Health Forum

1. www.cdc.gov 2. https://coronavirus.1point3acres.com/en 3. http://publichealth.lacounty.gov/media/coronavirus/locations.htm

At some point this month, a stray cough, minor sneeze, or tickly throat has likely stirred one immediate thought: Could I have coronavirus? But before you jump to the worst-case scenario, take a deep breath. It’s important to remember that flu season isn’t over, and coincidentally, we are in the middle of this public health crisis at allergy season. Symptoms of COVID-19, the respiratory illness caused by the novel coronavirus, can overlap with the common cold, flu, and allergies, so it’s crucial to pay close attention to how you’re feeling before you rush to the hospital. It’s very likely that patients could be experiencing allergy symptoms and common colds, But with all of the attention on COVID-19, it’s easy for patients to read into their symptoms too much. That’s why the Centers for Disease Control and Prevention (CDC) does not currently recommend rushing to the hospital if you think you might have COVID-19—at least, not right away. Going to a hospital means you either might spread the virus if you do have it or pick it up if you actually don’t. And with an overwhelmed system, it’s crucial to keep as many beds open for high-risk patients. When should I CALL my doctor about coronavirus symptoms? First, a quick primer on the signs of COVID-19. The CDC currently only lists three: fever, dry cough, and shortness of breath. But a February report of a joint World Health Organization-China mission states that any of the following can be symptoms to watch out for: Fever Dry cough Shortness of breath Fatigue Chills Sputum production Sore throat Muscle pain Headaches Nausea, vomiting, diarrhea (not as common) The distinguishing features are shortness of breath and high fever, which are unlikely to be symptoms of allergies or common colds. If you’re exhibiting one or more of these symptoms, but are managing well enough, it’s time to self-quarantine and get a doctor on the phone. At this point, every primary care provider should be aware of the guidelines for COVID-19 safety, and based on the symptoms you describe, they’ll be able to tell you what to do next. If they recommend continued isolation, it will likely be for 14 days. It is important that people contact their primary care provider for some guidance on whether or not they need to go to one of the testing centers. “COVID-19 is highly contagious, and by showing up at a healthcare facility without giving providers a heads up, you’re putting other people at risk.” When should I go to the hospital for coronavirus symptoms? Currently, you may only qualify for a COVID-19 test if you feel multiple symptoms associated with the illness, have traveled to an area with a high number of cases, or have been directly in contact with someone who has been diagnosed with COVID-19. If you call a healthcare provider and they recommend visiting a testing facility or going to a hospital, you should follow their advice as soon as you can, especially if you’re an older adult or immunocompromised. There is a real possibility of serious and fatal complications with COVID-19, and taking it seriously—while avoiding contact with others—is key. “People who are mildly ill with COVID-19 are able to recover at home,” the CDC says on its website, but “be sure to get care if you feel worse or you think it is an emergency.” The CDC recommends getting immediate medical attention if you exhibit one or more of the following: Temperature higher than 101°F that lasts more than 2 days or fails to respond at least partly to treatment (like these fever remedies) Temperature higher than 103°F under any condition Trouble breathing Persistent pain or pressure in the chest New confusion or inability to arouse Bluish lips or face Other severe or concerning symptoms

What is a coronavirus? Coronaviruses are a large group of viruses that are common among animals. In rare cases, they are what scientists call zoonotic, meaning they can be transmitted from animals to humans, according to the US Centers for Disease Control and Prevention. Coronavirus Symptoms The viruses can make people sick, usually with a mild to moderate upper respiratory tract illness, similar to a common cold. Coronavirus symptoms include a runny nose, cough, sore throat, possibly a headache and maybe a fever, which can last for a couple of days. For those with a weakened immune system, the elderly and the very young, there's a chance the virus could cause a lower, and much more serious, respiratory tract illness like a pneumonia or bronchitis. There are a handful of human coronaviruses that are known to be deadly. Middle East respiratory syndrome, also known as the MERS virus, was first reported in the Middle East in 2012 and also causes respiratory problems, but those symptoms are much more severe. Three to four out of every 10 patients infected with MERS died, according to the CDC. Severe acute respiratory syndrome, also known as SARS, is the other coronavirus that can cause more severe symptoms. First identified in the Guangdong province in southern China, according to the WHO, it causes respiratory problems but can also cause diarrhea, fatigue, shortness of breath, respiratory distress and kidney failure. Depending on the patient's age, the death rate with SARS ranged from 0-50% of the cases, with older people being the most vulnerable. The Wuhan coronavirus is currently thought to be more mild than SARS and MERS and takes longer to develop symptoms. Patients to date have typically experienced a mild cough for a week followed by shortness of breath, causing them to visit the hospital, explains Peter Horby, professor of emerging infectious diseases and global health at the University of Oxford. So far, around 15% to 20% of cases have become severe, requiring, for example, ventilation in the hospital. How it Spreads Viruses can spread from human contact with animals. Scientists think MERS started in camels, according to the WHO. With SARS, scientists suspected civet cats were to blame. Officials do not yet know what animal may have caused the current outbreak in Wuhan. When it comes to human-to-human transmission of the viruses, often it happens when someone comes into contact with an infected person's secretions, such as droplets in a cough. Depending on how virulent the virus is, a cough, sneeze or handshake could cause exposure. The virus can also be transmitted by touching something an infected person has touched and then touching your mouth, nose or eyes. Caregivers can sometimes be exposed by handling a patient's waste, according to the CDC. Human-to-human transmission has been confirmed for the Wuhan coronavirus, but experts are now trying to understand who is transmitting it most, who is at most risk and whether transmission is occurring mostly in hospitals or in the community. SARS and MERS were largely transmitted inside hospitals, Horby said. Some people are also considered to be "superspreaders." Who is ffected? MERS, SARS and the Wuhan coronavirus appear to cause more severe disease in older people, though uncertainty remains around the latest outbreak. Of the cases of Wuhan coronavirus reported so far, none are yet confirmed to be among children, Horby said. The average age is people 40 or over, he said. CoronaVirus Treatment There is no specific treatment, but research is underway. Most of the time, symptoms will go away on their own and experts advise seeking care early. If symptoms feel worse than a standard cold, see your doctor. Doctors can relieve symptoms by prescribing a pain or fever medication. The CDC says a room humidifier or a hot shower can help with a sore throat or cough. Drink plenty of fluids, get rest and sleep as much as possible. Should you worry about the Wuhan coronavirus? The Wuhan coronavirus fatality rate is lower than for SARS and MERS, but still comparable to the 1918 Spanish flu pandemic, explains Neil Ferguson, professor of mathematical biology at Imperial College London. "It is a significant concern, globally," Ferguson says, noting that we don't fully understand the severity. Ferguson believes the fatality rate is likely to be lower due to an "iceberg" of milder cases we are yet to find, but he highlights that novel viruses spread much faster through a population. How can you can prevent it? There is no vaccine to protect against this family of viruses, at least not yet. Trials for a MERS vaccine are underway. The US National Institutes of Health is working on a vaccine against the new virus, but it will be months until clinical trials get underway and more than a year until it might become available. You may be able to reduce your risk of infection by avoiding people who are sick. Try to avoid touching your eyes, nose and mouth. Wash your hands often with soap and water and for at least 20 seconds. Awareness is key. If you are sick and have reason to believe it may be the Wuhan coronavirus due to travel to the region or coming into contact with someone who has been there, you should let a health care provider know and seek treatment early. Cover your mouth and nose when you cough or sneeze, and disinfect the objects and surfaces you touch. If traveling to China, be aware of symptoms and avoid live animal markets, which is where the latest outbreak began in Wuhan. Coronavirus and pregnancy In pregnant women, the more severe versions of MERS and SARS coronaviruses can be serious. There are cases in which a woman infected with MERS had a stillbirth, a 2014 study showed. SARS-associated illnesses were linked to cases of spontaneous abortion, maternal death and critical maternal illness, a 2004 study found. Coronavirus and cats, dogs and other animals Pets can catch coronaviruses and the infections can become severe. Sometimes the viruses can lead to deadly diseases. One can cause feline infectious peritonitis in cats and something called a pantropic canine coronavirus can infect cats and dogs, according to a 2011 study. Cats can catch SARS, but none of the infected cats developed symptoms, according to the study. The feline coronavirus typically is asymptomatic, but can cause mild diarrhea. Feline infectious peritonitis, or FIP, can cause flu-like symptoms for a cat, but can also be more serious for cats and can cause organ failure, but it is not contagious and will not spread from animal to animal or person to person. Pantropic canine coronavirus that can impact cats and dogs can be fatal to dogs, studies show. These particular dog and cat viruses don't seem to spread to humans. CNN's Kristie Lu Stout contributed to this report