recover
• About 14 percent developed severe illness that caused breathlessness and pneumonia
• About 5 percent had critical illness that included septic shock, respiratory failure and multi-organ failure
• About 2 percent died
• Relatively few children developed COVID-19
• The risk appears greatest in people who are elderly or have underlying medical conditions

How does the danger of covid-19 compare to that of the flu?

In March, Tedos released updated information from WHO reporting a 3.4 percent global death rate from COVID-19. That is much higher than seasonal flu (which kills about 0.1 percent of those who get it), but still means that more than 96 percent of those who catch the new coronavirus will survive the infection.

A new article in New England Journal of Medicine, coauthored by Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Disease, offers a more optimistic view, stating that the true fatality rate of the COVID-19 “may be considerably less” than 1 percent and “may ultimately be more akin to those of a severe seasonal influenza (which has a case fatality rate of approximately 0.1%) or a pandemic influenza (similar to those in 1957 and 1968) rather than a disease similar to SARS or MERS, which have had case fatality rates of 9 to 10% and 36%, respectively.”

Moreover, flu is vastly more common than COVID-19. During the current flu season, the CDC estimates that 34 to 49 million Americans caught influenza, leading to 350,000 to 620,000 hospitalizations and 20,000 to 52,000 deaths. Not only can getting vaccinated against the flu dramatically lower these risks, but for those with heart disease, flu shots have been shown to lower heart attack and stroke risk over the next 12 months by 61 percent, according to a recent analysis of studies of nearly 7,000 patients.

Similarly, getting vaccinated against pneumonia, which the CDC advises for everyone age 65 or older and younger people with certain medical conditions, also helps protect against cardiovascular events. That’s because both vaccines help people avoid inflammation, the fire in the arteries that can ignite heart attacks and strokes in people with heart disease (plaque).

How is the virus transmitted?

While there is a lot that is not yet known about the new virus, it is thought to spread through large airborne droplets released when an infected person coughs or sneezes. Since this is a virus that infects the lungs, exposure could occur if an infected person coughs or sneezes near your unprotected face and you inhale the droplets. Because the droplets are relatively heavy, they don’t linger in the air long — but can contaminate surfaces and objects a sick person has touched.

Therefore, anything a sick person may have touched could be contaminated and potentially infectious for up to a week, according to some experts. That means your nose or mouth could get infected via your hands through contact with infected objects and surfaces. Most of us touch our noses and mouths 90 times a day, on average, highlighting the supreme importance of frequent hand washing as one of the best ways to avoid getting coronavirus and other germs. Studies show that overall, 80 percent of infectious diseases are spread by touch!

How effective is hand washing?

Numerous studies have shown that clean hands save lives! To wash away germs, follow these simple steps before and after preparing food, after changing diapers or using the toilet, after sneezing, coughing or blowing your nose, after touching an animal, and after touching garbage or any surface or object that may have been contaminated by a sick person:

• Wet your hands with clean, running water (warm or cold) and remove jewelry. A recent study compared bacteria counts on the hands of 50 healthcare workers who wore rings to 50 who didn’t. Hand washing lowered levels of staph bacteria by nearly 50 percent for those without rings, but only 29 percent among ring wearers.
• Lather up with soap. Avoid antibacterial products, which don’t work any better than regular soap, according to the Mayo Clinic, and can even lead to bacteria becoming resistant to that antimicrobial ingredient.
• Rub hands together for at least 20 seconds. To get the timing right, kids can recite the alphabet as they scrub or sing the “Happy Birthday” song twice. Pay equal attention to all surfaces of both hands: Research shows that righties don’t wash their right hand as carefully as the left, while the opposite is true for lefties. Fingernails and fingertips typically harbor the most microorganisms.
• Rinse thoroughly under running water; the force of the stream sweeps dirt and germs down the drain. And be sure to dry well, which helps rub away remaining microbes. A study published in Epidemiology and Infection found that when people touched someone else with freshly washed, but damp, hands, they transferred a whopping 68,000 microorganisms, compared to just 140 when their hands were dry.
• The CDC says that while soap and water is best, hand sanitizers containing at least 60 percent alcohol can do in a pinch.

What else can you do to protect yourself against COVID-19?

Although several manufacturers are working on a vaccine against the new coronavirus, it is not expected to be available for at least a year or longer. Meanwhile, along with frequent hand washing, these smart steps from health authorities, medical providers and virologists can help you and your family protect yourselves against COVID-19, flu, and other infectious diseases:

• Avoid close contact with people who are sick.
• No hand shaking! Switch to non-contact greetings, such as a friendly nod, hand wave or slight bow.
• Use only your knuckle to touch light switches, elevator buttons and other frequently touched public surfaces.
• Open doors with your closed fist or hip — do not grasp the handle unless that’s the only way to open the door. This is especially important with bathroom doors, given that a recent study found that only 26 percent of men and 17 percent of women wash their hands after using a public toilet.
• Use disinfectant wipes at stores, when available, or bring your own. Wipe down the handles and child seats of grocery carts. Also avoid contact with payment touchscreens and cash when possible: Consider using electronic payment methods, such as Apple Pay.
• Cover your cough or sneeze with a tissue, then throw it in the trash.
• Keep a bottle of hand sanitizer at each of your home’s entrances AND in your car for use after getting gas or touching other potentially contaminated objects when you can’t immediately wash your hands.
• Avoid touching your nose, eyes and mouth, particularly when out in public.
• Clean and disinfect frequently used objects in your home. The EPA has released a list of disinfecting products and chemicals that it says are strong enough to ward off “harder-to-kill” viruses than COVID-19. These include products from Purell, Clorox, Lysol and other well-known sanitizers.
• Follow the CDC’s recommendations for using a facemask. These are not currently advised for protection against COVID-19, but should be used by people with symptoms of the disease, as well as health workers and caregivers for the elderly and ill. Also check the CDC website for more tips, updates and advice for travelers.
• Get your annual flu shot if you haven’t done so already. The CDC cautions that rates of flu remain high in the U.S. and may continue into the late spring. Being vaccinated cuts the risk that you’ll need to go to a medical office or hospital (which could expose you to people with coronavirus or other infectious diseases) for treatment of flu symptoms by 55 percent. If you are 65 or older and haven’t yet been vaccinated against pneumonia, or under 65 and smoke or have other risk factors for pneumonia, also get that shot. Visit the CDC website to learn more about pneumococcal vaccination.