By Dr. Michael Jacobson, D.O.
From the May 2020 issue of Heartfelt Magazine.
Editor’s note: Rest assured that medical bills incurred from the coronavirus and other medical events are—and will continue to be—eligible for sharing in accordance with the CHM Guidelines and the member’s participation level, just as are costs for any testing or treatment for a confirmed illness, with Personal Responsibility amounts that depend upon the member’s participation level.
In January Americans watched with growing concern as a virus that began in China spread to over 50 locations across the globe. On January 31, 2020, concern turned to alarm when Health and Human Services Secretary Alex M. Azar II declared Coronavirus Disease 2019 (COVID-19) a U.S. public health emergency.
By the end of March 29, 2020, the worldwide death toll exceeded 33,966 and over 721,000 cases were confirmed. Some 122,000 cases were confirmed in the U.S., with 2,112 deaths. Through the U.S. public health surveillance system, the Centers for Disease Control and Prevention (CDC) identified multiple confirmed cases in the U.S., the majority of which were travel-related.
Of the 49 Americans who tested positive while traveling abroad, three traveled to Wuhan City in China’s Hubei province, the epicenter of the virus, and 46 were on the cruise ship Diamond Princess. Japanese health authorities prevented passengers and crew of the Diamond Princess from disembarking for two weeks. While quarantined onboard near Yokohama, the positive cases among ship occupants climbed from only 10 to over 700. Eventually, over 300 American passengers, including 14 newly confirmed cases, returned home on February 16 on a flight chartered by the U.S. State Department.
Global efforts were focused on limiting the spread and lessening the impact of the virus. In the U.S., the CDC purposed to prepare local communities to respond to the virus and minimize the potential of a COVID-19 pandemic.
What is COVID-19?
Coronaviruses are a large family of viruses typically found in a variety of animal species. The virus causing COVID-19 (SARS-CoV-2) most likely originated in bats and spread to intermediate animals such as cattle, cats and camels. Coronaviruses have the ability to jump from animals to infect people. This particular virus demonstrates capability of spreading person-to-person; however, the CDC confirmed at least two cases in California in which they have no idea how the individuals contracted the disease, the individuals having no known travel or contact with another infected person.
Symptoms and risk
Symptoms of COVID-19 range from mild to severe and include fever, cough and shortness of breath, indicating a lower respiratory infection as opposed to an upper respiratory infection or common cold. The incubation period (time between exposure to infection and the appearance of first symptoms) ranges from two to 14 days. Note that it’s possible to transmit the virus to someone else even when the infected person has no symptoms.
At the time of this writing, there are no vaccines currently available to protect against human coronaviruses and no approved medications to effectively treat COVID-19. While the CDC considers the potential public health threat of COVID-19 to be very high, the vast majority of Americans are at low risk for contracting the infection.
Individuals at high risk include those who travelled to the Hubei province, China. Also, those who have not followed recommended precautions while living in the same household or being within close contact of an infected person are at higher risk. An example of unsafe contact is being coughed upon within six feet.
The risk of infection drops to “medium” If proper precautions are followed. This holds true even if in close contact with an infected person. Air travel with an infected person poses only medium risk as long as there is six feet, or two seats, in any direction between you and the infected person. Sitting in a waiting room or classroom with an infected person does not confer higher risk.
If someone is exposed to COVID-19, but has no symptoms presenting (asymptomatic), he or she should adhere to specific protocol recommended by the CDC, according to risk level.
High risk* individuals should:
- submit to quarantine as directed by local public health authorities
- receive daily monitoring from public health officials
- avoid travel, unless approved by public health authorities
Medium risk* individuals should:
- remain at home
- avoid congregating with others or going out in public
- practice social distancing (i.e. maintaining at least 6 feet of distance from others)
Low risk* individuals should:
- monitor themselves for 14 days to ensure no symptoms develop
If symptoms of COVID-19 should develop in a person who is medium-to-high risk, he or she should immediately isolate himself or herself from others, wear a face mask, alert healthcare authorities of their concern and arrange for testing and transport in a manner that will not expose others. Low risk individuals who develop symptoms should similarly avoid public transportation and contact with others and reach out to healthcare authorities for advice regarding whether testing is warranted.
Based upon reports from China and the World Health Organization (WHO), out of more than 100,000 confirmed cases, over 96 percent of infected persons will survive. Risk of death increases to nearly 10 percent when other diseases, particularly diabetes and heart or lung disease, are present. Age can be a contributing risk factor; risk of death increases to 22 percent in the very elderly, while no children under the age of 10 have died from the virus. Although COVID-19 does not appear to be as deadly as the 2002 SARS virus, which had a 9.6 percent mortality rate, in less than two months, the number of those infected with COVID-19 exceeded that of SARS by 10-fold.
CDC recommended measures for preventing spread of infection
- Avoid close contact with people who are sick.
- Avoid touching your eyes, nose and mouth.
- Stay home when you are sick.
- Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
- Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe.
- Wash your hands often with soap and water for at least 20 seconds, especially before eating and after blowing your nose, coughing, sneezing, or going to the bathroom. Use hand sanitizers when soap and water are unavailable.
- Wear a facemask if you show symptoms of COVID-19 to help prevent the spread of the disease to others. The use of facemasks is also crucial for health workers and people who are taking care of someone at home or in a healthcare facility. CDC does not recommend facemasks as protection from respiratory diseases, including COVID-19, for those who are well.
While this information is presented specifically in reference to COVID-19, it is useful instruction for the prevention and containment of any infectious agents.
- Coronavirus Disease 2019 (COVID-19) Situation Summary. https://www.cdc.gov/coronavirus/2019-ncov/summary.html
- Coronavirus: how Diamond Princess cruise ship became a ‘super spreading’ site. February 13, 2020. https://www.scmp.com/week-asia/health-environment/article/3050517/coronavirus-how-diamond-princess-cruise-ship-became
- NBC News Feed. https://www.nbcnews.com/health/health-news/live-blog/coronavirus-updates-live-countries-prepare-outbreak-spreads-n1143556
- Are coronavirus diseases equally deadly? March 5, 2020. https://www.nbcnews.com/health/health-news/coronavirus-diseases-comparing-covid-19-sars-mers-numbers-n1150321