Dr. Hall Featured In Rolling Stone Magazine

Rolling Stone

Coronavirus Is Here: What We Know So Far

How is it transmitted? Should you be wearing a mask? We asked infections disease experts our most pressing questions

Over the past few weeks we’ve been confronted with daily reports about the coronavirus, but a lot of the information out there is confusing or contradictory. To start with, it’s a coronavirus, not the coronavirus. According to the World Health Organization (WHO), a coronavirus is part of a large virus family, responsible for illnesses like Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV). The condition that is currently in the news is a novel coronavirus — meaning that it’s a new strain that hadn’t previously been identified in humans. The illness associated with it has been named COVID-19, which stands for “coronavirus disease 2019.”

Ever since the first case of COVID-19 was reported in Wuhan, China on December 31, 2019, concern — now bordering on panic — has disseminated along with misinformation and plenty of rumors. In order to separate fact from fiction, Rolling Stone spoke with several medical experts on this novel coronavirus. Here’s what we found out.

Do we know how it’s transmitted?

Based on what we know now, COVID-19 appears to be transmitted through small droplets of spit that become airborne when an infected person coughs, exhales or sneezes. “If you inhale these particles or touch them on surfaces and then touch your mouth or nose you could become infected,”  Dr. Jennifer Haythe, an internist and a critical care cardiologist at Columbia University Center tells Rolling Stone. “This is similar to other common viruses like influenza.”

There are reports that the virus may also be transmitted through a fecal route, though Haythe says that this is not the major form of transmission. According to Dr. Michael Hall, a physician and CDC vaccine provider at Hall Longevity Clinic in Miami, Florida, when someone flushes stool, it becomes atomized, and the virus may be spreading from the toilet into the atmosphere in that way. New research from the Chinese Center for Disease Control and Prevention published on February 15th, found that people with confirmed cases of COVID-19 had the live virus in their stool samples, confirming this as a possible transmission route. Specifically, there is concern over fecal-oral transmission, which could happen if someone prepares food with hands that are contaminated — though of course that risk can be minimized with the frequent and thorough washing of hands, as health officials have recommended. There has been concern over possible COVID-19 transmission through pets — especially cats and dogs — there is no hard data to back this up.

At this point, the WHO is unsure of how long the virus can survive on surfaces, but assuming it operates like other coronaviruses, it’s thought to be able to live for anywhere from a few hours to several days. The length may vary depending on circumstances like the type of surface, the temperature and the humidity. This has caused some to worry that it’s unsafe to receive packages or products from places like China, with higher rates of COVID-19 infection. Though technically, this may be possible, the WHO says that the risk of contracting the virus this way is low, especially since the shipping time from China to the United States can take well over a week. Still, Hall — who has spoken with Miami postal workers about transmission risks — advises people to spray packages they’re unsure of with a disinfectant as an extra precaution. But for now, Haythe says that there have been no clear cases of someone getting sick from opening an infected package. And Dr. Michelle Barron, an infectious disease specialist at UCHealth in Colorado, says that the virus can’t survive in the conditions under which packages are generally transported. “The virus will either dry out or will die without the appropriate humidity and temperature it prefers,” she tells Rolling Stone.

Should I wear a face mask?

To wear a mask or not to wear a mask — that has been one of the most confusing questions associated with this COVID-19. For starters, not all masks are created equal. You can’t just throw on any random painting or sanding mask you find at Home Depot or CVS and expect to be protected. The CDC recommends N95 masks — meaning that they filter out at least 95 percent of tiny airborne particles.

However, both the CDC and WHO stipulate that for right now, the average person without respiratory symptoms does not need to wear these masks. And in order to work, the masks have to fit properly. “They require a fit test to ensure there is no air leakage, and one size does not necessarily fit all,” Barron says. “Wearing this type of mask also is not comfortable for long periods of time.”

In fact, the WHO advises “rational use of medical masks” to avoid taking necessary supplies from people in the healthcare industry — especially because there is already a worldwide shortage. According to Haythe, N95 masks are currently reserved for quarantined and/or infected individuals, as well as people  in the medical profession potentially exposed to the virus.

“Unless you are a healthcare worker taking care of patients, or are taking care of someone with the disease, wearing an N95 mask is not helpful,” Dr. Terry Simpson, a physician and molecular virology expert, tells Rolling Stone. “If you have a cold or flu or COVID-19, wearing a mask is polite.”

What’s going on with testing?

While there is a test for COVID-19, it has proven to be difficult to get. For example, doctors in California suspected that a woman was infected with the virus, so they requested diagnostic testing from the CDC. But because she failed to meet their strict criteria — meaning she hadn’t traveled to China or come in contact with someone who was infected — the organization refused to provide the test. She did eventually get tested, and on Wednesday it was announced that she did, in fact, have COVID-19, becoming the first case of infection without known contact. On Thursday, CDC officials said they were unaware of the California doctors’ request, and broadened the testing criteria to cover more Americans. Still, under the updated guidelines, a person has to be extremely ill before testing can take place.

At this point, only the CDC has the capability to conduct COVID-19 diagnostic testing. In addition, many of the test kits the organization distributed to state health departments did not work properly. As of today, though, the CDC has reportedly fixed the issue, and now 40 labs across the U.S. are authorized to use the new tests. In addition, New York state has begun developing its own diagnostic test.

According to Simpson, some companies are currently trying to develop rapid-detection kits, but for right now, only the CDC has them. “We want to make testing kits readily available that have a good sensitivity and specificity for the virus. This, along with working to get a vaccine and find antiviral medications that work, are a part of rapid research keeping many labs working late hours,” he explains.

The process is the same procedure as for testing for the flu virus — a swab from the nose or throat, Barron explains. The specimen is then sent to a lab, which will determine whether the virus is present. At this point, there isn’t a blood test for COVID-19. “We believe that the virus is primarily in your respiratory system — the nose, throat, [and] lungs — and we don’t have any evidence that it gets into the bloodstream at this time,” Barron adds.

Are men more likely to die from COVID-19?

Recent data from the Chinese Center for Disease Control and Prevention indicates that older men are more susceptible to COVID-19 than women. Though men and women appear to be getting infected at similar rates, the death rate for men was 2.8 percent, compared with 1.7 percent for women. However, Barron points out that the data from China may be skewed because it “does not account for other co-morbidities and for rates of smoking that are reportedly higher in men in China than women.” In addition, a study published in The Lancet on January 30th, 2020 examining the health characteristics found that those dying from COVID-19 were older men with a long history of smoking, and therefore had more lung damage than the average person. Barron says that more data is still needed to better understand the impact of the virus based on sex. It’s also worth noting that a new study found that at the time of publication, there were no COVID-19 deaths in children under the age of 10.

Is there anything that can be done to prevent infection?

Like most viruses or communicable illnesses, the best way to prevent the spread of COVID-19 is to avoid people who are infected and wash your hands frequently, and thoroughly with antiseptic soap. “Wash after going to the bathroom. Wash when you enter the house, when you get to work, and after being in public areas,” Simpson says. If you’re unable to wash your hands with soap and water, an alcohol-based sanitizer will suffice. And be aware of touching your face — especially your hands, nose and mouth — while in public or after touching a potentially contaminated surface. Speaking of which, using disinfectant wipes on frequently touched surfaces like your cell phone, door knobs, table tops, remote controls and light switches can also help stop the spread of the virus.

Beyond that, Barron says that staying hydrated is important, especially in winter months when the cold weather is often drying. “Additionally, good nutritional food including fruits and vegetables are always good for your body and for your immune system, which is how we fight off infections,” she explains.

If you’re experiencing any type of respiratory symptoms — like congestion, a runny nose, sore throat, or cough —  isolate as much as possible. Also, remember to cough and sneeze into your elbow or a tissue, especially in public. “If you have symptoms that concern you, or you worry you may have been exposed or traveled to an area with cases, contact your healthcare provider,” Haythe says. If you think you could be infected, call a doctor and be clear that you think you could be infected, and make sure they’re equipped to handle it — don’t just show up.

Finally, being up-to-date and informed about the latest COVID-19 developments is also important. “I think that at the current time it is crucial to remember that this is an evolving story and there is more that we don’t know than we do know,” Haythe says. “Doctors and scientists are learning more about COVID-19 every day. Listen to verified sources like the CDC when acquiring information and limit exposure to websites and social media accounts propagating false information.”

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