Norton Healthcare’s Erica Coghill discussed the new coronavirus with two Norton Healthcare physicians, including our system epidemiologist.
Here’s a COVID-19 Q&A with James M. Frazier, M.D., vice president, medical affairs and quality, Norton Healthcare; and Paul S. Schulz, M.D., infectious diseases physician with Norton Infectious Disease Specialists and system epidemiologist for Norton Healthcare.
What’s the difference between coronavirus and COVID-19?
Dr. Frazier: Coronavirus is actually a family of viruses. There are several coronaviruses, and they’ve been around for a long period of time. They’ve been known to cause common colds for a long time. COVID-19 is actually a disease caused by the SARS-CoV-2. This is a novel coronavirus. It’s only been around for about three months, and we’re still learning quite a bit about it; but it’s part of a bigger class of viruses.
What are the symptoms of COVID-19?
Dr. Frazier: Most of the time what we’re seeing are more upper respiratory symptoms. A lot of times fever, but not always. Cough, shortness of breath, sore throat, maybe a scratch in your throat. Gastrointestinal symptoms are less frequent, but we’ve seen that as well.
How is COVID-19 transmitted and how long does the virus live in the air or on surfaces?
Dr. Frazier: There are two main ways that we believe it is transmitted. One is by droplet or airborne spread, and the other is by contact. We think right now that the coronavirus lives in the air for several hours and on surfaces for up to six or seven days, which is one of the reasons why we feel like it’s so contagious.
If someone with the virus sneezes, we think you could walk into the room even after they’re gone and potentially still be infected, particularly if you make contact with an infected surface.
Why the ‘6 feet rule’?
Dr. Schulz: The idea of the “6 feet rule” is that it’s going to help prevent contact with a droplet, and if there is any aerosolization of the organism, you should be far enough away that you’re not infected. But some of this with this new virus remains uncertain.
What can I do to avoid getting it?
Dr. Schulz: Frequent hand washing, cough etiquette, and staying away from crowds. For sure, stay away from people who you know are ill.
If you are ill, stay away from other people.
All those things apply to this and aren’t really that different. We don’t have a vaccine, unfortunately, but that’s a possibility maybe later on this year. But for now, it’s the basics of preventing transmission of a virus.
Dr. Frazier: You can avoid getting COVID-19 by the typical measures that you would avoid any other virus. Hand hygiene is extremely important. Obsessively washing your hands and using hand gel, wiping down surfaces in your office as well as your home, practicing social distancing, maintaining a 6-foot radius from other folks whenever you possibly can. Avoid large gatherings; try to maintain your space inside your own house as much as you possibly can. Again, not sharing drinks with other family members and washing your hands. I can’t stress that enough.
Should I wear a mask to avoid getting sick?
Dr. Schulz: It’s not generally recommended for a person out in the community to wear a mask and considered for the most part unnecessary, particularly if you’re already practicing social distancing and the things that we talked about.
Another issue that’s happening right now — and it’s real — is if you are using masks and other personal protective equipment, the health care workers really need that. Supplies are short and getting shorter, and we hope that people wouldn’t be using those things in situations where there’s essentially no risk. Then, a person who really needs it doesn’t have it to help take care of somebody.
Dr. Frazier: I don’t think they would be helpful for the general public. Certainly, if you’re immunocompromised, or in our facilities if a patient is being seen in one of our outpatient care centers or in the hospital, we very well likely may put a mask on the patient, but for someone in the general public, I doubt it really helps very much at all.
If I think I’m sick, what should I do?
Dr. Schulz: Well, if you think you’re sick, first and foremost, I wouldn’t do anything differently than I would have done before the coronavirus was an issue. There’s not a necessity to get tested, and there’s not a necessity to get evaluated.
Obviously, if you are sick with the coronavirus and you go to a facility to get tested or evaluated, you could infect somebody else. I think the main message is that if you would not have sought care prior to the coronavirus being in our community, you probably don’t need to seek care now.
Please take our online questionnaire if you’re concerned about your symptoms. If you need to get care, try a remote visit using Norton eCare. If that doesn’t work for you or you have trouble getting through, make an appointment at a Norton Immediate Care Center.
What happens to a patient who suspects COVID-19 and goes to a Norton Healthcare facility?
Dr. Frazier: If you’re having symptoms, first of all, call ahead before you seek care so we can be prepared. We will immediately place a mask on you and place you in a private room. Then our providers will come in with their personal protective equipment, maintain as much as possible a 6-foot distance while they’re asking you questions and then proceed to examine you to determine if you require further testing or perhaps you can be sent home and self-quarantined until your symptoms are resolved.
What is PPE?
Dr. Frazier: When we say personal protective equipment, what we’re really talking about are gowns, gloves, masks etc …. A lot of people have been referring to the N95 mask: This is what we use for typical airborne diseases such as tuberculosis. We use those specifically in the facilities for aerosolizing procedures and any time we may cause a virus to be emitted into the air around the patient.
Why does it take so long to get back test results?
Dr. Frazier: The number of tests that are being done now and sent out to the national labs are just simply taking a long time to process, to come back. I expect that’s going to improve once more laboratories are able to test at a more local level. As for now, just be patient as we’re working through this. We were initially told three to five days; we’re finding out now that it’s five to seven days and sometimes even longer to receive the lab results back.
Is COVID-19 deadlier than the flu?
Dr. Schulz: I think that’s a better question answered retrospectively, but I understand the concern. For sure, it seems that there is a higher rate of mortality and bad outcomes in people that are older; the Centers for Disease Control and Prevention (CDC) gives guidance around people over the age of 60 based on data from other countries, and also people who have chronic illness.
But I think overall that the real challenge is a test that maybe is not that good, that gives significant false negative rates. There is also limited testing in the United States, and probably a lot of people out there that had either asymptomatic or very mild illness, never sought care — and then we wouldn’t really know if they had the infection. Then that really skews the data.
If you’re looking at, for instance, hospitalized people or people who have a positive test, you start skewing the data towards a higher mortality.
Is there any piece of hope that you can give people?
Dr. Schulz: The vast majority of people in the community are not going to be harmed in terms of their health. The hope is, is that this is going to be a short, limited situation, and we’re going to come out the other side and go back to, for the most part, business as usual.
Dr. Frazier: Our own data is showing that about 90% of hospitalized patients are going home with very minimal symptoms — they’re doing great. That’s consistent with what we’ve seen in other countries and what’s reported out there as well.