On March 10, a live KET Forum gathered state experts to discuss coronavirus disease 2019, or COVID-19.
Here are key takeaways to help you and your family prepare for the ongoing spread of the disease and keep as safe as possible.
What to know about COVID-19
The novel coronavirus responsible for COVID-19 infectious disease originated in Wuhan province in China in December 2019 and has spread across the globe in less than three months. It is from a family of viruses that includes the common cold and the more rare and harmful types SARS (severe acute respiratory syndrome) and MERS (Middle East respiratory syndrome).
The spread of COVID-19 was designated as a global pandemic by the World Health Organization (WHO) on March 11. It has galvanized public health experts worldwide for one very important reason: since it is a new strain of coronavirus, there is no vaccine for it and no anti-viral drug treatments for it.
“When you have an unknown disease with a fairly severe impact, that obviously instills concern or fear in people,” says Dr. Steven Stack, MD, Kentucky’s commissioner of the Department of Public Health.
The virus causing COVID-19 can currently only be diagnosed with an official testing kit. It spreads from person to person through infected droplets in coughs and sneezes, says Stack. The droplets can reach an uninfected person within a six-foot radius.
The virus can also be passed along if a person touches a surface where infectious droplets have landed and then touches his or her mouth, nose, or eyes.
The most common symptoms of COVID-19 are the following:
- dry cough
- shortness of breath
Based on cases over the past three months from around the world, officials estimate that most persons who are stricken with COVID-19 – approximately 80 percent – will only develop these mild symptoms, says Dr. Derek Forster, MD, medical director for Infection and Prevention Control at UK HealthCare in Lexington.
However, persons over the age of 60 and/or who have underlying health problems are at a higher risk of developing more serious symptoms from COVID-19, primarily respiratory failure.
“What caused issues in China was that people were coming in with what is called ARDS – acute respiratory distress syndrome,” Forster says. “This is a severe reaction typically to infection that also involves the immune system response. And since this is a virus that hasn’t circulated before, our immune systems haven’t seen it. Often times when there is no previous immunity to exposure, you get that type of response.”
According to the WHO, the following pre-existing medical conditions increase the risk of having severe outcomes after contracting COVID-19:
- high blood pressure
- heart disease
- lung disease
- kidney failure
Dr. Forster adds that immune-compromised individuals are also at higher risk.
Current research indicates that COVID-19 can incubate in a person for up to 14 days before symptoms appear. For persons with mild COVID-19, symptoms usually abate around 14 days after they first appear. “I would define cure as recovery,” says Forster. “You’ve had your illness, you’re over your symptoms, and you feel better or feel close to the way you were before you were ill.”
Best practices for avoiding exposure
According to the Centers for Disease Control and Prevention (CDC), the best way to keep from getting COVID-19 is to practice the following behaviors:
- Avoid close contact with people who are sick
- Stay home if you are sick
- Wash hands frequently, for 20 seconds
- Avoid touching your eyes, nose, and mouth
- Sneeze and cough into a tissue, or your arm
- Clean and disinfect often, especially surfaces that are touched often
- Do not purchase face masks unless you are ill
Practicing good hygiene will not only protect persons from COVID-19, Stack says. “It may also protect you from other viruses, and that’s important, because right now you don’t want to have a cough or a cold or a fever, because we might not know what it is. It’s better all the way around,” he explains.
As noted above, an infected person who coughs or sneezes can spray droplets out to six feet. Stack advises persons to practice social distancing over the coming weeks as public health officials work to boost COVID-19 testing and gain control over rising incidence rates. (On March 11-12, nearly all events involving large public attendance nationwide were either, postponed, or held without the public present, and in Kentucky, Gov. Andy Beshear advised county school districts to call off in-person classes for two weeks starting March 16.)
Ramping up disinfection is recommended for individuals in their homes, and also on an organizational level. “What is reassuring is that even though this virus can cause severe disease, it’s actually a pretty wimpy virus in the environment,” says Forster. “It’s very susceptible to your standard disinfectants.”
Dr. Lori Caloia, MD, is the medical director of the Louisville Department of Public Health and Wellness. She says that the virus that causes COVID-19 can live on surfaces up to nine days, but that duration depends on several factors including how many particles are present, the temperature and the humidity level.
“Obviously, if you have someone at home who has COVID-19 and you are caring for them, you want to make sure that you are cleaning those surfaces in the area that you’re around,” Caloia says. “In general, the surface concern is less of a concern than being around an individual that we know has that infection.”
Caloia remarks that there have been news stories about the public buying up medical masks, threatening the supply available to medical providers. She says that persons who don’t have symptoms of COVID-19 gain no benefit from wearing masks. They should be used by medical providers and persons who do have symptoms and/or have been diagnosed with the disease.
What to do if symptoms arise
Tests for COVID-19 are becoming more widely available through state and public health departments, but they are still limited, and Stack says that “right now, we have to use those tests for the patients with the highest risk, or the individuals who are at the highest risk for spreading to others, so we can try to contain the disease as much as possible.”
To that end, Stack, Forster and Caloia all recommend the following guidelines for persons exhibiting mild respiratory illness symptoms from CDC:
- Stay home and call your doctor, health care provider or the COVID-19 Hotline at 1-800-722-5725
- During the call, discuss your symptoms
- If you think you need medical care, please contact your doctor or hospital before arriving
- If you are not sick enough to be hospitalized, you can recover at home
- If you have runny nose, cough, fever, or other common respiratory infection symptoms, take Tylenol- or Motrin-like products and stay home
- Know when to get emergency help
Symptoms requiring emergency help are, according to Stack, “high fever and cough with difficulty breathing, if you feel lightheaded or you’re dizzy, or if you otherwise feel like you’re getting incapacitated by illness.”
“If you’re not having fever in addition to your cough or those type of things, and are otherwise well, then we would recommend that you not come into (the health care clinic/hospital) at all,” Forster says. “You can contact your provider and get some advice, but you may be more at risk just by overloading the health care system in general right now.”
“If you are ill, but you would not go to a doctor except for the fact that the coronavirus is out there, don’t go to a hospital or a doctor, because, if you have a small fever or a cough or body aches and think it’s just like the cold and you would normally stay home and take Tylenol, stay home and take Tylenol,” Stack says. “And if you have questions, call someone on the phone, don’t go somewhere where you could spread what you have or you could get what someone else has.”
For persons who do present with more severe respiratory symptoms, Caloia says that her public health department in Louisville as well as other local ones and the state’s department are working together to devise a comprehensive plan for diagnosis and treatment in Kentucky that is evolving constantly as new information about COVID-19 becomes available.
“Our epidemiologists both at the state level and locally look at each case individually, so if we have a positive case we go through contact investigations, we determine who those individuals were exposed to, determine the risk to those individuals and recommend testing in symptomatic cases,” she says. “I would encourage people that if you are contacted by your public health department or by the state public health department please do what we ask you to do, please be as honest and forthright as possible – we are here to help you as well as the rest of the community in trying to prevent this spread.”
Adjustments at school/work/travel
The first confirmed case of COVID-19 occurred in Harrison Co. in north central Kentucky. Dr. Harry Burchett, superintendent of Harrison Co. Schools, says school administrators acted swiftly to suspend in-class instruction and take other measures to assist students, families, and the community at large. Their efforts will be replicated statewide in the coming weeks as more school districts take a break from having students attend class in person.
“We had the opportunity to take some time off and practice what we call non-traditional instructional programming,” Burchett says. “We had that tool in our tool belt and we hadn’t used that this year, so we thought that we would give our public health officials and community a chance to get ahead of this and let it play out and see where it goes.”
Burchett adds that Harrison Co. Schools continue to provide free meals to students through pick-up or delivery, and that administrators met with the facilities director and implemented a comprehensive cleaning and disinfecting regimen for buildings and buses. “It’s safe to say that we have the cleanest schools in the state of Kentucky, right now,” he says.
Ashli Watts, chief executive officer of Kentucky Chamber of Commerce, says that her organization is advising members to offer extended sick leave to any employee that shows symptoms of COVID-19 if they are able to. She also recommends that businesses allow employees to work from home if necessary, noting that the Chamber is currently doing so with two of their own workers who are in the COVID-19 high-risk group.
“It’s a tricky situation right now that we’re all trying to find the balance of, making sure we are safe, our employees are safe, our workplaces are safe, but also making sure that business goes on and commerce continues to grow,” says Watts. Since employee safety and well-being is the Chamber’s highest priority, Watts adds that they are closely following CDC guidelines along with those from the Kentucky Department for Public Health.
As for travel, Caloia advises that persons follow the CDC’s guidelines on restrictions and refrain from going to any destination in the Level 3 category. “The CDC is recommending against travel to those locations, and anyone who returns from one of those locations should be on self-quarantine for 14 days after return,” she says. (On March 11, President Donald Trump ordered a one-month travel ban to persons coming from all countries in Europe except Great Britain, with certain exceptions.)
Stack notes that Americans who are stuck overseas after traveling could be at a disadvantage when receiving medical care since they will be accessing unfamiliar systems, which is a good reason to reconsider any international trips. He adds that traveling within the U.S. won’t post much of an added risk for the majority of the public, aside from those at higher risk of COVID-19 infection.
“I do think that if you’re over 60 and you have major medical conditions, you maybe ought to think about staying home for a little while until we figure this thing out better,” Stack says.
“It’s been really impressive to see how much evidence and scientific information (on this coronavirus) has come out in such a short period of time, and it’s really ramped up the literature on this to help the world respond,” says Forster. “I think we’ll be talking about COVID-19 a lot for the next several months, but I think we’ll get through it and I think we’ll learn and move forward.”
Stack and Caloia advise the public to follow kycovid19.ky.gov to keep up to date with the latest information on COVID-19 and new announcements from Gov. Andy Beshear, as well as other trusted resources such as the CDC website at https://www.cdc.gov/coronavirus/index.html.
“If you go to our site, you’re going to find the current data, the test results for the day from the state, you’re going to find updated information, you’re going to find new guidelines on a daily basis,” Stack says. “So be informed.”