Novel Coronavirus Fast Facts: Updated 03-22-2020

Coronavirus, Corona virus, COVID, Venincasa Dental

Risk of Dying from COVID-19 Infection

Preliminary numbers indicate that about 2-3% percent of those infected are killed by novel coronavirus infection (Grady, 03-01-2020; Johnson, 02-19-2020; Noack, et al., 02-20-2020; WHO, 03-08-2020).

A new report on 1,099 cases from many parts of China, published on [February 28, 2020] in The New England Journal of Medicine, finds a lower [coronavirus infection death] rate: 1.4 percent” (Grady, 03-01-2020).

These rates compare to the common flu; about 1-3% of patients infected with the common flu virus die from flu infection (CDC, 01-10-2020).

According to Dr. Anthony Fauci of the National Institute of Allergy and Infectious Diseases, which is part of the National Institutes of Health (NIH), “the mortality rate of the coronavirus [is] “dropping” to “only” 1%. It now stands at about 3.4%. A 1% mortality rate is 10 times higher than the common flu”(Stanton, 03-12-2020).

The main determining factor in how a patient responds to the coronavirus is their immune system, which resonates with the findings from SARS (severe acute respiratory syndrome) (Johnson, 02-19-2020).  “The people who are at greatest risk are those older and who also have serious long-term health conditions like diabetes, heart disease, or lung disease” (CDC, 03-09-2020).

As of March 20, 2020, globally, there is a 4.2% chance of dying from COVID-19 infection. Within the “regions of the Americas,” there is a 1.2% chance of dying from COVID-19 infection. Within the United States of America, there is a 1.3% chance of dying from COVID-19 infection, and there have been around 200 deaths to date (WHO, “Situation Report- 61,” 03-20-2020; cf. CDC, “Cases in U. S.,” 03-20-2020).

 “COVID-19: U.S. at a Glance: total cases: 15219; total deaths: 201.  These numbers include Washington, DC, Puerto Rico, Guam, and the US Virgin Islands” (CDC, “Cases in the U. S.,” 03-20-2020). With this, the risk of dying from COVID-19 infection within the United States is 1.3%.

 “The immediate risk of being exposed to this virus is still low for most Americans, but as the outbreak expands, that risk will increase.” (CDC, “Situation Summary,” 03-17-2020).

“Reports out of China that looked at more than 70,000 COVID-19 [infected] patients found that about 80% of illness [was] mild and people recovered, [and] 15 to 20% developed serious illness” (CDC, 03-09-2020).

 “[COVID-19 infected] patients who reported no underlying medical conditions had an overall case fatality of 0.9%” (CDC, accessed 03-16-2020, https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-guidance-management-patients.html). “An overall case fatality proportion of 2.3% has been reported among confirmed cases of COVID-19 in China” (CDC, accessed 03-16-2020, https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-guidance-management-patients.html).

Transmission and Spread

Coronavirus is spread by sneezing and coughing within a six-foot range (Johnson, 02-19-2020; NCIRD, 02-25-2020). A secondary way for infection is by contacting a contaminated surface and then touching the mouth, nose, or eye (NCIRD, 02-25-2020).

“People are thought to be most contagious when they are most symptomatic (the sickest). Some spread might be possible before people show symptoms; there have been reports of this occurring with this new coronavirus, but this is not thought to be the main way the virus spreads” (CDC, “How COVID-19 Spreads,” 03-04-2020).

“On March 13, [2020], the President of the United States declared the COVID-19 outbreak a ‘national emergency’. . . Different countries can be in different phases of the pandemic at any point in time and different parts of the same country can also be in different phases of a pandemic. . . Different parts of the country are seeing different levels of COVID-19 activity. . . The United States nationally is currently in the initiation phases, but states where community spread is occurring are in the acceleration phase. The duration and severity of each phase can vary depending on the characteristics of the virus and the public health response. . . Three U.S. states are experiencing sustained community spread [New York, California, Washington] (CDC, “Situation Summary,” 03-18-2020).

As of March 21, 2020, COVID-19 infection is “confirmed and presumptive positive” in 29 Dallas County residents, 13 Collin County residents, and 9 Denton County residents. Throughout the state, there are 304 “confirmed and presumptive positive” cases with COVID-19 infection, and five of them have died. The first known COVID-19 infection that initiated within the state of Texas was on March 4, 2020 (TDSHS, 03-21-2020).

As of March 20, 2020, the CDC indicates the state of Texas has reported 143 “confirmed and presumptive positive” cases of COVID-19 infection (CDC, “Cases in U. S.,” 03-20-2020).

As of March 21, 2020, “There have been 27 confirmed positive cases of COVID-19 in Collin County, [Texas]. Five persons have successfully recovered. Two are hospitalized and 19 are in home isolation. There has been 1 confirmed death associated with COVID-19 in Collin County. There are 73 Persons Under Monitoring (PUM) in Collin County at this time” (Collin County, 03-21-2020).

As of March 22, 2020, “There have been 31 confirmed positive cases of COVID-19 in Collin County. Eight persons have successfully recovered. Two are hospitalized and 20 are in home isolation (one is out of state). There has been 1 confirmed death associated with COVID-19 in Collin County. There are 75 Persons Under Monitoring (PUM) in Collin County at this time (Collin County, 03-22, 2020).

As of March 20, 2020, there are 27 confirmed cases of COVID-19 infection within Collin County, 9 cases in Plano, Texas, and one death in Plano associated with “an underlying health condition” (City of Plano, 03-20-2020).

Symptoms

Coughing, sneezing, common cold symptoms, infection of the upper airway making breathing more difficult, infection deeper into the lungs, loss of lung function (Johnson, 02-19-2020).

“The following symptoms may appear 2-14 days after exposure:fever, cough, shortness of breath” (CDC, “Symptoms,” 03-16-2020).

“Common signs of infection include respiratory symptoms, fever, cough, shortness of breath and breathing difficulties. In more severe cases, infection can cause pneumonia, severe acute respiratory syndrome, kidney failure and even death” (CDC, https://www.who.int/health-topics/coronavirus, accessed 03-16-2020).

“If you develop emergency warning signs for COVID-19 get medical attention immediately. Emergency warning signs include difficulty breathing or shortness of breath, persistent pain or pressure in the chest, new confusion or inability to arouse, bluish lips or face. This list is not all inclusive. Please consult your medical provider for any other symptoms that are severe or concerning” (CDC, “Symptoms,” 03-16-2020).

If you have these symptoms, the CDC recommends that the first thing you do is to CALL YOUR DOCTOR. The CDC does NOT want you to go to your doctor or other health care facility for the safety of all. Your doctor will ask you some questions and directly you appropriately. (CDC, “What to Do if You Are Sick,” 03-16-2020; cf. TDSHS).

“Stay home if you feel unwell. If you have a fever, cough and difficulty breathing, seek medical attention and call in advance. Follow the directions of your local health authority” (WHO, “Coronavirus Disease (COVID-19) Advice for the Public,” 03-18-2020; cf. TDSHS).

Prevalence of Common Flu and Coronavirus Infection

“The true death rate could turn out to be similar to that of a severe seasonal flu, below 1 percent, according to an editorial published in [The New England Journal of Medicine] by Dr. Anthony S. Fauci and Dr. H. Clifford Lane, of the National Institute of Allergy and Infectious Diseases, and Dr. Robert R. Redfield, director of the Centers for Disease Control and Prevention” (Grady, 03-01-2020).

Since 2012, each year in the United States there are about 24-34 million cases of “symptomatic illness” of the flu (CDC, 01-10-2020).

” As of Feb. 22, [2020], in the current season there were at least 32 million cases of flu in the United States, 310,000 hospitalizations and 18,000 flu deaths, according to the CDC. Hospitalization rates among children and young adults this year have been unusually high. To contrast, in this current season, “COVID-19: U.S. at a Glance: total cases 7038; total deaths 97; jurisdictions reporting cases 54 (50 states, District of Columbia, Puerto Rico, Guam, US Virgin Islands)” (CDC, 03-18-2020).

 “There is now a total of 95,265 reported cases of COVID-19 globally, and 3281 deaths” (WHO, 03-05-2020). This calculates to a 3.4% death rate for “reported cases.” It is unclear how many cases are not reported; thus, the death rate is actually lower to some degree.

“As of the evening of March 8, [2020],78 state and local public health labs in 50 states and the District of Columbia have successfully verified and are currently using COVID-19 diagnostic tests. Combined with other reagents that CDC has procured, there are enough testing kits to test more than 75,000 people” (CDC, 03-09-2020).

Risk Factors

Advanced age, underlying chronic illnesses, diabetes, high blood pressure (Johnson, 02-19-2020; TDSHS, 03-15-2020; WHO, “Situation Report 51,” 03-11-2020). “Those with . . .  cardiovascular disease [and] chronic respiratory disease are [also] at risk for severe disease” (WHO, “Situation Report 51,” 03-11-2020; cf. TDSHS, 03-15-2020). Included in this list are those with cancer (TDSHS, 03-15-2020).

“For most people, COVID-19 infection will cause mild illness however, it can make some people very ill and, in some people, it can be fatal. (WHO, 03-08-2020).

Countries Most Affected by Coronavirus

Began in China (CDC, 02-25-2020; Johnson, 02-19-2020, Noack, et al., 02-20-2020).

 “Outside China, 2055 cases were reported in 33 countries. Around 80% of those cases continue to come from just three countries [Korea, Italy, and Iran]” (WHO, 03-05-2020; 03-08-2020). “Although a few countries are reporting large numbers of cases, 115 countries have not reported any cases, 21 countries have reported only one case, and 5 countries that had reported cases have not reported new cases in the past 14 days” (WHO, 03-05-2020).

“This epidemic is a threat for every country, rich and poor. As we have said before, even high-income countries should expect surprises. The solution is aggressive preparedness” (WHO, 03-05-2020).

“These are plans that start with leadership from the top, coordinating every part of government, not just the health ministry – security, diplomacy, finance, commerce, transport, trade, information and more – the whole government should be involved” (WHO, 03-05-2020).

“Over 100 countries have now reported laboratory-confirmed cases of COVID19” (WHO, 03-08-2020).

Prevention of Flu/COVID-19 Spread

“CDC recommends getting a flu vaccine, taking everyday preventive actions to help stop the spread of germs, and taking flu antivirals if prescribed” (CDC, 02-25-2020).

“At this time, there is no vaccine to protect against COVID-19 and no medications approved to treat it” (CDC, 04-02-2020). “The FDA has been working closely with other government agencies and academic centers that are investigating the use of the drug chloroquine, which is already approved for treating malaria, lupus and rheumatoid arthritis, to determine whether it can be used to treat patients with mild-to-moderate COVID-19 to potentially reduce the duration of symptoms, as well as viral shedding, which can help prevent the spread of disease. Studies are underway to determine the efficacy in using chloroquine to treat COVID-19. . . While there are no FDA-approved therapeutics or drugs to treat, cure or prevent COVID-19, there are several FDA-approved treatments that may help ease the symptoms from a supportive care perspective. . . The FDA remains steadfast in helping to foster the development of safe and effective medical countermeasures and ensuring they are available as quickly as possible to protect public health and safeguarding Americans from fraudulent products claiming to prevent, treat, or diagnose COVID-19 as part of the agency’s around-the-clock response to this outbreak.” (FDA, 03-19-2020).

“People can protect themselves and their communities by taking steps such as frequent handwashing, avoiding contact with people who are sick and staying home if they develop symptoms, health authorities say” (Abbott, 03-01-2020).

“While we won’t have exact figures until after the flu season is over, the 2019-2020 vaccine is estimated to be 45% effective overall and 55% effective in children. In comparison, the 2018-2019 flu vaccine was roughly 29% effective” (Schumaker, February 21, 2020).

“Partly because of these misconceptions, only half of Americans reported that they planned to get the flu vaccine this year, according to a survey conducted by the National Foundation for Infectious Diseases this summer” (Schumaker, 03-02-2020).

“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 and then throw the tissue in the trash, clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe. Follow [the] CDC’s recommendations for using a facemask; [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 workers and people who are taking care of someone in close settings (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. For information about handwashing, see CDC’s Handwashing website. For information specific to healthcare, see CDC’s Hand Hygiene in Healthcare Settings. These are everyday habits that can help prevent the spread of several viruses. CDC does have specific guidance for travelers” (CDC, 02-15-2020).

For older adults and those with pre-existing conditions, the CDC recommends “When you have visitors to your home, exchange “1 metre greetings”, like a wave, nod, or bow. Ask visitors and those you live with to wash their hands. Regularly clean and disinfect surfaces in your home, especially areas that people touch a lot. If someone you live with isn’t feeling well (especially with possible COVID-19 symptoms), limit your shared spaces. If you become ill with symptoms of COVID-19, contact your healthcare provider by telephone before visiting your healthcare facility. Make a plan in preparation for an outbreak of COVID-19 in your community. When you go out in public, follow the same preventative guidelines as you would at home. Stay up to date using information from reliable sources” (CDC, “Situation Report 51,” 03-11-2020).

“The World Health Organization (WHO) reminds all countries and communities that the spread of this virus can be significantly slowed or even reversed through the implementation of robust containment and control activities” (WHO, 03-07-2020).

“We must stop, contain, control, delay and reduce the impact of this virus at every opportunity. Every person has the capacity to contribute, to protect themselves, to protect others, whether in the home, the community, the healthcare system, the workplace or the transport system” (WHO, 03-07-2020).

“Stay home if you feel unwell. If you have a fever, cough and difficulty breathing, seek medical attention and call in advance. Follow the directions of your local health authority” (WHO, 2020).

“If you are not in an area where COVID-19 is spreading or have not travelled from an area where COVID-19 is spreading or have not been in contact with an infected patient, your risk of infection is low. . . If you are in an area where there are cases of COVID-19 you need to take the risk of infection seriously. Follow the advice of WHO and guidance issued by national and local health authorities. For most people, COVID-19 infection will cause mild illness however, it can make some people very ill and, in some people, it can be fatal. Older people, and those with pre-existing medical conditions (such as cardiovascular disease, chronic respiratory disease or diabetes) are at risk for severe disease” (WHO, “Situation Report- 59,” March 19, 2020).

“The fight against rumours and misinformation is a vital part of the battle against this virus. . . If countries act aggressively to find, isolate and treat cases, and to trace every contact, they can change the trajectory of this epidemic” (WHO, 03-05-2020). From Dr. Nancy Messonnier of the CDC, “I want to clarify the reason to stock up is that there is a rationale for being in a higher risk group wanting to avoid congregate settings. . .Right now, in the United States, most communities. . . are not having community transmission. . . We really do not think this is the time for Americans to be going out and getting masks. . . I also think people need to understand that there are personal responsibilities that we’re asking everyone in the United States to take to make sure that they’re doing their best to protect themselves and their families and their communities and right now especially to make really strong efforts to protect those who are older and at underlying risk.  As a community. . . we can really mitigate the impact of this disease and as long as we work together. You will see . . . more communities starting to implement some kind of mitigation measures when they’re seeing community spread. [For those who are] older and [have] underlying illnesses, we are recommending avoiding crowds, congregate settings because those are places where in general there is lots of transmission of respiratory diseases” (CDC, 03-09-2020). Wash your hands often with soap and water for at least 20 seconds. If soap and water are not available, use an alcohol-based hand sanitizer. “Avoid touching your eyes, nose, and mouth with unwashed hands, avoid close contact with people who are sick, 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” (TDSHS, 03-15-2020).

“Avoid gatherings of more than 10 people and non-essential trips into public, cancel events of more than 10 people, limit close contact (at least six feet) with other people, employers should allow alternative work options as much as possible” (TDSHS, 03-18-2020).

“DSHS also recommends that you start practicing social distancing. Social distancing involves staying away from other people to avoid catching or spreading illness. It’s a fancy term for avoiding crowds and minimizing physical contact. This could mean avoiding concerts or weddings, skipping the handshake, and/or staying at least six feet away from others” (TDSHS, 03-18-2020).

“On March 19, 2020, Dr. John Hellerstedt, commissioner of the Texas Department of State Health Services, declared a public health disaster in Texas, because COVID-19 ‘has created an immediate threat, poses a high risk of death to a large number of people, and creates a substantial risk of public exposure because of the disease’s method of transmission and evidence that there is community spread in Texas.’. . The next two weeks [through April 3, 2020] are critical in slowing the spread of COVID-19. Texans must act now.” (TSDHS, 03-20-2020).

“If you work in a critical infrastructure industry. . . such as healthcare services and pharmaceutical and food supply, you have a special responsibility to maintain your normal work schedule” (Trump, 03-16-2020).

“Texas Gov. Greg Abbott on Thursday [March 19, 2020] closed schools for more than 5 million students for at least two weeks [through April 3, 2020], and warned that during that time the coronavirus outbreak could spread to ‘tens of thousands’ of cases across the state” (Vertuno and Weber, Associated Press, 03-19-2020).

State of Texas, through April 3, 2020: “In accordance with the Guidelines from the President and the CDC, every person in Texas shall avoid social gatherings in groups of more than 10 people; . . . people shall avoid eating or drinking at bars, restaurants, and food courts, or visiting gyms or massage parlors; provided, however, that the use of drive-thru, pickup, or delivery options is allowed and highly encouraged throughout the limited duration of this executive order; . . . people shall not visit nursing homes or retirement or long-term care facilities unless to provide critical assistance; . . . schools shall temporarily close” (Governor Gregg Abbott, 03-19-2020).

“[Collin] County health officials urge residents to follow advice and guidelines from the CDC or [Texas] DSHS websites, where the daily updated information is posted, including advice and information for travelersbusinesses and healthcare providershow the virus spreadsits symptoms, and how to protect yourself” (Collin County Texas, 03-18-2020).

“On March 16, 2020, The City of Plano declared a local state of disaster for public health emergency. . . Restaurants with or without drive-in or drive through services; drive-in restaurants; drive-through restaurants; or microbreweries, micro-distilleries, or wineries may only provide take out, delivery, or drive-in or drive- through services as allowed by law effective March 18, [2020], at 5 p.m. until April 27, [2020] (may be revisited or repealed by the Mayor or City Council at an earlier date). All bars, lounges, or taverns; theaters; gyms; and private clubs are closed effective March 18, [2020], at 5 p.m. until April 27, [2020] (may be revisited or repealed by the Mayor or City Council at an earlier date)” (City of Plano, 03-18-2020).

“With guidance from [Governor Abbott], the Texas State Board of Dental Examiners is directing all licensees to follow CDC guidelines regarding elective dental procedures. Please note, a strict interpretation may not necessarily be the best interpretation, and each licensee should use their professional judgement when making these decisions” (TSBDE, 03-22-2020).

“Healthcare facilities and clinicians should prioritize urgent and emergency visits and procedures now and for the coming several weeks. The following actions can preserve staff, personal protective equipment, and patient care supplies; ensure staff and patient safety; and expand available hospital capacity during the COVID-19 pandemic: delay all elective ambulatory provider visits, reschedule elective and non-urgent admissions, delay inpatient and outpatient elective surgical and procedural cases, postpone routine dental and eyecare visits” (CDC, “Resources for Clinics and Healthcare Facilities,” 03-16-2020).

“TDA has been in contact with the Texas State Board of Dental Examiners and Governor Abbott’s office. As of March 16, 2020, at 5:00 p.m. central, there are no federal or state directives mandating dental office closures. State governments and dental associations are issuing specific COVID-19 guidance, including the American Dental Association’s recommendation issued on Monday, March 16. TDA members are encouraged to review available resources and apply that information to their individual situations when making a decision about whether to keep offices open and whether to triage non-emergency dental care. Absent governmental directives (whether federal, state, county, or municipal), it is up to each individual dentist to exercise their professional judgement in deciding what additional precautions should be implemented and whether or how to continue dental office operations” (TDA, 03-21-2020).

“During a March 17, 2020, White House press conference, Dr Deborah Birx, who is coordinating the Trump administration’s response to the pandemic, announced that all doctors and dentists should avoid performing ‘elective surgeries’ . . . As of noon today [03-18-2018] there is no Texas state directive for dental office closures” (Miller of Texas Dental Association, 03-18-2020).

The Future

“COVID-19 is an emerging disease and there is more to learn about its transmissibility, severity, and other features and what will happen in the United States” (NCIRD, 02-17-2020).

“There’s still a lot we don’t know, but every day we’re learning more, and we’re working around the clock to fill in the gaps in our knowledge” (WHO, 03-05-2020).

“If you are not in an area where COVID-19 is spreading or have not travelled from an area where COVID-19 is spreading or have not been in contact with an infected patient, your risk of infection is low” (WHO, 03-08-2020).

In China, Starbucks has “continued to see encouraging signs of recovery with over 90% of stores reopened” (Johnson, K., 03-11-2020; cf. Dahstrom and Duong, March 5, 2020). In their experience with China, “Starbucks would be among the first major brands to proactively close their retail stores, eventually totaling more than half of the company’s 4,300 stores that employ 58,000 people. . . In China, in normal times, a new Starbucks opens about every 15 hours” (Dahlstrom and Duong, March 5, 2020).

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Abbott, Greg. Executive Order. “Executive Order GAO8 Relating to COVID-19 Preparedness and Mitigation” (March 19, 2020). Accessed March 22, 2020. https://www.tda.org/Portals/0/EO-GA_08_COVID-19_preparedness_and_mitigation_FINAL_03-19-2020_1.pdf?ver=2020-03-19-145021-520.

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