Coronavirus Information

Coronavirus Information

David Walker

March 4, 2020

Coronaviruses

Coronaviruses are a large family of viruses that are common in many different types of animals. This includes camels, cats, cows, and bats. In humans, coronaviruses cause infections like the common cold and most people will become sick with a coronavirus at some point during their life. Rarely coronaviruses cause more severe disease like COVID-19, MERS, and SARS.

 



 

Coronavirus Disease 2019 (COVID-19) (Information as of 2/28/2020 at 12:30 PM EST)

TRAVEL ALERT: The U.S. Department of State and U.S. Centers for Disease Control and Prevention (U.S. CDC) issued travel advisories for China and South Korea. Do not travel to China and reconsider travel to South Korea due to the novel coronavirus outbreak.

Healthcare Providers: U.S. CDC updated the definition for patients under investigation on 2/27/2020.

The U.S. Centers for Disease Control and Prevention (U.S. CDC) is responding to an outbreak of respiratory disease caused by a novel (new) coronavirus first detected in Wuhan City, Hubei Province, China and which has now been detected in 37 locations internationally, including cases in the United States. The virus is named "SARS-CoV-2" and the diseases it causes is named "coronavirus disease 2019" (abbreviated "COVID-19"). Person-to-person spread of this virus is reported outside China, including the United States and other locations.

Infogrpahic of Common vs Novel Coronavirus

On January 30, 2020, the International Health Regulations Emergency Committee of the World Health Organization declared the outbreak a “public health emergency of international concern” (PHEIC).

Signs and symptoms of COVID-19 include fever and/or cough and difficulty breathing. Sore throat is also reported in some patients. If you have these symptoms and did not recently travel to China or did not have contact with someone with 2019 Novel Coronavirus, it is likely to be a cold or the flu. If you are sick you should stay home, cover your coughs and sneezes, and wash your hands regularly.

Source and Spread of the Virus

Early on, many of the patients in the COVID-19 outbreak in Wuhan, China had some link to a large seafood and animal market, suggesting animal-to-person spread. Later, a growing number of patients reportedly did not have exposure to animal markets, indicating person-to-person spread. Chinese officials report that sustained person-to-person spread is occurring in China.  In addition, other destinations have apparent community spread, meaning some people are infected and are not sure how or where they became infected.

Illness Severity

Both MERS-CoV and SARS-CoV have been known to cause severe illness in people. The complete clinical picture with regard to COVID-19 is not fully understood. Reported illnesses have ranged from mild to severe, including illness resulting in death. Learn more about the symptoms associated with COVID-19.

There are ongoing investigations to learn more. This is a rapidly evolving situation and information will be updated as it becomes available.

Risk Assessment

Outbreaks of novel virus infections among people are always of public health concern. The risk from these outbreaks depends on characteristics of the virus, including how well it spreads between people, the severity of resulting illness, and the medical or other measures available to control the impact of the virus (for example, vaccine or treatment medications). The fact that this disease has caused illness, including illness resulting in death, and sustained person-to-person spread is concerning. These factors meet two of the criteria of a pandemic. As community spread is detected in more and more countries, the world moves closer toward meeting the third criteria, worldwide spread of the new virus.

The potential public health threat posed by COVID-19 is high, both globally and to the United States.

But individual risk is dependent on exposure.

  • For the general American public, who are unlikely to be exposed to this virus at this time, the immediate health risk from COVID-19 is considered low.
  • Under current circumstances, certain people will have an increased risk of infection, for example healthcare workers caring for patients with COVID-19 and other close contacts of persons with COVID-19. CDC has developed guidance to help in the risk assessment and management of people with potential exposures to COVID-19.

However, it’s important to note that current global circumstances suggest it is likely that this virus will cause a pandemic. In that case, the risk assessment would be different.

Situation in the United States and Maine

The United States reports imported cases of COVID-19 in travelers. Person-to-person spread of COVID-19 also has been seen among close contacts of returned travelers from Wuhan. On February 25, CDC confirmed COVID-19 in a person who reportedly did not have relevant travel history or exposure to another known patient with COVID-19 (unknown exposure). At this time, the virus is NOT currently spreading in the community in the United States. More cases are likely to be identified in the coming days, including more cases in the United States. It is also likely that person-to-person spread will continue to occur, including in the United States.

Widespread transmission of COVID-19 in the United States would translate into large numbers of people needing medical care at the same time. Schools, childcare centers, workplaces, and other places for mass gatherings may experience more absenteeism. Public health and healthcare systems may become overloaded, with elevated rates of hospitalizations and deaths. Other critical infrastructure, such as law enforcement, emergency medical services, and transportation industry may also be affected. Health care providers and hospitals may be overwhelmed. At this time, there is no vaccine to protect against COVID-19 and no medications approved to treat it. Nonpharmaceutical interventions would be the most important response strategy.

On January 31, 2020, Health and Human Services Secretary Alex M. Azar II declared a public health emergency (PHE) for the United States to aid the nation’s healthcare community in responding to COVID-19. The U.S. government has taken unprecedented steps related to travel in response to the growing public health threat posed by this new coronavirus, including suspending entry in the United States of foreign nationals who visited China within the past 14 days. Measures to monitor the health of those who are allowed entry into the United States (U.S. citizens, residents, and family) who have been in China within 14 days also are being implemented.

Maine has no confirmed cases for 2019-nCoV and no patients under investigation at this time. Maine CDC is working with U.S. CDC to monitor the situation, provide healthcare providers with the latest information, and stay up-to-date on any potential cases they may see. There are ongoing investigations to learn more. This is a rapidly evolving situation and information will be updated as it becomes available. For more information on the situation, visit U.S. CDC's COVID-19 situation summary webpage.

 

Interim Guidance for Healthcare Professionals

Healthcare providers should obtain a detailed travel history for patients with fever and acute respiratory illness. Healthcare providers in Maine should immediately notify Maine CDC (1-800 821-5821) in the event of a patient under investigation (PUI) for COVID-19.

Limited information is available to characterize the spectrum of clinical illness associated with 2019-nCoV. No vaccine or specific treatment for COVID-19 infection is available; care is supportive.

For more information, visit U.S. CDC's webpage on evaluating and reporting a PUI and U.S. CDC's webpage on infection control.

Additional Coronavirus Resources for Providers:

What Travelers Can Do

The U.S. Department of State issued a Level 4 Do Not Travel Advisory for China.

U.S. CDC issued a Level 3 Travel Warning for China and South Korea. U.S. CDC recommends travelers avoid all nonessential travel to China and South Korea.

U.S. CDC issued a Level 2 Travel Alert for Iran, Italy and Japan. These destinations are experiencing sustained community transmission of respiratory illness caused by the novel coronavirus (COVID-19). The virus can spread from person to person. Older adults and those with chronic medical conditions should consider postponing nonessential travel.

U.S. CDC issued a Level 1 Travel Watch for Hong Kong. CDC does not recommend cancelling or postponing travel to the following destinations. Travelers should practice usual precautions.

Other destinations with risk of community spread include Singapore, Thailand and Taiwan.

If you must travel:

  • Avoid contact with sick people.
  • Discuss travel to affected areas with your healthcare provider. Older adults and travelers with underlying health issues may be at risk for more severe disease.
  • Avoid animals (alive or dead), animal markets, and products that come from animals (such as uncooked meat).
  • Wash hands often with soap and water for at least 20 seconds. Use an alcohol-based hand sanitizer if soap and water are not available.

If you traveled to an affected area in the last 14 days and feel sick with fever, cough, or difficulty breathing, you should:

  • Seek medical care right away. Before you go to a doctor’s office or emergency room, call ahead and tell them about your recent travel and your symptoms.
  • Avoid contact with others.
  • Not travel while sick.
  • Cover your mouth and nose with a tissue or your sleeve (not your hands) when coughing or sneezing.
  • Wash hands often with soap and water for at least 20 seconds. Use an alcohol-based hand sanitizer if soap and water are not available.

Visit U.S. CDC's Travelers' Health website for more information.

 

Additional Resources for COVID-19: