Coronavirus Signs, Symptoms, Incubation and Treatments - HealthCentral.com

Posted: 30 Mar 2020 09:10 AM PDT

Reported in almost every country in the world and in all 50 states, the novel coronavirus has created widespread panic and an almost apocalyptic vibe. The 24/7 news updates have led to fearmongering and hoarding and a ton of anxiety. The best thing to do now is STAY AT HOME—and when you do go out for supplies, save some toilet paper for your neighbor!—and read up. Our coronavirus guide comes from a panel of top pros and dozens of studies so you can protect yourself, and others, in the most effective way possible.

What Is a Coronavirus, Exactly?

So just what is this illness? The novel coronavirus is a new disease strain in a family of viruses called "coronaviruses," which were discovered in the late 1960s. They cause everything from mild to severe upper-respiratory tract illnesses and are zoonotic, meaning they're transmitted from animals to people.

Named because, under a microscope, the surface of the virus has crown-like (or "corona," the Latin word for crown) spikes on their surface (to better grab hold of our cells), humans experience seven different strands. Turns out, it's quite likely you've already had a coronavirus—the common cold.

This latest version—officially a pandemic (meaning it's spread around the world) —is called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The illness that the SARS-CoV-2 virus causes is called COVID-19. It was discovered in December 2019 in the city of Wuhan, China, in the Hubei province. Most people are colloquially calling this new 2020 virus the "coronavirus," and technically that's accurate because it is the family it's a member of. But for the record, the virus' correct name is COVID-19.

Two other severe strains of coronavirus—severe acute respiratory syndrome (SARS-CoV, or just SARS) and Middle East Respiratory Syndrome (MERS-CoV, or just MERS)—broke out in the last two decades in more than 20 countries, leading to some 1,600+ deaths. While this new version of the virus seems more infectious than those two, it also seems less deadly (thank goodness).

The transmission sources of COVID-19 are still under investigation, but appear to be from bats to another, intermediary, animal—possibly a pangolin, a type of anteater that looks like an armadillo, which is the most heavily trafficked mammal in the world—and then to humans.

What Are the Main Symptoms of the Coronavirus?

First off, the World Health Organization (WHO) defines a suspected case of COVID-19 as a person with acute respiratory illness, meaning you have fever and at least one sign/symptom of respiratory disease, such as a cough or shortness of breath. However, as you'll see from the percentages below, not everyone has those symptoms, or even any of the symptoms below, but they can still have COVID-19.

Here's the thing to understand about COVID-19: With all symptoms, the severity and duration or whether you get that symptom at all is based on how your immune system handles the disease. It's why it's so difficult for doctors to give specifics about how long chills will last, or how bad a cough might be. Maddeningly, the coronavirus likes to get personal.

The symptoms we're presenting below come from the leading WHO report on 55,924 laboratory-confirmed COVID-19 cases in Wuhan, China. The most commonly cited symptoms of COVID-19 are:

Fever. This is the most prevalent symptom, occurring in about 88% of people. Our normal body temp is around 98.6 degrees Fahrenheit. A fever would be considered in the 101-104 range.
Cough. About 67% of people in Wuhan had this symptom, which has been described as a dry cough that happens intermittently. That said, your cough might be different. It might be dry and called "unproductive," meaning with no mucus. Or it might be wetter, producing mucus whenever you cough. You might cough so much, it hurts. You might not.
Shortness of breath. This was reported in about 18% of cases. Your immune system response and health risk factors will establish your baseline for this as well. So, say you have emphysema, you might be short of breath during the day already, but if you're an athlete, you wouldn't be winded until you ran a distance. Both are typical. What isn't typical? If you become short of breath doing daily activities that don't typically cause shortness of breath. Then it might be COVID-19-related.
Fatigue. You know that deep exhaustion that can hit during the flu? This feels the same, and about 38% of people with COVID-19 experience it.
Sputum production. Occurring in 33% of cases, this mix of saliva and mucus is coughed up from the respiratory tract.
Sore throat. This is typical throat pain, like the kind you might have with a cold. About 14% of people with COVID-19 had a sore throat.
Joint pain. Joint aches happen in 14.8% of cases. Which joints? Again, what impacts you might not impact someone else, so if you have joint pain with other symptoms listed here, it might be COVID-19 (though, of course, it might be the flu or a common cold).
Headaches. Feels like your basic headache—your head just hurts, and hurts bad—and it's coupled with other COVID-19 signs, so you'd know it's not just a stress headache from all the bad news. Thirteen percent of cases include headaches as a symptom.
Nasal congestion. Stuffy noses can happen with COVID-19, but they're not as typical as other symptoms, occurring in nearly 5% of cases studied.
Chills. Oh, that familiar feeling you get with the flu. It happens with COVID-19 too, in about 11% of people. Different people will have them for different durations.
Nausea or vomiting. You can see why people keep saying the coronavirus is like the flu. The symptoms are similar. While nausea and vomiting happen with COVID-19, they're not always routine: 5% of patients threw up or felt like they might in Wuhan.
Diarrhea. As with vomiting, this was a smaller number too, at 3.7% Still, further research is showing that this symptom might be more prevalent than first thought. Another published report of 138 patients in a Wuhan hospital found up to 10% had diarrhea or vomiting.
Hemoptysis. This is an awful one. It's when you cough up blood or blood-stained mucus from the bronchi, larynx, trachea, or lungs. It occurs in 0.9% of cases.
Conjunctival congestion. Your eyes are red and a watery discharge keeps flowing out of them—this happens in just 0.8% of cases.

Other symptoms, which have been reported anecdotally by doctors and people who've tested positive for COVID-19, include:

Loss of sense of smell and taste. More people are sharing this anecdotally as an issue with the disease, and more research should hopefully show us why this is a problem. (We know one patient who was able to down a full tablespoon of Tabasco and not even notice it.)
Muscle aches. Feeling soreness throughout your body has been reported too.
Runny nose. Just to confuse things further, some people with this new strain of the coronavirus have had a runny nose, the kind you get with a common cold. (FYI: A now-debunked post that made the social-media rounds incorrectly claimed that you couldn't have this symptom with COVID-19.)

Symptom stats incoming from the WHO:

More than 80% of people with COVID-19 have mild, uncomplicated illnesses and don't need to go to the hospital
About 14% develop severe disease requiring hospitalization and oxygen support, and, of those, 5% require admission to an intensive care unit (ICU)

As you can see, the way this illness plays out is a bit all over the place. COVID-19 can cause life-threatening symptoms, worsening to pneumonia, or you can feel just fine and still have this virus. Case in point: Study authors looking at COVID-19 cases on the cruise ship Diamond Princess found that 17.9% of people who tested positive for the virus on the ship were asymptomatic.

How Is the New Coronavirus Transmitted?

The main way you contract COVID-19, experts think, is from another person who has the virus, called person-to-person transmission. But you can also get it by touching infected surfaces/things, too, and a new study has shown that it might be airborne for up to three hours, in the right conditions (more on that in #1, below).

Information about COVID-19 is evolving as more people around the world get the illness, health care professionals share what they're learning as they treat patients, and researchers and the major world health organizations rush to publish the latest accurate data.

Here's how we know you can get COVID-19:

Coughing, sneezing, talking. If a person with COVID-19 coughs, sneezes, or even exhales within about 6 feet of you, droplets of varying sizes (large, medium, and small) from their nose (mucus) or mouth (saliva) can infect you when you inhale them into your lungs. This is called person-to-person transmission, and experts think this is likely the most common way you can be infected with the virus.

Researchers reported in the New England Journal of Medicine in mid-March 2020 that, in a controlled environment, those droplets can stay in the air—so, airborne—for up to three hours, but more real-world study is needed in the topic to determine how realistic this transmission is.
Touching someone sick. If you hug or shake hands, you can transmit those infected droplets from their body (like from the hand that they coughed into) into yours, by then rubbing your nose, mouth, and eyes.

It can't be transmitted just by touching someone's skin, only if they have droplets on their skin. Just rubbing against the virus, or touching it with your skin, won't give it to you unless you then rub it into your nose, mouth, or eyes. Still: Be careful!
Touching a surface or object with infected droplets. Keep in mind, the Centers for Disease Control and Prevention (CDC) in the U.S. reports that while you can possibly get COVID-19 from touching an infected surface and then touching your nose, mouth, or eyes, the most common way to catch it is through person-to-person transfer. With that knowledge...

A New England Journal of Medicine article found that this COVID-19 stays on the following objects (called fomites) for various amounts of time, with various levels of contamination:

Copper: 4 hours

Cardboard: 24 hours

Plastic: 3 days

Stainless steel: 3 days

Other studies, looking at coronaviruses in general, and how long they live on surfaces (which is likely how long this strain might, too), found they lived on:

Paper: 4 to 5 days

Cloth: 4 days

Here's how you might get it (but we're not sure):

Feces: Officials are recommending that anyone in your house with the virus—if possible—use their own bathroom to reduce potential infection of others in the house. Early research seems to indicate that the virus is "shedded," or released, through your stool, and since one COVID-19 symptom is diarrhea, experts are studying whether it's transmitted through feces. As for urine, nobody knows yet whether it's a transmitter, either; it was one way the first SARS virus, back in 2003-2004, was shed, so more study is happening in this area.

Here's how you probably can't get it:

Sexually. While you can get this novel coronavirus from kissing—in which you share saliva droplets mouth-to-mouth—it doesn't appear to be sexually transmitted and doesn't penetrate the skin, meaning you can wash it off your hands and be in the clear.
Vertical mother-to-baby. Scientists don't think pregnant people pass the virus to their babies, a process called vertical transmission. There has been a case in London of a mother and newborn who are both infected, but news reports say the mother likely transmitted it to the baby after birth.
Blood. Unlike other viruses, like Hepatitis C, it doesn't appear that you can be infected with COVID-19 through blood exchange.
Water. Unlike certain diseases—such as cholera, which can be caught by drinking water infused with harmful bacteria—COVID-19 seems to have no transmission through H20.
Food. It appears that food won't give you the virus, so takeout should be OK—though if you want to double-down on safety, you can recook your eats and bring up to temperature (depending on the specific kind of food) to ensure all pathogens are killed.

How Long Is the Incubation Period of the Coronavirus?

The onset of COVID-19 signs and symptoms is between two and 14 days after first exposure. It's this wide range that makes the virus so tricky to contain: People can be walking around with the virus and not even know it. And it appears that this disease can still be spread even before you have symptoms—which is why social distancing is so very important.

The median COVID-19 incubation period—the time between when you're exposed to the virus and your first symptoms appear—is just over five days, researchers found in a study published in Annals of Internal Medicine. They also reported that 97.5% of people who develop symptoms do so within 11.5 days of infection.

Symptoms often start mild and gradually, then increase in intensity.

Why Does COVID-19 Seriously Impact Older Adults?

Based on data from Wuhan, people at high risk for serious complications from COVID-19 include those who are 60 and older. If you're in this group, you're amongst many: In the U.S. alone, 68.7 million Americans are 60 and above.

Why is age likely an issue with COVID-19? The immune system responds more slowly to infections as we age, which can increase your chance of becoming sick. Your immune system has fewer immune cells at 60 and above, so you heal more slowly, too.

The highest number of fatalities reported in Wuhan was in people 80 and older, which accounted for nearly 15% of deaths. For those 50-59, the fatality rate was 1.3%, jumping up to 3.6% for those 60-69 years of age, and 8% for those 70 to 79.

In the U.S.? A staggering eight out of 10 deaths from COVID-19 reported in the states have been in those 65 and older. In adults with confirmed COVID-19 in America:

Estimated percent requiring hospitalization
- 31-70% of adults 85 years old and older
- 31-59% of adults 65-84 years old
Estimated percent requiring admission to an intensive care unit
- 6-29% of adults 85 years old and older
- 11-31% of adults 65-84 years old
Estimated percent who died
- 10-27% of adults 85 years old and older
- 4-11% of adults 65-84 years old

Is the Coronavirus Dangerous For Kids?

Many respiratory-based illnesses, such as the flu, are concerning for the oldest and youngest among us. While COVID-19 is a big worry for the elderly, it's not thought to be as serious for children, at least according to current research.

Most of the confirmed cases of COVID-19 in China happened in adults, and experience with SARS and MERS also had limited infections in children. In Wuhan, there were no COVID-19 deaths reported for children, from newborns to age 9, but tragically, an infant did pass away from the virus in Illinois in March.

Why isn't COVID-19 seriously affecting more kids? Researchers aren't sure. Children can get the disease, but it's possible they have very mild or even no symptoms, but then become vectors, or transmitters of the disease, especially to people at high risk, including their grandparents and older relatives.

It's important to note: Just like with adults, children with underlying health conditions (we'll talk about this in the section below) might be at increased risk, and the same precautions against germs are key for all kids, and all, well, everyone, to prevent infections.

How Does the Coronavirus Impact People With Chronic Health Conditions?

Some groups are at higher risk of having serious complications for the disease, and let us tell you—it's no small number of people. In one study based on Wuhan data, researchers found that people with COVID-19 who also had at least one additional medical condition—such as heart disease, diabetes, and others—had a 79% greater chance of needing intensive care or a respirator (or both) to recover, or of dying. About 1 out of every 5 people who gets COVID-19 become seriously ill and might need to be hospitalized.

We know how scary this is. That's why it's so important to be informed and to practice preventative safety measures (which we'll get into soon).

Per the Wuhan data, people at higher risk for serious complications from COVID-19 include those who have:

Diabetes. Some 30.3 million Americans, or 9.4% of the population, have this condition. The American Diabetes Association is providing tools to keep yourself safe during this pandemic if you have diabetes. Which is important, in light of statistics. According to the Chinese Center for Disease Control, in Wuhan the fatality rate was 7.3% for people with diabetes. With diabetes, it's tougher to fight any infection, and circulation issues can lead to organ issues, making it harder for you to heal when hit with something like this illness.
Hypertension. Experts are still trying to figure out why this patient population was at risk in Wuhan, where the death rate for hypertensive patients was 6%. An estimated 103 million Americans have high blood pressure, according to the American Heart Association (AHA), which is providing precautions for heart disease patients.
Cardiovascular disease. The death rate for people in Wuhan with heart health issues and COVID-19: a staggering 10.5%. Whom exactly is at risk in this group isn't known because that info hasn't yet been published. But here are a few of the types that might be impacted, courtesy of the WHO:
- Previous heart attack history
- Cerebrovascular disease
- Peripheral arterial disease
- Rheumatic heart disease
- Congenital heart disease
- Deep vein thrombosis and pulmonary embolism
Chronic respiratory diseases. A stat on just one of these: The fatality rate for people with chronic obstructive pulmonary disease (COPD) in Wuhan was 6%. Asthma is another at-risk population, because lung capacity is already compromised with this condition. If you have asthma, call your doctor and discuss if you might need an extra inhaler on hand if you end up with COVID-19.
Chronic autoimmune illnesses. Those that involve the lungs can run the risk of more serious cases of COVID-19. These include:
- Scleroderma
- Interstitial lung disease
- Lupus
- Pulmonary hypertension
Medically weakened immune systems. Are you a cancer patient on immunosuppressive drugs, like some forms of chemotherapy? Or taking a biologic medication for Crohn's disease or rheumatoid arthritis? You're also at higher risk for COVID-19.
Others who are immunocompromised. This can include if you've had bone marrow or organ transplantation, immune deficiencies, poorly controlled HIV or AIDS, on kidney dialysis, and prolonged use of corticosteroids and other immune-weakening medications, according to the CDC. Talk to your doctor if you're concerned about your condition and medication.
People who smoke or vape. Smoking—whether it's tobacco, marijuana, e-cigarettes, or vaping—can damage your lung's natural defenses, making them more susceptible to respiratory illnesses like COVID-19, according to the Mayo Clinic. Long-term smoking compromises lung function and can cause lung disease.

So much is still unknown about COVID-19 and the risks of underlying medical issues, so we're not sure if this applies just to current smokers or past smokers too, but the good news is that your lungs begin to heal as fast as a month after you stop smoking. Now is the time to pursue cessation programs to help your lungs start that process.
People who are obese. The CDC has updated its at-risk guidelines to include those who are any age with severe obesity, or a body mass index or 40 or greater. They're at additional risk if they have diabetes, renal failure, or liver disease, especially if uncontrolled.

Even if you aren't in a high-risk group for the virus, it's still better not to have it. Clinicians conducted a 15-year prospective cohort study examining patients who had the first SARS virus, finding long-term bone and lung issues, which could very well be an issue with COVID-19, too. Preliminary from Wuhan and Hong Kong with COVID-19 appear to show potential long-term effects of the disease, too, with diminished lung capacity for some COVID-19 patients.

Are There Other People at High Risk for COVID-19?

Beyond age or pre-existing medical conditions, there are three additional things, per the CDC, that can elevate your risk of exposure:

Community spread: Again, this means if you live in or just visited a place where lots of people have tested positive for the illness.
Being a healthcare worker: Don't forget how medical professionals put themselves in harm's way during infectious epidemics to care for those of us who are sick—it's no different with COVID-19. This includes doctors, nurses, and anyone else working in hospitals, ERs, clinics, and other places with coronavirus patients.
Close contact: In other words, people who are taking care of someone or live in the same house as someone who's tested positive for COVID-19

What Should I Do if I Have the Coronavirus? (Or Suspect I Do?)

Say you meet the above criteria. What to do next? These three steps can help.

Calm yourself (as much as you can). As we've mentioned, about 80% of cases turn out just fine, without special treatment needed. And in those 20% of cases that are more serious, you can get better.
Don't rush out. Before you rush to your doctor's office or the local emergency room, stop. Know that you can help prevent any future transmission of whatever illness you have. We know this might be tough to do if you're scared and feeling badly, but consider your own health, too: You don't want to expose yourself to other illness if you're already sick with something.
Call your healthcare professional, asking your doctor's office, urgent care clinic, or emergency room what you should do in light of your symptoms and recent travel/exposure to the illness. Another place you might be directed to—your local health department. They're helping with testing (see below for more on testing). The National Association of County and City Health Officials has a handy directory of local health departments, by state, that can lead you to the right person to speak to about finding out if your symptoms are COVID-19 or the flu or a cold.

How Do You Get Tested and Diagnosed with COVID-19?

Testing got off to a bumpy start in the U.S., when the CDC had an initial issue with their test kits. Then, it took time to roll out more tests across the U.S., and there have been delays across the country as healthcare professionals haven't received tests or haven't received enough tests. There are also delays in receiving test results because of a backlog of cases being processed in overwhelmed labs.

Depending on where you live, the severity of your symptoms, and your background (age, high-risk group, etc.), at this point you may not even be given a test. This is evolving as more tests are becoming available in the U.S., helped by research and testing capabilities from universities and private companies. Check out HealthCentral's piece about COVID-19 hotline numbers state-by-state.

How Does Coronavirus Testing Work?

If you get a test outside of the hospital, you'll likely receive a nasal swab (called a nasopharyngeal swab by the pros). For this one, the tester takes a sample from your nose using a special swab. You might've had this done for the flu. It can be unpleasant because it feels like the wire-like swab goes deep into your nose.

If you end up at the hospital without having been tested first, healthcare professionals might use a different method of testing. They'll decide which test is best based on your abilities (if you're unconscious, for instance, any test that requires your assistance, like coughing into a cup, isn't possible) and their preferences. The testing options include:

Nasal aspirate. Your health care provider injects a saline solution into your nose. Then, they remove the sample with gentle suction. This might feel a little funny as it happens.
Tracheal aspirate. This one features a thin, lighted tube (called a bronchoscope) that's put down your mouth and into your lungs for a sample to be collected there. There could be some discomfort with this test.
Sputum test. You cough into a cup for this test, releasing sputum, a thick mucus coughed up from your lungs. Easy enough, right? Or they might use a special swab to take a sample of mucus from your nose if you can't cough anything up.
Blood. A blood sample is taken from a vein in your arm. Typically, this is quick and relatively painlessly except for a quick pinch of the needle's prick.

One country that has done well with testing and diagnosis: South Korea. Officials quickly set up drive-through testing sites there, where people could drive up, be effectively tested, and then drive away, reducing the risk of exposure to health care professionals.

That's becoming the norm in the U.S., too, as areas in Washington, California, New Jersey, and New York add drive-through testing sites to more quickly offer testing services while protecting testers.

Who Gets Tested for COVID-19?

Because there currently aren't enough tests for everyone—or even those with symptoms—there's a first-second-third when it comes to testing. As of March 24, 2020, this was the CDC's who-gets-tested priorities:

Priority 1:

Hospitalized patients
Symptomatic healthcare workers

Priority 2:

Patients in long-term care facilities with symptoms
Patients 65 and older with symptoms
Patients with underlying conditions and symptoms
First responders with symptoms

Priority 3:

Critical infrastructure workers with symptoms
Individuals who do not meet any of the above categories but have symptoms
Healthcare workers and first responders
Individuals with mild symptoms in communities experiencing high COVID-19 hospitalizations

Non-priority:

Individuals without symptoms

If you've been in touch with your healthcare professinoal and can't get a test but have COVID-19 symptoms, have traveled to an area where there's been documented community spread (like China, Italy, France, Spain, South Korea, and—in the U.S.—New York City, Seattle, and on), or been in contact with someone who has tested positive for the novel coronavirus, the CDC says to stay home and not leave the house for at least two weeks from the onset of symptoms.

What's the Treatment for the New Coronavirus?

Thus far, there's no specific treatment for COVID-19. We can't use antibiotics to treat the virus itself, because they're used specifically to treat bacterial infections—there's nothing in a virus that an antibiotic can target and attack. What's needed is an antiviral. But currently there's no antiviral specifically for this new disease.

Along with creating and testing a vaccine—which, realistically, might not be available for another 18 months—companies and scientists are racing to develop, or find, a drug that could help in this case. WHO officials launched the SOLIDARITY trial on March 23, 2020, a worldwide study aimed to uncover the best treatment, fast, for COVID-19.

Researchers and healthcare professionals in the field are investigating promising treatments, including hydroxychloroquine sulfate and chloroquine phosphate, medications developed to treat malaria but now commonly used to treat lupus (which has led to another problem: a shortage of the drug for lupus patients, as it's been hoarded to potentially treat the coronavirus).

Other possible therapies have included remdesivir (developed to treat Ebola but not proven effective in trials), two HIV drugs (Ritonavir and lopinavir), and the use of convalescent plasma from COVID-19 patients who have recovered.

So what happens if you've got COVID-19 now? If your symptoms have just cropped up and are mild at the start and continue that way, here's what you should do:

Let your doctor know what's happening, and speak to her by phone regularly, especially if your symptoms worsen, you are concerned, or you're at high risk for negative outcomes with COVID-19.
Drink plenty of fluids to help your body maintain its overall health.
Rest. Rest. Rest. Did we mention you should rest?
Take over-the-counter pain meds, like acetaminophen (Tylenol) to combat the fever, joint pain, and headaches. There's been controversary over the use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil), after French doctors observed worsening conditions in patients taking them with COVID-19.

However, this is just anecdotal, meaning it hasn't yet been investigated fully in a study, and WHO officials have said that it's not yet clear if NSAIDs pose a substantial risk to all COVID-19 patients. The jury is still out. But maybe stick to Tylenol for now.
If possible, eat healthily, focusing on anti-inflammatory foods, like frozen fruits, vegetables, green leafy things; and take your normal medicine and multivitamin. You need to keep your body as robust as possible to fight this virus, and research has shown that a healthy diet can have a positive effect on overall wellbeing.
Practice self-care. If you're strong enough, meditate (it's been shown to have many health benefits, including reduced blood pressure and decreased oxygen utilization). Many apps, including Calm and Headspace (which is offering some of its services free to people, including teachers and healthcare professionals), can help you with this.
Don't drink alcohol. It can tamp down your body's ability to fight infection.

You'll likely do these things at home to help prevent overcrowding of hospitals if your case is mild or moderate. For many people, the symptoms eventually subside, and you get better without treatment. It can take time—up to two to three weeks to feel better.

When should you seek more medical help? And how should you do so?

Contact your healthcare provider or emergency room immediately if you have severe symptoms:

Persistent pain
Pressure in the chest
New confusion or inability to arouse
Bluish lips or face

This sounds morbid, but it's need-to-know: In Wuhan, those who ended up dying of the coronavirus had severe trouble breathing. If you start to show symptoms of pneumonia—which include worsening cough, increased trouble breathing, and high fever (103-104 and above)—call 911 and tell them that you have, or are being evaluated for, COVID-19.

If you have a paper facemask, put it on before emergency medical services arrive to help reduce the risk of spreading the disease, as much as you can, for the emergency responders. At the hospital, you could be given oxygen or put on a ventilator depending on how intense your case is.

How Can I Prevent Getting COVID-19?

We're not sure yet if having the virus once prevents you from getting it again: Experts say that past experience with coronaviruses suggests you'd develop an immunity to it, but that's preliminary thinking that requires more research. Right now, especially with a lack of real treatment, protecting yourself and your loved ones is critical.

First off, practice social distancing! Quarantining Wuhan, China, has finally brought the number of cases down, so this strategy—staying home and in physical contact with as few people as possible—does help flatten the curve.

Then follow these other tips for coronavirus prevention:

Wash your hands—often!
Use hand sanitizer, with at least 60% alcohol, when you don't have access to soap and water
Avoid touching your face, especially your eyes, nose, and mouth
Work from home, if you can; definitely stay home when sick.
Cough and sneeze into a tissue or, at the very least, your elbow.
Regularly disinfect high-touch surfaces—doorknobs, faucets, cell phones—with sanitizing wipes, diluted household bleach (not for phones!), or EPA-registered household disinfectants.
Kill COVID-19 from soft surfaces in the washing machine—laundry detergent does the trick.
Skip the handshake; elbow-bump or air high-five.
Use your knuckle for doorbells and elevator buttons.
Pay with credit card or Apple Pay instead of cash, if you can.
Rely on paper towels on public faucets, door handles, gas pumps, and that pen when signing with your credit card
Stock up on nonperishable goods—but don't clean the store out of toilet paper! Leave some for others.

But How Do You Wash Your Hands Properly?

Seems like a "how do you cut your steak properly" kind of Q, but there really is a science to proper handwashing.

First: Any bar or liquid/gel soap is fine. You don't need an antibacterial soap, because this is a virus, not bacteria. And, actually, antibac soaps put us at risk for "superbugs"—bacteria that's harder to fight off—so it might be better to avoid using them anyway.

Here's how to wash your hands:

Rinse your hands with water
Turn the water off without touching the faucet (use a paper towel or your elbow if you can—if you can't, leave the water running)
Lather soap all over your hands and between your fingers and under your nails
Do so for at least 20 seconds. Need some help counting those seconds? Sing the alphabet song to Z (you know the one… A, B, C, D, E, F, G…), or happy birthday twice, or parts of pop songs (think the chorus in Dolly Parton's "Jolene" or Lizzo's "Truth Hurts")
Rinse soap off with water
Dry your hands with a clean towel, air dryer, or the air (don't use a shared drying method, like a towel in a public bathroom—a towel in your home is just fine though!)

Here's why washing your hands works:

It turns out, COVID-19 has an Achilles heel.

Soap.

Viruses either have an envelope around them made of lipids (fats), or they don't. COVID-19 happens to be an envelope virus. It depends on that envelope for its survival. Things like soap, and disinfectant like hand sanitizer with 60% and higher alcohol content, disrupts that envelope, rendering the virus no longer viable.

More on that: The soap molecule has a hydrophobic end and a hydrophilic end. The hydrophilic end binds with water, and the hydrophobic end repels water, binding with fat. So soap accomplishes two good things at once—pulling the virus's fats off your hands, literally removing it, as well as destroying its all-important envelope, thus killing it.

Here's when to wash your hands:

Before, during, and after handling food
Before eating
After using the bathroom
After blowing your nose, coughing, or sneezing
After touching high-touch surfaces like door handles, public transportation surfaces, tables, and desks. This isn't always practical given how many surfaces we touch each day, so if you can't do this, avoid touching your eyes, nose and mouth, and wash your hands when you get home.
When you return from being in the public
When you handle anything that others have handled

Do Masks Actually Help Prevent the Spread of COVID-19?

The CDC is not recommending that you wear a mask (like the paper surgical mask) or a N95 respirator if you're trying to avoid the virus. There's a worldwide shortage of masks, and they're desperately needed for healthcare professionals to safely treat COVID-19 patients.

Wearing surgical masks might help in reducing exposure, especially to infected large and medium droplets (small droplets, not as much), but keep in mind that they're designed for surgeons to wear during surgery to protect the person being operated on, not themselves. They can protect others from your sneezes and coughs, but not protect you as much if exposed to those smaller droplets that can get into the sides of the mask. As for N95 masks, they need to be properly fitted to your face for a secure seal. Otherwise, they're not as effective.

But there are caveats: If you can find a surgical mask, it is advisable to wear one to see your doctor if you suspect you have COVID-19, if you're sick and around other people, or if you are a caregiver to someone with a positive test for the disease, to prevent exposing people or yourself. Talk to your doctor if you have a chronic condition and need to travel or visit the grocery store or bank, for instance, to see if you should wear a mask (again, if you can find one). Other people who need a mask or respirator in addition to healthcare professionals include firefights, police officers, and essential workers, so leave the masks and respirators to them, if you can.

Are There Additional Protective Measures If I'm High-Risk?

If you're over 60 or in one of the other at-risk groups for potentially severe experiences with virus, you might already know about prevention techniques because flu season poses a real risk to you already. You use social distancing, have a great supply of hand sanitizer, and know what it means to stay in for the duration.

You're also done with people saying that "for most people" this illness might have mild symptoms—you're not most people, and your health and well-being matters just as much as the other 80% that won't have serious illness does. For you, avoiding this disease is of paramount important. If you're at high risk for getting very sick, the CDC now recommends doing the following:

Take everyday precautions to keep space between yourself and others.
In public, keep away from anyone who is sick, limit close contact, and wash your hands often.
Stick with the smallest group of people that you can—if you live with someone, live with them and only them. Avoid crowds of 10 or more (true for everyone, actually), or even small gatherings (think, a dinner party with extended family), because flattening that curve means keeping your exposure to others as minimal as possible.
Avoid cruise travel and non-essential air travel.
If there's a COVID-19 outbreak in your community, stay home as much as possible.

If you are in one of these groups, here are some more things to do:

Talk to your doctor about your risks and how best to minimize them. Maybe not with a doctor's appointment, which could expose you to germs—instead, call ahead and ask if your doctor can do a phone consultation. Or email your doc through your patient portal system if possible.

As more of the U.S. turned to shelter-in-place and cities shut down, telemedicine became necessary for people to receive medical care. Rules that once made this tough have rapidly changed. To address these needs, in March 2020 federal privacy regulations were relaxed by the Health and Human Services (HHS) Office for Civil Rights (OCR) and Medicare expanded payment policies. The FDA issued guidance, only to be used during the pandemic, to allow more at-home monitoring of health measurements formerly only taken in your doctor's office, including home blood pressure readings, home weight measurements, and home electrocardiography.
Get the flu and pneumonia vaccines. Even now. Especially if you're over 60, or if you're prone to pneumonia. Call your primary care doctor and discuss if this is a good option for you, and if you can have one at a pharmacy, your doctor's office, urgent care, or some other safe location.
If you do need to go out, avoid high-traffic times. Go to the post office when it's off-hours (think mid-day). Do your food shopping when the store opens, or late at night before it closes. Visit a local restaurant to pick up dinner at 3:30 p.m.
Make sure to care for your mental health. This is a challenging time for all, but it's especially difficult If you're at major risk of negative outcomes with this virus. Try and schedule video calls with friends and family so you can see, not just hear, them. Set up a call with a therapist. And if you're feeling deeply lonely or suicidal, call the National Suicide Prevention Lifeline: 800-273-8255. They have a chat line, too: suicidepreventionlifeline.org/chat.

What Are the Differences Between COVID-19 and the Flu?

It's mind-boggling trying to self-diagnose when COVID-19's symptoms are so similar to the flu, a cold, or even seasonal allergies. But we can't say this enough (and if the president or any TV pundit says it, they're wrong): COVID-19 is not the flu. For these reasons:

More rapid spread: COVID-19 has been spreading more widely than the flu. How rapidly a disease spreads, or is transmitted, is measured with something called a reproductive number, called Ro (pronounced R-nought or r-zero). The Ro is how many people one infected person will transmit the disease to. For COVID-19? It appears to be between 1.4 and 2.5 people per person, according to the WHO. For the flu? It's 1.3 people for every one person.
No immunity to stop it: The flu has been around for years—the first influenza pandemic was in 1580—and while flu strains mutate (which changes the flu's viral structure, thus leaving more people at risk of catching it), COVID-19 is a brand-new virus. We are what's called a virgin population to it, meaning we have no herd immunity (when enough people have an illness or receive a vaccine against it, they develop antibodies to it so they don't all catch and spread it at once). Globally, everyone on earth could get COVID-1, all 7.5 billion of us—which isn't true of the flu, because if you've had some strains of the flu, even years ago, you have antibodies/immunity to it—even if you're exposed to it again, you won't likely catch it.
No vaccination to prevent it: We have yearly vaccinations to stop the newly mutated strains of the flu (since 1945!) but none for COVID-19.
No medications (yet) to treat it: We have four U.S. Food and Drug Administration (FDA) approved antiviral medications, like Tamiflu, to treat the flu. COVID-19 is so new, we have no specific therapy to treat it yet, though companies are racing to find a cure, medication or otherwise. So if you get it, you're older than 60 and/or have any of a long list of medical conditions (see more later on), you have no treatment options until the disease has worsened to pneumonia—and then the treatment is essentially to stabilize your worsening condition.
Mortality rates are higher: There have been some 20,000 deaths this year alone from the flu. You might hear people say, well, more people have died from the flu this year than COVID-19. Which, up until late March, was true. We're also not at the peak of the new coronavirus, nor do we know if it will be a seasonable disease, meaning that it strikes during the fall/winter and eases during the summer. The flu season typically begins in October or November and ends in May each year in the U.S. Meanwhile, right now, it's estimated that about 1% to 3.4% of people with COVID-19 are dying, and we don't know when this pandemic will ease. The mortality rate for the flu? Fewer than 1%. COVID-10 appears to be 10 times deadlier than influenza, but that number is still up in the air, as we're unsure how many people with COVID-19 have mild symptoms and haven't tested positive. Good news on that front though: A test that finds antibodies, meaning you've had COVID-19 already, could be released soon, so we'll know just how people had it, possibly pushing the mortality rate down.

The flu is actually the main point of reference for comparing one serious virus to another. In particular, the 1918 influenza, one of the deadliest pandemics in modern history. Caused by the H1NI flu virus, that disease struck an estimated 500 million people across the globe, killing an estimated 50 to 100 million people (675,000 of those were Americans) in a matter of months.

The differences between the 1918 influenza outbreak and COVID-19 are significant. Back in 1918, health authorities had no idea what was happening beyond that it was a bad flu—it wasn't until 1933, 15 years later, that scientists even knew a virus caused the human wreckage.

With COVID-19, scientists in China had identified the sickness sweeping Wuhan as a coronavirus, sequenced its genome to better help find an effective treatment, and pinpointed bats as the likely animal hosts, within two weeks of the virus first appearing. To read more about how COVID-19 compares to other pandemics—such as Ebola, bird flu, and SARS—check out our story.

Can coronavirus be carried by dogs or cats?

Yes, cats and dogs can get coronaviruses—but they can't give you their versions. And they likely can't get COVID-19 from you. WHO officials say that, while there's been one reported case in Hong Kong of a dog infected with this new strain, there's no evidence currently that a dog, cat, or any pet for that matter can transmit COVID-19. So rest assured that your pet it likely OK.

How long is coronavirus contagious?

We don't yet know. Clinicians found viral RNA—COVID-19's genetic material; so, like, its calling card—20 days after onset of symptoms in some COVID-19 patents, meaning those with the disease were still "shedding" the virus that many days out. And the virus was detectable until death in those who lost their lives to the illness. The longest time COVID-19 was detected in preliminary study? 37 days. According to the CDC, if you've had no fever for 72 hours (without needing medicine to reduce it), your symptoms have improved, and at least seven days have passed since your symptoms first appeared, you can leave home (even if you can't get a follow-up test).

Where did coronavirus come from?

Bats. That's the likely source of the novel, or new, strain of coronavirus called SARS-CoV-2. It's possible that bats had the virus and passed it to another animal (possibly an animal called the pangolin), which then passed it to humans, who then passed it to each other. It might have originated at Huanan Wholesale Seafood Market or other area markets in Hunan, China, and first appeared in December 2019.

How can you avoid the novel coronavirus?

Wash your hands with soap and water for at least 20 seconds, making sure to soap every part of your hands, regularly! Which means: after going to the bathroom, before eating, after being out in public. Use hand sanitizer with at least 60% alcohol if you don't have access to soap and a sink, making sure to cover your whole hands and rubbing them together until they feel dry. Avoid touching your eyes, nose, and mouth with unwashed hands. Cough or sneeze into your elbow, to prevent droplets from scattering 6 feet away from you. And finally, practice good social distancing. Maintain 6 feet from yourself and anyone else. Stay home, flatten the curve.

Check Out Our Sources

Coronavirus outbreak is making grocery shopping stressful - Times of India

Posted: 27 Mar 2020 03:48 AM PDT

As much of the world practices social distancing to stop the spread of coronavirus, trips to the grocery store are one of the few reasons many of us still are allowed to leave the house.
But the logistics of shopping for groceries can be daunting. What happens if some key items on my shopping list are sold out? How do I keep my distance in a crowded produce aisle? And just how many people have touched that jar of peanut butter or can of beans we brought home?
We talked to infectious disease experts about how to shop for groceries during the coronavirus crisis. Here's their advice.
— Check store policies: Look online for what your store is doing to protect both customers and workers. Many stores now close early to sanitize and offer dedicated shopping hours to customers who are 60 and older. Some stores have installed wipe and hand sanitizer stations and put colored tape on floors to help customers keep their distance at checkout lines. If your store isn't taking special measures, don't shop there.

— Should I wear a mask and gloves? The Centers for Disease Control and Prevention says people should not wear masks, but many shoppers are wearing masks and gloves anyway. If you choose to wear personal protective equipment (even though health care workers don't have enough), don't let it give you a false sense of security. You should still limit trips to the store, avoid touching your face and wash your hands when you get home.

— Bring your own wipes and sanitizer. "Most stores are providing hand sanitizer wipes, but I encourage people to bring some of their own — some stores have run out," said Dr. Elizabeth Eckstrom, professor and chief of geriatrics at Oregon Health & Science University. "When you finish shopping, wipe your hands again and wipe the handles of your car before getting in. I am also wiping my steering wheel, but that might be going overboard."

— Wipe the shopping cart. Even during the best of times, the handle on your shopping cart has more bacteria than most public restrooms. When researchers in 2012 swabbed the handles of 85 shopping carts in Iowa, California, Oregon and Georgia, they found digestive tract bacteria on 73% of the carts. If you can, wipe down the cart handle and child seat before you shop. And when you leave, do a good deed and wipe your cart handle for the next shopper.

— What if I don't have wipes? Don't freak out if you or your store have run out of wipes. "The risk of becoming infected from touching any individual shopping cart is probably very, very low," said Dr. Daniel Winetsky, infectious diseases fellow at Columbia University Irving Medical Center. "So if wipes are not available, there is no need to abandon your grocery shopping needs. Just try not to touch your face while shopping, and wash your hands or use hand sanitizer after you are done."

— Shop early. Most stores are closing early now to restock and sanitize at night. Try to shop early when stores are cleanest and shelves are full, or shop at off-peak hours when stores are less crowded.

— Keep your distance. It's probably not feasible to keep a 6-foot radius at all times in a grocery store, but try for at least 3 feet, as recommended by the World Health Organization. "The majority of respiratory droplets we produce while breathing and talking fall to the ground — and onto our hands — within a few feet from us, so even a little bit of distance helps," Winetsky said.

— Limit your trips to the store. Most people don't have the freezer space or the funds to stock up on two weeks of groceries. But try to get enough food so you don't have to shop more than once a week. "Every trip to the grocery store is a small exposure event," said Dr. Robert Amler, dean of New York Medical College School of Health Sciences and Practice and a former chief medical officer for the Centers for Disease Control and Prevention. "You don't want to do it too often or spend too much time there."

— Have a flexible plan. To minimize your time in the store, have a shopping list that allows for alternatives. Don't fret if your store has run out of chicken or salmon fillets. Just find a substitute protein — other meats, eggs, tofu, canned tuna, beans — and move on.

— Shop for long-lasting foods. Frozen fruits and vegetables are great to have in a pinch, but you can also buy longer-lasting fresh produce. Root vegetables such as potatoes or carrots, as well as squash, onions, celery, apples or oranges, can last for weeks. Taste of Home has a useful guide on how long fruits and vegetables will keep. Regular yogurt, hard cheese and nondairy milk can last a while. Whole-wheat tortillas can be frozen and are a great substitute for sandwich bread, which takes up more space in the freezer.

— Don't hoard. Panic buying has prompted some people to fight over toilet paper and pilfer from others' shopping carts. Take what you need for the week; leave food for others. Be reassured that while there may be some empty shelves and temporary shortages of some items, food makers are confident in the supply chain and that we'll have plenty to eat.

— Really, really don't touch your face. We know it's hard, but if there ever was a time to not touch your face, it's in a grocery store filled with people touching everything before you put it in your cart. Sanitize your hands while shopping and after touching high-contact areas like freezer doors. "Absolutely don't touch your face," said Amler. "Don't touch your mouth, don't touch your eyes, don't rub your nose until you've been able to sanitize your hands."

— Be kind to your checkout person. Try to maintain a reasonable distance at checkout. If paying with cash, set the money on the counter rather than handing it to the cashier. And given that this is an opportunity for in-person social interaction, try to make the most of it and be friendly. "Try to maintain distance at checkout, but be pleasant and supportive," Amler said. "There is a risk to them, being in that environment all the time. You might want to thank them for working during this hectic period."

— Is self-checkout better? Winetsky noted that at self-checkout, you're trading an interaction with one person for a self-checkout surface that has been touched by many, many people before you. Either way, wash your hands afterward.

— Reusable bags are still OK. A report from Loma Linda University noted that bacteria could persist on and in reusable checkout bags, but this is not a reason to stop using them. Wash and wipe bags when you can, and wash your hands after using them. Offer to pack your own groceries to protect the checkout person from your germs, said Eckstrom.

Winetsky agreed that the risk of infection from reusable bags is low, and noted that using them not only helps the environment but can serve as a reminder of the link between the environment and our health. "We should all be bringing reusable grocery bags to reduce our carbon footprint and lower our impact on the environment," he said. "This may seem like an unrelated idea, but deforestation can play a role in the emergence of pandemic viruses, by bringing humans into closer contact with mammal species from which we were previously very isolated."

— Should I wipe jars and plastic containers when I get home? The majority of transmission of coronavirus is likely from close contact with an infected person. Viral particles do not survive well on paper or cardboard surfaces. And while the virus lasts longer on hard surfaces, contamination from jars and plastic containers is not a big risk. If it makes you feel better, Amler said, give them a quick wipe as you unpack.

Winetsky agreed that the risk of contamination from jars, cans or other containers "is infinitesimally small" and that you have to balance risk with anxiety. "I would not do this myself or really recommend it to other people," he said. "This level of anxiety about sanitation can be harmful in and of itself."
— What about produce? Eckstrom advised washing your hands after unpacking groceries. And if you're going to eat raw produce, she recommends washing it with an organic soap for washing vegetables or any natural dish soap.
"I am not wiping everything down, but I am carefully washing my hands after touching these grocery items," said Eckstrom. "Cooking does kill the virus, but any fresh produce that is eaten raw should be carefully washed."
— Don't stress. While it's smart to take precautions, you also need to take care of your mental health and try to minimize the anxiety of shopping during the pandemic. "Be reasonable with yourself," Amler said. "Don't overly stress. Do the best you can, and most of the time you're going to come out OK."

Search This Blog

Mucus