Ben Kruskal, MD: What you should Know About the 2019 Novel Coronavirus

February 11, 2020

NEQCA Medical Director Ben Kruskal, MD discusses the recent outbreak, why we should pay attention, and prevention best practices

What is a Coronavirus?

Coronavirus is a class of viruses. And like most classes or families of viruses, it includes some strains that are disease causing for humans, some that are disease causing for animals and some that don’t necessarily cause diseases at all. Among more common Coronaviruses are several strains that cause pretty typical acute upper-respiratory infections or colds. The other members of this family that are well known are Severe Acute Respiratory Syndrome virus (SARS) which caused a big outbreak in 2002-2003, also starting in China. And, Middle East Respiratory Syndrome virus (MERS) which caused a much smaller outbreak starting in Saudi Arabia in 2012. 

Where and how did the 2019 Novel Coronavirus begin?

There’s a statistical association with a seafood market in Wuhan, China. In general, when you have multiple species of animals close together, multiple different viruses or strains of the same virus may infect a particular animal. That animal can have re-combinations of the viruses occurring, which is how novel or new strains develop. 

What are the symptoms of this new virus?

The current Coronavirus that started in Wuhan, China is a pretty typical respiratory infection. The symptoms are primarily cough, nasal symptoms and fever. And as with most viruses, there are sometimes Gastrointestinal (GI) symptoms but they are not prominent. What makes this Coronavirus distinctive is that it causes pneumonia at a higher rate than we would typically see with the flu.

Why are we concerned about this new virus?

We’re all protected from the flu to some extent, whether by vaccine or from immunity arising from prior infections with related strains of the flu. Because this Coronavirus is new, and is not closely related to existing coronaviruses, we have virtually no protection—either as a population (meaning it spreads quickly) or as individuals.

How do doctors know when to suspect the novel coronavirus is causing a particular person’s symptoms?

One of the problems with a virus like this is that there isn’t anything sufficiently different or characteristic to make it easy to recognize. If you’re in contact with someone who has this specific virus or with someone who’s ill who has traveled from China, those would be reasons to look specifically for that virus or treat yourself as if you have that virus. 

How effective are face masks in prevention? Are there other forms of prevention?

For illnesses that are transmitted by respiratory droplets, a typical surgical mask or frankly anything covering the mouth and nose is pretty effective. Staying at least three feet away from someone who’s ill is also a pretty effective means of avoiding catching it. We don’t know a lot yet about how this virus is transmitted, but respiratory droplets are likely to be at least one important component. The virus is also present in the GI tract. We don’t know how important that might be in transmission, so it is (as always!) important to thoroughly wash hands to prevent possible contact transmission from one’s hands to surfaces and other people. We don’t know how long the virus is viable on surfaces, in other words how long the virus would be able to be acquired by someone else touching that surface. For most viruses, it’s minutes, and I suspect the same will be true for the new coronavirus, but we don’t know yet.

Are there any current treatments for Coronavirus?

There are no treatments for Coronavirus, only “supportive care.” (Some existing antiviral medicines may have activity against this virus, but we don’t know for sure yet. They might be used in situations where their effects could be studied.) In many cases, this means what you would think it means-- chicken soup and TLC. But in much more severe cases, hospitalization may be necessary where there is access to medications and technologies that can support your body’s functioning until your immune system kicks in and wipes out the virus.

Any last words of advice?

While the outbreak is concerning, it’s not something that should change anyone's behavior in or around Boston right now. We should continue to do all the important things that we normally do to keep ourselves healthy. If the new coronavirus arrives in Boston, these will help reduce your risk—and they’ll also help you avoid the flu and all our normal viruses. Wash your hands well (for at least 20 seconds - or the equivalent of singing "Happy Birthday" twice through). If you’re sick, stay home. And, get your flu shot - not because it prevents Coronavirus but because you’re much more likely to get the flu right now in Boston than you are to get the Coronavirus.

Ben Kruskal, MD, PhD, FAAP, FIDSA is a NEQCA Medical Director who is both a pediatrician and infectious disease specialist. He was formerly Chief of Infectious Disease at Atrius Health, and led the Atrius response to SARs, the 2009 flu pandemic, and possible Ebola cases in 2014. He has worked extensively with the Massachusetts Department of Public Health on the role of primary care in outbreak preparedness and management.

Details surrounding the Coronavirus outbreak are continually changing. Please visit the Centers For Disease Control (CDC) for the latest information.