RICHMOND, Va. -- Dr. Michael Stevens is an infectious disease specialist at VCU Health in Richmond. He sat down with Jake Burns on Monday to answer 10 coronavirus COVID-19 questions submitted via social media. His comments have been edited for clarity.
Jake: How alarmed are you about coronavirus?
Dr. Michael Stevens: It is concerning that we’re seeing local community spread in the United States now, but it’s almost expected.
Why did medical community expect cases to continue to spread in U.S.?
Really, there was probably community spread before we identified there were cases out in the community, which means a lot of people were exposed and a lot of people have become infected.
Until we can identify who’s infected and properly either isolate them or they isolate themselves from other folks and sort of stop that spread of transmission, you can expect to see more new cases.
Who is most at risk of infection of COVID-19?
The older you are, the higher risk you are for more severe disease, that’s what we’ve learned. Also, if you have chronic medical problems like heart or lung issues, you’re more likely to have severe disease and be at high risk of death.
Younger, healthier people can still spread coronavirus, but their symptoms have not been as serious
Like the flu, young people feel really bad when they get it, but recover from it eventually. But if they spread it to someone in their 80s, that person has a higher risk of severe issues or death.
How is coronavirus spread?
Our understanding right now is that it’s droplet transmitted. So if I cough or I’m sneezing, it goes into the environment, and these sort of large droplets drop to the ground within about six feet of me.
If you’re within six feet of me and I’m doing that, you can inhale them and become infected yourself.
Once those are in the environment on surfaces and stuff, if you go ahead and touch them and touch your face, you could inoculate yourself.
Really, that it's droplet spread is probably the most important, and that role of the environment, we’re not sure exactly how important it is at this point, but it’s probably important enough to change your behavior.
This is the reason good hand washing and surface cleaning is critical to containing spread.
Some diseases are what we call airborne, they float around in the air and you can walk through air where somebody was hours before and inhale them and get the disease that way.
Things like tuberculosis and those sorts of things.
[Novel coronavirus] is very different, I have to cough and it drops within about six feet of me. It’s very important because things you can do and the person who is infected can do is social distancing.
So if they’re over six feet away from you, you’re much less likely to get exposed.
This is what you should do to protect yourself and others if you have an upper respiratory infection
What’s the difference between “community spread” and travel-related cases?
Travel-related cases are people who travel to places like Italy, China, Japan, Iran, where there is widespread cases of coronavirus already.
Community spread is when you have no link to anyone who’s tested positive or recently traveled to those regions.
The implication of that is you were exposed somewhere in your normal daily life with no epidemiological link to the disease.
Central Virginia should learn from other places like Washington or New York where community spread is already happening.
You can anticipate that ultimately we’re going to see them as well.
Why does it seem so hard to track/identify COVID-19 cases?
To get down do it, it’s really about how much testing there as been.
In the U.S., there’s only been a few thousand test performed, when really the number of folks who probably have been exposed is orders of magnitude higher than that.
Somebody had a good analogy, the cases were seeing that are positive are almost like looking at starlight. By the time it hits you, you know that it’s traveled for a period of time before you’re actually seeing that. That’s probably what we’re seeing, at least from a public health stand point.
What we need is the capacity to test more folks who are sick, then we’ll have a better understanding just how widespread the disease is.
Nationwide, the ability to test is ramping up.
I would anticipate within a week you’re going to see a lot more capacity for testing, but that hasn’t existed to date.
What are the symptoms of COVID-19?
Fever, cough, and shortness of breath. Most people only experience mild symptoms.
If you have shortness of breath and your feeling lousy or other reasons to seek care urgently, you should do so. In the absence of that, you should just distance yourself [from others].
Does it feel like we fell behind on this disease, but are catching up?
It feels like we’ll have a better understand of the number of people infected in the weeks to come.
Coronavirus vs. Flu comparisons being made?
The flu is something people have lived with their whole life, it’s something that’s familiar even if though it can potentially be devastating and deadly, it’s familiar. This is new virus that’s emerged from southeast Asia over the past few months. With any unknown, there is fear, and there’s a lot we don’t know about it yet.
So I think it’s a fair comparison to say “yes” there are other things here we need to take seriously and are bigger problems at the moment, but we also need to take this very seriously.
Look for good, credible sources of information. Understand that this is something that’s evolving.
Stay aware that this is something that’s evolving and take the measures you can take to protect others and protect yourself and really watch to see where this is going.
Personal perspective on global epidemic
We’re going to learn very quickly where this is going.
I have some older folks in my family who I care about very much, just like everyone cares about loved ones in there family. I’m advising them to look at good sources of information, social distancing is a good idea now. Good hand washing is critical, and don’t touch your face.
