By Mike DuBose
A fast-spreading illness called COVID-19 is sweeping across the world, bringing with it waves of fear and misinformation. Despite dire warnings from doctors in areas first affected by the virus, many American politicians and pundits originally downplayed the seriousness of the situation. Some media outlets took the opposite approach, creating a sensationalized “doomsday” image to gain attention rather than share accurate information.
With all of this “background noise,” it can be difficult to tell what is true and what is false when it comes to the coronavirus. Therefore, I have reviewed the most widely accepted scientific research available as of the third week of March 2020 in an attempt to summarize the things the average American should know about COVID-19. Let’s examine the facts.
What is COVID-19? COVID-19 (“co” for “corona,” “vi” for “virus,” and “d” for “disease) is the official name—given by the World Health Organization, or WHO, on February 11, 2020—for a disease caused by the SARS-CoV-2 virus, a type of coronavirus. The coronavirus draws its name, according to National Public Radio, “from the crownlike spikes it has on its surface—‘corona’ is Latin for ‘crown.’” WebMD.com says that coronaviruses were first identified in the 1960s and that their origin is unknown.
The specific coronavirus behind the current pandemic is called SARS-CoV-2, short for “severe acute respiratory syndrome coronavirus 2.” Although genetically similar to the virus involved in the 2003 SARS outbreak, they are not the same virus; to help avoid confusion, the WHO typically refers to “the virus causing COVID-19” rather than mentioning SARS-CoV-2 when discussing the current pandemic.
How did COVID-19 begin? The first known cases of COVID-19 were documented in December 2019 in the central Chinese city of Wuhan, which is a major transportation hub home to more than 11 million people. Scientists are still unsure of exactly how the virus originated, but most believe that contact between humans and animals—it is very similar in structure to a bat coronavirus—precipitated the spread of the virus to humans.
How many people has it sickened? As of March 22, 2020, about 334,500 cases of COVID-19 have been reported across the world. About 222,500 of those cases are active, and about 112,000 are closed. Of these closed cases, about 97,500 people recovered, but 14,500 people died. However, because of the fast-spreading nature of the virus, these numbers are likely to continue rising in the near future.
Where are infections occurring? The most severe outbreaks have been reported in China and Italy, with roughly 81,000 and 59,000 cases, respectively. Spain has seen about 28,000 cases, Germany about 25,000, and Iran about 22,000 at the time of this writing. US numbers as of March 22, 2020 are at more than 32,000 cases. The vast majority of American coronavirus cases are still active, but more than 400 people have died so far.
What are the symptoms of COVID-19? The Centers for Disease Control and Prevention (CDC) says that the primary symptoms of COVID-19 are fever, cough, and shortness of breath, appearing 2-14 days after exposure to the coronavirus. The CDC recommends contacting your doctor if you have a fever, are experiencing the respiratory symptoms, and think you have been exposed to the virus. (At this point, it is better to call your doctor over the phone versus going directly to a doctor’s office, urgent care, or emergency room unless you are experiencing trouble breathing.) If you exhibit any of what the CDC calls “emergency warning signs” for COVID-19—difficulty breathing or shortness of breath, persistent pain or pressure in the chest, confusion, and/or blue-colored lips or face—you should seek immediate medical attention.
According to a Bloomberg Businessweek article by Jason Gale, “The new coronavirus causes little more than a cough if it stays in the nose and throat, which it does for the majority of people unlucky enough to be infected. Danger starts when it reaches the lungs. One in seven patients develops difficulty breathing and other severe complications, while 6% become critical.” These patients’ respiratory and other bodily systems are likely to fail, leading to death if they do not receive emergency care. Gale notes that about 10-15% of mild-to-moderate patients worsen until they are considered severe cases, and of those, 15-20% become critical.
How does COVID-19 spread? The CDC says that the virus spreads mainly from person to person when people are within close proximity (six feet or less) from each other. If an infected person coughs or sneezes, droplets of their saliva may fly into the air and be inhaled by others close by. Although less likely, it’s also possible that individuals can become sick after touching a surface that an infected person’s droplets have landed on and then touching their own eyes, mouth, or nose.
Who is at greatest risk from COVID-19? For children, teenagers, and young adults, COVID-19 symptoms may be very mild. These patients may not even know they have it, thinking that they’re just suffering from allergies or a cold instead. However, infection with the coronavirus can make older adults and those with preexisting conditions (including heart disease, lung disease, and diabetes) very ill—or even cause death. In fact, CDC figures show that 80% of deaths from COVID-19 in America have been adults aged 65 or older! Residents in nursing homes are particularly vulnerable. Others at elevated risk include pregnant women, people with asthma, and individuals who have suppressed immune systems from conditions like HIV.
The Wall Street Journal has also projected that low-income and struggling middle-class neighborhoods will be stricken more aggressively than affluent ones. One reason: about 27 million people—often lower income individuals—don’t have medical insurance and will therefore delay seeking healthcare when they get sick. In addition, according to the US Department of Labor, more than 90% of low-income workers cannot work from home when sick. About 40% of these hourly-paid workers (32 million), who work pay-check-to-paycheck in customer-facing areas like retail, the restaurant industry, and childcare, don’t have paid time off. Many will have to choose between going to work sick (potentially spreading the coronavirus, if they have been infected) and paying their bills. That’s assuming, of course, that they have a choice at all—many restaurants and bars, for example, have closed their doors to dine-in customers due to government orders to limit the number of people gathering in one place.
Is the situation really as serious as people are making it out to be? In a word: yes. During a March 2020 forum of experts, Harvard School of Public Health epidemiologist Michael Mina called the coronavirus “the most daunting virus that we’ve contended with in half a century or more.” While some people drew parallels between the flu and the coronavirus in the early days of the outbreak in the US, Mina and other panelists noted that the virus differs in that there is no vaccine for SARS-CoV-2. Also, while people are exposed to the flu throughout their lifetimes and have opportunities to build immunity to it, this virus is new to us. Mina noted, “We have an entirely susceptible population. The potential for this to burn through a population very quickly is very high without extraordinary measures.”
Indeed, COVID-19 is spreading at an alarming rate. According to a March 20 Washington Post article by Jason Gale and John Lauerman, “While it took three months for the first 100,000 cases of confirmed infection, the next 100,000 took only 12 days, as the epicenter moved to Europe.” Expert opinions vary, but most place the United States’ outbreak one to two weeks behind Italy, where the population is essentially on lockdown in an attempt to combat the spread of the disease and doctors have reportedly been forced to choose which patients live and which die due to insufficient equipment, hospital beds, and staff. Worst-case scenario figures from the CDC say that 160 million to 210 million Americans could be infected by December, 21 million of whom would need to be hospitalized. In this worst-case-scenario model, 200,000 to 1.7 million would die by the end of the year.
What is the current situation in my area? As of press time, 195 South Carolinians have tested positive for COVID-19 and three have died. Kershaw County has seen the greatest number, with 44 cases, Richland County is second with 29, and Greenville third with 19. The Post and Courier recently warned that, based on an analysis conducted by the newspaper, hospitals could be “overwhelmed” if coronavirus cases surge in South Carolina. “A crush of new cases would put intense pressure on the availability of ventilators — machines that help vulnerable patients breathe while their lungs fend off a viral attack. It would also lead to a shortage of intensive care units and sterile masks and gowns,” the report noted. “If the number of cases spike as they have in other countries, such as Italy, hospitals in South Carolina simply won’t have enough beds to house ailing patients.”
Are there any medicines to prevent or treat coronavirus? Although there is no vaccine yet available for SARS-CoV-2, “about 35 companies and academic institutions are racing to create such a vaccine, at least four of which already have candidates they have been testing in animals,” Laura Spinney of The Guardian reported. However, Harvard Medical School reported that it typically takes several months of trials to secure data on potential new vaccines, then an additional 12-18 months before serums can be mass-produced.
Gilead Sciences’ drug “remdesivir” has recently emerged as a potential treatment for the coronavirus causing COVID-19. It was initially developed to treat the Ebola and Marburg viruses, but preclinical trials have indicated that it could treat SARS-CoV-2 as well. Rather than preventing the disease (as vaccines do), remdesivir would be used for treatment of patients who already have COVID-19. Scientists hope that it could be used to shorten the time needed for patients’ respiratory systems to recover and their fevers to drop, freeing up more hospital resources to help other patients.
It’s also important to note that, despite some misconceptions, having obtained your pneumonia and/or flu shot will not prevent you from getting the coronavirus. According to Harvard Medical School, vaccines against pneumonia only protect people against very specific bacterial infections often caused by the flu. (However, everyone, especially over the age of 50, should obtain both pneumonia and flu shots to protect against those illnesses. Also, you don’t want to come down with COVID-19 and the flu at the same time—which is possible!)
When and how will the COVID-19 pandemic end? At this point, there is no clear answer to how long it will take for the coronavirus threat to end and our lives to return to normal. A vaccine isn’t likely to come into production until at least 2021. We may develop a natural immunity to the virus over time, but this will take at least two years (and won’t be completely effective), according to a BBC article by James Gallagher. Experts say that our best chance for ending the pandemic as soon as possible is to avoid contact with others, which will keep the virus from infecting new sufferers. To this end, the CDC has urged Americans to forego gathering in large groups for at least two months, and a rising number of cities and counties are mandating that citizens stay in their homes (with the exception of trips to gather groceries and other supplies) in an effort to curb the spread of the virus.
China’s results from similar “social distancing” strategies, which it implemented beginning about two weeks into virus’s spread, are heartening. The Chinese government closed all schools, built temporary hospitals, put Wuhan (the city where the virus originated) on lockdown, and began testing and monitoring those who may have encountered the virus. This Wednesday, March 17—about 2.5 months after it became the starting point of the coronavirus outbreak—Wuhan reported just one new case for a second consecutive day, according to China’s National Health Commission. This suggests that social distancing efforts are an effective tool in slowing—and eventually stopping—the virus.
First and foremost, don’t panic. Crisis experts note that when people are fed inconsistent messages, untruths, and conspiracy theories by their leaders—which has happened during the past few weeks in America—they panic. Since the seriousness of the COVID-19 pandemic has grown, empty grocery store shelves and a badly bruised stock market have borne witness to rising hysteria throughout the US. Our lives have been disrupted, with schools swapping in-person instruction for online classes, businesses asking employees to work from home (for those fortunate enough to be able to do so), churches cancelling services, and some cities instituting mandatory curfews.
I have been through many personal and professional crises in my 70 years, but never have I seen such traumatic events unfolding! However, it’s vital at this point to stay calm. “Hope for the best; plan for the worst,” is a DuBose family motto that has served us well in this trying time. Make as many preparations as you can, while still maintaining a positive outlook! The following are some strategies to help protect you and your family from COVID-19 that you may want to incorporate:
Cancel or delay travel plans. If at all possible, do not travel until the spread of the virus has been controlled. Although airlines, hotels, and transportation companies have taken aggressive means to disinfect their environments before and after each use, anywhere that you’re within six feet of another person, you’re in danger of catching the virus (if they’re infected)! More than 30 large global companies like Twitter and Amazon have instructed employees not to travel domestically or internationally, and many large-scale events like concerts, festivals, and sports games have been cancelled. Most vendors are willing to refund (or at least reschedule) tickets and reservations that you need to change as a result of the pandemic.
Practice “social distancing.” “Social distancing is deliberately increasing the physical space between people to avoid spreading illness,” explained Lisa Maragakis, MD, MPH, Johns Hopkins University’s senior director of infection prevention. Staying at least six feet away from others will keep you out of range if an infected person is coughing or sneezing nearby. Therefore, avoid large crowds and opt to communicate over electronic devices for work, educational, or social needs rather than meeting in person. Although it can be difficult, as human beings are social creatures, don’t shake hands, hug, or kiss friends and loved ones when greeting them.
Social distancing doesn’t mean you have to literally stay inside your house at all times! As long as you stay six feet or more from others, take some brisk walks outside. The exercise will boost your mood and help you avoid isolation, which can cause or exacerbate mental health issues.
Keep your hands and possessions clean. Nurture a habit of frequently washing your hands, especially when you’ve been out in public. If you wash as directed by health professionals—vigorously, thoroughly, and for at least 20 seconds—regular soap is sufficient to kill the virus. For another layer of protection, carry bottles of sanitizer (you can mix your own with 1/3 alcohol and 2/3 aloe) and disinfect your hands regularly. While it can be difficult, try to avoid touching your face, nose, and mouth!
Even if you practice social distancing, it’s likely you’ll still have to occasionally go out in public, where you’ll be touching plenty of surfaces that others—and potentially, those with COVID-19—have touched: gas pumps, doorknobs, elevator buttons, handrails, touchscreens, grocery carts, etc. After touching these surfaces, you’re likely to touch your smartphone and inadvertently take the virus home with you! To prevent contamination of your smartphone, wipe it with alcohol several times per day or use a device like the PhoneSoap charger, which uses ultraviolet light to kill all germs on your phone within 10 minutes.
Stock up on food and other essentials—but don’t hoard them. Every family should keep enough food and other supplies on hand to last 30 days for any emergency, and this is no exception. With health organizations recommending that everyone stay home and avoid contact with groups of other people, it makes sense to stock up on supplies you know you’ll need in the coming weeks and reduce the frequency of your grocery store trips. Remember, though, that many dried goods and/or canned items have a shelf life of less than a year, so there’s no need to go overboard! Also, please don’t clear out a store of necessities so you can have a surplus when it means others will go without. If people were more considerate when shopping, we wouldn’t be seeing so many photos of empty shelves where toilet paper used to be!
Face masks have been in high demand since the pandemic took off, but they are mostly effective because they contain liquids being expelled when infected persons sneeze or cough. To actually prevent inhalation of others’ germs, you’d need a mask certified as N95 or higher (which are in very short supply). However, if you choose to wear a mask, try to avoid touching it, and clean your hands thoroughly after handling it.
Ensure you have a good supply of medications. If you take prescription medications, your main priority should be to obtain sufficient supplies to last for several months. Many generics are made in China, so it’s possible that their production could be disrupted! Ask your physician to change any monthly prescriptions to three-month scrips. Insurance companies often allow you to renew meds at 61 days, so you can build up extra stores of prescriptions you need to maintain your health.
Limit TV news-watching. Many of the messages coming from major news outlets at this time are frightening and stressful, and repeated exposure can flip the “fight or flight” response in your brain, causing significant anxiety and depression. Therefore, avoid sensationalized “entertainment news” programs in favor of unbiased, science-based information. I recommend reading cdc.gov or listening to Sirius/XM 121, which provides excellent, understandable information from epidemiologists, virus experts, and medical and emergency professionals.
Take care of yourself emotionally. Be kind to yourself and others. Look after your neighbors—for example, do any homebound or elderly people you know need help obtaining supplies? Helping them can make their lives easier, give you something to do, and increase your sense of positivity. I also highly recommend prayer. It helps me feel better to thank God for my many blessings and ask for His assistance in weathering the storm that this pandemic has brought!
The bottom line: The coronavirus outbreak is a situation unlike anything we’ve seen before. Many people are hurting, and many more will suffer, before COVID-19 is eliminated. However, if all of us pull together as one to aggressively follow the recommended precautions, we can beat this virus! Remember: it is in the darkest of nights that we see the most stars. Hang in there!
Visit Mike DuBose’s nonprofit website www.mikedubose.com for 100+ published articles on business, travel, retirement, and personal topics, and health columns written with Surb Guram, MD, as well as a free copy of his book, The Art of Building a Great Business, based on 30 years of experience with the DuBose Family of Companies and 100 bestselling business books he read. Mike is a retired staff member of the University of South Carolina’s graduate school.