We Asked An Infectious Disease Doctor About Coronavirus. Here’s What She Said

We asked an infectious disease doctor for some advice and fact checks amid the current wave of panic. Spoiler: Our “greatest enemy” is still the flu, and please, wash your hands!

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The novel strain of coronavirus (COVID-19) has infected more than 77,000 people globally and led to over 2,500 deaths since it was first detected late last year. For weeks, confirmed cases were mostly reported in and around the virus’ origin city of Wuhan, China. But in recent days and weeks, a sharp uptick in cases have been confirmed in Iran, Italy, and Korea.

Though the World Health Organization (WHO) has yet to declare the disease a pandemic, more countries are bracing for a potential spread — including the U.S. Reports on COVID-19’s spread have been thorough (and are constantly updating), but many people are still unsure how nervous they should be — or what exactly they should do to prevent themselves from getting infected.

NowThis talked to Elisa Ignatius, MD, a doctor and research fellow in infectious diseases at Johns Hopkins. We asked what advice she could give about the virus, including what people can be doing to protect themselves, and how worried everyone should actually be. Read our Q&A with Dr. Ignatius below.

NOWTHIS: Since the virus is so similar to a cold or flu, and it is brand new, how do people know if they have it or if someone near them does?

IGNATIUS: As COVID-19 continues to spread in various countries around the world, the link to Hubei province for individual cases and clusters is dissolving. This means that relying on a travel history to identify people in whom COVID-19 should be considered may soon not be feasible. Published case series on COVID-19 describe a wide range of symptoms and severity of disease.

Some people have very mild symptoms that resolve on their own within a matter of days to weeks, much like the common cold, while others progress to more severe symptoms requiring hospitalization. At this stage, while the virus is still exceedingly rare in the US, anyone with contact to a known case or recent travel to a country where there has been community transmission should call the Department of Health for guidance or, if feeling particularly unwell, go to the Emergency Room for evaluation.

There is not a constellation of symptoms that can immediately identify someone with COVID-19 versus seasonal influenza or other common respiratory viruses. This challenge is why the CDC has now released testing kits across the country that can be immediately used with the machines already in place to test for influenza.

Many are now wearing masks for air travel—how effective is that prevention method and are their more effective methods people could be employing?

IGNATIUS: While masks may lessen your risk if you are in direct, close contact with a person who has COVID-19, a much more effective strategy is regular hand washing with soap and water. COVID-19 can linger on surfaces and so our best defense is hand washing and avoiding touching our faces throughout the day.

There are tens of thousands of confirmed cases of coronavirus currently—what is the proper terminology to use for an illness of that scale (pandemic, epidemic?)

IGNATIUS: The proper terminology at this stage is “epidemic.” COVID-19 does have some concerning features, such as ease of infection and efficient spread between people, but the WHO has not yet declared that this outbreak is a pandemic. The last disease that was declared a pandemic was H1N1 influenza virus in 2009.

As someone who has studied the control of infectious diseases, what do you wish people knew when talking about the coronavirus?

IGNATIUS: Early estimates suggest COVID-19 does have higher rates of complications and mortality than seasonal influenza, though this is driven at least in part by the fact that more severe cases tend to present to the hospital and be diagnosed. That being said, our greatest enemy currently is still influenza. Just last week I saw three people admitted to the hospital with complications from [the] flu.

One of the most important things we can do to prepare for COVID-19 arriving to the US in force is to make sure that all of us are vaccinated against influenza. Even though the flu vaccine does not always prevent infection, it does significantly lessen our chance of needing hospitalization or dying from the flu. Getting vaccinated against flu will not prevent infection with COVID-19, but the more people who are flu vaccinated, the fewer who will need to be admitted to the hospital with complications, and the better prepared our hospitals and health systems we will be for the upcoming wave of patients with COVID-19.

Since a vaccine for the virus is still in the works, what is being done in the meantime to treat the virus? When one is developed - hypothetically, would everyone in the world have to get it?

IGNATIUS: While efforts continue to develop a vaccine, the mainstay of treatment, as it is for most viruses, is supportive care. This means supporting the patient while their own immune system fights the virus. There are some small trials ongoing in China to test some antiviral medications, but there have been no reports to date on any results.

In terms of vaccination, I think it’s still too early to speculate on how public health officials would deploy such a COVID-19 vaccine. It depends on what ends up happening with ongoing transmission in the weeks and months to come.

How are doctors and government officials strategizing to contain the spreading of viruses? TLDR how do we stop the virus?

IGNATIUS: The CDC and Departments of health are working tirelessly to gain important information about transmission dynamics and to control further spread of COVID-19. Right now, the emphasis is on containing the spread by detecting cases immediately upon return to the US and supporting periods of quarantine for those infected or potentially infected. The CDC has issued travel guidance for certain countries with ongoing community transmission, including China, South Korea, Japan, Iran, Italy, and Hong Kong. They have also developed a rapid test (like the flu nasal swab) to diagnose people with COVID-19 and have made that available across the country.

Do you feel the media attention on the disease has been beneficial or harmful to the outbreak?

IGNATIUS: Somewhere in the middle. I have been trying to stick to my tried and true resources like CDC and WHO and educating people about truths and myths surrounding COVID-19 at every opportunity. There has certainly been a lot of sensationalism and WHO has been leading a proactive campaign against this “infodemic”. They have worked with Google to make sure that WHO guidance is a top hit when people search for coronavirus, have kept their Twitter account constantly updated with accurate information, and have partnered with YouTube and Facebook to add a banner redirecting people to WHO when searching for coronavirus.

Building off the last question, do you believe people are panicking about the outbreak too much or not enough?

IGNATIUS: There remain very few cases in the US, but more recent estimates from the CDC do suggest that person-to-person spread in the US is increasingly likely and may have a large impact on our day-to-day lives. That being said, the CDC and others have been preparing for many years for the next major outbreak and provide some helpful tips on how to protect yourself and others.

We are fortunate in the US to have teams of dedicated public health officers working to rapidly identify any potential cases and to get our healthcare system ready for more cases of COVID-19. For individuals, my advice right now is to get vaccinated against flu, work on your hand hygiene skills, and if you’re feeling inclined, have a casual conversation with your employer about telecommuting infrastructure. I’m personally taking this opportunity to work with my daughter on her handwashing technique!

In your opinion, what are the best resources for staying educated about the coronavirus? What filters should people be putting on news updates to know if they are accurate or not?

IGNATIUS: The WHO has taken steps to try and stop false information and make sure that their resources are some of the first hits when people search for coronavirus online. My favorite references for high-quality, evidence-based, and fairly succinct reports are CDC and WHO. I have also subscribed to daily email updates from the Johns Hopkins Center for Health Security which provide brief reports on the emerging science, epidemiological trends, and overall status of the epidemic.