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Coronavirus Outbreak: What You Need to Know

Editor’s note: This post was first published Jan. 28 and last updated 9 a.m. May 30 with the latest confirmed national and global COVID-19 cases.

Cases of a new coronavirus continue to be identified in Michigan. As a result, Gov. Gretchen Whitmer has declared a state of disaster in Michigan to help officials and communities respond and slow the spread of the global pandemic.

May 30 Update:  

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The disease caused by the new coronavirus is called COVID-19 (formerly referred to as “2019 novel coronavirus” or “2019-nCov”). The outbreak of this previously unknown strain of coronavirus started in December 2019 in Wuhan, China.

Individuals and organizations across Michigan are being asked to limit non-essential travel, leave work or school if you feel sick and to practice good hygiene. COVID-19 has been declared a national emergency.

This is a rapidly developing situation and information is constantly changing and being updated as officials learn more about the virus.

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Symptoms

There is a lot of variability in patient symptoms from COVID-19. The CDC is now warning that as many as 25% of people infected with the new coronavirus may not show symptoms.

COVID-19 has been reported to cause symptoms including fever, cough, shortness of breath or difficulty breathing, chills, repeated shaking with chills, muscle pain, headache, sore throat and new loss of taste or smell. Increasing shortness of breath, persistent pain or pressure in the chest, new confusion or inability to wake up, or bluish lips or face are emergency warning signs and are reasons to seek medical assistance without delay.

The virus is mainly spread when the respiratory droplets from an infected person’s coughs or sneezes land on the mouths and noses of people nearby and may be inhaled into the lungs. The CDC believes people are most contagious when they are the sickest. According to current estimates, it takes two to 14 days for symptoms to appear.

People at Risk for Serious Illness from COVID-19

According to the Michigan Department of Health and Human Services, older adults and people of any age with underlying medical conditions are at a higher risk of developing a serious illness from COVID-19.

Based on what officials know now, those at high-risk for severe illness from COVID-19 are:

People of all ages with underlying medical conditions, particularly if not well controlled, including:

  • People with chronic lung disease or moderate to severe asthma
  • People who have serious heart conditions
  • People who are immunocompromised
    • Many conditions can cause a person to be immunocompromised, including cancer treatment, smoking, bone marrow or organ transplantation, immune deficiencies, poorly controlled HIV or AIDS, and prolonged use of corticosteroids and other immune weakening medications
  • People with severe obesity (body mass index [BMI] of 40 or higher)
  • People with diabetes
  • People with chronic kidney disease undergoing dialysis
  • People with liver disease

It is important to remember that stigma and discrimination occur when people associate an infectious disease, such as COVID-19, with a population or nationality. COVID-19 does not target people from specific populations, ethnicities, or racial backgrounds.

People over the age of 80 should especially take precautions, according to Dr. Nancy Messonnier, director of the National Center for Immunization and Respiratory Diseases.

The CDC is advising these groups of people at a higher risk to stock up on supplies  and medications in case of an outbreak in their community — and plan to stay home as much as possible if an outbreak occurs. People over the age of 80 should avoid crowded, poorly ventilated areas, have backup plans for home health care if they are homebound and cancel any cruise ship plans, according to Messonnier.

Take everyday precautions to keep space between yourself and others, avoid crowds and wash your hands often when you go out in public.

For people with underlying medical conditions, it’s important that you continue to take your medications as prescribed by your doctor to keep your conditions under control. Before changing a prescribed medication regimen, first talk to your doctor about your concerns and follow their advice. They have up-to-date information about what the latest recommendations are.

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Precautions

To prevent the spread of the virus, one should take the following precautions:

  • Frequent hand washing with soap and water for at least 20 seconds. If soap and water are not available, use a hand sanitizer that is at least 60% alcohol-based.
  • Avoid close contact with anyone who has a fever and a cough.
  • If you are sick with a respiratory illness, practice cough etiquette: maintain your distance, cover your coughs and sneezes with tissues or clothing, and wash your hands.
  • If you have a fever, are coughing and have difficulty breathing, seek medical care and share any travel history with your doctor.
  • Clean and disinfect frequently touched surfaces daily, including tables, doorknobs, light switches, countertops, handles, desks, phones, keyboards, toilets, faucets, and sinks.
  • The CDC is recommending that people wear cloth face coverings in public settings where other social distancing measures are difficult to maintain, especially in areas of significant community-based transmission.

The U.S. Environmental Protection Agency has identified disinfectant products that have qualified for use against the new coronavirus that causes COVID-19, some of which are familiar household names. Coronaviruses are some of the easiest types of viruses to kill with the right disinfectant, according to the EPA. Make sure to read the label on the disinfectant product before using it, especially the portion about how long the product should remain on the surface.

In addition to hand washing, using the right disinfectant products is an important step to prevent and reduce the spread of the new coronavirus.

If You Recently Traveled and Feel Well 

There is global ongoing community transmission of COVID-19. Stay home for 14 days from the time you left an international area with widespread, ongoing community spread (Level 3 Travel Health Notice countries) and practice social distancing.

Take these steps to monitor your health and practice social distancing:

  1. Take your temperature with a thermometer two times a day and monitor for fever. Also watch for cough or trouble breathing.
  2. Stay home and avoid contact with others. Do not go to work or school for this 14-day period. Discuss your work situation with your employer before returning to work.
  3. Do not take public transportation, taxis, or ride-shares during the time you are practicing social distancing.
  4. Avoid crowded places (such as shopping centers and movie theaters) and limit your activities in public.
  5. Keep your distance from others (about 6 feet or 2 meters).

When to Seek Medical Care

The CDC is advising you to call your health care provider for medical advice if you have been in close contact with someone with COVID-19 or if you live in a community where there is ongoing spread of COVID-19 and you develop a fever and symptoms.

Tell the health care worker about your recent travels or contacts, and the professional will decide if you need to be tested for COVID-19.

The guidelines that clinicians are using to decide who to test are being re-evaluated daily. These decisions are currently being made in consultation with the local health departments under guidance of the Michigan Department of Health and Human Services and the CDC. For more information, see this link. As there is no treatment for COVID-19, people who have a mild illness may be able to isolate from others and care for themselves at home.

  • The Michigan Department of Health and Human Services has launched a statewide coronavirus hotline. Call 1-888-535-6136 to speak with health officials from 8 a.m. to 5 p.m. seven days a week.
  • Find a testing site in Michigan by visiting Michigan.gov/CoronavirusTest and entering your ZIP code.
  • MDHHS will also answer questions by email by contacting [email protected] from 8 a.m. to 5 p.m. seven days a week.

How to Seek Medical Care

The CDC advises those being evaluated for COVID-19 and who have been diagnosed with COVID-19 to monitor their symptoms. If your illness is worsening — for example, if you have difficulty breathing — the CDC advises you call your health care provider and tell them you either have or are being evaluated for COVID-19.

If you have a medical appointment, call the health care provider and tell them that you have or may have COVID-19. This will help the health care provider’s office take steps to keep other people from getting infected or exposed.

Before entering the health facility, put on a facemask to protect others in the office or waiting room from possibly being exposed. Ask your health care provider to call the health department.

If you have or are being evaluated for COVID-19 and need to call 911 for an emergency, notify the dispatcher of your status regarding the coronavirus. If possible, the CDC advises putting on a facemask before help arrives.

Telehealth Options

Health care leaders are encouraging patients to use telehealth options in order to access virtual care during the coronavirus outbreak. For patients with mild symptoms including headaches, stomachaches and vomiting, painful urination, cold and flu symptoms, eye irritations and mild rashes and injuries, virtual care provides a convenient way to access health care professionals.

Blue Cross Blue Shield of Michigan is waiving the cost of telehealth visits to its members and customers that have that benefit included in their health care plans as a part of the company’s response to the new coronavirus pandemic. Blue Cross Blue Shield of Michigan and Blue Care Network offer two options to access virtual care: the 24-hour Nurse Line and Blue Cross Online Visits.

Additionally, BCBSM is offering a free crisis hotline for emotional support for members and non-members at 833-848-1764, which is staffed by BCBSM’s behavioral health partner New Directions.

Additionally, ask your primary care provider if they are available to you via telemedicine through their patient portals or other means.

BCBSM, BCN Coverage

BCBSM and Blue Care Network have expanded their insurance coverage in numerous ways to help members confront the COVID-19 pandemic.

Blue Cross is covering all COVID-19 inpatient and outpatient treatment from in-network and out-of-network providers through June 30, 2020. Member cost sharing is also waived.

BCBSM and BCN are waiving member cost sharing for physician-authorized COVID-19 testing and resulting services as of March 18, 2020 in line with the Families First Coronavirus Response Act. Testing and associated services must be consistent with CDC guidelines.

BCBSM and BCN are waiving early medication refill limits on 30-day and 90-day prescription maintenance medications.

BCBSM and BCN are providing no-cost telehealth services to members with existing telehealth benefits nationally through at least June 30. This includes common behavioral health therapy, and most common office visit and hospitalization-follow-ups.

Additionally, BCBSM is supporting Michigan-based physician organizations and practices to support their efforts treating COVID-19 patients. BCBSM is relaxing some of its administrative requirements to allow Michigan’s physician organizations and health systems to spend more time treating patients and hasten their diagnoses and treatment.

Cases

In the U.S., the first case was confirmed in a Washington state resident Tuesday, Jan. 21. As of May 30, there are 1,747,087 confirmed cases and 102,836 deaths due to COVID-19 in the U.S., according to data collected by a team at Johns Hopkins University. Also, as of May 30, there are at least 56,621 cases of the coronavirus in Michigan.

In communities where community-level spread of the new coronavirus has been reported, the CDC considers people to be at an elevated risk of exposure, with increase in risk dependent on the location. Also those at an elevated risk of exposure to COVID-19 are health care workers caring for patients sick from the virus, close contacts of people who have been diagnosed and travelers returning from international locations where community-level spread of the virus is occurring.

As of May 30, there are a total of 5,954,711 confirmed and clinically diagnosed cases and 365,535 deaths globally.

Cases of the virus continue to be reported as the outbreak spreads.

Restrictions in Michigan

  • As of May 21, gatherings of up to 10 people are allowed in Michigan
  • Beginning May 26, auto dealerships and retail can open to in-person shopping, by appointment only
  • Beginning May 29, nonessential medical, dental and veterinary procedures can resume
  • K-12 school facilities are closed for the remainder of the 2019-2020 school year.
  • Beginning Friday, May 22, certain businesses in Northern Michigan and the Upper Peninsula can resume business with guidelines in place for activity, including bars and restaurants at 50% capacity.
  • The stay-at-home order in Michigan has been extended to June 12.
  • On May 7, construction, real estate and other businesses that perform work outdoors can re-open
  • On May 11, manufacturing facilities can re-open — though auto manufacturers are choosing to re-open May 18
  • Exceptions still apply to essential workers and to essential trips like grocery shopping and visiting the pharmacy.
  • Individuals are required to wear face coverings in enclosed public spaces as long as they are medically able to.
  • Travel between Michigan residences is permitted, but individuals are not allowed to travel to vacation rentals.
  • Stores must still restrict the number of people inside the store.
  • Some businesses can re-open, including lawn services, garden shops, landscapers, nurseries, moving and storage, bicycle repair shops.
  • Outdoor activities including golfing and motorized boating are now allowed, as long as individuals abide by social distancing guidelines.
  • Large stores can re-open certain sections including carpeting, flooring, furniture, garden centers, plant nurseries or paint.
  • Gov. Whitmer issued an order that requires all checkout employees to wear face coverings, as well as requiring other measures businesses must take to protect workers and consumers.

For Michigan residents, there are numerous resources available for those in need of help during the pandemic:

Travel Guidelines and Restrictions

Foreign travelers who have been in China, Iran and Europe — as well as the U.K. including Britain and Ireland — within the past two weeks will be banned from entering into the U.S. for 30 days, under order from President Donald Trump. As of midnight May 26, the travel ban is being extended to Brazil as well. The ban does not apply to American citizens, permanent legal residents of the U.S. and their families — though they may have to travel through certain airports to receive enhanced screening measures.

The CDC is recommending that travelers avoid all non-essential visits to all global destinations as a result of the pandemic.

On March 19, the U.S. State Department issued a Level 4 travel advisory urging U.S. citizens to avoid any international travel and for those currently overseas to return to the United States or be prepared to remain abroad for an indefinite timeframe. Beginning Monday, March 16, domestic travel for civilian military employees and their families is halted until May 11.

The U.S.-Canada and the U.S.-Mexico border are closed to non-essential traffic for tourism and recreation, though trade is not affected.

As of March 8, the CDC is recommending that travelers — especially those with underlying health issues, defer all cruise ship travel worldwide. This is due to the fact that cruise ship passengers are at an increased risk of person-to-person spread of infectious diseases, including COVID-19. Additionally, older adults and travelers with underlying health issues should avoid situations that put them at an increased risk for more severe disease — including avoiding crowded places, non-essential travel like long plane trips and avoiding cruise ship travel. Cruise ships in the U.S. are under a no-sail order from the CDC.

The community-level spread of COVID-19 has prompted the CDC to ask travelers to consider their risk of exposure before going on any trip. State or local governments may have issued local travel restrictions. Check with public health departments for more information.

FREQUENTLY ASKED QUESTIONS
Am I at risk?

The CDC considers the novel coronavirus to be a serious public health threat.

In the U.S. communities where community-level spread of the new coronavirus has been reported, the CDC considers people to be at an elevated risk, with an increase in risk depending on location. Those also at an elevated risk of exposure to COVID-19 are health care workers caring for patients sick from the virus, close contacts of people who have been diagnosed and travelers returning from international locations where community-level spread of the virus is occurring.

Older adults and people with serious chronic medical conditions including heart disease, diabetes and lung disease are more at risk of developing a serious illness from COVID-19. See the “People at Risk for Serious Illness” section in this blog for a full list.

The situation is rapidly evolving, and the CDC is committed to share updated information as it becomes available.

Why is it called a coronavirus?

The term “coronavirus” refers to a group of viruses that have crown-like spikes on their surface, according to the CDC.

Is this coronavirus new?

Yes. The strain of coronavirus behind the current outbreak that started in China is a new strain that was previously unknown to health officials.

The virus’ official name is “SARS-CoV-2” and the disease it causes is named COVID-19. Currently there is no vaccine for this strain of coronavirus.

There are multiple types of coronaviruses that health officials are already familiar with, including strains that cause the common cold, the strain behind severe acute respiratory syndrome (SARS) and the strain behind Middle East Respiratory Syndrome (MERS).

Where did the novel coronavirus come from?

The novel coronavirus’ genes suggest that it originated in bats, as did SARS and MERS, according to the CDC.

World Health Organization officials believe the coronavirus outbreak began at a large seafood and live animal market in the city of Wuhan, China, and that it likely spread at first from animals to humans. Now the virus is spreading from person to person.

Is it safe to receive a letter or package from China?

As of this time, the CDC believes it is safe to receive a letter or package from China. The coronavirus is similar to SARS and MERS, both of which did not survive long on objects like letters or packages. The CDC believes there is a very low risk of the virus spreading from products or packages.

Find more answers to frequently asked questions here:

This content has been reviewed and approved by Dr. S. George Kipa, deputy chief medical officer at Blue Cross Blue Shield of Michigan.

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Photo credit: filadendron

 

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