“How this coronavirus kills its victims - Los Angeles Times” plus 1 more

How this coronavirus kills its victims - Los Angeles Times

Posted: 29 Feb 2020 05:29 PM PST

The new coronavirus spreading rapidly around the globe can be deadly because it targets a very vulnerable and essential part of the body — the lungs.

The coronaviruses that can set you back with a common cold typically infects just the nose, sinuses and throat. But it's more common for the one responsible for COVID-19 to spread into the cells of the airways and lungs as well.

"The virus basically hijacks the cell and reprograms it genetically to make more copies of virus ," said Dr. Otto Yang, an infectious disease expert at UCLA.

Then it begins its attack.

About 86,000 people around the world have been infected with the novel coronavirus from China, and 2,977 have died. The first fatality in the U.S. was reported on Saturday.

An analysis of nearly 45,000 patients in China revealed that the vast majority of those cases — 81% — caused only minor illness. An additional 14% had symptoms described as "severe." Just 5% of the cases were deemed "critical," and half of those infections resulted in death.

Here's what doctors and scientists have pieced together about how the coronavirus kills.

Destruction of the lungs

As the virus starts to destroy the lungs, "people become unable to breathe properly," Yang said.

Even worse, the body's efforts to fight the virus can cause inflammation in the lungs — making breathing even more difficult.

Blood vessels damaged in the war between the virus and immune system may begin leaking fluid into lung tissues, which can be visible as white spots on chest X-rays.

The fluid may drown some of the lung's tiny air sacs, preventing them from delivering oxygen to the blood and removing carbon dioxide. It is this kind of inflammation and destruction that is called pneumonia.

"The immune cells are like police officers or soldiers," Yang said. "If you have a small infection — so a small number of criminals — they can come in and they can effectively clear out the problem people without much collateral damage."

On the other hand, he said, "if you have a huge crowd of criminals all at once, and a huge crowd of soldiers all at once, then you have tons of collateral damage because it's a big clash."

Breathing problems

The analysis of patients in China reported that severely ill patients suffered from symptoms like shortness of breath and low levels of oxygen in the blood. Chest X-rays and CT scans of the lungs showed most of the organs covered in fluid.

Some of the severely ill were taking more than 30 breaths a minute — well above the normal rate of 12 to 20 breaths per minute.

"Even though each breath is not working as well as it should, if you take enough breaths, you can make up for that, and still breathe on your own," Yang said.

Attack on the kidneys

The lungs aren't the only target. The coronavirus also has the ability to latch on to, hijack and destroy cells of the kidneys, Yang said.

The kidneys play an essential role in removing waste from the blood. When they fail, toxic levels of waste can pile up in the body.

Respiratory failure

Patients are considered critically ill if they can no longer breathe on their own.

If this happens, patients are fitted with special masks that deliver very high concentrations of purified oxygen into the mouth, or they can be put on a ventilator, Yang said. This involves placing a tube into the throat so the machine can push oxygen directly into the lungs.

Septic shock

Despite treatment, the battle between the virus and the immune system may cause collateral damage throughout the body.

"It's no longer just limited to the lungs," Yang said. "There's this inflammation that's all throughout the whole body now."

That starts a chain reaction that can destroy other organs and cause blood pressure to fall to dangerously low levels.

Septic shock is a body-wide response, in which the immune system is trying to attack the virus everywhere. Unfortunately, the inflammation caused by the immune system damages human cells throughout the body.

"It's a process that can be triggered by any severe infection," Yang said.

Multiple organ dysfunction or failure

If the disease progresses, organs can start failing. This could be the result of the virus' direct attack, as with the lungs and kidneys, or because of septic shock.

The ways in which people die from COVID-19 are actually quite similar to the way people can die from the flu — even though influenza viruses are very different from coronaviruses.

"You can think of it as a final common pathway," Yang said. "The criminals coming in may be different. But the final effect is the same."

The effect of age

The oldest patients have faced the greatest risk of death, according to the study of Chinese patients by researchers with the Chinese Center for Disease Control and Prevention.

While the overall case fatality rate of the patients in the study was 2.3%, it was 8% for those in their 70s and 14.8% for patients 80 or older.

In a surprise, there were no deaths among infants, toddlers or children younger than 10. That's odd because with other respiratory illnesses like the flu, the very young and the very old face the greatest risk of death.

"The virus seems to be really benign in children," Yang said. "That applies even to children under the age of 1, which is really odd. Normally, children under the age of 1 are very susceptible to a lot of things."

One possible explanation for this is that children have less-developed immune systems, he said. In this case, an immature immune system might prevent the body from triggering inflammation severe enough to result in pneumonia, septic shock and multiple organ failure.

Coronavirus and flu: What to do about it - The Delaware County Daily Times

Posted: 28 Feb 2020 09:57 AM PST

Delaware County is responding to the growing threat of coronavirus as officials have set up a resource page on the county website as a clearinghouse for information.

"In the absence of a county health department, our Department of Intercommunity Health has been working to communicate with the state Health Department and (the Centers for Disease Control and Prevention) to be proactive," Delaware County Vice Chairman Dr. Monica Taylor said of the county information page,

https://www.delcopa.gov/ich/resources/coronavirus.html. "The health and safety of our residents is council's top priority and we are doing everything we can to prevent and prepare for an outbreak in our area."

More than 80,000 cases of 2019 novel coronavirus (COVID-19) have been confirmed throughout the world, including more than 2,700 deaths. There are believed to be 459 cases in the United States with the first fatality reported this weekend. The CDC has not reported any confirmed cases of coronavirus in Pennsylvania.

Concerns are growing. Last week, Villanova University students studying in Italy were informed they were going to be brought back to the United States due to what university representatives said was "the rapid increase in the number of confirmed cases in Northern Italy."

This novel coronavirus is a respiratory illness that can spread from person-to-person and was identified first in Wuhan, China. Symptoms may appear in as few as two days or as long as two weeks after exposure and include fever, cough or shortness of breath. According to the Pennsylvania Department of Health, people can have little to no symptoms with this coronavirus or be severely ill and dying.

The CDC said the disease spread mainly from person-to-person after an infected person coughs or sneezes. CDC officials have said it can also be potentially spread by touching a surface or object with the virus on it, then touching one's own mouth, nose or possibly their eyes.

Officials at the CDC have said that COVID-19 remains an emerging disease and more needs to be learned about it, particularly its transmissibility.

Delaware County's Senior Medical Advisor Dr. George Avetian offered some advice in line with CDC practices.

"There is currently no vaccine to prevent coronavirus disease 2019 (COVID-19)," Avetian said. "The best way to prevent illness is to avoid being exposed to this virus. However, as a reminder, CDC always recommends everyday preventive actions to help prevent the spread of respiratory disease."

Prevention includes avoiding close contact with those who are sick; avoid touching your eyes, nose and mouth; staying home when you are sick; covering your cough or sneeze with a tissue then throwing that tissue in the trash; clean and disinfect frequently touched items and surfaces using a regular household cleaner or wipe; wash your hands often with soap and water for at least 20 seconds; if soap is not available, use hand sanitizer with at least 60 percent alcohol.

The CDC does not recommend wearing face masks for prevention with people who are well. They do, however, say those infected with coronavirus should wear a face mask to prevent its spread.

State health officials do suggest preparing a home emergency kit with items such as non-perishable food, bottled water, medications, a flashlight with batteries, a first aid kit, warm clothing and baby and pet supplies.

On Friday, Avetian noted that the U.S. Department of Health and Human Services Secretary Alex Azar said at least 40 public health labs were capable of testing specimens for coronavirus and that number was expected to double by Saturday.

Azar added that "a newly manufactured CDC test can be sent to 93 public health labs as soon as Monday, and a privately manufactured test based on the new CDC test could be sent to those same labs as early as (Saturday), pending (U.S. Food and Drug Administration) clearance."

Thursday evening, Haverford Township School District Superintendent Maureen Reusche sent out a notice to all district parents.

"It is normal to be concerned when news agencies report on trending health-related events," she said. "It is an important topic and we want to share with you some information as it pertains to the School District of Haverford Township."

She said the daily cleaning process for the classrooms, bathrooms and common areas in school district buildings includes disinfection.

Reusche stressed the importance of every day common sense preventative actions as already outlined by the CDC and the Pennsylvania Department of Health, such as washing hands or staying home when sick, are the leading recommendations with regards to the coronavirus or any other.

She encouraged parents and caregivers to check the "Health Services" page on the district website.

"Please know that the district is firmly committed to protecting the health and welfare of our students and staff," she said.

Rabbi Barry Blum of Congregation Beth El-Ner Tamid in Broomall said he'd like to see the area churches and synagogues come together for a community gathering to pray for strength, courage and divine help in dealing with the coronavirus.

And while coronavirus is getting a lot of attention, area residents would be wise to not forget the flu.

The Pennsylvania Department of Health has classified the spread for influenza as widespread with confirmed reports in each of the 67 counties. Delaware County has 3,994 cases reported as of Feb. 22.

Regionally, for the same time period, Bucks County reported 2,447 cases; Chester County has 2,634 cases; Montgomery County recorded 7,148 cases; and Philadelphia has 5,990.

State health officials said that 47 influenza-associated deaths have occurred this season, including a second-grade student from the Marple Newtown School District.

Across the United States, anywhere from 3,000 to 49,000 people die annually from influenza-related causes.

The flu also spreads from person to person such as when an infected person coughs or sneezes. And, also, it can spread when droplets from a cough or sneeze land on an object, such as doorknobs and light switches, if another person touches it and then touches their mouth or nose.

The best way to prevent influenza is by getting a vaccine.

State officials delineate the difference between the flu and the common cold, explaining that the flu usually comes on suddenly. Symptoms include fever, headache, tiredness that can be extreme; dry cough; sore throat; nasal congestion; and body aches.

Complications of the flu include pneumonia, ear infections, sinus infections, dehydration and worsening of existing chronic medical conditions such as congestive heart failure, asthma or diabetes.

For more information about coronavirus, please continue to monitor the following sites: https://www.delcopa.gov/ich/resources/coronavirus.html;

https://www.cdc.gov/coronavirus/2019-ncov/index.html; and,

https://www.health.pa.gov/topics/disease/Pages/Coronavirus.aspx.

For more information about influenza, please visit

https://www.health.pa.gov/topics/disease/Flu/Pages/Flu.aspx.