What is the coronavirus and where did it come from?
Coronavirus 2019, also called COVID-19, is a virus that first appeared in Asia late last year. It is a contagious disease that is easily passed from person to person, causing flu-like symptoms that range from mild to moderate to severe. On March 11, 2020, the World Health Organization declared the coronavirus to be a global pandemic, meaning that it is spreading at a rapid rate in many countries around the world, including the United States.
How many cases of coronavirus do we have in Charleston?
At the time of this update (8 p.m., Friday, March 13, 2020), there is one confirmed case in Charleston County, with zero presumptive cases pending. Across the state, there are a total of 7 confirmed and 6 presumptive cases. However, with fewer than a hundred tests conducted to date in the state of South Carolina, we can’t really know how many cases there are in any given location, including Charleston.
Well, if that’s the case, why haven’t you performed more tests?
Under state law, the South Carolina Department of Health and Environmental Control (SC DHEC) in Columbia is the exclusive public health department for the state of South Carolina; as a result, SC DHEC makes all testing decisions. To learn more about their testing policies or to track tests conducted to date, please visit their coronavirus (COVID-19) website at https://www.scdhec.gov/health/infectious-diseases/viruses/coronavirus-disease-2019-covid-19.
Okay, so back up a minute. What’s the difference between a confirmed case and a presumptive case?
When SC DHEC conducts a test and gets a positive result, they have to send it to the US Centers for Disease Control (CDC) for confirmation. At present, that process usually takes several days.
What happens while they’re waiting for confirmation of presumptive tests?
SC DHEC asks all people tested for coronavirus to self-quarantine until the confirmed results of the test are known. SC DHEC has the authority to enforce this request by law if necessary.
I’ve heard this is basically just the flu. Is that right?
No. Based on information from several Asian and European countries, where the virus took hold earlier, the death rate appears to be higher with the coronavirus--perhaps as much as 10 times higher. And the elderly and those with serious pre-existing health problems are at even greater risk. In addition, unlike the flu, there is no vaccine for the coronavirus and there are no anti-viral treatments that are known to work.
When will there be effective treatments and a vaccine?
Doctors all over the world are testing available medicines now, and hope to find one (or more) that can help save more lives. It is expected to take one to two years to discover and distribute a vaccine.
But even without treatments or a vaccine, if I’m fairly young and healthy, I’m probably okay, right?
Based on all the best evidence we’ve seen so far, that appears to be true. Approximately 80% of those with the virus suffer mild to moderate symptoms, 15% suffer more serious symptoms requiring hospitalization, and 5% become critical. Again, those last two groups are made up primarily of the elderly and those with pre-existing health conditions. But that’s just a general rule of thumb--a relatively small number of young and healthy people have already died from this illness. Moreover, if you are young and healthy, you have a critical role to play in keeping our city and your fellow citizens safe--so please don’t stop reading yet.
If most people have only mild to moderate symptoms, why is everything from the NBA to our local St. Patrick’s Day parade here in Charleston being canceled?
That’s where we get into what public health experts call "social distancing." And while it may seem extreme at first, it’s actually vitally important, both for those who are at high risk for complications and for those who are not.
I’m not sure I’m buying that whole "social distancing" thing. Why’s it so important?
Okay, this is where things start to get serious, so please forgive us in advance for speaking plainly.
The one thing we know for sure about coronavirus is that it’s highly contagious, meaning that that millions of Americans will probably get the virus, perhaps even a majority. Therefore, the key question becomes how many people have the disease at the same time. And to understand why that’s so important, just think about these two scenarios for a moment.
First, imagine a world where we’re doing everything we can with social distancing and good hygiene (hand washing, deep cleaning, etc.) to keep the number of cases low at any given moment. In that world, people who become seriously ill -- approximately 20% of those with the disease -- can go to the hospital and get the treatment they need. And the vast majority of those people will eventually get better.
Now, imagine a different world, one that looks more like Northern Italy today. In this different world, where we’re not using every tool we have to keep the case number low, lots of people get the disease at the same time. Because of this, hospitals are overrun with patients. They start to run out of critical, life saving supplies and equipment, such as ventilators. Doctors and nurses begin to get sick themselves, as patients stack up in hallways and protocols break down. Soon, physicians are being forced to decide who lives and who dies because there simply isn’t enough equipment for everyone who needs it. In the end, large numbers of people -- including many who don’t have the coronavirus, but need critical care due to an illness or injury -- die unnecessarily as the medical system collapses.
Social distancing is all about protecting our citizens from that second scenario, which is playing out in Italy right now. We don’t want anything like that to happen in the United States or, more particularly, here in Charleston.
Yeah, but if that’s true, why are cruise ships still coming to Charleston? Shouldn’t they be part of this social distancing?
Put plainly, the port at Charleston is a state port, not a city port, and the state of South Carolina has all legal authority regarding cruise ship arrivals and departures. Mayor Tecklenburg has communicated our concerns about cruise ships to the director of the State Ports Authority and will continue to do so.
UPDATE (3/14/20, 10:30 a.m.): Cruise ship operations have been suspended for the next 30 days.
Alright. Then what is the city doing to try to protect us from this virus?
For the past two weeks, the city has been working closely with medical professionals at the MUSC to plan for this situation, and those plans are now being implemented. Essentially, those plans fall into two broad areas.
First, we’re working to protect our citizens through the only tools currently at our disposal--good hygiene and social distancing (see previous questions).
Second, we’re preparing for the moment when we may have to ensure the continuation of essential public services, such as police, fire and garbage, with a significantly reduced workforce.
Additionally, due to concerns about the coronavirus, the city has placed all city public meetings and gatherings under review and would encourage citizens to use caution as well. For specific guidelines, please visit: https://www.cdc.gov/coronavirus/2019-ncov/downloads/community-mitigation-strategy.pdf.
To learn about the city’s actions and plans in detail, please see our latest update here: https://www.charleston-sc.gov/CivicAlerts.aspx?AID=803.
Okay, I think I get it. Anything else we need to know?
Two things, for now.
First, make sure you’re following reliable sources for news about this virus. Here locally, that typically means sources like the Post and Courier, Charleston City Paper, and Channels 5, 4, 2 and 24 among others. Social media is also a powerful tool at times like these, but, as always, it’s wise consider the source.
Secondly, the best advice for individuals currently is to follow CDC guidelines. If you’re elderly or ill, avoid crowds. If you feel sick, do not go to work, and call your doctor to let them know your symptoms. Calling ahead will help your provider’s office take steps to keep other people from getting infected or exposed. And because the disease is spread so easily through direct contact, wash your hands and use hand sanitizer frequently.
Specifically, the CDC recommends the following:
- Avoid close contact with people who are sick.
- Avoid touching your eyes, nose, and mouth.
- Stay home when you are sick.
- Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
- Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe.
- Follow CDC’s recommendations for using a facemask.
- CDC does not recommend that people who are well wear a facemask to protect themselves from respiratory diseases, including COVID-19.
- Facemasks should be used by people who show symptoms of COVID-19 to help prevent the spread of the disease to others. The use of facemasks is also crucial for health workers and people who are taking care of someone in close settings (at home or in a health care facility).
- Wash your hands often with soap and water for at least 20 seconds, especially after going to the bathroom; before eating; and after blowing your nose, coughing, or sneezing.
- If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol. Always wash hands with soap and water if hands are visibly dirty.