COVID-19

 

What you need to know about the COVID-19 pandemic

Sanjay Srivatsa, MD

DISCLAIMER: Please note, the following information is for informational purposes only and is not intended to be medical advice for your situation even if worded as such. For all emergencies, call 911. For all other questions, contact your physician.

 

What is COVID-19?

COVID-19 is the name of the disease caused by a special type of coronavirus. Coronaviruses are a family of viruses responsible for diseases ranging in severity from the common cold to SARS (Severe Acute Respiratory Syndrome). Coronaviruses derive their name from their “crown-like” appearance. The “spikes” of the crown are actually proteins, and differences in these proteins are what determines how severe a version of coronavirus may be.

Why is COVID-19 so serious?

COVID-19 is so serious because it has a unique spike protein that humanity has never seen before. This new spike protein allows it to be more effectively invade human cells, making it both more serious of an infection and more efficient at transmitting from person to person.

How does coronavirus infect people?


Source: Frieman M. SARS coronavirus and innate immunity. Virus Res. 2008;133(1):101-12.

The genetic code for coronaviruses, unlike that of humans, is stored in RNA. RNA contains instructions for making proteins. Our genetic code is stored in DNA, which can be compacted and store a lot of information in a small space, but DNA cannot result in the creation of protein unless it is first translated into RNA. Therefore, the coronavirus genetic code is well-suited to being rapidly used to make proteins that form the virus because it does not have to be translated first.

The coronavirus is essentially a core of RNA surrounded by the proteins the RNA codes for. Proteins on the virus allow it to dock with receptors on host human cells, and the virus then enters the human cell and releases its RNA. The human cell follows the instructions contained in the RNA to both copy RNA and generate new virus proteins. The new copies of RNA and new proteins are repackaged into multiple new viruses, which are then released to propagate the infection.

Some additional facts:

  • Transmission is person-to-person through the air after someone coughs or sneezes, or by touching surfaces where those droplets have come to rest and then bringing them to your face
  • The virus can likely be transmitted even when individuals are not yet showing symptoms
  • The incubation period (time from exposure to the virus to having symptoms) is unknown. The average is close to 5 days, with 97.5% of patients showing symptoms within 11.5 days. However, 1% of patients may still come down with symptoms after 14 days

With the virus spreading rapidly, efficiently, and, in many cases, silently, it is important that we all practice social distancing and self-quarantine as much as possible.

How do I avoid getting COVID-19?

By avoiding close contact with other human beings, you can both decrease your risk of getting the virus and reduce person-to-person transmission. Here are steps you can follow:

  • Avoid close contact with all people, and especially those who are sick
  • Avoid touching your face
  • Clear and disinfect frequently touched objects and surfaces
  • Only wear a mask if you are sick and have to travel

What are the common symptoms?

Symptoms of COVID-19 range from none to mild cold symptoms to severe breathing difficulty from infections of both lungs. Those at risk for more severe disease include older adults, those receiving immunosuppression, and those with chronic medical conditions such as diabetes, high blood pressure, and chronic heart/lung/kidney disease. We are still learning more about the different ways COVID-19 can show itself, but the most common symptoms are:

  • Fever
  • Cough
  • Shortness of breath
  • Fatigue
  • Diarrhea
  • Loss of appetite

Many of these symptoms are common with other diseases, like the flu, pneumonia, and food poisoning, which makes it difficult to identify who may have it based on symptoms alone.

Could I have COVID-19?

The Center for Disease Control calls someone who may have COVID-19 a Patient Under Investigation (PUI). The current criteria for PUI (as of 3/22/2020) include those with symptoms who have:

  • Close contact with a confirmed COVID-19 patient within 14 days of the start of your symptoms
  • A history of travel from affected geographic areas within 14 days of the start of your symptoms
  • The need for testing is determined by the county health department.

What should I do if I have symptoms?

If you have a new cough*, shortness of breath, muscle aches, or fever:

  • If you have a life-threatening emergency (unable to breathe, chest pain, dizziness, confusion, etc.), call 911.
  • If you meet the criteria for Patient Under Investigation (PUI) above or are older than 65, are immunocompromised, or have diabetes or chronic heart / lung / kidney / liver disease, call your doctor.
  • If you are otherwise healthy and your symptoms are mild, the current recommendation is to avoid contact with others, stay hydrated, and wait to get better. Contact the County’s Public Health Department to determine whether you should be tested. If you are unsure which category you fall into, contact your doctor.

*New cough: change in quality / severity / frequency / sputum production of cough, associated symptoms such as fevers / muscle aches, decreased exercise tolerance, feeling like you are coming down with an illness, feeling short of breath with light exercise or with sleeping / lying down

What if I am a patient?

Our clinics are currently operating as scheduled. However, we are monitoring the situation closely. We are encouraging all patients with mild respiratory symptoms to self-isolate and contact the Public Health Department of their respective counties to determine whether they should be tested or not. We are offering telemedicine services to help with this determination. Those with more severe symptoms should call 911 or go to the ER.

For those without respiratory symptoms needing simply routine care, we are encouraging the use of telemedicine services in lieu of an in-person appointment. This is for your safety, the safety of our staff, and the safety of our community at large. Please use the link below for additional information.