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What once used to take months or years to spread across the globe and show up on other shores can now be in our country after a quick flight across ocean waters. Global pandemics, outbreaks or epidemics are reported on more and more by our modern media, and it seems each year we learn of some new superbug which could affect our lives from half a world away.

But when does observation of an outbreak in a foreign country become a cause for alarm domestically? Should you take precautions even if you have none of the listed reasons for concern? How do we wade through what is worrisome, and what shouldn’t cause us anxiety even when it's repeated over and over on the news?

Outbreaks of the 2019 Novel Coronavirus have been reported on consistently for the past 7-10 days by the media in the United States, even though we only have at present five actual diagnosed cases in our country. The main area of concern for the World Health Organization, Centers for Disease Control and others, is the area surrounding a meat market in the Wuhan Provence of China. Currently, these agencies (WHO, CDC, et al.) are conducting an ongoing investigation to determine more about this outbreak.

What is Coronavirus?

“Coronaviruses are a large family of viruses, some infect humans; others infect animals. There are common coronaviruses that cause respiratory infections around the world. Coronavirus is common in the United States; it looks like a common cold. However, rarely, animal viruses can evolve and infect humans and then be spread between people. For example, SARS-CoV came from civic cats, and the Middle East Respiratory Syndrome Coronavirus (MERS-CoV) came from camels,” shares Giselle Grimes, Infectious Disease Specialist at Memorial Hospital of Converse County.

It is noted by a “corona” or crown at the top when viewed through a microscope. It most often presents as a respiratory infection accompanied by a fever, cough, and shortness of breath. The common cold is a member of the coronavirus family, with other members ranging up in severity to SARS (SARS-CoV), MERS (MERS-CoV), or the most recent Novel Coronavirus (nCoV) outbreak in China.

“It is looking like the new 2019 Novel Coronavirus (2019-nCoV) came from a seafood/animal market in Wuhan City, Hubei Province, China. It was first reported on December 31. 2019. Person-to-person spread is now occurring in China,” stated Grimes. “We have five known cases in the United States: Washington, Illinois, two in California, and Arizona. All United States cases had recently traveled to the Wuhan Provence in China.”

Without seeking medical attention, more severe cases of coronavirus can become pneumonia. But this again is attributed to only a smaller number of cases compared with the larger body of representative diagnosis of these viruses in any given year worldwide. “Symptoms reported include fever, cough, shortness of breath. The time between exposure and development of symptoms (incubation period) is thought to be two to fourteen days. This is based on what is seen with MERS,” said Grimes.

How Does Novel Coronavirus Spread?

“The potential mode of transmission is respiratory droplets produced when an infected person coughs or sneezes. The spread of SARS and MERS generally occurs between close contacts. There is also the animal-to-person spread (not in the U.S.),” continued Giselle. “There is no available vaccine. Basic preventative actions of hand washing, avoiding contact with ill people, covering coughs and sneezes, and staying at home when sick. There is no specific treatment, just supportive care. Much remains unknown about the characteristics of this virus, i.e., the severity of infection or the ease of transmission to others.”

There are also no reports of person-to-person spread within the United States at this time though travel is becoming more impacted. “As of yesterday, all flights from Wuhan are directed to five U.S. airports: Los Angeles (LAX), New York (JFK), San Francisco (SFO), Atlanta (ATL), and Chicago (O’Hare). They are considering increasing the number of airports to 15,” Grimes reported. “Travelers from Wuhan are screened upon arrival to the U.S. at these five airports by the Centers for Disease Control and Prevention (CDC). They will look for lower respiratory symptoms and fever, ask about potential exposures, and, if symptomatic, undergo testing. If asymptomatic, they are given an informational card and asked to follow up with their physician if they begin to have symptoms.”

What Do Healthcare Organizations Do At Times Like This?

As shown with the SARS outbreak, the most dangerous place to be is on the front lines battling these illnesses. In recent years, infectious disease specialists located locally, regionally, and nationally work to train for the possibilities of outbreaks, epidemic, or possible pandemics. Giselle, and others in our hospital, work to train staff on safety precautions and readiness response for these possibilities - and help our staff (both medical and not) respond in safe ways to protect all involved. Giselle is currently keeping informed by attending the CDC and Wyoming Department of Health webinars as information on the 2019-nCoV is changing daily.

How Does It Compare To Other Wintertime Illnesses and Viruses?

You are far more likely to contract the flu than a severe coronavirus. Currently, the CDC estimates that already in our 2019-2020 flu season, over 8,200 Americans have perished from the flu, with 140,000 hospitalizations attributed to the yearly influenza outbreak. It is estimated that 15 million Americans have had some form of influenza already this season - with several months yet to go.

Wyoming is currently listed as widespread or high, according to both the Wyoming Department of Health and the Centers for Disease Control. Our hospital, and especially our third floor, has taken active precautions concerning visitors to our inpatient areas to better protect our patients as they heal, as well as our staff and community. You can read more about those precautions here.

Ways You Can Cut Down On The Spread Of Viruses

• Get Your Flu Shot - It's Not Too Late!
• Practice Respiratory Hygiene – cover your mouth and nose with a tissue when coughing or sneezing; use the nearest waste receptacle to dispose of the tissue after use.
• Perform hand hygiene or use alcohol-based hand rub after having contact with respiratory secretions and contaminated objects/materials.
• Clean and disinfect hard surfaces.
• Stay home if you are sick.
• While sick limit contact with others as much as possible to keep from infecting them.
• Take antiviral drugs if your doctor prescribes them.

For RSV (Respiratory Syncytial Virus) In Infants

• Wash your hands
• Clean and disinfect hard surfaces
• Avoid close contact, such as kissing, shaking hands, and sharing cups and eating utensils with others.
• Only let people touch your baby after they wash their hands.
• Avoid kissing your baby if you have cold symptoms.
• Keep your baby away from crowds.

Sources

https://www.cdc.gov/coronavirus/2019-ncov/about/index.html

https://www.who.int/health-topics/coronavirus

https://www.cdc.gov/flu/

https://health.wyo.gov/publichealth/infectious-disease-epidemiology-unit/disease/influenza/

https://health.wyo.gov/publichealth/infectious-disease-epidemiology-unit/disease/novel-coronavirus/