Coronavirus: What You Need to Know

By now, everyone has heard of the new virus spreading around the world. Coronavirus has been used in multiple headlines to illicit public fear, xenophobia and paranoia over public health concern. Whether it’s on Facebook, by word of mouth, or misleading news stories, finding the right information about coronavirus is impossible as some companies are driven by pay per click rather than providing accurate information. When the world is on edge, it can be easy for these companies to take advantage. This has led to massive amounts of misinformation and spreading of fake/invalid news stories that are destructive, predatory and simply dangerous. Through this article, we will explore the reputable facts, concerns and news around coronavirus reported by legit news and health organizations such as The Canadian Broadcasting Corporation (CBC), The Centers for Disease Control (CDC) and most importantly The World Health Organization (WHO). If any of the following symptoms discussed pertain to you, book an appointment with your doctor immediately. At Senior Home Care by Angels, we can help book your doctor’s appointment and transport you to and from the clinic. Whether you are in St. Albert, Edmonton, Sherwood Park, Spruce Grove or other surrounding communities, we can help alleviate the stress of driving by picking you up at your convenience. Click here for more information on our companion care program or here for our personal care services.

The Basics

Though a lot of articles make it seem like there is only one strain of coronavirus, this is simply not true. Coronaviruses are a large family of viruses that cause a vast array of illnesses. From the common cold to more severe conditions that affect the respiratory system, coronaviruses have existed in society for some time. In general, the virus is initially transmitted from animals to humans (zoonotic). This means that the infection harbours in an animal to the point where it evolves enough to be able to be transferred to humans (known as a spillover). This is not uncommon as bird flu, Ebola and Lyme disease were all originally transmitted through interactions with animals. Alternatively, not all animal borne illnesses can transmit to humans due to immunological differences (different cell receptors, means of infection etc.). For instance, there are several known coronaviruses that are currently circulating in animals that have not yet infected humans. Keep in mind that once the virus first spreads to one human, the increased transmission is further spread from human-to-human contact.

Below is an example of a coronavirus. The virus contains a piece of genetic material (Ribonucleic acid [RNA]) surrounded by an envelop with protein spikes (giving it an appearance as a crown i.e. corona in Latin)

(Photo taken from Wikipedia)

Types of Coronaviruses:

SARS-associated Coronavirus (SARS-CoV)

Severe acute respiratory syndrome (SARS) is a viral respiratory illness caused by SARS-CoV. SARS was a huge outbreak in 2003 spreading to more than two dozen countries around the world. From investigation by WHO, it was found that SARS-CoV was initially transmitted from civet cats to humans starting in Asia (though coronavirus first originated in bats). During the 2003 outbreak, a total of 8,098 people became sick with SARS with 774 dying from the disease. The disease was spread from close person-to-person contact and made worse by those returning from countries where SARS was more present (i.e. Asia). According to the CDC, SARS is said to be transmitted through respiratory droplets produced when an infected person coughs or sneezes. These droplets are deposited on the mucous membranes of the mouth, nose, or eyes directly or indirectly (when a person touches an infected surface then touches their mouth, nose, or eyes). It is possible for SARS to be spread through the air or by other methods that are not fully researched.

Symptoms of SARS include having a high fever, headache, body aches, and dry cough and pneumonia after 2-7 days. These symptoms can eventually lead to heart and liver failure as well as other complications. Treatment for the infection is various as everyone reacts differently to SARS. Antiviral medications, steroids and blood plasma from recovered SARS patients are often administered to help stop the infection. There have not been any known cases of SARS anywhere in the world as the last case was reported in China in April of 2004. The infection was officially contained due to isolating people suspected of having the virus and screening all passengers traveling by air from affected countries. In 2012, SARS-CoV was declared a selective agent (a bacterium, virus or toxin that has a potential to cause a severe threat to public health and safety) ending the timeline of SARS-CoV.

Middle East Respiratory Syndrome (MERS-CoV)

Middle East Respiratory Syndrome (MERS) is a respiratory illness caused by Middle East Respiratory Syndrome Coronavirus (MERS-CoV). The disease was first reported in 2012 in Saudi Arabia and has spread to 27 other countries from travelers returning from the Arabian Peninsula. Like SARS, MERS was originally transmitted from animal to human by means of dromedary camels. Also, like SARS, MERS symptoms include, fever, cough, shortness of breath and is spread by the same manner. Those who have previous health conditions are more at risk for MERS, however, some infected have mild to no symptoms are at all. There have been no reported cases of MERS-CoV in Canada, though there were confirmed cases in the United States in 2014. If you are infected with MERS-CoV, treatment is usually administered on a case by case basis. Though not as widespread as SARS, 2,494 cases of MERS were reported since 2012 with 858 deaths associated with the illness (most of them reported from Saudi Arabia). Reduction in transmission was mostly due to the virus being contained in Saudi Arabia in 80% of cases. Furthermore, MERS does not easily pass from person-to-person unless there is close unprotected contact with an infected patient. Most of the MERS cases have been in healthcare settings and has not sustained transmission via distant human-to-human contact (i.e. walking by a person, sitting across from them).

Common Human Coronaviruses

Common human coronaviruses cause mild to moderate upper respiratory tract illnesses. Most people get infected with these viruses at least once in their life as the virus causes runny nose, sore throat, headache, fever, cough and/or other symptoms of the common cold. Like MERS, those with previous health conditions can develop lower respiratory tract illnesses such as pneumonia or bronchitis. Transmission of the virus is usually spread by coughing or sneezing, personal contact (shaking hands/touching), and touching infected objects. Like the flu, people usually get infected with the virus in the fall and winter due to it thriving in cold temperatures. Those infected with the virus will often recover on their own but pain medication and increasing liquid intake usually helps with recovery.

Coronavirus Disease 2019 (COVID-19)

As most of the previously mentioned coronaviruses have been contained, COVID-19 is the brand-new epidemic causing concern. In this section we will break down everything you need to know about COVID-19 and how best to keep yourself safe from infection. Though more information is sure to be released after this article’s posting, be sure to periodically check WHO, CBC, CDC and other organizations for the latest on the disease. Not sure where to start? Check out our resource section at the bottom of the page for more information and helpful links to keep yourself up to date. 

Background

Unlike past coronaviruses, COVID-19 is a brand new/novel coronavirus strain that has not previously been identified in humans. The virus was first detected in Wuhan City in the Hubei province of China in December of 2019. Like MERS-CoV and SARS-CoV, COVID-19 originated in bats with a human transmission likely from an unknown animal reservoir. Now, COVID-19 has been detected in 44 countries and territories including 11 cases in Canada (7 cases in British Columbia and 4 cases in Ontario).

How is COVID-19 Spread?

Initially, a group of patients with pneumonia in Wuhan had a linkage between large seafood and the live animal market suggesting an animal-to-human spread. However, after this point, patients without this exposure seemed to contract the virus, indicating person-to-person transmission. Now, COVID-19 has spread to high rates within China and other countries due to travelers returning from infected regions. Though the exact intricacies of how the virus is spread is unknown, it is likely COVID-19 mimics other coronaviruses. In this case, it is believed that COVID-19’s transmission, like SARS, is through droplets. Thus, transfer is likely due to coughs, sneezing or interacting with a contaminated surface and touching your face or eyes. Those most at risk for COVID-19 are those who are in close contact with animals (live animal market workers) and those caring for others who have the infection (family members, health care workers). 

Symptoms

As mentioned above, coronaviruses present a multitude of different symptoms ranging from mild to severe. COVID-19 is no different as patients have exemplified mild symptoms like fever, cough, shortness of breath to more severe symptoms including kidney failure and pneumonia that has led to death. According to the Journal of the American Medical Association, the incubation period (the time when the first symptoms of disease are present) of COVID-19 is between one and 14 days. During this time, it is possible for the virus to be spread asymptomatically when no signs of infection are present, though, this is considered to be rare. Remember, people of all ages can be infected with COVID-19. However, those who are older and have pre-existing medical conditions are more vulnerable due to a lowered immune system.

Diagnosis

To test if someone is positive for COVID-19 (as well as other types of coronaviruses), scientists use PCR (Polymerase Chain Reaction). This test is used to identify the virus’ genetic fingerprint. This is done by taking a small sample of DNA (or RNA by modification) and amplifying it to a large amount to study it in detail. PCR has been used to screen for genetic disorders, improve food production and solve crime.

Treatment

Like past coronaviruses, there is no specific treatment. Supportive care is ongoing to quarantine and prevent the spread of the virus from those infected. There is currently no vaccine or antiviral medication to treat or protect against the virus, though, these are currently in development (more info below).

Preventing Transmission

Though the worldly transmission is increasing, COVID-19 does have a relatively limited spread. Most of the cases are in Asian countries with the majority being in China. Some travelers returning from China have caused the spread of the virus to countries such as Canada, the United States (U.S) and the United Kingdom. Implementing standard hygiene practices are your best bet at preventing transmission. Covering your nose and mouth when coughing or sneezing, avoiding close contact with sick people, wearing masks in hospitals, and constant hand washing (for at least 20 seconds) can all help you and others from getting sick. Avoiding unnecessary contact with animals, washing your hands after contact with animals or animal products, and ensuring animal products are cooked through before consuming are all good practices to prevent infection from an animal source.

What to do if You are Sick

If you are ill, stay home unless you are going out for medical care. If you have fever, cough or have difficulty breathing, see a doctor early and share your previous travel history with your healthcare provider. If you are visiting a doctor’s office, let them know about your condition beforehand to allow them to prepare proper safety protocols. If you believe there are infected surfaces, wipe it down with regular household or cleaning spray. Clean all “high-touch” surfaces such as door handles, tabletops, keyboards and any place that may contain body fluids on them. Restrict contact with other people and, if possible, stay in a separate room with a separate bathroom. Use your own glasses, silverware and bedding to avoid the spread of infection to another person. If you have pets, restrict contact with them as well. As there have not been reports of pets getting sick with COVID-19, it is still recommended to limit interaction until more information about the virus is readily available. By ensuring you follow these practices, you can help catch the disease early and stop the spread of infection. If you are a caregiver for those infected, a lot of the same rules apply. Click here for more information on precautions for household members, caregivers or intimate partners in a non-healthcare setting. For correct mask use click here. Mask use is only necessary if you are experiencing symptoms of illness or are caring for a infected individual (they can stop droplets from spreading). If you are a healthy individual, mask use is not required. Remember, COVID-19 is not a death sentence, just over 30,000 patients have recovered from the infection in closed cases. Though it is a serious ongoing situation and requires proper safety and procedure, recovery is possible.

If you are a Returning Traveler

As stated by the Government of Canada, the risk currently is very low. However, if you have traveled outside Canada it’s important to monitor your health upon return. Be sure to monitor your health for fever, cough and difficulty breathing for 14 days after your return. If you have traveled to China, limit your contact with others for 14 days. If you are traveling abroad, expect increased health screenings at points of entry. You can check Canadian travel advisories here. For those that develop symptoms before their return, do not get aboard any form of public transportation and seek medical attention immediately. If you feel ill on a flight, notify your flight attendant so they can contact a quarantine officer upon arrival. Don’t be alarmed, these professionals are here to help you and have training on how to stop the spread of infection.

Stigma Related to COVID-19

Unfortunately, the outbreak of COVID-19 has come with a lot of societal stigma. Fear and anxiety of the virus and its origins have led to a lot of racism, xenophobia and bigotry towards Chinese and other Asian Canadians. Stigma and discrimination occur when people associate an infectious disease, like COVID-19, with the population or nationality where the virus originally was found. This leads to a melting pot of discrimination as not only are first generation (originally born in China) are discriminated against but so are their children (second generation) who were born in Canada. Stigma hurts everyone and can lead to more fear, anxiety, anger, xenophobia and racism towards ordinary people. Remember, just because a disease originates in a certain country does not mean the people or the nation are to blame. Disease and infection are natural. Whether it’s the black death of 1347 or influenza, infectious viruses and bacteria have been around since the beginning of time. Specifically, with COVID-19, being Chinese or Asian Canadian does not increase the chance of getting or spreading COVID-19. Viruses are not specific and they can infect everyone no matter your age, race, or sex. We can fight stigma and help others through this time by providing social support and not placing blame. Even if you do have COVID-19, remember, your privacy and confidentiality are the utmost priority of health officials. Like through this article and in general at Senior Home Care by Angels, it’s important to raise awareness about COVID-19 without increasing fear. When reading headlines and news, make sure they aren’t reinforcing stereotypes and are only reporting on facts. Be sure to contact Alberta Health Services here for programs and social support related to COVID-19. 

What are the Numbers

As of writing this article, 81,109 people around the globe have been sickened by coronavirus. 78,191 cases have been confirmed in China with 2,918 confirmed around the rest of the world. The death toll has reached 2,761 with 43 deaths coming from outside of China and 2,718 deaths within China. According to the Chinese Center for Disease Control and Prevention, a fatality rate of 2% has been determined, though, this number has been highly contested. In comparison, influenza sits at a mortality rate of 0.1% with SARS and MERS at 9.6% and 35% respectively. Currently, officials are seeing rises in South Korea, Italy, Iran and the first case in Latin America has been reported in Brazil. Furthermore, dozens of Canadians were tested positive for the virus while on a cruise in Japan with the passengers of the ship now being under quarantine. A full breakdown of the numbers can be found here.

COVID-19 in Canada

As stated above, as of February 25^th, there are now 11 cases of COVID-19 confirmed in Canada. For the time being, The Public Health Agency of Canada (PHAC) has classified the public risk associated with COVID-19 as low. As new information becomes available, this may change in the future. Currently PHAC is working with WHO, CDC and other international partners to monitor the situation. Global efforts have been focused on containing the virus and reducing its transmission. Just like other countries, Canada’s National Microbiology Laboratory has begun testing of COVID-19 to further diagnose and research the virus. Though COVID-19 is at the epidemic level (a large outbreak that spreads among a population or region) and declared a public health emergency by WHO, Canada is preparing a response plan as COVID-19 is likely to become a pandemic (an epidemic that has spread on a global scale affecting large numbers of people). Canada developed a pandemic response plan in 2009, serving as the foundation for a shift from epidemic to pandemic. As indicated by Canada’s Chief Public Health Officer Theresa Tam, the response plan involves accelerated research to contribute to international efforts in developing vaccines, antivirals and access to diagnostic tools. So far, Canada has done a great job in detecting imported cases and preventing person-to-person spread.

The Canadian government has marked China as a travel level 3 with the rest of the countries infected are marked at level 2. Level 3 advises Canadians to avoid non-essential travel (issued during a large-scale outbreak in a large geographic area) whereas level 2 advises to practice special precautions (outbreak in a limited, often new, geographic location). New measures have been implemented in 10 Canadian airports to raise awareness about the virus. Those returning from Hubei would typically enter the airports in Vancouver, Toronto or Montréal, therefore, additional signage has been added to alert border security if travelers have any flu like symptoms. Furthermore, additional screening questions have been added to electronic kiosks for all international travelers.  Though Canada will not be closing its borders/banning flights from China, the Chinese government has closed all flights and transportation from Wuhan and other affected cities so the virus can be contained.

Recent News Around the World

As numbers continue to grow around the world, the biggest issue up for debate is why the WHO hasn’t considered COVID-19 a pandemic. According to WHO Director General Tedros Adhanom Ghebreyesus, the decision on declaring COVID-19 a pandemic is based on the geographical spread of the virus, the severity of the disease and its impact on society. Tedros believes that calling COVID-19 a pandemic could create unnecessary fear without proper assessment of its potential. As Tedros states in interview with the CBC "Does this virus have pandemic potential? Absolutely it has. Are we there yet? From our assessment, not yet". "For the moment, we are not witnessing the uncontained global spread of this virus, and we are not witnessing large-scale severe disease or death". On the other hand, critics of Tedros have stated that the more time is lost on classifying COVID-19 as a pandemic, the less prepared nations will be once a pandemic is declared. For example, when asked by the CBC about this issue Tam states, "These signs are concerning, and they mean that the window of opportunity for containment ... for stopping the global spread of the virus, is closing". To make things more complicated, scientists are having trouble predicting the trajectory of COVID-19 as not every country has the proper tools to diagnose and contain the virus. However, countries that have been able to prevent transmission have been successfully doing so.

For stories in the Middle East, Italy, Japan as well as other countries click here.

Future  

Currently, there is no antiviral medication or vaccine to treat/prevent COVID-19. Studies and investigations are ongoing at WHO, CDC and private medical companies to find treatment for the disease. As of writing this article, the U.S has officially started human testing of a drug to treat COVID-19. The antiviral drug Remdesivir (previously tested in humans for Ebola and in animals for MERS and SARS) is currently being tested at the University of Nebraska Medical Center for those diagnosed with COVID-19. Remdesivir is also being used in clinical trials in China to a similar affect. In terms of transmission, containment of the virus has been largely successful buying experts more time to prepare for the eventual pandemic. On the vaccine front, researchers have developed a vaccine and are starting animal treatments. Though this is promising, finding a vaccine that works on a wide scale is a long and tedious process. If animal trials go well, human trials will follow soon after later in the year. Even if these processes are quickened, mass producing the vaccine is a further hurdle. At best, we could expect a vaccine mid-way through next year but it’s not likely. Keep in mind, we currently don’t even have vaccines for the four other coronaviruses mentioned above. It would be more likely to see antiviral treatment make it to market first before a vaccine ever would.

Should I worry?

It is advised to prepare for self isolation if you are feeling unwell. Stock up on food, medical supplies and medication for extended stays at home or overseas. As reported by the Government of Canada and Canadian health officials, the risk of COVID-19 is low. However, it’s important to keep up to date on the news and exercise caution rather than fear. As health care officials are doing their best to contain and find treatment for the virus, the best thing you can do is keep up standard hygiene practices. Wash your hands, avoid unneeded air travel, and cover your mouth when sneezing or coughing. Keep in mind, containment of the virus is going well (especially in Canada) and there are safety practices in place if the situation turns pandemic. For the time being, stay healthy and go see your doctor immediately if any of the symptoms mentioned above pertain to you.

At Senior Home Care by Angels we can help you book appointments with your doctor if you are feeling unwell. Our experienced caregivers can help you set up appointments with your doctor and/or transport you to COVID-19 seminars for more information. Feel free to ask any Senior Home Care by Angels caregiver for advice on how best to contact healthcare professionals about information regarding coronaviruses.

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Resources

CDC COVID-19 Info

https://www.cdc.gov/coronavirus/2019-ncov/index.html

WHO COVID-19 Info

https://www.who.int/emergencies/diseases/novel-coronavirus-2019

CDC Travel Info

https://www.cdc.gov/coronavirus/2019-ncov/travelers/index.html

CDC COVID-19 Transmission

https://www.cdc.gov/coronavirus/2019-ncov/about/transmission.html

WHO COVID-19 Breakdown Video

https://www.youtube.com/watch?time_continue=254&v=mOV1aBVYKGA&feature=emb_logo

Government of Canada COVID-19 Updates

https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection.html#wb-auto-5

Government of Canada COVID-19 FAQ

https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/frequently-asked-questions.html

Correct Mask Usage

https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/when-and-how-to-use-masks

Guidance for Healthcare Workers and Caregivers

https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-prevent-spread.html#precautions

Alberta Health Services

https://www.albertahealthservices.ca/topics/Page16944.aspx

Sources:

WHO MERS Fact Sheet

https://www.who.int/news-room/fact-sheets/detail/middle-east-respiratory-syndrome-coronavirus-(mers-cov)

WHO Coronavirus

https://www.who.int/health-topics/coronavirus

WHO Situation Reports

https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports/

Government of Canada Travel Advice

https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/latest-travel-health-advice.html

CDC COVID-19 Stigma

https://www.cdc.gov/coronavirus/2019-ncov/about/related-stigma.html

CDC SARS Info

https://www.cdc.gov/sars/index.html

CDC MERS Info

https://www.cdc.gov/coronavirus/mers/index.html

CDC Common Coronavirus Info

https://www.cdc.gov/coronavirus/general-information.html

News Stories:

COVID-19 Misinformation

https://roguerocket.com/2020/01/30/doctor-coronavirus/

Coronavirus: Worst-hit Countries Boost Containment Efforts

https://www.bbc.com/news/world-51625123

News Around the World

https://www.cbc.ca/news/world/covid-19-what-s-happening-around-the-world-1.5476335

WHO Response

https://www.youtube.com/watch?v=6bKjQ4Q9fFU

Canada’s Pandemic Response

https://www.cbc.ca/news/politics/pandemic-response-cornavirus-canada-1.5473738

https://nationalpost.com/health/what-to-expect-if-covid-19-evolves-from-scattered-outbreaks-into-a-global-pandemic

China’s Questionable Numbers

https://www.nature.com/articles/d41586-020-00434-5