On Feb. 25, the U.S. Centers for Disease Control and Prevention issued an alert urging Americans to prepare for the spread of novel coronavirus disease (COVID-19) within American communities. A COVID-19 outbreak in the U.S. is not a question of if, but when, officials said.
While the rapid increase of COVID-19 cases internationally is concerning, Americans should avoid panicking, says Cole Zanetti, DO, a family physician and the director of digital health at the Rocky Vista University College of Osteopathic Medicine. There have been more deaths in the U.S. from the flu virus this year than the total deaths from coronavirus worldwide, Dr. Zanetti notes.
In fact, the U.S. has seen multiple severe flu seasons over the past decade. During the 2017-2018 flu season, over 61,000 people died, and up to 41,000 people have died this season so far, according to the CDC.
“We’re seeing more virulence with the flu,” Dr. Zanetti says. “We’ve had longer seasons. We’re going to see more and more of this, because these viruses are adapting.”
As is the case with the seasonal flu, diligence in avoiding transmission of COVID-19 is necessary to protect the most vulnerable populations, such as people with compromised immune systems.
Evidence suggests that the vast majority of people who contract COVID-19 survive the illness and recover fully, he says.
“Most of the people who get diagnosed with COVID-19 are having symptoms very similar to the flu, and after the illness runs its course, they’re able to move past the condition,” he says. “But it’s important to know that people with symptoms are not the only ones who are contagious. Someone can not be symptomatic and still spread the virus to another person.”
Everyone can do their part to protect people who are immunocompromised and prevent transmission with some common sense measures, he says.
Find more information on how to do this in the Q&A below, which the AOA put together to provide some answers to common questions about COVID-19.
At the time of writing, the CDC is reporting 59 total U.S. cases, all in patients who had either contracted the virus in Asia or contracted it from a close contact who had been in Asia.
What are the symptoms of COVID-19?
Symptoms can include fever, cough and shortness of breath.
What is the incubation period?
The incubation period is believed to be between two and 14 days.
Who is at risk of contracting COVID-19?
COVID-19 spreads via respiratory droplets, primarily from an infected person’s cough or sneeze. Some people who contract COVID-19 have no symptoms or mild symptoms, while others develop severe illness and die from the disease. Limited data suggests that elderly patients and people with compromised immune systems may be more likely to develop severe illness after contracting COVID-19.
How can people prevent transmission?
The same methods people use to prevent colds and the flu can prevent COVID-19 transmission: wash your hands frequently, cover your mouth when you cough or sneeze, avoid going to work or school when you’re sick and avoid touching your face or eyes with unwashed hands.
Are facemasks necessary or a good idea?
The CDC does not recommend that people who are not ill wear a facemask to protect themselves. People who have COVID-19 and are showing symptoms should wear a facemask, according to the CDC. Health care professionals should wear facemasks/respiratory protection such as an N95 facemask when treating or examining a patient who has or may have been exposed to COVID-19.
Teshina Wilson, DO, a family physician with Kaiser Permanente in Pinole, California, says many patients are asking her about facemasks. Facemasks may make sense for people with weak immune systems, she says.
“I’ve been telling patients that if you’re someone who’s maybe more prone to being ill or you’re immunocompromised, it may be in your best interest to wear a mask if you’re out and about amongst large crowds or getting on an airplane,” she says.
What should patients do if they think they have COVID-19?
If you’ve had close contact with someone who has COVID-19 or has traveled to an area with COVID-19 cases, the CDC recommends calling ahead to tell your physician you may have been exposed before visiting the physician’s office. You should stay home except to get medical care, wear a facemask when you’re around other people, and cover your mouth when you cough or sneeze. More advice for patients who suspect they have COVID-19 is available here.
If COVID-19 begins spreading in American communities, what should people do?
If this happens, people—especially those with compromised immune systems—should consider avoiding crowds, says Dr. Wilson.
“If you don’t need to go around large groups of other people, where there’s potential for transmission, try to avoid doing so,” she says. “Wash your hands at every step of the way. Cover your coughs and sneezes in your elbow creases. Remind other people to do the same. Be polite about it, but tell them they’re good habits, and be mindful of others.”
What should physicians do if they suspect a patient has COVID-19?
The CDC has released this flowchart to help health care professionals determine if a patient’s symptoms and travel/contact history suggest the patient may have been exposed to COVID-19. For suspected cases, the CDC recommends placing a facemask on the patient, isolating the patient in a private room and wearing appropriate personal protective equipment. Physicians should also immediately contact their local or state health department if they suspect a patient has been exposed to COVID-19.
Physicians can share the following resources with patients:
CDC COVID-19 landing page
WHO COVID-19 landing page
How to stay healthy during severe flu seasons
How to protect yourself from pneumonia