On planes, trains and buses; in grocery stores and malls; and most definitely walking across universities, surgical masks appear to be the latest fashion accessory. Mind you, few people are wearing them correctly…but I digress. People are understandably worried about this new Corona Virus, for which we have marginal understanding, no vaccine, little effective treatment and no cure.
First things first, though, let’s start with the name.
On Feb 11, 2020, the World Health Organization officially changed the name from Corona Virus to COVID-19, which is simply an abbreviation of “CO”rona “VI”rus “D”disease, which started in 20“19”. The earliest suspected cases in the USA (which ultimately were NOT actually COVID-19) were in fact, discovered on college campuses- Texas A&M and Baylor, both in Texas. Since then, there have been multiple other “persons under investigation” for COVID-19, including students at a few universities who have been quarantined, but thankfully, so far, we’ve only had one 20-year-old male college student in Boston that has been positively diagnosed with COVID-19. None-the-less, it’s not surprising that students and parents are especially concerned. We all know that close quarters like dorms and classrooms allow infectious diseases to spread quickly. Plus, show of hands for all who had (or have) a student studying abroad…yep, that’s most of us! And with Mandarin Chinese now ranking as the top spoken language, tons of our students have wisely chosen to study in China. Which leads to three common concerns:
- My roommate/friend/classmate studied in China last semester, and now (six weeks later) they have flu symptoms…can they infect me?
- I’m planning to study abroad in China this summer; will it be safe?
- How do I know if my fever/cough/flu symptoms are COVID-19?
Our best evidence now is that COVID-19 will show up within fourteen days of exposure. (That’s why people are being quarantined for two weeks if they are thought to have been exposed.) So, if your roommate has been back from China since mid-January, and now for the first time are having symptoms of fever and cough…we are far more concerned about them having influenza or another respiratory infection. They do not need to be tested for COVID-19.
Study abroad planning is much more challenging. Short answer is NO, do not plan on China for this summer. Fall 2020 is unknown. At this point, all travel is strongly discouraged to mainland China (including a US Department of State issued a Level 4 Travel Advisory) so universities have appropriately temporarily suspended their study abroad programs for that region. Hong Kong, Macau, Taiwan, Korea or Japan are still viable options at this point.
At this time (February 22, 2020), the only reasons to test for COVID-19 are if you have fever or cough/shortness of breath AND have either traveled to mainland China OR had close contact with someone known to have COVID-19 within the last two weeks.
Meanwhile, our 2019-2020 flu season is in full swing. Sadly, the CDC reports we’ve had 14,000 deaths (including 92 children) so far this season. There have been an estimated 26 MILLION cases of flu, leading to 250,000 hospitalizations and 14,000 total deaths. Not to minimize the concern about COVID-19, but for perspective: right now, there are roughly 70,000 total cases and close to 1666 deaths from COVID-19. We have had 15 cases in the United States. And to hopefully further reduce anxiety, know that 80% of all COVID-19 infections have mild symptoms.
Take home message? If you haven’t already, get your flu shot! It’s not too late. Is it perfect? Nope, never is, and some years are better than others, but EVERY year, the flu shot makes influenza less severe (less chance of ending up in the hospital or worse.) And college students- missing a couple days of class is way better than missing a couple weeks (which is what we see when unimmunized students get the flu.)
So back to those masks…are they necessary? No. Useful? Yes, sometimes. Surgical masks are considered “personal protective equipment” (PPE). We ask all our patients who have fever and cough to wear a mask in the waiting rooms to help prevent the spread of respiratory infections. Typical surgical masks (the blue ones with ties or elastic bands) are relatively loose-fitting barriers designed to protect against larger droplets/sprays of bodily fluids. These will not protect against tiny viral particles, but they do a nice job containing body fluids from the coughs and sneezes of the person wearing the mask. If you are going to wear one, make sure it covers your nose- then firmly pinch the metal piece over the nose to secure it, secure the upper and lower ties behind your head, (or elastic loops behind your ears) then last step is to pull down the center bottom edge below your chin, and then pinch that metal piece below your chin.
Respirator masks (firmer, white, attach with elastic bands, called N95 respirators) must be fitted to the wearer’s face and tested for leakage. These masks filter out over 95% of airborne particles. Health providers wear these masks when dealing with measles, chicken pox, tuberculosis and now COVID-19. Why don’t we use them all the time? Expense and discomfort. These respirator masks are hot and make it feel difficult to breathe for many users.
Bottom Line: The best advice I can give you to avoid catching ANY respiratory virus is to have consistent hand washing (soap and water OR hand sanitizer for 20 full seconds) and avoid touching your eyes, nose and mouth. Think about handrails, doorknobs and light switches, and realize how many other hands touch those. Sanitize after you touch them. And good nutrition, sleep and exercise wouldn’t hurt either.