Corona Virus – Update

I have been receiving multiple calls and inquiries from patients concerned about travelling within the continental United States and exposure to Coronavirus or its new name, Covid-19. To date, there have been NO cases identified in the general population outside the high-risk groups whose exposure came in China or from exposure to sick individuals who caught their illness from someone who had been to China. While the quarantine has slowed the spread of the virus here in the continental United States, there are still many unknowns such as:

  1. What are the different ways it is transmitted?
  2. Can asymptomatic persons transmit the disease before they become ill and how far in advance of symptoms can they be contagious?
  3. How long can the untreated virus live and transmit the disease on a surface such as a tabletop or doorknob?
  4. How aggressive is this virus? What percentage of the patients who contract the illness get minimally ill? What are the unexpected risk factors for severe complications? Why is the illness sparing children – for the most part?

If you have travel plans in the USA, I suggest you go. Given the season, it’s far more likely to contract illnesses such as cold or influenza.

When you travel, as always, wash your hands frequently and keep them away from your face.  Wipe down surfaces with antiviral commercial preparations frequently.

If you still haven’t received your flu shot, get one now!  Consider a second seasonal flu shot if it has been more than 3 months since the original one. However, expect to pay for the second shot since most insurers do not cover it.  Also, most pharmacy technicians will say you don’t need it.

Do not hesitate to call me if you are my patient and have any questions.

Making Sense of the Corona Virus Outbreak in China

The news media has been extensively covering the outbreak of a new virus that causes upper respiratory symptoms. What is known is that it probably originated in bats in a cave and passed through animals and is now infectious to human beings.

The first cases were reported as originating in a fish market in Wuhan, China that illegally sold exotic animals as well. Sources have reported on this new illness for months with much of the information being suppressed by the Chinese government.

Wuhan, China is home to a first-class, state-of-the art virology research lab. That lab’s main researcher has been urging infectious disease experts to evaluate these corona viruses for years while receiving little reward for her efforts. She reports that the previous epidemic of SARS is caused by a corona virus as well.

At this point, researchers from the World Health Organization (WHO) and the US Center for Disease Control (CDC) are attempting to obtain enough information to evaluate how much of a threat this new illness represents. We do not yet publicly know the exact incubation period. We do not know the length of time an individual is a contagious carrier prior to symptoms developing. Some have claimed you are contagious for about two weeks before symptoms appear. This is not consistent with a Vietnamese visitor to Wuhan who returned home ill and his family in Vietnam were all ill with the new coronavirus within three days. We do not know how aggressive this disease is yet.

Are the fatalities from it primarily in the infirm, very young and very old or does the disease strike down the fittest and healthiest as well? Are the deaths in China due to the lack of availability of modern health care, respiratory treatments and medications?

More information should be forthcoming soon. An evacuation of 200 Americans from Wuhan this week, to a military base in Riverside, California, for a voluntary quarantine should provide valuable data. These frightened but responsible individuals will be monitored and treated and studied.

Of interest to me was an article in the NY Times weekend edition by a “medical historian” who outlined the lack of success in containing infectious diseases we have had when no medications or treatments for these diseases existed. As I read it, I kept thinking that while the quarantines were certainly not 100% effective, what data exists to predict the infection severity and mortality that would have occurred if the quarantines had not been put in place?

As a doctor who regularly sees individuals with acute upper respiratory illness, I am comfortable with the CDC’s initial recommendations of avoiding travel to China, hand washing, wearing a mask and taking a travel history on your patients presenting with upper respiratory tract symptoms.

For those of you looking for more information on the new Corona Virus I suggest accessing the online infectious disease newsletter produced by the University of Minnesota School of Medicine called CIDRAP at http://www.CIDRAP.com. They cover this illness, Ebola, SARS, MERS (Middle Eastern Respiratory Syndrome) Bird Flu, food poisoning outbreaks due to infectious agents and other infectious diseases worldwide. If you read that newsletter you will be informed, and frightened, by the reality of what is out there.