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A Message from Dr. Joseph Weinstein, Chief Medical Officer for Steward Health Care

3-6-2020

Steward Health Care continues to monitor the national and global situation of coronavirus disease 2019 (COVID-19) and is prepared to support our communities and safely care for any ill patient. 

The Center for Disease Control (CDC) has emphasized that the risk to our communities remains low.  It is important to note that individuals are more likely to be exposed to common cold and/or seasonal flu than COVID-19.

We would like to provide the following information about coronavirus, as we know that outbreaks of new virus infections may cause concern and raise questions.

What is Coronavirus?

There has been an outbreak of respiratory disease caused by a novel coronavirus that was first detected in Wuhan City, Hubei Province, China.  This respiratory illness has now been detected in over 50 locations internationally, including scattered cases in the United States. There have been over 83,000 cases of the illness worldwide.  In the last few days, there has been an increase in the number of cases in South Korea, Japan, Italy, Iran, Cambodia and Thailand.

Coronaviruses are a large family of viruses that are common in many different species of animals, including camels, cattle, cats, and bats. Rarely, animal coronaviruses can infect people and then spread between people such as with Middle Eastern Respiratory Syndrome (MERS), Severe Acute Respiratory Syndrome (SARS) and now with this new virus.

There have been a growing number of patients who have never had exposure to animal markets, indicating that this virus is transmitted by person-to-person spread. Person-to-person spread has been reported outside China, including in the United States and other countries.

How is Coronavirus transmitted?

Current understanding about how the virus that causes COVID-19 spreads is largely based on what is known about similar coronaviruses. The virus is thought to spread mainly from person-to-person.  The disease is transmitted from people who are in close contact with one another (within about 6 feet).  The virus is disseminated through respiratory droplets produced when an infected person coughs or sneezes.  These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs.  It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes, but this is not thought to be the main way the virus spreads.  People are thought to be most contagious when they are most symptomatic (the sickest).

What are the symptoms of Coronavirus?

For confirmed coronavirus disease 2019 cases, reported illnesses have ranged from mild symptoms to severe illness and death. Symptoms can include fever, cough and shortness of breath.  The CDC believes at this time that symptoms of COVID-19 may appear in as few as 2 days or as long as 14 days after exposure. The average incubation period is approximately 5 days.

Risk factors for severe illness are not yet clear, although older patients and those with chronic medical conditions may be at higher risk for severe illness.  Approximately one-third to one-half of reported patients had underlying medical conditions, including diabetes, hypertension, and cardiovascular disease.

What should I do if I think I have Coronavirus?

If you are experiencing a cough, fever, and/or a shortness of breath and have recently traveled outside the United States — or been in close contact with someone who could have been exposed to coronavirus — please contact your primary care physician for further instructions.

If you are instructed to go to an Emergency Room, please notify ER staff of your symptoms immediately upon arrival, request and wear a face mask, and avoid close contact with others.

How is Coronavirus treated?

Patients with a mild clinical presentation may not initially require hospitalization. However, clinical signs and symptoms may worsen with progression to lower respiratory tract disease in the second week of illness, therefore all patients should be monitored closely. Possible risk factors for progressing to severe illness may include older age and underlying chronic medical conditions such as lung disease, cancer, heart failure, cerebrovascular disease, renal disease, liver disease, diabetes, immunocompromising conditions, and pregnancy.

No specific treatment for COVID-19 is currently available. Clinical management includes prompt implementation of recommended infection prevention and control measures and supportive management of complications, including advanced organ support, if indicated.

How do you prevent Coronavirus?

There is currently no vaccine to prevent COVID-19. The CDC recommends everyday preventive actions to help prevent the spread of respiratory diseases, including:

• Avoid close contact with people who are sick.
• Avoid touching your eyes, nose, and mouth.
• Stay home when you are sick.
• Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
• Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe.
• The CDC does not recommend that people who are well wear a facemask to protect themselves from respiratory diseases, including COVID-19.
• Facemasks should be used by people who show symptoms of COVID-19 to help prevent the spread of the disease to others. The use of facemasks is also crucial for health care workers and people who are caring for patients who are ill at home or in a health care facility.
• Wash your hands often with soap and water for at least 20 seconds, especially after going to the bathroom; before eating; and after blowing your nose, coughing, or sneezing.
• If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol. Always wash hands with soap and water if hands are visibly dirty.
   

Can I still travel?

At this time, the CDC recommends that travelers avoid all nonessential travel to China, Iran, Italy and South Korea.

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Steward Health Care is committed to the safety, health and well-being of our patients, staff, and the communities we serve. We will provide additional updates as they become available. 

In the meantime, for more information, please contact your doctor or visit the Center for Disease and Control (CDC) Prevention website on Coronavirus