• Natalie Nicole Wilson

Spread Facts, Not Fear

Updated: Apr 3, 2020


Welcome to my COVID-19 Q&A! I have answered these questions, hopefully, in a way that can be understood by EVERYONE! Please know that these answers are based on evidence and if there isn’t enough to answer a question, I state that. I will attach links for reference. I also have to mention that this article is not associated with that of my colleagues or institution I am working at.

1. What is the Corona Virus and where did it come from?

Coronavirus has actually been around for some time. This is not a new virus. You may remember SARS-CoV, severe acute respiratory syndrome coronavirus, and MERS-CoV, Middle East respiratory syndrome coronavirus, as the last coronavirus outbreaks to have caused elevated death rates. COVID-19 is a new strain of coronavirus first diagnosed in a human in December of 2019 in China. The disease COVID-19 is the result of the virus known as the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). At this time, it is believed that COVID-19 was transmitted from animal to human, possibly a bat. So, where did coronavirus get its name? Well, corona means crown in Spanish, and it is said that the virus looks like a crown under the microscope. COVID-19 has now been found in people all over the world, making it a pandemic. Think of it like this, you know how there are numerous strains of influenza? Some years, the year of H1N1, it seems to be more serious than others. COVID-19 is the H1N1 of the coronavirus.


2. How does the virus spread?

COVID-19 is mainly spread from person to person through respiratory droplets from coughs or sneezes and close contact with others where their respiratory droplets are landing in your mouth or being ingested through your nose. Less commonly, the virus can be spread from touching contaminated surfaces and then touching your mouth, nose, and eyes.


3. Can COVID-19 live on surfaces?

Studies are still being done to answer this question; however, studies suggest that the coronavirus can remain infectious on inanimate, or nonliving, objects for hours up to 9 days depending on the conditions and type of surface. This can contribute to the spreading of coronavirus but is not thought to be the main form of transmission.


4. What are the signs and symptoms of COVID-19?

The symptoms range from mild to severe. The incubation period of COVID-19, which is the time in which an individual is infected to the time one manifests, or shows, symptoms, is said to be 2-14 days. During the first cases of COVID-19, most people had a fever, shortness of breath, and a dry cough. As we learn more about this virus, we are seeing a broad range of symptoms including but not limited to, fever, chills, body aches, fatigue, shortness of breath, chest tightness, cough, headache, sore throat, and less common, GI upset (nausea, vomiting, and/or diarrhea). Recently doctors have reported their COVID-19 patients complaining of loss or change in smell or taste, which has been seen in other coronaviruses as well. Really, no symptoms can be ignored at this time. How severe one's symptoms have become is really what's key. When in doubt, if you have these symptoms, treat yourself as being COVID-19 positive and take the necessary precautions.


5. Can COVID-19 be spread if you are not feeling sick?

Yes, it can. This is another reason why remaining 6 feet away from others and self-isolating is so important. A large percent of the population will have coronavirus and have mild symptoms or no symptoms at all. In this case, you may still be spreading it to others. With that being said, you are most contagious when you are most symptomatic or showing symptoms.


6. Can I have corona more than once?

Of course, you can! Just as you can get the flu more than once, you can get the coronavirus more than once. It is thought that when one is exposed to COVID-19, you build up some immunity and antibodies for future exposures to that particular strain; however, we are unaware as to how many actual strains are out there as it is possibly mutating, or modifying and changing.


7. Will this virus die in warmer weather?

This is hard to say, and I would not count on it. The virus has only been around since December and in said cold months; however, we are seeing the disease spread in warmer countries at this time. Hopefully, in the following weeks and as it warms up we will have more information regarding this question.


8. What should I do if I become infected by COVID-19 or think that I am infected?

STAY HOME!! I know you are probably tired of hearing those two words, but I cannot explain how important it is for you to JUST.STAY.HOME. As I'm sure you have read, there is no cure for COVID-19 at this time. The only thing we can offer you is symptom management, and if your symptoms are manageable from home, we will send you right back into quarantine. But, it's way more than just that. When you come into the emergency department, you are putting everyone at risk. If you don't already have COVID-19, you just walked into a hot zone where you very well could now contract the virus. If you do have the virus, we will not be testing you, as most ERs are not testing at this time, and you are putting other patients in the hospital at risk. Although it may seem that the only disease being seen at this time is COVID-19, this is not the case. There are still emergencies walking through our doors from oncology patients, dialysis patients, congestive heart failure and chronic obstructive pulmonary disease patients, to many other immunocompromised populations. The emergency department is for those who need emergent intervention, and although you feel like now is the time to address your chronic heartburn, I assure you now is not the time. Along with putting yourself and others at risk, you are using up PPE and hospital resources that need to be reserved for those in critical condition. With that being said, you know your body, and if you feel like you are struggling to breathe, experiencing chest pain, having stroke-like symptoms, or find yourself with any other emergent symptoms, call 911 or get to your closest ER. We are 24/7, 7 days a week and happy to serve you the best way that we can!


9. Should I wear a mask? Should I wear gloves?

If you are not currently experiencing symptoms or taking care of someone with symptoms, wearing a mask is of little benefit to you. This is not effective in preventing the general public from contracting COVID-19. Most importantly, our health care providers do not have the protective attire that they need at this time. These masks need to be reserved for healthcare staff actively taking care of COVID-19 patients and for those already infected with the virus. Secondly, people are not wearing these masks appropriately, offering yourself a false sense of security from the virus. We as medical professionals have been trained on how to appropriately wear and dispose of these masks. You are potentially spreading more germs. Thirdly, your medical professionals go through annual fittings for the N95 masks. Without properly being fitted, you cannot assume it is the appropriate mask for your face and filtering appropriately.

However, if you are an immunocompromised patient and have been advised by your doctor to wear a mask, please follow their guidance!


Now, let’s talk about gloves. When you wear gloves, they are now acting as your hands. When you touch everything in the grocery store and then answer a call on your cell phone or scratch that itch on your face or TOUCH someone else, YOU‘RE STILL SPREADING. Don’t wear gloves, just wash your hands and avoid touching your face.


10. Why can’t anyone be tested?

Unfortunately, this is not feasible at this time. With the limited tests available, we have to ultimately prioritize the most serious and potentially worse outcome patients first. If you believe that you have COVID-19 and feel that you should be tested, call your primary care provider or the COVID-19 hotline for further guidance.


11. Who are ”high risk“ patients?

We are ALL at risk of getting COVID-19. Those with heightened risk include adults 60 years or older, people with other health conditions, asthma patients, pregnant women, and all immunocompromised populations.


12. What steps can I take to avoid becoming ill?

- Stay at home and follow your city/town regulations.

- 6 feet distance rule

- Wash your hands for at least 20 seconds with soap and water and keep fingernails short and clean

- Use a hand sanitizer that is at least 60% alcohol; however, this should never take the place of handwashing

- Clean your home surfaces with EPA approved household disinfectants


13. Should I worry about my pet getting COVID-19?

Per CDC, there is no evidence on this topic. If you become sick with COVID-19, it‘s best to restrict contact with your furry friends, although there have been no reports of dogs and cats with COVID-19. It is also very unlikely that petting yours/other pets is a means of spreading the virus but still possible.


14. Is there a cure for COVID-19? Is there a vaccine for COVID-19?

No and no. There are people working around the clock to make this a possibility in our future.


15. What precautions are COVID-19 for healthcare workers?

If you are caring for patients with or suspected COVID-19, the patient should technically be on droplet precautions as the virus is spread through respiratory droplets. This means surgical masks can be worn as long as the patient is not undergoing any aerosol-generating, or airborne particle producing procedures. Once airborne, the infectious virus may remain in the air for up to three hours. Aerosol procedures include but are not limited to nebulizer treatments, intubations, tracheostomy, etc. During these procedures, medical staff should wear N95 respirators. This should be accompanied by a waterproof isolation gown, eye protection or shield, gloves, and hair protection.


16. Should I avoid Ibuprofen?

This is not clinically proven at this time. Discuss this topic with your doctor if you have concerns regarding NSAIDs vs Tylenol. Depending on your medical conditions, talking with your doctor is your safest option. In the meantime, read your labels and don’t exceed daily dosing recommendations.


17. What does “flatten the curve” mean?

You may have heard the phrase “flatten the curve” used in the media or by healthcare professionals. So, what does this mean and how can we help? This does not aim to eradicate the disease, although that would be nice, it‘s to delay the peak of the COVID-19 outbreak. This is SO crucial for our hospitals. If we have one huge influx of patients at one time, there is a huge possibility and fear that we may not be able to treat every patient needing emergent care due to a lack of resources and medical personnel. This is quite possibly the scariest scenario, and we are actively seeing this in Italy where they are prioritizing treating those with the best possible outcome. This means people who need intubation, ICU beds, and life-saving interventions are NOT receiving them, because the hospitals simply aren't able to meet these needs. We hope to not get to that point. This is not a scare tactic, this is fact. If we “flatten the curve” this is biding hospitals and our country time. Time to get more PPE, get more staff, and ventilators and other equipment needed before the next influx of patients' role in. So, do your part. STAY HOME and let’s flatten the curve.


18. What can I do to help others?

There are numerous things you can do to support others! Besides staying home, make sure you call and check on your friends and family. This is a very difficult time for EVERYONE. If the pandemic is not scary enough, there are people suffering financially and emotionally. Check on them. People struggling with mental health may not have the resources that they typically have, such as counseling, small groups, and interaction with others. Even your strongest friends and family, send them your love and positive words. -Another thing you can do is spread positivity and factual information, but don’t obsess over it. Checking in a couple of times a day to stay informed is fine, but try not to sit in front if your television all day long. It’s not healthy.

-Protect our elderly and immunocompromised populations. With the resources we have, there should be no reason for our elderly and immunocompromised to be out and about getting groceries, etc.. they may not know about the resources available. Help them out by shopping for them or teaching them about delivery options.

-TIP WELL! If you are getting deliveries or take out of any kind, tip them well for helping your community out.

-If you are able, support your small business by purchasing gift cards for future shopping!

-DONATE BLOOD! There is a nationwide blood shortage.

-Stop hoarding. There is no excuse and no need for elaboration.


19. Pregnancy and COVID-19

Very little is known about COVID-19 and pregnancy; however, I did come across some information provided by The American Journal of Obstetrics and Gynecology that pregnant mommas may appreciate, as pregnant women and their fetuses already pose as a vulnerable population without the stress of COVID-19. Although the information on the virus is ever-evolving, a recent article posted by AJOG suggests that there has not been a major impact on pregnancy seen thus far. Most pregnancy COVID-19 cases have been seen in late pregnancy or the third trimester. Due to the physiological and mechanical changes of pregnancy, mothers should take the standard COVID-19 precautions and pay special attention to symptoms that could mask the virus. It's ok to be extra cautious when experiencing symptoms in pregnancy, no matter how "common" they are said to be, during such an uncertain time. AJOG expresses concern for the following symptoms in pregnancy that may mask the virus if the mother is exposed to COVID-19 - gestation rhinitis is a common pregnancy condition affecting approximately 18 and 42 percent of pregnant women most commonly in the first and third trimester. Symptoms include nasal congestion and discharge from the nasal cavity, leading to viral shedding and community transmission that could potentially be viral. Due to how common this is in pregnancy, it could be overlooked and ruled as a pregnancy side effect. Also mentioned in this article, slight dyspnea in pregnancy is common due to increased maternal oxygen demands. This needs to be distinguished from breathlessness in potential COVID-19 pregnant patients. Don't apologize for being extra cautious, make those phone calls, and take care of yourself and that baby!


20. Can I pass COVID-19 to my fetus?

As of now, No! Two neonates out of 46 neonates from COVID-19 infected mothers have tested positive for the virus shortly following delivery raising concerns for vertical transmission; however, there is NO convincing evidence supporting the possibility of vertical transmission of COVID-19 from mom to baby at this time. The two positive neonates were not tested immediately following birth.

21. Can I still have a vaginal delivery?

Vaginal delivery is not contraindicated, at this time. Always consult your doctor regarding your birth plan.


22. Can I breastfeed if I had/have COVID-19?

Yes! According to research thus far, breastfeeding is not contraindicated with COVID-19 mothers. Of the mothers found to have COVID-19, none had detectable viral loads of SARS-CoV-2, the virus that causes COVID-19, in their breast milk. There was also an absence of viral isolates in the amniotic fluid and cord blood. However, if you have been exposed or have COVID-19, you are advised to wear a mask while breastfeeding/handling your infant and continue good hand hygiene. Your infant should also remain isolated from others while under investigation for the virus.


23. Is it safe to have sex during this pandemic?

Just to note, the virus has been found in feces and vaginal secretions. If you are concerned about HAVING the virus, I would recommend not partaking in sexual intercourse as it most likely includes heavy breathing and spreading of respiratory droplets. Plus, you are not following the 6 ft rule.


24. Is it true that children are immune to the virus?

This is very FALSE, children can absolutely get COVID-19. Thankfully, the majority of children are showing to have very mild symptoms; however, children are still carrying and spreading the virus. It is important to educate children on how to protect themselves from the virus with good handwashing techniques and social distancing. There have been several reports across the world of children transmitting the virus to grandparents, parents, etc. Keep your precious ones home!


Please feel free to share this information, and stay tuned for updates in the coming weeks!


Natalie Wilson, Emergency Department RN, BSN


Disinfectants

Surface Contamination

CDC

WHO

Johns Hopkins

The American College of Obstetricians and Gynecologists

American Journal of Obstetrics&Gynecology




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