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This is what my sister’s doctor posted....

Westside Pediatrics, Inc.
February 26 at 2:02 PM ·
Good morning! We thought it would be helpful to share our thoughts on the coronavirus (COVID-19) outbreak. Although it has not hit North America yet, with it now spreading into Western Europe it is likely on its way and we want you to be as informed as possible.

Approximately 20% of the common colds we experience seasonally are coronaviruses. This viral family is nothing new, but over the years two strains have emerged that were more concerning. SARS and MERS had mortality rates of 9.5 and 34.5%, respectively. Fortunately these did not become widespread and have been contained. Unfortunately, we now have COVID-19 and it appears to be more easily spread and therefore harder to contain. Its origin is unclear and up for debate, as has been the quality of the data provided by China, but now we have numbers from outside of China (that are consistent with China’s reports) and we have included them below for your review.

Current mortality statistics based on best available prelim data:
• average overall mortality rate 2.3%
• history of high blood pressure, diabetes, heart disease, chronic lung disease, or cancer is 5-10%
• no history of chronic disease <1%
• overall men 2.8%
• overall women 1.7%

By age:
• over 80 years old 15%
• 10-19 of age 0.0018%
• 0-9 years of age ~0%

On a positive note, we can breathe a sigh of relief that our children are clearly not at significant risk. Unfortunately, the same cannot be said about our older family members (being male, elderly, and especially having chronic ailments puts one at greatest risk). The biggest problem is this illness is going to look like a sniffle for many of us and so it’s easy for it to go unnoticed and unknowingly spread it.

So, what can we do..

HYGIENE
• Washing our hands thoroughly (under water for more than 15 seconds) is always the best and most effective preventative measure.
• Remind your kids to keep their hands off their face! Pathogens enter our body through the eyes, nose and mouth...
• Don’t send your kids to school or the park when they may be contagious. For the common cold doctors typically advise 5-7 days of avoidance, but when kids feel better after 2-3 days so many of us send them back to school. It’s therefore no surprise our flu seasons are long and challenging. With COVID-19 this practice needs to STOP (and it should anyway). Although our children may not be at significant risk, our beloved friends and families are.

TRAVEL
• The CDC is advising against non essential travel to China and South Korea.
• Until we know more, we would suggest restricting any travel outside of North America.

TESTING
• Your local clinics do not have a reliable test for this yet. Commercially available testing is on the horizon, but initial batches were faulty and so there have been delays. Our practice is actively searching for testing options and will spare no expense when they become available.
• Suspected cases are currently being referred to the department of public health for testing. The CDC is only advising testing for patients with cold symptoms who have traveled to China or have a known exposure to a COVID-19 patient.

TREATMENT
• For most of us COVID-19 will just look like a common cold. Currently there are no known specific treatments for COVID-19 other than supportive care.

What we should do if we develop cold symptoms (runny nose, fever, mild cough)
• isolate
• see your doctor
• treat fever with Ibuprofen and or Acetaminophen
• address congestion with nasal saline, humidifiers, steam showers, vics, cough and cold remedies (as age appropriate)
• Hydrate

If your cold moves into your chest see your doctor to rule out pneumonia.
• COVID-19 mortality is generally due to acute respiratory distress syndrome (ARDS) and/or pneumonia
Early supportive care will improve outcomes. Options include:
• steroids to slow the immune response that can lead to ARDS
• Inhalers to improve lung function and ease breathing
• antibiotics to address and or prevent secondary bacterial complications
• inpatient care when extreme/necessary (diuretics, vents...)

Don’t forget there are other illnesses out there...
• If fevers are high see your doctor to rule out influenza - Tamiflu/Xofluza work best when started early (preferably <48h)
• If you have a red sore throat with or without fever or an upset stomach see your doctor to rule out strep.
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Coronaviruses are typically seasonal and so we can hope that by the time it gets here our weather warms, flu season ends, and this virus burns itself out. That said, with it so widespread worldwide there is a good chance it will become a seasonal threat, regardless. By then we hope that a safe and effective vaccine will be available. Until then we try to control spread and take care of each other.

In conclusion, please DO NOT PANIC. For the vast majority of us this is just another cold. Please let us help if you have any concerns.

Lawrence Kagan, MD, FAAP
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