A Briefing on the Novel Coronavirus Outbreak 2020

Dr. Ken Dietrich, CMO

By Dr. Ken Dietrich, Chief Medical Officer at Summit Pacific

Background

On December 31, 2019 officials in Wuhan, China first reported a cluster of people suffering from pneumonia who worked together. The disease spread rapidly and on January 7, 2020 Chinese health authorities confirmed the infection was caused by an outbreak of a new coronavirus (2019-nCoV). 

On January 19, 2020 a patient presented to an urgent care clinic in Snohomish County, WA with 4 days of cough and fever after returning from a visit in Wuhan, China on January 15, 2020. Because of international concerns related to anyone traveling from the Wuhan, China area specimens were collected and sent to the CDC. The patient was confirmed as the first case of 2019-nCoV in the United States, reported January 20, 2020. The number of cases in China has increased rapidly and is currently showing a 2% mortality rate (similar to influenza). 

What is coronavirus?

Coronavirus is a group of viruses that typically infect animals but can be transferred to humans.  Previous new diseases such as Severe Acute Respiratory Syndrome (SARS) and Middle Eastern Respiratory Syndrome (MERS) were caused by coronaviruses. 

What is 2019-nCoV?

The coronavirus originating in Wuhan, China 2019-nCoV is a previously unknown coronavirus.

Why such concern?

The 2019-nCoV coronavirus is concerning for several reasons. Like most viruses, the 2019-nCoV virus can be transmitted from human-to-human resulting in the potential for rapid, worldwide spread. Little is known about the effects of this infection. The mortality rate is currently estimated at 2%, but this is likely to be an overestimate as there are likely more cases than currently reported such as people with minimal symptoms, people without access to healthcare, and facilities without the resources to test for the virus. Another important factor is the lack of immunized people. Influenza has a mortality rate of 1-2%.  Worldwide Influenza is thought to cause approximately 600,000 deaths per year. The total number of Influenza cases is significantly limited by the number of people who are immunized against the virus. 

For example, the number of severe Influenza cases in 2018 was estimated at up to 5 million. Thus, the vaccine significantly reduces the number of people who can become infected and therefore spread the virus, limiting impact. However, this is not the case with the 2019-nCoV coronavirus. Since no one is immunized there is a concern that the infection could rapidly reach worldwide pandemic levels. Even with a morality rate of 1-2% if a large percentage of the worldwide population became infected with 2019-nCoV a very large number of deaths would result.

How is it transmitted?

Currently the exact method of spread of 2019-NoV is unsure. Current knowledge is based on experience with other coronaviruses. Person-to-person spread has been confirmed. This most often occurs when an unaffected individual comes into close contact (6 feet) with an infected person. Respiratory drops produced when an infected person coughs or sneezes is believed to be the primary means of spread. The respiratory droplets can land on an uninfected persons mouth, nose, or directly inhaled. It is unclear if the infection can be spread by touching a surface that has the virus on it or touching or shaking hands, then touching your mouth, nose, or eyes before washing your hands.

What are the Symptoms of 2019-nCoV?

Symptoms of 2019-NoV are similar to many other respiratory viral infections and include, runny nose, cough, sore throat, fever, headache, and general ill feeling. 2019-NoV should be considered in anyone who has these symptoms and has traveled to or from Wuhan, China or if anyone has come into close contact with someone who has exhibited these symptoms and traveled to or from Wuhan, China.

What is the Treatment?

There is currently no specific treatment for the 2019-nCoV infection. Like most respiratory viral infections, treatment is supportive in nature. Most people are recovering on their own. Patients with more serious infections may require hospitalization.

Prevention

Current recommendations for protection oneself from any respiratory infection include:

  • Wash your hands often with soap and water for at least 20 seconds or use an alcohol-based hand sanitizer that contains at least 60% alcohol
  • Avoid touching your eyes, nose, or mouth with unwashed hands
  • Avoid close contact with people who have a respiratory infection
  • Cover your mouth and nose with a tissue when you cough or sneeze, then throw the tissue in the trash and wash your hands
  • Clean and disinfect objects and surfaces
  • Stay at home and away from others if you are feeling ill

Currently face masks are not recommended for the general public in the United States since there is currently no evidence that the virus is spreading and the health risk to the general public is low. A face mask is recommended for people suffering from a respiratory infection when around other people to reduce the risk of spreading the infection.

For more information and the current status of Coronavirus in the U.S. please visit:

Washington State Department of Health Website:

Centers for Disease Control and Prevention