Coronavirus Disease What You ShoUld Know About COVID-19 a Special Supplement to MAYO CLINIC HEALTH LETTER

Coronavirus disease What you should know about COVID-19 A special supplement to MAYO CLINIC HEALTH LETTER

A Q&A with a Mayo Clinic infectious diseases expert

A new strain of coronavirus causes a Who is most at risk of infection disease called coronavirus disease 2019 Q and of serious complications? (COVID-19). It emerged at the end of Anybody who’s had close contact 2019 in some residents of a central Chi- with an infected person is at risk nese province called Hubei. Although A since most people have no protective initial cases were concentrated in China, antibodies against a new virus. Older there are increasing numbers of cases in adults with underlying medical condi- countries throughout the world, includ- tions such as lung and heart disease, ing the United States. The virus has killed diabetes, cancer, and a suppressed several thousand people worldwide, immune system seem to have a higher although most who have died of the virus rate of complications such as pneumo- have had serious underlying illness. nia and an increased risk of death. Here, Salvador Alvarez, M.D., an Salvador Alvarez, M.D. Infectious Diseases Infectious Diseases specialist at Mayo What is the risk level in the US? Clinic in Jacksonville, Florida, answers Is it expected to rise? How can I travel safely? questions about the virus. Q The risk in the U.S. is increasing Q Why is the new coronavirus A with 647 documented cases (as The CDC recommends the follow- Q such a big concern? of March 10). However, with a large A ing if you are traveling abroad: number of people traveling from other ■ Wash your hands often with soap This is the third coronavirus to countries and evidence of human-to- and water for at least 20 seconds after emerge in the human population A human transmission and spread of the contact with sick travelers or touching in the past two decades, after the severe virus to multiple states, the possibility potentially contaminated bodily fluids acute respiratory syndrome (SARS) out- of an increase in cases seems likely. or surfaces. Use alcohol-based hand break in 2002 and the Middle East re- The medical community should be sanitizer (containing at least 60% alco- spiratory syndrome (MERS) outbreak in prepared, as should individuals around hol) if soap and water are not available. 2012. Their emergence has put global the globe. ■ Avoid crowded areas. public health institutions on high alert. Many details of this virus, such as If I have a trip planned, should Are there any treatments or its origin and its ability to spread among I cancel it? vaccines in development? humans, remain unknown. But an Q Q increasing number of cases appear to The Centers for Disease Control There are no effective treatments have resulted from human-to-human A and Prevention (CDC) has issued A for COVID-19 so far. Researchers contact between people who are in a warning for people to avoid trips are testing some available drugs to see close proximity (within about 6 feet). to China and other countries in Asia if they are effective against the virus. When an infected person coughs or affected by the virus. Business, leisure There is also a rush to create a vaccine sneezes, he or she releases respiratory and educational trips to these areas since researchers already know the droplets that can land in the mouths or should be canceled. Travel advisories virus and its DNA composition. Once noses of people nearby and possibly be may change, so check for updates fre- the vaccine is available, it will take time inhaled into the lungs. quently (see internet links on page 3). to prove its protective value.

2 A special supplement

Infection prevention — appears to be most severe in older Wash hands frequently adults and in those with significant exist- Use soap and water or, when There are many unknowns about the ing medical conditions. However, there traveling or when water is scarce, an recent outbreak of COVID-19, a disease are practical steps you can take to help alcohol-based hand sanitizer — with caused by a member of the coronavirus avoid getting — and help prevent at least 60% alcohol — to help prevent family, which can cause illnesses such spreading — community-acquired in- the spread of infection of all kinds. as the common cold. Among the un- fectious diseases of all kinds. Here are knowns, what does the future hold for some important steps to remember: Get your flu shot this outbreak? Will it fade in coming A flu shot won’t shield you from weeks and months, or continue to Stay healthy COVID-19. But in the U.S., influenza spread worldwide, including more A healthy body means a strong is far more common than COVID-19. severely to the United States? immune system that fights off infection. As of the end of February, the CDC It’s understandable to feel worried Eating a balanced diet, exercising estimated there were between 34 to about news of a spreading illness. Par- regularly and getting adequate sleep 49 million cases of influenza — and ticularly since COVID-19 — like other are all things you can do to help main- between 20,000 and 52,000 influenza infectious diseases such as flu (influenza) tain good health. deaths — in the U.S. this flu season.

Hand-washing for virus protection

The process of hand-washing should Rub one palm over the back of the Rub the tops of your fingers in the take at least 20 seconds. To start, wet other hand, then switch hands and re- palm of the other hand. Switch hands your hands and apply soap to cover peat. Next, rub your fingers together. and repeat. the hand surfaces. Rub your hands together palm to palm.

Grab your thumb in the palm of the Twist the tips of your fingers back and Rub your hands while you rinse them other hand; rub all around the thumb. forth in the palm of your hand. This under running water. Dry your hands Switch hands and repeat. helps clean under your fingernails. well, preferably with a paper towel. Switch and repeat. Use the towel to turn off the faucet and open the door as needed. A special supplement 3

Try not to touch your eyes, nose and mouth with unwashed hands Should I use a face mask? It’s unclear exactly how contagious the COVID-19 virus is or how it spreads. The Centers for Disease Control and Prevention It appears to be spreading from person (CDC) recommends face masks for: to person among those in close contact. ■ People with COVID-19 symptoms ■ It may be spread by respiratory droplets Health care workers ■ released when someone with the virus Caregivers of people with COVID-19 coughs or sneezes. The CDC does not advise face masks for: It’s not known if a person can catch ■ The general public as a means of prevention against the virus the virus by touching a surface that an infected person has touched, and then The World Health Organization notes that masks must be: putting his or her hand to the mouth. ■ Coupled with hand-washing — Hands should be washed before putting However, other viruses can spread this on a mask, after taking it off and anytime the mask is unintentionally touched way. Remember to also wash your while it’s on. hands before handling food or after ■ Used properly — A mask must be secure on the face and should be using the restroom, coughing, sneezing disposed of if it becomes damp. or blowing your nose. ■ Discarded correctly — A mask should be removed by the ear straps and placed in a closed trash container right away. Clean and disinfect surfaces you often touch Since viruses can spread by hand- Stay informed with reliable sources to-surface contact, consider periodically wiping down frequently touched Centers for Disease Control and Prevention (CDC) surfaces in your environment with a www.cdc.gov/coronavirus/2019-ncov/index.html disinfectant wipe. This is especially important if you are ill to avoid spread- World Health Organization (WHO) ing the infection to others in your www.who.int/emergencies/diseases/novel-coronavirus-2019 household. In addition, avoid sharing bedding, dishes, cups or other house- Travel tips and advisories hold items if you are sick. U.S. Department of State travel advisory map Use proper respiratory hygiene https://travelmaps.state.gov/TSGMap Cover your mouth and nose with CDC’s Coronavirus Disease 2019 Information for Travel facial tissue when you cough or sneeze. www.cdc.gov/coronavirus/2019-ncov/travelers/index.html Throw away used tissues immediately. If no tissue is available, cough or sneeze into your upper sleeve. Follow travel advisories difficulty breathing — contact your Travel advisories to various countries doctor. Be sure to mention any recent Stay informed can change rapidly depending on how travel or contact with someone who has Look to reliable news sources for any disease outbreak evolves, including traveled recently. Your doctor can help up-to-date information and recommen- COVID-19. See the box above for reli- determine if you may have COVID-19, dations from health experts, whether it’s able website options. seasonal influenza or another infection. a reminder to get a seasonal influenza He or she can help you access appro- vaccine, or information on a disease Take steps if you become ill priate care. Otherwise, steps for self- outbreak. Don’t let conspiracy theories If you have signs and symptoms of care include rest, drinking plenty of and medical misinformation distract you a potentially serious viral infection — fluids, using nonprescription pain from the facts on staying healthy. Visit such as abrupt onset of fever, aches and medications to control fever and the CDC and WHO websites listed on chills, fatigue, headache, and respira- restricting social contact to avoid this page for trustworthy information. tory symptoms such as coughing and spreading the infection to others. ❒