Understanding the virus that has brought unprecedented crisis to Oklahoma— and to the world
This illustration, created at the Centers for Disease Control and Prevention (CDC), reveals ultrastructural morphology exhibited by coronaviruses. Photo by CDC/ Alissa Eckert, MS; Dan Higgins, MAMS
It is difficult to pinpoint the first COVID-19 case. In late December, several doctors in China’s Hubei province noticed a significant group of patients who were becoming sick with a flu-like illness without an infection source. Although finding patient zero (first person infected with the novel coronavirus) is nearly impossible, Chinese authorities have traced it back to November 17, 2019, according to the South China Morning Post. That patient presented with upper respiratory symptoms similar to a cold. It wasn’t until January 7, 2020, that this disease was announced as a new coronavirus. On January 30, the World Health Organization (WHO) declared a global public health emergency, followed by pandemic declaration on March 11.
By the time you read this article, the landscape of this coronavirus outbreak will be remarkably different. As of today, there is a significant amount of unprecedented disruption to our everyday life. President Trump has extended distancing guidelines through April 30, in order to slow viral spread. Following is a series of questions and answers to help OKL readers understand this new disease.
What are coronaviruses?
This is a family of viruses that can infect humans as well as animals. There are four coronaviruses that commonly cause upper respiratory tract infections in humans. But many more exist that have the potential to infect humans.
How does coronavirus spread?
Respiratory infections are spread through different modes. Some can be spread through airborne particles, droplets, direct contact or indirect contact. As of right now, we believe the majority of COVID-19 transmission seems to be through droplets. This is why the CDC and White House recommend people wear cloth masks while out in public. Masks protect others by preventing the wearer’s respiratory droplets from landing on other people or surfaces. COVID-19 spreads very quickly in part due to the fact that most people become contagious without symptoms.
How did the virus arrive in Oklahoma?
The first documented cases in the United States were from people who had traveled abroad or had contact with those who traveled overseas. The first case diagnosed in Oklahoma was in Tulsa on March 6. That person had just returned from a trip to Italy. On April 20, Oklahoma had registered 2,680 with 143 deaths; there had been a total of 561 hospitalized cases since the outbreak; and there were 153 confirmed COVID-19 hospitalized patients with 93 of those being in the Intensive Care Unit (ICU), according to the Oklahoma State Department of Health. Thus far, Oklahoma has a total of 1,614 people who have recovered from COVID-19.
What are some possible symptoms?
About eight out of 10 patients will experience a flu-like illness and will not require medical care at a hospital. Some patients may also develop a viral pneumonia. Symptoms usually start as a high fever and a dry cough but other symptoms include shortness of breath, trouble breathing, fatigue, headache, chills, chest pain, confusion and muscle aches. These symptoms tend to happen on average five days after infection, with most people having symptoms by day 11 or 12.
Who is at risk of severe COVID-19?
Individuals with underlying medical conditions like diabetes, heart disease, lung disease or cancer are at a higher risk of developing more severe disease. The chance of developing more severe disease is higher for our elderly population, with people who are 80 years old and older having close to a 15% chance of dying from the infection. More severe infections are often treated in the ICU where complex medical care can be delivered, often requiring a mechanical ventilator to maintain a person’s breathing when their lungs are no longer working properly.
What if you develop symptoms?
You should stay home and avoid personal contacts for mild and moderate COVID-19 symptoms, which include fever, cough, sore throat and possible muscle aches. Drink plenty of fluids, continue to practice hand hygiene and disinfect your area often. It is also important to monitor your temperature while at home. Keep track of your symptoms and contact your doctor if you are not improving after three to four days.
You should call your doctor if you are over the age of 60 and/or develop more severe symptoms, including shortness of breath and trouble breathing. Patients who develop significant confusion, chest pain and wheezing should seek medical care at an emergency room. The hospital or emergency room should only be used by people who are concerned about life-threatening symptoms. People with chronic medical conditions such as hypertension, diabetes, cancer, underlying lung disease or a weakened immune system are also at risk for developing a severe COVID-19 infection.
How can you protect yourself and others?
It is important to practice social distancing and to avoid contact with people who may be ill. Good hand hygiene is critical to staying safe. Avoid touching your eyes, your nose or your mouth with unwashed hands. Stay home and away from others if you are not feeling well. As previously mentioned, the CDC is now recommending that people wear cloth masks while out in public in order to decrease the rate of transmission.
What does a quarantine and self-isolation mean for a COVID-19 patient?
When self-isolating at home, you cannot leave your home unless it is for medical care. Try to stay in a separate room if there are other people in the home with you. Do not use the same utensils or appliances as others in the household. Do not accept visitors into your home unless they are medical professionals caring for you. Continue to monitor your symptoms to ensure you are improving. You must remain in quarantine for at least 72 hours after your symptoms go away.
COVID-19 has in many ways brought our nation together as we battle this invisible enemy. In other ways it has distanced us from one another with the many social distancing policies including Shelter in Place, Stay at Home and Safer at Home. Many of us will never forget historical moments such as the closure of all educational institutions across the state, closure of non-essential businesses in certain cities, the closure of most churches for Easter Sunday and the indefinite suspension of the 2019-2020 NBA season, among other things. We initially saw hospital systems collapse under pressure in China and Italy as the number of patients requiring medical care continued to soar. Eventually, that fight against COVID-19 moved onto American soil. We initially saw the outbreak in Washington State followed by the ravaging of New York City, New Orleans and other cities. As Oklahomans, we must watch out for each other during this time of great need, ensuring that we are caring for one another while flattening the curve.
Digital Update - May 5, 2020
By Gabriel Vidal
Many of us had hoped and prayed that by now the pandemic would be something that we could look and see in the rear view mirror. Yet the numbers continue to climb with the United States registering a total of over 24,000 new cases on May 4th, 2020 and over 1,300 deaths. The total number of cases in the US stands at 1.2 million people while the total death count is close to 70,000. Oklahoma currently has had a total of 4,044 cases and 238 deaths as of May 4. There were a total of 227 out of 238 deaths in people above the age of 50 according to the Oklahoma State Department of Health.
As numbers continue to climb, it is important that all of us engage in safe practices such as social distancing when possible and masking while out in public. The act of wearing a mask does not protect you as much as it protects those around you. Most of us would agree that we have to adapt to a new normal. We must start a gradual and safe return to work, schools, and medical care among other things. Many institutions across the state are putting protocols in place in order to ensure that services are resumed while keeping everyone safe.
Oklahoma is a culturally diverse state but the one thing we all have in common is solidarity. Oklahomans have always banded together when adversity came knocking and have risen to the occasion. We have always watched out for each other whether recovering through devastating tornado seasons or man-made tragedies like the Oklahoma City bombing. Now more than ever is the time for us to care for one another, to protect one another as we continue our fight against COVID-19. I will continue to wear my mask whether in clinic or at my local grocery store to protect you and your family from the virus and slow its spread. Will you do the same for me?
Dr. Gabriel Vidal is a board-certified internist who is currently pursuing further training in oncology at the Stephenson Cancer Center at University of Oklahoma Health Sciences Center.