Important information from SNAHC Medical Director, Dr. Hakeem Adeniyi:
Hello SNAHC Community,
As many of you are now aware, there has been a confirmed case of 2019 novel Coronavirus, now called COVID-19, in California. The patient is from Solano County and is currently being treated at UC Davis in Sacramento. This is the first case thought to be community-acquired, meaning that the patient did not have recent travel to China and did not have known exposure to the virus previously. Given the health concerns associated with this infection, here is some information to help protect you and your loved ones.
What is the latest news about COVID-19?
More than 81,000 cases of COVID-19 now have been reported in 47 countries. Nearly 3,000 people have died from the virus. The vast majority of cases and deaths are still from China.
What are the symptoms of COVID-19?
COVID-19 causes a wide range of symptoms. People with severe infections will have fever, cough, shortness of breath, and decreased oxygen levels. A recent report of nearly 45,000 cases in China showed that more than 80% of people had mild cases, defined as cold symptoms or mild pneumonia. It is unclear how many people may have the virus but do not have any symptoms., but we do know that children seem to have mild or asymptomatic infections, meaning that they can be infected without many signs or symptoms. Because COVID-19 has such a variable presentation – and symptoms are the same as other respiratory infections – there is no way to know who does or does not have COVID-19 without testing.
What are the risks for us now?
On February 26, news broke of a patient from Solano County being treated at UC Davis for confirmed COVID-19. As of this writing, there have been 9 confirmed deaths from COVID-19 from other parts in the US with no reported deaths in California. Several thousand people are currently being quarantined to check for infection and to help reduce risk of spreading infection.
Should I be tested for COVID-19?
The test for COVID-19 still can only be ordered by local Health Departments and performed at the CDC in Atlanta. California should be able to run its own tests for COVID-19, soon, but we are not sure exactly when that will be.
Who will the Health Department test for COVID-19?
The Health Department is still only performing tests on Persons Under Investigation (PUI) using the CDC criteria: fever, lower respiratory symptoms (like cough or shortness of breath), and known travel to China or exposure to someone who has COVID-19 infection. The PUI criteria soon may expand to include other travel history, like Korea, Japan, Italy, or Iran, but for now it is still just travel to China. The Solano resident likely was tested due to the severity of symptoms, even without any known exposure.
What can we do now?
Similar to other airborne infections, the most important things we can do are PREVENTION and CONTROL. Prevention means washing your hands for at least 20 seconds and to avoid being close to others who are sick. Control means reducing the risk of spread from those who are sick.
Can people who do not have symptoms still spread the virus?
Probably, but similar to other respiratory infections, the contagious risk is highest when fever and cough are present as the fever likely represents a higher amount of virus present and the cough leads to more production and spreading of droplets containing the virus.
What is the treatment for COVID-19?
The only treatment for COVID-19 is to take care of the symptoms. Patients with mild illness should rest, drink fluids, and take symptom-specific measures (such as fever-reducing and/or cough medicine). Patients with more severe infection, such as decreased oxygen levels, may need to be admitted to the hospital for more intense supportive care. Right now, there are no antivirals or other specific treatments against the COVID-19 virus.
What if I am concerned that I might have been exposed to COVID-19, should I come to clinic?
Patients with mild illness and who are concerned about COVID-19 should not come to be seen in the clinic, since we cannot test for COVID-19 or offer any specific treatment. Patients with fever and cough may still need to be seen to rule-out pneumonia, seasonal influenza, or other non-COVID treatable conditions, like asthma or COPD. Before coming to clinic, if you are concerned that you might have been exposed and are having significant symptoms, please call SNAHC so that we can direct you to the correct place.
If people with the virus may be in the clinic, how can we protect ourselves?
Like with other respiratory infections, anyone who presents with fever and cough will be given a surgical mask to wear and kept away from other patients, likely being brought back to evaluated in the exam room quickly. If we are not able to do that, we will likely have the person come through another designated door.
Again, the main goal is prevention and control. Wash hands for at least 20 seconds and/or use hand sanitizer frequently, and always before eating or touching your eyes, nose, or mouth, please clean your hands.
Is there anything else we can do?
If you are feeling sick with fever and cough, please stay home to recover and avoid infecting other people.
When will a vaccine be available?
A vaccine likely not be available for 12-18 months.
How does COVID-19 compare to the flu or other respiratory viruses?
Since this is a new virus, there is still much to learn. It is currently reported that 2-4% of people with COVID-19 die from the virus, which is very high, but the true percentage is likely lower due to very mild or cases without symptoms that have not been confirmed or reported. While the seasonal flu tends to decrease in the spring, we do not know if COVID-19 will do the same.
When comparing COVID-19 to H1N1 Influenza pandemic of 2009, H1N1 also appeared in the spring, decreased by summer, but surged in the fall. H1N1 affected a larger number of children while with COVID-19, children tend to have the least amount of symptoms. With H1N1, we were able to use or adapt many things that were already in place for seasonal flu like rapid testing, antiviral treatment, and vaccine manufacturing capability. With COVID-19, many of these things still need to be researched or created from scratch.
To put things in perspective, the seasonal flu affects 35-45 million Americans every year, and causes 35,000-60,000 deaths. According to the preliminary estimates from the CDC, there have been 16,000 deaths and 280,000 people hospitalized due to the flu during this 2019-2020 influenza season.
The information and recommendations listed above may be subject to change as the outbreak evolves. We will continue to keep you informed as the situation develops. For more information click here.