Information surrounding the COVID-19 virus is rapidly changing and affecting how hospitals are working to respond and treat patients. For more on how the virus originated and how it is attacking the body, we talked to Dr. Aaron Weinberg, a Pulmonologist at Cedars-Sinai, who tells Inside the Issues this particular disease is part of a family of other viruses, like the common cold, that originated in Wuhan, China from an animal source.
“The reason us healthcare professionals worry about that, is any time that goes from the Animal Kingdom into the human population, no one has any built-up immunity towards it and this can lead to significant disease,” he said.
The virus is spread through respiratory droplets, meaning when someone sneezes or coughs these respiratory droplets get projected into the air and anybody who is passing by within 3 to 6 feet of someone who just sneezed or coughed, has the potential of becoming infected, he explains. The droplets then go into the nose, mouth, or eyes which is how people become infected.
The New England Journal of Medicine recently published information which said the droplets can exist on surfaces anywhere from a few hours to a few days.
“So if a passerby is walking outside and they touch an object [and the virus particles are on it] and then they touch their face, that again would become a point of entry of the virus into the body,” he said.
That’s when the virus enters the respiratory system and the respiratory tract and it invades the cells and starts replicating.
Dr. Weinberg said this is the reason they are paying so much attention to someone’s incubations period - the time that it takes from being exposed to someone with the virus to developing symptoms.
“We feel like the incubation period is anywhere from one to 14 days and on average it’s around five days from the time of exposure until you start feeling symptoms,” he said, explaining why this period of time is so important. “During [the incubation period], you can still pass on the virus.”
This is where social distancing really comes into effect, in order to ensure the virus is not being passed around with asymptomatic people, and is especially important while a vaccine or drug is being created.
“In terms of other practical things we can do, I think it’s really important to cut down on large gatherings [and] parties and limit our exposure to elderly and other people at risk with underlying medical conditions,” he said. “This is truly our ‘ask what you can do for your country’ sort of moment and the situation we know is real; it’s serious.”
From a respiratory standpoint, he said, symptoms start as a fever, fatigue and a dry cough.
“Some people are having a runny nose, sore throat and even diarrhea. The vast majority of patients, 80 percent of patients, will have self-limited disease that will resolve without having to see any medical provider,” he said.
He said while they seem like simple tips, washing hands for 20 to 30 seconds or using an alcohol-based hand rub, which contains at least 60 percent alcohol, will cut down on the virus particles on hands.
“This is really our unique opportunity, where we all collectively play a role in reducing the severity in beating this pandemic through social distancing; through wise practices. I know this can be very scary and we’re living during uncertain times, but let’s try to take these fears and channel them into productive action by each of us,” he said. “Not just for ourselves, but for our loved ones and the greater community.”
While social distancing works for the larger community, he said Cedars-Sinai and hospitals across the country, are working to make sure staff stay safe and healthy to provide medical attention to those who need it.
“I really want to commend all the medical professionals - the nurses, the doctors, the technicians, the cleaning staff, administrators, local governments - who are really working tirelessly behind the scenes to upscale, allocate resources, implement sound policies and adopt and adapt hospital structures to account for these expected surges of patients,” he said.
Cedars-Sinai has responded by building tents outside of the ER where they can triage patients and provide care.
“We’re working on increasing our testing centers and capabilities in order to hopefully test more people in the community and help contain this virus,” he said. “And our inpatient and ICU services are working very hard to modify their structures and allocate resources so we can meet the demands. Because we want, at the end of the day, to provide state of the art treatment and compassion and care for these patients. … We’re not sacrificing any care but we also are shifting necessary resources to meet the demand.”
Dr. Weinberg said those with underlying lung conditions, like COPD or asthma, are at a higher risk for catching and having worse complications from the virus than others.
“About 1 in every 6 patients will develop more significant symptoms. Some of those will be shortness of breath, some people might require supplemental oxygen, and in the worst case scenario, people will end up on a breathing machine in the Intensive Care Unit,” he said. “Part of this is due to the virus infecting the cells and the lungs. And the other part of it is due to hyper inflammation.”
This means your body is responding, through an immune response, to the virus, which causes inflammation and respiratory failure, a condition sometimes described as acute respiratory distress syndrome or ARDS.
“When people typically worsen, we're seeing it around the second week so people may have mild symptoms to begin with and then they progress,” he said, “and during that second week the severity increases and we're seeing probably anywhere from 5 percent to 15 percent of the cases develop more severe illness that requires ICU level care.”
While information is rapidly changing, Dr. Weinberg suggests checking the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) regularly, for the most up to date information.
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