Doom and Bloom: Coronavirus

The Altons at Doom and Bloom medical have a short article up on what is a coronavirus and basic prophylaxis. The article was published on Jan. 22nd, so the numbers of confirmed cases and deaths have risen.

Masks Mandatory in Wuhan

Last week, we reported on a mysterious ailment first reported Dec. 8th, 2019, in Wuhan, China. Wuhan is the seventh most populous city in China with 11 million people. The previously unknown disease is now identified as a type of coronavirus. Medical officials are currently classifying it as a “class B” disease, which puts it in the same category as HIV/AIDS and Sudden Acute Respiratory Syndrome (SARS).

The rapidity and spread of the disease is impressive: When I began writing this article earlier in the day, there were 440 cases and 9 deaths, up from 200 cases last week. Later in the day, 555 cases and 17 deaths have been verified and other provinces in China are beginning to report cases.

(Note: I first reported on Ebola in early 2014, when 86 cases were reported. The epidemic eventually reached a total of 28,000 cases and 11,000 deaths.)

Chinese authorities have taken the drastic measure of placing the entire city of Wuhan under quarantine, including the suspension of train and airline service, a step that suggests that many more cases are still unreported.

(1/23 update: Several U.S. airports are now conducting health screenings)

Although little is known at this point about the virus, it is certain that the disease is respiratory in nature and that human-to-human transmission (including medical personnel) is likely. For most respiratory infections, contagion is usually by airborne particles.

The first U.S. case has just been identified in a 30-year-old man from the state of Washington who recently arrived from China. Similar coronavirus victims have been found in Japan, Thailand, Taiwan, and South Korea, almost all traced to an origin in Wuhan.

ABOUT CORONAVIRUSES

Fever may not be present in all patients including: young, elderly, immunosuppressed or taking fever-reducing medications; many only have respiratory symptoms

The Wuhan virus is from the same family of coronaviruses as SARS, which killed over 800 people worldwide in an outbreak toward the end of 2002. It is also similar to Middle East Respiratory Syndrome (MERS), another epidemic disease. Although not officially named, the new virus is designated 2019-nCOV.

Coronaviruses are viruses made from RNA genetic material. One of the larger RNA viruses, coronavirus is so named from the Latin “corona” (crown or halo), from projections on the virus which give the appearance of a crown.

Coronaviruses are thought to be responsible for a large number of common colds in humans. Coronavirus colds seem to be associated with more major symptoms like fever or sore throat than colds caused by rhinoviruses, another common cause. 2019-nCOV seems to cause even worse respiratory symptoms than the typical coronavirus. Coronaviruses can also lead to pneumonia, either directly or through a secondary bacterial infection due to a weakened immune system.

ABILITY TO CONTAIN THE VIRUS

Coronavirus has crown-like projections

Chinese officials are probably wise to enact quarantine orders, as there is only one lab (called a Biosafety Level 4 lab or BSL-4) in their entire country with the capability of handling severe outbreaks. Luckily for them, it is located in Wuhan. The facility can care for victims of highly contagious diseases like SARS, Ebola, etc.

Personnel in a BSL-4 lab are subject to the strictest protocols: They must change their clothing on entering and shower upon exiting. Full-body hazmat suits must be worn while working in the lab and decontaminated afterwards. The facility is required to be a separate building or a wing properly isolated with separate air filtration systems.

The chances of spread of the new coronavirus is increased by the upcoming Chinese New Year, when it is thought that millions of Chinese citizens will be traveling throughout the world.

(1/22 Update: China has just issued a travel ban for the city of Wuhan; public transportation in the city is also suspended)

Having learned lessons from our experience with Ebola, the United States is better prepared to deal with highly contagious outbreaks of infection.

HISTORY OF RECENT VIRAL OUTBREAKS IN CHINA

masks

The presence of any biosafety 4 lab (BSL-4) inside China at all is due to the 2003 viral SARS outbreak. SARS reached epidemic proportions quickly, with 8000 cases leading to 750 deaths worldwide. Chinese authorities hope to have 7 such units built by 2025, but only the Wuhan lab is operational.

Although the use of face masks is common (and wise) in China, Wuhan has declared their use manadatory while in crowded locations. This requirement is causing a shortage of masks in the area, which could eventually lead to the same worldwide.

WHAT TO DO ABOUT CORONAVIRUS AND OTHER VIRUS OUTBREAKS

As of yet, no cure nor vaccine is available to combat coronavirus. Treatment at present focuses on treating symptoms and supporting a victim through the infection, while protecting the healthy from the disease.

Contagious illnesses like coronavirus, however, may morph into epidemics, or is widely distributed enough, pandemics. If you are preparedness-minded, you might consider a personal protection “pandemic kit” (or several) and plan out how you would care for a person with a contagious disease if the hospitals were full. Have you thought about what goes into putting together an effective epidemic sick room?

The CDC recommends:

  •  Washing your hands with soap and water frequently
  •  Avoid touching your eyes, nose and mouth with dirty hands
  • Avoid close contact with sick people

If you are sick, you can protect others by:

  • Staying home until fully recovered
  •  Avoiding close contact with others
  • Cover your nose and mouth when sneezing or coughing
  • Keep objects and surfaces in your home or workspace clean and disinfected (bleach mixed 1:10 with water will do)

Alhough the CDC isn’t recommending this as of yet, having a supply of N95 face masks isn’t a bad idea.

By the way, while I was writing this, I received a notice sent to all physicians in the state of Florida, warning about….coronoavirus.

Doom and Bloom Medical: Coronavirus: The Next Pandemic?

 

The Medic Shack: Coronavirus, 2019NcoV. Do We Need to Be Worried?