A newly identified coronavirus now known as COVID-19 was first recognized in Wuhan, China, in early December 2019 and is rapidly spreading throughout the world.

Bernard Camins, MD, MSc, Medical Director for Infection Prevention for the Mount Sinai Health System, offers some basic guidelines for understanding this latest health concern. You can also get up-to-date information from the Centers for Disease Control and Prevention (CDC).

Who is most at risk?

According to the CDC, those at the most risk include: people in places where ongoing community spread has been reported and people  who have had close contact with those who have COVID-19. In addition, people who recently traveled to an area where cases of COVID-19 are occurring are most at risk, and they should consult their doctor or the CDC for the latest information. The CDC maintains a list of countries with significant COVID-19 cases.

What are the symptoms?

Symptoms have included mild to severe respiratory illness with fever, cough, and difficulty breathing. The symptoms usually begin within two to three days of exposure but could take as long as 14 days to develop. These symptoms are also typical of the flu and other seasonal viral illnesses, and if you have symptoms like these and you have not traveled to an area with COVID-19 cases or been in close contact with someone who has, you probably have a seasonal illness and not the novel coronavirus.

What if I recently traveled to an area with COVID-19 cases and now have symptoms of a respiratory illness and/or fever?

If you feel sick with fever, cough, or difficulty breathing within 14 days after you return to the United States, you should seek urgent medical care. However, before going to your doctor’s office, an urgent care center, or an emergency room, call ahead and alert the staff about your recent travel and symptoms.

Avoid contact with others. Cover your mouth and nose with a tissue or your sleeve (not your hands) when coughing or sneezing. Frequently wash your hands with soap and water for at least 20 seconds to avoid spreading the virus to others. Use an alcohol-based hand sanitizer if soap and water are not available. As soon as you arrive at the medical facility, let a staff member know about your symptoms and travel history.  You should be provided with a mask and moved to an area away from other patients.

How is coronavirus spread?

There are many types of human coronaviruses, including those that cause the common cold. They typically spread from an infected person through the air in tiny droplets produced when coughing or sneezing. These droplets, when they come into contact with another person’s mucous membranes (e.g., mouth, nose, or eyes), can lead to infection. The virus can also be transmitted if you touch a person, an object, or a surface on which the virus has settled and then touch your mouth, nose, or eyes before washing your hands.

How can I protect myself?

As with other respiratory viruses, you can protect yourself from infection through frequent, proper hand hygiene, either with an alcohol-based hand sanitizer or with soap and water. Also, practice proper respiratory hygiene by covering your mouth and nose with a tissue or your sleeve (not your hands) when coughing or sneezing.

How is Mount Sinai prepared to treat infectious diseases?

For a long time, Mount Sinai has been developing procedures to make sure that people arriving for care at our facilities are quickly screened for infectious diseases. This includes questioning people about whether they have traveled abroad in the last three weeks or come into contact with people who are traveling abroad. Our procedures enable us to quickly isolate any possible cases of infectious disease.

The novel coronavirus is transmitted through the air and replicates in the respiratory system and in blood.

The novel coronavirus that began in Wuhan, China, has been labeled a Public Health Emergency by the U.S. government. As confirmed cases of the coronavirus now known as COVID-19 continue to increase in this country and around the world, and additional information unfolds, two renowned microbiologists at the Icahn School of Medicine at Mount Sinai, Peter Palese, PhD, and Adolfo García-Sastre, PhD, recently provided insights into the disease. Dr. Palese is the Horace W. Goldsmith Professor and Chair of the Department of Microbiology, and Professor of Medicine (Infectious Diseases); and Dr. García-Sastre is the Irene and Dr. Arthur M. Fishberg Professor of Medicine (Microbiology, and Infectious Diseases), and Director of the Global Health and Emerging Pathogens Institute.

What is COVID-19?
Dr. Palese: It belongs to a group of viruses known as coronaviruses, to which the SARS (severe acute respiratory syndrome) virus and MERS virus (Middle East respiratory syndrome) belong. It is transmitted through the air and replicates in the respiratory system and in blood.
Dr. García-Sastre: The COVID-19 and the SARS-CoV are closely related and they originated from bats. In the case of the COVID-19, we are not yet sure of its precise origin—whether the virus went directly from bats to humans or whether it went from bats to a host animal and then to humans, which is what happened with SARS. But we believe it originated from bats.

How did this novel coronavirus start?
Dr. Palese: Samples of the virus were found in a large fish market in Wuhan where other live animals are kept in cages and sold as food.

Dr. García-Sastre: People went to the market to buy food and were exposed to the virus, which infects through the respiratory tract. Like the flu, it is spread by aerosols.

What are the most important factors to consider as the disease unfolds?   
Dr. Palese: The reproduction number, or “R” number, appears to be around 2.5. That means every person who is infected will pass the disease on to 2.5 other people. The influenza virus is a little lower. Measles has a much higher R number of about 18. These are averages. But we have to be vigilant. There are reports that the disease can be transmitted for about 24 hours before symptoms develop. If that is confirmed, it would make it more difficult to contain. The disease caused by the novel coronavirus is accompanied by flu-like symptoms, including very high fever. Fatalities stem from pneumonia and comorbidities, such as old age, asthma, or chronic obstructive pulmonary disease.
Dr. García-Sastre: Don’t panic. The virus does not seem to be associated with very high mortality. It is progressing more quickly than the SARs virus did, but it also appears to be less deadly. The rate of transmission appears to be similar to that of the seasonal flu. That is an estimate because we don’t know for sure whether all of the people who have the disease have been diagnosed. Some may have very mild cases. Another consideration is at what moment does an infected person begin to transmit the virus? With flu, people can transmit the disease before there are symptoms. With SARS, most transmissions happen after there are symptoms.

Are vaccines available?
Dr. Palese: Our government is rapidly developing vaccines and they are in the pipeline, but nothing has been approved as of today.
Dr. García-Sastre: Vaccines may be first available only on an experimental basis.