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Bill Klaproth: Every day we hear more about the Coronavirus or Covid-19. So it's good to hear from an expert at New Hanover Regional Medical Center. With us is Dr. Paul Kamitsuka, an Epidemiologist at New Hanover Regional Medical Center. This is The Healthy Conversations Podcast. I'm Bill Klaproth. Dr. Kamitsuka, thanks for your time. So first off, what is COVID-19?

Dr. Kamitsuka: So COVID-19 is the infection, is the illness that's caused by the SARS COVI-2 virus, which is a new virus not previously recognized before, a couple months ago. And which is causing an epidemic in China but also has spread to 75 other countries around the world.

Host: Well it is very concerning. All you have to do is turn on the news and usually it's the top story.

Dr. Kamitsuka: Yeah. And the thing about Coronavirus, we have other Coronaviruses commonly present in the United States. And typically, you know, they would cause like the common cold or upper respiratory illness. The difference between those common Coronaviruses and this one, is its propensity to cause more serious illness, particularly pneumonia and respiratory failure.

Host: Right. So that's why we all need to take this seriously. Not necessarily panic, but be prepared and understand what it is. So how is this different from other recent health episodes including SARS and Ebola?

Dr. Kamitsuka: So this actually is quite similar to SARS, it shares the name of the virus itself. This is sort of a SARS version two. And unlike Ebola, which is a totally different virus, presents with very different signs and symptoms, a lot being gastrointestinal. This is a respiratory virus. And what happened in the case of SARS and what happened again now is that a animal virus, we think the actual native host of bats, did two things. First became able to transmit from animals to humans. But then the second step is to transmit from human to human quite efficiently. So these Coronaviruses circulate in the animal population. But with both SARS, the first SARS in 2003 and this SARS in 2019, 20, this virus has the capacity to spread among human beings.

Host: So then COVID-19 primarily is spread human to human. Is that right? And is that through sneezing or coughing near someone?

Dr. Kamitsuka: Yes. So it is through droplets spread primarily, and it spreads very similarly to how the flu spreads. So if you or cough into someone else as a face, that's a good way to transmit it. If you cough into your hand and then touch something, then at least for a short period of time the virus will still be viable. So if someone else touches the same surface and then touches their mouth or nose, then they could acquire the infection. Although the current recommended precautions include precaution against airborne spread, it's not thought to be spread via that route, although there's still much that we don't know exactly about this virus, but airborne spread would be, for example, things like measles where even after a person who is contagious is out of the room for a couple hours, the viral particles are still suspended in the air in such a way that someone else could inhale them and they become infected. This does not appear to be like that. It appears to spread much more like influenza, the flu.

Host: Well, it's good to understand how it's spread. So how is New Hanover Regional Medical Center preparing for COVID-19?

Dr. Kamitsuka: Right. So we have work groups that have been organizing and preparing over the past several weeks meeting regularly to make sure that we ensure that we protect the safety of patients, their families and caregivers. So that if we have protocols in place in terms of if a patient presents with signs and symptoms and a reason to believe that they may be at risk for COVID-19, we follow three steps. First is to identify those patients. Secondly, to isolate them and to have the patient wear a standard mask, and separate them from others by at least six feet. And then put them into a designated isolation room with doors closed. And then also for healthcare workers who go into that room, to wear special protective equipment in order for the healthcare workers themselves not to become infected. And then thirdly, to notify communication with anything like this, this is very important. We have a very active infection control unit at New Hanover Hospital that would be immediately notified and in the distance notifying the local Public Health Department. And further along the line if we have more cases, on down to the state health department and the CDC.

Host: Well, it's good to know that Hanover Regional Medical Center is ready. And then who is at risk for COVID-19?

Dr. Kamitsuka: The definition of who is at risk for having COVID-19 is evolving sort of day by day. But basically for today we would be thinking primarily among persons who develop symptoms if they have traveled within 14 days to other areas of the world where they've had a number of cases, a lot of cases of COVID-19 such as China, Italy, South Korea, Iran, and Japan. In the United States. Washington state has a recent outbreak and so Washington State and California increasingly might be included today in that definition in terms of travel, but basically symptoms within 14 days of travel or within 14 days of contact with someone who's known to have COVID-19. And we use the 14 day criteria because generally once you get infected, if you don't develop symptoms within 14 days, chances are you're not going to.

Host: So Dr. Kamitsuka, that brings up my next question. Let's talk about those symptoms. What should people look for? What are the symptoms?

Dr. Kamitsuka: Basically mostly same as we think about with flu and it becomes an issue right now because we have both viruses circulating at the same time, but fever and respiratory symptoms like cough or shortness of breath would be really the cardinal symptoms that we'd be talking about. But patients have other more minor symptoms like headache and things of that sort. But primarily we're focusing on fever and lower respiratory symptoms like cough.

Host: Okay, fever, cough, shortness of breath. Those are the main things we're looking for. And then what about steps people can take to prepare themselves and their family members? What can we do for prevention?

Dr. Kamitsuka: So I think a couple things. One is everybody should be doing hand hygiene frequently. So either using a hand sanitizers with at least 60% alcohol content and or washing your hands with soap and water for at least 20 seconds. Both of those interventions are critically important to prevent the spread of viruses such as this, the role of masks is really quite minimal. And I know people have been running out to get masks, but that's not going to afford much in the way of protection in all likelihood. Avoiding crowds I think would be a prudent idea. The more people congregated in a small space, the more chance for droplets spread, which is the mechanism, major mechanism for spread of this virus. And then also preparing just in terms of if you do have someone in the household who develops illness and is diagnosed with COVID-19, how would you quarantine that patient at home? And so if the person having a separate bedroom and also preferably a separate bathroom would be prudent. Having some disinfectants such as Lysol or bleach or other such items to be able to decontaminate high touch surfaces would be a good thing to have on hand. And, but the most important thing is for things like quarantine, that guidance as to do that effectively, would be provided by the Health Department.

Host: Very good. So that's a great list. We all should remember on prevention one, make sure you wash your hands, wash your hands, wash your hands. If you don't have soap and water available, use a hand sanitizer with at least 60% alcohol content. Avoid large crowds. That makes sense. And then think ahead. How would you quarantine someone if they did catch COVID-19, and you had to quarantine them in your home? Last question then Dr. Kamitsuka, and thank you so much for your time. If someone comes down with these symptoms, fever, cough, shortness of breath and it's fairly severe, what should they do if they suspect they have COVID-19?

Dr. Kamitsuka: Okay, so first thing is to try to contact their provider and indicate, so that the provider or the health department could make a quick assessment as to the level of risk and the appropriate place for them to receive care. It's important to try to notify either the health department or the person's own providers so that other steps can be taken to try to mitigate transmission to other patients. So calling ahead so that if they're being seen in an office, they are given a mask, or come in with the mask again to try to prevent spread. Likewise, if they're critically ill and notifying the ambulance of the suspected risk and the ambulance will know then to use protective precautions and also notify the hospital emergency room of that, so that the proper protocols can be followed to protect everybody.

Host: Really good steps and things for us to know. Well, thank you so much for clarifying a lot of things we're hearing about COVID-19 Dr. Kamitsuka, this has been really informative and educational. Thank you so much for your time.

Dr. Kamitsuka: My pleasure.

Host: That's Dr. Paul Kamitsuka. And for more information, please visit NHRMC.org/coronavirus, that's NHRMC.org/coronavirus for Up To Date information. And if you found this podcast helpful, please share it on your social channels. This is The Healthy Conversations Podcast from New Hanover Regional Medical Center. I'm Bill Klaproth. Thanks for listening.