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Coronavirus sample, via Riverside County Public Health

COVID-19 basics

According to the Centers for Disease Control and Prevention, a novel coronavirus is a new coronavirus that has not been previously identified.

The virus causing coronavirus disease 2019 (COVID-19), is not the same as the coronaviruses that commonly circulate among humans and cause mild illness, like the common cold.

A diagnosis with coronavirus 229E, NL63, OC43, or HKU1 is not the same as a COVID-19 diagnosis.

Patients with COVID-19 will be evaluated and cared for differently than patients with common coronavirus diagnosis.

On February 11, 2020 the World Health Organization announced an official name for the disease that is causing the 2019 novel coronavirus outbreak, first identified in Wuhan China.

The new name of this disease is coronavirus disease 2019, abbreviated as COVID-19. In COVID-19, ‘CO’ stands for ‘corona,’ ‘VI’ for ‘virus,’ and ‘D’ for disease.

Formerly, this disease was referred to as “2019 novel coronavirus” or “2019-nCoV.”

There are many types of human coronaviruses including some that commonly cause mild upper-respiratory tract illnesses.

COVID-19 is a new disease, caused be a novel (or new) coronavirus that has not previously been seen in humans.

The name of this disease was selected following the World Health Organization best practice for naming of new human infectious diseases.

Source and spread of the virus

The CDC states that coronaviruses are a large family of viruses that are common in people and many different species of animals, including camels, cattle, cats, and bats. Rarely, animal coronaviruses can infect people and then spread between people such as with MERS-CoV, SARS-CoV, and now with this new virus (named SARS-CoV-2).

The SARS-CoV-2 virus is a betacoronavirus, like MERS-CoV and SARS-CoV. All three of these viruses have their origins in bats.

The sequences from U.S. patients are similar to the one that China initially posted, suggesting a likely single, recent emergence of this virus from an animal reservoir.

Early on, many of the patients at the epicenter of the outbreak in Wuhan, Hubei Province, China had some link to a large seafood and live animal market, suggesting animal-to-person spread.

Later, a growing number of patients reportedly did not have exposure to animal markets, indicating person-to-person spread.

Person-to-person spread was subsequently reported outside Hubei and in countries outside China, including in the United States. Some international destinations now have ongoing community spread with the virus that causes COVID-19, as do some parts of the United States.

Community spread means some people have been infected and it is not known how or where they became exposed.

Severity

The complete clinical picture with regard to COVID-19 is not fully known.

Reported illnesses have ranged from very mild (including some with no reported symptoms) to severe, including illness resulting in death. While information so far suggests that most COVID-19 illness is mild, a reportexternal icon out of China suggests serious illness occurs in 16 percent of cases.

Older people and people of all ages with severe chronic medical conditions — like heart disease, lung disease and diabetes, for example — seem to be at higher risk of developing serious COVID-19 illness.

The following symptoms may appear 2-14 days after exposure (this is based on what has been seen previously as the incubation period of MERS-CoV viruses): fever, cough, shortness of breath.

COVID-19 now a pandemic

A pandemic is a global outbreak of disease. Pandemics happen when a new virus emerges to infect people and can spread between people sustainably.

Because there is little to no pre-existing immunity against the new virus, it spreads worldwide.

The virus that causes COVID-19 is infecting people and spreading easily from person-to-person. Cases have been detected in most countries worldwide and community spread is being detected in a growing number of countries.

On March 11, the COVID-19 outbreak was characterized as a pandemic by the World Health Organization.

This is the first pandemic known to be caused by the emergence of a new coronavirus. In the past century, there have been four pandemics caused by the emergence of novel influenza viruses. As a result, most research and guidance around pandemics is specific to influenza, but the same premises can be applied to the current COVID-19 pandemic.

Pandemics of respiratory disease follow a certain progression outlined in a “Pandemic Intervals Framework.” Pandemics begin with an investigation phase, followed by recognition, initiation, and acceleration phases.

The peak of illnesses occurs at the end of the acceleration phase, which is followed by a deceleration phase, during which there is a decrease in illnesses. Different countries can be in different phases of the pandemic at any point in time and different parts of the same country can also be in different phases of a pandemic.

Risk assessment

Risk depends on characteristics of the virus, including how well it spreads between people; the severity of resulting illness; and the medical or other measures available to control the impact of the virus (for example, vaccines or medications that can treat the illness) and the relative success of these.

In the absence of vaccine or treatment medications, nonpharmaceutical interventions become the most important response strategy. These are community interventions that can reduce the impact of disease.

The risk from COVID-19 to Americans can be broken down into risk of exposure versus risk of serious illness and death.

Risk of exposure

According to the CDC, the immediate risk of being exposed to this virus is still low for most Americans, but as the outbreak expands, that risk will increase.

Cases of COVID-19 and instances of community spread are being reported in a growing number of states.

People in places where ongoing community spread of the virus that causes COVID-19 has been reported are at elevated risk of exposure, with the level of risk dependent on the location.

Healthcare workers caring for patients with COVID-19 are at elevated risk of exposure.

Close contacts of persons with COVID-19 also are at elevated risk of exposure.

Travelers returning from affected international locations where community spread is occurring also are at elevated risk of exposure, with level of risk dependent on where they traveled.

Risk of severe illness

Early information out of China, where COVID-19 first started, shows that some people are at higher risk of getting very sick from this illness. This includes: Older adults, with risk increasing by age. People who have serious chronic medical conditions like: Heart disease,Diabetes, Lung disease.

What may happen

The CDC website states, more cases of COVID-19 are likely to be identified in the United States in the coming days, including more instances of community spread.

CDC expects that widespread transmission of COVID-19 in the United States will occur. In the coming months, most of the U.S. population will be exposed to this virus.

Widespread transmission of COVID-19 could translate into large numbers of people needing medical care at the same time.

Public health and healthcare systems may become overloaded, with elevated rates of hospitalizations and deaths.

Other than schools and businesses, critical infrastructure, such as law enforcement, emergency medical services, and sectors of the transportation industry may also be affected.

Healthcare providers and hospitals may be overwhelmed. At this time, there is no vaccine to protect against COVID-19 and no medications approved to treat it.

Nonpharmaceutical interventions will be the most important response strategy to try to delay the spread of the virus and reduce the impact of disease.

How people can protect themselves

There is currently no vaccine to prevent COVID-19. The best way to prevent illness is to avoid being exposed to this virus.

Every person has a role to play. So much of protecting yourself and your family comes down to common sense:

• Washing hands with soap and water.

• Clean and disinfect frequently touched surfaces daily. If surfaces are dirty, clean them using detergent or soap and water prior to disinfection.

• Isolate at home and practice social distancing.

• Avoiding touching eyes, nose or mouth with unwashed hands.

• Cover your cough or sneeze with a tissue or your elbow.

• Avoiding close contact with people who are sick.

• Staying away from work, school or other people if you become sick with respiratory symptoms like fever and cough.

• Following guidance from public health officials.

Please consult with your health care provider about additional steps you may be able to take to protect yourself.

Facemasks

CDC does not recommend that people who are well wear a facemask to protect themselves from respiratory illnesses, including COVID-19.

You should only wear a mask if a healthcare professional recommends it.

A facemask should be used by people who have COVID-19 and are showing symptoms.

This is to protect others from the risk of getting infected.

The use of facemasks also is crucial for health workers and other people who are taking care of someone infected with COVID-19 in close settings (at home or in a health care facility).

Testing for COVID-19

According to the CDC, if you develop symptoms such as fever, cough, and/or difficulty breathing, and have been in close contact with a person known to have COVID-19 or have recently traveled from an area with ongoing spread of COVID-19, stay home and call your healthcare provider.

Older patients and individuals who have severe underlying medical conditions or are immunocompromised should contact their healthcare provider early, even if their illness is mild.

If you have severe symptoms, such as persistent pain or pressure in the chest, new confusion or inability to arouse, or bluish lips of face, contact your healthcare provider or emergency room and seek care immediately.

Twenty-one public health labs in California are testing for COVID-19. These labs include the California Department of Public Health's Laboratory in Richmond, Alameda, Contra Costa, Humboldt, Los Angeles, Monterey, Napa-Solano-Yolo-Marin (located in Solano), Orange, Riverside, Sacramento, San Bernardino, San Diego, San Francisco, San Joaquin, San Luis Obispo, San Mateo, Santa Clara, Shasta, Sonoma, Tulare and Ventura County public health laboratoriesThe Richmond Laboratory will provide diagnostic testing within a 48-hour turnaround time.

More public health labs will soon be able to test for COVID-19. This means California public health officials will get test results sooner, so that patients will get the best care.

If you don’t have health insurance

• Check with your local community health center or hospital to see if fees for testing can be waived.

• See if you’re eligible for Medi-Cal.

• See if you’re eligible for Covered California.

Self-isloate or hospitalization when positive for COVID-19

Local health departments are working in partnership with the California Department of Public Health and the CDC, and making determinations on whether a person ill with COVID-19 requires hospitalization or if home isolation is appropriate.

That decision may be based on multiple factors including severity of illness, need for testing, and appropriateness of home for isolation purposes.

If you are unable to work after being exposed

According to the California Department of Public Health, individuals who are unable to work due to having or being exposed to COVID-19 (certified by a medical professional) can file a Disability Insurance claim.

Disability Insurance provides short-term benefit payments to eligible workers who have full or partial loss of wages due to a non-work-related illness, injury, or pregnancy. Benefit amounts are approximately 60-70 percent of wages (depending on income) and range from $50 - $1,300 a week.

Californians who are unable to work because they are caring for an ill or quarantined family member with COVID-19 (certified by a medical professional) can file a Paid Family Leave (PFL) claim.

Paid Family Leave provides up to six weeks of benefit payments to eligibile workers who have a full or partial loss of wages because they need time off work to care for a seriously ill family member or to bond with a new child. Benefit amounts are approximately 60-70 percent of wages (depending on income) and range from $50-$1,300 a week.

Some things California is doing

The Public Health Department is supporting hospitals and local public health laboratories in the collection of specimens and testing for COVID-19.

California activated the State Operations Center to its highest level to coordinate response efforts across the state.

Governor Gavin Newsom requested the Legislature make up to $20 million available for state government to respond to the spread of COVID-19.

California made available some of its emergency planning reserves of 21 million N95 filtering facepiece masks for use in certain health care settings to ease shortages of personal protective equipment.

The Franchise Tax Board is providing a 90-day extension to file California tax returns for taxpayers affected by the COVID-19 pandemic.

The California Business, Consumer Services and Housing Agency released guidance for homeless assistance providers in the state.

The California Department of Public Health is coordinating with federal authorities and local health departments that have implemented screening, monitoring and, in some cases, quarantine of returning travelers.

24 million more Californians are now eligible for free medically necessary COVID-19 testing.

This information was compiled from the Centers for Disease Control and Prevention and California Public Health websites. 

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