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A new strain of coronavirus causes a
disease called coronavirus disease 2019
(COVID-19). It emerged at the end of
2019 in some residents of a central Chi-
nese province called Hubei. So far,
cases have been concentrated in China,
with increasing numbers of cases in
other parts of the world, including the
United States.The virus has killed more
than 2,700 people in ­China, although
most who have died of the virus have
had serious underlying illness.
Here, Salvador Alvarez, M.D., an
Infectious Diseases specialist at Mayo
Clinic in Jacksonville, Florida, answers
questions about the virus.
QWhy is the new coronavirus
such a big concern?
AThis is the third ­coronavirus to
emerge in the human population
in the past two decades, after the severe
acute respiratory syndrome (SARS) out-
break in 2002 and the Middle East re-
spiratory syndrome (MERS) outbreak in
2012. Their emergence has put global
public health institutions on high alert.
Many details of this virus, such as
its origin and its ability to spread among
humans, remain unknown. But an
­increasing number of cases appear to
have resulted from human-to-human
contact between people who are in
close proximity (within about 6 feet).
When an infected person coughs or
sneezes, he or she releases respiratory
droplets that can land in the mouths or
noses of people nearby and possibly be
inhaled into the lungs.
QWho is most at risk of infection
and of serious ­complications?
AAnybody who’s had close contact
with an infected person is at risk
since most people have no protective
antibodies against a new virus. Older
adults with underlying medical condi-
tions such as lung and heart disease,
diabetes, cancer, and a suppressed
­immune system seem to have a higher
rate of complications such as pneumo-
nia and an increased risk of death.
QWhat is the risk level in the US?
Is it expected to rise?
AThe risk in the U.S. ­remains low
with 59 documented cases (as of
late February), mostly in people who
traveled to China. However, with the
large number of people traveling from
other countries and the evidence of
human-to-human transmission, the
possibility of an increase in cases seems
likely. The medical community should
be prepared, as should individuals
around the globe.
QIf I have a trip planned, should
I cancel it?
AThe Centers for Disease Control
and Prevention (CDC) has issued
a warning for people to avoid trips
to China and other countries in Asia
affected by the virus. Business, leisure
and educational trips to these areas
should be canceled. Travel advisories
may change, so check for updates fre-
quently (see internet links on page 3).
QHow can I travel safely?
AThe CDC recommends the follow-
ing if you are traveling abroad:
■	 Wash your hands often with soap
and water for at least 20 seconds after
contact with sick travelers or touching
potentially contaminated bodily fluids
or surfaces. Use alcohol-based hand
sanitizer (containing at least 60% alco-
hol) if soap and water are not available.
■	 Avoid crowded areas.
QAre there any treatments or
­vaccines in development?
AThere are no effective treatments
for COVID-19 so far. Researchers
are testing some available drugs to see
if they are effective against the virus.
There is also a rush to create a vaccine
since researchers already know the
­virus and its DNA composition. Once
the ­vaccine is available, it will take time
to prove its protective value.
Coronavirus disease
What you sho­uld know about COVID-19
A special supplement to MAYO CLINIC HEALTH LETTER	
Salvador Alvarez, M.D.
Infectious Diseases
A Q&A with a Mayo Clinic
infectious diseases expert
2 A special supplement
Infection prevention
There are many unknowns about the
recent outbreak of COVID-19, a disease
caused by a member of the coronavirus
family, which can cause illnesses such
as the common cold. Among the un-
knowns, what does the future hold for
this outbreak? Will it fade in coming
weeks and months, or continue to
spread worldwide, including more
­severely to the United States?
It’s understandable to feel worried
about news of a spreading illness. Par-
ticularly since COVID-19 — like other
infectious diseases such as ­flu (influenza)
— appears to be most severe in older
adults and in those with ­significant exist-
ing medical conditions. However, there
are practical steps you can take to help
avoid getting — and help prevent
spreading — community-acquired in-
fectious diseases of all kinds. Here are
some important steps to remember:
Stay healthy
A healthy body means a strong
­immune system that fights off infection.
Eating a balanced diet, exercising
­regularly and getting adequate sleep
are all things you can do to help main-
tain good health.
Wash hands frequently
Use soap and water or, when
­traveling or when water is scarce, an
alcohol-based hand sanitizer — with
at least 60% alcohol — to help prevent
the spread of infection of all kinds.
Get your flu shot
A flu shot won’t shield you from
COVID-19. But in the U.S., influenza
is far more common than COVID-19.
As of mid-February, the CDC estimated
there were between 29 to 41 million
cases of influenza — and between
16,000 and 41,000 influenza deaths
— in the U.S. this flu season.
Hand-washing for virus protection
The process of hand-washing should
take at least 20 seconds. To start, wet
your hands and apply soap to cover
the hand surfaces. Rub your hands
­together palm to palm.­
Rub one palm over the back of the
other hand, then switch hands and re-
peat. Next, rub your fingers together.
Rub the tops of your fingers in the
palm of the other hand. Switch hands
and repeat.
Grab your thumb in the palm of the
other hand; rub all around the thumb.
Switch hands and repeat.
Twist the tips of your fingers back and
forth in the palm of your hand. This
helps clean under your fingernails.
Switch and repeat.
Rub your hands while you rinse them
under running water. Dry your hands
well, preferably with a paper towel.
Use the towel to turn off the faucet
and open the door as needed.
A special supplement 3
© 2020 Mayo Foundation for Medical Education and
Research, Rochester, MN 55905. All rights reserved.
Try not to touch your eyes, nose
and mouth with unwashed hands
It’s unclear exactly how contagious
the COVID-19 virus is or how it spreads.
It appears to be spreading from person
to person among those in close contact.
It may be spread by respiratory droplets
released when someone with the virus
coughs or sneezes.
It’s not known if a person can catch
the virus by touching a surface that an
­infected person has touched, and then
putting his or her hand to the mouth.
However, other ­viruses can spread this
way. Remember to also wash your
hands before handling food or after
­using the restroom, coughing, sneezing
or blowing your nose.
Clean and disinfect surfaces you
often touch
Since viruses can spread by hand-
to-surface contact, consider ­periodically
wiping down frequently touched
s­urfaces in your environment with a
disinfectant wipe. This is especially
­important if you are ill to avoid spread-
ing the infection to others in your
household. In addition, avoid sharing
bedding, dishes, cups or other house-
hold items if you are sick.
Use proper respiratory hygiene
Cover your mouth and nose with
facial tissue when you cough or sneeze.
Throw away used tissues immediately.
If no tissue is available, cough or sneeze
into your upper sleeve.
Stay informed
Look to reliable news sources for
up-to-date ­information and recommen-
dations from health experts, whether it’s
a reminder to get a seasonal influenza
vaccine, or information on a disease
outbreak. Don’t let conspiracy theories
and medical misinformation distract you
from the facts on staying healthy. Visit
the CDC and WHO websites listed on
this page for trustworthy information.
Follow travel advisories
Travel advisories to various countries
can change ­rapidly depending on how
any disease outbreak evolves, including
COVID-19. See the box above for reli-
able website options.
Take steps if you become ill
If you have signs and symptoms of
a potentially serious viral infection —
such as abrupt onset of fever, aches and
chills, fatigue, headache, and respira-
tory symptoms such as coughing and
difficulty breathing — contact your
doctor. Be sure to mention any recent
travel or contact with someone who has
traveled recently. Your doctor can help
determine if you may have COVID-19,
seasonal influenza or another infection.
He or she can help you access appro-
priate care. Otherwise, steps for self-
care include rest, drinking plenty of
fluids, using nonprescription pain
medications to control fever and
­restricting social contact to avoid
spreading the infection to others. ❒
Stay informed with reliable sources
Centers for Disease Control and Prevention (CDC)
www.cdc.gov/coronavirus/2019-ncov/index.html
World Health Organization (WHO)
www.who.int/emergencies/diseases/novel-coronavirus-2019
Travel tips and advisories
U.S. Department of State travel advisory map
https://travelmaps.state.gov/TSGMap
CDC’s Coronavirus Disease 2019 Information for Travel
www.cdc.gov/coronavirus/2019-ncov/travelers/index.html
Should I use a face mask?
The Centers for Disease Control and Prevention
(CDC) recommends face masks for:
■	 People with COVID-19 symptoms
■	 Health care workers
■	 Caregivers of people with COVID-19
The CDC does not advise face masks for:
■	 The general public as a means of prevention against the virus
The World Health Organization notes that masks must be:
■	 Coupled with hand-washing — Hands should be washed before putting
on a mask, after taking it off and anytime the mask is unintentionally touched
while it’s on.
■	 Used properly — A mask must be secure on the face and should be
­disposed of if it becomes damp.
■	 Discarded correctly — A mask should be removed by the ear straps and
placed in a closed trash container right away.

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Coronavirus special-report

  • 1. A new strain of coronavirus causes a disease called coronavirus disease 2019 (COVID-19). It emerged at the end of 2019 in some residents of a central Chi- nese province called Hubei. So far, cases have been concentrated in China, with increasing numbers of cases in other parts of the world, including the United States.The virus has killed more than 2,700 people in ­China, although most who have died of the virus have had serious underlying illness. Here, Salvador Alvarez, M.D., an Infectious Diseases specialist at Mayo Clinic in Jacksonville, Florida, answers questions about the virus. QWhy is the new coronavirus such a big concern? AThis is the third ­coronavirus to emerge in the human population in the past two decades, after the severe acute respiratory syndrome (SARS) out- break in 2002 and the Middle East re- spiratory syndrome (MERS) outbreak in 2012. Their emergence has put global public health institutions on high alert. Many details of this virus, such as its origin and its ability to spread among humans, remain unknown. But an ­increasing number of cases appear to have resulted from human-to-human contact between people who are in close proximity (within about 6 feet). When an infected person coughs or sneezes, he or she releases respiratory droplets that can land in the mouths or noses of people nearby and possibly be inhaled into the lungs. QWho is most at risk of infection and of serious ­complications? AAnybody who’s had close contact with an infected person is at risk since most people have no protective antibodies against a new virus. Older adults with underlying medical condi- tions such as lung and heart disease, diabetes, cancer, and a suppressed ­immune system seem to have a higher rate of complications such as pneumo- nia and an increased risk of death. QWhat is the risk level in the US? Is it expected to rise? AThe risk in the U.S. ­remains low with 59 documented cases (as of late February), mostly in people who traveled to China. However, with the large number of people traveling from other countries and the evidence of human-to-human transmission, the possibility of an increase in cases seems likely. The medical community should be prepared, as should individuals around the globe. QIf I have a trip planned, should I cancel it? AThe Centers for Disease Control and Prevention (CDC) has issued a warning for people to avoid trips to China and other countries in Asia affected by the virus. Business, leisure and educational trips to these areas should be canceled. Travel advisories may change, so check for updates fre- quently (see internet links on page 3). QHow can I travel safely? AThe CDC recommends the follow- ing if you are traveling abroad: ■ Wash your hands often with soap and water for at least 20 seconds after contact with sick travelers or touching potentially contaminated bodily fluids or surfaces. Use alcohol-based hand sanitizer (containing at least 60% alco- hol) if soap and water are not available. ■ Avoid crowded areas. QAre there any treatments or ­vaccines in development? AThere are no effective treatments for COVID-19 so far. Researchers are testing some available drugs to see if they are effective against the virus. There is also a rush to create a vaccine since researchers already know the ­virus and its DNA composition. Once the ­vaccine is available, it will take time to prove its protective value. Coronavirus disease What you sho­uld know about COVID-19 A special supplement to MAYO CLINIC HEALTH LETTER Salvador Alvarez, M.D. Infectious Diseases A Q&A with a Mayo Clinic infectious diseases expert
  • 2. 2 A special supplement Infection prevention There are many unknowns about the recent outbreak of COVID-19, a disease caused by a member of the coronavirus family, which can cause illnesses such as the common cold. Among the un- knowns, what does the future hold for this outbreak? Will it fade in coming weeks and months, or continue to spread worldwide, including more ­severely to the United States? It’s understandable to feel worried about news of a spreading illness. Par- ticularly since COVID-19 — like other infectious diseases such as ­flu (influenza) — appears to be most severe in older adults and in those with ­significant exist- ing medical conditions. However, there are practical steps you can take to help avoid getting — and help prevent spreading — community-acquired in- fectious diseases of all kinds. Here are some important steps to remember: Stay healthy A healthy body means a strong ­immune system that fights off infection. Eating a balanced diet, exercising ­regularly and getting adequate sleep are all things you can do to help main- tain good health. Wash hands frequently Use soap and water or, when ­traveling or when water is scarce, an alcohol-based hand sanitizer — with at least 60% alcohol — to help prevent the spread of infection of all kinds. Get your flu shot A flu shot won’t shield you from COVID-19. But in the U.S., influenza is far more common than COVID-19. As of mid-February, the CDC estimated there were between 29 to 41 million cases of influenza — and between 16,000 and 41,000 influenza deaths — in the U.S. this flu season. Hand-washing for virus protection The process of hand-washing should take at least 20 seconds. To start, wet your hands and apply soap to cover the hand surfaces. Rub your hands ­together palm to palm.­ Rub one palm over the back of the other hand, then switch hands and re- peat. Next, rub your fingers together. Rub the tops of your fingers in the palm of the other hand. Switch hands and repeat. Grab your thumb in the palm of the other hand; rub all around the thumb. Switch hands and repeat. Twist the tips of your fingers back and forth in the palm of your hand. This helps clean under your fingernails. Switch and repeat. Rub your hands while you rinse them under running water. Dry your hands well, preferably with a paper towel. Use the towel to turn off the faucet and open the door as needed.
  • 3. A special supplement 3 © 2020 Mayo Foundation for Medical Education and Research, Rochester, MN 55905. All rights reserved. Try not to touch your eyes, nose and mouth with unwashed hands It’s unclear exactly how contagious the COVID-19 virus is or how it spreads. It appears to be spreading from person to person among those in close contact. It may be spread by respiratory droplets released when someone with the virus coughs or sneezes. It’s not known if a person can catch the virus by touching a surface that an ­infected person has touched, and then putting his or her hand to the mouth. However, other ­viruses can spread this way. Remember to also wash your hands before handling food or after ­using the restroom, coughing, sneezing or blowing your nose. Clean and disinfect surfaces you often touch Since viruses can spread by hand- to-surface contact, consider ­periodically wiping down frequently touched s­urfaces in your environment with a disinfectant wipe. This is especially ­important if you are ill to avoid spread- ing the infection to others in your household. In addition, avoid sharing bedding, dishes, cups or other house- hold items if you are sick. Use proper respiratory hygiene Cover your mouth and nose with facial tissue when you cough or sneeze. Throw away used tissues immediately. If no tissue is available, cough or sneeze into your upper sleeve. Stay informed Look to reliable news sources for up-to-date ­information and recommen- dations from health experts, whether it’s a reminder to get a seasonal influenza vaccine, or information on a disease outbreak. Don’t let conspiracy theories and medical misinformation distract you from the facts on staying healthy. Visit the CDC and WHO websites listed on this page for trustworthy information. Follow travel advisories Travel advisories to various countries can change ­rapidly depending on how any disease outbreak evolves, including COVID-19. See the box above for reli- able website options. Take steps if you become ill If you have signs and symptoms of a potentially serious viral infection — such as abrupt onset of fever, aches and chills, fatigue, headache, and respira- tory symptoms such as coughing and difficulty breathing — contact your doctor. Be sure to mention any recent travel or contact with someone who has traveled recently. Your doctor can help determine if you may have COVID-19, seasonal influenza or another infection. He or she can help you access appro- priate care. Otherwise, steps for self- care include rest, drinking plenty of fluids, using nonprescription pain medications to control fever and ­restricting social contact to avoid spreading the infection to others. ❒ Stay informed with reliable sources Centers for Disease Control and Prevention (CDC) www.cdc.gov/coronavirus/2019-ncov/index.html World Health Organization (WHO) www.who.int/emergencies/diseases/novel-coronavirus-2019 Travel tips and advisories U.S. Department of State travel advisory map https://travelmaps.state.gov/TSGMap CDC’s Coronavirus Disease 2019 Information for Travel www.cdc.gov/coronavirus/2019-ncov/travelers/index.html Should I use a face mask? The Centers for Disease Control and Prevention (CDC) recommends face masks for: ■ People with COVID-19 symptoms ■ Health care workers ■ Caregivers of people with COVID-19 The CDC does not advise face masks for: ■ The general public as a means of prevention against the virus The World Health Organization notes that masks must be: ■ Coupled with hand-washing — Hands should be washed before putting on a mask, after taking it off and anytime the mask is unintentionally touched while it’s on. ■ Used properly — A mask must be secure on the face and should be ­disposed of if it becomes damp. ■ Discarded correctly — A mask should be removed by the ear straps and placed in a closed trash container right away.