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Soliman Care Family Practice Center Inc.
Novel Coronavirus (COVID-19) Update
My Dear Patient,
Based on my own experience, is that I really think that the Novel Corona Virus started in the fall of 2019 during November /December time. Remember how many people you know and maybe including yourself, suffered from bad flu symptoms during Thanks Giving and Christmas of 2019? Remember how long it lingered? Those symptoms were different from any year before. At that time no one discussed the new COVID-19. Yet many physicians were wondering what’s going on. Luckily all of us survived.I included here all the updates that I felt that I need to share with you about COVID-19.
Human Corona virus Types:
Corona viruses are named for the crown-like spikes on their surface. There are four main sub-groupings of corona viruses, known as alpha, beta, gamma, and delta.
Human corona viruses were first identified in the mid-1960s. The seven coronaviruses that can infect people are:
Common human coronaviruses
229E (alpha coronavirus)
NL63 (alpha coronavirus)
OC43 (beta coronavirus)
HKU1 (beta coronavirus)
Other human coronaviruses
MERS-CoV (the beta coronavirus that causes Middle East Respiratory Syndrome, or MERS)
SARS-CoV (the beta coronavirus that causes severe acute respiratory syndrome, or SARS)
SARS-CoV-2 (the novel coronavirus that causes coronavirus disease 2019, or COVID-19)
Sometimes coronaviruses that infect animals can evolve and make people sick and become a new human coronavirus. Three recent examples of this are 2019-nCoV, SARS-CoV, and MERS-CoV.
COVID-19: In early 2020, after a December 2019 outbreak in China, the World Health Organization (WHO) identified a new type, 2019 novel coronavirus (2019-nCoV), which can be fatal. The organization named the virus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and named the disease it causes COVID-19. The outbreak quickly moved from China around the world. Symptoms of COVID-19 include fever, cough, and shortness of breath.
Middle East Respiratory Syndrome (MERS): About 858 people have died from MERS, which first appeared in Saudi Arabia and then in other countries in the Middle East, Africa, Asia, and Europe. In April 2014, the first American was hospitalized for MERS in Indiana and another case was reported in Florida. Both had just returned from Saudi Arabia. In May 2015, there was an outbreak of MERS in Korea, which was the largest outbreak outside of the Arabian Peninsula.
Severe Acute Respiratory Syndrome (SARS): In 2003, 774 people died from an outbreak. As of 2015, there were no further reports of cases of SARS.
But how did the deadly outbreak start?
The World Health Organization’s China office says it began receiving reports in late December of a mysterious virus behind a number of pneumonia cases in Wuhan, a city in eastern China with a population of roughly 11 million people.
Researchers suspect the virus originated at a seafood market in Wuhan, where wild animals, including birds, rabbits, bats, and snakes are traded.
Prevalence in California and Globally:
California cases
Updated March 14, 6:46 PM EDT
Confirmed
Fatal
Recovered
223
5
6
US cases
Updated March 14, 6:46 PM EDT
Confirmed
Fatal
Recovered
2,499
55
49
Global cases
Updated March 14, 6:46 PM ED
Confirmed
Fatal
Recovered
155,215
5,811
74,262
Prevention & How it Spread?
There is currently no vaccine to prevent coronavirus disease 2019 (COVID-19).
The best way to prevent illness is to avoid being exposed to this virus. The virus is thought to spread mainly from person-to-person. 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.
Take steps to protect yourself:
Clean your hands often: Wash your hands often with soap and water for at least 20 seconds especially after you have been in a public place or after blowing your nose, coughing, or sneezing.If soap and water are not readily available, use a hand sanitizer that contains at least 60% alcohol
. Cover all surfaces of your hands and rub them together until they feel dry.
Avoid touching your eyes, nose, and mouth with unwashed hands.
Avoid close contact with people who are sick
Put distance between yourself and other people if COVID-19 is spreading in your community. This is especially important for people who are at higher risk of getting very sick.
Take steps to protect others
Stay home if you are sick, except to get medical care.
Cover your mouth and nose with a tissue when you cough or sneeze or use the inside of your elbow.
Throw used tissues in the trash.
Immediately wash your hands with soap and water for at least 20 seconds. If soap and water are not readily available, clean your hands with a hand sanitizer that contains at least 60% alcohol.
If you are sick:You should wear a face mask when you are around other people (e.g., sharing a room or vehicle) and before you enter a healthcare provider’s office. If you are not able to wear a face mask (for example, because it causes trouble breathing), then you should do your best to cover your coughs and sneezes, and people who are caring for you should wear a face mask if they enter your room. Learn what to do if you are sick.
If you are NOT sick:
You do not need to wear a facemask unless you are caring for someone who is sick (and they are not able to wear a facemask). Facemasks may be in short supply and they should be saved for caregivers.
Clean AND disinfect frequently touched surfaces daily
. This includes tables, doorknobs, light switches, countertops, handles, desks, phones, keyboards, toilets, faucets, and sinks.
If surfaces are dirty, clean them: Use detergent or soap and water prior to disinfection.
Symptoms
Reported illnesses have ranged from mild symptoms to severe illness and death for confirmed corona virus disease 2019 (COVID-19) cases.
The following symptoms may appear 2-14 days after exposure.*
Fever
Cough
Shortness of breath
*This is based on what has been seen previously as the incubation period of MERS-CoV viruses.
If you develop emergency warning signs for COVID-19 get medical attention immediately. Emergency warning signs include*:
Difficulty breathing or shortness of breath
Persistent pain or pressure in the chest
New confusion or inability to arouse
Bluish lips or face
*This list is not all inclusive. Please consult your medical provider for any other symptoms that are severe or concerning.
What is going on now with the health care system?
Till almost week ago there were no real guidelines for our medical practices to follow in a case of suspected Covid-19. Should a patient come or go to the ER? Should we screen? Should we swab and test every flu case for Covid-19? What should we do exactly?
“At this time, testing for COVID-19 is performed only through the Los Angeles County Department of Public Health, with its authorization. Hospitals and physician offices do not yet have testing capabilities.”
Here are the guidelines we received as Physicians :
In an effort to prepare for an outbreak of COVID-19, and manage patient and community concerns, we encourage our physician partners to follow local and state public health recommendations.
1- * Identify o Patients presenting with fever and respiratory symptoms should be immediately masked and placed in a private room with the door closed for evaluation. Healthcare providers should wear a mask and follow DPH physician checklist to evaluate patients who may have COVID-19. Refer to the attached for the complete DPH physician evaluation checklist.
2- * Contact LACDPH Acute Communicable Disease Control (ACDC) for assistance in diagnosis and infection control 213-240-7941 (8am-5pm M-F) or 213-974-1234 (after hours emergency operator) o only patients with serious or life-threatening symptoms should be referred to the Emergency Department (call to alert ED in advance). Do NOT refer patients with minimal respiratory symptoms to the ED. Page 2 of 9
3- * Isolate o Encourage patients with mild fever or respiratory symptoms to self-isolate at home until 24 hours after the resolution of fever and/or improvement of respiratory symptoms. Patients should contact their provider if symptoms worsen.
4- * Notify o Suspected cases should be reported immediately to the DPH ACDC o Testing for COVID-19 is performed only through the Los Angeles County Department of Public Health, with its authorization. Hospitals do not yet have testing capabilities. Environmental Cleaning and Disinfection Recommendations
CDC recommends that older adults or those who have certain medical conditions consider postponing travel.
If you are at higher risk of getting very sick from COVID-19, you should:
Stock up on supplies.
Take everyday precautions to keep space between yourself and others.
When you go out in public, keep away from others who are sick, limit close contact and wash your hands often.
Avoid crowds as much as possible.
Avoid cruise travel and non-essential air travel.
During a COVID-19 outbreak in your community, stay home as much as possible to further reduce your risk of being exposed.
Information on COVID-19 and Pregnant Women and Children
There is not currently information from published scientific reports about susceptibility of pregnant women to COVID-19. Pregnant women experience immunologic and physiologic changes which 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. Infections in children have been reported, including in very young children. There is an ongoing investigation to determine more about this outbreak. This is a rapidly evolving situation and information will be updated as it becomes available.
COVID-19 is a new disease and we are still learning how it spreads, the severity of illness it causes, and to what extent it may spread in the United States.
Pregnant Women
What is the risk to pregnant women of getting COVID-19? Is it easier for pregnant women to become ill with the disease? If they become infected, will they be sicker than other people?
We do not currently know if pregnant women have a greater chance of getting sick from COVID-19 than neither the general public nor whether they are more likely to have serious illness as a result.
Pregnant women experience changes in their bodies that may increase their risk of some infections. With viruses from the same family as COVID-19, and other viral respiratory infections, such as influenza, women have had a higher risk of developing severe illness. It is always important for pregnant women to protect themselves from illnesses.
How can pregnant women protect themselves from getting COVID-19?
Pregnant women should do the same things as the general public to avoid infection. You can help stop the spread of COVID-19 by taking these actions:
Cover your cough (using your elbow is a good technique)
Avoid people who are sick
Clean your hands often using soap and water or alcohol-based hand sanitizer
Interim Guidance on Breastfeeding for a Mother Confirmed or Under Investigation for COVID-19
This interim guidance is intended for women who are confirmed to have COVID-19 or are persons-under-investigation (PUI) for COVID-19 and are currently breastfeeding.
This interim guidance is based on what is currently known about COVID-19 and the transmission of other viral respiratory infections.
CDC will update this interim guidance as needed as additional information becomes available. For breastfeeding guidance in the immediate postpartum setting Transmission of COVID-19 through breast milk.
Much is unknown about how COVID-19 is spread. Person-to-person spread is thought to occur mainly via respiratory droplets produced when an infected person coughs or sneezes, similar to how influenza (flu) and other respiratory pathogens spread.
In limited studies on women with COVID-19 and another coronavirus infection, Severe Acute Respiratory Syndrome (SARS-CoV), the virus has not been detected in breast milk; however we do not know whether mothers with COVID-19 can transmit the virus via breast milk.
Can pets get Corona-virus?
There’s no evidence pets can spread corona virus, despite positive test in Hong Kong
The World Health Organization (WHO) states: “At present, there is no evidence that companion animals/pets such as dogs or cats can be infected with the new corona virus.” It also says there is no evidence that dogs or cats “have infected humans with Covid-19.”
However, the statement goes on to advise pet owners to maintain good hygiene, like washing their hands with soap and water after contact with their pets.
