In 2011, there was a movie released called “Contagion.” It starred Matt Damon and Gwyneth Paltrow and had (in my opinion) a particularly wonderful performance by Jude Law. The movie came out when I was in residency and I had the opportunity to ask several of the Infectious Disease doctors at the hospital I worked at if they’d seen it. Many of them had, and actually enjoyed it. The thing that may have been the most accurately depicted aspect of the movie was its tagline: “Nothing Spreads Like Fear.”
Now, statistically, things like the Wuhan coronavirus outbreak of 2020 and the Ebola virus outbreak of 2015 are incredibly unlikely to affect anybody reading this (there have been more Americans married to Kim Kardashian than have died of the Ebola virus) (no, really, that’s an actual mathematical fact). Still though, I get why people are captivated by virus outbreaks. I understand and completely appreciate the dread fascination with virus outbreaks because I am, myself, rather entranced by them as well. I certainly understand people wanting more information. So, let’s talk about coronavirus.
What is coronavirus?
Let’s get this out of the way right now—you’ve probably had a coronavirus before, and if you’re reading this you almost certainly lived to tell the tale. Coronavirus is estimated to cause between 5-10% of all respiratory infections, and between 15-30% of common colds. In other words, with as many colds as you’ve likely had in your life, it’s very probable that at one point or another you’ve had a coronavirus.
It is worth noting that coronavirus has been rather challenging to study; it’s very difficult to get coronavirus to grow and replicate in tissue culture. Until recently, it was hard to even test for, but fortunately we’ve come up with specific tests now that can search for individual types of coronavirus by looking for the virus’ DNA profile (well, actually RNA profile, but whatever).
Here’s the thing, though: There are many different strains of coronaviruses out there and they all have distinct profiles that our tests look for. If you go into an Urgent Care, they can run something called a viral filmarray, a really cool test that will look for all sorts of viruses that might be infecting your respiratory tract (which, by the way, can include anything from your nose all the way down to the end point of your lungs called your alveoli).
The filmarray panel includes, among other things, a test that looks for coronavirus 229E, HKU1, NL63, and OC43, which are just four of the possible versions of coronavirus that can give you a respiratory tract infection. It’s important to note that none of these are the Wuhan coronavirus—they’re just different kinds of coronaviruses that cause respiratory tract infections.
The Wuhan coronavirus, which has been formally named the 2019 Novel Coronavirus (2019-nCoV), not surprisingly, is different. For reasons we’re not sure about, the Wuhan Coronavirus has greater potential to cause pneumonia and other significant complications which can include, yes, death. Is this likely? Absolutely not. Is it still scary? Of course it is. Anytime there’s the idea of a virus floating around that seemingly indiscriminately kills some people but not others, it’s very scary.
How does coronavirus spread?
Here’s what we know about the coronavirus family, which includes Wuhan coronavirus:
- Coronavirus appears to spread through self-inoculation. What that means is if you get coronavirus on your hands and you wipe your nose, that’s how the virus gets into your body. Coronavirus also appears to be transmitted through large water droplets that you can get on your hands. As near as we can tell, if you don’t want to get any coronavirus (and why would you?), make sure you wash your hands.
- Coronavirus is enveloped, meaning the virus has coating on the outside of it. As it happens, the envelope means that the virus doesn’t survive well outside of the body—they usually can’t last longer than 24 hours outside of the body and usually only last less than 12. This is a good thing in terms of containing an outbreak. It also means coronavirus can be killed by hand sanitizer and soaps, which isn’t the case with other types of virus (most notoriously norovirus), so your biggest defense against coronavirus is washing your hands. The problem with viral envelopes is that they allow the virus to more easily evade your immune system. So, the enveloped virus has a disadvantage outside of a person, but once it gets in, the envelope gives it a dangerous edge. Enveloped viruses (which include influenza) tend to cause longer, more problematic infections for this reason and are more difficult to develop a vaccine for because of the envelope.
- Coronavirus doesn’t appear to be airborne. This is very much a good thing. Some viruses can be transmitted easily by aerosolized water droplets; influenza is one of these. The flu is so good at transmitting itself this way that people with the flu can put infectious water droplets in the air by simply breathing quietly or talking. As far as we can tell, coronavirus doesn’t do this. So, while the HazMat suit on people looks impressive, it’s probably not necessary. How would you feel if your doctor walked in to examine you with a HazMat suit on when they didn’t really need one? Remember, nothing spreads like fear.
- People with coronavirus are shedding virus during the incubation period. If you aren’t familiar with these terms, let me explain. Shedding virus is the fancy medical way of saying, “You’re contagious.” Basically, if you’re shedding virus, you’re putting it out in the environment for other people to catch. The incubation phase is when the virus is replicating in your body, but you’re not having any symptoms yet. So, yes, people with the virus can be contagious even when they don’t have any coronavirus symptoms.
- We’ve seen this before. Do you remember SARS? SARS stands for Severe Acute Respiratory Syndrome, but really SARS was a specific strain of coronavirus. There was an outbreak in 2003, and according to the World Heath Organization, 8,098 people were infected and 774 of them died. Those are very striking statistics; a virus that kills 1 in 10 people who get it is certainly very noteworthy and scary. SARS has a cousin, MERS (Middle East Respiratory Syndrome), which isn’t as deadly but is also a coronavirus.
The point is that while some strains of coronavirus certainly are deadly—again, 774 people died in the SARS ’03 outbreak—the outbreaks are relatively well-contained. If you’ve had a travel contact from China or you yourself have been to China and you’re feeling ill, best to go get checked out. We can do our part to contain the outbreak and we can test for this specifically, but it’s important to note that the Wuhan coronavirus won’t be on a regular filmarray panel. A sample will have to be sent off to the CDC to test for it and you’ll get the results back in 48-72 hours, most likely.
I can absolutely understand why people get scared by these things because outbreaks of disease from foreign lands are very captivating. That said, I wouldn’t be doing my job if I didn’t point out one other thing: you are far, far, far more likely to have a serious complication due to influenza. The flu is more easily transmitted and is all over the United States…and has already, in the flu season of 2019-20, killed an estimated 8,200 people. So please get your flu shot because we’re currently right in the middle of flu season and it can still benefit you.
Coronavirus outbreaks captivate people, but it’s fairly unlikely this outbreak will affect you. If you do find yourself with a respiratory infection and you have difficulty breathing, get to a medical provider right away to be evaluated. If you know you have a chronic lung disease and you feel a respiratory infection coming on, get to a medical provider to be evaluated. If you are diagnosed with a respiratory tract infection, keep a close eye on your breathing and stay away from people who shouldn’t be around one—kids, the elderly, and especially immunocompromised people.
Hand washing and common sense go a really long way here and remember, fear spreads farther and faster than coronavirus does. If you have to travel, make sure you stay as healthy as you can while you’re away. We’ll be here if you need us when you get back.
The expert family medicine providers at the Des Moines University Clinic are here to help you and your loved ones stay healthy year round. If you or your family have cold and flu symptoms, make an appointment with us by visiting the DMU Clinic website or calling 515-271-1710.