Feb 10, 2020

Coronavirus: COVID-19

Keith Varnes

What is a Coronavirus?

Coronaviruses were first identified in the 1960s and they get their name from their crown-like shape. In fact, the common cold is a coronavirus. They generally cause upper airway infections, with symptoms like runny nose, sore throat, coughing, and sometimes fever. Occasionally, such as with MERS and SARS, they migrate to the lower airways and can cause pneumonia. As you are aware, pneumonia is very dangerous.  They infect both humans and animals and with animals it mostly causes G.I. issues.

What is a Novel Coronavirus?

It just means it’s a new coronavirus and the one causing all the current panic in Asia was originally known as 2019-nCoV, but it now has an official name: COVID-19.

Prevention

  • Wash your hands often and thoroughly with soap and warm water or with an alcohol-based hand sanitizer. Alcohol-based hand sanitizer is better than hand washing for infection control, unless the hands are visibly soiled, or it is a spore forming microbe like C-Diff.
  • Keep your hands and fingers away from your eyes, nose, and mouth. This is harder to do than you realize and women touch their faces more than men.
  • Avoid close contact with people who are infected. If you find yourself taking care of an infected patient current CDC guidelines are droplet and airborne protection, eye protection, gloves, N-95 mask, and gowns.
  • Routes of transmission and when an infected person is contagious are still under investigation. However, the utilization of a 14 day quarantine appears to be effective in stopping the spread of the virus.

Treatment

Currently there is no vaccine and since it is a virus antibiotics are ineffective. There have been no guidelines released for antivirals. Therefore, the treatment is the same as for the common cold:

  • Get plenty of rest
  • OTC meds for symptoms, but don’t give aspirin to anyone younger than 19 – use ibuprofen or acetaminophen instead
  • Lots of fluids

If hospitalized:

  • Isolation
  • Supportive care
  • Oxygenation
  • Possibly mechanical ventilation
  • Some cases have required ECMO
  • Be on guard for pneumonia, ARDS, cardiac injury, and acute kidney injury

Unanswered questions

  • How contagious is it?
  • How deadly is it?
  • How long does it take to show symptoms?
  • How much have infected people traveled?
  • How effective is the current response?
  • How long until there is an effective vaccine?
  • Once a vaccine is released, how long will it take the anti-vax movement to come out against it?

The bottom line

You are far more likely to contract or get killed by the flu than COVID-19 even if you are in China! Practice good hand hygiene, cough and sneeze etiquette, and get a flu shot.

Resources

The best resources I know of are the U.S. Center for Disease Control and the World Health Organization.

Keith Varnes

Keith Varnes

Keith Varnes, RRT-NPS, RRT-ACCS, AE-C, is the company founder, President, and chief visionary of Respiratory Associates. He creates content for live and self-directed continuing education courses. He has been in the respiratory field since 1983 enjoying a diverse career including DME, software development, agency staffing, and working at a level 1 trauma center.

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