March 10, 2020
By Dr. Keri Althoff
"The scientific conference I am "virtually" attending today had a GREAT session on COVid19. I thought I would share some insights presented.
1 - We can't point to a symptom that distinguishes COVid19 from influenza. Fever, cough, fatigue and achy muscles are the common symptoms of COVid19 AND influenza. But COVid19 is more deadly than influenza. Estimates are still rough, but suggest COVid19 is 5 to 35 times more deadly that influenza.
2 - COVid19 is spread through droplets. Only one report has found the virus in stool and there is no evidence that there is transmission of the virus from stool. Additionally, there is no evidence that infected pregnant women are passing the virus to their babies. How the virus is spread will continue to be researched.
EDIT to clarify: There is NO evidence that women are passing infection to fetuses in utero (with limited data from infections occurring at or after 36 weeks).
3 - Viral shedding (when your body produces the virus that can infect others through droplet transmission) is greatest when symptoms are present, but it does start before symptoms appear. Great research conducted by my JHSPH colleague, Justin Lessler, and his team supports the estimates of about 5 days between infection and feeling sick, but it could be up to 12 days (this is why quarantine is 14 days).
4 - Right now, the burden of COVid19 among kids may be lower because we are not looking for it. Kiddos get lots of fevers and coughs, and it may be that we are not necessarily thinking to test kids for COVid19. From a personal perspective, when my son (who has asthma and had a respiratory virus when he was 2yo that landed him in the pediatric ICU for a few days) develops illness that looks to me like influenza, I take him to his pediatrician's office for testing and (if positive) Tamiflu because I worry that he is at higher risk for complications. Influenza is still circulating widely in many communities in the US. If you have a child that gets sick, and you think they are higher risk for complications, contact your pediatrician for guidance. To balance the anxiety I feel about keeping my kids safe, I remind myself that kiddos are NOT considered a high risk group for death and other negative health outcomes from COVid19.
5 - Wash, wash, wash your hands! It works better than hand sanitizer (and they are not price gouging on bottles of soap!). Use hand sanitizer if soap and water are not available, but don't forget to wash multiple times a day!
6 - Social distancing and other "non-pharmaceutical interventions" (see #5) are used when transmission of the virus outpaces our containment efforts. With social distancing, we are trying to keep as many people safe as possible, especially our most vulnerable. We are also trying to keep the demand on the healthcare system manageable.
7 - There are currently existing medications that are being studied to see if these medications can safely and effectively treat COVid19. Vaccine clinical trials are anticipated to start in the next 2 months to prevent COVid19. No one is letting the grass grow under their feet for vaccine or treatment development!
The scientists that presented this information today are listed below. They represent teams of scientists and public servants who are dedicated to keeping our communities safe. They are very busy right now, and I appreciate their help in keeping us all informed.
Dr. Zunyou Wu, Chinese Center for Disease Control and Prevention: He has been deeply involved in the response to COVid19 in China
Dr. John T. Brooks: A seasoned outbreak epidemiologist having played a role in the response to SARS, Ebola, and the HIV outbreak in Indiana. He is a fantastic colleague, who I know and wholeheartedly trust.
Dr. Ralph Baric: An expert in coronaviruses
Dr. Anthony Fauci: The Director of the National Institute of Allergy and Infectious Disease (you have probably heard him on the radio or seen him on TV lately): He is a special talent for telling us exactly what is going on without creating alarm. I think Dr. Fauci's talent comes from lots of practice...he has been in a leadership role for many infectious disease outbreaks over the last 2-3 decades."
