New developments have unfolded rapidly since an outbreak of respiratory disease caused by a coronavirus sickened people in China in December 2019.

Since then cases have appeared in countries across the globe, including the U.S.

While federal health officials say COVID-19 could cause severe disruption in everyday life, questions remain.

What does that mean for individuals? Our communities?

And how do we prepare for that?

“My hope is that it will feel like a bad flu season to us,” said Russell Lampen, DO, division chief for infectious disease for Spectrum Health Medical Group.

“I think we are going to see things like the potential cancelation of extracurricular events like church services. We might see schools being closed, and maybe sporting events canceled,” he said.

Spectrum Health infectious disease specialists say now is the time to prepare for those possibilities. Could they work from home? How will they care for children if schools are closed?

Yet given what’s known about the virus and the mortality rate, Dr. Lampen does not foresee a complete disruption in the supply of goods that could affect the availability of food and medicine.

“For there to be a supply chain disruption, we would have to have a lot of people sick,” he said.

The impact may be similar to what happened during the H1N1 influenza pandemic in 2009, he said. At that time, in areas hit hard by outbreaks, events were canceled and schools closed to curb the spread of the disease.

Spectrum Health infectious disease experts provide insights into what is now known about the potential impact of COVID-19 and ways to protect ourselves.

Are we talking about a pandemic?

The World Health Organization has not declared a pandemic, because it has not seen intensive and widespread community transmission of the virus worldwide. Agency leaders say the illness has the potential to become a pandemic and is working with countries to prepare for that possibility.

Overall, the World Health Organization is trying to avoid causing needless fear while encouraging preparedness, Dr. Lampen said.

How dangerous is COVID-19?

“We still don’t know the true severity of it,” Dr. Lampen said. “It’s hard to know because it’s such a limited population involved.”

In Wuhan, China, the death rate is 2% to 4%. But outside Wuhan, it is far lower—about 0.7%, according to the World Health Organization.

“There will be a number of people who will have a mild respiratory illness that causes limited or no symptoms at all,” Dr. Lampen said. “And there will be a population that will be sicker and require hospitalization.”

Those most likely to suffer serious illness are the elderly and adults with chronic medical conditions.

What symptoms does it cause?

The symptoms that raise concerns are lower respiratory symptoms, such as cough and shortness of breath. Fevers are common with infection as well.

How is the COVID-19 virus transmitted?

“What we are seeing is that this virus appears to spread easily. It appears to spread by droplets—when you sneeze and cough,” Dr. Lampen said.

Health officials are worried about a case recently diagnosed in California, which appears to be the first case of community spread of the disease in the U.S. The woman diagnosed with COVID-19 had no contact with a virus hotspot or known contact with someone who did.

“Transmission in the United States is still somewhat limited,” Dr. Lampen said. “But I agree with the CDC that it has spread into too many places. It seems like it’s too hard to contain at this point.”

How can we protect ourselves and help slow the spread of this virus?

Take the usual precautions you would take against influenza and other contagious disease.

“Stay home if you’re sick. Make sure you wash your hands. Get a flu shot if you haven’t gotten one,” Dr. Lampen said.

Why a flu shot?

“The flu vaccine won’t impact whether you get coronavirus,” Dr. Lampen said. But there is always the potential for co-infection—getting both coronavirus and influenza would deliver a double whammy to your immune system.

“Getting a flu vaccine is another way to stay heathy,” he said.

How important is hand washing?

Very.

“Not only can you get sick from people coughing and sneezing close to you, but often times, the things they cough and sneeze actually land on your body and you touch it with your hands,” said Rosemary Olivero, MD, the section chief of pediatric infectious disease with Spectrum Health Helen DeVos Children’s Hospital. “And if you put your hands on your eyes or nose or mouth, you can then infect yourself.”

She suggests people use hand sanitizer and wash their hands regularly.

Can we get specific about how to get those hands clean?

Good question.

Spectrum Health infection prevention manager Doreen Marcinek, DNP, RN, explained:

“You should have running water and an adequate amount of soap. You should apply soap onto the palm of your hand and, using friction, wash your hands throughout the top of your hands, the back of your hands, in between your fingers, under your nails and around your cuticle beds. Do this for a minimum of 20 seconds. An easy way to remember this is to sing in your head the song Happy Birthday.”

Given the number of cases in the U.S., why is there so much concern about this?

“If this comes through and infects a big swath of the population—even if it’s like a bad flu season—it would be like getting two flu seasons back to back,” Dr. Lampen said. “That would tax the health care system.”

What is Spectrum Health doing to prepare for an outbreak?

The infection prevention team has been closely monitoring the situation and drawing on experience with other outbreaks to plan a response, said Julie Bulson, DNP, director of emergency preparedness at Spectrum Health.

“We have already implemented a few things,” she said. “In the Emergency Department and Urgent Care, we stop all visitors.”

Patients are screened from there, to take into consideration international travel and contact they might have had with others. If patients are considered at risk, they get a mask.

“They are isolated in their own room and are seen and treated appropriately,” Bulson said. “We then connect with the local health department, and if they meet Centers for Disease Control criteria, we get them tested and monitor the patient.”

If we think we have a respiratory illness, including COVID-19, what should we do?

As a service to our community, Spectrum Health is offering free virtual screenings for COVID-19. If you are in the state of Michigan and experiencing COVID-19 symptoms, call the hotline number at 616.391.2380. If you have severe or life-threatening symptoms, please call 911. Hotline callers will be scheduled for a free virtual screening through Spectrum Health Now, a telehealth service that connects people with providers 24/7.

“The goal for this virus is to contain it,” Bulson said. “We are building our plans as this escalates throughout the country to keep people in their homes versus in a public location.

“If we can do anything to keep these patients home, without coming into the emergency department with a potential spread, that’s what we want to do.”

With COVID-19 showing up in more locales by the day, how should that affect our travel plans?

Check the CDC’s travel advisories, Dr. Olivero said.

At this point, the CDC has issued an Alert Level 3 for China, South Korea, Iran and Italy, recommending that people avoid nonessential travel to those countries.

It has issued an Alert Level 2 for Japan, where travel is not recommended for older adults and those with chronic medical conditions.

 

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