By Dr. Vivek Sinha
The COVID-19 pandemic has changed every single aspect of our lives. Everything from how we work to how we walk our dogs – and everything in between – has changed. News reports in every medium keep us up to date on the number of people infected and the number of patients who have succumbed to this infection.
As I’ve been speaking to patients, the conversation invariably turns to COVID-19: “What are the symptoms? What are my risks of catching it? What should I look out for if I think I have it?”
These are some of the common questions that are being asked over and over again and a good reminder that, often when there is extensive news on medical topics, the basic information can sometimes be lost in the vast array of information. While the situation is very fluid and new information and data is being released in real time, here are some of the basics.
The official name of the virus is Severe Acute Respiratory Coronavirus-2 (SARS-CoV-2) and the disease that it causes is called Coronavirus Disease 2019 (COVID-19). Experts believe the virus spreads via respiratory droplets. In other words, if someone with the infection sneezes, coughs or talks, the respiratory secretions that are expelled out from their mouth and nose contain the virus. These secretions can travel approximately six feet. If anyone touches those droplets and then touches their eyes, nose or mouth, they can become infected.
The presence of the virus has also been detected in blood and stool samples. It is important to note that at this time, because there is uncertainty in definitively identifying all routes of transmission, it is recommended to use airborne precautions, such as masks, in certain circumstances.
Determining when symptoms appear is also important when faced with infectious diseases. For COVID-19, the average incubation period is between two to seven days. This means that people can have the infection several days before they show any symptoms. Furthermore, this means that people can be infectious and not know it for several days. This becomes critically important when we put it in the context of social distancing. Staying away from each other, even if you feel well, is the best way to decrease the risk of viral transmission.
While anyone who gets infected and develops COVID-19 can develop significant illness, there are certain underlying conditions that predispose someone for having a more severe infection. Cardiovascular disease, diabetes, lung disease, cancer, kidney disease and obesity are some of the conditions that have been linked to a more extreme course of illness. People who have these conditions should make sure that they are taking all of their medications as prescribed and do their best to keep these conditions under exceptionally good control. We also have found that while all age ranges are susceptible, older patients are associated with increased mortality.
The most common question that I am asked when speaking to patients is, “What are the symptoms that I should be looking out for?”
In order to answer this question, it’s important to remember that, first and foremost, COVID-19 is a viral disease. It presents very similarly to other viral conditions. The most common initial presentation is fever, cough and shortness of breath. Other symptoms, such as diarrhea, fatigue, sore throat, rhinorrhea, decreased appetite and body aches are also common. There also has been some evidence of patients presenting with decreased ability to smell or taste food. All these symptoms are very non-specific and can point toward the beginning of several different conditions.
The take home message is that when we are talking about symptoms, it’s important to note that unfortunately there are no specific clinical features that can reliably differentiate COVID-19 from other viral infections. Much has to be based on the clinician’s clinical judgment. Multiple factors must be taken into account, such as the person’s profession, age, risk for exposure and their current living situation.
What can we do to protect ourselves? The first and foremost recommendation is appropriate handwashing. Soap dissolves the membrane around the virus and once that membrane is dissolved, the virus becomes inactive. In other words, soap and water are the most important components when it comes to combatting viruses. Hand washes containing alcohol are also good, and even though they are not as good as soap and water, they are very good options when handwashing is not an option or readily available.
Covering our coughs and sneezes is also important in protecting each other and limiting the spread of the virus. Making a conscious effort not to touch our eyes, nose and mouth is also important. Wearing a mask will limit the spread.
Ultimately, viruses have been present for a long time and while we as a society are currently struggling with a deadly type of new virus, we must remember certain points: Wash your hands with soap and water, maintain social distancing until it is deemed okay to relax these measures and make sure to speak to your doctor if you start to have symptoms consistent with COVID-19.
As a primary care physician, my main goal is to keep people out of the hospital. Having a primary care physician to help guide you is invaluable during these difficult times. Hospitals should be reserved for patients who cannot be treated at home. If you have symptoms that are concerning, symptoms that are worsening or symptoms that are unusual for you to have and are causing duress, speak to your doctor. Stay healthy. Stay home. And wash your hands.
The writer is the chief medical officer of Belleview Medical Partners, an office and house call practice based in Old Town.