The Coronavirus explained by Dr Alexis Shields.
By Dr Alexis Shields
Everyone is talking about the coronavirus. You’ve heard it being discussed constantly in the media and it’s made its way into everyday conversation. Given that this variant of the coronavirus is new, there has been much speculation as scientists determine the specifics of this novel variant.
This is what I believe you need to know about the virus and how to protect yourself and your loved ones.
What is COVID-19?
SARS-CoV-2 is the final name that has been given to the virus that causes COVID-19. COVID-19 is a new variant of a large family of coronaviruses that cause illnesses ranging from the common cold to more severe diseases such as SARS-CoV (severe acute respiratory syndrome) and MERS-CoV (Middle East respiratory syndrome). At the time of publishing this article (03/12/2020), COVID-19 has spread to more than 116 countries since it first broke out in Wuhan, Hubei Province, China, in December 2019. There have been 124,954 confirmed global cases, and 4613 deaths.
The majority of people who get sick only develop mild disease. The most common symptoms are fever, dry cough, shortness of breath, and, as with any viral illness, fatigue. Some people experience muscle aches, confusion, headache, sore throat, nasal congestion, runny nose, chest pain, diarrhea, and nausea and vomiting.
How does it spread?
COVID-19 is spread from person to person by respiratory droplets that are produced when a person coughs or sneezes. The current incubation period (the time between catching the virus and beginning to have symptoms of the disease) as reported by the WHO is 1-14 days (with one report of 27 days) and most commonly around 5 days. This means that someone can spread the virus to others before they are showing any signs that they are sick.
It is still unknown how long the virus that causes COVID-19 survives on surfaces such as metal, glass, and plastic, but it seems to behave like other coronaviruses and may range from a few hours to nine days and can be efficiently inactivated by surface disinfection procedures with 62–71% ethanol, 0.5% hydrogen peroxide or 0.1% sodium hypochlorite within 1 minute.
Who is likely to get sick?
This virus is more likely to affect older males with underlying health problems such as high blood pressure, heart disease, and diabetes. This population is also more likely to develop serious illness leading to pneumonia, SARS, kidney failure, and death.
Currently, there is no evidence that children are more susceptible to the virus. There have been cases reported in children, but most of the confirmed cases are in adults. There have been very few reports of the clinical outcomes in children, but of which the disease appears to be mild.
There is no solid evidence that pets such as cats and dogs can be infected with coronavirus or spread it to humans. There is one case of a dog in Hong Kong who tested a weak positive but scientists are not sure if the dog just picked up the virus from a contaminated surface with its mouth or nose.
Is COVID-19 more deadly than the seasonal flu?
Yes, it appears that it is with the information that we currently have.
Current death rates of COVID-19:
3.9% in China*
3.3% outside of China
*Dr. Paul Herscu suggests that the death rates outside of China may be a better indicator of the true death rates given the inaccuracies in disease reporting that have come from China.
This year’s death rates of influenza A and B:
0.05% in the US
Is all of the hype and fear surrounding COVID-19 really necessary?
On Feb 29, the World Health Organization (WHO) raised the global level of risk to “Very High” which is the highest marker on their alert scale. The level was raised due to the difficulty in identifying cases and the potential for undetected transmission, as well as the potential for major impact on healthcare systems in affected countries.
So, it is important to educate and prepare yourself; however, not to the level of complete hysteria that some media outlets would have you believe. It’s important to find and follow reputable reporting on this issue and many of these resources are included in this article.
What contributes to much of the confusion and fear?
Any time a new virus develops and starts to spread there is a lot that is unknown as researchers begin to study the new virus and the people whom it infects. These unknowns include the incubation period, effective treatments, and how easily the virus spreads and how virulent, or deadly, it can be. Developing testing for the virus and the dissemination of those tests is also a problem that needs to be solved quickly on a global scale.
Disease reporting itself is also a big area of confusion and here’s why:
- Different countries report on the disease differently. Although China has recently taken some measures to improve it’s reporting of COVID-19 the reported cases and death rates have been drastically changing. For example, with the seasonal flu, China reports only death caused directly by influenza and not those who die from complications of the flu.
- Reporting methods in China did change to include anyone who has tested positive with a telltale pattern of pneumonia. This may, however, miss people with milder symptoms and is highly dependant on the skill of the doctor reading the CT scan.
- Testing for COVID-19 has also had its challenges. Insufficient samples and faulty test kits, as well as lack of supplies, all account for inaccuracies in the reporting. Some people have initially tested negative, but have then gone on to test positive at a later date.
- The confirmed cases do not include people who are asymptomatic but who also have the disease. If this number was included we would assume the death rate would reduce drastically.
What tools do scientists use to predict if a virus will become an epidemic/pandemic?
In epidemiology, the measure that scientists use to estimate how contagious or easily a virus spreads is known as the basic reproduction number or R0 (pronounced R-nought). This is the estimate of the average number of people who catch the virus from a single infected person. So, if the R0 is 1.3, as it tends to be with the seasonal flu, people with the flu tend to infect 1.3 other individuals, on average.
For a point of comparison:
Seasonal flu = R0 of 1.3
SARS = R0 of 2-5
HIV = R0 of 2-5
Measles = R0 of 12-16
R0 is important because if it’s greater than 1, the infection will probably keep spreading (but doesn’t tell you how fast), and if it’s less than 1, the outbreak will likely die out. However, it’s very important to note that R0 is hard to calculate and tricky to interpret.
The current R0 estimates for COVID-19 range from 1.4-5.5, with the WHO estimate from 1.4-2.5.
Where do we go from here?
How to get prepared and take proper precautions
As with any virus, these sanitary measures can be the most important things:
- Regularly wash your hands with soap and water for 20 seconds, especially before eating.
- *Use alcohol-based hand sanitizers with 60-95% alcohol only when handwashing is not possible. Regular handwashing with soap and water is far superior.
- Avoid touching your face, eyes, nose, and mouth with unwashed hands.
- Cover your mouth and nose with your bent elbow or a tissue when you sneeze and throw the tissue in the trash. Tissues are preferred because the virus may continue to live on your clothing.
- Limit handling doorknobs and other public surfaces.
- Avoid close contact with people who are sick.
- Avoid large crowds and places with poor ventilation.
- Stay home if you feel unwell!
- **The use of a specialized face mask (N95 respirators) should only be used by health workers and caregivers at this time and is not recommended for public use.
*A note on alcohol-based hand sanitizers – Coronavirus is an enveloped virus and in general, these types of viruses are easily killed or inactivated by alcohol. However, makers of hand sanitizers have been known to make unsubstantiated health claims about the efficacy of their products against viruses and there are problems with the usage. Hand sanitizers do not remove dirt and are less effective on dirty hands, can give people a false sense of security leading to less hand washing, and they can break down the protective skin barrier if used too frequently and in people with skin conditions. It is not recommended to make your own hand sanitizer.
**A note on face masks – Wearing a regular surgical mask will not protect you from the virus. However, surgical masks can help prevent infected people from spreading the virus further by blocking any respiratory droplets that could be expelled from their mouths.
If you are sick with a fever, cough, and shortness of breath:
- Contact your local health department for the next steps
- Stay at home and avoid going to public places and using public transport
- Separate yourself from other people and animals in your home
Effective supportive treatments for COVID-19 & all viral illnesses
To date, there is no vaccine and no specific antiviral medication to prevent or treat COVID-2019.
- Prioritize sleep! Getting 7.5+ hours each night of good quality sleep is crucial to a healthy immune system. Need something to help track your sleep? I recommend the Oura ring.
- If you are feeling run down, take the day off. Being run down makes you more susceptible to contracting an illness.
- Eat a whole-foods based diet rich in antimicrobial and anti-inflammatory herbs and spices such as garlic, ginger, cinnamon, and turmeric.
- Avoid eating sugars and refined food, as well as limiting alcohol.
- Exercise and move your body regularly. Your muscles act as a pump to your lymphatic tissue, which is part of the body’s immune system that helps to protect you from infection.
- Practice daily stress reduction – mindfulness, meditation, journaling, prayer, gratitude, sunshine, fresh air, time with family and friends, play, pets, hobbies, self-care, etc. High cortisol levels from high stress negatively impact the immune system. My favorite ways to practice daily mindfulness are: HeadSpace, CALM, Muse brain-sensing headband, and 10% Happier.
- Decrease or discontinue smoking, as well as avoid all second-hand smoke. Need help to stop smoking? Read this book.
- Make sure that you are addressing any chronic health ailments! Healthy people with healthy immune systems are less likely to come down with a viral illness.
A note on fevers
Fever is the body’s normal response to infection. High temperature triggers the body’s production of infection-fighting white blood cells and inhibits the growth of viruses and bacteria. If you lower the fever with medications such as paracetamol/acetaminophen, aspirin, or ibuprofen, you may be affecting the body’s ability to respond to the infection.
Short-lived fevers (>38.3°C or 101°F) come and go without any long-term complications, however, the aches and pains that you feel during your illness may be in part due to the fever. So, lowering your fever with medication may improve comfort but will not help with the virus to run its course. In fact, it may lengthen the amount of time that you are sick. Instead of immediately reaching for the antipyretic medications, try taking a bath with 1-2 cups of Epsom salt or applying cool compresses for comfort.
The biggest source of concern with fevers is that you must stay hydrated! Dehydration during illness can lead to serious complications. Adequate water intake (about 1 L per 30 kg of body weight for the average healthy person) and minerals from drinking broth are very important when body fluids are being lost from sweating.
Note: Infants of <3 months are an exception and should always be seen by their doctor with any fever. Do not give children <18 years of age aspirin since it has been linked to the deadly disease Reye’s syndrome.
Should I stock up on supplies?
It’s never a bad idea to be prepared in case you become ill and are unable to leave the house for an extended period. Some recommended supplies include:
- Frozen or canned broths and soups
- Rice, canned or dried beans
- Nut butter
- Nutrition bars
- Protein powder + nut milk + frozen berries
- A reliable water filter or bottled water
- If you take any essential medications for chronic health conditions, keep a 30-day supply of all your medications
As is the nature of viruses, once it has escaped the region of origination and made its way across the globe it will likely stay with us. New viruses eventually become commonplace over time, such as the cold and annual flu. We just don’t know how much it will change over time and how virulent it will remain.
One of the main experts that I follow on the topic of epidemics, Dr. Paul Herscu, believes that the current information suggests that we “might just miss another scary global epidemic”. However, this outbreak brings to the forefront just how important the topic of epidemics is and the inevitability of new viruses that will continue to appear throughout our lifetime.
So, rather than panic, please take this opportunity to educate yourself and prepare.