Coronavirus: Expert Provides a Guide to Common QuestionsMarch 6, 2020
In this Q&A, PCOM Georgia faculty member Valerie Cadet, PhD, explains what coronavirus
is, how it spreads, preventive measures and more.
Valerie E. Cadet, PhD, an associate professor of pathology, microbiology, immunology and forensic medicine,
works to educate PCOM Georgia students and the general public about respiratory pathogens and emerging infections,
in addition to other aspects of health, infection and immunity. She teaches students
in PCOM Georgia’s Doctor of Osteopathic Medicine program and in the Masters of Biomedical Sciences program.
Dr. Cadet is a graduate of the University of Georgia College of Veterinary Medicine
where she earned her PhD in infectious diseases studying the basic virology and immunology
Considering herself a guide to point people to the Centers for Disease Control and
Prevention (CDC) and the World Health Organization (WHO) for updated information,
Dr. Cadet recently appeared on an Atlanta news station as a subject matter expert
on the coronavirus. This Q & A contains her answers to the questions most concerning
What is the coronavirus?
This virus, which originated in China and is causing illness across the globe, is
a member of the virus family Coronaviridae. Most viruses in that family come from
animals, including camels, cattle, cats and bats. Coronaviruses infecting animals
can evolve and gain the ability to cause human disease. People around the world commonly
become infected with human coronaviruses, experiencing a mild respiratory infection
in most cases. With the SARS-CoV outbreak of 2002 and 2003, for the first time, we
saw a new coronavirus that could spread between people and caused a severe acute respiratory
illness and also some deaths. Again, in 2012, another new coronavirus called MERS-CoV
emerged causing serious illness in humans.
This virus, named SARS-CoV-2, causing the disease called COVID-19, is different from
SARS and MERS in key ways, however, all most likely originated from bats, mingled
with animal coronaviruses and gained the ability to transmit to humans, though extensive
research is needed to confirm its origin.
How contagious is it? How does it spread?
Many of the early identified patients in Wuhan, China had some link to a particular
seafood and live animal market, suggesting that is where the infection may have originated.
As the number of cases grew, however, patients reported no exposure to that market,
indicating that person-to-person spread was occurring.
As with other respiratory viruses, such as influenza for instance, this person-to-person
spread happens via respiratory droplets produced when an infected person sneezes or
coughs. The droplets can land in the noses and mouths of people nearby or be inhaled,
leading to infection. Many respiratory viruses also spread by fomite exposure (an
object carrying the infectious agent) when someone touches a surface with the virus
on it, then touches their mouth, nose or eyes without washing their hands. A recent
report from the Chinese CDC (China CDC Weekly, 2020, 2(8): 123-124) indicates a potential
fecal-oral route for spread as well. This may be an additional way COVID-19 is spreading
though more research is needed to confirm.
With most respiratory viruses, people are the most contagious when they have the most
symptoms, however, there are reports of spread to a close contact from someone showing
Ultimately, this is a new disease and we are still learning exactly how it spreads
and the full extent of the illness it causes.
Why is it so hard to contain?
This virus is hard to contain because it is new to humans, meaning we don’t have pre-existing
immunity for it. In addition, unlike for the flu, there is no vaccine for it. This
leaves a huge number of people potentially susceptible to infection and spreading
the virus. Ultimately, this makes it more difficult for vulnerable members of the
population to protect themselves.
What are some symptoms and how can it be treated?
Reported symptoms in people confirmed to be infected with COVID-19 range from none
(asymptomatic) to typical (fever, cough, shortness of breath) to severe (atypical
pneumonia along with fever and in severe cases, a patient may develop organ failure
and die). Based on data gathered so far, symptoms may appear as soon as two days or
as long as 14 days after exposure.
In terms of treatment, antibiotics don’t work because this is a virus not a bacteria
causing the disease. There is no specific treatment for this disease. People who are
infected would receive supportive care for their symptoms and organs as necessary.
Should people in the metro Atlanta area be worried? What is the likelihood that they
could get infected?
Although the spread of this virus is concerning, we shouldn’t panic. The CDC and local
health departments are aggressively working to limit the transmission through keeping
us informed of the latest information.
Who is most at risk?
The CDC has outlined the following risk assessment:
- For most of the American public, who are unlikely to be exposed to this virus at this
time, the immediate health risk from COVID-19 is considered low.
- People in communities where ongoing community spread with the virus that causes COVID-19
has been reported are at elevated, though still relatively low risk of exposure.
- Healthcare workers caring for patients with COVID-19 are at elevated risk of exposure.
- Close contact of people with COVID-19 are at elevated risk of exposure.
- Travelers returning from affected international locations where community spread is
occurring are at elevated risk of exposure.
Please describe preventive measures to help keep from getting the virus.
The same general advice on how to prevent spreading respiratory viruses applies. Frequent
thorough handwashing using soap and water for at least 20 seconds, especially after
going to the bathroom, blowing your nose, coughing or sneezing and before preparing
or eating food, is advised. Use hand sanitizer with at least 60 percent alcohol if
soap and water aren’t available. Avoid touching your mouth, nose and eyes. Frequently
clean and disinfect surfaces that might be contaminated. Avoid close contact with
other people if you are unwell or they are sick.
What are some misconceptions you can help clear up?
A lot of people are dying from this virus.
This is not true. While it is tragic when even one person loses their life to disease,
we are looking at an approximate death rate of 3.4% (WHO, 3.4.2020) of reported cases
of COVID-19, meaning 96.6% of all patients survive this infection worldwide. Ebola,
by contrast, has a case fatality rate of approximately 50%. Influenza has an annual
death rate of 0.01%. As of the morning of March 5, 2020, the US death toll is at 10.
Every person who is coughing or has a fever is infected with coronavirus.
This is not true. We are in the thick of flu season, other respiratory pathogens are
circulating, this is wintertime, and most of us haven’t traveled to locations with
confirmed COVID-19 cases or been around people who have.
Is the coronavirus worse for patients who have cancer because their immune system
is already compromised?
Unfortunately, people most at risk for severe illness due to COVID-19 are the elderly,
as well as people with cardiovascular disease, diabetes, chronic respiratory illness,
high blood pressure and cancer due to being immune-compromised because of their treatment.
What this means is that a cancer patient (and people in the other groups listed) needs
to take precautions to prevent getting infected with COVID-19 in the first place.
This happens in the same way you would for any respiratory disease: frequent hand
washing with soap and water for 20 seconds and avoiding touching face (eyes, mouth
and nose) with unwashed hands. If soap and water aren't available, using hand sanitizer
with at least 60 percent alcohol is okay.
In addition to good hand washing practices, can immune booster and vitamin C products
help with prevention, i.e., Emergen-C and elderberry products?
Elderberry has been studied for its antiviral and antimicrobial effects and what several
small studies show is that it does have an ability to help reduce the severity and
duration of symptoms caused by the common cold and influenza infection, however, more
studies are needed. As far as studies with coronaviruses, we don't have data showing
that elderberry is effective against this virus. You can boost your immune system
by getting plenty of rest, minimizing stress and eating a balanced diet rich with
foods that are full of vitamins C, E, A, D and minerals such as zinc, to name a few.
Mega doses of vitamin C haven't been shown to significantly reduce the incidence of
colds and haven't been studied for coronaviruses.
Should travel be postponed?
The CDC has a great interactive map that will help travelers keep up to date on developments and travel restrictions
related to COVID-19 globally. The situation is rapidly evolving so travelers should
check back frequently to help guide decisions. In addition to travel notices, there
is specific information on air and cruise travel as well.
How long does the virus last once it’s contracted?
Symptoms may appear two to 14 days after exposure and currently data is limited on
how long COVID-19 disease lasts in the majority of people (those who experience minimal
to mild symptoms). Other human coronaviruses typically run their course in under a
week in mild cases. In the severe cases that require hospitalization, studies on COVID-19
cases report that hospitalization occurs on average nine to 12 days after the onset
Should people avoid eating out in restaurants until this virus has passed?
Currently, there is no evidence showing that COVID-19 can be transmitted in association
with food. As always for food safety, it is important to wash your hands with soap
and water for 20 seconds both before preparing or eating food. In addition, the risk
of transmission from food products or packaging that are shipped over days or weeks
at room temperature, in refrigeration, or at frozen temperatures is very low. In short,
getting the virus from food at restaurants is highly unlikely.
Is the coronavirus transmitted only by touch or is it airborne?
So far, studies suggest that the virus that causes COVID-19 is mainly transmitted
through contact with respiratory droplets rather than through the air. These small
droplets come from the nose or mouth and are spread when an infected person coughs
or exhales. They land on objects and surfaces within six feet and other people who
then touch these surfaces and then their mouths, nose or eyes without washing their
hands can become infected. Also, these droplets can be inhaled by people around the
infected person, leading to infection. This is how respiratory infections are typically
Is the only treatment for the virus to let it run its course?
Currently, there are no FDA-approved treatments for COVID-19. Treatment involves supportive
care (treating symptoms) such as the fever, cough and other complications, including
advanced organ support for individuals with severe disease.
How long can someone have the virus before getting symptoms?
Symptoms may appear two to 14 days after exposure with many people reporting symptoms
on average five days after exposure.
Can the same person get this coronavirus more than once or do they develop immunity?
A study published recently in the Journal of the American Medical Association (doi:10.1001/jama.2020.2783)
reported that among four COVID-19 patients treated in Wuhan, China, who all recovered
and tested negative for the virus after recovery, all later tested positive five to
13 days after they were considered virus-free. With this and several additional similar
reports, what we know is that either some patients are not developing a lasting immunity
and are being re-infected or they are not completely clearing the virus although their
symptoms are going away. Until more study is done, it's difficult to say for sure
which is correct.
Is there anything else you would like to add?
So much is still unknown about COVID-19. This is an ongoing outbreak that is rapidly
evolving. The WHO has said there is a “window of opportunity” to curtail the spread
of this disease and the worldwide health and science communities are collaboratively
working on learning more about how transmissible it is from human-to-human, the characteristics
of an individual who becomes severely ill and is hospitalized, and on vaccine development,
among many other factors. Up-to-date information should be sought from reputable sources
listed below, along with your local health department.
Centers for Disease Control and Prevention: About Coronavirus Disease 2019 (COVID-19)
Danny Martinez (DO '22): May His Light Forever ShineFirst Patients Teach Students Intricacies of Human BodyClass of 2024 Celebrates Halfway Mark with Pinning Ceremony
Centers for Disease Control and Prevention: Coronavirus Disease 2019 Information for
World Health Organization: Coronavirus disease (COVID-19) outbreak
About PCOM Georgia
Established in 2005, PCOM Georgia is a private, not-for-profit, accredited institute of higher education dedicated
to the healthcare professions. The Suwanee, Georgia, campus is affiliated with Philadelphia
College of Osteopathic Medicine, a premier osteopathic medical school with a storied
history. PCOM Georgia offers doctoral degrees in osteopathic medicine, pharmacy, and
physical therapy and graduate degrees in biomedical sciences, medical laboratory science,
and physician assistant studies. Emphasizing "a whole person approach to care," PCOM
Georgia focuses on educational excellence, interprofessional education and service
to the wider community. The campus is also home to the Georgia Osteopathic Care Center,
an osteopathic manipulative medicine clinic, which is open to the public by appointment.
For more information, visit pcom.edu/georgia or call 678-225-7500.
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