Coronavirus (also referred to as COVID-19 and SARS-CoV-2) continues to affect our lives, causing deep dives in the stock market, shuttering amusement parks across Asia, and leaving festivals like Austin's SXSW in limbo as major players like Apple, Amazon, Facebook and Twitter drop out. There's even talk of the Summer Olympics in Japan being postponed. As the virus develops and spreads, people's fears and questions mount and The Doctors spoke to infectious disease expert Dr. Ravina Kullar to help us better understand the virus and who is most at risk.
She answered our many questions, shared vital information on protecting yourself and explains why she is hopeful about how we are handling the health scare.
“We just don’t have answers to a lot of questions, which we should have by now, and that’s probably the most concerning aspect of what is happening,” she says, explaining coronavirus is very similar to SARS and MERS, but appears to have a higher transmissibility rate. She says questions like, “How long does it live on surfaces?” “How does it spread?” and “Where did it originate from?” still need to be answered. She warns to expect more and more cases in America as more testing is done.
What Makes Coronavirus More Contagious Than Other Viruses?
She says until more data is gathered and studied, it is unknown why this virus appears to be more contagious than others. She notes the most recent data from The World Health Organization (as of March 4, 2020) has the mortality rate at 3.4 percent, compared to seasonal flu, which kills less than 1 percent of those infected. She notes theories and data are changing from week to week and says it is believed the incubation period (the time span from exposure to showing symptoms) is around 14 days, but a recent study found it may be up to 24 days.
Is Coronavirus Only Spread through Coughing and Sneezing?
Dr. Kullar notes initially it was thought to spread mainly through body fluid droplets from sneezing or coughing, but now she points to studies that have shown the virus may also be spread through fecal matter. She stresses this is another reason why handwashing (and proper hand drying with a paper towel) is vital to stop the spread of the virus, especially after using the restroom.
In Addition to Fecal Matter, Can It Be Transmitted through Other Bodily Fluids?
She tells us, "Saliva is another route of transmission so kissing could potentially spread SARS-CoV-2. Though coronaviruses are typically not sexually transmitted, it is too soon to know specifically about SARS-CoV-2."
Are Children Less Likely or Just as Likely to Be Infected?
She explains the largest study of coronavirus conducted in Wuhan, China, found it affected elderly people over the age of 60 and particularly those over the age of 80, who had a 15 percent mortality rate. She says children are also susceptible to the virus but have higher recovery rates due to stronger immune systems. She notes that many of the fatality cases in America are patients in nursing homes. She says the study also found that people with health issues like respiratory conditions and diabetes (more common in the elderly population) were more prone to a negative prognosis.
Should Immune-Compromised Kids Be Kept Home from School or Daycare If Possible?
"In general, those on medications that suppress the immune system (such as chemo) are going to be at an increased risk for infection, as well as getting more severe symptoms from infection if they do get it. It is key to pay attention to your local news to determine if cases are prevalent in your area. Infection prevention is even more critical in these patients. Most important, wash your hands frequently, make sure you cover your cough and your sneezes, stay away from others with respiratory symptoms, and avoid travel to places where there are documented cases of COVID. I recommend talking to your oncologist to get guidance on other preventative measures."
Can Coronavirus Cause Long-Term Damage?
Unfortunately, Dr. Kullar says there is the potential for “long-term lung damage implications,” but cautions more studies need to be done in order to determine the possible lasting effects.
If You Catch It Once and Recover, Can You Be Reinfected?
"Yes. People who have gotten SARS-CoV-2 and recovered can get it again in the future, according to the CDC and WHO — the body does not become immune after infection. When a virus enters a human body, it tries to attach to and take over host cells. In response, our immune systems produce antibodies. That's how we become immune to certain illnesses. Children that have contracted chickenpox, for example, are immune to the disease as adults. For SARS-CoV-2, researchers have found that the antibody will be created; however, in certain people, the antibody can’t last that long; therefore, causing a re-infection. Once you have the infection, it could remain dormant and with minimal symptoms, and then you can get an exacerbation if the virus finds its way into the lungs."
Should Those with Respiratory Issues Like Asthma Be More Concerned about Coronavirus?
She cautions anyone with asthma and respiratory allergies to be cautious and to take precautions like (routine hand-washing, staying away from people who are sick, and minimal travel) in order to reduce their risk, as it is believed the virus infects and multiplies in the linings of the airways.
Will There Be a Larger Wave of Cases Later in the Year?
Despite theories, predictions, and rumors of another wave of cases hitting this fall, Dr. Kullar says more data is needed before any of this can be determined.
Are Men Being It Harder and If so Why?
She notes the male coronavirus death rate is around 3 percent, according to the largest study, compared to women at 1.5 percent. She explains this may be linked to hormones, specifically estrogen. She also notes other studies have found men are less likely to wash their hands and more likely to smoke, all of which can contribute to the spread of the virus or make someone more susceptible to infection. Additionally, she believes women who have gone through menopause could be more impacted by the virus, due to lower hormone levels.
Should Parents Wash Their Children’s Clothes When They Return Home from School?
The infectious disease expert tells The Doctors all preventives measures are wise, including the washing of clothes after being at school and stresses the need to have kids wash their hands (for 20 seconds with soap and water and to dry with a paper towel) when they get home from school or spending time with other kids.
Should People Avoid Cruise Ships, Amusement Parks, Concerts and Traveling?
She advises against taking a cruise, going to an amusement park, attending a concert, and suggests minimizing travel on airplanes unless it is essential. If you are flying on an airplane, she suggests wiping down the surfaces of the tray table and seat and washing your hands before and after the flight.
Should We Avoid Using Hand Air Dryers in Restrooms?
Yes. Dr. Kullar says to only dry your hands after washing with a paper towel, as air dryers disperse bacteria and viruses from person to person. “Hand dryers are like setting off a bacterial and viral bomb in the bathroom,” she says, noting if paper towels are not available, to use toilet paper and to not wipe your hands on your clothes or simply allow them to air dry. When it comes to wipes and hand sanitizers, she says to use products with 60 percent ethyl alcohol. And with shortages of hand sanitizers and cleaning wipes, she says one possible alternative would be using a mixture of rubbing alcohol and water with a paper towel to clean your hands, but she notes there have not been any studies on this approach.
Should People Refrain from Shaking Hands and Fist-Bumping?
Dr. Kullar says unless you are sure someone has washed and dried their hands properly, she advises against shaking hands, high-fiving and fist-bumping.
What Is the Scariest Part of the Coronavirus?
The infectious disease expert is concerned most about the “rapid transmissibility” taking place outside of China, along with the many unanswered questions about the virus and the lack of available testing.
Has the Coronavirus Changed How Dr. Kullar Lives Her Life?
She tells The Doctors she has accelerated her infection prevention methods like hand washing and now carries hand sanitizer and wipes with her, along with being mindful about touching her face. She shares she has also cut down on her travel, limiting it to essential travel only.
Is Dr. Kullar Hopeful about Any Aspect of the Coronavirus?
She says the CDC and local health authorities in America deserve credit for their rapid response and handling of the issue thus far. “We are ready for an outbreak if this should come to pandemic standpoint,” she tells The Doctors, noting our experts and preparatory measures in America are the best. Adding, “We have handled these situations in the past and we are very well-equipped… we have full support to prevent this from being a pandemic and to keep us all safe. There is a light at the end of the tunnel.”
Get the latest information on the coronavirus from the Centers for Disease Control and Prevention and the World Health Organization and learn about the virus and its symptoms, prevention methods and what to do if you infected.