Unless you just got back from a trip to Mars, you probably
know that there’s an epidemic going on in China. It appears to be viral in
nature; viruses are tiny, much smaller than bacteria, and barely meet the definition
of a living organism as it must enter the cells of a host to activate and reproduce.
Once it’s hijacked the cell’s machinery, however, it
produces a lot of little viruses that enter the bloodstream, often killing the
host cell in the process. The physical symptoms caused depend on the type of
virus and the cells that are infected.
First reported December 8th in Wuhan, a city of 11 million
people in Hubei province, the new virus appears to belong to the coronavirus
family. Coronaviridae is a family of viruses with little projections that might
remind you of a crown or the corona of the sun. The genetic material is not
DNA, but RNA or ribonucleic acid.
RNA viruses generally have very high mutation rates compared
to DNA viruses, which leaves the possibility of genetic mistakes more frequent.
When I say “mistakes”, I mean an imperfect copy of the RNA genetic material as
it reproduces. In most cases, not much happens. In some cases, it may hinder
the virus but just as or more often, mutations improve the ability of the virus
to succeed in some way, such as letting it multiply faster or making it harder
to kill. Each person who becomes a host has the potential to become patient
zero for a new, improved virus.
(Note: My first full article on this new coronavirus occurred when there were only 200 cases and 9 deaths, after mentioning it on January 7th at 60 cases, 0 deaths in an article on pneumonia. There are some who believe the number of cases and, perhaps, deaths, are much higher than reported)
Two per cent doesn’t seem like much, but the death rate from the Spanish Flu 100 years ago was also a little more than two per cent. That virus went on to infect a third of the world’s population and cause 50-100 million deaths.
You may have heard that 2019-nCoV was first found in some of
the live markets common in China. Some mutation may have appeared which allowed
a bat, a common living source of coronavirus, to infect other animals and then
humans. That’s a big step, but it doesn’t mean that same mutation will make it
easy to pass from human to human. What is known, however, is that it can
That depends on the R Naught number. The what? The R Naught. R with a zero down where a comma would be. “R0” tells you the average number of people in a previously infection-free area who will catch a disease from one contagious victim. If the number is 1 or less, the virus will likely peter out, but the Spanish flu infected 2-3 people from each contagious victim. So did Ebola, and measles was a lot more contagious, with numbers between 6-18. This virus in China’s R0 numbers are about estimated by Chinese authorities to be 1.5 or so, but perhaps higher.
In most cases, people exhibit mild symptoms 1-14 days after
exposure, similar to a cold or mild flu, and get better after a week or so. About
1 in 5, however, get very sick, including pneumonia, breathing difficulty, and
respiratory failure. There appears to be evidence that people can be contagious
before they experience symptoms, not unusual for a viral infection.
Should you panic? The answer is no. Right now the coronavirus epidemic is 99% in China, and no community-wide outbreaks have occurred outside its borders. That’s good news, at least for now, because no traveler from China to the U.S. has proven to be patient zero in an outbreak here. In the U.S.
When a community has a crisis, nearby municipalities rush to
help. That goes for wildfires as well as epidemics. The situation which would
concern me the most is if many communities are hit and have to direct their
resources to their own people and not be able to help others. We’re a long way
from that right now.
That doesn’t mean that you shouldn’t have a plan of action. There’s no testing labs for the new coronavirus outside of the CDC at present, so your local family doctor probably will send you to the hospital. That’s a problem if the hospitals are already crowded. If outbreaks occur here in the US, you may have to work to keep your family safe without much help.
It’s yet unclear how bad this outbreak will get outside of
China’s borders, but some simple preventive measures will be worth much more
than a pound of cure (for which there is none, at present).
This includes some changes in your lifestyle in a
community-wide epidemic, including:
• Social distancing. This means staying away from large crowds,
• Not going
to work if you’re sick or a lot of people there are sick,
kids home from school
• Isolating sick persons in your family from healthy ones.
Avoiding close contact with possibly sick individuals is very important, especially if you don’t have personal protection gear. Close contact is defined as being within 6 feet (2 meters) or in a closed room with a coronavirus victim without any personal protection gear. An unprotected person having direct contact with infectious secretions of a 2019-nCoV patient (for example, being coughed on) also qualifies.
The best policy is to wash hands frequently and carry hand
sanitizer when touching surfaces. Close attention should be focused on avoiding
touching eyes, nose, and mouth.
Masks and protective eyewear help you to avoid infection but
chances are you’ll touch a lot of areas at work, school, or home that have been
touched by a bunch of other people. This virus appears to be able to live on
surfaces for longer than the average microbe, so work surfaces must be
disinfected often. Work surfaces, by the
way, includes computers used by more than one person. Other surfaces that could
get contaminated could be your shirt, pants, shoes, and more.
For masks, look for a supply of N95 masks, these are better
than standard surgical masks but are NOT 100% protective. During outbreaks in
your community always wear n95 masks or better if you must be outside of your
home. This isn’t just an option, it’s a sign of social responsibility.
It’s not just important to have proper masks, but more
importantly to know
How to put them on
How to achieve a proper fit
Take them off safely
Articles on the proper procedure can be found at
doomandbloom.net and in our latest book “Alton’s Antibiotics and Infectious
Disease. Although the book is about antibiotics and bacterial (not viral)
disease, you’ll find the donning and doffing process in a section in the back
of the book. You’ll also find my thoughts on putting together an effective
epidemic sick room in the book, but also at doomandbloom.net and our YouTube
Joe Alton MD
Have you put together a plan of action for disasters, both natural and man-made. Learn more about medical preparedness and get quality medical and pandemic kits, as well as individual items, at store.doomandbloom.net.