Written by Sophia Pollalis ATC, LAT and Jayme Taylor MSN, APRN-CNP, FNP-BC, CSOWM, DIPACLM


What is coronavirus?

COVID-19, which stands for Corona Virus Disease 2019, is a strain of coronavirus that was discovered in late 2019 not previously identified in humans. The coronavirus is a family of viruses that were first discovered in 1965 when it was noted that the corona virus had a similar structure to viruses seen in animals1. They had a crown-like structure, hence “corona.”

Coronaviruses are common and generally present as upper respiratory tract infections. There are seven known strains of coronaviruses that can infect humans. Four are very common and have not produced worldwide panic and precaution; three of them, including the most recent COVID-19, have produced significant response in recent years2. These include SARS3 (Severe Acute Respiratory Syndrome) in the early 2000’s and the MERS4 (Middle East Respiratory Syndrome) in 2012. In the cases of SARS, MERS, and COVID-19, the source of the coronavirus were animals5. Coronaviruses are also common in different species of animals, such as camels, cattle, cats, and bats; in rare cases they can infect humans.

What are the symptoms of COVID-19?

COVID-19 is characterized by fever, cough, and shortness of breath as it is an upper respiratory tract infection5. These symptoms can show up as early as 2 days after exposure, running up to 14 days based on the previous outbreaks of MERS and current trends, however we don’t know how long the actual incubation period is because it is new5,6.

 How does it spread?

While COVID-19 originally came from an animal-human contact, the pandemic risk spreads very easily from person-to-person5. Transmission can occur through droplets in the air, like if someone sneezes and you happen to inhale the droplets, or by touching the same surfaces as someone else, like shaking hands or touching doorknobs. Because we don’t know a whole lot about COVID-19, experts are referring to the known infection transmission of MERS, SARS, and animal coronaviruses7. These experts postulate that, at room temperature, human coronaviruses can survive up to 9 days on inanimate surfaces. A preliminary study led by researchers at Princeton, UCLA, and the National Institutes of Health (NIH) found that the virus can survive up to 3 days on non-pourous surfaces, up to 24 hours on pourous surfaces like cardboard, and possibly be able to survive suspended in a mist for 3 hours8. This information does have to be taken with a grain of salt, as these are just preliminary tests in a laboratory setting and won’t be the same as conditions in your home, on the bus, or in a store5,8.

How can I protect myself and others from the virus?

  • Wash your hands for at least 20 seconds with soap and water, especially after being in public places, blowing your nose, coughing or sneezing, or if your hands are physically dirty. Hand sanitizer can also be used, but washing your hands is king5. Check out our article here on how hand washing gets rid of bacteria and viruses.
  • Avoid touching your face5. If you weren’t before, you are going to be so aware of how many times you touch your face. Your skin is a protective barrier to the body, but germs can get in through the useful openings we have in them, like our eyes, nose, and mouth. We can also take germs from our faces and transmit them to others by touching our faces.
  • Clean and disinfect surfaces likely to transmit the disease, especially doorknobs, light switches, your steering wheel, keyboards, and sinks5. If surfaces are physically dirty, clean them with soap and water or another detergent first, then sanitize after. Bleach and alcohol solutions work well. Make sure your disinfectant is appropriate for the surface your are cleaning and your follow manufacturer instructions. If it says leave on the surface for 5 minutes, they really mean that.
  • Stay home from work and other social gatherings if you feel sick EXCEPT to get medical care.
  • Cover your mouth and nose with a tissue or into your elbow when you sneeze or cough. Your droplets can travel almost 20 feet when you cough and 26 feet when you sneeze9!
  • If you are sick and going to be sharing a space with another person, wear a face mask. If you are NOT sick, there is no reason for you to wear a face mask unless you are caring for someone who is sick, or the person that is sick can’t wear one5.

Why is social distancing important?

On March 11, 2020, the WHO characterized COVID-19 as a pandemic10. This is the first coronavirus to spark a pandemic, as we typically see pandemics with the flu or other diseases. What that means for the US is widespread transmission in the coming months5. Most of the population will be exposed to the virus, but not all will show symptoms and some will only show minimal symptoms. If we compare COVID-19 to the yearly flu, its current hospitalization rate is significantly lower. According to the CDC, the United State sees between 9 million and 45 million cases of influenza each year, resulting in 1.5 to 2% hospitalizations11.  The current trend in China and Italy shows a 15% or greater rate of hospitalization12. This is a problem for the US because we have about 2.8 hospital beds per 1000 people and around 100,000 ventilators total in the country13. If the coronavirus follows the trajectory of what has happened in China and Italy, healthcare workers would be forced to choose which patient gets a bed or which patient gets a ventilator. Our healthcare system would not be able to handle the strain of a mass outbreak. Limiting our exposure by closing schools, cancelling sporting events and seasons, not going to birthday parties, and not running to the store unless you have to, we can flatten the curve and allow our healthcare system to do its job, preserving lives that don’t have to be lost.

A note from Jayme Taylor, Positively Balanced contributor and Nurse Practitioner on the front lines:

“The symptoms of the coronavirus are very similar to influenza, and because we are in the middle of the flu season right now our only real way to distinguish risk of coronavirus vs flu is to assess for potential exposure. We triage every patient that calls with “flu-like symptoms” to see if they have been out of the country or in contact with someone who has recently been out of the country, traveled to a high risk state, etc. So not taking adequate precautions to limit community spread and exposure actually complicates the diagnostic process. It is also a burden on the healthcare system to be seeing mild cases of upper respiratory illnesses in healthy people because they are afraid it could be the coronavirus. It is important to stress that like flu, the coronavirus is a virus and treatment is supportive. Those at risk like elderly, young children, and the immunocompromised should take extra precautions to limit risk of exposure. However, mild cases in otherwise healthy people will likely resolve on their own without complication. Limiting spread of this virus protects those high risk patients from exposure. So if someone is sick they should stay home, regardless of viral cause; if symptoms worsen and they have uncontrollable fever, shortness of breath or other severe symptoms then they should seek medical attention.”

Sources

1.       https://journals.lww.com/pidj/fulltext/2005/11001/history_and_recent_advances_in_coronavirus.12.aspx

2.       https://www.cdc.gov/coronavirus/types.html

3.       https://www.cdc.gov/about/history/sars/timeline.htm

4.       https://www.cdc.gov/coronavirus/mers/about/index.html

5.       https://www.cdc.gov/coronavirus/2019-ncov/index.html

6.       https://www.health.harvard.edu/diseases-and-conditions/coronavirus-resource-center#COVID

7.       https://www.journalofhospitalinfection.com/article/S0195-6701(20)30046-3/fulltext

8.       https://abcnews.go.com/Health/covid19-days-surfaces-experiment-findings/story?id=69569397

9.       https://www.sciencefocus.com/the-human-body/how-far-do-coughs-and-sneezes-travel/

10.   https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19—11-march-2020

11.   https://www.cdc.gov/flu/about/burden/index.html

12.   https://www.statnews.com/2020/03/10/simple-math-alarming-answers-covid-19/

13.   https://www.npr.org/sections/health-shots/2020/03/14/815675678/as-the-pandemic-spreads-will-there-be-enough-ventilators