Covid-19

Coronavirus is a type of virus that can infect both animals and humans. A new strain of the coronavirus emerged in the later part of 2019 in Wuhan, China.  Since this particular strain of the coronavirus had not been experienced previously in the human population, it spread rapidly and has caused the illness COVID-19. There is still much to learn about this new (“novel”) coronavirus and information is changing constantly. Please refer to the CDC website for the latest recommendations/information about this infection.

What is COVID-19?

The coronavirus that is responsible for COVID-19 belongs to a class of betacoronaviruses that caused the outbreak of SARS (Severe Acute Respiratory Syndrome) in 2003.  SARS resulted in 8096 cases worldwide with 774 deaths (9.6% mortality).  COVID 19 is also in the same class of betacoronaviruses as MERS (Middle East Respiratory Syndrome) which appeared in 2012.  There have been 2494 laboratory identified cases of MERS with 858 deaths (34.4% mortality).  In comparison, since the end of 2019 (just 5 months as of April 2020), Coronavirus SARS-CoV 2 has been identified in 2,621,748 people worldwide with 183,030 deaths (6.9% mortality). It can be seen that the prevalence of this current coronavirus is much more widespread than the previous SARS and MERS outbreaks. That is why SOCIAL DISTANCING IS SO IMPORTANT.  The actual death rate of COVID-19 will be affected as more testing becomes available.

When a person is exposed to the novel coronavirus, they may contract COVID-19.  The incubation (time from exposure to the virus to when symptoms appear) is thought to occur within 14 days with most cases occurring 4-5 days after exposure.

Symptoms of Coronavirus
The COVID-19 infection shares many similar symptoms to the flu that we experience every year.  The severity of the COVID infection can be affected by things such as a patient’s age and underlying medical illnesses (high blood pressure, diabetes, chronic lung disease, cancer, chronic kidney disease, cardiovascular disease, obesity).  It is felt that some people may experience an “asymptomatic” (ie without symptoms) infection where others develop the typical fever, cough, sore throat, muscle aches, or headache.  If you develop any of these symptoms it may indicate that you have contracted COVID-19, and may want to come in for an evaluation..  More advanced infection can result in findings such as increasing shortness of breath, pneumonia and confusion.  If you develop these more serious symptoms, it is advised that you seek emergent medical care.

How Coronavirus Spreads & How to Prevent It

The understanding of the transmission of COVID-19 is incomplete.  It appears that the majority is spread by respiratory droplets.  This means when an infected person coughs, sneezes or even talks, they can release coronavirus particles.  If these infected repiratory particles come in direct contact with another individual’s mucous membranes (eye, mouth, nose), COVID-19 infection can occur.  It is believed that these infected respiratory droplets do not travel more than 6 feet (again the importance of SOCIAL DISTANCING), but they can land on surfaces (tabletops, phones, doorknobs, elevator buttons, etc.) and then be transferred if an individual touches these infected objects and then touches their mouth, nose or eyes.  That is why face masks appear helpful since they limit the touching of one’s face.  It is not known how long COVID-19 can survive on inanimate surfaces, but other coronaviruses have lasted up to to 9 days without disinfection.  That it is why hand sanitizers and disinfecting surfaces are recommended.  Additional measures include:

• Avoid touching your face after touching surfaces, especially your eyes, ears, nose and mouth without washing your hands first. Germs can quickly build up on your hands and promptly spread through the rest of your body.
• Wipe down each of your main surfaces including your workspace, steering wheel, kitchen counter and door handles throughout your home regularly with disinfectant wipes. Many germs can live longer on surfaces than your hands.
• Wash your hands throughout the day with soap and hot water for at least 20 seconds, especially after using the restroom, handling food or changing a diaper. If you are teaching younger children how to wash their hands, have them sing Happy Birthday while scrubbing.
• When you need to cough or sneeze, always use the “Vampire Cough” and cover your nose and mouth with the crook of your elbow. This contains germs without getting them on your hands.

Testing for COVID-19

There has been daily news reports about the availability (or lack of availability) of testing for COVID-19.  At TNC Walk-In Clinic, we offer two separate types of testing:

1.Reverse Transcriptase-PCR (Polymerase Chain Reaction) testing—this involves taking a swab from a SYMPTOMATIC patient’s nose or throat to determine if they have an ACTIVE coronavirus-19 infection.  The exact sensitivity (ability to correctly identify those with the illness — true positive rate) and specificity (ability to correctly identify those who don’t have the illness—true negative rate) is not known.

2.Serology testing (Antibody Testing)-this involves taking a small sample of blood and testing it for antibodies against the COVID-19 virus.  A positive test would indicate that a patient had been infected and has formed antibodies against the COVID-19.  The current test offered at TNC Walk-In Clinic will detect the IgG antibody against COVID-19.  A positive IgG test may allow you to return to your normal activities without the worry of re-contracting COVID-19.  The sensitivity and specificity of the antibody test is not yet known.

Your TNC Walk-In Clinic Medical Provider can determine which test is indicated in your situation.

Treatment and Vaccine for COVID-19

As of April 2020, there is no specific antiviral treatment for coronavirus.  If you have any questions or concerns, please arrange an appointment online. If you are experiencing possible acute COVID-19 infection (ie fever, cough, sore throat, muscle aches or headaches), please contact our office by phone upon arrival, so we can expedite your triage outside of the waiting room and allow you to be placed in an exam room directly.

At this point in time, there is no vaccine available to prevent COVID-19.  Current estimates indicate that this will take, at a minimum, over a year to develop (for reference, there are still no licensed vaccines that have been developed for SARS or MERS, which are similar types of coronaviruses).