A lot has been written and said about what people should do, and should not do, in response to the new coronavirus. Some of it makes sense, some seems extreme, and some is confusing and even contradictory. Here are some medically-informed suggestions to questions people are asking. I am using the common term coronavirus rather than the more technical terms “novel coronavirus” or “COVID-19.”

  1. Why is it called ‘novel’? Doesn’t that mean fictional?
  2. “Novel” can refer to fiction, but it also means “new.” When a virus human

have never been exposed to starts infecting people and causes a new kind of

sickness, it’s called a “novel virus.”

  1. How bad is this going to get? Are there going to be bodies lying in the streets?
  2. There won’t be bodies in the streets. That happened in epidemics of Ebola virus

and the plague because those illnesses can make people very sick so quickly, they cannot return home and because those illnesses are so deadly that people have been afraid to let sick people into their houses. Ebola virus can cause sickness within days, and in Ebola outbreaks, death rates have been as high as nine out of ten infected people (90%). In contrast, with the current coronavirus outbreak, it takes up to two weeks after becoming infected with the virus for a person to feel sick. (These two weeks are called the incubation period.) With coronavirus, at most one in 30 infected people have died (3%). Some medical authorities believe that, because testing has been done mainly on the sickest people, the true death rate may be much lower. With Ebola and plague, most people didn’t understand how the disease was passed from person to person, so they didn’t know how to help a sick person without getting infected themselves. With coronavirus, we know that:

1) If people who are near (within ten feet of) a person who is coughing or sneezing have the sick person wear a mask to decrease the spread of secretions and wash their own hands or use hand sanitizer often and thoroughly, their chance of becoming infected is lower, and

2) Most people who do become infected with coronavirus have little risk of dying or becoming seriously sick.

  1. Why aren’t we quarantining infected people?
  2. Some cruise ships have been quarantined. One nursing home in Washington State has been quarantined. Public health officials in some areas of the US are trying to isolate seriously ill infected people in hospitals. They are also asking people who have been diagnosed with coronavirus but don’t need hospital care, as well as people who have been exposed to known cases or traveled to areas with high rates of infection, to quarantine themselves at home for two weeks. However, in many places there is no system in place, not even follow up phone calls, to make sure people actually do self-quarantine.

Also, because of the two-week incubation period, infections occur, and the person becomes contagious, long before realizing they are ill.

In China, there currently are quarantines of entire cities and regions in attempts to stop the spread of the virus; as a result, the rate of infection in China has slowed down. Less strict forms of quarantine are in place in Italy.

  1. Should I keep the kids out of school?
  2. If their school is open, send them. There are no reports of deaths of children from coronavirus in any country, and very few reports of severe illness from coronavirus in children. The rate of serious infection in children has been very low.
  3. Should older people stay home?
  4. That’s a more difficult question. People over 60 are at higher risk of severe illness and death from coronavirus. People over 70 are are even higher risk, and those over 80 are at the highest risk. In some areas, more than one in five people over the age of 80 with test-proven coronavirus infection have died. It’s appropriately cautious (not overly cautious) for older people to avoid places where there will be many people close together, such as theatres, restaurants, religious gatherings, and conferences. When possible, older people should work from home; videoconferences should be substituted for meetings. It would be smart to avoid airplanes, cruise ships, buses, or subways for the next couple of months. However, individuals’ risk varies. A person of 60 with lung disease or diabetes is more likely to become seriously ill from coronavirus than an otherwise healthy 70-year-old.

Especially in areas where there are many cases of coronavirus, it’s appropriate for big gatherings like conferences, church services, and weddings to be cancelled, postponed, or scaled back. This is particularly true of gatherings where many older people are expected. For example, in Northern Italy all Catholic masses have been cancelled until further notice.

  1. What is a zoonose? It makes me think of an elephant’s trunk or a tapir’s snout…
  2. A zoonose is a short version of “zoonotic infection,” which means an infection formerly found only in animals that starts to infect people. These infections have included swine flu from pigs, bird flu from ducks, AIDS from chimpanzees, MERS from camels, and now coronavirus, thought to have come from pangolins or bats.
  3. Should we wear face masks?
  4. It’s not very likely to help. This is because there are gaps between face masks and the skin of our faces where virus droplets can get in, and also because viruses are so small, they cannot be seen under a microscope. Viruses are so tiny they can pass through the tiny holes in paper and cloth face masks. The coronavirus is not carried on air, only in droplets of saliva and nasal discharge (snot). Masks can be useful if they remind you not to touch your mouth, nose, or eyes: that is the main way people pick up coronavirus infections.
  5. What about gloves?
  6. Gloves can help more, but only if you understand that virus particles cling to your gloves the same way they stick to your hands. Gloves, like masks, can be useful if they remind you not to touch your mouth, nose, or eyes: that is the main way people pick up coronavirus infections. If you use gloves, choose close-fitting gloves the right size for you and get non-latex gloves, because many people have reactions to latex.
  7. Does Corona beer contain coronavirus?
  8. No. Corona is a Latin word that means “crown.” The virus is named for crowns because the spikes on the virus’s surface reminded the person who named the virus of the metal spikes that stick up from the edges of some crowns.

I’m not sure why Corona beer is named for crowns, but I’ve heard that the makers of Corona want the virus to be renamed “Budweiservirus”!

If some of these statements sound extreme, consider how fast this virus spreads. For example, in Italy there were 2,500 cases as of March 4st, then three days later, on March 7th, there were 5,000.

Corona Virus Resources

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Dr. Eva Hersh, MD
Dr. Eva Hersh, MD
Eva Hersh is a family physician. Send your comments and questions to her by email at dreva@baltimoreoutloud.com