Coronavirus Questions and Answers

Q: What is Coronavirus?

 

The virus consist of a protein capsule housing the chemical brain made from single strand of RNA.

 

Q: Is it a living particle like a bacteria?

 

No, it is an inanimate object. You cannot see it unless you place it under an electron microscope. It does not have its own metabolism that means it needs your cells in order to replicate and propagate. You are the host! This is why antibiotics do not work.

 

Q: I don't understand how something that is not alive can cause a disease in my body?

 

Virology is quite fascinating. Simplistically stated the virus attaches to your cells in the nose or throat. The virus then injects its chemical brain known as RNA. The RNA takes over your cells and immediately creates more virus within your cells. It needs a few key enzyme in order to make this happen which we will discuss later. Once the virus has produce more virus within your cells your cells dies and the new viral particles spread. There is a point in this process when you will become symptomatic… sore throat, nasal congestion, fatigue, and fever.

 

 

Q: So if the virus needs me in order to replicate and propagate how do I get the infection?

 

You need to come in contact with the virus. Viruses have a specific number of viral particles that need to be present in order to cause an infection in a new host. This is also dependent upon the health of the host. Some people who are immunocompromised will not have the proper defenses and need less viral particles to cause the same initial infection. Also, the infection will propagate without resistance and the infection may become more severe for those in poor health which is directly related to the immune response. 

 

Q: What is considered poor health?

 

Factors such as age, obesity, cardiovascular disease, lung disease, diabetes, past or present chemotherapy, and autoimmune diseases. All of these factors affect immunity. Keep in mind that there are young people below the age of 60 that might be affected by the above and puts them at risk as well.

 

Q: How contagious is Coronavirus?

 

There is a scientific term that tells us how contagious viruses are. It is known as the “R nought”. This estimates the number of people the average infected person spreads the disease to. One single infected patient with Covid-19 will infect between 2 and 3.1 new people. This is clearly higher than influenza which has a 1 to 1.3 ratio according to John Hopkins.

 

Q: How do I come in contact with the virus?

 

The majority of exposure to the virus is through airborne particles. This means that someone who has an infection is shedding virus. If you are in close contact they can give off enough viral particles to invade and adhere to the cells within your nose and throat. This potentially can leads to an infection in you. Therefore respiratory route is the main factor by which it is passed from person to person.

 

Q: Are there other ways that I can become infected?

 

Yes, anything by way of the hands coming contact with the virus and then are taken to the face has a risk of contaminating you and initiating an infection. Keep in mind that used Kleenex and kitchen towels have been noted as a vector for infection, handle appropriately. Hand washing and sanitizers are clearly of benefit.

 

Q: How can I not get infected?

 

Ideally one would not want to be exposed to contaminated air particles. Anything between social distancing to full quarantine minimizes exposure. As one researchers stated this is like trying to stop the wind. The only treatment at present for the coronavirus is quarantine. And logically this is not a treatment for the patient only for the public.

 

Q: What about a surgical mask, do they protect me?

 

The two most important characteristics of any mask is there filtering capabilities and the fitting of the mass to the face. The surgical mask factually has greater protection to a patient than to the healthcare provider or party wearing the mask. You do get some filtering but unfortunately they are not designed to tightly fit which minimizes its effectiveness. You still are at risk for inhaling contaminated air particles.

 

Q: What about the N95 mask? First what does N95 mean?

 

The N stands for non-oil proof and the 95 represents 95% efficacy. That means it will screening out 95% of the anything greater than .3 microns. This mask was mainly designed for anyone that was at risk for exposed to toxic gases, smoke, soot or ash. The firefighter would be a great example. 

 

Q: Are they effective in regard to the Coronavirus?

 

Yes, the N95 mask is effective in screening out airborne bacteria and viruses that are in respiratory droplets. The mask is mainly limited by proper fitting on the face. It is not recommended to have a beard or mustache and there is a formal fit testing for sizing. They do come in pediatric sizes.

  

Q: Are these masks in high demand and can anyone get a hold of them?

 

I know they had limited supplies and very difficult to get a hold of but it is my understanding that they have ramped up production. Where that lies at present I am unaware. I will state this though it is my opinion that any healthcare providers on the front lines of this battle should be of high priority. If they get sick you will have no one taking care of you or your love ones.

 

Q: Why are some people getting very sick from the Coronavirus and dying?

 

There are thousands of viruses that cause infection in humans. They are all unique but do share some characteristics. This particular virus has the ability to start out as a benign upper respiratory tract infection, sore throat, nasal congestion, cough, and fever. The virus can spread and become more invasive depending on the health status of a patient which is dictated the immune system. Coronavirus can invade the deep lung tissue and cause significant damage including viral pneumonias which could lead to Acute Respiratory Distress Syndrome (ARDS) and death. 

 

Q: What other organ systems can the Coronavirus affect?

 

The coronavirus in its uniqueness can bond to Angiotensin receptors. These receptors are present in the kidney, heart, gastrointestinal tract, and lungs. These particular organ systems are at a higher risk from this specific virus. Logic would have it that the more virus in the blood (viral load), would have a greater propensity to affect these organ systems.

 

Q: What is the difference between Coronavirus and COVID19?

 

Coronavirus is the virus. COVID19 stands for Co-Corona or crown,VI-Virus, D-disease,19-2019 date discovered

 

Q: What about testing for the virus is it accurate?

 

Good question and I don't think the data is available to answer that yet. The questions I have that if you test positive what is the specificity of the test? In other words what is the percentage accuracy confirming that I do indeed have the virus. Also if I test negative could I still have the virus? This would be a false negative and is concerning because I would need to be quarantined and would still be contagious to others. As they learn more the answers to these questions should become available.

 

Q: Can I have the virus and not have symptoms and be contagious to others?

 

Yes, if you do not have symptoms they are not recommending testing. If you do not test you will not be quarantined and therefore be contagious to others. This group of patients is concerning in regard to the spread of the virus.

 

Q: What are the symptoms of Coronavirus?

 

The most frequent symptoms is fever. Followed by dry cough and fatigue. Other symptoms of shortness of breath, joint and muscle pain, sore throat, headache, nausea vomiting and diarrhea. Less than 5% of patients have presented with nasal congestion according to John Hopkins data from china.

Q: Should I be tested?

 

There are particular criteria recommending testing and is rapidly changing. At present you need to be symptomatic and have either contact with a known Coronavirus patient or a specific history of recent travel to high risk countries. I am hearing that they are thinking of changing this criteria.

 

Q: How do I get tested if I can get tested?

 

At present they are implementing testing to be performed a private labs versus the CDC/Public Health. Prior to this the Department of Public Health and CDC had a full reign of control in regard to testing. The test is done on a nasal swab. The private lab will only run the test but they will not perform the collection. In other words you will need a healthcare provider to obtain the nasal sample. I am unaware of any clinic or healthcare provider that has the test kit at present.

 

Q: I have seen on the news that they have drive-up testing. Is that true?

 

Yes, in particular states and particular cities they are offering drive through testing. The only one I know of in California is up in San Francisco. If it is successful I imagine it will expand. 

 

Q: Is there a blood test for a Coronavirus antibody?

 

Yes, it is my understanding that a lab has been chosen but the test is not available just yet. This will be very important to studying patients. As with other viruses such as SARS, antibody titers seem to be related to the severity of illness.

 

Q: Can I get the coronavirus more than once let's say in a year? 

 

It has been documented that patients can get a second round of symptoms. Is this reinfection or just a relapse I am not sure? Serial nasal swabs and antibodies, when available, should help to answer this question. 

© Jeffrey B. Nordella M.D., INC. 2020

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