Coronavirus, respiratory droplets — and you

Flying from Atlanta to New York the other day, I could see that many people on the plane were nervous. I tried to reassure them that the coronavirus was nowhere to be found and that they were far more likely to catch the flu, which, according to the Centers for Disease Control (CDC), has already infected 32 million people, with 310,000 hospitalizations and 18,000 deaths in the U.S. this year alone.

Over the weekend we had the first U.S. death from the coronavirus COVID-19, and it was all anyone talked about. As I wrote about in “False Alarm: The Truth About the Epidemic of Fear,” this hysteria alters perception and causes people to mistreat and marginalize each other for the wrong reasons at a time when we should all be coming together. Public health and public cooperation are essential in the fight against all contagions, which have killed more than 2 million people in the world so far in 2020. 

People are afraid of the unknown, afraid of an emerging threat for which we have no immunity, no vaccine, no treatment. They fear a virus that comes from a foreign land that we automatically see as suspicious, a country whose government suppresses information and then uses techniques from the Middle Ages to try to rope off and squash the emerging contagion.

Here in the U.S., we don’t have the needed test kits yet so that doctors can reassure most of those with a cough and fever that they don’t have the coronavirus while isolating those who do. (The Food and Drug Administration now says that more extensive testing is becoming available).  

Surgical masks are a mark of coronavirus fear. They are fear “props” which signal to you that something is in the air around you — when it really isn’t. Not only that, but masks are virus collectors and, when worn improperly or discarded incorrectly, can actually spread more virus than they protect you against. If a person does wear one, it may keep them from realizing that viruses get in through the skin, the mucous membranes of the eyes and from a person’s fingers being put into their mouths. Masks have been shown to be helpful when you are sick, to keep you from spreading virus on respiratory droplets to others. This is particularly true in close quarters, such as on a plane.

There is a silver lining to all the coronavirus panic. If we can use this as a teaching moment — to promote infection prevention through thorough hand-washing, disinfecting of common surfaces, proper use of hand sanitizers along with moisturizing lotion to keep skin moist (dry skin allows viruses to get in through the cracks) — then our new vigilance can help protect us against all bacteria and viruses. Social distancing is useful to prevent viral spread, especially in the winter when we group closer together while respiratory viruses rely on cold, dry air to travel farther on droplets and infect more people.

It is no accident that the summer months bring a dramatic decrease in most respiratory viral infections, including the flu and, most likely, this coronavirus. Virus-containing respiratory droplets encounter hot, humid conditions and they fall to the ground. Keeping your mucous membranes moist, along with the hair inside your nostrils, by drinking more fluids and using saline spray also helps to protect you from viral invasion. 

Currently, according to the CDC, there are 71 confirmed coronavirus cases in the U.S., with 44 from the Diamond Princess Cruise ship, 12 in California, six in Washington state and three in Illinois. The first three cases were brought here from Wuhan, China, and so far we have recorded one death. The true numbers are likely far greater, as most cases remain unreported. 

The push to increase the number of test kits available through the FDA is finally bearing fruit at just the right time, which will help us to find more cases but also to reassure people who don’t have COVID19 despite experiencing its chest and fever symptoms. 

It is concerning that the numbers of cases have recently increased in other countries with well-developed health care infrastructures — specifically, Italy (almost 1,700 cases with 34 deaths) and South Korea (more than 3,700 cases). This a reason to be concerned that we soon may be dealing with the same kinds of numbers here despite our best public health efforts at containment, including identification, isolation and contact-tracing of cases coupled with increased travel restrictions for other affected areas.

Currently, the death rate appears to be 1.4 percent — higher than with flu — and the rate of spread (R0) appears to be 2.2, meaning that for every patient with coronavirus, more than two other people will get it — also making it more contagious than flu. 

Most public health experts agree that there are many thousands of cases — most of those probably mild or even asymptomatic — that have never been diagnosed. The concern is that even if the outbreak dies out in the spring, it will come back strong in the fall if it manages to gain a foothold in a particular region. By then, we may be ready with working anti-viral treatment, if not yet a vaccine. 

In the meantime, we can be reassured that our efforts to control personal spread is useful in the war against all respiratory viruses, if not yet necessary against this one. Public health measures outside China appear to have slowed its spread, and these efforts should be lauded, not criticized.

Marc Siegel, M.D., is a professor of medicine and medical director of Doctor Radio at NYU Langone Health. He is a Fox News medical correspondent. Follow him on Twitter @drmarcsiegel.