As Coronavirus Spreads, Many Questions & Some Answers From Harvard Health Blog

The rapid spread of the coronavirus and the illness it causes called COVID-19 has sparked alarm worldwide. The World Health Organization (WHO) has declared a global health emergency, and many countries are grappling with a rise in confirmed cases. In the US, the Centers for Disease Control and Prevention (CDC) is advising people to be prepared for disruptions to daily life that will be necessary if the coronavirus spreads within communities.

Below, we’re responding to a number of questions about COVID-19 raised by Harvard Health Blog readers. We hope to add further questions and update answers as reliable information becomes available.

Does the coronavirus spread person-to-person?

What is the incubation period for the coronavirus?

What are the symptoms of the new coronavirus?

Can people who are asymptomatic spread coronavirus?

Can the coronavirus live on soft surfaces like fabric or carpet? What about hard surfaces?

Should I wear a face mask to protect against coronavirus? Should my children?

Should someone who is immunocompromised wear a face mask?

Should I accept packages from China?

Can I catch the coronavirus by eating food prepared by others?

Should I travel on a plane with my children?

Is there a vaccine available for coronavirus?

Is there a treatment available for the new coronavirus?

How is this new coronavirus confirmed?

How deadly is this coronavirus?

What should people do if they think they have coronavirus or their child does? Go to an urgent care clinic? Go to the ER?

Can people who recover from the coronavirus still be carriers and therefore spread it?

Does the coronavirus spread person-to-person?

Yes, the virus can spread from one person to another, most likely through droplets of saliva or mucus carried in the air for up to six feet or so when an infected person coughs or sneezes. Viral particles may be breathed in, land on surfaces that people touch, or be transferred when shaking hands or sharing a drink with someone who has the virus.

Often it’s obvious if a person is ill, but there are cases where people who do not feel sick have the virus and can spread it.

Basic steps for avoiding flu and other infections — including steps for handwashing shown in this video and avoiding touching your mouth, nose, and eyes — are likely to help stop the spread of this virus. The CDC has a helpful list of preventive steps.

Quarantines and travel restrictions now in place in many counties, including the US, are also intended to help break the chain of transmission. Public health authorities like the CDC may recommend other approaches for people who may have been exposed to the virus, including isolation at home and symptom monitoring for a period of time (usually 14 days), depending on level of risk for exposure. The CDC has guidelines for people who have the virus to help with recovery and prevent others from getting sick.

What is the incubation period for the coronavirus?

An incubation period is the time between being exposed to a germ and having symptoms of the illness. Current estimates suggest that symptoms of COVID-19 usually appear around five days on average, but the incubation period may be as short as two days to as long as 14 days.

What are the symptoms of the new coronavirus?

Fever, dry cough, and trouble breathing are the common symptoms of COVID-19. There have been some reports of gastrointestinal symptoms (nausea, vomiting, or diarrhea) before respiratory symptoms occur, but this is largely a respiratory virus.

Those who have the virus may have no obvious symptoms (be asymptomatic) or symptoms ranging from mild to severe. In some cases, the virus can cause pneumonia and potentially be life-threatening.

Most people who get sick will recover from COVID-19. Recovery time varies and, for people who are not severely ill, may be similar to the aftermath of a flulike illness. People with mild symptoms may recover within a few days. People who have pneumonia may take longer to recover (days to weeks). In cases of severe, life-threatening illness, it may take months for a person to recover, or the person may die.

Can people who are asymptomatic spread coronavirus?

A person who is asymptomatic may be shedding the virus and could make others ill. How often asymptomatic transmission is occurring is unclear.

Can the coronavirus live on soft surfaces like fabric or carpet? What about hard surfaces?

How long the new coronavirus can live on a soft surface — and more importantly, how easy or hard it is to spread this way — isn’t clear yet. So far, available evidence suggests it can be transmitted less easily from soft surfaces than frequently-touched hard surfaces, such as a doorknob or elevator button.

According to the WHO, coronaviruses may survive on surfaces for just a few hours or several days,  although many factors will influence this, including surface material and weather.

That’s why personal preventive steps like frequently washing hands with soap and water or an alcohol-based hand sanitizer, and wiping down often-touched surfaces with disinfectants or a household cleaning spray, are a good idea.

Should I wear a face mask to protect against coronavirus? Should my children?

Follow public health recommendations where you live. Currently, face masks are not recommended for the general public in the US. The risk of catching the virus in the US is low overall, but will depend on community transmission, which is higher in some regions than in others. Even though there are confirmed cases of COVID-19 in the US, most people are more likely to catch and spread influenza (the flu). (So far this season, there have been nearly 30 million cases of flu and 17,000 deaths.)

Some health facilities require people to wear a mask under certain circumstances, such as if they have traveled from areas where coronavirus is spreading, or have been in contact with people who did or with people who have confirmed coronavirus.

If you have respiratory symptoms like coughing or sneezing, experts recommend wearing a mask to protect others. This may help contain droplets containing any type of virus, including the flu, and protect close contacts (anyone within three to six feet of the infected person).

The CDC offers more information about masks. The WHO offers videos and illustrations on when and how to use a mask.

Should someone who is immunocompromised wear a mask?

If you are immunocompromised because of an illness or treatment, talk to your doctor about whether wearing a mask is helpful for you in some situations. Advice could vary depending on your medical history and where you live. Many people will not need to wear a mask, but if your healthcare provider recommends wearing one in public areas because you have a particularly vulnerable immune system or for other reasons, follow that advice.

Should I accept packages from China?

There is no reason to suspect that packages from China harbor COVID-19. Remember, this is a respiratory virus similar to the flu. We don’t stop receiving packages from China during their flu season. We should follow that same logic for this novel pathogen.

Can I catch the coronavirus by eating food prepared by others?

We are still learning about transmission of COVID-19. It’s not clear if this is possible, but if so it would be more likely to be the exception than the rule. That said, COVID-19 and other coronaviruses have been detected in the stool of certain patients, so we currently cannot rule out the possibility of occasional transmission from infected food handlers. The virus would likely be killed by cooking the food.

Should I travel on a plane with my children?

Keep abreast of travel advisories from regulatory agencies and understand that this is a rapidly changing situation. The CDC has several levels of travel restrictions depending on risk in various countries and communities.

Of course, if anyone has a fever and respiratory symptoms, that person should not fly if at all possible. Anyone who has a fever and respiratory symptoms and flies anyway should wear a mask on an airplane.

Is there a vaccine available for coronavirus?

No vaccine is available, although scientists are working on vaccines. In 2003, scientists tried to develop a vaccine to prevent SARS but the epidemic ended before the vaccine could enter clinical trials.

Is there a treatment available for coronavirus?

Currently there is no specific antiviral treatment for this new coronavirus. Treatment is therefore supportive, which means giving fluids, medicine to reduce fever, and, in severe cases, supplemental oxygen. People who become critically ill from COVID-19 may need a respirator to help them breathe. Bacterial infection can complicate this viral infection. Patients may require antibiotics in cases of bacterial pneumonia as well as COVID-19.

Antiviral treatments used for HIV and other compounds are being investigated.

There’s no evidence that supplements, such as vitamin C, or probiotics will help speed recovery.

How is this new coronavirus confirmed?

A specialized test must be done to confirm that a person has COVID-19. Most testing in the United States has been performed at the CDC. However, testing will become more available throughout the country in the coming weeks.

How deadly is this coronavirus?

We don’t yet know. However, signs suggest that many people may have had mild cases of the virus and recovered without special treatment.

The original information from China likely overestimated the risk of death from the virus. Right now it appears that the risk of very serious illness and death is less than it was for SARS and MERS. In terms of total deaths in the United States, influenza overwhelmingly causes more deaths today than COVID-19.

What should people do if they think they have coronavirus or their child does? Go to an urgent care clinic? Go to the ER?

If you have a health care provider or pediatrician, call them first for advice. In most parts of the US, it’s far more likely to be the flu or another viral illness.

If you do not have a doctor and you are concerned that you or your child may have coronavirus, contact your local board of health. They can direct you to the best place for evaluation and treatment in your area.

Only people with symptoms of severe respiratory illness should seek medical care in the ER. Severe symptoms are rapid heart rate, low blood pressure, high or very low temperatures, confusion, trouble breathing, severe dehydration. Call ahead to tell the ER that you are coming so they can be prepared for your arrival.

Can people who recover from the coronavirus still be carriers and therefore spread it?

People who get COVID-19 need to work with providers and public health authorities to determine when they are no longer contagious.

Reliable resources

Also, read our earlier blog posts on coronavirus:

Related Information: Cold and Flu

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What Is Coronavirus (COVID-19)? The World Health Organization declared the new #Coronavirus disease (COVID-19) outbreak a global health emergency in January 2020. Experts at Johns Hopkins Medicine are closely monitoring the spread of the virus and offering useful information on what the disease is and how to help prevent transmission. For more information, please visit the #JohnsHopkins Medicine coronavirus website. https://www.hopkinsmedicine.org/coron…

With COVID-19 Coronavirus, Should You Cancel Or Postpone Air Travel?

Have things gotten plane confusing for you? With the COVID-19 coronavirus outbreak occurring, are you having trouble deciding whether to cancel or postpone your air travel plans?

It seems like a fair number of people are trying to make such decisions right now. Social media certainly has had its share of “should I stay or should I go” clashes of opinions and discussions. For example, @scottbudman tweeted out these recommendations:

                             

And someone here is worried about more than hot farts:

                             

Then there was this question to Florian Krammer, PhD, a Professor at the Department of Microbiology Icahn School of Medicine at Mount Sinai:

Today In: Healthcare
                             

On the flip side, if you don’t like lines and crowds at the airport, this may seem like a great time to fly, with an emphasis on the word seem. According to Rick Clough reporting for Bloomberg, commercial air traffic is on track to drop by 8.9% this year, which would be the biggest decline since 1978 and in fact only the fourth year that air travel has fell in that time frame. Declines also have occurred in 1991, 2001 after the 9/11 terrorist attacks, and 2009 amidst the recession and the H1N1 flu pandemic. Cecile Daurat and Justin Bachman have written for Bloomberg that the airline industry stands to lose up to $113 billion in sales and that some airlines are already cutting back on available flights. Who knows? Maybe you can even find a seat on the plane that has a free seat next to it, so that you can actually do things like see your feet while sitting.

So what should you do? Well, as you’ll see in a bit, there are clearer-cut situations in which air travel is not advisable and canceling or postponing makes sense. However, for some other situations, the answer is a bit more complicated and evolving. The SARS-CoV2 outbreak and accompanying travel recommendations are evolving and serious situations. The SARS-CoV2 seems to be significantly more contagious and more virulent than the flu virus. But it is not yet clear exactly how much more. Its reported case fatality rate has been in the 1.5% to 3.8% range, nowhere near that of the original SARS virus. But things continue to change as more info emerges. There is still much to learn about SARS-CoV2 and its spread. So caution but not panic is worthwhile. Moreover, you’ve got to weigh different factors, risks, and benefits.

The first thing you should do is check to see where you will be going and cross check it with the the Centers for Disease Control and Prevention’s (CDC’s) Coronavirus Disease 2019 Information for Travel website. In general, it is a good idea to know where you and your airplane will be going. But additionally, the CDC website should have up-to-date information on COVID-19 risk by country. Look for your listed destination on the interactive world map on the CDC website that offers the latest warnings and precautions.

If your destination has some major travel warnings or restrictions, then the answer may be easy. For example, China and Iran fall into the category of “widespread sustained (ongoing) transmission and restrictions on entry to the United States.” That means that you shouldn’t consider traveling to these countries unless you absolutely have to do so. South Korea and Italy are listed as having “widespread sustained (ongoing) transmission,” which also means that postponing travel to these countries is a good idea. There’s a warning about Japan as well, if you are an older adult or someone with a chronic medical condition.

As things are changing fairly rapidly, check this website often. Bookmark the site. Treat it like you would Cristiano Ronaldo’s Instagram feed. Follow it. Learn it. Absorb it.

A second thing to do is double-check whether the meeting, the gathering, or whatever you’re going to may be canceled. Recently meetings have been like primary candidates in a political race: “it’s going to happen, it’s going to happen, no problems, oh, time to shut things down.” Last minute cancellations have been occurring, so you don’t want to be stuck with a ticket and no place to go, just like what may be going on, or perhaps not going on, here:

                              

So what do you do if your destination doesn’t have a major warning and your event still seems on track? Air travel certainly isn’t the same as staying in your apartment or house surrounded by mounds and mounds of toilet paper rolls. The only way to completely avoid the possibility of infection is to completely avoid contact with people or any of the objects or surfaces that they touch. This is may not be practical. Life is never risk-free. So there will be risks with any activity, especially ones that involve larger numbers of people.

But let’s be clear what the real risks may be. For example, how much of a risk is the recycled air in airplanes? Well, the air does go through HEPA filters. HEPA stands for “high efficiency particulate air [filter]” and is supposed to filter out at least 99.97% of microbes, dust, pollen, mold, and any airborne particles that are 0.3 microns (µm) in size. The filter may even be more efficient at filtering particles that are smaller or larger than 0.3 µm, such as French fries.

Assuming that the HEPA filter is working properly then you may not have to worry so much about the air nozzle overhead that’s creating a mini-tornado on your face. Plus, SARS-CoV2 can only travel so far in the air. It’s not as if they have little wings. Viruses don’t drink Red Bull. Instead, they hitch rides on respiratory droplets that come out of an infected person through coughing, sneezing, spitting, or the like. These droplets can travel up to three to six feet from the person.

What may be of greater concern is the close proximity between passengers on the plane. Over the past decade or so, passengers haven’t exactly been declaring, “wow, what do I do with all this legroom? There’s just too much legroom here in economy seating.” In fact, Stephanie Robertson has written for the New York Times about “Fighting the Incredible Shrinking Airline Seat” and how airplane seat sizes have been shrinking since since the U.S. airline industry underwent deregulation in the 1970’s. Maintaining a three to six foot distance from other passengers may be tough even if you were to have excessive and obvious heated flatulence. So yes, if the person next to you is infectious, you could get exposed.

Then there are the various surfaces on the plane. You are probably more likely to catch respiratory viruses like coronaviruses and flu viruses through touching things that have been contaminated with the virus. That includes body parts like hands or surfaces like seat belt buckles and Baby Yoda figurines that have been touched by someone infectious. Quite a few of the surfaces in an airplane cabin would be considered “high touch,” meaning that different people touch them frequently. These include tray tables, seats, seat belts, video monitors, and that crypt-like pocket in the back of the seat in front of you. People shove who knows what in those pockets, including magazines, wrapping papers, used tissues, and maybe even a doughnut.

That’s why limiting what you touch, washing your hands thoroughly and frequently, and not touching your face with unwashed hands will be more important than holding your breath for the entire duration of the six hour or so flight. (By the way, you can only hold your breath for a few minutes before you pass out, so don’t even try it.) Of course, not touching your face is easier said than done, as I described previously for Forbes. Your face can feel like a gigantic planet with a massive gravitational pull on your fingers. Therefore, try keeping your hands occupied like putting them in your pockets, typing on a computer, or flashing gang signs to yourself.

Hand sanitizer can help but make sure you use it properly. Use enough sanitizer to cover all parts of your hands. Then massage your hands together as if they were the main characters in a romance novel. Keep up the rubbing until they become dry. Recite the alphabet while doing this so that you know that you’ve gone long enough, because isn’t that what lovers in a romance novel do?

Washing your hands with soap and water, if done properly, is always better than just using hand sanitizer. However, airplane bathrooms may be areas of really high touch, in more ways than one. A lot can go on in a bathroom and a decent percentage of it is not good, from a microbe standpoint, that is. The words “airplane bathroom” and “luxurious” usually don’t go together. While in a cramped airplane bathroom, it can be difficult to limit your touching, especially when turbulence makes it feel like you are an ingredient in a smoothie being made.

Therefore, definitely wash your hands thoroughly at the end of an adventure in an airplane bathroom. This may not be the easiest thing with the design of the bathroom sink. Many such bathrooms don’t have automatic sensor-driven faucets. Instead you’ve got to continuously hold down those little faucet handles, and keep pushing that lever that allows the sink to drain. After drying your hands with a paper towel, try not to touch other used items when throwing the towel away in the garbage. This can be tough when the garbage container lid slams back shut like gator’s mouth. When you are leaving the bathroom, use a paper towel to handle the door knob so that you don’t just re-contaminate your hands.

Pay attention to how everything in the cabin is maintained and cleaned. As a customer, consider it a right to know what safety and disinfection procedures are in place during and between flights. According to the World Health Organization (WHO), the new coronavirus may be able to survive on surfaces for “a few hours or up to several days.” That means what happened in the cabin during the flights before yours may stay in the cabin. Therefore, before a flight, consider inquiring about the specifics of an airline’s cleaning policies. After all, scrimping and saving on such things may be one way some airlines try to cut costs, unless customers shine more of a light on such practices.

Another question that is coming up is whether flights will be canceled or grounded due to the outbreak, leaving you stranded. That will depend on where you are flying, how the outbreak proceeds, and what the governments and the airlines plan on doing. It is difficult to predict what may happen. Therefore, follow closely official CDC announcements and the news, the real news that is and not what Uncle Joey or Aunt Marmy are saying on Facebook.

Stick with airlines that have more flexible cancellation and change policies. Beware of the airlines that say, “oh, you can change your flight but it will require this massive fee and a body part.” If you have already booked a flight and the airline has instituted a new more flexible change policy, see if you can benefit from that policy too. For example:

                           

Consider purchasing travel insurance or a Cancel for Any Reason (CFAR) policy to cover you in case plans have to change. As always, read the fine print of such policies, which may not always be so fine.

Related: Compare & Buy Travel Insurance for 2020

Also, look into alternatives to air travel. Even if you do end up taking a flight, it is helpful to know how you may get back if your return flight ends up getting canceled. Make sure that the options are viable. After all, find a bicycle and pedal like mad may not work if you are going from San Francisco to New York City.

Ultimately, it’s difficult to make blanket recommendations about air travel. (Oh, by the way, make sure that airline blankets are properly cleaned before using them.) In general, this doesn’t seem to be the best time to schedule optional travel. There’s still a fair amount of uncertainty. So if you can easily cancel your air travel, then you may want to do so.

If your travel isn’t completely optional, try to identify alternatives such as video-conferencing or sending a gigantic cake. Cutting down air travel not only may decrease your risk of getting sick but also reduce the risk of you carrying the virus to others who may be of even greater risk for bad health outcomes if they have other diseases or are older. It ain’t a bad thing for the environment either.

If you are over 65 years of age or have a chronic medical condition like lung disease, have a very low threshold for canceling your air travel. You may be at risk for worse health outcomes if you get infected. Check with your doctor before considering such travel. If you are a little kid, enjoy smearing things on your face, and don’t quite understand boundaries yet, you may not want to travel either because you won’t be able to maintain the necessary aforementioned infection control precautions. Besides if you are a kid, you are probably less likely to have essential work travel.

If canceling or postponing your air travel is difficult to do and you do end up having to travel by air, no need to be paranoid. “Be paranoid” is rarely the recommendation for any situation. Just take the precautions mentioned above, which are probably precautions that you should always take when traveling by plane regardless of whether a novel virus is circulating.

So, again, right now, you should avoid the locations that the CDC website warns you to avoid and consider canceling or postponing all non-essential air travel if it is reasonably feasible to do so. You also may want to avoid air travel if you are in a higher risk group such those over 65 years of age or with a chronic medical condition.

Of course, lots of air travel doesn’t quite fall into these categories, which makes decision making more difficult. As with all difficult decisions, your decision on whether to cancel your flight plans is personal, depending on your risk tolerance and needs. Yes, being confined close together with others in a cabin for several hours does have its risks. Yes, you are depending on others to keep surfaces clean and disinfected. Yes, you don’t know exactly what will happen in the ensuing weeks. But there are things that you can do to reduce the accompanying risks. Realize that nothing has no risk.

Be aware of the real risks and not what so-and-so with ten followers on Twitter is trying to get you to believe. Don’t listen to some of the panicky chatter out there or anyone who tells you that there is one definitive answer for everyone, such as all air travel should be canceled immediately or that no one should be concerned about air travel at all. Keep in mind the expertise and agendas of anyone who may be giving advice. Follow closely announcements from trusted sources. If you can follow what a celebrity is doing with his or her hair each day on social media, you can frequently check websites like the CDC’s. In other words, just stay appropriately grounded when making your decision of whether to fly.

Follow me on Twitter or LinkedIn. Check out my website.

I am a writer, journalist, professor, systems modeler, computational and digital health expert, avocado-eater, and entrepreneur, not always in that order. Currently, I am a Professor of Health Policy and Management at the City University of New York (CUNY), Executive Director of PHICOR (@PHICORteam), Associate Professor at the Johns Hopkins Carey Business School, and founder and CEO of Symsilico. My previous positions include serving as Executive Director of the Global Obesity Prevention Center (GOPC) at Johns Hopkins University, Associate Professor of International Health at the Johns Hopkins Bloomberg School of Public Health, Associate Professor of Medicine and Biomedical Informatics at the University of Pittsburgh, and Senior Manager at Quintiles Transnational, working in biotechnology equity research at Montgomery Securities, and co-founding a biotechnology/bioinformatics company. My work involves developing computational approaches, models, and tools to help health and healthcare decision makers in all continents (except for Antarctica) and has been supported by a wide variety of sponsors such as the Bill and Melinda Gates Foundation, the NIH, AHRQ, CDC, UNICEF, USAID and the Global Fund. I have authored over 200 scientific publications and three books. Follow me on Twitter (@bruce_y_lee) but don’t ask me if I know martial arts.

Source: With COVID-19 Coronavirus, Should You Cancel Or Postpone Air Travel?

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Subscribe to our YouTube channel for free here: https://sc.mp/subscribe-youtube Is it better to take a window seat or an aisle? What should you do if you think the person next to you is ill? These are among the most common questions being asked by travellers around the world as the Covid-19 epidemic spreads. Dr David Powell is a veteran medical adviser to the International Air Transport Association (IATA). He spoke with the South China Morning Post about the safety of air travel during a disease outbreak and how best to protect yourself from infections like the deadly coronavirus that causes Covid-19. Follow us on: Website: https://scmp.com Facebook: https://facebook.com/scmp Twitter: https://twitter.com/scmpnews Instagram: https://instagram.com/scmpnews Linkedin: https://www.linkedin.com/company/sout…

 

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