Coronavirus: What you need to know

No St. Louis cases yet, but Page, health officials preparing for possibility

St.+Louis+County+Executive+Sam+Page+updates+the+public+about+COVID-19+%28coronavirus%29+preparedness+on+Friday%2C+Feb.+28%2C+2020.+At+right+is+Spring+Schmidt%2C+co-director+of+the+Saint+Louis+County+Department+of+Public+Health.

St. Louis County Executive Sam Page updates the public about COVID-19 (coronavirus) preparedness on Friday, Feb. 28, 2020. At right is Spring Schmidt, co-director of the Saint Louis County Department of Public Health.

Despite a warning from the Centers for Disease Control last week that it is not if, but when, coronavirus will become a widespread epidemic in the United States, St. Louis County officials say that they are prepared and the spread of the disease in this area is still far off.

The respiratory illness coronavirus, also known as COVID-19, was first identified in people in December. It appears to have originated in a live animal market in Wuhan, China, but now it has spread worldwide, becoming an epidemic in Japan, Italy and elsewhere, reaching 50 countries at The Call’s press time. While 90 percent of the fatalities have happened in China, the virus is now spreading faster outside China than inside it.

The coronavirus has not yet been declared a pandemic, as were the previous new flus that also came out of China, H1N1 or swine flu in 2009 and SARS in 2003.

Worldwide, officials ramped up response to the disease to prevent its spread, with Japan keeping all schoolchildren home for the entire month of March and Saudi Arabia canceling all pilgrimages to mosques. Some officials have speculated that the Summer Olympics, set to start in Tokyo this summer, will have to be canceled. The uncertainty caused stock markets to fall to their lowest numbers since the 2008 recession.

The CDC warning last week said that that spread of the illness inside the United States is now inevitable, and businesses and schools need to plan ahead for workers to work from home through “telework” and students to finish their lessons online.

So far, the closest confirmed case to St. Louis is in Chicago. BJC officials in Belleville, Illinois said last week they were testing a patient for possible coronavirus, but the person did not have the virus.

Coronavirus hit a milestone in the United States last week with both the first death, in King County, Washington, and the first cases of community spread, or a person coming down with the virus who had no known contact with someone who had been exposed. That case was seen in the same California county as Travis Air Force Base, where a group of evacuees from the Japanese cruise ship Diamond Princess who had coronavirus were brought by the federal government.

To add to the complexity of identifying and treating a new virus, Hong Kong officials said a dog tested positive for coronavirus last week, although they were going to retest to see if the virus was just in the dog’s nose from being next to the dog’s coronavirus-suffering owner.

But while the virus is something to know about and be prepared for, County Executive Sam Page wanted to emphasize in a press conference Friday that drastic measures like staying home from work and school are still far off and may not happen.

“At the moment the risk is very low, and there is no need to panic,” Page said.

Still, the county will be ready to “prepare, educate and respond,” he said.

Prevention

St. Louis County is primarily relying on recommendations and guidelines from the CDC both now and in the case of the sickness spreading in the metro area.

Page said he knows U.S. Surgeon General Jerome Adams, and trusts him to provide a “professional and appropriate” response to the coronavirus. President Donald Trump called the virus a “hoax” orchestrated by Democrats in a campaign rally in South Carolina Feb. 27.

As a medical doctor, Page said he is familiar with the prevention of viruses like the coronavirus, and everyone else should be too, since they are essentially the same as the tips given every year to combat the spread of the flu.

The county Department of Public Health is continually updating its website and set up a coronavirus hotline at 314-615-2660, or 314-842-0062 for languages other than English.

“As a medical doctor I’ve certainly had the chance to take care of patients who are in similar situations,” Page said, also noting that the county health department has been tackling another epidemic in the opioid crisis. “This is certainly a shift, but we understand this space. This is a serious challenge for public health officials, any time there is a new disease we have to adapt, but the fundamentals are the same and we are engaged.”

The advice from top experts in the world on how to prevent getting the coronavirus are simple, and the same as the flu.

In a February county executive’s report, Page had noted that you cannot get the coronavirus from eating Chinese food in a restaurant, and urged residents to support local Chinese restaurants, where business has fallen.

“There isn’t a pill, there isn’t a bullet — prevention is the way you fight this epidemic,” Page said. “There are very simple steps, and they should all be familiar to everyone because the way you fight the coronavirus is exactly the same as prevention for the influenza that we fight every year that kills tens of thousands of people in our country.”

To prevent transmission of the virus, people are urged to wash their hands, rubbing all surfaces with soap and water for at least 20 seconds — or a full time around with the song “Happy Birthday”; or use alcohol-based sanitizer with at least 60 percent alcohol; don’t touch your mouth, nose or face with unwashed hands, or after touching shared surfaces like doorknobs; keep those shared surfaces clean; and stay away from others if you’re sick.

Face masks are not completely effective at preventing the coronavirus, despite images from across the world of people waiting in line hours to buy one. And despite warnings from health officials that washing hands is much better at prevention, masks are sold out at some stores and are being limited at others, sparking concerns that there won’t be enough to go around for actual surgeries and medical treatment.

Adams tweeted over the weekend, “Seriously people- STOP BUYING MASKS! They are NOT effective in preventing general public from catching #Coronavirus, but if healthcare providers can’t get them to care for sick patients, it puts them and our communities at risk!”

If someone is already sick, it could make sense for that person to wear a mask to prevent infecting others, but they are still often improperly reused, taken off to eat or talk and improperly worn, doctors say. A mask has to be worn over both the nose and mouth, and a person who constantly adjusts the outside of the mask will cross-contaminate fingers and shared surfaces. A face mask should never be worn more than a day. And many people improperly dispose of them, possibly spreading the virus. Counterfeit masks are abundant online.

If someone really wants to protect themselves from getting the virus, only masks with an N95 respirator could really do the trick. But they are also not effective in the general public because people have to be trained on how to wear them properly. A person who wears an N95 mask for a length of time can have difficulty breathing due to the pressure change from inside the mask to the outside atmosphere. That encourages people to take them off frequently, which defeats the purpose of wearing one. Older users might have a particularly hard time wearing one.

Most importantly, the World Health Organization says that wearing a face mask could provide a false sense of security against the virus that would lead to someone not taking basic precautions. The best way to prevent the coronavirus is washing your hands, all doctors are emphasizing.

Symptoms are not exactly the same as flu

Although they are both respiratory illnesses and are prevented the same way, the symptoms of the coronavirus and influenza are not exactly the same.

With the seasonal flu, symptoms include muscle aches, fever, cough, sore throat, headaches, runny or stuffy nose, fatigue and potentially vomiting or diarrhea, with complications including pneumonia, according to the CDC.

As a new sickness, doctors are still trying to get a handle on all the symptoms of coronavirus. But a study of about 100 people with the virus published Jan. 30 in the journal The Lancet found that the most frequently cited symptoms were fever, cough and shortness of breath. Unlike the common flu, only about 5 percent of patients reported a runny nose or sore throat, and only 1-2 percent reported diarrhea, nausea or vomiting.

So far, the coronavirus has a higher mortality rate than the flu. In the United States so far this year, about 0.05 percent of people with the flu have died. That’s lower than the more typical rate of around 0.1 percent. But a study published Feb. 18 in China found a 2.3 percent mortality rate for the coronavirus.

The death rate changes depending on a person’s age and complicating factors. For people older than 80, the death rate in China was 14.8 percent, and 8 percent for those between 70 and 79. Other rates were 3.6 percent for ages 60 t0 69, 1.3 percent for 50 to 59 and 0.4 percent for 40 to 49. People 39 or younger have just a 0.2-percent death rate. So far, no one under the age of 9 has died.

Treatment

If someone believes they have either been exposed to the coronavirus or are showing symptoms, Page urged them to call their urgent-care center or doctor’s office ahead of time instead of just showing up to an emergency room and potentially exposing everyone there, “unless you’re really sick and can’t take care of yourself.”

The first thing that will be done if you have been exposed is to keep you from others and then treat symptoms, just like the flu.

A possible vaccine is at least a year away from being on the market.

You can reach Gloria at @glorialloyd@callnewspapers.com or at 314-843-0102.