Coronavirus screening measures have been implemented at 20 busy airports such as this one.

Coronavirus Outbreak: What You Need to Know

Editor’s note: This post was first published Jan. 28 and last updated 11 a.m. March 28 with the latest news updates and confirmed global and U.S. 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 emergency in Michigan to help officials and communities respond and slow the spread of the global pandemic.

March 28 Update:

  • On March 28, President Donald Trump approved disaster funding for Michigan, which will be made available to assist in dealing with the pandemic.
  • The city of Detroit has launched a drive-through testing station at the former state fairgrounds site, though a doctor’s prescription and appointment are needed to be tested.
  • The U.S. Centers for Disease Control and Prevention are advising all individuals avoid nonessential travel to all global destinations.
  • Michigan residents and most businesses are being ordered to stay home as of 12:01 a.m. March 24 for the next three weeks, except for the following cases:
    • Grocery shopping or picking up medication
    • Medical appointments or treatment
    • Obtaining fuel
    • Walking and hiking for exercise, including pet walking
    • Staffing for minimum basic operations for employers
    • Essential workers (police, fire, hospital, grocery and pharmacy workers) and their workplaces
  • There are 3,657 cases and 92 deaths from COVID-19 in Michigan.
  • The federal government is asking people to avoid social gatherings of 10 people or more until March 31.

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

This coronavirus causes symptoms including fever, cough and shortness of breath. Since the virus is brand new, there is no vaccine to prevent an infection. It is spread through close contact (within six feet) with an infected person. 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:

  • These individuals include, but are not limited to, older adults and persons of any age with underlying medical conditions, such as persons with a blood disorder (e.g., sickle cell disease or a disorder being treated with blood thinners), an endocrine disorder (e.g., diabetes mellitus), or a metabolic disorder (such as inborn error of metabolism); those with heart disease, lung disease (including asthma or chronic obstructive pulmonary disease), chronic kidney disease, or chronic liver disease; those with a compromised immune system (e.g., those who are receiving treatments such as radiation or chemotherapy, who have received an organ or bone marrow transplant, who are taking high doses of immunosuppressant, or who have HIV or AIDS); those who are currently pregnant or were pregnant in the last two weeks; and those with neurological or neurologic and neurodevelopment conditions.

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.

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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 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 now 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.
  • 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 will be waiving the cost of telehealth medical 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, ask your primary care provider if they are available to you via telemedicine through their patient portals or other means.

Cases

In the U.S., the first case was confirmed in a Washington state resident Tuesday, Jan. 21. As of March 28, there are 104,865 confirmed cases and 1,709 deaths due to COVID-19 in the U.S., according to data collected by a team at Johns Hopkins University. Also, as of March 27, there are at least 3,657 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 March 27, there are a total of 591,802 lab-confirmed and clinically diagnosed cases and 26,996 deaths globally.

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

Restrictions in Michigan

  • As of 3 p.m. Monday, March 16, the following are temporarily closed in Michigan:
    • Dine-in service at bars, restaurants and coffee shops, though take-out will still be permitted
    • Movie theaters, theaters and indoor and outdoor performance venues
    • Hookah bars, cigar bars and vaping lounges
    • Libraries and museums
    • Gyms, fitness centers and studios, spas, indoor sports facilities
    • Casinos and racetracks
  • Non-essential personal care services that require individuals to be within 6 feet of each other, including but not limited to hair, nail, tanning, massage, tattoo and piercing services are to cease through April 13 in Michigan.
  • Michigan health care facilities, residential care facilities, congregate care facilities and juvenile justice facilities must prohibit unnecessary visitors.
  • All Michigan K-12 school buildings — public, private and boarding — are closed to students until Sunday, April 5.
  • As of 5 p.m. March 21, non-essential medical and dental procedures must be postponed at Michigan health care facilities.
  • An executive order bans landlords from evicting renters from rental units through April 17 in Michigan.
  • Gatherings of 50 people or more are banned in Michigan until 5 p.m. April 5.

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. 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.

While there are no general U.S. travel restrictions in place at this time, the community-level spread of COVID-19 has prompted the CDC to ask travelers to consider their risk of exposure before going on a trip.

FREQUENTLY ASKED QUESTIONS
Am I at risk?

The CDC considers the novel coronavirus to be a serious public health threat. Community-level spread of COVID-19 are being reported in a growing number of states.

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. These individuals include, but are not limited to, older adults and persons of any age with underlying medical conditions, such as persons with a blood disorder (e.g., sickle cell disease or a disorder being treated with blood thinners), an endocrine disorder (e.g., diabetes mellitus), or a metabolic disorder (such as inborn error of metabolism); those with heart disease, lung disease (including asthma or chronic obstructive pulmonary disease), chronic kidney disease, or chronic liver disease; those with a compromised immune system (e.g., those who are receiving treatments such as radiation or chemotherapy, who have received an organ or bone marrow transplant, who are taking high doses of immunosuppressant, or who have HIV or AIDS); those who are currently pregnant or were pregnant in the last two weeks; and those with neurological or neurologic and neurodevelopment conditions.

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. Currently, the CDC is not recommending the use of face masks by the general public in the U.S.

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.

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: baona 

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