Zulfiqar Rana, MD, MPH, FACP

Board Certified in Internal Medicine

COVID-19

This is the main summary article. Click on links to see more details.

The Virus (in a nutshell)

  • Biology SS- RNA virus
  • Epidemiology
    Originated Wuhan, China
    Source bats?
  • Spread
    • Zoonotic – Patient 0
    • Human- most common
      • from a sick person/ within 6 feet
      • from asymptomatic individuals (esp. young)
    • Fomites – It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes, but this is not thought to be the main way the virus spreads.
    • Attack Rate 30-40% (what is it?)
    • R0 2-4 (what is it?)
    • Fatality Rate about 3.4% (what is it?)
  • Virus Survival on Surfaces (few hours to few days)
    • Coughed up virus particles – up to 3 hours
    • fine droplets in still air – several hours
    • disinfecting surfaces with 62-71% alcohol, or 0.5% hydrogen peroxide bleach or household bleach containing 0.1% sodium hypochlorite –  less than 1 minute
    • Fibers and clothes – not known
    • Metal, glass, and plastic – for as long as nine days
    • Touching the infected surface and then touching face – per CDC, not a major risk
    • Food – not a major risk factor as the virus is respiratory
    • References
      NEJM study (PDF)
      See this BBC article
      NPR article

Symptoms

  • Cough 65-80%
  • Fever 45%
  • Dyspnea 20-40%

Diagnosis

  • Based on history
    Changed criteria per CDC as of March 9, 2020
  • CDC guidance for healthcare professionals
  • Labs
    PCR
  • Identify High-Risk Individuals
    Early information out of China, where COVID-19 first started, shows that some people are at higher risk of getting very sick from this illness. This includes:

      • Older adults
      • People who have serious chronic medical conditions like:
        • Heart disease
        • Diabetes
        • Lung disease

Treatments

Prevention

  • Use of PPE
  • Masks (click the link to see full CDC statement)
    • CDC does not recommend the routine use of respirators outside of workplace settings (in the community).
    • An N95 FFR is a type of respirator which removes particles from the air that are breathed through it. These respirators filter out at least 95% of very small (0.3 microns) particles. N95 FFRs are capable of filtering out all types of particles, including bacteria and viruses.

      Achieving an adequate seal to the face is essential. United States regulations require that workers undergo an annual fit test and conduct a user seal check each time the respirator is used. Workers must pass a fit test to confirm a proper seal before using a respirator in the workplace.
    • Difference between N95 and surgical masks [1]
  • Social distancing
  • Frequent testing and quarantining.

Directions for outpatient clinics

Please see our post on directions for outpatient clinics


 

References

[1]: https://www.cdc.gov/niosh/npptl/pdfs/UnderstandDifferenceInfographic-508.pdf

 

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