THIS STORY WAS UPDATED ON MARCH 12, 2020.

Editor's note: Information on the COVID-19 crisis is constantly changing. For the latest numbers and updates, keep checking the CDC's website. For the most up-to-date information from Michigan Medicine, visit the hospital's Coronavirus (COVID-19) webpage. 

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As the 2019 coronavirus (COVID-19) begins to spread outside of China to other countries, many people are concerned and looking for answers. Michigan Medicine experts address what is currently known about the novel coronavirus and how you can protect yourself.

How does the virus spread?

"This coronavirus spreads from person to person primarily through close contact with respiratory droplets," says Laraine Washer, M.D., associate professor of internal medicine in the Division of Infectious Disease and medical director of infection control. You can protect yourself and others the same way you'd protect yourself from the flu, colds and other respiratory illnesses:

• Wash your hands with soap and water or use alcohol hand sanitizer, especially after being out and about in public and after blowing your nose, coughing or sneezing

• Avoid touching your eyes, nose and mouth

• Avoid close contact (within 6 feet) with people who are sick

• Stay home and away from others when you are sick

Can the virus be spread by asymptomatic people?

"It is not entirely clear, but the available data suggest instances where people without symptoms, or perhaps with very mild symptoms appear to have transmitted to others," says Adam Lauring, M.D., Ph.D., associate professor of Internal Medicine in the Division of Infectious Disease. But, he says, it's likely not a major driver of transmission and people with the most symptoms are probably the most likely to transmit it.

Is COVID-19 more contagious than the flu or common cold?

Both Lauring and Washer say COVID-19 appears to rival the flu or cold for how easily it's transmitted. "Epidemiologists use the term R0 (R naught) to estimate the individuals that each infected person will transmit to. The estimates of R0 for the coronavirus in China were somewhere between 2 and 3.5," says Lauring.

How deadly is COVID-19? How likely is it that someone with COVID-19 will require hospitalization?

Lauring notes that while there are still some unknowns, it appears that 15-20% of the cases are severe enough to require hospitalization and a significant fraction of that might require intensive care.

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A recent study of cases in China, just published in JAMA, provides more insight into the age breakdown of the disease and its case fatality rate (how many of the people who get the disease end up dying from it).

Lauring notes that severe disease tends to be in people 60 and over.  As for the fatality rate, "Two percent is on the high side. I would guess closer to .5 or 1 percent. That's still five times higher than seasonal flu."

How should older people and those at risk of serious illness protect themselves?

According to the CDC, "Older people and people of all ages with severe underlying health conditions — like heart disease, lung disease and diabetes, for example — seem to be at higher risk of developing serious COVID-19 illness." The guidance for these groups, including people who are immunocompromised, is to avoid crowds, stay away from sick people and stay home as much as possible.

Are kids at risk of getting COVID-19?

According to the JAMA article, out of the confirmed 44,672 cases, just 1% were in children younger than 9 and 1% in kids age 10-19. Says Lauring, "Kids are probably getting infected but it appears they have more mild symptoms. You might not even know, as we're in the middle of flu season."

What should you do if you think you've been exposed to coronavirus?

According to the Centers for Disease Control and Prevention, the current risk for the general American public is low.

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"Right now, specific travel history or exposure to persons with known COVID infections are the most predictive of whether respiratory symptoms could represent COVID infection," says Washer.

If you have fever, cough, or difficulty breathing and have an exposure that is concerning for COVID, says Washer, call your doctor ahead of time so that preparations can be made for you to wear an isolation mask and for staff to wear appropriate personal protective equipment while evaluating you. 

If you do need to go to the emergency department, she adds, please share any travel or other exposure history immediately with health care providers so that appropriate precautions can be taken.

Stay up to date

Both Washer and Lauring note that the situation is constantly changing but steps can be taken to reduce your risk of getting sick. For the most up to date information, visit the CDC website.

For the most updated information from Michigan Medicine about the outbreak, visit the hospital's Coronavirus (COVID-19) webpage.