- [Rachel] My name is Rachel Worth,
education and outreach coordinator
for Akron Children's Hospital School Health Services.
And in this presentation,
I will be discussing the disease process of COVID-19.
It's important to understand though that with more
and more research happening, more detailed information
about the virus will come to light.
Today, we'll learn about what we know so far
about this new virus and disease.
Coronavirus refers to a large group of viruses.
Many people are actually diagnosed with coronavirus.
However, it may not be the strain connected
with the current pandemic.
For example, the flu or influenza
is a virus that has many different strains.
Do you remember H1N1 or the swine flu?
This was a specific strain of the influenza virus.
In the same way, this is how coronaviruses work.
Corona is Latin for crown, under a microscope
the virus has spikes that appear crown-like.
Coronaviruses can infect birds and mammals,
less than 10 coronaviruses have been identified
to cause diseases in humans.
Many of them are common viruses that typically just result
in a common cold.
You may have had it and not even known.
Three of them however, can cause more severe symptoms.
These three recent coronaviruses most likely came
from infected animals that evolved to then infect humans.
Can you name any of these three?
You've probably heard of these three serious diseases caused
by coronaviruses, severe acute respiratory syndrome or SARS
originated in Southeast Asia in 2003 and became a pandemic.
Middle East respiratory syndrome or MERS
originated in the middle East in 2012.
This did not qualify as a pandemic as it was not easily
spread, but it was very dangerous for humans.
And then of course,
COVID-19 which we will dive deeper
into in this presentation.
Let's talk about the many names that we hear
describing the current coronavirus.
The term coronavirus itself refers to the virus group.
Sometimes you hear it called the novel coronavirus.
Novel means new,
and this is an appropriate term for the current coronavirus
is we have never seen this strain before, SARS-COV2.
This is the specific strain of the virus
that is causing the current pandemic.
Like how I mentioned H1N1 being a strain of influenza.
COVID-19 stands for coronavirus disease 2019.
And this is the name for the disease
that is caused by SARS-COV-2.
Next let's review the outbreak.
This specific strain of the virus first appeared
in the Wu Han province in China and spread
from person to person resulting in a pandemic.
This virus strain appears to event a zoonotic infection
that adapted or evolved to infect humans.
The CDC States the exact source of the current outbreak
of COVID-19 is unknown,
but it is confirmed that it originally came
from an animal, likely a bat.
Genetic analysis shows a great similarity
to a coronavirus that infects bats.
In order to better understand COVID-19,
it helps to understand how viruses work in general.
Viruses are a dormant cell,
which means they cannot reproduce on their own.
However they're full of genetic material as in RNA or DNA.
They must infect loving cells in order
to replicate and cause an infection.
A virus will essentially hijack a living cell,
causing it to replicate its own genetic material,
making more virus cells,
the crown like structure of coronaviruses act like a key
to enter the living cell.
And this is one reason why it infects more easily
than other viruses.
All diseases are spread through the chain of infection.
Let's dive deeper into how COVID-19 is spread.
To start the chain of infection,
you need to have an infectious agent,
which can cause the disease.
In the case of COVID-19, it would be the SARS-COV-2 virus.
The infectious agent will live in a reservoir,
SARS-COV-2 lives in humans, but evolved from animals
as we talked about earlier.
Then we have a port of exit,
which is the way the infectious agent leaves the body,
SARS-COV-2 exits the body
through coughing, sneezing, or talking.
This is what's called respiratory transmission.
Respiratory transmission is where heavy,
large particles that contain the virus land
and do not stay suspended in the air.
You may have heard the term airborne transmission,
which is different than respiratory transmission.
Airborne transmission refers to small particles
that contain the virus end up staying suspended in the air.
Currently the research shows that SARS-COV-2
is respiratory transmission.
This leads into the mode of transmission.
The mode of transmission is how the infectious agent
is transmitted from one person to another.
The chief way SARS-COV-2 transmits is
through droplets from coughing, sneezing, or talking.
It may also be transmitted from contact with surfaces where
the droplets land, but more research is being done on this.
The portal of entry is a place where the infectious agent
enters another person's body.
This is similar to the portal of exit for SARS-COV-2,
it can be through the mouth, nose or eyes.
It could also be from touching these areas after coming
into contact with a surface that has the virus on it.
Finally, we have a susceptible host.
This is someone who now has the virus in their system.
For the SARS-COV-2, everyone is at risk
for getting the virus because it
is a novel coronavirus, no one has immunity to it.
So that is the chain of infection
for the SARS-COV-2 virus.
And the virus will continue to spread
until measures are taken to break the chain of infection.
Let's talk about what we know so far about who's most at
risk and identify what at-risk means.
At risk does not mean at risk for contracting the virus,
as we have learned, we are all at risk for that.
At risk means those who are more prone
to develop serious disease symptoms.
The following are those who are currently found
to be most at risk.
Older adults, it has been found that risk
for severe symptoms increases with age.
According to the CDC,
people of any age with the following conditions are
at increased risk of severe illness from COVID-19.
Chronic kidney disease, COPD,
immunocompromised state, obesity,
serious heart conditions,
sickle cell disease, and type two diabetes.
The CDC goes on to explain that people with the following
conditions might be at an increased risk for severe illness
from COVID-19, asthma, cerebrovascular disease,
cystic fibrosis, high blood pressure,
neurologic conditions like dementia, liver disease,
pregnancy, smoking, Fallacemia and type one diabetes.
You probably have heard that children are not at risk,
but are carriers of the virus.
Children can have the virus in their system without any
signs of illness and through the chain of infection,
infect those around them,
if those around them are more at risk,
they may develop the disease.
Remember the information can change
as more research comes to light,
but this is what we know so far
about the symptoms of COVID-19.
Symptoms appear two to 14 days after exposure to the virus.
This means you could have the virus
and not know it for a long time.
Most people who have COVID-19 experience mild to moderate
symptoms and report a wide range of symptoms that include
the following, early signs like fever or chills, cough,
shortness of breath, or difficulty breathing.
And then later signs like fatigue,
muscle or body aches, headache,
new loss of taste or smell, sore throat, congestion,
or runny nose, nausea or vomiting and diarrhea.
Children are actually less likely to have a fever.
All of these symptoms can be attributed
to other illnesses as well,
which is why we should take precautions like washing our
hands to protect ourselves.
Some who are infected by the virus show absolutely no signs
or symptoms, but remember they can still transmit the virus
from person to person.
Lungs can be an easy target for the virus.
We talked about how the portal of entry for SARS-COV-2
is commonly the mouth and the nose.
While the virus can easily travel through the mouth
and nose and into the lungs, and if the lungs are affected,
this is where more serious illness can occur.
Acute respiratory distress syndrome or ARDS can occur
in COVID-19 patients.
The picture on the top is what non-disease lungs look like.
And the one below is a patient with ARDS.
ARDS occurs when the virus enters deep into the lung cells
where oxygen exchange occurs and is transported to organs,
the cells in your lungs are then taken over by the virus
and essentially die, and as a result, two things happen.
One, oxygen exchange is lost.
So there's a decrease of oxygen getting to the organs like
the heart, brain, and kidneys,
and two, there's debris from the lung cells that died.
And that debris will build up inside the lungs.
Multi-system inflammatory syndrome in children seems to be a
post infectious disease that occurs two to four weeks
after a SARS-COV-2 infection.
It is a delayed inflammatory response seen in children.
It is rare, but can be very serious.
The connection between COVID-19 and MIS is not well
understood yet, but we do know that there is a connection.
The symptoms include fever, abdominal pain, vomiting,
diarrhea, neck pain, rash, bloodshot eyes,
and feeling extra tired.
It's important to understand that some who have contracted
the virus will not show any signs or symptoms,
but can still spread the virus to others.
This is why the virus spreads so easily.
Those who don't have signs or symptoms
assume they don't have the virus.
So may not take precautions to stop the spread.
Here's an example of how the virus can still be spread
with asymptomatic carriers through the chain of infection.
Charlie, a three year old,
who goes to daycare during the week,
gets infected with the virus.
Charlie doesn't develop any signs or symptoms of infection.
It's the weekend and grandma takes Charlie
to get some ice cream.
Charlie shares a spoonful of his ice cream
with grandma, in this scenario, Charlie,
who has the virus can easily give it to grandma who is in
close contact with him and even shared a utensil with him.
Grandma is at high risk due to her older age
and could easily develop severe symptoms of COVID-19.
So how can we stop the spread of the virus
and protect ourselves and others?
We need to break the chain of infection.
This means doing things that eliminate coming
in contact with the virus.
There are a couple of things to remember though,
without testing, there's no way of knowing who has the virus
as symptoms don't show right away.
And a lot of the symptoms can be signs of other illnesses.
Some don't even have any signs or symptoms,
but still have the virus.
And we need to remember that the virus spreads
through droplets in the air and possibly surfaces.
So this is what we can do to break the chain of infection,
cleaning and disinfecting surfaces,
avoiding touching your face, social distancing,
or staying six feet apart,
which is about two arms length away from others,
wearing a mask while in public,
over the nose and the mouth washing hands with soap
and water for 20 seconds and staying home when you're sick.
Let's put it all together.
COVID-19 is a disease caused by the SARS-COV-2 virus,
a type of coronavirus.
We still don't know everything there is to know about the
virus, but currently this is what we know.
The virus is spread through droplets
and possibly surfaces, symptoms may not appear right away.
Symptoms can range from mild to severe,
but most experience mild to moderate symptoms.
Some people are more at risk
for developing severe symptoms than others.
There are things we can do to stop the spread of the virus,
like wearing a mask,
washing our hands and socially distancing.