Today we have Dr Christina Madison, who will give us the latest on the Coronavirus.






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What you will learn

  • Where the virus came from
  • Who is being impacted …..which countries
  • How many cases in US and where they are
  • What are the symptoms
  • How do healthcare workers protect themselves
  • How do pharmacists & other healthcare workers prevent themselves from getting sick
  • What Myths are out there

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Michelle: This is Michelle Sherman, president of Michelle RX pharmacist consulting services, and the host of the conscious pharmacist podcast, one of the many court costs on the pharmacy podcast network. Welcome to today’s episode. I am so thrilled to have a guest on our show today who has been on two of our other podcasts recently, who’s right on the forefront of what’s happening, things going on. Dr Christina Madison, the public health pharmacist. She has joined us today to give us the latest four one one on the novel. Coronavirus welcome back to the show. Christina.

Christina: Thank you so much for having me.

Michelle: Oh, absolutely. There’s all this hype going on in the news and everywhere that everybody’s panic stricken about this Coronavirus that they say written that originated out of Wuhan China. Can you shed some light on what’s going on and tell us where the virus came from and which countries are impacted?

Christina: Yeah, absolutely. So at, obviously this is still an evolving story and every day we get updates and, and more news about what’s happening as it relates to where the virus is globally. But just to confirm what you stated earlier, the virus was originally identified in 2019, so the end of 2019. And it’s what we call a zoonotic virus, which means that it made the leap from animals to humans. And then we saw sustain human to human transmission. And that’s really when we started to become a little bit more concerned. So the thought process is that that leap from animals to humans happened in a seafood market, in who? Wuhan in China, which is in Hubei province. And that these markets, they’re called wet markets. They maybe don’t utilize the most cleanliest of techniques. And because there’s a lot of mingling of different types of breeds and animals they think that that’s maybe why the virus was able to sort of flourish in that environment.

Christina: And then after we saw the first cases of people with severe respiratory illness, which was categorized with difficulty breathing as the hallmark sign, in addition to you know, the runny nose and the fever they started thinking, okay, maybe this is something different and something novel. So, as you know, Coronavirus is actually very common. It’s what causes the common cold. But in this case, it’s different because it’s genetically different from what we’d seen in the past. And I think that’s what’s making people so afraid is because we don’t have a vaccine for it. There’s technically no official treatment for it. Even though there has been some success with antivirals that were used for influenza in some cases of individuals who’ve been hospitalized. So that is promising. But again, because it is new it’s about 85% similar to what we saw with SARS, which was also something that we saw, which was concerning out of China a few years ago. W we are at the point right now where we haven’t even seen the peak of the virus yet, but when we look at it in comparison to something like, well, when’s a w we haven’t even scratched the surface. So hopefully by the end of this podcast we will make sure that our listeners know that our risk, if you are currently living in the United States is still a very low.

Michelle: Excellent. So how have they been cases in the United States and how many, Oh, then especially, you know, looking at our state of California and Nevada. And where are these cases in the U S coming from?

Christina: Yeah, so as of right now we’ve had a total of 11 cases and that’s been pretty steady for the last couple days. And part of that is because being in the United States, we have excellent public health infrastructure. Sure. So as soon as someone was identified, they were appropriately put into respiratory isolations. A contact investigation was done to identify anyone else who’d come in contact with them. And so because of that, we’ve really done an excellent job of, of really staving off the, the transmission of the virus. So the, of those 11 cases nine of those people had recently traveled to the endemic area, which was in Ruan China and then repatriated back to the United States. And of those the other two, those were the ones that were in close contact with those individuals that had recently traveled to the endemic area. So we only have had two cases of sustain human to human transmission after travel.

Christina: So only two of those 11 cases where somebody that came in contact with a traveler. So I, I feel like in that case, we, we’ve done a pretty good job of really honing in, in the, the transmission rate. So as far as locations, we’ve seen cases in, in woke Southern and Northern California Arizona Washington state, Illinois, and now mashes Massachusetts. And then the case in Illinois where we saw the, the sustain human to human transmission, it was an individual who came back from Mohan and unfortunately was able to transmit that to their spouse. And then we also saw another case of sustained human to human transmission from somebody who recently traveled and gave it to someone that was a close contact in California. So that’s where the cases are currently in the United States. Here in Nevada we had a little bit of a of a scare because we had somebody who had fairly recently traveled, but it had been about a month since they had been to the endemic area. And that person had a laboratory isolate, sent to the CDC and was actually confirmed to be negative. And that happened last week. And that was somebody who lived here in Clark County. And as of right now, we don’t have anyone else that’s being looked at as a suspected case.

Michelle: Oh, that’s, that’s excellent. And [inaudible] what I find interesting is, you know, the world today in the 21st century is, is really like one global country or city. It’s like a small entity that, you know, something could happen where you could just isolate it in a small place and then people get infected or, or whatever, and then they hop on a plane and go globally. They spread out everywhere. So, you know, it’s, it’s, it’s easier to transmit these, these viruses globally because of like air travel. And I’d seen on the news last week that several USA lines in suspended aid travel to, to, to the area in China. Is that still the case or,

Christina: Yeah, so as I mentioned before, the incubation period is thought to be about 14 days. So as of right now we have seen several commercial airlines suspending travel to China as well as the fact that the global travel advisory is that it’s at what we call a level four, which means do not travel. And that’s a temporary precaution again, to try to stop the spread of the virus because it is rapidly spreading around the globe as we can see. But we know that Alliance share of the cases are still in China and mostly in Asia. So all but I believe one of the cases that we’ve seen of individuals who have passed away from the virus have all been in China. And the other individual that, one person that did not pass away in China, he actually had traveled recently from China.

Christina: He was a Chinese citizen and had traveled to the Philippines and became ill pretty much as soon as he arrived in the country. He was hospitalized and unfortunately passed away shortly after they identified that that’s what he had, that he was, he had tested positive for the, for the Coronavirus. So again, it’s still pretty isolated and they’ve closed borders. Again, you know, we have travel restrictions. The state department here in the United States issued a warning to not have any non-essential travel well to China or to the areas that are seeing a majority of the cases. So those travel restrictions are in an abundance of caution in order to really slow down the spread of the virus because as you said you know, somebody could get on a plane today and be halfway across the world in a matter of hours and, you know, anybody that they came in contact with, you know, they’re they’re sneezing, coughing, you know, and, and a lot of times individuals aren’t symptomatic and are still able to spread. So that’s the thing that I think is also scaring people is that that 14 day incubation period, a big chunk of it, you’re asymptomatic and you’re still able to spread the virus.

Michelle: Right, exactly. And, and globally, like what other countries or continents have been impacted? Is it, is it, is it every way or just so there’s about

Christina: 24 countries that have identified the virus in their country right now. And the ones that have had the highest amount of cases are the ones that are closest to the epicenter, which is China. So 24 countries have had a confirmed case, at least one. So China’s had the most followed by Thailand, Singapore, Japan, and then South Korea. So that’s, you know, but we, we were talking over, you know, a 17,000 cases in China down to the next tightest, which is 19. Yeah, exactly. So I mean, in comparison or I, excuse me the next would be a Japan actually as of today, I’m looking at the dashboard right now. So China as of 7:50 AM on February 5th it’s 24,000, 433 cases and China. And then Japan now has the second-highest with 29 followed by Singapore with 28, Thailand, 25, South Korea 18. So there’s still the still the same countries that they’ve just kind of shifted in and where they are as far as number of cases, but still, you know, we’re talking 0.1% or less compared to China. Right. And it’s all in that same vicinity.

Michelle: Yeah. And, and, and you know, I’m so, so glad you just read out those numbers because that’s where the virus originated in Wu Han and it’s the greatest number, right? Like concentrated in that area. And then you mentioned the next highest of Japan, which was minimal compared to that. So, you know, our listeners need to realize that while there’s massive hype in the media and you know, people should be aware when you look at the actual numbers at the epicenter where it’s concentrated that way, you know, the focus is with all these smaller amounts like in the rest of the world. So, you know, there’s so much panic and so much misinformation. And you had mentioned earlier, like a lot of myths you know, for listeners, I mean, a lot of our listeners are pharmacists. I mean, what can we do as pharmacists to allay the, the mess hysteria out there for this and, and help our patients and you know, and the other people that come in contact with us and other healthcare providers to you know, ensure their safety and let them, you know, lay a lot of these fears. Like what are the symptoms and what can we do to help our patients and, you know, kind of dispel some of this messy Steria that’s going on.

Christina: Yeah. So I think first and foremost is being knowledgeable and staying up to date. I think that’s the number one thing. So who, and the CDC are both you know, putting out great information on an hourly basis, updating, you know, what’s going on with the virus. I follow them on Twitter, I follow them on Instagram. I tagged them in all my posts. So, you know, they’re really getting the information out to the public. So being knowledgeable about, you know, what’s going on with the virus. I think that’s the first thing, right? So if people ask you questions, you can give them accurate information. But then the other thing too is just looking at this in comparison to something like influenza. So I just want to give you a couple of statistics. So the CDC just recently posted

Christina: Some information about where we are as far as the preliminary flu bird estimate for this year’s flu season. So between October 1st of 2019 to January 25th of 2020, there were 19 million illnesses, 8.6 million medical visits, 180,000 hospitalizations and 10,000 deaths from influenza. So like, let’s look at that in comparison to what we’re seeing right now with Coronavirus, which by all intensive purposes, we have definitely not seen the peak, which is projected to be around April or may of this year. But just think about that for a minute. This is just a snapshot, just a few months of what we’ve seen with our current influenza season and we haven’t even, we haven’t even reached the peak of influenza. So just think about that in comparison. So what can people do to help prevent illness? They can get vaccinated for things that we know when we have a vaccine for. So if you have respiratory problems, if you have cardiovascular problems, if you have things like diabetes, you should be up to date on your back and nation, which includes both influenza and pneumococcal vaccine.

Christina: So those are gonna be ways that you can help protect yourself. Even if you did come in contact with somebody who had the Coronavirus, which again is extremely low considering the fact that we’ve only had 11 confirmed cases in the United States. And then ultimately things like washing your hands frequently washing down surfaces that are in high traffic areas are touched by lots of people because that’s how this is assumed to be spread. We’re, we’re not exactly sure, but what we think it’s, it’s from respiratory droplets. So someone sneezes, someone costs, they touch their face, they touch their, their eyes, they touch their mouth, and then they touch a surface. So if you’re in a high, a high traffic area, like a pharmacy, making sure that you’re constantly wiping down those surfaces with alcohol based sanitation supplies, washing your hands frequently if you don’t have the ability to use soap and water, at least use alcohol based hand sanitizers. And then also making sure that we’re cooking. Our, our foods, any raw meats are being prepared properly. Cause again, remember we said that this originated in a seafood market. So preparing and touching food may also be a potential risk for transmission. Staying away from people who are sick or ill if you’re sick or ill staying home, you know, these are all normal preventative care measures that we would use for any other respiratory illness. We can use the same ones for the Coronavirus.

Michelle: Well, you know, that’s, that’s excellent information and you, you bring up like a, a really good point. You know, even just with all the flu going on, I, I’m always asking myself like why are people going to work being around people when they are sick. Why do companies not insist that people stay home when they sick? Because it just makes the rest of the employees sick or not to mention the customers. I know like even at a lot of like germs way like trainers are sick or clients are sick or hairdressing salons. I mean it’s unfair to everybody around either the client or, or, or the employee to make people sicker. I know even for myself when I’m sick or I feel like I have the flu or some illness like that, I just prefer to stay home. I don’t want to be around my patients to make them sick and the other way round as well. So I think you bring up a great point that as pharmacists can really encourage this to patients and people need to practice just normal hand-washing, things like that. Like constantly. Like if we practice those things like constantly, then these things wouldn’t even be issues to be like, concerned about.

Christina: Yeah. And I did want to just touch briefly on the wearing the mask. So I know that this is something that’s like been a really hot topic. I was on our local news station last week talking about this. And that’s the big thing right now. So like all of our medical supplies stores in Vegas are all sold out of surgical masks because there was, the health department came out and said that there was a suspected case. Although now we know that that person is now negative. It really you know, brought up a lot of fear and anxiety within our community. And so a lot of people were, you know, going out and buying masks cause they thought they needed a mask. So one thing I just wanted to say is, so the surgical mask for most people is not going to fit completely sealed.

Christina: Right? And so there’s, that’s the one thing, right? So if you are truly going to wear a mask and it’s going to be, and it’s going to work, you need to be fit, tested, and it needs to be an 95. So for somebody who worked in tuberculosis management for years, I got fit tested every year for a decade. So having that mask on and making sure that it’s properly, that it, that’s really the only way that it’s going to protect you from a respiratory illness. Not to mention that that surgical mask is only recommended for somebody who’s sick. So that’s, that mask is only protecting other people from you, not you from other people. So that’s a big misnomer that I want to make sure that people know about as well. So the surgical mask isn’t really gonna do much for you. If you’re, well, if you’re sick, then yes, absolutely.

Christina: I would highly recommend wearing it. If you’re going to be traveling. Cause again, even though these travel restrictions to Asia are in place right now, they’re, they’re most likely going to be temporary. So I don’t want people to feel like they can’t travel. They can’t you know, go to places they can’t visit family, friends. That’s not what, who wanted to happen when they made the declaration last week. They even made a big point of saying that even though we’re making this public health emergency declaration that there’s no restriction on travel or trade. So no issues with packages coming from China, no issues with you know, people traveling that haven’t been to the endemic area, you know, those kinds of things. So wearing a mask is not necessary, especially if you’re currently living in the United States.

Michelle: Excellent. Thank you. And thanks for clarifying those. Those misnomers are, I know that here in California there’s also been a run on the masks and people are walking around with them, so you know, for people to, to understand you know, the myths and the reality is like really important to prevent, you know, that, that mass panic. Before we end off, is there anything else that you want to add or that our listeners know?

Christina: Yeah, just one more thing. So the who, which is a world health organization, they’ve done two things in the last couple of days that I think could be very useful to your listeners. So one is that they’ve created a dashboard that has, where all the confirmed cases are on a global map. So you can see the map and it has a little, little dots on it. And it shows you where people have had a confirmed case. It also lists all the countries as well as how many people have died and where there’s airports where there have been restrictions in place as far as travelers or evaluation that’s being done at those airports. And then also

Michelle: They have a section

Christina: I’m under the novel coronavirus called MythBusters, which is actually really cool. So if you go there, it actually has a lot of these infographics that you can post to your social media that dispel a lot of those rumors that I said about earlier. So is this, is it safe to receive a package or a letter from China? Yes. Can pets at home spread the new coronavirus? There is no evidence to that. Is a vaccine like the pneumonia vaccine, can that protect you from coronavirus? Not necessarily, but anytime that you get a vaccine that protects your respiratory health, that could help you if for some reason you do become exposed. So there’s lots of different things on here. And they have really great little graphics that you can just copy paste to your phone, you can post it to your social media. Cause that’s really the only way that we’re going to help reduce some of these fears. And some of the hysteria is that you know, qualified clinicians that have medical background are spreading accurate information to the public, which is why I’m so happy that you asked me to be on the blog.

Michelle: Yeah. Oh absolutely. And you know, I, I thank you for your time and you know, for giving this great information, I’m going to put the few dashboard the myth busters and everything on the show notes. So everybody who’s listening can access that and have it readily available. To all the listeners out there dr Madison has been putting out information all day, every day with these things. You can go to the public health Follow her on Twitter and Instagram. Her, her Twitter handle is at public health RX. You can follow the public health pharmacist on Instagram. It’s really important that we that we get all the right information so we can give this to our patients. So again, dr Madison, thank you so much for being on the show and to all our listeners out there, remember, be the change.