Protection from a pandemic

A week after officials from the Centers for Disease Control and Prevention (CDC) called the spread of the coronavirus “inevitable” in the United States, six people in the country have died, all in the Seattle area.

Currently the United States has more than 90 cases of coronavirus infection, about half of them passengers from the Diamond Princess cruise ship. The outbreak started in Wuhan, China, and in the past few weeks has spread quickly in South Korea, Iran, and Italy.

I asked Dr. Gregory Poland, director of Mayo Clinic’s Vaccine Research Group, more about the novel coronavirus that originated in Wuhan, China, and causes the respiratory disease known as COVID-19 and how Americans can keep themselves safe.

Where are we on finding a cure to COVID-19?

Because of previous coronavirus outbreaks—SARS in 2002 and MERS in 2012—scientists have learned a lot about zoonotic diseases, which jump from animals to humans. Poland said scientists started to work on developing treatments for the coronavirus, but as the outbreaks died off, the work halted: “We are behind in this regard … that 18-year time span is just beyond the attention span of the public and funders. I think we’re going to have to take this third chance very seriously.”

Around the world, scientists are racing to create treatments for COVID-19. A leading contender is the drug remdesivir, which scientists have found to block SARS and MERS in mice. Scientists in China and United States have started clinical trials and could determine its effectiveness by April.

But vaccines are still 12-18 months away: Scientists have never developed a vaccine for any type of coronavirus.

Why is the CDC concerned about a coronavirus outbreak in the United States?

Scientists still don’t know whether an outbreak in the United States will occur. But Poland said, “It’s not a good sign that we are starting to see the rapid rise of cases outside of China,” especially as the virus spreads in countries with cultures more similar to the United States in hygiene and eating habits. If it can still spread in those conditions, then the United States should also be concerned about widespread circulation.

How does the virus spread?

Transmission is primarily respiratory: An infected person coughs or sneezes, and another person breathes it in. It can also spread when someone touches a contaminated surface then touches his eyes, nose, or mouth. A third route is fecal-oral, as an infected person’s stool can contaminate hands, food, or water.

What can individuals do to protect themselves from the virus?

First, Poland said, those who have not yet gotten a flu shot should do so immediately. This flu season, 16,000 Americans have already died from the flu, according to the CDC. Getting a flu shot also helps prevent overburdening local medical centers—the symptoms of influenza and the coronavirus are similar. This allows for more hospital beds and resources for those with the coronavirus.

Next, Poland suggests several low-tech approaches to minimize the chances of catching the virus:

Poland also noted that during an outbreak, it is important to avoid public bathrooms. Most public toilets do not have lids, and because the virus is in infected stool, flushing causes an aerosolized plume of the virus.

Prepare a 30-day supply of food, toiletries, and medicine so that if an outbreak occurs, you wouldn’t have to go out to the store and increase the risk of infection.

Are face masks useful?

“I think masks have their place but they pale in comparison to the importance of respiratory etiquette and hand washing,” Poland said.

Surgical masks have two purposes. They reduce inhalation of large respiratory droplets after an infected person coughs into your face from a close distance (but they don’t stop aerosolized viruses in the air). And they remind you to keep your hands out of your nose and mouth.

N95 masks can filter about 95 percent of aerosolized particles, but they must fit properly to do so. Poland said he can typically wear them for an hour before breathing becomes difficult and the mask gets wet from his breath, rendering it ineffective.

U.S. Surgeon General Jerome Adams echoed Poland’s comments Monday. On the television show Fox & Friends, Adams discouraged the general public from buying masks. Shortages were making it hard for medical professionals—who need them when coming into contact with infected patients—to get masks.

Do closing borders and shutting down cities work in stopping the spread of the virus?

Poland said restricting people's movements, known as cordon sanitaire, has never proven to work. There’s no way to ensure that people will obey. Plus, it increases the level of public panic and makes people want to flee.

He also said closing borders doesn’t prevent the spread of the virus—because borders are still porous—but it can decrease the number of infected people coming into a country. “But all it takes is one infected person going to a mass gathering or an apartment building and you infect everybody there.”

What role should churches play in this outbreak?

“The church has an important role here as it has had in every major pandemic and that is to care for the sick,” Poland said. The most vulnerable are the elderly and those with other medical conditions. Christians should be prepared to care for them, whether that means bringing food to their door or providing comfort: “Somebody’s going to have to take care of them because there aren’t enough healthcare workers and there aren’t enough hospitals. Sometimes [the Christian’s role] may be to be there and help someone die well.”