© 2020 PRIVATE HEALTH MANAGEMENT

The Coronavirus Outbreak

What You Need to Know, Now

UPDATED February 25, 2020

 

Private Health provides periodic communications  to our clients to help you maintain optimal health and remain informed about important health issues. Given the recent coronavirus (COVID-19) outbreak, we prepared this report to help you understand the status of this global health concern and what you can do to reduce your risk. We will continue to monitor the situation and provide updates as it evolves. Items noted in bold below will be closely watched and updated. This briefing is an update on our previous communication.

 

Since our last update, coronavirus (COVID-19) incidence and deaths have increased significantly, the geographic footprint has expanded and the toll on the global economy is beginning to be felt and measured. However, the authoritative guidance for individuals has not changed greatly. We continue to support the following recommendations, and encourage rigorous adherence to them, especially for international travelers and in all situations that involve large numbers of people, some of whom have traveled internationally:

  • Avoid close contact with people suffering from respiratory infections and keep your distance in large group settings 

  • Wash hands frequently with soap and water or and use hand sanitizer with at least 60% alcohol

  • Get a flu shot if you have not already done so

  • Avoid touching shared surfaces (handrails, doorknobs)

  • If you do become symptomatic (fever, cough, headache), especially if you have any reason to suspect interaction with someone who may have been exposed, we suggest that you immediately contact your primary care physician, use a mask and stay out of social and work settings

International Travel Warnings

Here are key CDC travel warnings:

  • Warning Level 3, Avoid Nonessential Travel: China, South Korea

    • Do not travek

    • Note: the U.S. Department of State posted a Level 4 “do not travel” warning, its most severe level of travel advisory

  • Alert Level 2, Practice Enhanced Precautions: Japan

    • Older adults and those with chronic medical conditions should consider postponing nonessential travel

    • Travelers should avoid contact with sick people and wash hands frequently with soap and water or use hand sanitizer with at least 60% alcohol

  • Watch Level 1, Practice Usual Precautions: Hong KongIranItaly

    • Travelers should avoid contact with sick people and wash hands frequently with soap and water or use hand sanitizer with at least 60% alcohol

  • Reconsider cruise ship travel to or within Asia​

 

Overview 

A new strain of coronavirus, now called COVID-19, short for “coronavirus disease 2019”, was first identified in January by Chinese researchers in Wuhan, a city in central China of 11 million people. The cases were linked to a market that sold live animals. The market was shut down and disinfected, but the confirmed human infections have spread. 

 

To date, there have been more than 80,370 cases worldwide, of which 77,666 are in China, and at least 2,707 deaths worldwide  (World Health Organization). There are confirmed cases in 40 countries and territories, including Taiwan, Japan, Thailand, South Korea, Hong Kong, Macau, Australia, Cambodia, Malaysia, Nepal, Sri Lanka, India, Singapore, Thailand, Philippines, Vietnam, United Arab Emirates, Egypt, Canada, Finland, France, Germany, Italy, Spain, Belgium Sweden, UK and the U.S.

 

 

Coronavirus (COVID-19) World Outbreaks (CDC)

On February 5, 2020, WHO announced a $675 million plan to establish international coordination, scale up county readiness and response operations and accelerate key research over the next two month. On February 11, 2020 WHO announced COVID-19 as the official name for the disease.

 

Key Outbreaks: Iran, Italy and South Korea 

There are outbreaks in Iran (95 cases, at least 15 deaths), Italy (287 cases, at least seven deaths) and South Korea (977 cases, at least 11 deaths). Iran closed schools and cultural and religious centers across 14 provinces and Turkey and Pakistan announced temporary border closures. Italy is imposing lockdowns and quarantines on 11 cities in northern hotspot regions and is closing Venice Carnival two days early. South Korea raised the alert level to its maximum (Level 4: Serious), paving the way for the government to restrict travel and enforce city lockdowns as needed. Please see travel advisories above.

 

United States Status

Centers for Disease Control reports 14 confirmed cases out of the 426 people tested, as of yesterday. In addition, 39 people have been repatriated to the U.S. and tested by CDC – three from Wuhan and 36 from the Diamond Princess cruise ship. CDC cautions that person-to-person spread will likely continue and more cases will be identified. Yesterday, the White House requested $2.5 billion in new emergency funding to address the global outbreak.

World Health Organization Response

Yesterday, WHO said that the outbreak is “not yet” considered a pandemic, but it is being closely monitored. On February 5, 2020, WHO announced a $675 million plan to establish international coordination, scale up country readiness and response operations and accelerate key research over the next two months. On February 11, 2020 WHO announced COVID-19 as the official name for the disease.

 

About the Disease

Coronaviruses are characteristically named for the crown or “corona”-like spikes on the microscopic surface of the virus. This large family of viruses causes respiratory illnesses ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS), each of which killed approximately 800 people in 2012 and 2002-2003, respectively. So far, COVID-19 has infected almost 10 times the number of people who contracted SARS and approximately three times as many people have died of COVID-19 than either SARS or MERS. The fatality rate is estimated to be 2%, but this is an early estimate.

 

Symptoms

Common human coronaviruses typically cause mild to moderate upper-respiratory tract illnesses with symptoms that resemble the flu or a bad cold, such as a runny nose, headache, cough, sore throat, and a general feeling of being unwell. Approximately 70% of cases report an initial fever presentation that comes on slowly and a dry, barking cough after the first day. More severe symptoms may include difficulty breathing, pneumonia, bronchitis and lung lesions. 

 

Incubation

The time from exposure to the onset of symptoms is thought to be about two to 14 days. Approximately 90% of the cases present clinical symptoms by nine days post-infection. Researchers observe that approximately 37% of cases had evidence of the virus in their sputum samples in the 24 hours prior to exhibiting observable symptoms like fever. The quantifiable amount of the virus is low, but there is a chance that asymptomatic patients may be infectious in the 24 hours before they have symptoms. 

 

Transmission

Initially, the source of outbreak was linked to animal sources. Person-to-person transmission is now occurring, with an estimated two – three people becoming infected from one already infected person. The exact mode of transmission of this new strain of coronavirus is not completely understood, but prior strains of human coronavirus are most commonly spread from an infected person to others via: 

  • Air droplets by coughing and sneezing (~60%)

  • Touching an infected object or surface (~20%)

  • Touching contaminated surfaces then touching your mouth, nose, or eyes (~20%)

 

Those with the greatest risk of infection are older than 55 years old, men, smokers, people with diabetes, people with kidney disease, and immunocompromised patients. 

 

Prevention 

There are currently no vaccines available to protect against human coronavirus infection. In order to reduce the risk of infection, consider the following tips: 

 

  • Try to avoid contact with people who are sick. Maintain an eight foot distance if you are near someone with symptoms to avoid air droplets from coughing and sneezing.

  • Wash your hands frequently with liquid soap and water for at least 20 seconds, especially after touching public installations such as handrails or doorknobs and before touching your mouth, nose, or eyes.

  • When your hands are not visibly soiled and soap and water are not available, clean your hands with sanitizer containing at least 60% alcohol, such as Purell Advanced Hand Sanitizer.

  • Get the flu vaccine – the flu is co-circulating and several flu patients have caught the coronavirus in the hospital because of the compromised immune system.

  • Try to stay generally healthy as being run down puts your body at greater risk.

  • High risk individuals may consider putting on surgical masks while in public and not adequately ventilated places. WHO provides detailed guidance on proper technique.

  • Thoroughly cook meat and eggs.

  • Avoid animal markets in Asia. ​​

 

Treatment

There is no specific treatment available. If you believe that you have been exposed to someone with coronavirus or you might have coronavirus, we recommend that you contact your primary care physician immediately. 

 

Your physician may prescribe medication to address pain and/or fever. CDC suggests taking a hot shower or using a humidifier to alleviate a sore throat or cough. Drinking lots of fluids and getting as much rest as possible are also advised.

 

 

If you have any concerns about the coronavirus outbreak,

Private Health is here to help

 info@privatehealth.com