How Do You Catch the Covid19?
While our understanding of this virus continues to evolve, we know that coronaviruses, in general, are spread in the same manner as the common cold—through infected water droplets from a sneeze, cough, or the breath. Because the coronavirus is novel, the human population has little or no immunity against it. This allows the virus to spread quickly from person to person worldwide.
It’s important to note that person-to-person spread can happen on a continuum (meaning just because you have had the virus, that doesn’t mean you won’t get it again). If these droplets come in contact with the eyes, nose, or mouth of an individual directly or indirectly, the individual may become infected. Health experts agree 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.
It is uncertain how long the virus that causes COVID-19 survives on surfaces, but it seems to behave like other coronaviruses. Studies suggest that coronaviruses (including preliminary information on the COVID-19 virus) may persist on surfaces for a few hours or up to several days. This may vary under different conditions (e.g. type of surface, temperature or humidity of the environment, etc.).
According to the CDC, the virus is thought to be spread mainly person-to-person in the following ways:
- • Between people who are in close contact with one another (within about 6 feet).
- • Through respiratory droplets produced when an infected person coughs or sneezes. These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs.
- • From contact with infected surfaces or objects.
Soft surfaces like fabrics and carpet are not reported to be of concern for the presence of coronavirus. What health officials are concerned with are frequently touched items. Unfortunately, there isn’t a lot you can do to make a dent in all of those nasty germs stuck on surfaces in public places like grocery store cars, park benches, school desks, and even at the airport. But you can encourage your children to wash their hands frequently and keep their hands away from their little faces. But at home, there are some surfaces more prone to being carriers of germs and illnesses. These areas in the home include tabletops, countertops, remote controls, game controllers, computer keyboards, doorknobs, sinks, light switches, faucet handles, sinks, countertop, tub, and toilet (including the entire seat and the toilet handle).
- What Coronavirus Is Not and the Misinformation Surrounding COVID-19
- Symptoms of the Coronavirus
- What Exactly Does COVID-19 Do to a Person?
- Emergency symptoms for CHILDREN:
- Emergency symptoms for ADULTS:
- Mortality Rate and Morbidity Rate: Why Are They So Important?
- Viral Mutations
- Recovery Times
- Which Is Deadlier: The Flu Or Coronavirus?
- What the Princess Cruises Can Teach Us About COVID-19
- How Do You Catch the Covid19?
- How Do You Catch the Covid19?
The worst types of disasters are the ones that we do not know much about. This, of course, invites speculation, hysteria, and anxiety-driven decisions, and ultimately clouds what the facts really are. What is clear is that when a contagious disease is breaking out in random parts of a nation and people are dying from it, it frightens people. As a result, people are going to want answers; they are going to want to protect their families, and they will look to the country’s leaders for guidance. Practical advice and truth must be shared in order to prevent misinformation from running rampant and the “chicken little effect” from taking over.
Here are some common questions surrounding the novel COVID-19:
• Is COVID-19 airborne? There has been some confusion on whether or not the virus is airborne, such as in the diseases of the measles or chicken pox. According to the CDC, no evidence suggests that this virus is airborne. However, if you are sick, it is highly recommended that you protect others around you and in your community by wearing a mask to prevent the spread of germs from coughs and sneezes.
• Who is the most at risk? Moreover, individuals who are over 60 years old or have an underlying health condition such as cardiovascular disease, have a weakened immune system, a respiratory condition, or diabetes could have a high risk of developing a severe form of the virus. In a published study in the official China CDC Weekly, it was revealed that out of a subset of 44,700 infections confirmed in Chinese patients through lab tests, more than 80 percent were at least 60 years old, with half over 70.
• Is it safe to receive packages in the mail? Yes. The likelihood of an infected person contaminating commercial goods is low, and the risk of catching the virus that causes COVID-19 from a package that has been moved, travelled, and exposed to different conditions and temperature is also low.
• Can I catch COVID-19 from my pet? No. There is no evidence that companion animals or pets such as cats and dogs have been infected or could spread the virus that causes COVID-19.
• Will warm weather stop the outbreak? It is not yet known whether weather and temperature will impact the spread of COVID-19. Some other viruses, like the common cold and flu, spread more during cold weather months, but that does not mean it is impossible to become sick with these viruses during other months. At this time, it is not known whether the spread of COVID-19 will decrease when weather becomes warmer. There is much more to learn about the transmissibility, severity, and other features associated with COVID-19 and investigations are ongoing.
• Are pregnant women and children more susceptible to getting COVID-19? There is not currently information from published scientific reports about susceptibility of pregnant women to COVID-19. Pregnant women experience immunologic and physiologic changes that might make them more susceptible to viral respiratory infections, including COVID-19. There is no evidence that children are more susceptible to COVID-19. In fact, most confirmed cases of COVID-19 reported from China have occurred in adults. Relatively few infections in children have been reported, including in very young children.
• Should I be tested for COVID-19? Call your healthcare professional if you feel sick with fever, cough, or difficulty breathing and have been in close contact with a person known to have COVID-19, or if you live in or have recently traveled from an area with ongoing spread of COVID-19.
COVID-19 can be difficult to diagnose based on symptoms because it presents so similarly to a general cold or flu. Reported illnesses have ranged from mild symptoms to severe illness and death for confirmed coronavirus disease 2019 (COVID-19) cases.
Symptoms may appear 2–14 days after exposure:
- • Fever
- • Cough
- • Shortness of breath
- • Pneumonia (in some cases)
- • Body aches
- • Nausea and/or vomiting
- • Diarrhea
What Exactly Does COVID-19 Do to a Person?
The virus infects the lower respiratory tract and multiplies. It attacks two specific lung cells: mucus producing cells (protecting lungs from pathogens) and ciliated cells (clears debris, including viruses, out of the lungs). Ciliated cells are thought to be the preferred cells that the coronavirus attacks. When the cells are attacked and die, they slough out into the lungs, which fill with debris and fluid. Many patients infected with this virus end up getting pneumonia as a result.
The immune system responds to the lungs and, as a result, the lungs become inflamed. While this inflammation is a normal part of fighting infection, in the lungs it can be uncomfortable. In some cases where the immune system is fighting the coronavirus there is a hyper-reactivity of the immune system which results in more healthy tissue dying off in the lungs and worsening the pneumonia.
The inflammation also results in more permeable alveoli, the tiny air sacs in the lungs, filling with fluid and crowding out air so that not enough oxygen can reach the bloodstream. In severe cases, it floods the lungs so a person can no longer breathe. The damage can also cause a cytokine storm, which can result in multi-organ failure. More on this in Chapter 2.
As damage to the lungs increases, pulmonary destruction escalates quickly. Patients who get to this stage in the coronavirus could incur permanent lung damage in the form of scars that stiffen the lungs, or they may die.
As frightening as this sounds, most people only become mildly ill, or are infected but are asymptomatic, while others show mild symptoms for a few days and then it quickly escalates into more severe symptoms of pneumonia and organ failure. It should be noted that a person who is asymptomatic may be recovering from the virus and still make others ill. It’s not clear how often asymptomatic transmission is occurring. The antibodies produced from this particular virus are weak and often do not provide any immunity to further infections.
Illness due to COVID-19 infection is generally mild, especially for children and young adults. However, it can cause serious illness: about 1 in every 5 people who catch it need hospital care.
Dr. Maria Van Kerkhove, who heads the WHO’s Health Emergencies Program, warns, “You have mild cases, which look like the common cold, which have some respiratory symptoms, sore throat, runny nose, fever, all the way through pneumonia. And there can be varying levels of severity of pneumonia all the way through multi-organ failure and death,” she told reporters in Geneva on February 7.
Incidentally, in the Journal of the American Medical Association (JAMA) on February 7 reported that “the most common symptoms were fever, fatigue and dry cough. A third of the patients also reported muscle pain and difficulty breathing, while about 10 percent had atypical symptoms, including diarrhoea and nausea.”
The patients, who ranged in age from 22 to 92, were admitted to the Zhongnan Hospital of Wuhan University between January 1 and 28. “The median age of patients is between 49 and 56 years,” JAMA said. “Cases in children have been rare.”2
Patients are thought to be most contagious when they are symptomatic. However, there have been reports that found an asymptomatic person who transmitted COVID-19 to 5 other people and may have had a longer incubation time of 19 days.
Emergency symptoms for CHILDREN:
- • Fast breathing or trouble breathing
- • Bluish skin color
- • Not drinking enough fluids
- • Not waking up or not interacting
- • Being so irritable that the child does not want to be held
- • Fever with a rash
- • Flu-like symptoms that improve but then return with a fever and a worse cough
Emergency symptoms for ADULTS:
- • Difficulty breathing or shortness of breath
- • Pain or pressure in the chest or abdomen
- • Sudden dizziness
- • Confusion
- • Severe or persistent vomiting
- • Flu-like symptoms that improve but then return with a fever and a worse cough
- *Additional emergency signs for infants include being unable to eat, no tears when crying, and significantly fewer wet diapers than normal.
How Do You Catch the Covid19?
Mortality Rate and Morbidity Rate: Why Are They So Important?
To further understand this novel virus, it is important to understand the mortality rate, what it is, and why it is measured. Mortality and morbidity rates are important tools of indication of the health status of a population. In simple terms, the underlying difference between morbidity and mortality rates are life and death.
• Morbidity Rate is the state of being symptomatic or unhealthy from a disease or condition. This is important to measure because in the investigation of a deadly pathogen it helps tell the story and provides patterns of occurrence of illness. Further, indicators of morbidity such as the prevalence of chronic diseases and disabilities become more important in tracking.
• Mortality Rate is related to the number of deaths caused by the health event under investigation. In high mortality settings, information on trends of death (by causes) help to substantiate the progress of health programs.
Pandemics, in general, can cause significant, widespread increases in morbidity and mortality and have disproportionately higher mortality impacts. With regards to COVID-19, early estimates had the mortality rate between 2% and about 3.4%, according to calculations of confirmed cases and deaths worldwide.
It is alarming when you read a 3.4% mortality rate, but you have to understand that when you see this mortality rate, it is not 100% accurate. Real time numbers are inaccurate right now because different countries can be better or worse at spotting the milder, harder to count cases. As well, there is an issue with under-reported cases or cases not reported at all because the symptoms may be so mild that the infected patient does not realize they have it.
It is easy to overestimate the death rate. But you can also get it wrong in the other direction. Scientists cannot study the morbidity rate if a person with the mild version of the illness does not go to a doctor to have it diagnosed. As the data evolves, scientists will develop a clearer picture of who will be most at risk if the coronavirus outbreak continues to spread into more communities.
It is not uncommon for viruses to mutate and change after they jump from animals to humans. After all, a pathogen’s job is to evade the immune system, create more copies of itself, and spread to other hosts.
A virus’s ability to drift from its original form makes it difficult for vaccines to work and a body’s natural immunity to keep up and prepare. As well, it makes the job of health officials all the more difficult because it is harder to track and treat infected patients. Moreover, there is a possibility that those who have recovered from the initial viral outbreak can become re-infected.
It is believed that we may not develop a natural immunity to COVID-19, but only time will tell. And while the latest research at the time of this writing is that COVID-19 may continue to infect people due to lack of immunity, humans have developed an immunity to other viruses studied. Hopefully, in time, this will be the case with COVID-19.
As an example, consider the flu. According to a report from the Neiman Foundation for the Harvard Journal, “Like all living things, influenza makes small errors—mutations—when it copies its genetic code during reproduction. But influenza lacks the ability to repair those errors, because it is an RNA virus; RNA, unlike DNA, lacks a self-correcting mechanism. As a result, influenza is not genetically stable.”3
A study from Nankai University in Tianjin lead by Professor Ruan Jishou discovered that the new SARS-Cov-2 coronavirus that causes the COVID-19 disease has a mutated gene that is found in the HIV virus. As a result, the study found two distinct versions of the virus, which they named L and S.
L Strain – This is the more aggressive and faster-spreading strain, compared to its milder counterpart, S. This strain is responsible for around 70% of infected patients. Due to its aggressive nature, it has become less common as the outbreak has gone on, with it apparently struggling to spread since early January. The L strain surged at the beginning of the outbreak and made people so ill, those who caught it were quickly diagnosed and isolated. This isolation has given it less opportunity to spread widely. Experts suggest the “human intervention” and lockdown of areas where it was spreading fast is controlling the transmission rate, and hopefully leading to this virus strain to burn itself out.
S Strain – This milder strain is less severe but people will carry it for longer before ending up in a hospital, thus spreading the infection to more people. This is the original strain and, from an evolutionary standpoint, this strain is winning out compared to its more aggressive form.4
Jishou states, “This finding suggests that 2019-nCoV coronavirus may be significantly different from the SARS coronavirus in the infection pathway and has the added potency of using the packing mechanisms of other viruses such as HIV.”
That added potency, the study revealed, was a mutation that can generate a structure known as a cleavage site (similar to those in HIV and Ebola) in the new coronavirus’s spike protein. The cleavage site structure’s role is to trick the human furin protein, so it will cut and activate the spike protein and cause a “direct fusion” of the viral and cellular membranes.
Because viruses are part of the RNA family, mutations in viral diseases are normal. It is still out for debate about which coronavirus strain will win out in this pandemic, but the bright side to all of this is scientists are one step closer to understanding the virus and, hopefully, finding a way to bring an end to its spread.
If you or a loved one contracts COVID-19, it is important to understand what the recovery times will look like. While recovery times vary, the sliver of good news is, it seems that most people who get sick will recover from COVID-19.
- • In non-severe cases, the recovery may be similar to the aftermath of a flu-like illness, and those with mild symptoms may recover within a few days.
- • In moderate cases, which may or may not have the presence of pneumonia, recovery may take longer (days to weeks).
- • Twenty percent of cases may be severe and/or life-threatening and could take months for a person to recover, or the person may die.
Most people who fall ill recover within two weeks. People with more severe cases generally recover in three to six weeks. During the recovery period, it is important to do what you can to help your body recover. Your body needs time and energy to fight off the virus, which means that your daily routine should be put on the backburner. Stay home until you can be tested to make sure you are no longer contagious, hydrate, get plenty of sleep, eat healthy foods, and allow your body the time it needs to heal.
Do not be alarmed if after you begin to recover from this serious viral illness that you may feel symptoms similar to depression. There is a condition called post-viral depression, something that many who recovered from the Spanish Flu admitted to experiencing.
Almost any viral infection can trigger post-viral syndrome because when a virus enters the body, it causes the immune system to respond and attack. This response can put stress on the body and cause inflammation. The effects of this response often leave people feeling down, fatigued, and sometimes depressed. Some symptoms include:
- • confusion
- • trouble concentrating
- • headaches
- • aches and pains in the muscles
- • stiff joints
- • a sore throat
- • swollen lymph nodes
If you are experiencing any of these symptoms after recovery, the most important thing to do is talk to your doctor and let them know. As well, this is your body’s way of telling you to slow down and let it rest.
How Do You Catch the Covid19?
The coronavirus is novel, meaning it has not been seen before. A flu pandemic occurs when a new flu virus that is different from seasonal flu viruses emerges and spreads quickly between people, causing illness worldwide. Most people will lack immunity to the pandemic flu virus. Pandemic flu can be more severe, causing more deaths than seasonal flu. Because it is a new virus, a vaccine may not be available right away. A pandemic could therefore overwhelm normal operations in schools, workplaces, and other community settings.
While the typical flu causes more harm every year, at this point, coronavirus seems to be more deadly when compared with the average flu strands. On average, seasonal flu strains kill 0.1% of people who become infected from it. At the time of writing this, the mortality rate for coronavirus is around 1.4% – 2%. Even if it dropped to 1%, it still is 10 times more lethal than the standard influenza that we have on a seasonal basis.
The new coronavirus also seems to be more contagious than most flu strains. The infection rate of the coronavirus is averaging to about 2.2, but this number may not be exact. Due to some coronavirus cases having mild symptoms in patients, it is hard to access accurate numbers, because some patients may not realize they have the virus.
In both the flu and the illnesses caused by the coronavirus, people may be contagious before symptoms develop, making it next to impossible to control the spread of the virus.
Interestingly, the average flu seems to be more dangerous to children. If a child becomes infected with the coronavirus, on average, their symptoms seem to be mild.
How Do You Catch the Covid19?
What the Princess Cruises Can Teach Us About COVID-19
Cruise ships are notorious for spreading illnesses. The Diamond Princess and Grand Princess cruise ships exposed thousands of their passengers to the coronavirus. This is the timeline of the nightmarish month at sea on the Diamond Princess as recorded by the Princess Cruise line.
February 1, 2020 – Princess Cruises confirms that a guest onboard tested positive for coronavirus on February 1. The passenger traveled for 5 days on board Diamond Princess from Yokohama, Tokyo and disembarked on January 25th in Tokyo, Japan. He visited a local Hong Kong hospital, six days after leaving the ship, where he later tested positive for coronavirus on February 1. According to the ship logs, during the voyage, the passenger was not seen in the ship medical center for any reported illnesses. The guest is currently admitted to a local hospital and reported to be in a stable condition.
February 4, 2020 – Princess Cruises confirms that Diamond Princess has a 24-hour delay to allow Japan public health authorities to check the health status of all guests and crew on board.
Later that day, Princess Cruises decided to cancel the next voyage of Diamond Princess to help facilitate the health screening and records review process after testing found that 10 people on board tested positive for Coronavirus. This includes two Australian guests, three Japanese guests, three guests from Hong Kong, and one guest from the U.S. in addition to one Filipino crewmember.
The infected passengers were taken ashore by Japanese Coast Guard and transported to local hospitals for care. For the remaining passengers and crew, the ship will remain under quarantine in Yokohama for the length of the quarantine (at least 14 days) as required by the Ministry of Health.
The ship plans to go out to sea to perform normal marine operations including, but not limited to, the
February 6, 2020 – New Cases / Nationalities / Quarantine End Date: New cases arise onboard Diamond Princess. According to ship logs, 41 people tested positive. The Japanese Ministry of Health has confirmed this is the last batch to be tested and the quarantine end date will be February 19, unless there are any other unforeseen developments.
February 9, 2020 – Additional Cases Confirmed by Ministry of Health: 66 confirmed cases of coronavirus are now confirmed onboard Diamond Princess.
February 12, 2020 – A voluntary “phased approach” disembarkation of guests has been planned for those who completed their quarantine period at a shoreside facility. The first to disembark will be the most medically vulnerable guests, including older adults with pre-existing health conditions.
Guests in the first phase will be tested for coronavirus. If the test is positive, they will be transported to a local hospital for further evaluation and isolation. If the test is negative, they will be given the option to leave the ship and be transported to a quarantine housing facility.
February 16, 2020 – The Japanese Ministry of Health states there are 67 new positive cases of COVID-19 onboard Diamond Princess.
February 18, 2020 – The total number of new positive cases onboard Diamond Princess is now at a staggering 169. As a result, the cruise ship was denied entry into a San Francisco port due to 20 coronavirus cases among 3,500 people on board.
February 19, 2020 – Embassies of countries including Canada, Australia and Hong Kong are coordinating the collection and transport of their respective citizens (guests and crew) via charter flights. Citizens will be required to have an additional 14 days of quarantine upon arrival in their country of origin. A negative COVID-19 test following this quarantine will be required before being allowed to travel to their final destination.
February 20, 2020 – Approximately six hundred guests onboard Diamond Princess were the first to be cleared by the Japanese Ministry of Health and released to disembark the ship yesterday.
February 27, 2020 – All guests have disembarked the Diamond Princess. There are fewer than 500 team members on board, with some awaiting government charter flights. Princess Cruises has hired a WHO-certified company to provide team members with health and wellbeing care during a quarantine at a land-based center in Japan.
But the journey did not end there for everyone. Quarantined at sea, the cruise line had been forbidden to dock in San Francisco amid evidence that the vessel was the breeding ground for a cluster of nearly 20 cases that resulted in at least one death after its previous voyage.
On March 5, 2020, docked 45 miles off the California coast, the National Guard dropped coronavirus testing kits on board in order to test the passengers to ensure they were safe to dock on US soil. Out of the 44 remaining passengers and crew, 21 tested positive for the virus including 19 crew members. While the cruise line has been accepted to unboard at an Oakland port, extra precautions are being made to ensure the passengers and crew do not have COVID-19 and will further spread the contagion to the surrounding communities. At least 21 of the nearly 3,000 people who subsequently took the same ship to Hawaii have tested positive for the virus. All of those passengers remain on board, and many more still need to be tested. It’s unclear what will happen to those who are found to be sick.
Dr. Grant Tarling, the cruise’s medical officer, said the man who died at Kaiser Permanente Roseville Medical Center after leaving the ship sought onboard medical care Feb. 20 and had been sick for several days. Tarling said two waiters who served the man multiple times were subsequently infected.
Incidentally, Princess Cruises also owns the Diamond Princess, another ship that was quarantined in Yokohama, Japan, and experienced a coronavirus outbreak that infected more than 700 passengers.
Without realizing it, the 3,500 passengers unknowingly became the perfect test study for understanding the virus in a closed off environment. The passengers who were quarantined off the coast of the United States may have helped experts better understand the virus and it effects.
While COVID-19 is not considered airborne, it is easily transmissible from the moisture droplets from coughs. The ventilation systems on board the cruise ship, which were all inter-connected, likely played into the transmission rate. As well, because some of the rooms in the cruise ships do not have access to fresh air and provide poorer air quality, the virus likely festered and spread more easily.
Health experts have warned about the potential for cruise ship outbreaks for years. Purdue University’s Qingyan Chen, an expert on ventilation during virus outbreaks, weighs in on the subject.
A ship’s ventilation system, which relies on recirculated air filtered by medium-strength air filters, is an efficient way of spreading virus particles from room to room aboard a ship, said Chen. In a 2015 study, he and his colleagues looked at the spread of flu aboard cruise ships, finding that one infected person would typically lead to more than 40 cases a week later on a 2,000 passenger cruise, with transmission occurring through the ventilation system. In contrast, on land, the coronavirus seems to have a reproductive rate of two new cases per infected person, which would lead to three new cases in that time.5
Breakdowns and gaps in necessary protocols were also exposed. While it is unknown if one of the passengers who is thought be the one who brought the virus onboard knew he was infected or if the symptoms came on after boarding, this has taught cruise ships to have better boarding protocols, which now include:
- • Further enhancement of entry and exit screening and shipboard testing for the coronavirus.
- • New quarantine standards coordinated with the CDC for all cruise ships.
- • A protocol to move any patients that contract the coronavirus or otherwise become seriously ill to land-based facilities.
Also, even though the cruise ship took the necessary precautions and quarantined passengers, crew members who unknowingly were infected with the virus came to the rooms to deliver meals and inadvertently exposed more passengers to the deadly virus.
At this point, the unknowns of this health crisis seem to outweigh the knowns. And until a vaccine is found—which is months if not years away—the only way to prevent it is to avoid it.