What You Need to Know Now About COVID-19

A Q&A with Emergency Medicine Physician, Dr. Zachary Levine.

What exactly is the Coronavirus (COVID-19)? 

Coronaviruses (CoV) are actually a family of viruses. These illnesses range from the common cold to more severe diseases like MERS-CoV (Middle East Respiratory Syndrome) and SARS-CoV (Severe Acute Respiratory Syndrome)The one we’re currently experiencing, COVID-19 (Corona Virus Disease 2019) is a new strain that has never before been identified in humans, and every day we’re learning more about it.  

Where did COVID-19 come from? 

It originated in a market in Wuhan, China where live animals are sold. Coronaviruses are considered zoonotic, meaning they’re transmissible from animals to people. COVID19 seems to have come from bats, spread to chickensthen to humans, and spread from there. 

Who is most at risk for COVID-19? 

Like any infection or disease, those most at risk are older people and those with existing illnesses such as cardiopulmonary issues or weakened immune systemsWhen we look at who caught the virus in China, two-thirds of those who tested positive were male with a median age of 45. It seems to have affected older adults and men more than young people and womenbut we don’t yet know why or if that will continue to remain the case. 

How long is the incubation period of the virus? 

It seems to be 2-10 days, but out of caution we’re saying 14 daysPeople who have traveled and come back are being advised to selfquarantine for 14 days because those infected may not develop symptoms for 10-14 days. During this time, they are still infectious which is very worrying because people may be spreading the virus without knowing. 

How is COVID-19 different from the flu, and can a flu vaccine prevent someone from catching it? 

Influenza (the flu) and COVID-19 are both viral infections, but the flu is different kind of virus with different symptoms. Symptoms of COVID-19 generally include fever, cough, and shortness of breath. While someone experiencing influenza will mostly likely experience body and muscle aches, sore throatchills, and sometimes vomiting and diarrhea. 

In terms of vaccines, we know that the flu is coming every year and we have vaccines and treatments that are somewhat effectiveI always recommend a flu vaccine to my patients. But, because COVID-19 is new, there is currently no treatment or vaccine against it. 

How does COVID-19 spread? 

It seems to be spread by droplets, which distinguishes them from airborne viruses. If someone sneezes or coughs directly on you then you can become infected, but droplets don’t stick around in the air. They fall on a surface or on your hand, then spread to things you touch like doorknobs. If someone touches an infected surface, the virus doesn’t enter the body through their skin but through their nose, eyes, or mouthMost people don’t realize how often they touch their face! 

What are the symptoms of COVID-19 and how would I know if I had it?  

Symptoms of COVID-19 are generally fever, coughand shortness of breath. If you’ve traveled to a region or been in contact with someone who has it, and then you have flu-like symptoms that include shortness of breath, you should reach out to your physicianDifferent states and provinces have phone numbers you can call about how to proceed. Most people will be fine and won’t even need to go to the hospital. For doctors like me, there’s a fear that everyone will come to a waiting room and then easily infect a whole room of already ill people. So, if your area has instructions on where to go with an isolation room, that is ideal, especially if you’re not that sick. 

Should I be wearing a surgical mask to prevent catching the virus? 

Right now, my recommendation is that you should not be wearing a mask to prevent catching COVID-19. 

Those typical paper masks you see around are more helpful for people who already have symptoms like coughs or sneezing and then only in combination with alcohol-based hand sanitizers and good handwashing. Sure, they may prevent a sick person from infecting you, but they’re unlikely to prevent you from catching the virus. Also, most masks get damp after 20 min and really aren’t meant to be worn for a long period of time. Healthcare professionals like myself are using N95 masks that have been properly fitted to our face. I know exactly what size and make I need. Those paper masks you buy online don’t have a proper seal and tiny particles can get in.

What can I do day-to-day to prevent catching COVID-19? 

Wash your hands often with soap and water for at least 20 secondsavoid touching your face, and clean and disinfect oftentouched surfaces like tables, doorknobs, and toilets. Also, stay away from sick people. If you’re sick yourself, stay home! It’s your responsibility as a good world citizen to avoid spreading it to others, especially to those who are immune suppressed. Cough into your sleeve, or use a tissue, throw it in the trash, then wash your hands. There’s not enough evidence to say that hand sanitizers are 100% effective but we know they do help. Be sure to check the ingredients. They should have 60% alcohol to be most effective. 

What is the treatment for the Coronavirus? 

There is no specific antiviral treatment yet, but they are certainly working on it. For now, health professionals are treating symptoms like fever, dehydration via fluids, and then the healthy immune system will mount an immune response to rid the body of the infection. Shortness of breath is one of the biggest complications and we treat this with different levels of oxygen. If they’re still having trouble we give them breathing support administered through a face or nasal mask. If that isn’t working, they might get a breathing tubeThings become very serious when we simply can’t catch up, there’s respiratory failure, and their lungs fail them. Very low blood pressure and high fever can cause sepsis or organ failure. This and respiratory failure that can cause death. 

Can you offer some tips on how to prevent catching the virus while traveling? 

Unfortunately traveling is a good place to catch infections because there are so many people around us.  

Think about where you’re going, its changing every day, look out for travel advisories. Centers for Disease Control and World Health Organization (WHO) are good sources for travel information. They update how many cases of the virus are in each place. While traveling, the same prevention practices apply as at home. Be aware. Be careful touching surfaces, don’t touch your face, bring hand sanitizer with you, and, if possible, keep a distance from symptomatic people. If you’re sitting on a plane next to a sick person, it’s acceptable to ask to move. 

Where is the best place to get updates on the virus?  

I recommend reliable sources like Centers for Disease Control, WHO, public health agencies such as PHAC, as well as bona fide medical schools. Be suspicious of any source that is selling you something!

Dr. Zach Levine is an emergency medicine physician at McGill University Health Centre and Associate Professor at McGill University’s Faculty of Medicine. Dr. Zach is passionate about educating people about their health and empowering them to take control of it. He appears regularly on television, radio, and print.