The pandemic is worsening. It is important for everyone to do their part. We can fight this virus with knowledge. It is important to understand exactly what the novel coronavirus is, it’s symptoms, the most common tests to make a diagnosis, the evolution of treatment, what’s the best way we can avoid getting infected and what we should do if we are exposed.
An infection with COVID-19 can be a real threat to our well being. COVID-19 stands for corona virus disease in 2019.
This novel coronavirus virus was first detected in China in late 2019 and became a pandemic in 2020.
Most commonly, it is spread from one person to another through respiratory droplets.
These droplets come into contact with mucosa in our nasal cavity or our mouth and can infect us.
The most common symptoms are fevers, muscle aches, a runny nose and a cough.
The loss of taste and smell are observed in most patients. Many patients also have low oxygen levels in the blood.
The decreased oxygenation is in part due to the destruction of the wall of the air sacs in your lungs (alveoli). You can also have nausea, vomiting and diarrhea yet those gastrointestinal symptoms are less common. The illness can last weeks or even months. These array of more severe symptoms comprise 20% of the patients who get infected.
Patients can also be asymptomatic or have few symptoms.
An individual can have the virus in their nasal cavity and be a vector or spreader of COVID-19 without ever knowing they have it. An individual can also have a runny nose and a slight cough as if they have a mild cold. Approximately 80% of infected people fall into this category.
This viral infection can be lethal. 244,000 Americans have died of COVID-19. If the upper respiratory infection is severe, the alveoli fill with fluid. It becomes more difficult to exchange oxygen for carbon dioxide. Patients develop a chest X-ray with diffuse infiltrates in the lungs. It is called ARDS. As it becomes more difficult to absorb oxygen some patients require a ventilator.
Once an individual gets infected with COVID-19, our blood tends to clot more easily. This has lead to sudden deaths due to large clots going to the lungs. Clots can also form elsewhere. Clots in the blood vessels in the heart can cause a heart attack, blood clots in the brain can cause strokes and clots in the kidneys can cause renal failure.
The diagnosis of COVID-19 has improved over time but is not perfect. The rapid nasal swab tests have a false negative rate. Therefore in the hospital, patients will get a second test that takes two to three days to get a result. This is considered the more accurate test.
The treatment of COVID-19 has improved. The mortality is now lower than it was in March.
There are many reasons. We understand the disease process more. Patients are being kept off ventilators as long as possible. There are now medicines to help decrease the severity of an infection.
Antibodies to COVID-19 from the plasma of previously infected patients has also been proven to work. One of the most effective ways to prevent the blood clots from harming or even killing patients is by thinning the blood with aspirin if the patient has a mild case not requiring hospitalization. If the patient is ill enough to come into the hospital, a low dose heparin shot is given once or twice a day to prevent blood clots.
Presently the pandemic continues to worsen. We all need to stay vigilant. We need to wear masks every time we leave the house. We need to not gather in groups larger than 10. This means we all need to re-think Thanksgiving and Christmas. We need to wash our hands often. We should not shake hands.
If we are in close contact with someone with the coronavirus, we should quarantine for 14 days. A test should be done in five days after the exposure. At anytime in the course of a COVID-19 quarantine, if you become very ill, go to the nearest emergency room. Let them know immediately you have been exposed to the novel coronavirus.
Together we will get through this. Check the CDC website (cdc.gov/coronavirus/2019) for any questions.
Do not hesitate to call your doctor especially if you become sick. There is a vaccine on the horizon yet we still need to be cautious.
It is still months away. Let’s all wear masks for our own health, our family’s health and our neighbor’s health.
Gregory Jarrin, MD is a medical doctor practicing in Whiteriver. He can be reached via email at GregoryJarrin@icloud.com