Selected Podcast
Everything You Need to Know About Coronavirus
Dr. Rafaele Milizia shares the symptoms of Coronavirus and everything you need to know about the recent outbreak.
Featured Speaker:
Rafaele Milizia, MD
Raffaele Milizia is a Board Certified Emergency Medicine Physician and serves as the Medical Director for the St. John's Riverside Emergency Departments. Dr. Milizia completed his Emergency Medicine Residency at New York Presbyterian, caring for patients at Columbia Presbyterian and Weill Cornell medical centers. He is a member of the Core Faculty for the St. John's Riverside Emergency Medicine Residency program and serves on the Regional EMS advisory committee overseeing pre-hospital care in Westchester county. Transcription:
Everything You Need to Know About Coronavirus
Introduction: This is Riverside Radio HealthCast, featuring the doctors and staff of St. John's Riverside Hospital. Here's Melanie Cole.
Melanie Cole: Welcome. This is Riverside Radio HealthCast, with St. John's Riverside Hospital. I'm Melanie Cole. Today we're discussing the Coronavirus. Joining me is Dr. Raffaele Milizia. He's the Medical Director of Emergency Medicine at St. John's Riverside Hospital. Dr. Milizia, it's a pleasure to have you on. People have been waiting for this podcast. Tell us what is the 2019 Novel Coronavirus? What does that mean? What are Coronaviruses? What does novel mean? What is this that we're hearing about?
Dr. Milizia (Guest): The Coronavirus is not a new concept. It's a family of viruses and then there's many subsets of viruses, and the 2019 Novel Coronavirus is just the name that was given to this specific subset of the coronavirus family. Coronavirus vary in the symptoms that they do, so most people are familiar with coronavirus because it's the family of viruses that causes the common cold. Coronavirus was also in the news over the last few years because that's the family of viruses from which things like MERS, the Middle East Respiratory Syndrome, and SARS, the Severe Acute Respiratory Syndrome. Those are all examples of Coronavirus. And so there's variability in the types of illnesses that it causes. The 2019 Novel Coronavirus is the name that they gave to this particular strand that they found.
Host: Wow. Thank you for that. I just learned something right there. I didn't know that Coronaviruses also were involved with the common cold. So thank you for this. But why is this one so mysterious and what do we know about the source of it?
Dr. Milizia: So, it's mysterious because prior to the earlier this month, actually, this was never a virus that existed in humans. This was a virus, a Coronavirus that existed in animals. But earlier this month we found transmission in humans. And that's why it's a bit, it's novel, thus the name, to us and new and why we're, you know, doing some new investigations to learn more about it.
Host: Well, then tell us a little bit about the symptoms and the complications because we're hearing about people dying, and the symptoms can be quite ambiguous and similar to things we come up with any way at this time of the year. So tell us about specific symptoms and complications, and the reasons that we shouldn't put those symptoms aside.
Dr. Milizia: The spectrum of symptoms that patients can experience who have the novel Coronavirus or any Coronavirus for that matter is large. So symptoms can be mild ranging from low grade fevers with some congestion, some cough, to severe with high grade fevers, and significant respiratory distress. Similar to other Coronaviruses, the people who are most vulnerable to having the severe symptoms are patients who are at risk. So elderly patients, very young patients or patients who have underlying chronic pulmonary issues, lung diseases, or are immunocompromised like cancer patients or diabetics. The patients who appear to be least at risk at this time are otherwise healthy patients who obtained this virus, and might get some of the symptoms that you described, which tend to be on the more mild side.
Host: Once we feel like we're coming up with some of these respiratory symptoms, what do we do? Is this an emergent situation? You run off to the emergency room, you call the CDC. What do we do as far as if we start to feel like something is happening with us?
Dr. Milizia: There's a lot of this happening at this time of year, every single year, and this is not all happening because of the Novel Coronavirus. The biggest differentiator with being concerned about whether you may have this particular strand is whether you've had exposure. And exposure right now means that you've traveled to or from China within the last 14 days or you've been exposed to someone who has the symptoms of Coronavirus who has traveled to China recently. Without the piece of travel or exposure, the symptoms should not necessarily be tied to the Novel Coronavirus at this point. We've seen some diagnoses of Novel Coronavirus outside of China. We've seen five in the United States, but we have not seen any person to person transmission of the virus within the United States yet. All five of those patients traveled from China and likely obtained it there. So the biggest key in worrying about whether or not you may have been exposed or have the Novel Coronavirus is whether you had traveled to China or have been exposed to someone with symptoms who had traveled to China.
Host: So expand a little bit more because it is confusing as we hear more cases in the US or people are being quarantined or you know, people that work there are being told to leave. Tell us a little bit about what you're actually seeing and people walk around with masks. Dr. Milizia, does that help us?
Dr. Milizia: The most reassuring thing is that the CDC and the world health organization, and all of the different agencies that oversee the care of our population have really been paying a lot of attention to this from the beginning. So there are Federal, State, County and you know, Hospital level interventions that have really been ongoing already for a few weeks. And if you look at the numbers of diagnoses, there are over about 6,000 cases diagnosed across the world, less than a hundred of those are outside of China. So, you know, everyone has done a very good job of containing this so far, and identifying who might be at risk and you know, looking out for symptoms and trying to minimize the exposure and the amount that this spreads. So there is a level of reassurance from the perspective of, you know, how rapidly and how widely is this, is this expanding.
For now, you know, we believe that the transmission of the virus is similar to most of the Coronavirus family, which is sort of near direct contact with patients who are symptomatic. So direct contact or droplet meaning, you know, secretions from patients with direct contact, can potentially be exposed. It is not at this time believed to be airborne. So if you're within, you know, a short range of someone who's symptomatic, it's not necessarily contagious. So, in the United States at least, we have five isolated cases. There are several more that are under testing, but there are only five confirmed cases. So for our purposes in this country at this time, it's not really necessary to protect yourself when you're in the general public.
Host: You work in emergency medicine, what treatments are available if someone comes in with severe respiratory illness and maybe they have been exposed in some way, are there treatments available? Is there a vaccine at all?
Dr. Milizia: As of today, there is no direct treatment or vaccine available for the Novel Coronavirus, we treat mostly the symptoms. So if patients come in with cough or difficulty breathing, the treatment is focused on supportive care, just like it is with all of the other Coronaviruses
Host: Well then what do you want us to do? And I'm assuming Dr. Milizia, it's going to be advice about really keeping ourselves healthy at this time of the year to try and give our immune systems a real chance. Please wrap it up for us with not only your best advice about trying to protect our self from the Coronavirus and other viruses that are all around at this time of the year, but really also what you want us to know about not panicking about this particular virus.
Dr. Milizia: So, the key here is minimizing the transmission of this virus. So hand hygiene, like washing your hands for 20 seconds with soap and water, whether you're ill and trying to minimize exposure to others or exposed and trying to minimize it to yourself. Hand hygiene is important. Avoiding touching your nose and your mouth with your hands, particularly when you're in public places where you can pick up the virus. And then respiratory hygiene. So anyone who's symptomatic should really only ever cough or sneeze into their elbow, not into their hand. If someone has these symptoms, as with any symptoms that might be contagious from any virus, you want to minimize your other people's exposure to you. So if you do have to go out to a public place, there are, you know, they are pretty comfortable surgical masks that you can wear. If you are able to isolate yourself at home or from other family members, particularly those who are ill or more vulnerable, then the recommendation is to do so.
If anyone is at risk for this particular virus at this time, so they have these symptoms of fever, cough, shortness of breath and they've traveled to China in the last two weeks or have been exposed to someone, then we do encourage them to seek medical attention. Clearly if you're feeling ill, you should go to your nearest emergency department, and seek and seek treatment. At that point, it's our responsibility to minimize other patient's exposure, but also to make sure that we include the department of health to get you the proper testing and the proper treatment. If you're not feeling so ill, but have that risk. Then the idea is you can seek, you know, seek care at your physician's office also. But the recommendation currently is that you actually call ahead so that the office can prepare to accept you while minimizing some of the exposure. But the key is there's still some information to be learned about this virus. The overall transmission of the virus is being closely watched at multiple levels. And our key is to keep our population safe. And getting back to health.
Host: Thank you so much Dr. Milizia for joining us today and sharing your expertise. Everybody's got questions about this. Thank you for coming on and explaining this to us all. Thank you again. That concludes this episode of Riverside Radio HealthCast with St. John's Riverside Hospital. For more information, please visit Riversidehealth.org to get connected with one of our providers. Please remember to subscribe, rate, and review this podcast and all the other St. John's Riverside Hospital podcasts. I'm Melanie Cole.
Everything You Need to Know About Coronavirus
Introduction: This is Riverside Radio HealthCast, featuring the doctors and staff of St. John's Riverside Hospital. Here's Melanie Cole.
Melanie Cole: Welcome. This is Riverside Radio HealthCast, with St. John's Riverside Hospital. I'm Melanie Cole. Today we're discussing the Coronavirus. Joining me is Dr. Raffaele Milizia. He's the Medical Director of Emergency Medicine at St. John's Riverside Hospital. Dr. Milizia, it's a pleasure to have you on. People have been waiting for this podcast. Tell us what is the 2019 Novel Coronavirus? What does that mean? What are Coronaviruses? What does novel mean? What is this that we're hearing about?
Dr. Milizia (Guest): The Coronavirus is not a new concept. It's a family of viruses and then there's many subsets of viruses, and the 2019 Novel Coronavirus is just the name that was given to this specific subset of the coronavirus family. Coronavirus vary in the symptoms that they do, so most people are familiar with coronavirus because it's the family of viruses that causes the common cold. Coronavirus was also in the news over the last few years because that's the family of viruses from which things like MERS, the Middle East Respiratory Syndrome, and SARS, the Severe Acute Respiratory Syndrome. Those are all examples of Coronavirus. And so there's variability in the types of illnesses that it causes. The 2019 Novel Coronavirus is the name that they gave to this particular strand that they found.
Host: Wow. Thank you for that. I just learned something right there. I didn't know that Coronaviruses also were involved with the common cold. So thank you for this. But why is this one so mysterious and what do we know about the source of it?
Dr. Milizia: So, it's mysterious because prior to the earlier this month, actually, this was never a virus that existed in humans. This was a virus, a Coronavirus that existed in animals. But earlier this month we found transmission in humans. And that's why it's a bit, it's novel, thus the name, to us and new and why we're, you know, doing some new investigations to learn more about it.
Host: Well, then tell us a little bit about the symptoms and the complications because we're hearing about people dying, and the symptoms can be quite ambiguous and similar to things we come up with any way at this time of the year. So tell us about specific symptoms and complications, and the reasons that we shouldn't put those symptoms aside.
Dr. Milizia: The spectrum of symptoms that patients can experience who have the novel Coronavirus or any Coronavirus for that matter is large. So symptoms can be mild ranging from low grade fevers with some congestion, some cough, to severe with high grade fevers, and significant respiratory distress. Similar to other Coronaviruses, the people who are most vulnerable to having the severe symptoms are patients who are at risk. So elderly patients, very young patients or patients who have underlying chronic pulmonary issues, lung diseases, or are immunocompromised like cancer patients or diabetics. The patients who appear to be least at risk at this time are otherwise healthy patients who obtained this virus, and might get some of the symptoms that you described, which tend to be on the more mild side.
Host: Once we feel like we're coming up with some of these respiratory symptoms, what do we do? Is this an emergent situation? You run off to the emergency room, you call the CDC. What do we do as far as if we start to feel like something is happening with us?
Dr. Milizia: There's a lot of this happening at this time of year, every single year, and this is not all happening because of the Novel Coronavirus. The biggest differentiator with being concerned about whether you may have this particular strand is whether you've had exposure. And exposure right now means that you've traveled to or from China within the last 14 days or you've been exposed to someone who has the symptoms of Coronavirus who has traveled to China recently. Without the piece of travel or exposure, the symptoms should not necessarily be tied to the Novel Coronavirus at this point. We've seen some diagnoses of Novel Coronavirus outside of China. We've seen five in the United States, but we have not seen any person to person transmission of the virus within the United States yet. All five of those patients traveled from China and likely obtained it there. So the biggest key in worrying about whether or not you may have been exposed or have the Novel Coronavirus is whether you had traveled to China or have been exposed to someone with symptoms who had traveled to China.
Host: So expand a little bit more because it is confusing as we hear more cases in the US or people are being quarantined or you know, people that work there are being told to leave. Tell us a little bit about what you're actually seeing and people walk around with masks. Dr. Milizia, does that help us?
Dr. Milizia: The most reassuring thing is that the CDC and the world health organization, and all of the different agencies that oversee the care of our population have really been paying a lot of attention to this from the beginning. So there are Federal, State, County and you know, Hospital level interventions that have really been ongoing already for a few weeks. And if you look at the numbers of diagnoses, there are over about 6,000 cases diagnosed across the world, less than a hundred of those are outside of China. So, you know, everyone has done a very good job of containing this so far, and identifying who might be at risk and you know, looking out for symptoms and trying to minimize the exposure and the amount that this spreads. So there is a level of reassurance from the perspective of, you know, how rapidly and how widely is this, is this expanding.
For now, you know, we believe that the transmission of the virus is similar to most of the Coronavirus family, which is sort of near direct contact with patients who are symptomatic. So direct contact or droplet meaning, you know, secretions from patients with direct contact, can potentially be exposed. It is not at this time believed to be airborne. So if you're within, you know, a short range of someone who's symptomatic, it's not necessarily contagious. So, in the United States at least, we have five isolated cases. There are several more that are under testing, but there are only five confirmed cases. So for our purposes in this country at this time, it's not really necessary to protect yourself when you're in the general public.
Host: You work in emergency medicine, what treatments are available if someone comes in with severe respiratory illness and maybe they have been exposed in some way, are there treatments available? Is there a vaccine at all?
Dr. Milizia: As of today, there is no direct treatment or vaccine available for the Novel Coronavirus, we treat mostly the symptoms. So if patients come in with cough or difficulty breathing, the treatment is focused on supportive care, just like it is with all of the other Coronaviruses
Host: Well then what do you want us to do? And I'm assuming Dr. Milizia, it's going to be advice about really keeping ourselves healthy at this time of the year to try and give our immune systems a real chance. Please wrap it up for us with not only your best advice about trying to protect our self from the Coronavirus and other viruses that are all around at this time of the year, but really also what you want us to know about not panicking about this particular virus.
Dr. Milizia: So, the key here is minimizing the transmission of this virus. So hand hygiene, like washing your hands for 20 seconds with soap and water, whether you're ill and trying to minimize exposure to others or exposed and trying to minimize it to yourself. Hand hygiene is important. Avoiding touching your nose and your mouth with your hands, particularly when you're in public places where you can pick up the virus. And then respiratory hygiene. So anyone who's symptomatic should really only ever cough or sneeze into their elbow, not into their hand. If someone has these symptoms, as with any symptoms that might be contagious from any virus, you want to minimize your other people's exposure to you. So if you do have to go out to a public place, there are, you know, they are pretty comfortable surgical masks that you can wear. If you are able to isolate yourself at home or from other family members, particularly those who are ill or more vulnerable, then the recommendation is to do so.
If anyone is at risk for this particular virus at this time, so they have these symptoms of fever, cough, shortness of breath and they've traveled to China in the last two weeks or have been exposed to someone, then we do encourage them to seek medical attention. Clearly if you're feeling ill, you should go to your nearest emergency department, and seek and seek treatment. At that point, it's our responsibility to minimize other patient's exposure, but also to make sure that we include the department of health to get you the proper testing and the proper treatment. If you're not feeling so ill, but have that risk. Then the idea is you can seek, you know, seek care at your physician's office also. But the recommendation currently is that you actually call ahead so that the office can prepare to accept you while minimizing some of the exposure. But the key is there's still some information to be learned about this virus. The overall transmission of the virus is being closely watched at multiple levels. And our key is to keep our population safe. And getting back to health.
Host: Thank you so much Dr. Milizia for joining us today and sharing your expertise. Everybody's got questions about this. Thank you for coming on and explaining this to us all. Thank you again. That concludes this episode of Riverside Radio HealthCast with St. John's Riverside Hospital. For more information, please visit Riversidehealth.org to get connected with one of our providers. Please remember to subscribe, rate, and review this podcast and all the other St. John's Riverside Hospital podcasts. I'm Melanie Cole.