Coronavirus, Contagion, and Civility

In times of crisis, communities can unify together or be torn apart. Santa Barbara is already being tested by the threat of Wuhan novel coronavirus as this pandemic unfolds. Our world has people living in denser populations with faster, less expensive global travel than ever before in history. As people continue to encroach on habitats and global travel becomes easier, a virus can move from origin to most anywhere worldwide in 24 hours. It was just a matter of time before a global health emergency like this emerged.

Coronavirus is actually a family of common cold viruses that can cause a variety of respiratory illnesses. There’s lots of versions of this virus, some more severe than others. You’ve likely already had some bout of it in your lifetime. It’s usually responsible for a third of all viral colds. Symptoms include runny nose, cough, muscle aches, and a night or two in with hot tea and Netflix.

Coronavirus can also infect animals and can jump from animal to people. Occasionally, a severe strain of coronavirus hits (such as SARS, severe acute respiratory syndrome, in 2003 or MERS, Middle Eastern respiratory syndrome, in 2012). The current novel coronavirus outbreak originating in Wuhan, China (designated 2019-nCoV) was discovered in December 2019. This virus likely originated in an animal market in Wuhan, though how it evolved is still being studied.

We know human-to-human transmission of this virus is occurring, and there are new cases that have no connection to the Wuhan market. We are still trying to figure out exactly how it’s spread and how contagious it is. The Centers for Disease Control believes it is likely aerosol droplet and contact (you get it from breathing in or touching virus particles).

Clinically, this novel coronavirus presents similar to flu. The incubation period is about 14 days, meaning once exposed, it will take time for someone to show symptoms (although likely will begin within 3-6 days after exposure). The illness presents with fever, cough, shortness of breath, and muscle aches, and it may progress to pneumonia.

In one Chinese cluster, 20 percent of those with the virus required hospitalization, and 2 percent died from the infection. As we learn more about the virus, we are finding people who have been exposed who are either asymptomatic or only minimally ill. Most of the deaths from this virus happen to people who are already sick with preexisting conditions. The most vulnerable for severe illness are infants, the elderly, and those with chronic illness or weakened immune systems.

With this in mind, here are some simple tips on how to keep our Santa Barbara community safe during this evolving epidemic.

•  Wash your hands. Use soap and water or hand sanitizer. Wash them often. This is the most effective way to prevent infection transmission.
•  Get the flu vaccine. Flu has killed and hospitalized a lot more people than coronavirus. A lot more. Get your vaccine. At of today (February 6), there are 11 cases of coronavirus in the U.S.A., and yet more than 10,000 Americans have already died of flu this flu season, not to mention the thousands of lost work days as people recovered. Get the flu shot. Get the flu shot. Get the flu shot.
•  Stay home if you are sick. Do not bring your germs to school or work. Don’t bring any misinformation either. Cut your colleagues some slack: If they are sick, tell them to stay home.
•  Masks. Simple face masks, on someone who is sick, may help prevent them from spreading it to others. A simple facemask will not protect you, as a healthy unexposed person, from coronavirus (unless it is an N95 respirator fitted with a tight seal). Know this before you got to the hardware store to stock up.
•  Cough or sneeze into your elbow (not your hands). Maybe consider fist bumping, elbow bumping, bowing, or smiling instead of shaking hands of strangers.
•  Don’t touch your face if you can avoid it. The virus likely enters through mucous membranes of the eyes and mouth. If you do touch your face, make sure you do it with clean hands.
•  Eat healthy, exercise, and take extra care of any chronic illness (diabetes, chronic congestive heart failure, emphysema, asthma, etc.). Some of what we learned from SARS is that young, healthy people had better outcomes when infected. So do your best to get healthy. And if you are sick with flu or an influenza-like illness, don’t go out in public. Some of our community have weakened immune systems from chemotherapy, infection, cancer, or chronic disease. Share with them your well wishes, but not your germs.
•  Tell our politicians to invest in public health and access to medical care. As this outbreak ramps up, our funding for public health is dwindling. If the most chronically ill are the most vulnerable, then we as a community need to invest in getting them access to care and getting healthy before the virus hits.
•  If you have cough, fever, and influenza-like illness, and have been to Wuhan City or exposed to someone who has been to Wuhan City, call your local public health department. Do not immediately go to crowded, public places, such as a hospital or health-care clinic. The 24/7 access line for Santa Barbara Public Health Department Disease Control is (805)681-5280. Quarantine is not a punishment, but a public health tool to help contain and prevent disease spread. Cooperate with public health officials. We all have a part to play to keep our community safe.
•  Be informed. Get your information from reliable sources. The CDC, World Health Organization, and local/state public health departments are all reliable. Twitter feeds, Facebook posts, and social-media fear-mongering is spreading gossip and fear. Be informed. I have provided a list of reliable sources with regular updates below. By the time this article goes to print, some of the info will be out of date. Stay informed with up to date reliable sources.
•  Don’t be racist. I should not have to say this, but I will. This outbreak is not an excuse to hate or fear people of Chinese ancestry. The virus doesn’t care about your politics, ethnicity, geography, language you speak, clothes you wear, or religion you practice. Do not ask that all people of Chinese ethnicity wear masks or be quarantined if they have not been exposed. Uncertainty breeds fear. Please do not be fearful, hateful, or racist. Instead, be a constructive member of your unified community and advocate for public health.

The world is responding to this emerging pandemic. Our Santa Barbara community is strong, resilient, dynamic, and unified. The brave men and women of public health, emergency healthcare, primary health care, community health, and civil defense are ready and willing to serve when the moment comes. Keep your hands clean, your minds sharp, your hearts open, and your decisions influenced by scientific best practice. Stay healthy, friends.

If you think you have novel coronavirus infection, please call your doctor, call the Santa Barbra Public Health Department Disease Control 24/7 access line, or, if it’s severe, call 9-1-1.

Dr. Jason Prystowsky is an emergency physician with Cottage Health, academic coordinator for the UCSB Medical Humanities Initiative, and medical director of Doctors Without Walls – Santa Barbara Street Medicine.

Reliable Sources for Information

U.S. Centers for Disease Control — daily situation summary
https://www.cdc.gov/coronavirus/2019-ncov/summary.html

Santa Barbara Cottage population health
https://www.cottagehealth.org/about/newsroom/2020/novel-coronavirus/

S.B. County Public Health
https://www.countyofsb.org/phd/dcp/novel-corona-virus.sbc

California Department of Public Health
https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/Coronavirus-Press-Releases.aspx

World Health Organization — daily situation report
https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports/

Lancet — coronavirus resource center
https://www.thelancet.com/coronavirus