a doctor talking to a patient
Tuesday, March 3, 2020

Coronavirus (synonyms: COVID – 19; Wuhan flu)

As we all know, the Coronavirus disease (synonyms: COVID – 19; Wuhan flu) originated in the city of Wuhan, China. So far there are over 90000 confirmed cases around the world, with over 3000 deaths so far. The disease is already present on all continents except Antarctica.

In the United States alone, there are already 6 confirmed deaths related directly to the Corona virus disease. The states with confirmed cases of Coronavirus are: Washington state, California, Oregon and Florida. There are no confirmed reports of Corona virus cases in North Carolina yet.

Prevention of Corona virus disease through immunization – there are no developed vaccines that are confirmed to prevent the Corona virus disease. There is one vaccine against the Corona virus disease that has already been developed, however it is just about to enter its testing stage on humans, therefore it is not yet available to be distributed for the general population or health care institutions. The first vials have been sent to the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health (NIH) in Bethesda, MD, which will ready the vaccine for human testing as early as April.

Transmission of the disease: according to the latest updates - the Coronavirus disease is transmitted via:

1. droplets, mainly during coughing or sneezing, and,

2. contact, (touching).

As of March 2nd, 2020, there is no evidence that the virus is transmitted via airborne transmission (aerosol size particles).

Incubation period:the incubation period for the Coronavirus disease (the time between exposure and first symptoms of the disease) : from 5 to 14 days, however latest studies suggest up to 27 days, meaning that someone may have the disease for up to 27 days before the first symptoms appear.

Symptoms of COVID-19:

A. Mild

- Fever

- Cough

- Shortness of breath.

B. Severe:

- Pneumonia

- Acute respiratory distress syndrome.

The difference between the seasonal (common flu) and Coronavirus disease are very vague, however, the Coronavirus disease tends to have a more aggressive course and fatal complications. Diagnosing the Coronavirus disease requires a precise history assessment and specific testing.

Questions to ask patients:

1. Have they travelled abroad (at this time not just China, but out of the country in general)

2. Have they been in contact with a known case of COVID – 19.

Treatment of the COVID-19: to this day, there are no medicines that can effectively treat the Corona virus disease.

-  Please educate patients, family members and friends that the regular flu vaccines, high dose (senior) flu vaccines do not provide protection against COVID -19. However DO encourage everyone to vaccinate against the seasonal flu, as it is a wide spread disease, too, moreover, it would be highly detrimental to anyone to contact COVID -19 on top of an already existing seasonal flu.

- Please educate patients, family members and friends that Tamiflu, Xofluza – are excellent remedies for seasonal flu, but they DO NOT provide treatment against COVID-19.

- While it is difficult and lengthy to differentiate the COVID -19 from seasonal flu based on symptoms only, it is entirely up to Agape healthcare providers to decide whether or not to offer Tamiflu to patients who present with flu-like symptoms.



- Ask about recent traveling out of USA (not only China).

- Ask about any recent known contact with anyone with confirmed/suspected COVID -19 diagnoses.

- Ask about any new onset of flu like symptoms.

- Consider referring someone with moderate shortness of breast to a chest X-ray exam – here we are looking for pneumonia/pneumonitis-like image (since pneumonia has a greater incidence and a much faster on-set in Corona virus disease).

- Recommend patients to wear surgical mask and wash hands frequently, as COVID-19 is transmitted via droplets and contact.

- N95 masks – the more protection, the better, but according to the recent studies surgical masks are sufficient, since the disease is not known to be spread via airborne (aerosol) pathway.


- Frequent hand washing with warm water and soap, and, frequent hand sanitizing.

- It would be highly recommended for staff to use surgical masks.

- It is recommended that staff gets vaccinated against seasonal flu (as mentioned above, these vaccines do not provide any protection against the Corona Virus disease, however an immune system weakened by seasonal flu will considerably add to the vulnerability against the disease).


1. There are sufficient surgical masks stocked, with more ordered.

2. N95 masks have been ordered.

3. Lysol and bleach wipes are available (with more ordered).

4. Plenty of hand sanitizer containers have been purchased.

5. Door handles are being treated with bleach wipes on regular bases.

6. Agape public health department will update the Agape website with the most recent news.

Also, the CDC recommends stocking of non-perishable food for up to 1 months, in case isolation will be imminent.

For more updated information please review:

National Updates: https://www.cdc.gov/coronavirus/2019-ncov/index.html

International updates: https://www.who.int/emergencies/diseases/novel-coronavirus-2019

Tudor Rolinsky Rader, MD, RN, BSN

Chief Nursing Officer