Coping With COVID-19 (Coronavirus)
Authors: Kent D Katz, MD and Don Kuenz
Date: March 1, 2020
Keywords: coronavirus, covid19, protein, spike
Taxonomic Hierarchy: Group IV ((+)ssRNA); Coronaviridae;
    Coronavirinae; Betacoronavirus; Sarbecovirus; 
    Severe acute respiratory syndrome coronavirus 2

Coping With COVID-19 (Coronavirus)

Lab

Figure 1. COVID-19 diagram (courtesy of US CDC).

The coronavirus is now called the “novel coronavirus” or “COVID-2019” has infected more than 85,000 globally, with more than 2,900 deaths. Last week’s numbers were 79,930 & 2,465. These numbers are clearly up, but by a much smaller increment than we’ve seen in weeks prior. Much of this has been by the stringent public health measures implemented by China. While the vast majority of these cases continue to be around Wuhan China, cases are increasing elsewhere. The World Health Organization says the outbreak has reached the “highest alert” level, but has not called it a pandemic (worldwide epidemic), yet. That said, numbers will continue to rise, both in the US and worldwide, and I expect at some time, it will become an official pandemic. Numbers are low in the US because of the public health measures we’ve implemented, and it is also being contained in China because of their measures as well. These include isolating those who are infected and exposed. In affected areas, China has temporarily closed factories, public transportation, schools, and public gatherings. They encouraged working from home. They are now starting to relax those restrictions.

Casper will likely see some cases, but as we get closer to summer, transmission of COVID-19, like influenza, will decrease. That said, as colder weather drives many in the southern hemisphere indoors, they will see an increase in transmission. Next fall, as the cases in the southern globe begin to drop, we will likely see a rise in cases in our hemisphere, as we move in doors to avoid the cold. This is the pattern we see with influenza and even the common cold.

COVID-19 is part of a family of virus that can cause the common cold. So, as you’d expect, it causes symptoms like a common cold or, in more severe cases, like influenza or pneumonia. We’re pretty sure at least 85% of those infected with the virus has mild or no symptoms. The real number has been estimated to be closer to 95%, as healthy people, or those with just mild symptoms, don’t come in to get tested. It likes to attack the lungs, and so it can cause a pneumonia. Some people have a hyperimmune response, so their immune system is not only attacking the infection, but healthy lung tissue as well. These people do not do well, and some die. There are no sure cures for the infection but some promising results have been reported with specific treatment programs. Not surprisingly, most healthy people handle the infection well, but those with underlying lung, heart, kidney, or immune issues are more likely to have problems. The very young have not yet developed their immune system, the elderly have lost part of their immune response, and those on chemotherapy or immune-modulators are at highest risk. As you would expect, these risk factors mirror those of influenza.

Other coronaviruses are spread the same way as the cold or influenza. Common person-to-person transmission is through the air. Someone coughs or sneezes in a confined area full of people, such as an elevator, would be a typical mode of transmission. It can also spread by touching your mouth, nose, or eyes with the virus, that you picked up from some object that an infected person sneezed on or touched with the virus on their hands. We don’t know about COVID-19, but assuming it is like similar virus, it would remain viable on plastic, wood, or paper for up to ten days, but only two hours on metals, like coins.

A few of the tight-fitting masks, that filter the air, can protect you, but they are somewhat expensive, and difficult to wear for long periods of time. The surgical type masks limits how someone infected with the virus can spread the virus when they cough or sneeze, but do not protect the uninfected from airborne transmission. They do limit how often the wearer touches their mouths or noses, however. Most common disinfectants kill typical coronaviruses and are thought they can kill COVID-19 but this hasn’t yet been proven. It doesn’t matter if they are wipes or sprays, they all work, but beware, typical household cleaners are NOT disinfectants. Look for the word “disinfectant” or “Kills 99/9%”. Cleaners remove dirt and grime, but are not designed as a disinfectant. If you choose to disinfect surfaces, plan to use a lot of disinfectant. Read the label, as it will typically say the surface needs to remain visibly wet for 4 minutes. Always wipe in one direction, to prevent backspreading the virus. Replace wipes or towels often. Furthermore, some surfaces are too intricate to adequately disinfect, like a TV remote. Put it in a ziplock bag. It will work fine, and you can keep the bag clean.

That said, the best way to minimize contracting the virus remains washing your hands frequently with soap and water, especially if out in public where you contact surfaces, such as a shopping cart, after going to the bathroom, sneezing, coughing, or before you eat. Wash your hands for at least 20 seconds, scrubbing between fingers and the backs of hands. Hand sanitizers don’t work well, but are felt to be at least partially effective. Try to avoid being in close vicinity of sick people, or closed rooms. Some people choose not to shake hands.

A few other suggestions. Use only your knuckle to turn on light switches, push button on elevator or public phones, etc. Open doors with your hip or closed fist, not your open hand, especially if a public door, like a bathroom, store, post office, etc. When filling up your car’s gas tank, use a paper towel to grab the pump handle. Zinc Lozenges, like Cold-Eeze work with similar viruses, and may work with COVID-19.

To prevent spreading the virus, cough or sneeze into your elbow or tissue (then throw the tissue away.). If you are sick, stay home or don’t go out to crowded public places like markets, movies, work, schools, public transportation, etc. If you must leave the home while ill, wear a “surgical” mask.

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<© 2020 Kent Katz & Don Kuenz>