Like EEE this summer, coronavirus is in the news. Your patients may be concerned about the information they're getting — and the information they're not getting. To help you answer patient questions, Medical Director Jim Hellinger, MD, and the AllWays Health Partners blog team present answers to 4 top questions about 2019 novel coronavirus.
On January 21, the first coronavirus infection in the United States was reported following many infections and some deaths in Asia. The strain, known as 2019 novel coronavirus, or 2019-nCoV, was first discovered in the city of Wuhan in China and has since spread to other countries in Asia, Europe, and North America. Dr. Jim Hellinger MD MSc, a medical director at AllWays Health Partners and infectious disease specialist, says, “Since the first cases of this novel coronavirus were identified in sicker patients in the hospital, public health authorities in China are concerned this is a much more dangerous respiratory virus.”
As the number of cases grows, here are some answers to four common questions your patients may have.
4 questions about coronavirus
1. What is coronavirus, and where did it come from?
Coronaviruses are a large family of viruses that are common in humans and many mammals. Human coronaviruses commonly account for 5–10% of acute upper respiratory infections in the community. These coronaviruses have been the source of epidemics including SARS (mostly in Asia, from bats), MERS (in the middle East, from camels), and now 2019-CoV. 2019-CoV seems to have begun with an animal-to-person transmission in a large seafood and live animal market in Wuhan, China. Later, people with no reported exposure to animal markets began contracting 2019-CoV, suggesting that the disease is now spreading person-to-person.
"Since the first cases of this novel coronavirus were identified in sicker patients in the hospital, public health authorities are concerned this is a much more dangerous coronavirus," notes Dr. Hellinger. "With high rates of person to person transmission, it may spread swiftly." At this time, however, the CDC does not know how infectious 2019-CoV is. Recently, the first confirmed instance person-to-person spread occurred in the United States
2. Is coronavirus as dangerous as SARS or the flu?
Many fear that 2019-nCoV is as severe and deadly as SARS, and it’s not an unfounded assumption: SARS is a type of coronavirus that also started in Chinese animal markets, and it became an epidemic in 2002-2003. Although SARS infected only 8,000 people (currently, there are more than 24,000 people infected with 2019-nCoV), it has a much higher mortality rate: 9.6% of SARS patients died. So far, a quick calculation suggests 2019-nCoV has a mortality rate closer to 2%, and may be more severe among the very young, elderly, and immunocompromised.
Because it is so much more widespread, the influenza is a far greater risk today to Massachusetts than 2019-nCoV. "Placed in context, influenza is a far more common respiratory virus for Massachusetts residents. Despite effective vaccination, and effective tablets that work to treat and prevent influenza, this winter already, the CDC US national reports more than 10,000 influenza deaths and more than 19 million cases," says Dr. Hellinger.
Though the mortality rate from influenza is considerably lower than for 2019-nCoV, the sheer number of cases make it a far greater health risk in this country. Only a dozen American 2019-nCoV cases have been confirmed so far compared to the previously mentioned flu numbers.
3. Is Massachusetts at risk for a coronavirus outbreak?
The first case of 2019-nCoV in Massachusetts was diagnosed on January 31. The individual is a University of Massachusetts Boston student who recently returned from China, and sought medical attention for a runny nose the day after his return to the states. To minimize the risk of infecting others, he was not hospitalized and has been isolated in his home instead. UMass Boston alerted its students to the situation, though the student does not live in the dorms.
Despite this case, the risk of a large outbreak in Massachusetts is low. Logan International Airport has increased screening protocols, and American public health officials are stressing that the flu is still more dangerous than 2019-nCoV, and that no American 2019-nCoV deaths have occurred.
4. How do I prevent coronavirus?
2019-nCoV causes respiratory illness in the form of fever, cough, and shortness of breath ranging from mild to severe severity. Many patients have even developed pneumonia in both lungs. There is currently no vaccine or specific treatment for 2019-nCoV, aside from symptom-relieving treatment. The CDC believes that symptoms can appear anywhere from 2 to 14 days after exposure, based on the incubation period of MERS viruses. As of February 3, 2019-nCoV has infected over 24,000 people across 23 countries and killed 492 people, mostly in China. Chinese authorities have quarantined more than 50 million people to control the spread.
The best way to prevent illness from respiratory illnesses is to avoid exposure. This includes avoiding contacting with those who are sick, avoiding touching your face with unwashed hands, and washing your hands with soap and water. Clinical and hospital staff rely on hand sanitizer. If you or your patients get sick, they should stay home, use tissues when sneezing or coughing, and disinfect frequently touched objects and surfaces. Encourage your patients to delay or cancel any travel outside the United States, especially to Asia. CDC and US Customs and Border Protection (CBP) are currently using advanced health screenings to detect travelers with symptoms, but the safest option is still to stay in the country.
Dr. Jim Hellinger MD MSc, a medical director at AllWays Health Partners, advises that patients “Contact your clinician if you have travel to Hubei province in China or personal exposure to someone at risk of the novel coronavirus within the last 14 days. And if you or your contact has both travel/traveler exposure AND respiratory symptoms, contact your clinician to plan your care, before you go to a health care facility. That will allow the clinical team to safely plan isolation, evaluation and care.” Pass this guidance along to your patients.
More info about coronavirus
For more information on 2019-nCoV as the situation evolves, see the CDC’s Situation Summary for the 2019-nCoV outbreak.