One word has gained worldwide attention in a relatively short period of time – Coronavirus. How concerned should you be about the novel Coronavirus, known to clinicians as COVID-19?
First, you should know that as of now, there are no laboratory-confirmed cases of COVID-19 in Maryland. However, healthcare providers at UM Shore Medical Centers at Chestertown, Dorchester and Easton are preparing around the clock— focused on ensuring our patients, families and staff are protected in anticipation of COVID-19 reaching Maryland. Our clinical experts, in collaboration with academic medicine colleagues from the University of Maryland School of Medicine, are actively, regularly and closely monitoring the situation locally and nationally in real-time, and are following guidelines and protocols issued by The Centers for Disease Control and Prevention (CDC).
UM Shore Regional Health has implemented precautionary screening measures and our Hospital Incident Command System has been activated to facilitate preparedness, planning and response to COVID-19. For the most up-to-date information about COVID-19, including hospital preparations and important messages for the public, visit www.umms.org/coronavirus.
As part of the University of Maryland Medical System, we are rapidly preparing for the reality of COVID-19 impacting our region. This will be a challenge but we have the resources and medical expertise of one of the top health care systems in the United States, which delivers approximately 25 percent of all hospital care in Maryland, to guide our providers and care teams both inside our hospital and in our outpatient services.
The first important piece of advice is do not panic, which perhaps is easier said than done. Coronaviruses are part of a family of viruses that can affect humans and are commonly found in many different species of animals. The coronavirus originated in Wuhan, China, and has now been detected in almost 70 locations internationally, including in the United States.
While the complete clinical picture for COVID-19 is not yet fully understood, reported illnesses have ranged from mild to severe, including some illness resulting in death. Fortunately, about 80 percent of patients who have the virus have no symptoms or only mild ones like a cold. While information so far suggests that most COVID-19 illness is mild, older individuals and people with certain underlying health conditions like heart disease, lung disease and diabetes appear to be at greater risk of serious illness. At this time, most people in the United States will have little immediate risk of exposure to COVID-19 and for most of the American public, the immediate health risk is considered low.
Comparisons have been made between COVID-19 and the seasonal flu. Like seasonal flu, COVID-19 is an infectious respiratory illness, and while the symptoms are similar between the two illnesses, they are caused by different viruses.
On average, the seasonal flu has a mortality rate of about one half of one percent. COVID-19 is believed to have a mortality risk of around 2-3 percent, however this may be less, as mild cases are thought to be underreported or undiagnosed. As of early March, there have been approximately 90,000 known COVID-19 cases worldwide with just over 3,000 deaths. In comparison, the CDC estimates that since October 1, 2019 there have been at least 32 million flu illnesses, between 310,000 and 560,000 flu-related hospitalizations and between 189,000 and 46,000 deaths from the seasonal flu. In Maryland, as of early March, there have been 40 flu-related deaths, more than 200 influenza-related hospitalizations and the CDC is reporting flu activity this season in the state as “high.”
Whether it is flu or COVID-19, people experiencing respiratory symptoms along with high fever and shortness of breath should get medical attention. Treatment for severe cases is aimed at supporting recovery and prevention of additional bacterial infection.
The similarities mean that measures we can take to reduce the risk of becoming infected are also similar. Currently, there is no vaccine to prevent coronavirus, but the best way to prevent the spread of illnesses from respiratory viruses like COVID-19 are the same important precautions that should be taken to protect against seasonal flu. I cannot stress enough the importance of practicing non-pharmaceutical interventions like performing vigilant hand hygiene (including frequent hand-washing and use of alcohol-based hand cleaners), avoiding shaking hands, frequent cleaning of surfaces like doorknobs, handrails, and counters, maintaining social distances, staying at home if you develop mild symptoms, and seeking medical attention for more severe symptoms. In addition, the state can enact non-pharmaceutical interventions as necessary, such as school closures, cancelations of mass gatherings telework and tele-education. These strategies are all fundamental to protecting our workforce, patients and the community.
None of these precautions are new to us. We hear them every flu season. We might ask, then, why we aren’t following them all the time already? The answer is that the flu, despite the above statistics, doesn’t frighten most of us that much. We think of it as a week or so of fever, coughing, congestion, and general misery followed by recovery and return to life as usual. Many people who could do so won’t even take the flu vaccine because they fear the vaccine more than the illness itself.
Our attitude toward COVID-19 is different. It may have commonalities with influenza, but it is a new disease in humans, which worries us. International travel gives the disease access to global populations. While there have been few cases in the U.S. to date, public health experts predict that it will inevitably find its way into local communities and potentially spread among people who have no known prior exposure.
This is not time to panic, but instead, prepare. Like an infection that triggers an overreaction by our immune system that causes us more harm than the microorganism itself, a public overreaction could potentially cause more collective harm than the disease. Become informed, understand what you can do to protect yourself and your family. See what your neighbor needs. Let’s pull together as a healthcare system, community, city and state. Together we will confront this threat, knowing that our public health and healthcare partners stand ready to assist when we need it.
William Huffner, MD is Senior Vice President, Medical Affairs and Chief Medical Officer, UM Shore Regional Health