COVID-19: Prepare, don't Panic!

Coronavirus is all over the news and I'm seeing either panic or denial in many people. Neither of those positions will help. We need to prepare, not panic.

I first wrote about coronavirus in January. If you don't want to read the post, the TLDR version is coronavirus is a family of viruses that often cause common cold symptoms. COVID-19 is a new strain that sometimes causes more significant illness. We're still learning more about how long this virus remains contagious, what the actual risks are, and more.

Last month I wrote a general Infection Prevention post that follows the CDC guidelines for helping to stop the spread of coronavirus. COVID-19 likely spreads through respiratory droplets produced when a person coughs or sneezes. This is how most respiratory viruses spread, so I am hopeful that the precautions we use for other infections will help contain this one.

Today I want to reinforce many of the infection prevention recommendations and share the most current recommendations of what to do if you someone in your family is sick. We cannot all run to the clinic or hospital - the system will be overrun and no one will be properly served. I suspect that there will be many people who get this virus who will never know it because their symptoms don't warrant hospitalization or testing.

We are learning that children do not seem as sick as older adults if they get coronavirus. While this is great for the children, it can increase the spread. They might not seem very sick so they will continue to go to school and other public venues.

We also know that many people spread this virus before they show symptoms of illness.

It is very important that we follow infection prevention every day, whether or not we think we're around sick people!

Who is at risk of COVID-19?

• Those who live with a person with a confirmed or suspected case of COVID-19.

• Those who come into close contact (within 6 feet) of a person with confirmed or suspected COVID-19 - Examples include close conversation, eating together.

• People who have traveled to an area of high risk per the CDC. Currently the countries with a travel advisory include China, Italy, Iran, South Korea and Japan.

• Those with a fever with acute lower respiratory illness requiring hospitalization and no alternative diagnosis even if no source of COVID-19 exposure has been identified.

These are NOT considered close contact exposures:

• Living in a city where there is a confirmed COVID-19 infection (though this increases the risk of exposure).

• Being in the same building as a person with COVID-19 (unless you are within 6 feet for a time, such as a conversation).

• Walking by a person with COVID-19.

• Eating Chinese food.

• Receiving packages from China. It appears that COVID-19 does not survive long on surfaces, so there is likely very low risk of spread from food products or packages.

Important if you are high risk for COVID-19:

Call your physician's office if you feel sick with fever, cough, or difficulty breathing, and have been in close contact with a person known to have COVID-19, or if you live in or have recently traveled from an area with ongoing spread of COVID-19.

DO NOT use a walk in clinic or schedule an appointment without specifically identifying your risk. This will allow you to be directed to the location that can best serve your needs and for proper precautions to be taken when you arrive at the facility.

All travelers returning from geographic areas with widespread community transmission are encouraged to remain at home and avoid large gatherings for 14 days after returning to the United States.

What if I want to be tested?

Most clinics at this time cannot test for COVID-19, so do not expect to be tested unless the health department deems you to be at risk.

At this time only people with known exposure or increased risk are being tested.

Testing kits are in limited supply and are not 100% accurate. According to the CDC, in the early stages of infection, it is possible the virus will not be detected during testing, so even the testing is limited in capabilities.

What to do if sick?

One of the unfortunate realities of COVID-19 coming the the US now is that we're still in the middle of cold and flu season. It will be difficult to know what you're infected with because symptoms can all be similar: fever, runny nose, cough, sore throat.

The good news is most of these illnesses can be managed at home.

You do not need to know what it is to treat symptoms. The CDC is recommending that people with mild illness stay home. This helps prevent spread regardless of what is causing symptoms.

Standard treatment tips are going to work for mild illness and can be seen here and here.

Be especially cautious and avoid being around people over 50 years of age if you're sick, since that age group is at higher risk of serious illness with COVID-19.

If you have been exposed to COVID-19

If you have a potential exposure, the most important thing initially is to not spread the virus further. This can happen even before symptoms start, so don't wait until you have symptoms to take precautions.

• Call your local health department or physician's office for instructions.

• Stay home unless you have need for medical attention. This means no work, no school, no shopping, no sports, no church.

• Do not have visitors come to your home.

• If you need food or medicine delivered to your home, advise people to leave it at your door. After they leave you can retrieve it.

• If symptoms develop, call the health department for further instructions. Do not go into a hospital or clinic without first calling!

Who should be seen at their doctor's office?

The recommendations for who should be seen in their doctor's office remain the same overall. If you do not need medical treatment, it is best to stay home, but if your child has the following symptoms, they should be evaluated:

• Any infant under 2 months of age with fever (>100.4F) or older child with persistent fever - call for advice first

• Mild difficulty breathing (rapid breathing, barky cough, inability to run/play without distress) - allergy and asthma season is upon us: make sure you have your needed medications!

• Dehydration

• Sore throat, fever, swollen glands, abdominal pain WITHOUT runny nose (due to possible treatable Strep throat)

• Pain that is not controllable

• Symptoms of urinary tract infection (painful urination, accidents, altered urine smell or color, fever)

• Call your doctor's office if there is a fever or cough that starts within 14 days of a potential exposure to COVID-19.

When to go to the ER?

• Severe respiratory distress - struggling for each breath, can only speak in single words, blue lips: Call 911.

• Any difficulty breathing that occurs within 14 days of exposure to a known or suspected case of COVID-19 (call ahead - DO NOT show up unannounced)

Tracking COVID-19

The CDC and WHO sites have information about COVID-19.

This is a great tracker from Johns Hopkins CSSE.