The disease caused by the new coronavirus (SARS-CoV-19-2) has officially been named COVID-19. As the number of infections and deaths continues to climb in China, concerns are rising throughout the world about the potential global impact. Well over 1,000 people have died—a death toll that has surpassed that of the severe acute respiratory syndrome (SARS) epidemic that occurred in 2002 and 2003. Officials everywhere have implemented measures to contain the virus, including travel restrictions and quarantines.
But SARS-CoV-2 is one that scientists haven’t seen before. Like other viruses—including Ebola (a deadly infectious disease that originated in Africa) and influenza—it is believed to have started in animals and spread to humans. And people are understandably on edge as tens of thousands of cases have been identified in China and the virus continues to spread around the world.
Scientists and public health officials are working to find answers to key questions about the severity of the disease and its transmission, which they believe are difficult to answer as they’re not yet aware of how many minimally symptomatic cases exist.
“I think there are two main questions,” says Richard Martinello, MD, a Yale Medicine infectious diseases specialist and medical director of infection prevention at Yale New Haven Health. “First, we need to know how this virus is transmitted between people so we can be more precise in our efforts to stop its spread. Second, there needs to be a better understanding of the pathogenesis of the infection and resulting inflammatory response, so that knowledge can drive the development of therapeutic and preventive medications.”
Below is a list of five things you should know about the coronavirus outbreak.
1. For now, this year’s flu presents a greater danger to us than this new illness
People in the U.S. should remain calm, Dr. Martinello says. While data from China show the new coronavirus to be both more contagious and associated with greater severity of disease than influenza, at this point only a small number of people here have been infected, he adds. But influenza is having a substantial impact in Connecticut and across the country. “Therefore, the risk of influenza is much greater for the U.S. than the risk of the novel coronavirus,” Dr. Martinello says.
That doesn’t mean doctors in the U.S. aren’t keeping a close eye on the new virus. “This is a time of watchful waiting,” says Joseph Vinetz, MD. “The bottom line is that there is a new flu-like bug. With the new virus in a culture dish, they are looking at the biology and working to make drugs to treat it.” There is also a great deal of effort underway to assess drugs in development (and some medications currently available) to determine if they are beneficial for treating patients infected with COVID-19, adds Dr. Martinello.
2. The virus is contagious, even before symptoms appear
Many of the first people to be diagnosed with the new coronavirus were linked in some way to a large animal and seafood market in Wuhan, Hubei Province, China, which suggests animal-to-person transmission. There is now sustained person-to-person spread in the country, according to the CDC, though the exact mechanism for transmission is still unclear.
“There is still much to learn about how this pathogen is transmitted between individuals,” Dr. Martinello says. “Data is needed not only to better understand when those who become ill shed the virus, but also which body fluids contain the virus and how those may contaminate surfaces and even the air surrounding them.”
The CDC believes the new virus is contagious during the incubation period—estimated to be 5 to 6 days on average and up to around 14 days—and symptoms can appear anytime between two and 14 days after exposure. The CDC has confirmed person-to-person transmission in the U.S., but notes that so far, the virus is not spreading in the community here.
Doctors say the most important route of transmission is likely close contact (six feet or less) with sick patients who spread respiratory droplets when they cough or sneeze. The risk of spread from asymptomatic people and from touching surfaces and objects contaminated with virus is much lower than droplets spread from sick patients.
Older people and people with pre-existing medical conditions appear to be at highest risk for the virus, but people at any age have also been infected.
3. If you feel ill, here's what you can do
The severity of COVID-19 infection ranges from mild to severe, but the majority of cases in China have not required hospitalization. Scientists say it’s possible that the new coronavirus is a mild one that often causes cold-like respiratory symptoms that develop gradually. Common symptoms have included:
- Fever (of >100.4 F)
- Sore throat in some people
- Difficulty breathing that can be severe enough to cause people to seek hospital care
The new coronavirus has caused kidney failure in some cases, according to WHO, as well as some early clinical reports published in The New England Journal of Medicine, JAMA, and The Lancet.
Officials are urging patients to stay home and contact a health care provider (or hospital emergency room) for guidance if they experience fever, cough, or difficulty breathing, and if they have had contact with a confirmed COVID-19 patient and/or traveled from mainland China within 14 days of the onset of illness.
4. There are things you can do to protect yourself
As with a cold, there is no vaccine for the coronavirus—and a flu vaccine won’t protect people from developing it.
To protect yourself from the new coronavirus, Dr. Vinetz says, “The best thing you can do at this point is take care of yourself the way you would to prevent yourself from getting the flu. You know you can get the flu when people sneeze and cough on you, or when you touch a doorknob. Washing hands—especially after eating, going to the bathroom, and touching your face—and avoiding other people who have flu-like symptoms are the best strategies at this point.”
As for masks, there is little evidence supporting their widespread use. “We generally do not recommend the use of either masks for the general public,” says Dr. Martinello. “Masks may provide a modest degree of protection against fluids, including spray from a cough or sneeze, and they provide some filtration of the air. But, since the masks do not provide a tight seal around the wearer’s nose and mouth, much of the air inhaled and exhaled remains unfiltered.”
5. Precautions remain extremely important
Given that the symptoms tend to be mild and, on a global scale, the number of people infected remains small, you may wonder why so much attention is being paid to this particular illness. For one thing, public health specialists are observing exponential growth in infections worldwide and expect that the rate will continue to climb. Second, extreme caution is warranted because so much remains unknown about this new virus. New diseases aren’t discovered often and some (such as Ebola) are deadly. For now, spreading awareness and keeping people updated as scientists learn more, screening people who might be at risk, and separating those who are infected from healthy people—a basic public health intervention—are the best tools available. So, if you travel or if you visit a health care provider or facility, it may be helpful to know that the COVID-19 signs you see and questions you may be asked about your recent travels and exposures are important.
While the immediate risks from the virus to the American public is considered to be low, the potential public health threat is high, according to the CDC.
Since threats like COVID-19 can lead to the circulation of misinformation, it’s important to trust information only from reputable health organizations and government sources such as the CDC.
Guidelines will evolve as doctors learn more
Here’s the latest information everyone should have to minimize the risk of exposure to the new virus. “Whether it is the flu, which we see every winter, or an outbreak of an emerging infectious disease, the public health infrastructure in the U.S. is a critical resource for leading the federal, state, and local response,” Dr. Martinello says. Because knowledge about the new virus is evolving rapidly, you can expect recommendations to change, even frequently.
The CDC advises people who travel anywhere, locally or internationally, to:
- Avoid contact with sick people
- Avoid animals, whether they are dead or alive, as well as animal markets, and animal products
- Wash hands often with soap and water for at least 20 seconds, whenever they are visibly dirty, and immediately after coughing or sneezing, after going to the bathroom, or before eating. If soap and water are not available, use an alcohol-based hand sanitizer containing at least 60 percent alcohol
- Discuss any recent travel to China (within the past few weeks) with their doctor
Healthcare providers who may be in the position of caring for a patient with the virus should follow infection control protocols.The CDC is working with public health officials to manage risks posed by travelers from China. Anyone who has traveled to Wuhan and is experiencing fever or respiratory symptoms should:
- Seek medical care immediately. Call ahead to their doctor or emergency room to let them know about recent travel and symptoms.
- Avoid contact with others
- Avoid travel if they are sick
- Cover their mouth and nose with a tissue or sleeve (not hands) if they must cough or sneeze
- Wash hands often with soap and water for at least 20 seconds. If soap and water are not available, use an alcohol-based hand sanitizer.
Infection prevention specialists at Yale New Haven Health have provided guidance for the screening of patients with acute respiratory infections to determine whether they have been to China within the 14 days before they got sick, or if they’ve been exposed to anyone who may have been ill with COVID-19.
Researchers are working on a vaccine to prevent the new coronavirus, and it’s hard to predict when one might become available. So, while there is no vaccine for coronavirus, public health authorities strongly advise everyone to get their annual flu shot if they have not done so already. In addition to preventing or mitigating the severity of flu, the vaccine will simplify the evaluation of patients with flu-like symptoms if potential cases of COVID-19 surface in the community.
[Originally published: January 23, 2020. Updated: February 18, 2020.]