’I feel sick and think I might have COVID-19. What should I do?'
Do you self-quarantine? Who would you alert?
The new coronavirus continues to make headlines as President Donald Trump recently signed an $8.3 billion measure to help public health agencies deal with the crisis and spur development of vaccines and treatments.
Worldwide, the virus has infected more than 100,000 people and killed more than 3,400, the vast majority of them in China, according to The Associated Press.
Most cases have been mild, and more than half of those infected have recovered.
Most of the dead in the U.S. were from suburban Seattle’s Life Care Center nursing home, now the subject of federal and state investigations that could lead to sanctions against it, including a possible takeover of its management. Washington state has the nation’s biggest concentration of cases, with at least 70.
So, what would you do if you feared you had this new coronavirus? We thought we’d ask.
Dr. Frank McGeorge, a health reporter and emergency room doctor, weighed in.
First things first. Why would you suspect it’s COVID-19?
“If you’ve traveled to an area where there’s considerable spread of the virus and now you’re feeling ill, it wouldn’t be an unreasonable concern,” McGeorge said.
You’d then want to consider contacting your physician or your local public health authorities.
At this point, the three main symptoms to watch for are fever, cough and shortness of breath.
The thinking is different if you’re in a state or an area where there haven’t been many, or any, cases -- or if you haven’t traveled recently. Don’t jump to assume that your illness would be COVID-19.
If you were to feel sick in the next few weeks, while the flu is still widespread, then it’s more possible that you simply have the flu. Doctors can test for that.
Speaking of testing …
If you were to test positive for COVID-19, doctors at this time don’t have any direct treatment for you.
It is more important for officials to know that you’ve tested positive for public health reasons, rather than a direct treatment value -- unless you become severely ill.
“In that case, we would have a very low threshold to provide more aggressive care as needed,” McGeorge said.
Doctors really want to avoid and limit the number of people coming in to medical offices and emergency departments unnecessarily, and possibly exposing otherwise-healthy individuals.
Let’s say you DO have COVID-19. If you’re young and otherwise healthy, you should self-quarantine. Avoid contact with people who are unaffected. This will limit the spread or possible spread, and you can monitor your symptoms and allow your body to take the time that it needs to recover.
“With coronavirus, there’s no direct treatment, whereas for influenza, I can treat you with a specific anti-viral medication like Tamiflu,” McGeorge said. “And we know that can have an impact.”
Why it’s important
If you’re otherwise healthy, doctors are not as concerned about you medically.
It’s people in high-risk groups that are most concerning: for example, if you transmitted coronavirus to someone with lung disease, heart disease, diabetes or an elderly person.
And if you expose health care workers or other vulnerable populations, that’s when things can really spread.
“This is what makes quarantine, social isolation and distancing that much more important than with other illnesses. … Odds are, if you’re under 60 or so and you’re in generally good health, you’ll have minor symptoms and recover relatively quickly," McGeorge said.
It’s all the people you come into contact with over the course of a day that may be at a higher risk.
When it comes to the numbers
Coronavirus currently poses a much higher risk for older populations and people with significant diseases, as we just mentioned. If you’re age 80 or older, your chances of dying from COVID-19 are about 15%, McGeorge said.
The overall average mortality rate for coronavirus depends on what source you’re looking at, considering the World Health Organization and the Centers for Disease Control and Prevention are providing slightly different numbers.
But that average percent is about 2% to 3%, throughout all populations.
Why this is regional
Every region is going to have its own concerns, when it comes to worrying about the coronavirus.
The outbreak in Washington state has proven to be a worst-case scenario because of the fact that someone inadvertently introduced the virus to a vulnerable population -- the worst kind of patients to contract the illness.
“And that’s why we’re seeing the death rate that we’re seeing," McGeorge said. "If you do the math, how many people in Washington state have (COVID-19)? How many have died? That’s why the percentage is way higher than 2% -- because they have so many older people who were infected early on in the course of this epidemic.”
Over time, it’s likely that more people in a younger age group will test positive, McGeorge said.
And then the number of cases will rise while the number of deaths will not -- because these younger people will recover.
So much depends on the case count, and the how and why behind those people’s illnesses.
In the Seattle area, it was community transmission.
But let’s say four people return to the United States from Italy, and they all test positive for COVID-19. That’s not community transmission. That’s the group picking it up out of the country and returning home. Do they pose a risk? Sure.
“But we know where they got it and we can isolate them. So they pose a different risk,” McGeorge said.
It is, however, important to note …
There are examples of younger people who, for reasons to be determined, have died in connection with COVID-19 -- or they’ve developed a severe illness. So, no one is immune.
When McGeorge says it’s not as significant when a younger patient contracts coronavirus, he simply means “Their odds are just better, compared to a 70-year-old who has a history of smoking and heart disease.”
A fluid situation
It might seem frustrating to get such different information about the coronavirus from week to week. It’s hard to know how to feel or what to believe.
“Any advice we give is based on what we know at this moment," McGeorge said. "What we knew from week one to week four was night and day different.”
The same went for weeks four through week eight.
“Every day that goes by, we modify our opinions or recommendations,” McGeorge said.
That can be unsettling for the public because things are so dynamic.
But these are the facts. The experts are in progress of learning more about this illness, the doctor said.
The WHO, the CDC, individual counties and individual health departments are doing their best to collect data and formulate a strategy.
How many Americans will end up with some form of COVID-19?
“Half of the adult population could eventually become infected with the virus that causes COVID-19," McGeorge said. “So, there’s a decent chance, if the models are correct, that most could become infected.”
But if you look at the numbers and extrapolate the chance of death, it all depends: Is it the older half of our population that would get coronavirus? Then we could see a higher death rate. But if it’s the other end of the adult population, we’d have a different death rate.
“That’s why it’s so important to protect those vulnerable populations,” McGeorge reminded.
Fourteen days is no small amount of time to stay quarantined. And that’s what health officials are asking people to do, if they fear they have COVID-19.
So if you do develop those three main symptoms: fever, cough or shortness of breath, “Most likely, you’ll do fine not knowing if you have COVID-19 or not,” McGeorge said.
But do you quarantine?
We’ve already gone over why you wouldn’t want to expose others.
Still, quarantine for two weeks is a big deal, particularly for medical workers and first-responders. Can everyone self-quarantine if they fear they were around someone possibly exposed?
“The cost to stay at home just to not spread it -- is not insignificant,” McGeorge said.
Will we take out large sectors of the workforce?
A lot remains unknown.
And it’s still a process to get tested. Some are pushing for broader testing and for doctors to relax the testing criteria.
“Right now, we’re quarantining people who have had close contact with known cases before these people even have symptoms, because it’s possible for someone to spread the virus before they have symptoms," McGeorge said.
A lot of this comes down to individual circumstances. Where do you live? Who have you been near recently? Who do you live with currently?
Discussing with your physician is a great place to start when it comes to quarantine concerns, testing and self-reporting to the health department.
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