FAU Schmidt College of Medicine FAQs on Coronavirus COVID-19
FAU Medicine is now offering virtual visits with our physicians! Visits can be check-ups, follow-ups or sick visits. We are especially interested in supporting our patients with visits for concerns for COVID-19. To make an appointment with one of our providers, please call (561) 566-5328.
The CDC defines those at higher risk of serious illness from coronavirus infection as:
- Older Adults (people over age 60)
- People with serious chronic medical conditions like heart disease, diabetes and lung disease
Older adults, especially over age 80 have the highest risk of death from COVID19.
Specifically, those at higher risk of serious disease includes anyone of any age with the following chronic medical conditions but especially people over age 60:
- Heart disease such as congenital heart disease, congestive heart failure, coronary artery disease
- Blood disorders such as sickle cell disease
- Chronic kidney disease such as people on dialysis
- Chronic liver disease such as cirrhosis and chronic hepatitis
- Any condition causing compromised immune system such as undergoing cancer treatment, s/p organ or bone marrow transplant, taking high doses of steroids or other immune suppressant medications, HIV/AIDS, IBD, RA, lupus.
- Endocrine disorders such as diabetes/Metabolic disorders such as mitochondrial disease
- Lung disease including significant asthma, Chronic Obstructive Pulmonary Disease (COPD) or any other condition causing impaired lung function (e.g. requires O2)
- Neurological/neurodevelopmental conditions such as spinal cord injuries, stroke, Multiple Sclerosis, etc.
- Pregnancy or postpartum within the first month. (note early studies have shown that pregnant women who have been infected have done well, mild illness but numbers were small)
- Young infants
There is also some evidence that people who are smokers or former smokers are also at higher risk for serious disease.
It is not certain right now where exactly the virus has originated from. COVID19 disease is caused by a coronavirus called SARS-CoV-2, which is similar to the SARS coronavirus that first emerged in China in 2002 that caused severe respiratory disease in humans. That outbreak emerged after human contact with civets. The later MERS outbreak in the Arabian Peninsula in 2012 was associated with camel to human contact. While the current coronavirus, causing the world-wide COVID19 pandemic, is very similar to a bat coronavirus, there has been no documented cases of direct bat to human transmission and so this suggests that there was an intermediate host between bats and humans. But we don’t have the answer yet.
We are learning from other countries about the behavior of the virus and whether mitigation measures are working. In Singapore for example they aggressively tested their population and anyone testing positive for coronavirus, underwent “contact tracing, which is determining who they were in contact with and quarantined the people exposed while isolating people who were positive on the test in isolation hospitals. Singapore and other counties in Asia also were prepared because they were hit with SARS in 2002 so they knew what to do. Also, their government took an “all government” approached and were very well coordinated in their response. Clearly social distancing was a key part of Singapore’s response and they only had 266 cases and 0 deaths. Community mitigation measures, such as social distancing, is the only way we will keep the numbers of patients below our health care system’s capabilities.
The CDC says that people infected with coronavirus can have mild to severe symptoms and may have fever, cough and shortness of breath. Other reported symptoms include sore throat, fatigue, runny nose and aches. There are also reports of people having vomiting and/or diarrhea. There are also reports of people having the infection and not experiencing symptoms so may not have had fever. As this pandemic evolves we will know more.
The COVID-19 pandemic is very different from the 2009-H1N1 pandemic primarily because they are caused by two different viruses. The virus causing COVID-19 is caused by a coronavirus called SARS-CoV-2 whereas H1N1 is an influenza virus. While both viruses were “novel” to humans meaning no one had been exposed to the viruses so did not have immunity to them, H1N1 caused mild disease whereas SARS-CoV-2 causes more severe disease.
Importantly, for the 2009-H1N1 pandemic, we had the capability to more quickly develop a vaccine since we have done this for influenza annually and therefore were able to get vaccines to people during the first wave. For COVID-19, we have to develop a vaccine for a new class of virus, test it for safety and efficacy and then ramp up the capability to manufacture it, which means 12-18 months to get the vaccine into the arms of people.
Unfortunately, right now we can only recommend supportive care such as fluids, throat lozenges, cold medicines and Tylenol. Very importantly, people suspected of or confirmed to have COVID-19 must isolate themselves for 14 days from the beginning of the illness.
We do not have any evidence, yet, that anti-inflammatory medications such as Ibuprofen cause harm in people with COVID-19. There is some thought that Ibuprofen (Advil, Motrin) triggers certain cell mechanisms that can cause more severe disease. If someone is concerned, then you don’t have to take Ibuprofen for fever or aches because Acetaminophen (Tylenol) should work just as well.
People should remain at least 6 feet apart in order to ensure that they are not exposed to someone who sneezes or coughs.
The CDC says that people infected with coronavirus can have mild to severe symptoms and may have fever, cough and shortness of breath. Other reported symptoms include sore throat, fatigue, runny nose and aches. There are also reports of people having vomiting and/or diarrhea. There are also reports of people having the infection and not being sick so may not have had fever.
The CDC will be issuing guidance soon recommending that people should wear a home-made mask when leaving their homes. It may not help from getting infected since the virus is thought to more often be contracted through contact as opposed through the air. There is little to no evidence that homemade masks or scarves will protect someone form contracting the virus though. Medical grade masks should be reserved for health care workers who are being exposed to people with the virus constantly.
According to the CDC, the virus is most likely to spread from person to person through close contact and respiratory droplets from coughs and sneezes that can land on a nearby person's mouth or nose.
People who have a high-risk condition such as immune suppression and must go out should consider wearing a mask. Masks are very important for health care workers because they have a higher number of contacts with sick people. Goggles are also important for health care workers caring for people with the virus especially when performing procedures on the respiratory tract that can cause a spray of droplets. People who are not health care workers do not need goggles.
It’s been reported that the virus causing COVID-19 is very susceptible to soap and water. The CDC recommends that diluted household bleach solutions, alcohol solutions containing at least 70% alcohol and most EPA-registered common household disinfectants should be effective at disinfecting surfaces against the coronavirus. Frequent hand washing is important and if using an anti-microbial gel, make sure it is at least 60% alcohol.
It is not certain how long the virus can remain on surfaces. One study found that the virus can remain viable in the air for up to 3 hours, on copper for up to 4 hours, on cardboard up to 24 hours and on plastic and stainless steel up to 72 hours while some conjecture that if this coronavirus is like other coronaviruses, then it can remain on surfaces for as long as nine days. The CDC recommends that diluted household bleach solutions, alcohol solutions containing at least 70% alcohol and most EPA-registered common household disinfectants should be effective at disinfecting surfaces against the coronavirus.
It is still early in the pandemic so we are still learning about how it is transmitted. It is not clear yet if someone who is sick and handles food can transmit the virus to someone else. If so, it would be a very unlikely mechanism for transmission. That said, coronavirus has been found in people’s stool so theoretically it could be transmitted between people if someone does not wash their hands after using the bathroom. With regard to cooked food, it is likely the virus would be killed since it does not tolerate heat.
No, we are not overreacting. This infection causes a much higher rate of serious illness and death than seasonal flu, at least 10 times the death rate. Seasonal flu has a 0.1% death rate causing 20,000 to 70,000 deaths annually whereas this virus reportedly has a 1% to 3.5% rate of death. While it appears that those most likely to suffer severe symptoms or die are older people (> age 60) and/or people with chronic medical conditions, it also has caused severe illness and death in younger, healthier people. Also, there is a high risk of overwhelming the health care system which has a limited number of critical care beds and ventilators.
This info based on CDC information may be helpful:
Cold or Allergies
A patient will not know for certain he or she has COVID-19 but since testing is not easy to get one should assume it is likely and isolate for 14 days or until testing can be done.
It is currently not known for how long someone who has had this coronavirus will have immunity. There were some early reports in other countries of people being sick with COVID-19, seeming to recover and then coming down with symptoms again. It is thought that these people did not fully recover from the original illness. There is still a lot we will need to learn about this virus and disease and whether a person can get sick with the virus again.
It appears that those most likely to suffer severe symptoms or die are older people (> age 60) and/or people with chronic medical conditions but it also has caused severe illness and death in younger, healthier people. The death rate has been reported to be between 1 to 3.5% but we will likely not know until later into the pandemic.
For fever, body aches and sore throats, Acetaminophen (e.g. Tylenol) can help. Cold preparations can help runny noses.
You should call your doctor if you have any concerns about your symptoms, especially if you are an older adult and/or have chronic medical conditions. If you are not having difficulty breathing or chest pain, avoid going to the emergency department. If you do have difficulty breathing or chest pain, then call 911 or go to the emergency department.
Most testing sites set up by health care systems or public health department require appointments and/or a doctor’s prescription. So it’s best to consult with your doctor first before going to get tested.
Do the best that you can to stay separated. Sleep in different rooms and don’t use the same towels or utensils. It is best to consider family members of someone who is sick to be exposed so they should remain quarantined for 14 days after exposure.
Testing for active infection is done by obtaining a specimen with a swab up the nose (a nasopharyngeal swab).
Currently antiviral medications are being tested such as Remdesivir, which is showing promise against coronaviruses. Others are being tested as well. Also, post infection sera, with antibodies against the virus, is being tested for the sickest patients. Scientists are or will also develop concentrated immunoglobin to use for sick patients as well.
The behavior of the virus in cold vs warm climates is not known yet. We should not assume that the warmer climate will help Florida get rid of the virus quicker.
There is no evidence that dogs can get sick from coronavirus. However, recently there were reports that cats can get infected with the virus and become sick.
It doesn’t appear that we are running out of food and grocery stores remain open. There are grocery items that people are buying up more than other items such as toilet paper. Hopefully manufacturers will be able to keep up with the demand so that people do not feel like they need to hoard certain items.
The right term at this stage of the pandemic is community mitigation. Our goal now is to keep the peak of infections below the capacity of our health care system. We have only a finite number of ICU beds and ventilators so social distancing of the entire U.S. population is very important to achieve that goal. We will need to commit to social distancing for at least 8 weeks, maybe longer.
Best case scenario, for the U.S. and Florida, is that we keep the number of serious cases below our health care system’s ability to care for patients. There is variation in response across the United States. Florida is behind the best states because we are not being aggressive enough in instituting community mitigation measures, testing and contact tracing. The Florida Governor instituted a stay at home order on 4/2 which will go into effect on 4/3 which may help but exempts places like churches where people congregate. To experience the biggest benefit, community mitigation measures need to be implemented early in the pandemic.
It is not true that this is not affecting children. A study published in Pediatrics the week of March 16 found that children at all ages were susceptible to COVID-19, but symptoms were generally less severe than those of adults’ patients. However, young children, particularly infants, were vulnerable to coronavirus infection.
The reason why we close schools is not so much to protect school age children who are likely to not get very sick from coronavirus, but to prevent spread to more vulnerable people. Children are known to be active spreaders as they congregate in groups more often than adults.
Based on what we know to date, 14 days is sufficient for self-quarantine.
If someone is not sick and does not know they are infected, then they will not know to stay away from loved ones. This is why public health officials are strongly encouraging social distancing for everyone.
Hospitals tend to be higher risk sites for contracting an infection. Most hospitals are canceling elective (not urgent) surgeries. If you are scheduled for an elective surgery, a surgery that can wait, talk to your doctor about postponing.
If you have to go to the doctor’s office in person, then make sure to sit at least 6 feet from other people. Wash your hands frequently while there and make sure your doctor and nurse does as well.
Routine appointments such as checkups should be postponed until it is safer to leave home. If you have chronic conditions, are immune suppressed or are not sure, call your doctor for guidance.