MGH infectious diseases physician answers questions about the Coronavirus (Covid-19)

02/18/2020

Published Tuesday, January 28, 2020 9:00AM EST

Michael Garron Hospital (MGH) is closely following the spread of coronavirus (COVID-19) that emerged from the Wuhan province in China.

Dr. Jeff Powis, infectious diseases physician and medical director of infection prevention and control (IPAC) answers some questions about COVID-19 below.

1. What is the coronavirus and what are the symptoms?

The term corona actually describes what the virus looks like under an electron microscope. There are proteins on the surface that people think look like a crown [corona is Latin for crown]. The group of viruses is actually quite diverse. These viruses can infect birds, animals and, of course, humans.

There are a number of coronaviruses that infect humans every year. There are four in particular that cause the common cold. So, most of us would have been infected with one of these coronaviruses, if not all of them, at some point in our lives. These are coronaviruses that are fairly well-characterized. Obviously, there’s a spectrum of illness associated with them, like the common cold – most cases are mild, but for some patients, even a common cold can lead to a more severe illness. In addition to those four common strains, up until now there were two strains associated more with severe illness: SARS and MERS.

The COVID-19 represents a new or novel form of coronavirus that first emerged in late 2019 in Wuhan district in China. Most people who have been infected with COVID-19 appear to have mild symptoms and improve over time - similar to what you might expect with a common cold. Some individuals however appear to have more serious symptoms consistent with pneumonia. Fortunately, even among the more serious cases the mortality rate has been low.

To learn more about the COVID-19 symptoms click here.

2. What is the current status of COVID-19, and does it pose a threat to patients and employees at MGH?

At this time, the Public Health Agency of Canada states that the risk to Canadians is low. The province is actively monitoring and is fully prepared to respond. For detailed information on the number of confirmed cases in Ontario, please click here.

For the latest information on confirmed global cases please click here.

3. What measures is MGH taking to prevent transmission of the virus?

At MGH, we perform enhanced screening of patients at points of entry to the hospital, including clinics and Emergency Departments. Specifically, we aim to quickly identify patients who have signs and symptoms of the infection along with travel and/or contact with ill contacts who have travelled to the affected areas. Patients who meet these criteria will be placed in isolation and tested.

The MGH IPAC team is in close contact with Public Health Ontario and other agencies to help guide decision-making and receive updates on the virus. We continue to adhere to routine practices which includes monitoring patients for new onset of symptoms, diligent hand hygiene, appropriate use of personal protective equipment (PPE) and disinfection of equipment.

4. What should I do if I’ve travelled to China in the last 14 days and have symptoms consistent with COVID-19?

If you have recently visited China, especially Wuhan province, or other affected countries and are experiencing fever or a combination of respiratory symptoms (cough, congestion, runny-nose) there are several options. First if your symptoms are mild and you feel well then we would recommend you stay well hydrated, rest and monitor your symptoms. Most people will improve with time only and you may simply have any one of the many respiratory viruses circulating at this time of year. You should also “self-isolate” to limit the potential spread to others. Please see the guidance from Public Health Ontario regarding how to “self-isolate”.

If you feel you need to seek medical assistance but you don’t feel you need to go to the Emergency Department then you should contact your family physician’s office to inform them of your travel history and concern about COVID-19. Do NOT go to a clinic before calling them ahead of time. If your family physician’s office is equipped to see you safely and do the required testing they will arrange with you a time to do so in their office. The East Toronto Health Partners (ETHP) have taken proactive steps to help family physicians facilitate specimen collection.

If you feel you need to come to hospital then upon arrival put on an ear-looped mask and inform the screener of your travel history and concern about COVID-19. We’ll take care of you from there.

If you are really sick and need urgent help then call 911 and inform the dispatcher of your travel history and concern about COVID-19.

It is important you are honest with all of your healthcare providers regarding any travel history. Regardless of where you’ve travelled to we are happy to provide you with great care. We ask these questions to ensure we can provide you with the best care and keep our other patients and staff safe.

5. Is it safe for me to travel?

For the Government of Canada’s latest travel advice, please click here.

6. What do we know about human-to-human transmission?

Like other human coronaviruses, COVID-19 is thought to be transmitted through large droplets generated by coughing, sneezing and spitting. There have been documented instances of human-to-human transmission with COVID-19, including transmission from patient to healthcare worker. All transmission events have thus far occurred in China and none outside the country. Although this may imminently change, this is the most up to date information we currently have. We remain vigilant and will isolate all patients with suspected infection using full precautions.

7. How is this infection similar to SARS?

Similarities to SARS include that both viruses are coronaviruses, a group of viruses known to also cause common colds, but also sometimes pneumonias. Both SARS and COVID-19 originated in China and likely came from animals. The main differences between the two – from what we currently know about COVID-19 – is that the mortality rate from SARS was much higher.

Compared to the state of public health and infection prevention and control during the SARS outbreak in 2003, we now have far better communication across the city, country and globe, more rapid viral testing, better screening, more infrastructure for infection control programs across the country and at MGH and more policies in place to prevent transmission. We are in a far better state to face this challenge than we were during the SARS outbreak. Therefore, the likelihood of an outbreak, here in Toronto, similar to the one seen due to SARS is low.

8. Is there a vaccine available for this infection, and what can we do to protect ourselves from the infection?

No vaccination is available for this infection at this time.

While it is unlikely that the influenza vaccine has any influence on acquiring COVID-19, it is one of the most effective ways to protect yourself from seasonal influenza currently circulating in Canada. Because influenza is a deadly and highly contagious virus, we encourage everyone to get the flu shot annually. Click here to search for a flu shot clinic near you.

Recommendations for the general public to reduce exposure to and transmission of a range of illnesses can be found on the Centres for Disease Control (CDC) website. This includes practicing hand and respiratory hygiene, and safe food practices.

9. What’s next at MGH?

A response committee is meeting daily to discuss MGH's current state and needs to ensure the safety of patients and staff. The schedule will be adjusted accordingly pending recommendation(s) by the governing bodies to alter control/containment measures.

We will continue to monitor World Health Organization (WHO), Centers for Disease Control and Prevention (CDC), Health Canada and Public Health Ontario for updates and will participate in GTA hospital IPAC discussions pertaining to COVID-19.

This page will be updated as more information becomes available.

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