Heavy is the Head that Wears the Corona(Virus)

On December 31, 2019, the World Health Organization (WHO) received its first notification of a several cases of pneumonia of "unknown origin" stemming from Wuhan, China. On January 7, 2020, Chinese officials were able to isolate the cause of these, and now many more, cases of pneumonia. And from that moment on, the novel coronavirus 2019 became the focal point of health organizations, media outlets, and public discussion dominating headlines up to and including the day this article was written.

The official name of this virus is COVID-19, and the disease which this virus causes is called SARS-CoV-2. For us Canadians over the age of 20, we still cringe at the word SARS, which stands for Severe Acute Respiratory Syndrome, an outbreak of which had a particularly hard impact in Toronto in 2003. Indeed, the virus that caused the 2003 SARS (full name SARS-CoV) outbreak was also a coronavirus, but coronaviruses are numerous and are implicated in lots of respiratory illnesses, including the common cold. So, considering there are lots of them, and we even give them a cute crown name (corona) because of their shape, how did we not know about this one? Where did it come from?

Photo cred: cnn.com

Coronaviruses are common in a few certain animals, and sometimes these viruses learn and adapt and figure out how to jump into humans. This jump, called a "spillover", is most commonly the effect of either a mutation by the virus, or an increased amount of time spent with the animals carrying the virus. The Middle Eastern pandemic virus from 2013, MERS-CoV, originated from camels. The 2003 SARS-CoV virus came from civet cats (a small, mostly nocturnal mammal native to tropical Asia and Africa, with a cat-like appearance). So, our new virus, COVID-19, which animal reservoir is its keeper? Currently, we still don't know.

How is this virus transmitted? Well, the WHO and other health officials are still not 100% sure, BUT the current best evidence is that it is spread via droplets. Droplet transmission goes like this: someone you are near coughs or sneezes, the virus exits their body in the "droplets" that just shot out of their face, and if you are within 6 feet of that person and you breath in one of those droplets, boom. You have the virus. Also, if that same person coughs or sneezes their droplets onto a surface, or into their hand and then the TOUCH a surface, that bug can live on that surface for up to 48 hours. So, if those touch surfaces aren't getting cleaned properly, and you touch the bug (who obviously jumps right on your hand), and you innocently touch your nose/mouth/eye, the boom. You now also have the virus. This is assuming the virus remains as a droplet transmission virus... if we learn it can also be spread by airborne transmission, well, that will be a whole other article.

Photo cred: nypost.com

I don't think we need to worry too much about that happening though, and here's why. There have been cases of COVID-19 pop up in a large number of countries, some truly on the opposite side of the planet from Wuhan China, including Canada and the US. How? People who had been exposed to the virus in Wuhan got on a plane and travelled to those other countries. Planes recycle 50% of the breathed air, meaning if the guy up front coughs out a virus that is spread by airborne transmission like, oh I don't know, the measles (looking at you, anti-vaxxers), then the entire plane has a real world 50% chance of breathing in that same virus. Or, put another way, half of the plane is now at risk of developing the measles. Thanks a lot, Karen. But, we haven't seen this with the COVID-19. Truly, 7 of the 8 people in Canada to date who contracted COVID-19 were in Wuhan, China, or live with people who were. There is only one case which isn't super clear how it was transmitted. If the virus were airborne, we would have a huge number of people in at least Toronto and Vancouver with the virus as a result of being on the same plane as those folks.

Now, the real question: what next? Well, if you're a germ nerd like me, I highly recommend reading the daily situation reports released by WHO. In it, we are able to see daily numbers of new cases, deaths, countries with reported cases, all that fun stuff. But also, they include little gems like how to isolate yourself in order to protect others and prevent the spread if you suspect you have the virus, and international travel recommendations. This is a brand new bug, so information is released as officials learn more, meaning recommendations may change with new information.

But really, think of it this way. This is a brand new virus (really only 2 months old), that we know is pretty contagious and can cause a pretty serious infection that could cost you your life. We still do not have a vaccine, and we still do not have virus-specific treatment. The only treatment at present is what is called "supportive treatments". Know what that means? Intravenous fluids, antibiotics (that probably won't do anything), oxygen via a mask or in severe cases a ventilator, medications to keep your blood pressure up (that can also diminish blood flow to your hands and feet, leading to amputations), and admission to hospital. Is that risk worth taking that cruise?

By all means, if you have to travel for school/work/health care or another important reason, go for it. But make sure you have the TSA approved size hand sanitizer (alcohol based) in your pocket for use at all times. Don't bother with surgical masks, with a virus this small you're not doing anything but scaring everyone else. If you are someone who is in one of the higher risk groups however, I would suggest having a fit test completed for an N95 respirator mask. And I must stress, you can use masks wrong, so seriously, ask a professional. Wash your hands (like, a lot), eat healthy, get lots of sleep, all that general illness prevention stuff.

Now, I already called out Karen for not vaccinating her children for measles, so you KNOW I'm also going to take this opportunity to point out the obvious. If they discover a vaccine for this virus, get it. The mortality rate for COVID-19 is 2.5 percent, meaning 2-3 people for every 100 people who catch it will die. In Canada, we have an average of 30,000 lab confirmed cases of seasonal influenza each year, and approximately 3500 deaths annually. That's a mortality rate of nearly 12%. For perspective, the mortality rate of SARS 2003 was 10%.

So, let's take all precautions necessary against this new, no-treatment-available virus. Make sure hospitals, airports, and all major points of entry have appropriate screening and isolating tools at their disposal to keep the virus out. However, let's also take the time to acknowledge we have many deaths every single year from an assailant we DO have preventative measures against. Everybody who can, get the flu shot. Every year.

For more information on seasonal influenza, flu shots, COVID-19, or any other health issue you would like to learn more about, feel free to reach out to Nurse June at Catalyst Health Solutions on Facebook, LinkedIn, Twitter or Instagram. More importantly, if you want to challenge and discuss any of the points I'm making, let's do that too!

Wishing you all health and happiness,

Nurse June

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