Living Through A Pandemic Series 2

COVID-19 Prevention and Treatment
Dr. Xie Min, Professor, Chief Physician of Respiratory Department in Wuhan Tongji Hospital

On March 21st, Dr. Xie Min, Professor of Medicine, Chief Physician of Pulmonology Department in Wuhan Tongji Hospital, gave a seminar to Chinese Americans in the SFO Bay area. Around 1,000 people attended the seminar online via Zoom and Wechat conference. In the 70 minute seminar, Dr. Xie discussed basic features of COVID-19, its prevention and treatment. She answered questions at the end. Below is a summary of her talk.

What is the novel Coronavirus?

  • It is an RNA virus and it has a relatively simple structure. Compared to SARS, the coronavirus spreads faster and easier. The virus can be found in the throat cells as early as 96 hours after exposure and the average incubation period lasts between 5-7 days but can be as long as two weeks. So the recommended quarantine time is 14 days. COVID-19 has been shown to bind to angiotensin-converting enzyme 2 (ACE2) via the S protein on its surface and enters human cells through an interaction with ACE2. We found that the ACE2 also expressed in lymphocytes within oral mucosa, and similar results were found in various organs of the digestive system and in lungs; and this explains why the virus is detected in the respiratory tract, gastrointestinal tract, urine or feces. It was also found that the coronavirus is sensitive to UV light, heat (scientists found that the virus can be killed at 133 Fahrenheit in 30 minutes), alcohol and chlorine-based bleaches.

How does it spread?

  • The virus is thought to spread mainly from person-to-person. we should avoid group gathering, and practice social distance.

How does it infect?

  • Droplet transmission: The virus can be passed through respiratory droplets when an infected person coughs or sneezes. Very rarely through aerosol, unless there is a lot of people together without airflow (in a crowded subway or hospital)
  • Contact transmission: Washing your hands frequently is important. Wash hands with soap thoroughly or use a hand sanitizer that contains at least 60% alcohol,  and avoid touching your eye or mouth.

Who is most at risk for the coronavirus disease?

  • People with pre-existing medical conditions (such as high blood pressure, diabetes, chronic bronchitis, COPD and smoking habit) appear to be more vulnerable to becoming severely ill with the virus.
  • Older people

How do you know if you have coronavirus?

  • Dry Cough
  • Fever/ Prolonged or persistent fever (lasting longer than about 2 weeks)

How to distinguish coronavirus symptoms from a common cold?

  • The difference from the common cold is that fever is much higher and lasts longer, the patient has more fatigue. 
  • Common cold only affects and causes discomfort in the upper respiratory tract while the coronavirus affects more organs and causes chest pain, shortness of breath, heart damage, liver damage or vomiting. It appears that older people also show symptoms of dizziness and the clouding of consciousness.

Seek medical help as soon as possible if…

  • you have a high fever (above 102 degrees Fahrenheit) longer than 3 days
  • you experience severe chest tightness
  • you have trouble breathing in a simple activity like walking 
  • low blood oxygen level (oximeter equipment can be purchased online)

Treatment for coronavirus:

  • Use Tylenol instead of Ibuprofen to treat the fever
  • Keep hydrated and take vitamins
  • There isn’t any very effective treatment yet:
    • Umifenovir (not available in the U.S., only sold in China and Russia)
    • Hydroxychloroquine & Azithromycin. The Chinese clinical test result has not been released yet, but the speaker thought that an effective dose would cause too much side effects. It can lower the doses to a safety level but whether that can still achieve anti-virus results remains unclear. There is an ongoing study on Hydroxychloroquine & Azithromycin as  prevention treatment.  The result should be out soon.