5 Things Everyone Should Know About the Coronavirus Outbreak
Strict precautions could save lives as the disease spreads

While news about the coronavirus has been evolving, doctors says the best advice is to follow public health directives and take care of yourself.
Credit: Getty Images
[Originally published: January 23, 2020. Updated: April 9, 2020.]
COVID-19 is changing daily life in the United States as SARS-CoV-2, the new virus responsible for spreading the disease, continues to sweep across the country. The U.S., which declared a national emergency in mid-March, now has the most detected cases in the world. Americans are still adjusting to strict guidelines urging them to stay home, avoid unnecessary travel, and stay 6 feet away from other people.
In early March, the World Health Organization (WHO) declared COVID-19 a pandemic—a disease outbreak occurring over a wide geographic area and affecting an exceptionally high proportion of the population. According to the WHO, there are more than 1.4 million confirmed cases of people with COVID-19 and more than 85,000 people have died from the disease—a death toll that has far surpassed that of the severe acute respiratory syndrome (SARS) epidemic that occurred in 2002 and 2003. (While some news sources report different numbers, the WHO provides official counts of confirmed cases once a day.)
In the U.S., the numbers are multiplying, as different parts of the country experience different levels of COVID-19 activity. All 50 states have reported community spread (meaning the source of infection is unknown), and there have been large clusters in certain areas of the country. The Centers for Disease Control and Prevention (CDC) currently provides a rough picture of the outbreak in the U.S. here, currently putting the total confirmed and presumptive cases at almost 430,000, with almost 15,000 deaths, but data provided by state public health departments should be considered the most up to date, according to the agency.
SARS-CoV-2 is a virus that scientists haven’t seen before. Like other viruses, it is believed to have started in animals and spread to humans. Animal-to-person spread was suspected after the initial outbreak in December among people who had a link to a large seafood and live animal market in Wuhan, China.
Scientists and public health officials are working as quickly as possible to find answers to key questions about the severity of the disease and its transmission. They are investigating treatments and a potential vaccine for the disease.
Below is a list of five things you should know about the coronavirus outbreak.
- What we know about COVID-19 is changing rapidly
What we do know about coronaviruses is that they cause respiratory tract illnesses that range from the common cold to such potentially deadly illnesses as SARS, a global epidemic that killed almost 800 people. COVID-19 is the first pandemic known to be caused by the emergence of a new coronavirus—novel influenza viruses caused four pandemics in the last century (which is why the response to the new disease is being adapted from existing guidance developed in anticipation of an influenza pandemic).
According to the CDC, reported COVID-19 illnesses have ranged from very mild (with no reported symptoms in some cases) to severe, including illness resulting in death. People ages 65 and older, those who living in a nursing home or long-term care facility, and people of all ages with underlying health conditions seem to be at higher risk of developing serious illness. But doctors are still working to develop a complete clinical picture of COVID-19, as evidenced by a recent CDC report noting that 20% of those who have been hospitalized for the disease in the U.S. are younger adults (between 20 and 44 years old).
“I think there are two main questions,” says Richard Martinello, MD, a Yale Medicine infectious diseases specialist and medical director of infection prevention at Yale New Haven Health. “First, we need to know how this virus is transmitted between people so we can be more precise in our efforts to stop its spread. Data is needed not only to better understand when those who become ill shed the virus, but also which body fluids contain the virus and how those may contaminate surfaces and even the air surrounding them,” says Dr. Martinello. “Second, there needs to be a better understanding of the pathogenesis of the infection and resulting inflammatory response, so that knowledge can drive the development of therapeutic and preventive medications.”
More information is becoming available. The American Academy of Otolaryngology has called for adding anosmia (loss of smell) to a list of screening tools for COVID-19, and while evidence is still preliminary, the WHO says it is probing a possible link between the disease and the symptom.
Meanwhile, a letter to the editor published in The New England Journal of Medicine in mid-March showed the virus that causes COVID-19 may be stable for several hours in aerosols and for several hours to days on surfaces. Scientists from National Institutes of Health (NIH), CDC, UCLA, and Princeton University who participated in the analysis found SARS-CoV-2 was detectable in aerosols for up to three hours, copper up to four hours, cardboard up to 24 hours, and plastic and stainless steel up to two to three days. While there is much to learn, scientists involved in the analysis observed that emerging evidence suggests people who are infected might be spreading the virus without recognizing, or prior to recognizing, symptoms, according to the NIH.
But Yale Medicine Infectious Diseases specialist Jaimie Meyer, MD, MS, notes, “A lot of times people will make basic science observations in the research lab, but it takes time for us to figure out how clinically relevant it is. So, we don’t know yet know what this study means for transmissibility. Until we understand more about the granular details of how SARS-CoV-2 passes from person to person, public health dictates that people maintain social distancing, wash hands, and frequently disinfect high-touch surfaces."
- Strict measures are critical for slowing the disease
While no one knows for sure how the situation will progress around COVID-19, studies of influenza have shown that pandemics begin with an “investigation” phase, followed by “recognition,” “initiation,” and “acceleration” phases, according to the CDC. The peak of illnesses occurs at the end of the acceleration phase (the U.S. is currently in an acceleration phase), and that is followed by deceleration, during which there is a decrease in illnesses. Finally, there is a "preparation" phase, where the pandemic has subsided, and public health officials monitor virus activity and prepare for possible additional waves of infection. Different parts of the country can be in different phases of the pandemic, and the length of each phase can vary depending, in part, on the public health response.
- Infection prevention is key
There are many things you can do to protect yourself and the people you interact with. As with a cold, a flu vaccine won’t protect people from developing COVID-19. “The best thing you can do at this point is take care of yourself the way you would to prevent yourself from getting the flu,” says Yale Medicine infectious diseases specialist Joseph Vinetz, MD. “You know you can get the flu when people sneeze and cough on you, or when you touch a doorknob. Washing hands—especially before eating and touching your face, and after going to the bathroom—and avoiding other people who have flu-like symptoms are the best strategies at this point.”
The CDC also recommends the following preventive actions:
Wash hands with soap and water for at least 20 seconds. Dry them thoroughly with an air dryer or clean towel. If soap isn’t available, use a hand sanitizer with at least 60% alcohol.
Stay home if you’re sick.
Avoid touching nose, eyes, and mouth. Use a tissue to cover a cough or sneeze, then dispose of it in the trash.
Use a household wipe or spray to disinfect doorknobs, light switches, desks, keyboards, sinks, toilets, cell phones, and other objects and surfaces that are frequently touched.
It may also be important to create a household plan of action. You should talk with people who need to be included in your plan, plan ways to care for those who might be at greater risk for serious complications, get to know your neighbors, and make sure you and your family have a household plan that includes ways to care for loved ones if they get sick. This includes planning a way to separate a family member who gets sick from those who are healthy, if the need arises.
The CDC recommends that people voluntarily wearing cloth face masks in public settings where other social distancing measures are difficult to maintain, including grocery stores and pharmacies, especially if they live in an area of significant community-based transmission. It should be noted that the cloth mask is not meant to protect the wearer from infection. It is instead meant to slow the spread of the virus (if people who have the virus and do not know it wear masks, they help prevent transmitting it unknowingly to others). The CDC advises making face coverings at home from simple materials, and reserving surgical masks and N95 respirators for health care workers and other medical first responders.
- Experts are working rapidly to find solutions
In the U.S., widely available testing will be important in understanding how the disease is transmitted and the true infection and mortality rates. In addition to COVID-19 testing being done by the CDC, state and local public health labs in all 50 states and the District of Colombia are currently using the CDC's COVID-19 diagnostic tests, although the number of available tests is still limited. Until there can be comprehensive testing for COVID-19, it's difficult to know how many cases have not been identified. "Testing is still very limited in Connecticut," says Yale Medicine infectious disease specialist Manisha Juthani, MD. "This will hopefully change, but testing will have to be prioritized for those that are the sickest."
- If you feel ill, here's what you should do
So far, information shows the severity of COVID-19 infection ranges from very mild (sometimes with no reported symptoms at all) to severe to the point of requiring hospitalization. Symptoms can appear anywhere between 2 to 14 days after exposure, and may include:
Fever
Cough
Difficulty breathing
You should call your medical provider for advice if you experience these symptoms, especially if you have been in close contact with a person known to have COVID-19 or live in an area with ongoing spread of the disease.
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