Philadelphia Medicine Spring 2020 - 7

p h i l a m e d s o c .o rg

confronting

COVID-19

in Philadelphia
By: Steven J. Alles, MD, MS, Jessica Caum, MPH

ince the early part of this year, public health authorities
around the world have been working to contain the novel
coronavirus (SARS-CoV-2), which causes coronavirus disease
2019 (COVID-19). W.H.O. has declared the outbreak to be a
pandemic. President Trump has declared a national emergency over
the coronavirus outbreak.
This novel coronavirus was first detected in Wuhan City, Hubei Province, China, in late 2019. Early cases seem to be linked
to visiting or working in the Huanan Wholesale Seafood Market,
although a specific animal source has not been identified.1 Subsequent cases did not report that same exposure, indicating the
initiation of person-to-person spread at some point early in the
outbreak.

Since those early cases in Wuhan City, SARS-CoV-2 has now
been detected in more than 150 countries, including more than
10,000 cases in the United States and more than 160 deaths. The
late February surge of cases in South Korea, Japan, Italy, and Iran
in late February marked the acceleration of community transmission outside of China, and the growing number of cases in
the United States suggests that community transmission is now
occurring here as well.

With over 230,000 cases and 9,300 deaths worldwide, it's
impossible to predict how severe the pandemic will be and how
long it will last. While we wait to see how this unfolds, there are
core actions that health care providers can take now to support
disease containment and ensure their own continuity of operations. Rapid case identification and identification and quarantine
of contacts are critical for containing COVID-19.
Rapidly Evolving
As evidenced by the never-ending news cycle, this is a dynamic
and rapidly evolving situation. Much of the current guidance is
based on SARS and MERS-CoV; however, there are still many
questions surrounding this new coronavirus, including uncertainty about viral shedding during different phases of the disease.1
According to reports from around the world, clinical illness ranges
from mild to severe. While the data are still limited, severe illness
requiring hospitalization seems more likely to occur in older
adults and/or persons with underlying health conditions. Mild to
moderate illness can typically be managed in the home with rest,
fluids and over-the-counter fever-reducing medications, although
ill persons should be advised to self-isolate, and caregivers should
use appropriate personal protective equipment (PPE), such as
facemasks and gloves.
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Spring 2020 : Philadelphia Medicine

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Philadelphia Medicine Spring 2020

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