There’s plenty of uncertainty about the novel coronavirus in Oregon and beyond.
But we’re learning more about the virus every day. And knowledge can be power. It can help us combat the virus -- to do what we can with what we know. And stay calm.
Here are some answers to frequently asked questions given the latest developments in the outbreak locally and nationally.
HOW LONG CAN THE VIRUS LIVE ON A DOOR HANDLE, U.S. MAIL OR TOUCH SCREEN?
Scientists are eager to answer this question with certainty, but there is little known about the outside-the-body longevity of the virus that specifically causes COVID-19.
But a recent study published in the Journal of Hospital Infection has given us an idea, based on the length of time other coronaviruses -- such as SARS and MERS -- have been found to last on surfaces. The answer? As few as two hours and as long as nine days.
The lasting power of the coronaviruses varied widely based on the strain and the type of surface -- metal, wood, paper, plastic. For example, one strain of SARS lasted less than 24 hours on paper, while another strain lasted four to five days.
If you’re worried about this, you might think twice before picking up a baguette at the grocery store, then returning home to slice it on the brown paper bag it came in. Or you might be more comfortable sanitizing the handle of that plastic jug of milk you just brought home.
The study found that coronaviruses tend to die more quickly in warm temperatures, such as 85 to 105 degrees, and they tend to linger the colder the temperature gets. One coronavirus was found to last for a month or longer at 39 degrees, the approximate temperature of a refrigerator.
In Hong Kong, health authorities who learned of an outbreak at a Buddhist prayer hall swabbed various surfaces there, presumably days later. They found the virus that causes COVID-19 on a prayer book and a restroom faucet.
AM I GOING TO GET CORONAVIRUS?
There’s much that’s unknown about how this outbreak will play out.
Oregon’s top medical officer, Dr. Dean Sidelinger, said Monday that the coronavirus’ reach into a tiny town in northeast Oregon means the disease is fairly widespread -- but not enough to impose drastic containment measures in the state.
Based on what’s happened in Washington state, Sidelinger estimated that 300 to 500 people in Oregon might currently have or already have had the virus without realizing it.
But while he acknowledges the number of cases will grow, he’s not sure by how much and believes the state has systems in place to keep the spread in check.
“I’m not pessimistic and giving up that it’s going to spread like wildfire,” Sidelinger said in an interview with The Oregonian/OregonLive.
Sidelinger said he believes testing people suspected of being sick and monitoring others who might have been exposed will help to hinder the disease in Oregon.
But some epidemiologists on the national and international scene foresee a much different future.
An article in The Economist predicts that the chance to contain the virus is over.
“Some public-health officials still talk in terms of the window for containment coming closer and closer to closing. In reality, it seems to have slammed shut,” reads the Feb. 29 piece, titled “Covid-19 is now in 50 countries, and things will get worse.”
(Note: The number of countries or territories as of Monday afternoon had grown to at least 75, with more than 90,000 identified cases worldwide, according to a Johns Hopkins University tracker.)
The Economist article referenced epidemiologists who predict 25% to 70% of the world’s population could become infected with COVID-19.
Even if most people do end up getting the disease, one hope is that efforts to limit the disease will slow its spread enough to ease the burden on the health care system, so medical staff aren’t slammed all at once.
THAT SOUNDS FRIGHTENING. AM I GOING TO BE OK?
Experts stress that a major study of nearly 45,000 Chinese patients found that 81% suffered no symptoms or “mild” symptoms -- ranging from what felt like a cold to what feels like a really bad case of the flu but that can be treated at home.
About 14% of cases were severe, and 5% were critical.
The study by the Chinese Center for Disease Control and Prevention measured a death rate of 2.3%, although experts have pointed out that many of these cases were from Wuhan, Hubei Province, China, and the death rates elsewhere in the country was 0.4%. Some experts say the actual overall death rate might be closer to 1%.
That number is still deeply concerning because of the hundreds of people an individual might include in their circle of family, friends and co-workers, 1% could represent several deaths.
The greatest problem is for elderly people or for those with pre-existing health problems. In Washington, where six people have died from the disease since Saturday, one patient was in his 50s, three were in their 70s, one was in her 80s and there wasn’t information about the sixth patient.
Washington is the only state to report deaths so far, but the number of diagnosed U.S. cases had surpassed 100 across 15 states Monday. Three have been diagnosed in Oregon.
HOW DOES COVID-19 AFFECT DIFFERENT AGE GROUPS?
The same Chinese study that looked at the severity of infections also looked at death rates.
People who were 80 years or older had the highest rate of fatalities -- 14.8%. Those in their 70s had an 8% death rate.
For people in their 60s it was 3.6% and for people in their 50s it was 1.3%.
The death rate was 0.4% or lower for people who were 49 and younger.
One surprising piece of data so far is that younger children, while infected with the virus, seem to develop few symptoms and in many cases are relatively unaffected by it.
The data for the elderly, of course, isn’t comforting to senior citizens or anyone who has a parent, grandparent or friend in this age group. But it shows the coronavirus certainly isn’t a death sentence -- even for the oldest among us.
WHAT SMART STEPS CAN I TAKE TO ADDRESS THE OUTBREAK?
Experts say to take good care of yourself: Eat well, sleep well, stay in good health. Stay calm and try not to stress, because stress can wear down the immune system.
But part of preparing is mentally readying yourself for the possibility of “major disruptions” to your daily routine. Develop a plan for your family if school gets closed or you’re quarantined at home.
The latter is the case for dozens of employees at Kaiser Permanente’s Westside Medical Center in Hillsboro, after the first Oregonian to be diagnosed with the disease sought treatment there and dozens of staff were told to quarantine themselves because they are thought to have had contact with that person, according to a spokesman Monday.
Preparing for a quarantine means buying some extra food and medicines -- such as decongestants, cough suppressants and fever reducers -- products that you might need to combat a bad case of the flu. Also, if you’re on prescription medication, make sure you have an extra supply on hand. The idea is if you’re quarantined or you come down with the virus, you don’t leave home -- even to pick up some items at the store -- because that could expose others to the virus.
Experts caution that each of us should be prepared, but don’t hoard because that takes resources away from others.
IF I’M SICK, SHOULD I STAY HOME? IT’S PROBABLY JUST A COLD, RIGHT?
The advice here from health and school authorities has been a bit all over the map.
At a news conference announcing the first presumptive diagnosis in Oregon on Friday, public health officials repeatedly told Oregonians to stay home if they had symptoms of a flu or a cold. Other officials stressed that children -- who tend to show only very mild symptoms of the coronavirus -- should stay home from school if they have any symptoms -- even if yes, it is most likely just a cold.
“If you wake up with a runny nose, I would say give yourself a day,” said Jennifer Vines, who is the lead health officer for Multnomah, Washington and Clackamas counties, during an interview Sunday.
But some Portland-area school district officials have taken a less strict approach -- encouraging parents to keep students who are feverish or coughing heavily at home, but not drawing a hard line when it comes to kids who are sneezing, coughing or sniffling.
School leaders acknowledged that it’s unrealistic to expect that families will keep their children home because of a light cough or lingering cold -- nor can every family afford to.
WHAT ABOUT WORK?
The drive to go to work is strong in the U.S., where Americans tend to brush off the cold or sometimes even the flu and soldier on to work or return too soon after the worst of it is past.
Oregon is one of a handful of states that requires companies to give workers time off if they’re sick -- five days of paid leave for companies with at least 10 employees, and five days of unpaid leave for smaller companies.
Given the news of the spread of coronavirus in the Northwest, some companies are allowing employees to work from home.
Many people don’t have the option of staying home for a prolonged period of time -- either financially or because of the nature of their jobs, including jobs in food service, construction or retail.
“Taking time off, losing income -- even potentially your job -- leads many to continue working when they might be contagious,” said Bill Griesar, who teaches psychology and neuroscience at Portland State University.
Those income concerns also might mean many people don’t seek out a health professional when they’re sick, and that means they won’t get tested.
“For many of us, health care is prohibitively expensive,” Griesar said. “In fact, there’s often great uncertainty about what even one visit might ultimately cost.”
SHOULD I GO TO THAT BASKETBALL GAME OR TO A FRIEND’S HOUSE FOR A PARTY?
Health officials recommend that people also practice social distancing when they’re not feeling their best. That’s also an effective way for healthy people to reduce exposure to an outbreak.
But that doesn’t appear to be what happened Saturday, when a casino worker attended a youth basketball game at Weston Middle School in Umatilla County, near the border with Washington. That person was taken from the game to a hospital and was announced Monday as Oregon’s third presumptive case of coronavirus after a test came back positive.
Although state health officials said there’s a low exposure risk to those at the game, the news has led students, staff and adults who attended the game to watch for symptoms -- and many to worry -- as the school closed the gym for a deep cleaning.
WITH ALL THIS TALK ABOUT WASHING HANDS, WHAT TRULY IS THE BEST METHOD?
Although this step isn’t stressed by the U.S. Centers of Disease Control and Prevention, the World Health Organization emphasizes its importance: Washing your hands the proper way means using a paper towel to turn off the faucet after you’re done so you don’t recontaminate your freshly cleaned skin. Also, using a paper towel to open the restroom door is a good idea, too.
The CDC also recommends that the hand-scrubbing part of the process take at least 20 seconds. The WHO says the entire cleansing process should take 40 to 60 seconds.
If you don’t have a sink available, hand sanitizer is the next best option. The WHO outlines a process that can take 30 seconds -- and includes rubbing and interlacing fingers and also scrubbing your nails against the palms of your hands.
WHAT’S JUST AS IMPORTANT AS HAND WASHING?
Epidemiologists say don’t touch your face. Train your kids not to touch their faces, either.
This is a tall order and likely will take lots of practice for you and your children. But if you’re able to refrain from doing it, you will drastically lessen your likelihood of being infected because the virus enters bodies through the mucous membranes of mouths, eyes and noses.
A 2015 study of medical students at the University of New South Wales found that they touched their faces 23 times per an hour -- and 44% of the time their hands made contact with those mucous membranes.
“Scratching the nose, rubbing your eyes, leaning on your chin and your fingers go next to your mouth — there’s multiple ways we do it,” Dr. Nancy Elder, a professor of family medicine at Oregon Health & Science University, was quoted in The New York Times as saying. “Everybody touches their face, and it’s a difficult habit to break.”
Elder studied doctors and other employees at a group of Cincinnati medical clinics, and they touched their mouths, eyes and noses a mean of 19 times in two hours. Also of interest, the researchers determined that staff overall only washed their hands following CDC guidelines 9% of the time.
IS IT RUDE NOT TO SHAKE SOMEONE’S HAND?
There’s a growing understanding of why hand-shaking is falling out of vogue. Some are opting for a wave, or a head nod and a smile.
As concerns over the coronavirus grow, health officials say it’s OK not to offer an outstretched hand.
But the custom is ingrained in European and American cultures, as well as others, and hard to leave behind. German Chancellor Angela Merkel ended a speech Friday by saying she wasn’t “going to shake anyone’s hand tonight” -- signaling to Germans that it’s OK not to in these times, according to The LA Times.
Then on Monday, Merkel attempted to shake the hand of Interior Minister Horst Seehofer, who rejected the attempt. Merkel threw up her hand in good humor and took her seat, and the room broke out in laughter.
In France, the country’s health minister on Saturday advised the French to stop their traditional greeting of kissing others on both cheeks.
“Touch is hugely important for human social connection,” said Griesar, the PSU psychology and neuroscience instructor.
Declining to shake someone’s hand or hug a friend who offers one takes some forethought. Because, Griesar said, “if you’re not consciously thinking about stopping these responses, they’re just going to happen."
Brad Schmidt and Betsy Hammond of The Oregonian/OregonLive contributed to this story.
-- Aimee Green; email@example.com; @o_aimee