COVID-19 By Dr. Darryl Addington, NSSAR Surgeon General

General: • Coronaviruses are well known causes of respiratory diseases in humans
• COVID-19 appears to be a unique form of Coronaviruses. • Two of its cousins have been responsible for serious respiratory diseases (MERS and SARS) Transmission:
• True mode of transmission is not completely known • Person-to-person spread appears to be the primary mode of transmission at this time.
• The likely mechanism is through respiratory droplets (eg cough, sneeze, etc.) or other bodily fluids (eg blood, stool, etc.) • Transmission from people without symptoms of the disease have been reported. Incubation Period (Time from exposure to when symptoms appear):
• Incubation period is up to 14 days • However, majority of individuals show symptoms within 5 days. Symptoms:
• Fever, dry cough, shortness of breath, body aches are common symptoms • Pneumonia is frequent and serious
• Usually lacks runny nose, nasal congestion typical of common cold. Also, nausea and diarrhea are not a common feature of COVID-19. • 80% will have mild symptoms, 15% severe symptoms, 5% critical symptoms. On one cruise, half of the confirmed COVID-19 cases had no symptoms.
• Fatality rate is currently estimated at 2.3%, all within critical cases group. • Most fatalities occur in patients with advanced age or underlying medical conditions (diabetes, copd, heart disease, etc.).
• Recovery time is approximately two weeks for mild and 3-6 weeks for severe disease Preventing Community Exposure: • Stay at home when you are sick
• Good hand washing with soap and water for at least 20 seconds • Wash hands especially after going to the bathroom, before eating and after coughing or sneezing.
• Soap and water preferred but use sanitizers with at least 60% alcohol if don’t have access • Cover up coughs and sneezes
• Avoid touching face, eyes, nose and mouth • Cleaning and disinfecting objects that are frequently touched
• For those without symptoms or family contacts, wearing a face mask is NOT recommended • Facemasks should be worn by those already sick to prevent further spreading the disease
• Facemasks are crucial for health care workers or others in close contact with the sick What to Do if You Are Sick: • Stay home except to get medical care
• Separate yourself from other people and animals in your home. Close contact means being within 6 feet (2 meters) of a COVID-19 patient for prolonged periods. • Wash hands often
• Clean all “high touch” surfaces everyday • Monitor your symptoms
• Influenza treatment must start within 48 hours, so don’t wait to contact your physician Should I Cancel my Upcoming Trip, Meeting, Cruise, etc? • The Centers for Disease Control (CDC) publishes up-to-date warning and recommendations for travelers both within the United States and internationally. More info can be found here:

• Specific risk-benefit questions should be directed to your personal physician