Be strong

A digital billboard in Tokyo last month shows "Be Strong China," conveying support to that country in fighting the novel coronavirus epidemic.

With persistent media attention on coronavirus, take a breath and remember the best defense is to do what you likely have been doing all along.

Dr. Bob England, the Pima County Health Department's interim director, says the best course of action is to take common-sense steps to avoid catching or spreading the virus.

That means treating the outbreak like a severe flu season: plenty of hand-washing, avoid touching your face, covering coughs, and avoid crowds if you're vulnerable to complications from infections.

England said a person-to-person transmission of coronavirus (COVID-19) in Pima County will likely happen at some point. But he said the county wants to balance precaution and observation with actions that won't do more harm than good.

"There's obviously stuff we still have yet to learn about this new virus, but there's much that we already do know, and we already know a lot about this group of viruses as well," he said.

The numbers of cases around the world shows that the virus is highly contagious, and that's a double-edged sword, England said.

"That's not good, obviously, but it means there are probably way more cases out there than we realize," he said. "And that means the fatality rate that has been in the media is probably exaggerated, certainly is exaggerated. Probably by a lot."

Reported cases

The World Health Organization reported there had been 88,913 COVID-19 cases globally, with 90 percent of them in China where the virus started and first reported on December 31.

 WHO reported 8,739 cases of COVID-19 outside of China, with 81 percent of those cases found in four countries.

The CDC reported on Tuesday the United States has 60 cases of COVID-19, with six deaths and 12 states affected.

Of the 60 cases, the CDC reported that 22 were travel-related, 11 were person-to-person and 27 are under investigation. Arizona is among the 12 states with COVID-19 cases reported.

The Arizona Department of Health Services confirmed a presumptive positive case of COVID-19 in Maricopa County on Tuesday. The unidentified man in his 20s is recovering at home. Tuesday's case is the second for Arizona. Both incidents were in Maricopa County. AZDHS announced the first case on Jan. 26. 

Coronaviruses are a family of viruses with several types known to cause respiratory infections. COVID-19 is the most recently discovered type, which was unknown before the December outbreak in Wuhan, China.

 WHO said some people who get infected don't develop symptoms or feel unwell, and 80 percent of people recover without special treatment. About 2 percent of infected people have died from the disease, the WHO reported.

Putting it in perspective

England said the reported COVID-19 cases might not be giving a complete picture of the situation.

"Take regular flu, for example, seasonal influenza," he said. "We only ever get a positive test result on about one case out of every 50 or so people who are infected. And that's because most people don't get sick enough to go seek health care, and even if they do, not everyone gets tested."

England said a significant number of people produce or show no symptoms. It wouldn't surprise him if the actual number of infections were much higher, which would also imply a lower mortality rate, he said.

"What we think we're heading for is something that feels like what we've all experienced as a bad flu season," England said. "In fact, the same individuals who are at high risk for the flu are at high risk of becoming seriously ill from (COVID-19). That includes older adults, people with chronic heart and lung disease, diabetes and so forth."

But there's a silver lining.

England said it has appeared that children who tend to have complications when flu is involved haven't been particularly at risk from COVID-19 complications.

"We want to take this seriously, we want to try and limit the spread of this disease, slow it down and minimize it as best we can, but we don't want to go overboard and do more harm than good," he said. "You've seen a lot of talk in the media about closing schools. We don't think that will be practical."

England said canceling events, closing business and other such measures, in general, would do more harm than good.

Last week, La Posada cancelled its 2020 Taste of La Posada event scheduled on March 20, citing concerns over coronavirus.

La Posada's announcement said although risks are hard to assess at this point, they took into account the CDC's recommendation to avoid large gatherings. The annual event drew hundreds of visitors.

Don't panic

Green Valley Fire District Chief Chuck Wunder, said there is a need to find a happy medium of being prepared.

Wunder made his comments during the Green Valley Council's Safety Forum on Monday at GVR's West Center.

Wunder said COVID-19 is the real deal and that while Green Valley's population tends to be a higher risk for  complications, he doesn't want any responses to go too far.

"I want to make sure that we're acting in a tempered manner," he said. "I don't want us to go off the deep end and go to the Nth degree, but I don't want us to ignore it either and think that something doesn't exist."

GVFD has protocols to screen callers, which helps first-responders take protective measures, he said.

Wunder said he has been working closely with hospitals here and in Tucson on how to respond should there be a case of COVID-19 and developing protocols.

GVFD has also been in daily communication with the Pima County Health Department to keep up with the rapidly changing situation.

England said taking personal steps to protect yourself if you're in a high-risk group for complications is the best action at this point.

For the general public, England said using face masks aren't effective.

Why aren't they effective if medical professionals rely on them? Because the general public tends to use them incorrectly, which mitigates the protective benefits, he said.

England said people are misusing masks by touching their faces more, prolonged usage and not changing them after each interaction. As a result, they reduce the mask's protective abilities, whereas medical professionals who use them correctly can reduce their exposure to COVID-19 and other infections.

In addition to personal protection, England said people should call ahead before visiting a doctor or hospital over COVID-19 concerns.

"The healthcare system is going to be probably really busy both from people who have mild illness and are scared and from the smaller number of people who really do become sick," he said.

Calling ahead can also cause an otherwise healthy person to become exposed while visiting a doctor or hospital. However, if you are seriously ill, then you should seek out medical attention, England said.

"If you're having shortness of breath and it's becoming difficult for you to breathe, you should seek health care whether it's this or the flu or anything else," he said. "We want people to seek health care just the same way they would have before had (COVID-19) not existed."

Jorge Encinas | 520-547-9732