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For a detailed description of the symptoms and signs of the COVID-19 coronavirus, we turn to MedicineNet's resident microbiologist and emergency medicine doctor; he describes an illness frightening even for many of those who survive.
Many of the 80 percent of COVID-19 sufferers who don't need hospitalization remain unwell for a couple weeks, with fatigue and shortness of breath, said MedicineNet author Charles Patrick Davis, MD, PhD.
The prognosis for coronavirus is worse for the 16% to 20% who need medical care, and there probably won't be nearly enough hospital beds, staff, or breathing machines to treat everyone who needs it, Dr. Davis said.
Dr. Davis is a retired ER doctor and professor of emergency medicine with a PhD. in microbiology.
Dr. Davis, also an author of medical texts and a member of MedicineNet's board of medical editors, believes the worst of the COVID-19 coronavirus pandemic is approaching the U.S. in the coming weeks.
The following is from an interview with Dr. Davis:
MedicineNet: Can you detail how a coronavirus infection occurs?
Once you cough, the virus becomes airborne for a period of time until gravity pulls down the droplets on a surface. Then, someone who touches that surface can transfer the virus, usually hand-to-mouth. That's when the virus begins to multiply.
The worst landing spots are smooth metal surfaces. Things like cardboard and fabric can also transfer the virus, but it's much more difficult with porous material.
MedicineNet: How long after exposure to coronavirus do symptoms appear and what are the symptoms?
Dr. Davis: You'll show coronavirus symptoms usually between two to 14 days, with the average being about day five.
Then you'll develop a fever, and as the coronavirus multiplication goes on, you'll become fatigued easily and have trouble breathing.
You may have diarrhea, but not everybody does.
MedicineNet: That sounds like the flu or a bad cold. It's how coronavirus progresses that makes it different, correct?
Dr. Davis: If you're in the 80% who does well with coronavirus, you won't feel well for a few days, but eventually your immune system is capable of stopping the coronavirus multiplication and you recover without any further problems. It may take you a week or two to really feel up-to-par.
Even though you're getting rid of the virus, you're still going to have some lingering fatigue.
To say that you've recovered from coronavirus takes two tests 24 hours apart that are viral negative for COVID-19. Then you can be relatively sure you are not passing the coronavirus on to anyone else.
MedicineNet: What about the people who get the coronavirus infection and have to go to the hospital?
Dr. Davis: You have to ask yourself, what happens to that 16% to 20% of folks who don't do as well?
Some of them with severe coronavirus symptoms, especially the cough and chest discomfort, will do fairly well just by getting oxygen. It may take them longer to recover afterward.
There are others who will need more intensive care for coronavirus. They might need high-flow oxygen or even be intubated to use a breathing machine.
So, the people that will require breathing assistance with a ventilator is about 5% of all infected patients.
Their symptoms will be oxygen blood saturation falling from normal to below 90, and it will continue to go down. They will be very uncomfortable and won't be able to do much of anything; they may not be able to get out of bed.
MedicineNet: Why do the blood oxygen levels fall in severe coronavirus cases?
Dr. Davis: On a chest X-ray, you'll see little round, fluffy areas that are produced by the coronavirus infection, they're like globs, and when you see those globs, you know that area of the lung is not being oxygenated.
What happens with these patients who are very ill, it's a race between the coronavirus cutting down the oxygen supply and the patient's ability to fight it off. If the patient is otherwise compromised, they might be fighting a losing battle.
For example, Kirkland Nursing Home in Seattle had a population of 108 and 26 died of COVID-19 coronavirus. If you take 26 and divide it by 108, that's a 24% death rate. That's an example of what happens when these populations are compromised and exposed to COVID-19.
MedicineNet: Is there any way to know the difference between the mild symptoms of COVID-19 vs. a common cold other than difficulty breathing?
Dr. Davis: Right now, if you have a common cold, you need to be careful. If you get shortness of breath, get a test right away. You probably can't tell in the early stages. What happens with COVID-19 coronavirus that distinguishes it from the cold and flu is the shortness of breath. But that isn’t an early symptom. It's reasonable to get a flu test and COVID-19 test right away, but up until now we haven't been doing that because there haven't been enough test kits.
MedicineNet: Should you wear a mask to protect yourself from coronavirus in public?
Dr. Davis: In general, if you don't have the infection, you don't need a mask. It will probably not help you. Mainly masks help reduce the virus being spread by those who have the infection.
If you're in a hospital situation and a caregiver, that's another story. In general, it's the N-95 mask that healthcare workers wear, which are different than retail dust masks, etc.
MedicineNet: What about the UK's approach? Hoping to develop herd immunity and avoid a second infection spike later?
Dr. Davis: I think that approach is not the best. Even though you develop a herd immunity, there are going to be people in the herd that are more vulnerable and they are going to get the virus. I think social distancing is still the best. They may develop herd immunity, but it may come at the expense of a lot of lives. That's a good possibility.
MedicineNet: Is coronavirus at risk of becoming a yearly, seasonal infection?
Dr. Davis: It's probably a little early to say. It certainly is a possibility. We're still at the beginning of the development of this pandemic.
MedicineNet: Do climate and weather conditions play a part in how long coronavirus lasts? For example, I've heard the flu thrives in both dry and high humidity, but is weaker in more moderate humidity.
Dr. Davis: Again, it's difficult to say. If you're talking about landing on surfaces, that probably plays a role. But if you look at COVID-19, it's everywhere but Antarctica. It's all over the world, and in the southern hemisphere, it's the exact opposite seasons.
I'm not convinced there's a big change from climate to climate.