COVID-19

FactsheEt

COVID-19

 the facts tell us how to act 

prepared for Open Futures Lab

by Gada Jane

 INTERVENTIONS ARE ACTIONS WITH OUTCOMES.

This factsheet lays out recommended interventions to manage the spread of COVID-19. What to do and why. 

THE BASICS

What is COVID19 / Coronavirus? How does it spread? What makes it so serious? 

COVID-19 is an infectious disease caused by a new strain of Coronavirus.

There is currently a pandemic of COVID-19. 

This page focuses on actions that can affect the spread of the disease, who can take them, and why they work. 

The information provided here is meant to encourage responsible action, not cause panic. This is a serious crisis. We need communities to work together to slow the spread of the virus and avoid overwhelming the medical system. 

Symptoms

And when to seek medical attention

If most cases are mild, why is it such a big deal? 

COVID-19 spreads fairly quickly and relatively easily. It is also moderately deadly.

 

This combination means that even with a relatively low death rate it can do a lot of damage. 

If it spreads too quickly cases overwhelm healthcare systems. This has happened already in some regions.

Drastic actions are required immediately to slow the spread and lower the death toll. 

See FAQs "How many people are going to die?" 

What can we do? 

COVID-19  has not been contained. It is a global pandemic and the disease is spreading. 

The goal now is to "Flatten the Curve." This means collectively taking community isolation measures to keep the daily number of disease cases at a manageable level for medical providers. 

FOR THIS TO WORK, EVERYONE MUST PARTICIPATE.

NOT AFTER THE DISEASE IS OUT OF CONTROL IN YOUR REGION.

 

NOW. 

Everyday the disease is spreading. Acting quickly is crucial. 

DO

The Reasons behind Interventions to Manage the COVID19 Pandemic

Personal

Interventions

  • Wash your hands

  • Cover coughs and sneezes

  • Don’t touch your face

  • Wear a mask (in some cases)

 

Lifestyle

Interventions

  • Social distancing

  • Keep two metres away from others

  • Don’t touch, shake hands, hug, kiss

  • Stay home if you can

  • Don’t travel

 

Health Interventions

  • Wash your hands

  • Cover coughs and sneezes

  • Don’t touch your face

  • Wear a mask (in some cases)

Government Interventions

  • School and business closures

  • Border closures and travel restrictions

  • Lockdown

  • State of Emergency

WHAT?

Wash your hands for 30 seconds at a time, frequently throughout the day. 

WHO?

Everyone. 

(Always - but if you haven't been doing it frequently and thoroughly, now is the time to start.) 

Coronavirus spreads through respiratory droplets.

These can live on surfaces and end up on our hands, but the virus is contracted only when the virus comes in through our eyes, nose, etc.

Wash your hands thoroughly and  often to get the virus off your hands to avoid catching or spreading the virus. 

WHY?

WHAT?

Cover your mouth and nose with a tissue or your elbow when you cough or sneeze. 

WHO?

Everyone. 

Coronavirus spreads when people come in respiratory droplets from the coughs and sneezes of an infected person. 

Covering coughs and sneezes can directly prevent the spread of the virus. 

WHY?

WHAT?

Avoi​d touching your face. 

WHO?

Everyone. 

The virus comes in through our eyes, nose, etc.

By avoiding touching our face we can stop the virus from entering our systems. 

WHY?

WHAT?

1. Do not shake hands, hug or kiss. 

2. Maintain a 2 metre (6 feet) distance from others. 

3. Avoid groups. 

4. If you can stay home, stay home. 

WHO?

Everyone.

 

No exceptions. No excuses. 

Even if there are not many or no confirmed cases in your region, The virus is spreading worldwide and social distancing is key to saving lives. 

IF YOU CAN STAY HOME, STAY HOME. 

The virus spreads through contact with a contagious person. 

You do not have to have symptoms to be contagious. 

Physical distance helps to keep you out of range of a contagious cough or sneeze. 

Staying away from groups limits how many people are potentially exposed to a contagious person and therefore how fast it can spread. 

WHY?

WHAT?

Avoid travel as much as possible.

WHO?

Everyone. 

Do not travel unless you have to. 

Some governments may choose to limit travel between regions.

CHECK YOUR LOCAL RESTRICTIONS AND RECOMMENDATIONS.

You do not have to have symptoms to be contagious. 

Traveling while contagious can spread the virus 

Travel on trains, airplanes, buses, and boats provide opportunities for the virus to spread. 

Travel spreads the virus more quickly because people come from different places, mingle, and then go to different places carrying the virus with them. 

 

WHY?

WHAT?

Get tested for COVID19.

WHO?

CHECK YOUR LOCAL RECOMMENDATIONS.

According to the World Health Organization, anyone with cold or flu symptoms should be tested. 

Many regions do not have enough tests and recommend self-isolation if you have any symptoms. 

DO NOT PANIC IF TESTING IS NOT WIDELY AVAILABLE IN YOUR REGION. Testing is recommended in order to get accurate numbers. If you are feeling sick, just monitor your symptoms and self-isolate. See above for when to see a doctor.  

Testing for COVID-19 provides information about how to treat any symptoms you might be experiencing. 

 

It also lets you know if you are contagious and could infect others. 

Testing also provides useful information about how many people are infected and where they are. 

 

WHY?

WHAT?

Complete separation from other people.  

WHO?

CHECK THE REQUIREMENTS AND RECOMMENDATIONS IN YOUR REGION. 

In every region, this applies to: 

People who have tested positive for COVID 19 and people who live with them.

People who have cold or flu symptoms and people who live with them .

The virus spreads through contact with a contagious person. 

Self Isolation cuts off contact with anyone who might become infected. 

WHY?

WHAT?

Separation from others after being exposed to the virus. 

WHO?

People who know or have reason to believe that they have been exposed to COVID19.

People who have recently traveled (check local requirements) 

If someone has been exposed to the virus or believes that they have, quarantine removes them from any contact through which they could spread the virus. 

WHY?

WHAT?

Avoid closed or poorly ventilated spaces with other people.

Ventilate high-risk areas, especially in hospitals. 

WHO?

As an additional precaution, health care workers and hospitals should probably ensure good ventilation around certain areas.  

There is some evidence that Coronavirus can live in the air.

However, it's spread primarily through contact with respiratory droplets. 

The virus has only been present in the air in very specific hospital areas, It's not clear if airborne spread is likely to happen at all. It does not seem to be a possibility under most circumstances. [11]

See FAQ about whether it is airborne for more information. 

WHY?

WHAT?

Wear a mask when around others. 

WHO?

Healthcare practitioners.

People who are or suspect they might be infected with COVID19.

People caring for people who are infected with COVID19.

Possibly people who are in confined areas with others during this pandemic. 

Masks create a physical barrier to stop the virus entering your nose and mouth. 

They are useful in certain cases. Their use is widespread in China but not North America. 

For more information on the debate, see FAQs "Should I wear a mask?"

WHY?

WHAT?

Closing schools and moving classes to online or distance education. 

WHO?

School boards or governments may decide to close schools, depending on the situation in their region. Many have done this worldwide. 

Individuals with school-age children may choose to keep them home from school. 

Older students may choose not to attend classes. 

Schools bring large numbers of people into close contact. Closing schools keeps people apart from each other in order to slow the spread of the virus. 

Studies suggest that the earlier schools are closed in a pandemic , the more effective it is to contain the spread of the virus. 

For more information see FAQs "Why are they closing schools before there are cases in the community?" 

WHY?

WHAT?

Government imposed restrictions on movement. 

WHO?

Governments may choose to impose restrictions on people's movement. 

Several countries and regions have done this. 

To prevent spreading the disease through social contact. 

WHY?

WHAT?

Closing borders or limiting who may enter a country or region. 

WHO?

Governments may choose to impose restrictions on who may enter a country or region. The may also choose to close the border. 

CHECK YOUR REGION'S INFORMATION.

To prevent spreading the across regions. 

WHY?

WHAT?

Declaring a State of Emergency in a country or region. 

WHO?

Governments may choose to declare a state of emergency. 

CHECK YOUR REGION'S CURRENT STATUS.

A state of emergency temporarily allows the government unusual powers to address a crisis. 

Depending on local laws the state of emergency might allow the government to limit personal travel, close down public or private buildings, fix prices for goods to prevent unreasonable inflation, 

supplement local resources, and take other measures to address the crisis. 

WHY?

KNOW

Clarifications and Frequently Asked Questions.

HOW DO YOU GET COVID-19?

COVID-19 is spread through respiratory droplets from coughs and sneezes. 

Most patients become infected through contact with someone who is carrying the virus. It is also possible to catch the virus by touching a contaminated surface and then touching your face. 

WHY IS COVID-19 ALSO CALLED CORONAVIRUS? 

Coronavirus is the virus that causes the infectious disease called COVID-19. 

There are many types of human coronaviruses including some that commonly cause mild upper-respiratory tract illnesses like the common cold. COVID-19 is a new disease, caused be a novel (or new) coronavirus that has not previously been seen in humans.

(CDC)

WHAT ARE THE SYMPTOMS OF COVID-19?

According to the World Health Organization:

The most common symptoms of COVID-19 are fever, tiredness, and dry cough. Some patients may have aches and pains, nasal congestion, runny nose, sore throat or diarrhea. These symptoms are usually mild and begin gradually. Some people become infected but don’t develop any symptoms and don't feel unwell. Most people (about 80%) recover from the disease without needing special treatment. Around 1 out of every 6 people who gets COVID-19 becomes seriously ill and develops difficulty breathing. Older people, and those with underlying medical problems like high blood pressure, heart problems or diabetes, are more likely to develop serious illness. People with fever, cough and difficulty breathing should seek medical attention.

IS IT REALLY THAT SERIOUS? 

Yes.

COVID-19 is the most serious pandemic the world has seen since the flu pandemic of 1918. 

The seriousness of any pandemic is determined by how many people are likely to die. Number of deaths depends on both how many people are infected and how many people die for every infected person. 

Even though the death rate of COVID-19 is likely less than 1%, because the disease is fairly contagious it is likely to infect a lot of people. This means even with a low death rate, it will kill a lot of people unless people collectively work together to flatten the curve. 

You can follow the current numbers of infected, dead and recovered here or here

WHAT DOES IT MEAN TO "FLATTEN THE CURVE"?

Flattening the curve means collectively taking community isolation measures to keep the daily number of disease cases at a manageable level for medical providers. 

Any epidemic has a peak after which number of cases start to decline. If this peak is reached through rapid spread the number of cases flooding the medical system is likely to be way beyond the system's capactity, leading to poor treatment outcomes and more deaths.

The idea of flattening the curve is to use social interventions to slow the spread so that number of cases occur at a rate that is manageable for the medical system. 

 

Slowing the spread is also important because it give doctors and researchers time to develop and improve treatments. 

IS COVID-19 REALLY WORSE THAN FLU? 

Yes. 

COVID-19 poses a significantly more serious threat than flu for several reasons. 

1. The death rate is higher than a flu. 

2. There is no vaccine.  

3. No one is immune. 

In short, it's more deadly and more people will be infected.

You might hear that COVID-19 is the most serious pandemic the world has seen since the flu pandemic of 1918, but that the flu was worse. It was worse at the time because it was a particularly virulent strain of the flu, there was no flu vaccine and no antibiotics to treat secondary bacterial infections. There was also a world war in progress that likely contributed to the spread. 

HOW DOES COVID-19 COMPARE TO PAST OUTBREAKS? 

Coronavirus is the most serious pandemic the world has seen since the flu pandemic of 1918. 

In more recent years we have had pandemics of other serious illnesses but the outcomes were less severe  because the disease in question was either less contagious, spread less widely or was less deadly. 

 

For example SARS was more deadly but less contagious. It killed more of the people infected than COVID-19, but significantly fewer people were infected.

On the other hand, H1N1 Flu was very contagious but was less deadly, so it infected a lot of people but killed fewer of them. 

This is not to say that people made a big deal out of nothing in these previous cases. These were all serious situations that were managed by experts to prevent them from becoming global crises.

 

The fact that SARS was not a more devastating crisis is due to its management by healthcare professionals. These are the same people who are now saying the only course of action that will work is to collectively practice careful hygiene and social distancing. They saved us before. This time we have to do our part. 

WHO CAN BE INFECTED WITH CORONAVIRUS?

Everyone. 

It is a new strain of the virus which nobody it immune to. 

HOW LONG DOES IT TAKE FOR SYMPTOMS TO APPEAR AFTER EXPOSURE?

2-14 days [12]

Time between cases is generally less than a week.

ARE MOST CASES MILD?

Yes. 

Most people who become infected will have mild to no symptoms. 

Note: This actually makes the virus easier to spread because people with mild or no symptoms might be walking around spreading the virus without knowing they have it.

IF I AM YOUNG AND HEALTHY, COULD I STILL GET SICK?

Yes.  

Most deaths occur in the elderly and people with underlying medical conditions, but serious illness and death do occur in younger and otherwise healthy people. 

 

Also note that men seem to be getting more sick, perhaps due to more exuberant immune responses [4]

CAN I BE CONTAGIOUS WITHOUT SYMPTOMS?

Yes.

According to a recent study, more than 10 percent of patients are infected by somebody who has the virus but does not yet have symptoms. [8]​

WHAT SHOULD I DO IF I THINK I HAVE COVID-19?

Check your local recommendations for testing and engaging with healthcare. 

Monitor your symptoms. 

WHO recommends avoiding smoking, wearing two masks and taking antibiotics. [11]

SEEK MEDICAL CARE IF YOU EXPERIENCE FEVER, COUGH, AND DIFFICULTY BREATHING. [11]

IF POSSIBLE, CALL BEFORE GOING TO THE DOCTOR. 

CAN I GET COVID-19 BY TOUCHING A SURFACE?

Yes.

You can get COVID-19 from a surface or object if someone coughed or sneezed directly onto it or on their hands and then touched it. 

It’s not clear how much the disease has spread this way but it is believed to be possible.  

HOW LONG DOES CORONAVIRUS LIVE ON A SURFACE OR OBJECT?

Up to several days depending on the surface.

The virus lasts up to 24 hours on cardboard to up to two or three days on plastic and stainless steel. [5]

 

It is easily deactivated by household cleaners [4]

 

It’s also still difficult to say how much “fomite” transmission is actually happening—that’s the term for when a bug is left on an object, which is then picked up by others. But this is more evidence to continue playing it safe. 

CAN YOU CATCH IT THROUGH FOOD? 

COVID-19 does not seem to spread through food, however good food prep hygiene is very important.

Harvard Health recommends staying away from restaurants and not sharing food outside your immediate family. Most sources simply recommend very careful attention to hygiene in the preparation of food. 

LEARN MORE

Sources and Resources. 

IS COVID-19 AIRBORNE? 

Maybe. 

Transmission through the air might be possible but it's not clear if it has happened. 

There is not clear evidence that COVID19 has been transmitted this way, but it might be a factor in certain areas in hospitals. 

 

Scientists have shown that the it can live in the air for 3 hours in an aerosol mist. These were under lab conditions designed to keep the virus in the air. The scientists specifically aerosolized the virus for this study, so the study showed only that the virus can live in the air.  It did not show that the virus is likely to be lingering in the real world in one spot for 3 hours. [5]

 

In general, is known to transmitted via droplet, for example through contact with an infected sneeze. When people sneeze they generally produce droplets rather than fine aerosol mist. These fall to the ground more quickly. Some viruses do actually linger in the air and are therefore much genuinely airborne. Measles, for example, does stay in the air for some time. [4]

There is some evidence of the virus lingering in certain areas of hospitals. 

 

Experts disagree about how to respond:

“We shouldn’t be waiting to figure out the exact split between transmission modes before we act—we should be taking an ‘all-in’ approach,”

“The guidance for hospitals already includes bringing in more fresh air and enhancing filtration. It strikes me as inconsistent that the public is not getting a similar message.”

  • Joseph Allen, professor of public health at Harvard [5]

 

“There's currently no evidence that the general public needs to worry about aerosol transmission of SARS-CoV-2, but there plausibly could exist risks in specialized hospital settings,”

  • Dylan Morris, researcher at Princeton who coauthored the study on aerosol Covid-19 [5]

 

Summary:  spread through the air is unlikely but not impossible. If it is a risk at all, it is probably only a risk in closed environments and specific zones of high-risk areas of hospitals. [5]

IS THERE A VACCINE?

No. ​

Vaccines are being developed but will not exist for 12-18 months. Probably closer to 18. [4]

WHAT DO THE RECOVERY STATISTICS MEAN?

The official count of the number of recovered patients generally means: fever free for certain number of days and 2 clear diagnostic tests.

This classification is useful for determining who might spread the disease. 

Recovery in the practical sense might happen more or less quickly. People might return to feeling normal before being classified as recovered or still have things to recover from after being classified as recovered. Some patients might bounce back in a week, others might be left with lasting lung damage. (Sam Harris 191)

DOES AMOUNT OF EXPOSURE MAKE A DIFFERENCE TO HOW SICK YOU GET?

Probably yes. ​

According to Amesh Adalja, infectious disease specialist at the Johns Hopkins University Center for Health Security, higher dosages of the virus might make people sicker than lower ones [4]. This means just because you have been exposed doesn't mean you are safe to continue being exposed. It might also mean that young healthy people in medical professions that expose them to the virus are more at risk of getting seriously ill. 

ARE WE ALL GOING TO GET IT EVENTUALLY?

No. [4]

Estimates suggest between 30 and 60% of the population will become infected.  

Social distancing and other interventions can lower the ultimate number to some degreee. Interventions also slow the spread of the virus (aka flatten the curve) which makes the number of cases occur at a rate that is manageable for the medical system. 

 

Slowing the spread is also important because it give doctors and researchers time to develop and improve treatments. 

HOW MANY PEOPLE ARE GOING TO DIE? 

Unknown.

It depends on how people respond now. 

But estimates are sobering.

Amesh Adalja, infectious disease specialist at the Johns Hopkins University Center for Health Security suggests that 35,000 dead from Coronavirus this year would be an optimistic number. By comparison, about 40,000 people die in the US yearly from automobile accidents. He says 300,000-800,000 deaths this year in the US is not an unreasonable estimate. This would make it one of the top killers. [4]

Francis Collins, the director of the National Institutes of Health says "There are estimates that if nothing goes right and if we fail to flatten the curve and if health systems are overwhelmed, we might see the deaths of as many as a million and a half people in the United States.” That is a worst-case scenario. [9]

In the US alone, there is likely to be somewhere between 35,000 and 1,500,000 deaths in the next year from COVID-19 [4][9]. What the actual number is depends on flattening the curve through social distancing and other interventions.

You can see current numbers here or here

WILL COVID-19 GO AWAY IN WARMER WEATHER?

Probably not. 

Based on the behaviour of related viruses, it is suspected that COVID-19 will stick around, spreading more during cold weather months but that does not mean it is impossible to become sick with these viruses during other months.

IS THERE ANY GOOD NEWS?

Yes. ​

Most people with COVID-19 will be fine. 

Most people in the world will be fine. 

We have the ability to significantly improve the outcome by acting now. 

Handled well, this crisis can be managed. 

WHY ARE SCHOOLS CLOSING?

​School closures are an effective measure to prevent the spread of infectious disease. 

In many regions, schools are closing as a preventative measure before the outbreak gets out of hand. Studies show this is a very effective way to flatten the curve and save lives. ​

There are two kinds of school closures. 

  • Reactive School Closures (ie. school closures once someone is sick at the school)

  • Proactive School Closures (ie. school closures once someone is sick within the community or once there is community transmission)

Research shows that reactive school closures are effective. Proactive school closures are more effective.​

  • Empirical results on reactive school closures in Japan and Italy as well as computer models suggest that reactive school closures lowered cumulative attack rate by 24 % and delayed the peak of the outbreak by 13 days. ​

  • A Study of 43 schools in 1918 flu epidemic suggests proactive closing lowers death rates significantly over reactive school closures.[3]

HOW LONG WILL THIS LAST?

Unclear.

It depends on a lot of factors including on what actions people in your region and other regions take and  when effective treatments are developed. 

CAN I GO OUT?

Check local recommendations and restrictions. Some regions have placed restrictions on leaving the house. 

Regardless of region, the general rule is if you can stay home, then stay home. 

 

In every case, avoid people you do not have to see. Practice social distancing. 

HOW CAN I TRACK THE VIRUS IN MY COMMUNITY?

Look at local public health resources and news. 

For global tracking go here or here

LEARN MORE

Sources and Resources. 

CORONAVIRUS TRACKING SITES:

[1] https://ncov2019.live/data

[2] https://coronavirus.jhu.edu/map.html

SOURCE PODCASTS

[3] Nicholas Christakis on Making Sense with Sam Harris 190. https://samharris.org/podcasts/190-respond-coronavirus/

[4] Amesh Adalja on Making Sense with Sam Harris 191. https://samharris.org/podcasts/191-early-thoughts-pandemic/.

https://www.statista.com/chart/21134/age-distribution-coronavirus-italy-south-korea/

SOURCE ARTICLES

[5] https://www.wired.com/story/how-long-does-the-coronavirus-last-on-surfaces/

[6] https://tincture.io/covid-19-the-state-of-play-from-the-front-lines-9ebf2513ed74 (Good summary of symptoms, definitions of terms, etc)

[7] https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing

[8] https://www.sciencedaily.com/releases/2020/03/200316143313.htm

[9] https://www.theatlantic.com/ideas/archive/2020/03/interview-francis-collins-nih/608221/

[10] https://www.statnews.com/2020/03/16/coronavirus-can-become-aerosol-doesnt-mean-doomed/

[11] https://www.who.int/news-room/q-a-detail/q-a-coronaviruses

[12] https://www.cdc.gov/coronavirus/2019-ncov/faq.html

 

FAQS & REFERENCE MATERIAL

https://www.who.int/news-room/q-a-detail/q-a-coronaviruses

https://www.health.harvard.edu/diseases-and-conditions/coronavirus-resource-center

https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public

https://www.cdc.gov/coronavirus/2019-ncov/faq.html

SOURCES OF GOOD INFORMATION ON TWITTER

https://twitter.com/mlipsitch (Twitter Account of Harvard Epidemiologist Mark Lipsitch)

https://twitter.com/NAChristakis (Twitter Account of Sterling Professor of Social & Natural Science at Yale, Nicholas Christakis)