March 20, 2020in Doctor Resource

Novel Coronavirus: Update on the Outbreak, for All Persons

Last updated: March 20, 2020

The Centers for Disease Control (CDC) continues to closely monitor the COVID-19 novel coronavirus outbreak that originated in December 2019. The first COVID-19 case in the United States was detected January 21. By March 20, the US had 14,000 confirmed cases or about 5.7% of the world’s confirmed cases.

Prevention – The World Health Organization (WHO) learned from previous coronavirus outbreaks, the Middle East Respiratory Syndrome and the Severe Acute Respiratory Syndrome, that human-to-human transmission occurs through droplets in the air, direct personal contact, and objects touched by other people, suggesting that the transmission method of COVID-19 can be similar.

The WHO recommends during this coronavirus outbreak:

  • Social distancing: avoid close contact with people who are coughing, sneezing, or sniffling
  • Frequent handwashing: or use alcohol hand sanitizer, especially after contact with ill people or their environments
  • Avoid touching your eyes, nose, or mouth: to avoid catching the viruses your hands pick up from touching objects and surfaces
  • Practice cough etiquette: maintain a distance from others, cover your coughs and sneezes with disposable tissues or clothing, and wash hands afterwards
  • Stay home if you any mild symptoms. If you have a fever, cough, or breathing symptoms, call your doctor by video or phone, to ask what to do next. For emergencies, call your local emergency number for an ambulance
  • Read more about the World Health Organization’s recommendations at: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public

Testing – the US Centers for Disease Control developed a PCR (polymerase chain reaction) test kit to diagnose the SARS-CoV-2 virus that is causing this outbreak. Some research centers and private companies are producing similar tests to help diagnose the virus.

Test kits are currently in short supply in many locations. Doctors use their experience and judgment to decide if a patient has signs and symptoms compatible with COVID-19 and whether or not the patient should be tested. Priorities for testing include:

  • Hospitalized patients who have signs and symptoms of COVID-19
  • Symptomatic older adults, or persons with chronic medical conditions or an immunocompromised state that may put them at higher risk (examples: diabetes, heart disease, immunosuppressive medications, chronic lung disease, chronic kidney disease)
  • Persons who within 14 days of symptom onset had close contact with a suspected or confirmed COVID-19 patient
  • Persons who within 14 days of symptom onset had travelled in areas with high COVID-19 activity. See CDC’s risk assessment by country at: https://www.cdc.gov/coronavirus/2019-ncov/travelers/index.html
  • Read more about CDC’s coronavirus testing recommendations at: https://www.cdc.gov/coronavirus/2019-nCoV/hcp/clinical-criteria.html

Social distancing, Self-quarantine – Mildly ill patients may stay home and contact their doctor by video or phone for guidance. Patients with severe symptoms should seek care immediately by calling their local emergency number (911 in US). Older patients and individuals with underlying medical conditions should contact their doctor early in the course of even a mild respiratory illness.

A self-quarantine may be the doctor’s plan for a:

  • Person with suspected or confirmed COVID-19 who does not need hospitalization
  • Person with confirmed COVID-19 who was hospitalized but is now discharged home

If you are a patient, your own doctor and local public health staff will decide whether you can be cared for at home. If they feel that you do not need hospitalization, and you can be safely isolated at home. While in self-quarantine:

  • Stay at home, except for going to get medical care
  • Do not go to work, school, church, playgrounds, or other public areas
  • For medical care questions about your COVID-19 symptoms or other health issues, first get advice from your doctor by video or phone. You generally do not want to walk into a clinic or ER during this coronavirus outbreak
  • If having an emergency (for example, difficulty breathing, chest pain, etc.), call 911 or your local emergency services number for an ambulance, and don’t waste time trying to reach your doctor. Tell the 911 dispatcher that you are in self-quarantine for COVID-19, and describe your emergency
  • Avoid using public transportation, ride sharing, or taxis unless absolutely necessary. Wear a mask when going somewhere
  • Read more about self-quarantine recommendations at: https://www.healthtap.com/blog/post/covid19-coronavirus-self-quarantine-guide

Robert Kwok

Robert Kwok

Robert Kwok, MD, Director of Health Informatics at HealthTap, is a board-certified physician who practiced medicine for 27 years. He earned his MD and pediatrics credentials at Baylor College of Medicine. Before HealthTap, he practiced clinical pediatrics in Northern California, most recently with Stanford Medicine.