As the leading healthcare provider in Boone County, Witham Health Services is on the front line in combating the COVID-19 pandemic.

In an effort to educate area residents, Chief of Staff Tom Heniff, M.D., M.B.A., is answering some basic questions for readers of The Lebanon Reporter.

What is Corona virus?

Corona virus is a new respiratory illness that is transmitted from person to person or surface to person. It was first identified in Wuhan, China. In the U.S., it was initially associated with travel related outbreaks, but now has become a community spread illness. This means it is spread from person to person while in contact with others.

How is it spread?

It is spread person to person via droplets from coughing or sneezing. You typically have to be within 6 feet of an infected person for this to occur. The virus can live on surfaces for several days and can be caught by touching a surface and then touching your face, mouth, nose or eyes.

When are you infectious?

People are potentially infectious from 5 days prior to onset of symptoms until about 14 days after onset of symptoms. This is the reason for 14-day quarantine of people exposed. People typically develop symptoms 2 to 14 days after exposure with most beginning by day 5.

Who is at risk?

The Corona virus can infect any age group. In younger, healthier people, it tends to be a milder illness with people having fever, cough and shortness of breath as the main symptoms. Most do not need to seek any specific medical care. The highest risk groups are those over age 50 and especially those over 70. If you have other medical conditions (heart disease, COPD, asthma, etc.) it also carries increased risk. Most of the hospitalizations and deaths are in people over the age of 70.

Although children do not seem to be as susceptible to the infection and do not get severely ill, they likely carry the virus and can infect others. This is the reason for closing schools to prevent them from continuing to spread illness to those at higher risk.

What are the symptoms of Corona virus?

The main symptoms of Corona virus are fever, cough and shortness of breath. It can present similar to other respiratory illnesses. About 80% of people get a mild illness that they recover from in 5 to 7 days. In severe cases people develop pneumonia in both lungs which can lead to organ failure, hospitalization and supportive care.

How to prevent infection?

Currently there is no vaccine available for this infection. The best way to prevent infection is to avoid contact with those infected and frequent hand washing. You can do this with soap and warm water. Hand sanitizer is also effective at reducing infection if it contains at least 60% alcohol. Try to avoid touching your mouth, nose and eyes which is usually where the virus enters the body.

How is it treated?

There is no specific treatment for Corona virus at this time. We treat the symptoms and in severe cases provide supportive care for the lungs until they can heal.

Who needs to see a medical professional?

Unless you are suffering a life-threatening emergency, call your physician prior to going to Urgent Care or the Emergency Department. The majority of patients do not need any specific treatment or testing. If you have a fever and a respiratory illness, you should self-quarantine (stay home, away from others) to prevent spread to others. About 80% of people have a mild illness that will resolve on its own.

Who needs to be tested?

Since there is no treatment and most cases are mild, most people do not need to be tested. Currently there is a limited supply of tests and these are being used on hospitalized patients who meet the CDC criteria. There is an increased availability of tests coming but currently these take between 3 and 7 days to get results back.

What to do if you are sick?

If you are sick, avoid contact with other people, especially those in high risk groups. You should also cover your mouth and nose when coughing or sneezing with arm, not just your hand. Clean and disinfect any surfaces that are frequently touched. You should self-quarantine to avoid spreading the illness to others.

What is Social Distancing?

Social distancing means avoiding close contact with others who may be infected. This means not going to events where large numbers of people gather, avoiding unnecessary travel and going out in public where you may come in contact with people. The goal is to slow the spread of the disease. If we do not do this, the virus quickly spreads and the number of severely ill people will hit quickly and overwhelm the medical system. As medical providers become ill, there are less people left to care for those that need it.

What is flattening the curve?

Social distancing should lead to a slower rise in number of infected people and decrease the risk of the medical system being overwhelmed with patients and unable to care for them. This is what has happened in Italy and China as many steps were delayed in implementation. The Chinese quarantine of cities appears to have slowed the number of new cases and gotten the epidemic under better control.

When the medical system is overwhelmed, it leads to higher mortality for all patients as resources are stretched thin and optimal care cannot be provided.

Here is great article showing simulations of how social distancing works:

Who should I listen to?There is a lot of misinformation out there about the disease and what needs to be done. As we gain more experience treating the virus, the recommendations may change. There is much posting on social media that is false and many non-healthcare professionals giving opinions that are not based on scientific fact. Consult your doctor and the Centers for Disease Control websites and also the Indiana State Department of Health for up to date information.

Tom Heniff, M.D., M.B.A., Chief of Staff at Witham Health Services.

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