New developments have unfolded rapidly since an outbreak of respiratory disease caused by a coronavirus sickened people in China in December 2019.
Since then cases have appeared in countries across the globe, including the U.S., which now has the highest number of confirmed cases in the world.
While federal health officials say COVID-19 will cause severe disruption in the weeks and months to come, questions remain.
What does that mean for individuals? Our communities?
“My hope is that it will feel like a bad flu season to us,” said Russell Lampen, DO, division chief for infectious disease for Spectrum Health Medical Group, said in late February, as he accurately predicted the closure of schools and the cancellation of events.
“If this comes through and infects a big swath of the population—even if it’s like a bad flu season—it would be like getting two flu seasons back to back,” Dr. Lampen said. “That would tax the health care system.”
That is being seen and felt on the east side of Michigan, and certainly in New York City, where field tents are being set up in Central Park as hospitals become overloaded with sick patients.
Spectrum Health officials are preparing for a surge in patients in April and May even as the governor asks people to stay at home, shelter in place, and slow the spread of COVID-19.
Spectrum Health infectious disease experts provide insights into what is now known about the potential impact of COVID-19 and ways to protect ourselves.
What is a pandemic?
The World Health Organization declared COVID-19 to be a global pandemic, because it has seen intensive and widespread community transmission of the virus worldwide.
Overall, the World Health Organization has tried to avoid causing needless fear while encouraging preparedness, Dr. Lampen said.
“In the days and weeks ahead, we expect to see the number of cases, the number of deaths … to climb even higher,” said WHO director-general Dr. Tedros Adhanom Ghebreyesus at a news conference announcing the pandemic declaration. “We’re deeply concerned both by the alarming levels of spread and severity, and by the alarming levels of inaction …We have rung the alarm bell loud and clear.”
How dangerous is COVID-19?
“We still don’t know the true severity of it,” Dr. Lampen said. “It’s hard to know.”
In Wuhan, China, the death rate is 2% to 4%. But outside Wuhan, it is far lower—about 1%, according to the World Health Organization.
“There will be a number of people who will have a mild respiratory illness that causes limited or no symptoms at all,” Dr. Lampen said. “And there will be a population that will be sicker and require hospitalization.”
Roughly 80% of people will experience mild or moderate symptoms, and be able to treat themselves in their homes.
Those most likely to suffer serious illness, and require hospitalization, are the elderly and people with medical conditions. Most children seem to only suffer mild symptoms, if infected.
What symptoms does it cause?
The symptoms that raise concerns are lower respiratory symptoms, such as cough and shortness of breath. Fevers are common with infection, and many people have gastrointestinal issues, body and head aches, and report the loss of smell and taste.
How is the COVID-19 virus transmitted?
“What we are seeing is that this virus appears to spread easily. It appears to spread by droplets—when you sneeze and cough,” Dr. Lampen said.
Cases in the United States continue to increase day by day.
“It has spread into too many places,” Dr. Lampen said. “It seems like it’s too hard to contain at this point.”
Spectrum Health Medical Group interventional pulmonologist Gustavo Cumbo-Nacheli, MD, said he contacted doctors in Asia months ago.
“They started sharing that some sort of infection was spreading really fast,” he said. “We made the system aware this was going to be worse than anything we could anticipate. We started preparing.”
He said a big issue is that people can be carrying the virus, and not have symptoms.
“People feel well and have the virus and, unfortunately, they’re contagious for others,” Dr. Cumbo-Nacheli said.
How can we protect ourselves and help slow the spread of this virus?
Take the usual precautions you would take against influenza and other contagious disease.
Practice good hygiene by coughing or sneezing into your elbow, wash your hands for a minimum of 20 seconds with soap and water, practice social distancing of 6 feet or more, and adhere to state orders to shelter in place.
“Stay home if you’re sick. Make sure you wash your hands. Get a flu shot if you haven’t gotten one,” Dr. Lampen said.
Why a flu shot?
“The flu vaccine won’t impact whether you get coronavirus,” Dr. Lampen said. But there is always the potential for co-infection—getting both coronavirus and influenza would deliver a double whammy to your immune system.
“Getting a flu vaccine is another way to stay healthy,” he said.
How important is hand washing?
“Not only can you get sick from people coughing and sneezing close to you, but often times, the things they cough and sneeze actually land on your body and you touch it with your hands,” said Rosemary Olivero, MD, the section chief of pediatric infectious disease with Spectrum Health Helen DeVos Children’s Hospital. “And if you put your hands on your eyes or nose or mouth, you can then infect yourself.”
She suggests people use hand sanitizer when soap and water aren’t handy, and wash their hands regularly when possible.
Can we get specific about how to get those hands clean?
Spectrum Health infection prevention manager Doreen Marcinek, DNP, RN, explained:
“You should have running water and an adequate amount of soap. You should apply soap onto the palm of your hand and, using friction, wash your hands throughout the top of your hands, the back of your hands, in between your fingers, under your nails and around your cuticle beds. Do this for a minimum of 20 seconds. An easy way to remember this is to sing in your head the song Happy Birthday.”
What is Spectrum Health doing to prepare for an outbreak?
The infection prevention team has been closely monitoring the situation and drawing on experience with other outbreaks to plan a response, said Julie Bulson, DNP, director of emergency preparedness at Spectrum Health.
“We have already implemented a few things,” she said. “In the Emergency Department and Urgent Care, we stop all visitors.”
Patients are screened from there, and if patients are considered at risk, they get a mask.
“They are isolated in their own room and are seen and treated appropriately,” Bulson said.
Additionally, Spectrum Health has restricted patient visitors, are staffing a free community screening hotline 24/7, and canceled or postponed many public events and elective procedures. Many appointments for routine or non-urgent conditions are being performed virtually by phone or video.
The health system also opened triage tents outside each emergency department and is working with federal and state emergency officials to staff and equip auxiliary spaces to house patients.
We also are sharing resources and information for the community on spectrumhealth.org.
We want to assure you that we are here to serve the needs of our communities.
If we think we have a respiratory illness, including COVID-19, what should we do?
As a service to our community, Spectrum Health is offering free screenings for COVID-19. If you are in the state of Michigan and experiencing COVID-19 symptoms, call the hotline number at 833.734.0013 or access the virtual chat screening options at spectrumhealth.org/covid19.
If you have severe or life-threatening symptoms, please call 911.
“The goal for this virus is to contain it,” Bulson said. “We are building our plans as this escalates throughout the country to keep people in their homes versus in a public location.
“If we can do anything to keep these patients home, without coming into the emergency department with a potential spread, that’s what we want to do.”
How will this affect our travel plans?
Check the CDC’s travel advisories, Dr. Olivero said.
At this point, the CDC has issued an Alert Level 3 for the entire world, recommending that people avoid nonessential travel to those countries.
Cruise lines have voluntarily ceased operations until mid-May. Hawaii and Alaska and several countries have instituted mandatory quarantine for all incoming visitors. Other countries are not allowing incoming or outgoing travel.
It’s best to stay close to home at this point.