I know that all of us have been inundated with an overwhelming amount of information in the past few days regarding the global coronavirus outbreak. The internet is a scary enough place to begin with, even without every news outlet in existence reporting on a global pandemic. But I know that many of us have a lot of questions, and, at least for me, it’s helpful to have answers all in one place, curated and checked by a knowledgeable source.
My dear friend Alexandra Soare is a PhD candidate in microbiology and immunology at the University of Maryland, Baltimore and has worked on various research projects involving infectious diseases, such as Ebola and HIV. Her input has been incredibly valuable in helping me navigate and comprehend the huge waves of information coming at me from every direction. She has kindly offered to help answer some common questions about the coronavirus disease in the following piece for Dinner Party, using a combination of her own training and knowledge, a cache of reputable articles, and input from her colleagues and mentors, including Dr. Matthew Frieman, an expert on coronaviruses who has been featured on CNN and The Washington Post.
So, without further ado, here is our fact-checked and (hopefully) non-panic-inducing guide to the coronavirus outbreak:
What is COVID-19? Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). As the name suggests, SARS-CoV-2 is related to the SARS virus that caused the 2002-2003 outbreak.
These viruses belong to the coronavirus group, which is a large group of viruses with shared biological features that are known to infect humans and other mammals. There are several strains of coronavirus that can cause respiratory tract infections in humans, but most of these infections manifest as a simple cold.
How is COVID-19 different from the flu or other coronaviruses? Dr. Akiko Iwasaki is a professor of immunobiology at Yale University, where her research is focused on viral immunity. She made this chart to compare COVID-19 to other respiratory viruses, such as the flu and other coronaviruses.
According to Dr. Iwasaki, current epidemiological data suggests that COVID-19 is more deadly and contagious than the flu. While COVID-19 and the flu have many overlapping symptoms, they come from two completely different groups of viruses. Unlike the flu, there is no pre-existing immunity to COVID-19.
As far as comparison of COVID-19 to other coronavirus diseases such as SARS and MERS, preliminary research done by Dr. Frieman and other laboratories suggest that SARS-CoV-2 infects similar cells in the respiratory tract as SARS and MERS. However, as Dr. Frieman and Dr. Iwasaki have pointed out, these are still different diseases in terms of lethality and rates of transmission. According to Dr. Stanley Perlman, a professor of microbiology at the University of Iowa, we currently do not know whether previous exposure to another coronavirus, such as SARS, MERS, or cold-causing coronaviruses, would lead to immunity against SARS-CoV-2.
What are the symptoms for COVID-19? Is it true you can have the virus and be asymptomatic? Before we get into all of this, it is important to note that researchers are working with limited amounts of data since the outbreak started in December 2019. We have not had the time to conduct rigorous scientific research to fully understand all of the risks for COVID-19, and it will be quite some time before we get a more complete picture.
What we do have is data from the China outbreak, along with additional information from other parts of the world. According to a Joint Mission that was held in February 2020 between international experts and the World Health Organization (WHO) on the China outbreak, the most common symptoms of laboratory-confirmed cases include fever, dry cough, fatigue, and shortness of breath. The symptoms may appear between 2-14 days after exposure to the virus.
As is the case with many viruses, it is possible for a human to carry SARS-CoV-2 and be asymptomatic. According to the WHO report, patients with mild cases recovered on average two weeks after appearance of symptoms. Patients with more severe or critical diseases recovered 3-6 weeks after appearance of symptoms.
Who is most at risk for COVID-19? While COVID-19 may present as a mild illness in most cases, there are certain populations that are at high risk for developing more severe illnesses. As we grow older, our immune system becomes less responsive, which is why individuals over 60 years old are more susceptible to severe COVID-19 and other infections. Other individuals considered at high risk include those with underlying conditions such as diabetes, cardiovascular disease, cancer, hypertension, and lung disease.
That said, this is by no means a complete list of risk factors for COVID-19. As mentioned before, health experts are working with data from only a four-month window. According to Dr. Kevin Winthrop, an infectious disease epidemiologist at OHSU School of Medicine, we do not yet know whether individuals with autoimmune diseases such as rheumatoid arthritis are more susceptible to COVID-19.
However, many immunosuppressant drugs that are used to treat autoimmune diseases are known to contribute to a higher risk or increased severity of viral infections. If you have questions about an underlying condition or medication, it is important that you contact your healthcare provider to ask about any precautions you might have to take.
Further, please note that age and pre-existing conditions are only two of multiple factors that control the severity of any pathogenic infection, not just COVID-19. Do not simply assume that because you are young and healthy, you will not get a severe form of COVID-19.
What do we do if we get the virus and have to treat it at home? Many cases of COVID-19 manifest as a mild illness that can be treated at home. If you are sick with COVID-19 or suspect that you might be infected, follow these CDC guidelines. The most important thing is to stay at home to limit the spread. If you have to go to the doctor, call ahead of time and tell them that you may have COVID-19.
What is the timeline for a vaccine? The beauty of a vaccine is that it can give you long-lasting protection against a pathogen. Unfortunately, that is also why the timeline for developing a vaccine can be long and tedious. Much of the vaccine development has already been fast-tracked for COVID-19, with the first administration in a clinical trial with a human subject scheduled to begin on March 16th. However, even with this accelerated timeline, it will take many months, possibly years, to determine if this vaccine works or not.
Okay, so no vaccine in the foreseeable future. So what can I do to not get COVID-19? Without a doubt, the most important thing right now is to practice social distancing. In the off chance you aren’t familiar with the practice already, check out this article for basic guidelines and an explanation for how this is different than quarantine or self-isolation.
It may feel a bit dramatic, but limiting social interactions and self-isolating as much as possible are the best things we can do right now to stop the spread of the virus. Dr. John Drazan, a biomedical engineer and educator at Lincoln University made this excellent graphic to help explain the importance of following these guidelines as much as possible.
What we definitively know about COVID-19 is that it is a highly infectious virus that is rapidly spreading through our population. Limiting unnecessary person-to-person contact and shifting to online solutions as much as possible (e.g. working from home, taking clients virtually, chatting with friends over FaceTime or Google Hangouts) will be extremely critical in these upcoming 48 hours to slow the spread of the virus and “flatten the curve.”
The idea of “flattening the curve” is to slow down the spread as much as possible so that our healthcare system is not overwhelmed with patients. The ugly truth that this graph acknowledges is that yes, many of us will get COVID-19. Make no mistake, we were woefully unprepared for this pandemic, and when this is all over, that should be remembered the next time program funds for combatting an outbreak are cut.
But it’s not too late in preventing this from becoming a catastrophe. By having cases spread out over time, we won’t overwhelm our hospitals and end up in a situation similar to Italy, where the number of infected individuals far exceeds the capacity of their healthcare system.
Does soap really work to fight a virus as dangerous as SARS-CoV-2? After all of this bad news, it’s incredibly refreshing to say: Yes! Soap does work against SARS-CoV-2!
How you ask? Dr. Pall Thordarson, a chemistry professor at the University of New South Wales, gave an excellent explanation as to how soap and other disinfectants help against SARS-CoV-2. Basically, the SARS-CoV-2 virus particle is surrounded by a lipid (fatty) membrane. Soap contains fat-like molecules that are biologically similar to the molecules within the viral membrane. This allows soap to disrupt the membrane and causes the virus to “[fall] apart like a house of cards.”
How long should we anticipate practicing social distancing or self-isolation? Unfortunately, we don’t know. There are too many unknown variables presently to provide a conclusive answer to this question. The most prudent course of action would be to anticipate following social distancing guidelines for the foreseeable future, and to have a personal plan to take care of your mental health as you continue to adjust to unexpected disruptions to your daily life.
Hang tight, wash your hands, and stay tuned for Volume Two of this series, which will feature ideas and suggestions on how to stay healthy (and sane!) in a time of heightened collective anxiety and stress.