The Truth About COVID-19

Lots of information and disinformation out there, lets get the basics straight:

1. What is it?

COVID-19 ("corona") is a virus that is new to the world. It originated in late 2019 in China. It is believed to have originated in bats, but jumped to domestic animals and then mutated slightly so it could affect humans. This happens a few times every year with all manner of viruses, but often they burn out and rarely go on to cause epidemics. The way we know this -- and that it did not originate in a lab for example -- is that scientists have captured and sequenced its genetic code (RNA), and they can see that it is just like a bat coronavirus, with a few differences. For those who remember the SARS epidemic in 2002-03, that was also a coronavirus from bats, similar story.

2. Is it like the flu?

It appears in its symptoms similar to flu (fever, cough, etc), but is actually a different class of virus with a different identity and behaviors.

- It is twice as contagious as flu (every one person infects two others on average)

- Currently, it is 30x more deadly than flu

- We have no vaccine to prevent it

- No medication to treat it

- No natural immunity to it

3. What are the symptoms?

- Fever (at some point in the illness, 85%)

- Cough (65-80%)

- Short of breath (20-40%)

- Runny nose or congested (15%)

- Upset stomach (diarrhea, etc 10%)

4. How is it transmitted?

It is currently considered airborne (meaning in microscopic droplets in the air from the breath of people infected). It is also transmitted oral/fecal route (not washing hands after using bathroom). So far it is has not been found in vaginal secretions or semen.

COVID-19 appears to be able to live on surfaces like elevator buttons or door handles for over a week, and current thinking is that clothes need to be washed hot to get rid of the virus, but it is not known fully. It can be washed off hands with 20-30 seconds of vigorous soapy hand-washing, and alcohol/purell gel is thought to be about 80% effective at removal.

The virus is transmissible in the incubation period before showing symptoms. There also appear to be many who transmit the virus but do not become ill from it (see below). Thus, you may feel completely healthy but be transmitting the virus to your close contacts.

5. Who gets it?

So far it appears that it is mostly adults (18+) who contract the disease. Interestingly, it seems that the most affected population is YOUNG ADULTS (Age 18 - 29) where up to 1 in 3 people tested were carrying it according to recent data out of South Korea. The thing is, this group may have it and not know / not feel sick. They therefore go out and spread it to the rest of the population where between 1 in 5 - 1 in 10 are sick with it in South Korea.

Most of the deaths are OLDER ADULTS and those with chronic medical problems. But as the epidemic develops, more reports are emerging of health people in their 20s and 30s succumbing to the illness, notably healthcare workers. Death is of respiratory compromise -- unable to breathe -- which is why ventilators / ICU beds have been key. It had not been as much from secondary pneumonias, so those vaccines do not appear to be protective for COVID19.

6. If I have had it, can I catch it again?

Million-dollar question. We do not know. Right now, the jury is out on this. It is possible that having antibodies to it is protective, but also possible that like common cold, we could catch it multiple times.

7. When they say "social-distancing" what does that really mean for me?

The easier parts of social distancing are cancelling large events and avoiding indoor spaces (malls, cafes, etc). The harder part is figuring out childcare, groceries, etc.

When deciding what interactions to have, or whether to go, think of it this way: Each person who you come into contact with becomes part of your quarantine circle. Meaning if they are sick, you have been exposed and need to stay in your house for 14 days strictly. Each person you come in contact with increases your risk of meeting someone with the virus.

The flip-side is that you may be carrying it unknowingly to them. So think, would I forgive myself for infecting this person? If its you caring for your child, (a) there is no one else/better to do that and (b) they are unlikely to fall extremely ill. That risk/benefit makes sense. If you are visiting your elderly parents, you are (a) increasing their risk, and (b) can likely find other ways to interact with them (unless you are the primary caregiver). So that risk/benefit may not make sense. But every circumstance is individual, just think it through.

8. How do I know I have or had it?

You don't. There are not enough tests yet to determine this.

Calling to get testing is not necessary for your health as there is no treatment for it besides staying in bed and hydrating. If you have been exposed or recently travelled, you call MDA and they will tell you if you qualify for the testing that is being done sake of public health tracking. If you are sick enough to feel that it is difficult to breathe, that is when you will need to be seen.

9. What is the true mortality rate?

We don't know right now. That number depends on the resources of the country and also on how widespread the testing is. What we do know is that if only 60% of the world catches it, and just 1% die, thats 50 million people dead, and many more hospitalized.

The mortality rate is not in a vacuum, it depends how conscientious we are about social distancing, how much we succeed in slowing the spread of the virus. "Two weeks ago, Italy had 322 confirmed cases of the coronavirus... One week ago, Italy had 2,502 cases of COVID-19... Today, Italy has 10,149 cases of the coronavirus. There are now simply too many patients for each one of them to receive adequate care. Doctors and nurses are unable to tend everybody. They lack machines to ventilate all those gasping for air."


The dire measures imposed by the government are because slowing it enough to keep the healthcare system is our only hope and containing the disaster.

10. When will it pass?

No one knows, of course. But we do have some countries "ahead" of us in time with this epidemic to take cues from. Since the numbers increase exponentially, if we continue with our social interactions, the numbers show we are 1 - 2 weeks from the medical warzone that Italy has become. If we separate now, we may be able to reduce the spread like South Korea and China have succeeded in doing.

It may be months like this, hard to say, because we are waiting on the hard work of our scientists to find a vaccine or treatment -- relying on genius, or a miracle.

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