What You Need to Know About Corona Virus

General background: Coronaviruses are a large family of viruses, and they are common sources of infection in humans, generally causing mild disease such as the common cold. This particular variant is new in humans and this novel strain has been named SARS-CoV-2 (not the same as the prior “SARS”). The disease itself is called COVID-19.

Coronaviruses also cause disease in multiple other species. Sometimes these animal viruses can spread to humans, which is currently thought to be the case with this outbreak. MERS and SARS were examples of this. 

Method of transmission: The Corona virus is thought to be spread mainly by person-to-person transmission, which is understood at this time to be by close proximity (6ft or less) and/ or by droplet transmission from coughing or sneezing. It is also possible that one can become infected by touching surfaces or objects containing the virus and then touching one’s mouth, nose, or eyes.

It is currently thought that people are most contagious while symptomatic, but there are reports of persons likely spreading the disease prior to significant symptoms, as well. Certain viruses are spread more easily than others. It is currently thought that the Corona virus  spreads fairly easily, meaning more easily than influenza, although not as easily as highly contagious viruses such as measles. It can sustainably spread in the community. 

Quarantine: This is recommended for cases of Corona virus. Strict guidelines about release from quarantine have not yet been determined. At a minimum, the following criteria should be met: 

  • free from fever without use of medication to lower fever (e.g. Tylenol, aspirin, motrin, etc.;
  • no longer symptomatic, including cough-free; and
  • test negative on two consecutive respiratory specimens

Current recommendations for post-exposure quarantine is two weeks, which is thought to be the incubation period for this disease based on other coronaviruses. 

Symptoms: Illness can vary significantly from nonspecific or mild symptoms to severe illness or death. Some patients have had no symptoms. The mortality rate is not known because the number of cases (the denominator in any calculation) isn’t accurately known. The range is from tenths of a percent up to 2%. 

Symptoms can appear 2-14 days after exposure and usually include fever, cough, and shortness of breath. Severe cases can progress to severe pneumonia, respiratory failure, and septic shock with mortality. It is not currently understood which segment of the population is at higher risk for severe manifestations. 

Treatment: At this point, treatment is purely supportive. There are no currently available vaccines or antivirals for this virus. Clinical trials are underway. 

Specific recommendations at our Starling facilities:

  1. Signage: We are working on signage that will direct patients to notify us if they have risk factors for coronavirus infection. 
  2. Triage:
  3. For urgent/ sick patients, if you are significantly short of breath with viral syndrome symptoms, you will be directed to the ER, as opposed to an office visit.
  4. For milder symptoms, if you have a fever and respiratory symptoms, you can be seen but will be instructed on practice appropriate hand/ contact/ droplet hygiene.  
  5. We will ideally ask sick patients to maintain a distance of 6 feet or more from other patients in the waiting area, or be otherwise sequestered. You may be asked to wait in your cars and we will communicate by cellphone if significant suspicion exists and the waiting area does not permit sequestration.  
  6. Disinfection: Rooms will be carefully wiped with standard disinfectants after visits.
  7. Use of masks: Providers will wear masks with any suspected infection and practice good hand/ contact/ droplet hygiene. Patients with suspicion for Coronavirus or flu will be given a mask, if available, upon entering the clinical space. 
  8. Testing for coronavirus: Labs in Connecticut are now fully capable of conducting diagnostic testing for COVID-19.

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