We have started to field a number of questions about Coronavirus; also referred to as COVID-19, so it’s time to make information accessible to everyone! Let's start by saying that this is a very fluid situation. Infection rates and mortality rates can change quickly.
We intend for this to be a practical and basic discussion to consider reasonable and factual information.
We aren't infectious disease experts, but we do read the scientific literature (not Dr. Google) and we do weigh what is factual and what is hype. We also have personal experience with germ protocols having survived cancer treatment using chemo that resulted in blood cell counts so low they were classified as “infection fatal”. So, let's break down what we've learned and how that can be applied to our current situation.
We'll first talk about humans and then we’ll talk about our dogs and cats.
Background on Coronaviruses
Coronaviruses are not new. They were first isolated in 1937 from a flock of poultry birds and were found to spread to the human population in the 1960s.
Coronaviruses, named because they have a crown like structure - “corona” originate in an animal species such as birds, bats, camels, monkeys or other and may mutate, allowing them spread to humans.
As we are witnessing first hand, with the increase in international travel, the spread of a new coronavirus can be astonishingly fast and a bit scary. So, it’s even more important to consider the spread of this virus in a reasonable and pragmatic way.
Let's break down the facts.
What Do We Know About Coronaviruses in Humans?
There are four fairly common coronaviruses that are responsible for a large number of upper respiratory infections in humans: (OC43, 229E, NL63, and HEU1). There are also coronaviruses that cause gastrointestinal issues as well as those that can create both respiratory and gastrointestinal issues.
For the vast majority of the population, COVID-19 will be viewed as a new respiratory disease that poses very little health risk. Estimates are that 80% of people who become infected with COVID-19 will not be sick enough to seek medical intervention.
For the 20% that must seek medical intervention, COVID-19 can be scary. This is particularly true as the risks increase as you get older and if you have existing health issues such as a weakened immune system, or an active disease process (cancer, diabetes, hypertension, heart disease, etc.). Your risks of infection and severity of symptoms are increased.
Based on the limited data as of March 3, 2020, the mortality rate by age would look something like this with zero deaths documented for children aged 0-9 years.
The average mortality rate based on the available data would be approximately 3.19%. Since the majority of people are by age in the middle, the estimated mortality rate is around 2%.
Important: Mortality rates are based upon the number of tested and verified reported cases. It is very possible many people (up to 80%) have had mild cases or cases without symptoms. These cases were not tested or reported and they recovered without hospital or medical intervention making the mortality rate much lower than what is represented in the data. Taking this into consideration the estimated mortality rate is thought to be closer to 1.4%.
Compared to other coronaviruses in humans, COVID-19 has a lower mortality rate than SARS (9.6%) and MERS (34%).
If we compare COVID-19 with the flu virus, the mortality rate (based on a 10 year study) of flu is 0.1% on average across all age groups.
The World Health Organization (WHO) puts the mortality rate at 0.46% based on all currently tested and untested cases as they estimate only 30% of the infections are tested and reported.
With the flu, the mortality rate of 0.1% is responsible for infecting approximately 5%-20% of the population with an estimated 30,000-40,000 deaths annually worldwide.
If we take the 3.14% estimate, the 1.4% estimate and the WHO 0.46% estimate, one thing is clear - COVID19 has a higher mortality rate than the flu (0.1%).
It is easy to extrapolate the numbers and cause panic. It is important to keep in mind that other viruses (bird flu, SARS, etc) have dissipated before it could infect on the scale of flu (typically 5-20% of the population). There are now two strains of the Coronavirus - one more aggressive than the other which will of course need to be analyzed.
What can you do?
If you are healthy, have a strong immune system, and don't smoke, recovery is in your favor even if you do get infected. The mortality rate with no pre-existing conditions is estimated to be 0.9%. Meaning, 99.91% of people infected will recover. If you are sick with any virus, you should limit your exposure to other people to stop the spread of disease.
If your immune system is not strong from chronic respiratory disease (6.3% mortality rate), cardiovascular disease (10.5% mortality rate), diabetes (7.3% mortality rate), hypertension (6% mortality rate), cancer (5.6% mortality rate), or an immune compromising disease (no available data), then you are at higher risk of infection and an increased risk for mortality by COVID-19. If you have cancer and your cell counts are low, you are at a significantly higher risk.
Because of my previous cancer, I have long term lung damage called interstitial lung disease from radiation and chemo that I received during my metastatic breast cancer treatment. This puts me in a higher risk bracket as my lungs are simply not as strong.
COVID-19 Incubation Period
Incubation is the length of time from when you are exposed to the infectious agent and when you first exhibit symptoms.
- Flu has an incubation of approximately 2 days
- SARS was 2-7 (but as long as 10)
- MERS was on average 5 days (with a range of 2-14)
- COVID-19 is estimated to be 2-14 (but as long as 24)
This means the virus may be inside you replicating before you have symptoms or feel unwell.
As a result, you could potentially spread it before you even realize you are sick.
Scientists don't know how long COVID-19 can survive on surfaces outside of the body but estimates currently project up to 9 days (depending on the type of surface).
Coronaviruses in Dogs and Cats
Coronaviruses are not new to dogs and cats. Some kennel cough infections are caused by a coronavirus.
While we have seen the number of COVID-19 human infections grow rapidly, as of March 3, 2020, there has only been one "weak positive" test for a dog in Hong Kong, that has no symptoms of the virus. The test samples were from oral, nasal and rectal areas, not blood.
This indicates the virus was the result of environmental contamination; not a true infection. That dog is currently in quarantine and is being monitored. Hopefully this pup will be reunited with a recovered Mom soon!
At this time, there is no evidence that humans can spread the virus to dogs and cats. Nor is there any evidence that dogs and cats can become sick with COVID-19 and spread it to humans.
It is absolutely heart breaking to see dogs and cats being abandoned out of unfounded fear that they can spread disease. As we begin to understand and take steps to protect ourselves, keeping your dog or cat clean should be a consistent part of your normal routine.
If someone coughs or sneezes on your dog, they, like the dog in Hong Kong may have the virus on them. It doesn't mean they have COVID-19 or that they are sick or will get sick. It simply means they have it on them, much as you would have it on your person if someone sneezed on you.
If you touched your dog and picked up the virus and then touched your nose or mouth, you could infect yourself through contamination.
This would NOT be your dog passing the virus to you. It would be you giving yourself the virus through an environmental exposure.
Again ... there is absolutely no evidence that your dog or cat will become infected with COVID-19 even through direct exposure.
To limit your exposure, if your dog or cat has been around someone with COVID-19, the flu, or even a cold, they should get frequent baths to keep them as germ free as possible. This is just part of being a responsible dog parent.
In the winter, we turn the heat up a few notches, give the dogs a bath and once they have dried turn the heat back down. We may also blow dry them to take off the chill. We also make sure they have an opportunity to go potty before the bath so if it is cold outside we don't expose them to the cold while being damp from their bath.
Using 4-Legger USDA certified organic dog shampoo, you can bathe your dog or cat as often as needed. If someone in your house becomes sick, increase the frequency of baths if your dog hangs out with them.
You should also wash your dog more frequently if they are out and about. Just like you should wash your hands more frequently if you are out and about.
It is about limiting your exposure as well as your dog's exposure to viruses, using common sense and just being smart. You should NOT slather your dog in hand sanitizers. They can be very drying to the skin and depending on the ingredients, can pose some health concerns. Use them on yourself only if you have no option to wash your hands.
It is also important that you don't touch your dog or cat until you've washed your hands if you have been out of the house. [See our tips below.]
What You Can Do To Protect Yourself And Your Dog From Coronavirus
Our culture has become engrained with "get a flu shot" and less concerned about how to stop the spread through good hygiene and taking precautions. It is important to note that these tips are for all infectious disease - for colds, flu and coronaviruses.
We recommend these tips be followed all of the time but especially during outbreaks of any infectious disease:
Our #1 Tip:
Don't touch your face and wash your hands!
Infection spreads from your hands to your mouth and nose (mucous membranes) making it the #1 way germs are spread.
While there are limited studies that track how frequently people touch their face, one study estimated 23x an hour! Of those, 44% involved a mucous membrane (nose or mouth). Face touching is hands down (pun intended) the #1 way to self-infect!
Compare the number of times you touch your face to how many times you wash or sanitize your hands an hour and you'll quickly realize the dangers of frequently touching your face!
Fill up those foamer bottles at every sink with 4-Legger organic dog shampoo and be sure to wash your hands for 20-30 seconds each time!
Tips for at home (these are all things I did during my cancer treatment when cell counts were low):
- Take your shoes off at the door to your home and put them in a shoe holder or a crate. Shoes are responsible for spreading germs and environmental toxins. Keeping your shoes limited to the area around the door is just smart!
- As soon as your shoes are put away, wash your hands (before you touch your dog or cat) for at least 20-30 seconds or use an alcohol based (60% or more alcohol) hand sanitizer without artificial fragrance or other harmful ingredients. Every sink in our house has 4-Legger organic dog shampoo in a foamer bottle. It makes it easy to use and is great to lather and clean away those germs! Wash your hands for a minimum of 20-30 seconds.
- Change your clothes. Ideally, keep a change at the door you frequently use and don’t walk through your house in germy clothes.
- Wash your hands again.
- Clean and disinfect your counters.
- Wipe down objects you bring in from outside the home. Create an area that will be your germ-zone and contain those items there until wiped down. The more you can contain outside germs to one area, the better!
- If you bring in the mail go through it in your germ zone before allowing it into the rest of the house. Then, wash your hands!
- If you are opening packages you had shipped to your house, handle them in your germ zone. Open it up, take out what was shipped and wipe it down. Then take the box directly to recycling. Next ... you guessed it... wash your hands!
- If you have to cough or sneeze, use a disposable tissue and dispose of it immediately. Don't carry around that same tissue and use it over and over again.
- Take out your trash daily if it contains dirty tissues and don't forget to wash your hands!
- Give your dog frequent baths with 4-Legger organic dog shampoo especially if they are exposed to potential infectious people or materials.
- Make up a disposable wipes box using 4-Legger shampoo and wipe your dogs paws off at the door after being outside or taking a walk.
- If someone in your house becomes sick, washing your dog's toys should be part of your normal routine as you likely handle the toys when playing with your dog.
- Since your phone, laptop, glasses and other devices are "high touch devices" you should get into the habit of disinfecting your devices on a regular basis.
Tips for on the go:
- No handshakes! Do a fist bump, an elbow tap, head bob, bow, or wave.
- Use your car keys or knuckles to touch light switches and elevator buttons.
- Carry alcohol based (60% or greater) hand sanitizers with you and use any time you touch an object that other people have touched.
- Disinfecting Things You Touch. During the course of the day you come into contact with a LOT of objects - from the gas station buttons you have to push when paying at the pump and the pump itself, to grocery cart handles, door knobs, and your credit card. And more than anything else, your electronic devises. Just consider how many times you handle your cell phone - holding it in your hand and putting it next to your mouth. Cleaning everything and washing your hands after you touch it is just smart if you are in the high risk category for infection.
- Clean your car steering wheel with alcohol wipes to minimize germ transfer.
- Opening Doors: Unless there is no other way to open a door, don't touch the handle with your hand. If you must touch the handle, sanitize your hands after you touch door knobs or sanitize the door knob before touching.
Good habits start with good hygiene. It is very hard to not touch your face if you are in the habit! Make it a game. If you see a family member touching their face blast a buzzer sound at them or make them put a dime in a jar.
COVID-19 Myths and Rumors
Here are some important facts to consider:
- COVID-19 is an airborne disease. False. COVID-19 can spread in droplets from a sneeze or cough. It doesn't "live" in the air and spread through ventilation systems.
- You can pick up COVID-19 from surfaces. True. Touching a contaminated surface and then your face or having someone sneeze or cough on you is the most common way to become infected. While scientists don't know how long COVID-19 can survive on surfaces, estimates are between 7-9 days. Copper and steel are typically a few hours. Other surfaces are even longer.
- Wearing a mask will protect me. False. Masks are effective at capturing droplets which is the transmission route of COVID-19. However, viruses can transmit through tiny viral particles called aerosols which can still penetrate most masks. Additionally, since most people aren't used to wearing masks, it may actually increase the number of times a day you touch your face.
- A vaccine will be ready soon. False. It usually takes a minimum of a year to develop a new vaccine.
- COVID-19 is only as dangerous as the flu. False. At the most conservative estimates, COVID-19 has a higher mortality rate than the flu. If you are older or have an underlying health issue you are at greater risk. This is why it is so important for us to minimize exposure and practice good hygiene for ourselves and our dogs and cats.
- My dog (or cat) can give me COVID-19. False. There is no scientific evidence that your dog or cat can catch COVID-19. It is your responsibility to keep them clean so you don't contaminate yourself!
Keep you hands and pups clean and lower your risk of exposure to all germs!
The best way we can help each other and manage the onset of COVID-19 is to elevate our individual commitment to hygiene at home and out in the community.
Be proactive with yourself, your family and your pets and think in terms of prevention as you go through your day.
- Characteristics of and Important Lessons From the Coronavirus Disease of 2019 (COVID-19) Outbreak in China. https://jamanetwork.com/journals/jama/fullarticle/2762130. Wu, Zynyou and McGoogan, Jennifer. JAMA. February 24, 2020
- Update on the situation regarding the new coronavirus. World Health Organization (WHO), January 29, 2020
- A novel coronavirus outbreak of global health concern - Chen Wang et al., The Lancet. January 24, 2020
- Case fatality risk of influenza A (H1N1pdm09): a systematic review - Epidemiology. Nov. 24, 2013
- Updated understanding of the outbreak of 2019 novel coronavirus (2019nCoV) in Wuhan, China - Journal of Medical Virology, Jan. 29, 2020
- Methods for Estimating the Case Fatality Ratio for a Novel, Emerging Infectious Disease - Ghani et al, American Journal of Epidemiology
- Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19) [Pdf] - World Health Organization, Feb. 28, 2020
- https://www.researchgate.net/publication/271647859_Face_touching_A_frequent_habit_that_has_implications_for_hand_hygiene American Journal of Infection Control. Face Touching: A frequent habit that has implications for hand hygiene. February 2015.