First US Coronavirus fatality reported - but is panic premature?

ConnectLocal looks at the science, the facts and the statistics behind the newest disease scare

News was released this morning, March 1, of the first United States fatality attributed to a new strain of virus with more than 87,000 confirmed cases worldwide, and responsible for almost 3,000 deaths, according to statistics published by Johns Hopkins. All but 119 of those deaths have occurred in mainland China, where the outbreak originated.

With a flood of publicity – from news reports to rumors on social media, talk of the “coronavirus” is a topic of conversation from coast to coast in the US. While social media and water cooler talks for the past week have often centered around the disease, and a multitude of related memes have flooded Facebook, the term “Coronavirus” has rarely cracked the top 20 search terms on Google in the past month, and factual information on the disease is often overlooked by both those who are responding in panic and fear, and those who are disregarding the disease as “no worse than the flu.”

I’ve seen that name before

“Coronavirus” is not new, and is not, actually, a single specific disease. The specific outbreak of the respiratory disease that was first detected in China in December 2019 is a new form of a group of viruses called Coronaviruses. The new form of the virus has been labeled SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2). The disease caused by the virus has been labeled as COVID-19.

In recent years, two coronaviruses, MERS-CoV and SARS-CoV, caused much more severe respiratory infections in humans than other coronaviruses. In 2012, the coronavirus MERS-CoV was identified as the cause of Middle East respiratory syndrome (MERS). In late 2002, SARS-CoV was identified as the cause of an outbreak of severe acute respiratory syndrome (SARS). COVID-19 is similar to SARS and MERS, as they are all Coronaviruses.

What is a Coronavirus?

Coronaviruses are a large family of “enveloped RNA” viruses that are common in people and many different species of animals, including camels, cattle, cats, and bats.

The SARS-CoV-2 virus is a betacoronavirus, like MERS-CoV and SARS-CoV. All three of these viruses have their origins in bats. The sequences from U.S. patients are similar to the one that China initially posted, suggesting a likely single, recent emergence of this virus from an animal reservoir.

COVID-19 has an incubation period of up to two weeks, which facilitates the spread of the disease. With fast-incubation diseases, an infected individual comes in contact with fewer people before the contagion is noted and the individual is removed from general populace, normally through hospitalization and quarantine. With long incubation period viruses, an infected individual spends a significantly larger portion of time among the general populace before they are diagnosed and quarantined or hospitalized.

What are the symptoms of COVID-19?

The most common symptoms of COVID-19 are fever, tiredness, and dry cough. Some patients may have aches and pains, nasal congestion, runny nose, sore throat or diarrhea. These symptoms are usually mild and begin gradually. Some people become infected but don’t develop any symptoms and don't feel unwell. Most people (about 80 percent) recover from the disease without needing special treatment. Around 1 out of every 6 people who gets COVID-19 becomes seriously ill and develops difficulty breathing. Older people, and those with underlying medical problems like high blood pressure, heart problems or diabetes, are more likely to develop serious illness. About 2% of people with the disease have died. People with fever, cough and difficulty breathing should seek medical attention. (World Health Organization)

Can you prevent/cure COVID 19 with antibiotics or vaccines?

There’s no specific antiviral treatment or vaccine for it as of yet, but on Feb. 15, theNational Institute of Health announced that “a randomized, controlled clinical trial to evaluate the safety and efficacy of the investigational antiviral remdesivir in hospitalized adults diagnosed with coronavirus disease 2019 (COVID-19) has begun at the University of Nebraska Medical Center (UNMC) in Omaha.” In addition, scientists at the U.S. National Institutes of Health are already working on a vaccine. In a daily COVID-19 press briefing, the WHO Director-General said that more than 20 vaccines are in development globally, and several therapeutics are in clinical trials.

Antibiotics do not work against viruses, they only work on bacterial infections. COVID-19 is caused by a virus, so antibiotics do not work. Antibiotics should not be used as a means of prevention or treatment of COVID-19. They should only be used as directed by a physician to treat a bacterial infection, according to the CDC.

Mortality rate

While this rapid-spread disease can be lethal – its overall deaths worldwide already exceed those from SARS, its mortality rate is less than both SARS and MERS. According to a report from The Chinese Center for Disease Control and Prevention, this outbreak is ”up to 20 times more deadly than the flu, with a fatality rate of about 2.3 percent.” In the U.S., the seasonal flu fatality rate is approximately 0.1 percent.

According to the report, which only took into account 72,314 cases in mainland China, ages 9 and younger suffered no fatalities, while those aged 70-79 suffered an 8 percent fatality rate, with the rate rising to 14.8 percent for those aged 80 and older. No deaths were reported among cases labeled “mild” or “severe,” while the fatality rate for “critical” cases was 49 percent. Preexisting conditions increased the fatality rate by 10.5 percent (cardiovascular disease), 7.3 percent (diabetes), 6.3 percent (chronic respiratory disease), 6 percent (hypertension) and 5.6 percent (cancers.) Of the confirmed cases, 42,670 have been pronounced as “recovered.”

According to the WHO, SARS is more deadly but much less infectious than COVID-19. There have been no outbreaks of SARS anywhere in the world since 2003. The SARS fatality rate was 9.6 percent, and the MERS fatality rate was 34.4 percent.

How does SARS-CoV-2 virus spread?

People can catch COVID-19 from others who have the SARS-CoV-2 virus. The disease can spread from person to person through small droplets from the nose or mouth which are spread when a person with COVID-19 coughs or exhales. These droplets land on objects and surfaces around the person. Other people then catch COVID-19 by touching these objects or surfaces, then touching their eyes, nose or mouth. People can also catch COVID-19 if they breathe in droplets from a person with COVID-19 who coughs out or exhales droplets. This is why it is important to stay more than 1 meter (3 feet) away from a person who is sick. (World Health Organization)

What is the risk of getting COVID-19 in the United States?

Although the current risk-level posed by COVID-19 remains low in the United States, federal health officials, as well as national, state and local health organizations are adopting early precautionary measures, and on Friday, Feb. 28, The World Health Organization raised its risk assessment of COVID-19 to “very high,” citing the risk of spread and impact. WHO officials said their assessment — the highest level short of declaring a global pandemic — doesn’t change the approach countries should take to combat the virus but should serve as a “wake up” and “reality check” for countries to hurry their preparations.” New Centers for Disease Control and Prevention (CDC) guidelines now allow doctors and public health officials to test for the virus if they have clinical suspicion that the person has the disease, regardless of travel.

“COVID-19 is still affecting mostly people in China with some outbreaks in other countries,” the U.S. Center for Disease Control stated Friday, Feb. 28. “Most people who become infected experience mild illness and recover, but it can be more severe for others.”

According to Laraine Washer, M.D., associate professor of internal medicine in the Division of Infectious Disease and medical director of infection control, a review of confirmed cases of COVID-19 show that . Statistics from the Chinese Center for Disease Control indicates that only 1 percent of confirmed cases were in children younger than 9 years of age, and an additional 1 percent in children ages 10-19.

Once infected, approximately 15-20 percent if COVID-19 cases are severe enough to require hospitalization and a significant fraction of that might require intensive care.

The World Health Organization stresses that being of Asian descent does not increase the chance of getting or spreading COVID-19 and people of Asian descent, including Chinese Americans, are not more likely to get COVID-19, or transmit COVID-19,than any other American.

Can wearing a mask keep you from getting COVID-19?

According to the CDC website, the CDC “does not recommend that people who are well wear a face mask to protect themselves from respiratory diseases, including COVID-19. Face masks should be used by people who show symptoms of COVID-19 to help prevent the spread of the disease to others. The use of face masks is also crucial for health workers and people who are taking care of someone in close settings (at home or in a health care facility).”

WHO advises that using face masks to prevent contracting COVID-19 is not only ineffective for the general public, it reduces the supply of face masks available to healthcare workers who do rely on the masks in the performance of their jobs.

The U.S. Surgeon General also made the following post on the Surgeon General’s official Twitter account: “Seriously people – STOP BUYING MASKS! They are NOT effective in preventing general public from catching Coronavirus, but if healthcare providers can’t get them to care for sick patients, it puts them and our communities at risk.”

However, according to the CDC, you can protect yourself and others the same way you’d protect yourself from the flu, colds and other respiratory illnesses:

  • Regularly and thoroughly clean your hands with an alcohol-based hand rub or wash them with soap and water. Why? Washing your hands with soap and water or using alcohol-based hand rub kills viruses that may be on your hands.

  • Maintain at least 1 metre (3 feet) distance between yourself and anyone who is coughing or sneezing. Why? When someone coughs or sneezes they spray small liquid droplets from their nose or mouth which may contain virus. If you are too close, you can breathe in the droplets, including the COVID-19 virus if the person coughing has the disease.

  • Avoid touching eyes, nose and mouth. Why? Hands touch many surfaces and can pick up viruses. Once contaminated, hands can transfer the virus to your eyes, nose or mouth. From there, the virus can enter your body and can make you sick.

  • Make sure you, and the people around you, follow good respiratory hygiene. This means covering your mouth and nose with your bent elbow or tissue when you cough or sneeze. Then dispose of the used tissue immediately. Why? Droplets spread virus. By following good respiratory hygiene you protect the people around you from viruses such as cold, flu and COVID-19.

  • Stay home if you feel unwell. If you have a fever, cough and difficulty breathing, seek medical attention and call in advance. Follow the directions of your local health authority. Why? National and local authorities will have the most up to date information on the situation in your area. Calling in advance will allow your health care provider to quickly direct you to the right health facility. This will also protect you and help prevent spread of viruses and other infections.

  • Stay informed on the latest developments about COVID-19. Follow advice given by your healthcare provider, your national and local public health authority or your employer on how to protect yourself and others from COVID-19. Why? National and local authorities will have the most up to date information on whether COVID-19 is spreading in your area. They are best placed to advise on what people in your area should be doing to protect themselves

FYI - The science stuff

What is a virus?

Viruses are small obligate intracellular parasites, which by definition contain either a RNA or DNA genome surrounded by a protective, virus-coded protein coat. Viruses may be viewed as mobile genetic elements, most probably of cellular origin and characterized by a long co-evolution of virus and host.

For propagation, viruses depend on specialized host cells supplying the complex metabolic and biosynthetic machinery of eukaryotic or prokaryotic cells. A complete virus particle is called a virion. The main function of the virion is to deliver its DNA or RNA genome into the host cell so that the genome can be expressed (transcribed and translated) by the host cell. The viral genome, often with associated basic proteins, is packaged inside a symmetric protein capsid. The nucleic acid-associated protein, called nucleoprotein, together with the genome, forms the nucleocapsid. In enveloped viruses, the nucleocapsid is surrounded by a lipid bilayer derived from the modified host cell membrane and studded with an outer layer of virus envelope glycoproteins.

Viruses are inert outside the host cell. Viruses are unable to generate energy. The main purpose of a virus is to deliver its genome into the host cell to allow its expression (transcription and translation) by the host cell.

A fully assembled infectious virus is called a virion. The simplest virions consist of two basic components: nucleic acid (single- or double-stranded RNA or DNA) and a protein coat, the capsid, which functions as a shell to protect the viral genome from nucleases and which during infection attaches the virion to specific receptors exposed on the prospective host cell. Capsid proteins are coded for by the virus genome.

Some virus families have an additional covering, called the envelope, which is usually derived in part from modified host cell membranes. Viral envelopes consist of a lipid bilayer that closely surrounds a shell of virus-encoded membrane-associated proteins. The exterior of the bilayer is studded with virus-coded, glycosylated (trans-) membrane proteins. Virus envelopes can be considered an additional protective coat. Coronaviruses are a large family of “enveloped RNA” viruses.


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