Wednesday, March 4, 2020

Coronavirus and COVID-19


Introduction
     Coronaviruses are a group of viruses that cause illnesses in humans, mammals, and birds. In humans, the viruses typically cause respiratory illnesses. In 2019, a new (“novel”) coronavirus infection was first found in China. It has been named COVID-19. Since that time, the infection is spreading to other countries. As of 2/4/2020, the countries with the most widespread numbers of coronavirus infections are China, Japan, South Korea, Iran, and Italy. However, many other countries have had some cases and this list is likely to expand as the infection spreads. Because this is a new viral strain, people are not immune to it from a prior infection.

How The Illness Presents
     COVID-19 presents with symptoms similar with influenza: fever, cough, and fatigue. Sore throats and shortness of breath have been less common at the start of the illness. As with influenza, most of the cases of breathing difficulty (respiratory distress) are occurring later in the course of the illness – the average is 8 days after the onset of the illness. It is the respiratory distress that has caused the deaths associated with the COVID-19. A patient with COVID-19 infection with respiratory distress will be breathing hard and fast, as well as coughing very frequently.
     Most of the severe infections have been in adults, especially older adults. The more severe infections are also in those with underlying medical conditions, such as asthma, heart conditions, and diabetes. As with other respiratory illnesses, there will be some persons with COVID-19 infection where the illness is very mild.

Testing For COVID-19
     There are tests for this virus. The testing is NOT available at this point in doctor’s offices and urgent cares. The testing is more available through large hospitals, emergency departments, and health departments. At this time, we do not have this testing available to us.
     Who should be tested? If someone with worrisome symptoms with a known exposure to someone with the virus OR recent travel to a country where the illness is more wide-spread (China, Iran, Japan, South Korea, Italy). Realize, if a child had a possible exposure or concerning travel history AND had a cough, fever, and respiratory distress, they likely have another virus – often influenza with pneumonia.

What To Do
     If your child has traveled to a country where the virus is more common OR they have had an exposure to someone known to have the infection AND has a fever and cough, especially if they have breathing problems, they should be seen at the pediatric emergency room. You should CALL AHEAD to alert the emergency room before you arrive to discuss how to avoid exposing others to the infection.
     As with avoiding all common respiratory viruses, frequent hand washing, avoiding places where ill people may be (large gatherings), and covering your nose with sneezing and covering your cough. Wearing a mask Is appropriate IF you have symptoms, but it is not currently recommended if you are trying to avoid getting the virus.
     This information will very likely change quickly. The www.cdc.gov website is an excellent source of up to date information.