In the Time of Corona

Coronaviruses are human and animal pathogens which has known to cause respiratory illnesses similar to the common cold. Towards the end of 2019, a novel coronavirus was identified as the cause of a cluster of pneumonia cases in Wuhan, China. It has since rapidly spread, resulting in an epidemic throughout China, with sporadic cases reported globally including Asia, Europe and the Americas. In February 2020, the World Health Organization designated the disease COVID-19, which stands for coronavirus disease 2019.

We may not know a lot about this disease as of the moment, but both the World Health Organization and the CDC are currently making progress in understanding this illness.

At the end of 2019, there have been 70,000 cases in China, and the numbers outside China have since outpaced and has since been increasing since. However, based on the information we have, the threat to contracting the novel coronavirus outside or with no contact to a traveler form china is very low. Cold and influenza are far more common. If someone has traveled to China or has been exposed to a traveler, watch out for fever, sore throat, cough and difficulty breathing. They should call ahead to their medical provider to receive subsequent care.

TRANSMISSION

Transmission understanding at this point is incomplete— spread through person to person via respiratory droplets is thought as the sole source resembling the influenza but there are a few but rare cases of airborne precautions needed in the setting of high risk procedures or cases. Human to human seems to be the most plausible cause of transmission.

 

CLINICAL FEATURES

Incubation period for the COVID-19 is thought to be 14 days but most of the cases we have seen show symptoms 5 days post-exposure.

Most infections are not severe, ranging from a cold to a sore throat and pneumonia seems to be the most serious manifestation of infection where one suffers from fever, cough, and difficulty breathing. No deaths have been reported with milder cases and the fatality rate form the more critical cases remains to around 2%. Most fo the fatal cases have underlying medical issues or are in their advanced age.

WHO reports the recovery time to e around 2 weeks for mild cases and 3-6 for more severe ones.

PREVENTION

While there is currently no vaccine for this coronavirus, we can all help prevent the spread of this disease. The CDC recommends:

1. Avoiding close contact with people who are sick

2. Avoiding repeated touching of your eyes, nose and mouth with unwashed hands

3. Washing your hands with soap and water for at least 20 seconds or using an alcohol-based hand sanitizer

4. When you are organizing playdates, make sure everyone in the group bot parents and children are healthy and symptoms free.

(5. Avoid contacts who have had recent travel to hotspot areas for 2 weeks unless they have been quarantined. )

There is currently no guidelines for the general public to wear masks as they may in fact help with the spread of the virus. Travel to hotspot areas is currently not recommended.

WHEN TO CALL

  1. Labored or difficulty breathing. More critically ill patients of the coronavirus will have pneumonia and lessons will start appearing in the lungs to make breathing difficult. This usually occurs within 2-6 days after exposure.

  2. Fever. In the setting of an exposure, and during flu season, lets get the children tested at least for the flu to rule that out. And our guidelines show that we have the best success in treating flu if we catch the fever/ symptoms within 40 hours of onset.

  3. Pain. Pain specially on coughing or breathing that doesn’t seem to be going a way is a sign that there may be something deeper that is going on int he lungs and not just the throat.

  4. Dehydration, given that children have smaller bodies and their metabolism is faster. They are more prone to getting dehydrated due to their higher metabolic demand. If he/she is not peeing the same amount or is significantly peeing less in a 24 hour period, it’s best to get assessed.

https://www.cdc.gov/coronavirus/2019-nCoV/hcp/index.html

https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance

https://www.ecdc.europa.eu/en/novel-coronavirus-china

Https://wwwmed.navy.mil/sites/NMCPHC/prgoram-and-policy-support/pages/novel-coronavirus.aspx

Hope this finds you well. Stay healthy and happy Monday.

Doc Lance

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