COVID-19 Update & Your Health, March 15, 2020

COVID-19 Update & Your Health

With suspended international travel, school closures, even Disneyland shutting its doors, some of you may be wondering what can be done to protect yourself from COVID-19.

Today, we have 73 confirmed cases of COVID-19 in British Columbia, 304 confirmed cases across Canada and one fatality. COVID-19 is a dynamic situation as cases, countries and recommendations are changing by the hour. For the most current updates, you can visit the Government of Canada Website.  According to the World Health Organization Situation Report 55 for March 15, 2020, there are now 153 517 confirmed global cases of COVID-19 and 5735 deaths, carrying a 3-4% mortality rate (although this is significantly lower in Canada and the US).

Understanding Coronavirus

A Little History

Coronoviruses comprise a vast family of viruses, 7 of which are known to cause disease in humans.  The four types of coronaviruses (229E, NL63, OC43 and HKU1) associated with the common cold will affect most individuals at some time in their life. The typical coronavirus infection is short-lived, with symptoms such as a runny nose, headache, cough, sore throat, fever and a general feeling of being unwell. In compromised individuals, the elderly, the young and those with a compromised immune system or other severe health issues, the common coronaviruses can cause bronchitis or pneumonia. (1)

This novel coronavirus (COVID-19) is a new strain. It begins as a common cold with fever, lethargy, cough and difficulty breathing. Additional symptoms may include sore throat, nasal congestion and swollen adenoids. In some people, especially those that are compromised, it can rapidly cause respiratory symptoms including viral pneumonia. The rapid progression is what makes individuals very ill and can cause death.

COVID-19 is more similar to the pathogenic Coronavirus strains both SARS and MERS that were problematic back in 2002 and 2012. In 2002, Severe Acute Respiratory Syndrome (SARS) infected up to 8000 people and carried a mortality rate of up to 10%, where COVID-19 is much less in its severity – with an average 2% to 5% mortality (even though it is 70% genetically similar to  SARS)(1). The 2012 Middle East Respiratory Syndrome (MERS) outbreak, has had a total number of laboratory-confirmed cases globally (from October 2012 until 5 March 2020) to the WHO as 2521 with 866 associated deaths – a 33% death rate.

Unlike COVID-19, past corona viruses have been so severe people were forced to stay at home as they were too ill to go out and travel, thus lessening the spread.

Some Perspective

Infectious Rate

Immunologist and researcher Dr. Heather Zwickey, PhD, spoke about the coronavirus and how infectious diseases take hold. This particular COVID-19 disease is not as infectious as, let’s say, the measles. For example, where 1 person with measles may infect 18 other people, the corona virus person can infect 2-4 other people.  That’s not to downplay the seriousness of our current global situation, however, perspective can be helpful.

Mutagenicity

COVID-19 is not as Mutagenic as the Flu.

There is a particular protein on the Corona virus called a Spike Protein (or the S Protein) that makes this virus specific and explains why it can infect a particular animal or tissue in humans. This Spike protein targets the lower part of the lung, thus causing Pneumonia. If this protein mutates, it can change the specificity of the target tissues, but to date, this virus is not currently mutating. This bodes well for vaccine research.

The common flu mutates over and over and the CDC estimates that there are over 1200 flu strains currently circulating in the population at this time. Since December, COVID-19 has not mutated in the last 3 months, which is good news.

Can you Tell the Difference between a common flu and COVID-19?

This is a really good question. The only true way to differentiate a regular cold and flu from the Coronavirus is through Sputum collection for PCR testing. However, in brief:

Common Cold & Flu

• Most individuals will have a fast response to a cold or flu as a result of past exposures and the body’s ability to experience cold & flu symptoms occur in 2-3 days.

Coronavirus

• The worst of the symptoms may occur 8-10 days after exposure and so the incubation time is much longer due to it being a new virus.
• This virus infects lower in the lungs and the progression to pneumonia in the lungs is much faster, especially in compromised individuals, such as in COPD patients.
• A fever will also spike faster and higher than the typical flu
• The rest of the symptoms are fairly similar

The clinical criteria include fever or history of fever (≥38 ºC) and acute respiratory infection (sudden onset of respiratory infection at least one of shortness of breath, cough or sore throat).
or
Severe acute respiratory infection requiring admission to hospital with clinical or radiological evidence of pneumonia or acute respiratory distress syndrome (i.e., even if there is no evidence of a fever).

In the initial Lancet report of 41 patients infected with COVID-19 in Wuhan, China, Huang et al., reported the following findings:

• 78% were male (average age of 42) and 32% of all patients had an underlying condition
• Common Symptoms included: fever (98%), cough (76%), myalgia and fatigue (44%), and dyspnea or shortness of breath (55%).
• Less common symptoms included: Headache, sputum production, and diarrhea

All patients with Pneumonia had abnormal lung findings, and of these 29% developed acute respiratory distress with ground-glass opacities on CT Scan. (2)

Steps You Can Take to Prevent Spread & Infection

Practicing a healthy lifestyle that includes good nutrition, quality sleep, regular exercise, staying hydrated and not smoking, will help to keep your immune system strong.

COVID-19 is not airborne. This is spread via respiratory droplets.

Be active and intentional about keeping high-touch surfaces clean and disinfected throughout the day, as well as promoting good hand hygiene and respiratory etiquette.

The most important ways to prevent and control respiratory viruses, including COVID-19, include:

1. Consistent practice of good hand hygiene and respiratory etiquette. Washing your hands with soap and water frequently is the most effective way to reduce your risk. It is helpful to sneeze into your elbow and not into your hands.
2. Wash your hands, as soon as you get home and disinfect your phone (it’s amazing what they carry!)
3. Don’t travel, if you don’t need to!
4. Practice social distancing. It is important to take action and practice social responsibility to help protect others as well as yourself. While undesirable, we encourage you to work from home if possible, cancel holiday plans, cancel spring break camps, and not participate in social gatherings.
5. If you are ill with respiratory illness symptoms (fever, cough, fatigue, and/or muscle aches) – Please stay home from school and/or work but also let your family know. Do not travel, rather call your health care provider or 811 first.

According to multiple infectious disease experts, this global pandemic has the potential to impact 60% of our population over the next 12 months. Individuals can reduce their risk of coronavirus. Prevention is always the best measure.

Courtesy of Dr. Emina Jasarevic, ND

Resources:

1. Center for Disease Control. 2020. Novel coronavirus 2019, Wuhan, China. cdc.gov
2. https://www.thelancet.com/coronavirus