The Coronavirus Outbreak: A Health Briefing Update

The Coronavirus Outbreak: A Health Briefing Update

A new strain of coronavirus, 2019 novel coronavirus (2019-nCoV), was first identified earlier this month by Chinese researchers in Wuhan, a city in central China of 11 million people. The cases were linked to a market that sold live animals. The market was shut down and disinfected, but the confirmed human infections have spread.
Early on, many of the patients in the outbreak of respiratory illness caused by 2019-nCoV in Wuhan, 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. Chinese officials report that sustained person-to-person spread in the community is occurring in China. Person-to-person spread has been reported outside China, including in the United States and other countries. 
Most often, spread from person-to-person happens among close contacts (about 6 feet). Person-to-person spread is thought to occur mainly via respiratory droplets produced when an infected person coughs or sneezes, similar to how influenza and other respiratory pathogens spread. These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs. It’s currently unclear if a person can get 2019-nCoV by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes.


Confirmed 2019-nCoV Cases GloballyWorld map showing countries with 2019-nCoV casesView larger image and see a list of locations
2019-nCoV in the U.S.2019-nCoV cases within the U.S.
View larger image
On January 30, 2020, WHO declared that the 2019-nCoV outbreak is a global health emergency, which acknowledges that the disease now a risk beyond China (previous emergencies include Zika and Ebola). On February 5, 2020, WHO announced a $675 million plan to establish international coordination, scale up county readiness and response operations and accelerate key research over the next two month.

There have now been 13 documented infections of the 2019-nCoV in the states of Arizona, California, Illinois, Massachusetts, Washington and Wisconsin and 399 patients under investigation in 37 states and territories. There are at least 20 airports screening for the virus, including Atlanta, Boston, Chicago, Houston, Los Angeles, New York, San Francisco and San Diego. 
The global number of confirmed coronavirus cases now exceeds 43,000 and the global death toll exceeds 1,000. The vast majority of cases remains in mainland China.
About the Disease
Coronaviruses are characteristically named for the crown or “corona”-like spikes on the microscopic surface of the virus. This large family of viruses causes respiratory illnesses ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS), each of which killed approximately 800 people in 2012 and 2002-2003, So far, 2019 novel coronavirus has infected almost four times the number of people who contracted SARS.
Common human coronaviruses typically cause mild to moderate upper-respiratory tract illnesses with symptoms that resemble the flu or a bad cold, such as a runny nose, headache, cough, sore throat, high fever and general feeling of being unwell. More severe symptoms may include difficulty breathing, pneumonia, bronchitis, and lung lesions. 
The time from exposure to the onset of symptoms is thought to be about two to 14 days. Approximately 90% of the cases present clinical symptoms by nine days post-infection. Researchers observe that approximately 37% of cases had evidence of the virus in their sputum samples in the 24 hours prior to exhibiting observable symptoms like fever. The quantifiable amount of the virus is low, but there is a chance that asymptomatic patients may be infectious in the 24 hours before they have symptoms.
Initially, the source of outbreak was linked to animal sources. Person-to-person transmission is now occurring. The exact mode of transmission of this new strain of coronavirus is not completely understood, but prior strains of human coronavirus are most commonly spread from an infected person to others via:
  • Air droplets by coughing and sneezing (~60%)
  • Touching an infected object or surface (~20%)
  • Touching contaminated surfaces then touching your mouth, nose, or eyes (~20%)
Those with the greatest risk of infection are older than 55 years old, men, smokers, people with diabetes, people with kidney disease, and immunocompromised patients.
There are currently no vaccines available to protect against human coronavirus infection. In order to reduce the risk of infection, consider the following tips:
  • Try to avoid contact with people who are sick. Maintain an eight foot distance if you are near someone with symptoms to avoid air droplets from coughing and sneezing.
  • Wash your hands frequently with liquid soap and water for at least 20 seconds, especially after touching public installations such as handrails or doorknobs and before touching the mouth, nose, or eyes.
  • When your hands are not visibly soiled and soap and water are not available, clean your hands with sanitizer containing at least 60% alcohol, such as Purell Advanced Hand Sanitizer.
  • Get the flu vaccine – the flu is co-circulating and several flu patients have caught the coronavirus in the hospital because of the compromised immune system.
  • Try to stay generally healthy as being run down puts your body at greater risk.
  • High risk individuals may consider putting on surgical masks while in public and not adequately ventilated places. WHO provides detailed guidance on proper technique.
  • Thoroughly cook meat and eggs.
  • Avoid animal markets in Asia.
Avoid travel to China. The U.S. Department of State posted a Level 4 “do not travel” to China advisory on February 2, 2020. This is the most severe level of travel advisory.
Chinese authorities have imposed internal travel restrictions on 17 million people in six cities. Airports around the world, including in the U.S., are screening passengers from Wuhan to detect infection and prevent further spread of the disease. American Airlines, British Airways, Delta and United Airlines suspended all flight to and from mainland China.
The U.S. government has taken unprecedented steps related to travel in response to the growing public health threat posed by this new coronavirus, including suspending entry in the United States of foreign nationals who have visited China within the past 14 days. Measures to detect this virus among those who are allowed entry into the United States (U.S. citizens, residents and family) who have been in China within 14 days also are being implemented.
There is no specific treatment available. If you believe that you have been exposed to someone with coronavirus or you might have coronavirus, we recommend that you contact your primary care physician immediately.
Your physician may prescribe medication to address pain and/or fever. CDC suggests taking a hot shower or using a humidifier to alleviate a sore throat or cough. Drinking lots of fluids and getting as much rest as possible are also advised.
Click here for additional Q&A on Coronovirus from WHO.


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