The world at the moment is deeply concerned about the current and future impacts of a new viral respiratory disease, called “COVID-19”. This blog post briefly discusses approaching your dentist in this environment, and then covers the characteristics and issues of COVID-19 in some detail.

Approaching your dentist

For the safety of all, it’s important that when deciding to visit your dentist that you only do so if you are free of any symptoms of COVID-19. Described in detail below, these symptoms primarily include fever, dry cough, muscle ache, and fatigue. If you are experiencing these symptoms, DON’T go to the dentist.

Also, if you have been outside the country in the two weeks prior to your dentist’s appointment, call before going to the dentist to discuss your situation. Depending on when and where you have travelled, your dentist might request that you postpone your appointment until a longer time has passed.

What is COVID-19?

“COVID-19” is a short written form for “novel COronaVIrus Disease 2019”. It describes a specific disease caused by a specific virus, identified in the year 2019. This virus is one of a family of viruses called “coronaviruses” that in turn get their name from their appearance seen through an electron microscope, where they supposedly look something like a crown (“corona” means “crown” in Latin and some other languages).

The disease caused by this virus has a set of characteristics that make it similar to — but not the same as — on one hand seasonal flu and on the other hand the common cold. But it is neither of these. For one thing it has a different combination of symptoms and traits. For another, very importantly, it is new or “novel”, with the result that humans have absolutely no immunity to it.

Distinguishing between COVID-19 / Seasonal Flu / Common Cold

Symptoms

COVID-19	Seasonal Flu	Common Cold
COMMON SYMPTOMS
Fever	Fever
Dry cough	Dry cough
Muscle ache	Muscle ache
Fatigue	Fatigue
	Headache
	Sore throat	Sore throat
	Runny or stuffy nose	Runny or stuffy nose
		Sneezing
LESS COMMON SYMPTOMS
Headache		Headache
Coughing up blood
Diarrhoea	Diarrhoea
	Vomiting
		Low grade fever
		Muscle or body ache
		Fatigue

Traits

	COVID-19	Seasonal Flu	Common Cold
Incubation	1 to 14 days (may go up to 24 days)	1 to 4 days	2 to 3 days
Complications	5% of cases	1% of cases	Extremely rare
Recovery	2 weeks (mild) 2 to 6 weeks (severe)	1 week (mild) 2 weeks (severe)	1 week (typical)
Treatment	None available	Annual seasonal vaccine	None available, treating symptoms

The long incubation period for COVID-19 presents a very serious problem for controlling the spread of this virus. It is possible for an infected person to carry the virus for a long time without symptoms, and through some of that time they also may be capable of infecting others. Consequently, when a person shows up as infected, it’s often very difficult to determine when, or how, or from whom, they got infected.

Another unusual characteristic of COVID-19 is that it does not affect all people equally. In particular, the children and the very young are hardly affected at all, while those older than 60 years and especially those 75 and above are particularly hard hit.

Not only are certain people hard-hit, but they are hit harder than those experiencing seasonal flu or the common cold. COVID-19 has both more severe complications and a much higher mortality rate than the flu.

Taken all together, COVID-19 can kill significant percentages of those it infects, is easily transmitted from person to person, is hard to initially detect, and humans have no immunity. This is a potent combination of features and as of mid March 2020 this disease has spread worldwide and is increasing exponentially in areas where it has not been controlled.

Geographical spread

COVID-19 began in late 2019 in the area of Wuhan, a city in Hubei Province, China. It proliferated rapidly in that area and soon spread to other areas and provinces. It was not long before further cases of the virus were manifesting in other countries and on cruise ships. Some of the most dramatic appearances of this disease were on cruise ships, where infection rates were high and passengers were forbidden to leave.

At the same time as the virus was appearing throughout the world, the Chinese made a massive and fast-acting clampdown in their own country. This has led over the past month or so to a dramatic reduction in new cases of the disease in China. That’s all great, but concurrent with that victory has been rapid and disturbing spread: first in Iran, South Korea, and Italy. In South Korea the outbreak grew rapidly but appears now to have been brought under control.

However, in Iran, Italy, and now many other countries particularly in Europe the spread of the virus has been essentially uncontrolled. Countries are introducing measures to limit social interactions between people as that method is really the only technique available to control spread.

In the United States, the situation is disturbing because it’s very unclear how many people have become infected. The United States has been slow to deploy tests to detect the virus, and it’s likely that there are many more cases than the number officially diagnosed.

Finally, in Canada at the moment we are faring somewhat better than many countries. Canada has just reached 300 identified infections and has to this point only got one death, although those rather optimistic statistics are likely to change for the worse with time. It’s not really possible to create an accurate snapshot of the spread of this disease in a blog post, but this coronavirus tracking website is a good way to keep up-to-date with the status of the disease globally.

What can people do?

The three most effective things to prevent the spread of COVID-19 infection are regular hand washing, taking care not to touch one’s face, and “social distancing”.

Wash hands thoroughly and regularly

One good thing about the COVID-19 virus is that it is highly susceptible to soaps of any sort. As people grow nervous about this disease, they are hurrying to buy hand sanitizers, and shortages of such products have appeared. But there is no cause to worry; pretty much any household already has something suitable for the need.

Traditional soaps, whether in bar or liquid form, shampoo, dish soap, or laundry soap, are all extremely effective against the COVID-19 virus. ANY soap will do. If you have not got hand sanitizer (which must be 60 percent alcohol or more to be properly effective), make your own soap mixture. Mix your choice of the soaps above with some water and you have something as good **or better** than alcohol-based sanitizers against COVID-19 virus.

You can take two bottles (pump bottles if you are feeling fancy) out with you — one with the soapy liquid for cleaning, one with straight water — and a J-Cloth to wipe away soap after cleaning. Use this soap-water mixture (or use hand sanitizer) regularly, and especially after touching surfaces others might have touched any time in the previous day.

For the curious, the chemistry of soaps (“amphiphiles”) and their effect against COVID-19 is explained here: https://www.vox.com/science-and-health/2020/3/11/21173187/coronavirus-covid-19-hand-washing-sanitizer-compared-soap-is-dope

To be fully effective hands must be washed for at least 20 seconds, taking care to wash all the fingers and surfaces front and back.

Avoid touching your face

The COVID-19 virus enters the body through our noses, mouths, and possibly eyes. While we touch our faces involuntarily and often, it’s essential to make every effort not to, especially if our hands have not been very recently cleaned.

Practice “social distancing”

A new term, “social distancing”, has entered our speech with the appearance of COVID-19. The term might be new, but the idea is old. It’s basically staying away from other people, particularly those potentially infected with COVID-19.

Because this virus spreads by riding along in tiny droplets of water emitted by an infected person speaking, sneezing, or coughing, the primary goal of social distancing is to prevent those droplets from passing between sick and healthy people.

To achieve that goal, people should maintain a separation of at least six feet if there is any chance one has COVID-19. People should not shake hands, and should eschew unnecessary physical contact whenever transmission is possible.

Moreover, people should avoid gathering in groups, to the extent possible. In a large group, a single infected person can in turn infect many people at one time. Avoiding people and large groups is not how we normally operate, but in the face of COVID-19 people are quarantined, businesses and schools are shut or people work from home, often telecommuting or using e-learning tools.

As the recent experience of China’s response shows https://medium.com/@tomaspueyo/coronavirus-act-today-or-people-will-die-f4d3d9cd99ca, social distancing works, but requires early intervention and rigorous enforcement.

Impacts on society

The impacts on society of the COVID-19 virus are changing daily as the virus spreads. Social distancing changes how people live their daily lives, and the activities that they can engage in. Financial markets are greatly disrupted. People feel nervous about their personal safety and the future. Supplies of goods and services are often unreliable.

Many of these impacts are short-term and will settle down in a few months. To understand the current situation and for reliable information on the Canadian experience of COVID-19, the Canadian government has an information website.

Canadian Government COVID-19 web site

At this time people need to keep themselves well-informed and to take all precautions to protect their health and the health of others. Be well!