What is COVID-19 and what should a person with symptoms do?

As number of new coronavirus cases rises worldwide, experts say death rate may turn out to be similar to seasonal flu, urge good hygiene to help prevent the pathogen’s spread

This undated electron microscope image made available by the US National Institutes of Health in February 2020 shows the Novel Coronavirus SARS-CoV-2. Also known as 2019-nCoV, the virus causes COVID-19. (NIAID-RML via AP)
This undated electron microscope image made available by the US National Institutes of Health in February 2020 shows the Novel Coronavirus SARS-CoV-2. Also known as 2019-nCoV, the virus causes COVID-19. (NIAID-RML via AP)

The global spread of infection from the coronavirus reached a critical stage this week with the number of new cases reported in the rest of the world surpassing the number of new cases in China, where the emergency began.

Reflecting how tourism and business travel unite the planet, Antarctica is the only continent with no reported cases of the illness COVID-19. Troubling outbreaks in South Korea, Japan, Italy and Iran have seeded cases elsewhere as travelers bring the virus home with them.

There have been seven confirmed cases of the virus in Israel. Three of the people contracted the virus after returning from Italy, while three others who tested positive were on a cruise ship quarantined off Japan due to an outbreak of the virus onboard. The last case is the wife of one of the infected Israelis who was in Italy.

With the world at a tipping point, there was hopeful new evidence from China showing that containment is possible. And as more mild cases are counted, experts said, the death rate may be more like seasonal flu than like previous new coronavirus outbreaks.

Here’s what you should know about the illness:

What is a coronavirus and what is COVID-19?

Coronaviruses are a group of viruses that can infect humans or animals. They can cause respiratory tract infections among humans, such as the common cold. However, they can also be lethal, such as the Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS).

COVID-19 is the disease caused by the new coronavirus that was previously unknown before emerging in December 2019. It is believed to have originated with animals and spread to humans at a live animal market in the central Chinese city of Wuhan.

People gather outside the Wuhan Huanan Wholesale Seafood Market, where a number of people related to the market fell ill with a virus in Wuhan, China, January 21, 2020. (AP Photo/Dake Kang)

What are the symptoms and how does it spread?

The main symptoms of the virus are fever, tiredness and coughing. According to the World Health Organization, other symptoms include aching, nasal congestion, runny nose, sore throat and diarrhea.

There have been confirmed cases of person-to-person transmission of the virus, including one in Israel. The WHO says the virus “can spread from person to person through small droplets from the nose or mouth which are spread when a person with COVID-19 coughs or exhales.”

What should someone who has symptoms of the virus do?

The Israeli Health Ministry has issued instructions that anyone showing symptoms of the virus should contact the Magen David Adom ambulance service, and not a hospital or health clinic.

“If needed a paramedic will come to your home for laboratory tests and continued treatment, in accordance with the doctor’s decision,” the ministry’s website says.

The ministry has also ordered anyone who was in close proximity to one of the infected Israelis to home quarantine for 14 days, as well as anyone who recently returned from China, Hong Kong, Thailand, Singapore, Macau, South Korea, Japan or Italy.

Those under home quarantine must report this to the Health Ministry.

An ambulance carrying an Israeli who was diagnosed with the coronavirus arrives at Sheba Medical Center in Tel Hashomer on February 28, 2020. (Jack Guez/AFP)

What do we know about the death rate?

The death rate from COVID-19 was 1.4% in the latest report from Chinese health officials on 1,099 patients with confirmed disease at more than 500 hospitals throughout China.

The report, published Friday by the New England Journal of Medicine, gives a much broader view of the outbreak beyond Wuhan, where it started and has been most severe.

Assuming there are many more cases with no or very mild symptoms, “the case fatality rate may be considerably less than 1%,” US health officials wrote in an editorial in the journal.

That would make the new virus more like a severe seasonal flu than a disease similar to its genetic cousins SARS or MERS.

Given the ease of spread, however, the virus could gain footholds around the world and many could die.

And the report by National Health Commission of China scientists shows how easy it is for many cases to be missed early on: 44% of these patients had fever when they were admitted to the hospital, but 89% ultimately developed it. Severe illness developed in 16% after hospital admission.

About 5% were treated in an intensive care unit and 2.3% needed machines to help them breathe.

South Korean soldiers wearing protective gear spray disinfectant as part of preventive measures against the spread of the COVID-19 coronavirus, at Dongdaegu railway station in Daegu, on February 29, 2020. (Yonhap/AFP)

Is containment possible?

World Health Organization chief Tedros Adhanom Ghebreyesus suggests that countries with few cases can take aggressive action now to prevent its spread.

He takes heart that in China’s Guangdong province, where scientists tested more than 320,000 people, and only 0.14% were positive for COVID-19.

UN Secretary-General Antonio Guterres said “we know containment is possible, but the window of opportunity is narrowing.” He urged governments on Friday to do everything possible to contain the disease while also respecting human rights.

Who’s most at risk from COVID-19?

Older people, especially those with chronic illnesses such as heart or lung diseases, are more at risk.

The Chinese study released Friday found that less than 1% of hospitalized patients were younger than 15 years old, while 42% were 65 and older.

People wearing masks, attend a vigil for Chinese doctor Li Wenliang, in Hong Kong, February 7, 2020. (AP Photo/Kin Cheung)

Deaths also are rarer among younger people. But some young deaths have made headlines, such as the 34-year-old doctor in China who was reprimanded by communist authorities for sounding an early alarm about the virus only to later succumb to it.

In China, 80% of patients are mildly ill when the virus is detected, compared with 13% who already are severely ill. While the sickest to start with are at highest risk of death, a fraction of the mildly ill do go on to die — for unknown reasons.

On average, however, the WHO says people with mild cases recover in about two weeks, while those who are sicker can take anywhere from three to six weeks.

How can people prevent infection?

There’s no vaccine, although researchers are working on it. For now, the best way to prevent infection is hand washing, cleaning surfaces with regular household sprays and wipes, and avoiding close contact with people who are sick. The virus spreads mostly through droplets from coughs and sneezes.

Staying home when you are sick is recommended every flu season, but may be especially important now.

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