“I just got a package from China–what do I do?”

Feb. 20, 2020 – While examining a patient with a suspected upper respiratory infection, he mentioned to me that he had recently received a package from China. From Wuhan, China, no less. He had discovered the origin of the package while it was still in transit, but even though he attempted to cancel the order, the package arrived and was subsequently opened. “So when exactly did your symptoms begin?” I ask. “Before or after you received the package?” He couldn’t be sure. 

The Wuhan coronavirus officially termed severe acute respiratory syndrome coronavirus 2, also known as SARS-CoV-2 causes a flu-like illness referred to as COVID-19 (‘CO’ stands for ‘corona,’ ‘VI’ for ‘virus,’ and ‘D’ for disease). Some patients with this particular virus will have no symptoms at all. Others have mild illness, and some will develop acute respiratory distress and succumb to the infection. There is no treatment or vaccine–yet. 

At the present time, I’m reminding my patients that the seasonal influenza virus kills 50,000 people in the US… every year. At the time of this writing, the coronavirus has taken the lives of approximately 2,800. Most of these individuals have been very young, very old, or battled chronic diseases such as asthma or diabetes. 

The worst disease outbreak in history was the Spanish Flu of 1918 which took up to 100 million lives. The Black Plague, in comparison, claimed approximately 75 million lives. 

There are several theories as to why the Spanish Flu was so deadly, at one point infecting over 25% of the world’s population at the time. I remember learning in an undergraduate microbiology class that many victims of the Spanish Flu were young healthy adults who suffered a cytokine storm or the toxic effect of an overly aggressive immune system. Other experts suggest that poor hygiene, sanitation, and medical care led to secondary bacterial infections such as pneumonia that were more likely responsible for the fatalities. The whole World War 1 thing going on at the same time surely didn’t help. The majority of the fatalities from the coronavirus have so far occurred in mainland China where access to medical care is sparse. 

According to the CDC, based on what we know of other coronavirus infections, the SARS-CoV-2 virus is unlikely to survive long on inanimate objects. This means that products imported from China that were shipped over days and weeks are not considered a risk. 

What can you do right now to prepare for the landfall of the coronavirus in the United States? With dozens of confirmed cases already in the country, it’s a possibility that the virus is already spreading undetected… So:

• Get your flu shot (and other applicable immunizations if you have a chronic illness)
  • If you are able to remain healthy throughout the next several months, you are less likely to contract a secondary infection
• Practice good hygiene
  • Wash your hands, cover your mouth when you cough, don’t touch your face unnecessarily, etc.
• Stop smoking for heaven’s sake!
• Don’t bother stocking up on masks
  • Unless you are a healthcare worker
• Avoid unnecessary travel outside the country, especially to China… Duh!

What are you doing to prepare?