WORDS BY ALEX HOEFT AND BECCA LOUX, ILLUSTRATIONS BY SARAH MILLER | Moonshine Ink

The novel coronavirus that has caused a worldwide pandemic has likewise made a rapid and dramatic impact on the Truckee/North Tahoe region. First came one voluntary closure and cancellation after another, then California Gov. Gavin Newsom’s ‘stay at home’ directive and the closure of nonessential businesses rocked the area, pulling people from their workplaces and sidewalks to within their living quarters.

But rewind to before the effects began trickling into Tahoe, and there was a beginning. Here, we go back to the basics of the novel coronavirus: How did it start? How does it spread? And what happens if you survive one round, but are reinfected? Information shared is based on the Centers for Disease Control and the World Health Organization unless otherwise noted.

Advertisement

The source of the coronavirus is unknown. Current evidence points to an animal-based origin, likely a bat.

The first known human cases of COVID-19 were identified in Wuhan, China in December 2019. Again, it’s unclear how exactly humans were infected by the coronavirus, but experts are comparing the virus, more specifically known as SARS-CoV-2, to the SARS 2003 outbreak. Like the speculated bat origin of the novel coronavirus in humans, that outbreak began with the virus jumping from an animal reservoir to humans, then human to human from there. Until a source is confirmed, reintroduction of the virus is an ongoing risk, and outbreaks could continue.

According to NPR, Li Wenliang, an opthamologist in Wuhan, warned Chinese authorities of the emerging coronavirus’ danger early on and was reprimanded. Wenliang died in early February after contracting COVID-19, and authorities posthumously apologized to his family for their actions.

COVID-19 spreads person to person. If you have the disease, you are able to spread it to those you come in contact with through small droplets from your nose or mouth. When you cough, sneeze, or even exhale, these respiratory droplets land on different surfaces. Others who touch those surfaces and then touch their eyes, nose, or mouth can catch COVID-19. It’s also possible, though not quite as likely, studies state, for someone to breathe in the droplets from an infected person; hence, the current recommendations to keep 6 feet of separation between people. The WHO stated, “Studies to date suggest that the virus that causes COVID-19 is mainly transmitted through contact with respiratory droplets rather than through the air.”

The virus can survive on a variety of surfaces for a few hours up to several days. CDC- and FDA-provided materials state that the coronavirus can live for five days on metal and ceramic objects and surfaces, up to five days on glass or paper, four days on wood, and two to eight hours on aluminum. 

According to the National Institute of Allergy and Infectious Diseases (NIAID), the coronavirus is also “detectable in aerosols for up to three hours, up to four hours on copper, up to 24 hours on cardboard, and up to two to three days on plastic and stainless steel.” Recommendations are for people to frequently clean and disinfect oft-touched surfaces every day, including countertops, doorknobs, and phones.

And person to person? How sick does one have to be to spread the virus? It is possible to catch the disease from someone who only has mild symptoms or is even asymptomatic (see our Jane Doe infographic), and experts recently confirmed that transmission of the virus can happen before symptoms are apparent, up to three days before the onset. The study, performed in Singapore, found that 6.4% of the cases they reviewed were attributed to presymptomatic transmission of COVID-19. A similar examination in China found that 12.6% of patients studied likely acquired the virus in a similar way. Most people who contract COVID-19 will only experience mild symptoms.

It’s currently understood by the World Health Organization that one infected individual can infect between 2 and 2.5 people — a higher reproductive number than for influenza.

Masks are more useful than originally thought. Though some experts touted masks as objects to use only if you are caring for someone who is sick or are coughing or sneezing, mindsets about mask effectiveness have shifted in response to the aforementioned new study about presymptomatic transmissions. The CDC (as well as Placer County) now recommends wearing cloth to cover your face while in public settings.

There’s a range of COVID-19 symptoms, the most common being a fever, tiredness, and a dry cough. Additional symptoms could be aches and pains, nasal congestion, a runny nose, sore throat, or diarrhea. It’s been recommended by some to add anosmia, the loss of sense of smell, and ageusia, a diminished sense of taste, to the list of symptoms.

Some people may become infected and not develop any symptoms or feel unwell, and roughly 80% of those with the disease won’t need any special treatment. The WHO notes that about 1 out of every 6 people with COVID-19 will become seriously ill and develop difficulty breathing. This is where ventilators are needed, as they mechanically assist those who are unable to breathe on their own and help suppress the amount of mucus in the windpipe. People with underlying health conditions (high blood pressure, heart problems, or diabetes) are more likely to develop a serious illness.

Rumors of the use of ibuprofen worsening the disease were put to bed by the WHO, which does not advise against the use of ibuprofen at this time.

If you are infected with COVID-19 and recover, can you be reinfected? In an interview with The Daily Show host Trevor Noah, Fauci explained that though it’s not confirmed because studies haven’t been done yet, he’s pretty certain that those who recover from the disease won’t get it again.

“I feel really confident that if this virus acts like every other virus that we know,” Fauci said, “once you get infected, get better, clear the virus, that you’ll have immunity that will protect you from reinfection. It’s never 100%, but I’d be willing to bet anything that people who recover are really protected against reinfection.”

The spread is shifting.
Worldwide hotspots for the disease have been Italy, Spain, Germany, and China. The United States, however, has surpassed all of these countries in number of total cases.

The Institute for Health Metrics and Evaluation projects peak amounts of COVID-19 cases state-by-state based on forecasts from local and national government, hospital networks, the American Hospital Association, the WHO, and other sources. California is projected to peak in resources used on April 13; Nevada, on April 17. Peak resource use for the entire United States was expected on April 11. (These assumptions are based on full compliance with social distancing efforts.)

A Propublica article breaks down different COVID-19-themed hospital scenarios, tracking how overwhelmed hospital regions would be based on whether x-percent of adults were infected with the disease over certain periods of time. For the Reno, Nevada region, which automatically filters in Truckee/North Tahoe locations, during a moderate scenario of 40% of the adult population contracting COVID-19 over one year, hospitals would need to expand capacity. Reno hospitals, the article furthers, would receive approximately 50,900 infected patients, requiring 1,700 beds (based on an estimated 8% of the population requiring hospitalization) over 12 months — 2.6 times available beds during that period. These projections are based on 2018 numbers.

According to the annual report put out by the American Hospital Association, as of 2018 the U.S. had 924,107 total staffed hospital beds, at a total of 6,146 hospitals.

Coronavirus vs. COVID-19 (per the AP Stylebook):
Yes, we know that person who keeps saying “COVID-19” instead of “coronavirus” sounds annoying, but they could actually be right … or very, very wrong. Or at least, not specific enough to this particular pandemic; turns out, our current coronavirus has a large family. Here’s the skinny:

  • Coronavirus: A family of viruses named for the crown-shaped spikes on their surfaces. These viruses can cause anything from the common cold to SARS, MERS, or our latest enemy, COVID-19.
  • COVID-19, or coronavirus disease 2019: This disease is caused by a virus known as SARS-CoV-2.

To reiterate, COVID-19 is the disease; the coronavirus is the virus.

Let’s Get Local:
Our region, with its rugged mountains, smooth slopes of white, skyscraper pines, and crystal clear blue lakes, has not always been known to be jurisdictionally simple. Tahoe itself spans two states with very different histories and governing styles, and Moonshine’s coverage area ranges four counties. In the time of COVID-19, when we’re shuttered in our houses and our tourism-based economy is hemorrhaging money, knowing what agency or government entity is in charge of what is not getting any easier.

For the most accurate and up-to-date information about the spread of the coronavirus locally, each county’s public health department is the lead agency overseeing new restrictions and providing information to the public as it comes in from the CDC and the WHO. Visit your county’s website for the latest information:

• El Dorado County: edcgov.us/Government/hhsa/Pages/EDCCOVID-19.aspx

• Nevada County: mynevadacounty.com/coronavirus

• Placer County: placer.ca.gov/6367/Novel-Coronavirus-COVID-19

• Washoe County: covid19washoe.com

The Tahoe Forest Health System is the primary hospital system in the area, and we connected with CEO Harry Weis about what to do locally if you or someone you know may have symptoms of COVID-19. His response: Call the hospital’s hotline seven days a week, 8 a.m. to 5 p.m., at (530) 582-3450. If you’re experiencing shortness of breath, fever, cough, or other severe symptoms after hours, he said to go to the emergency department.

The drive-through testing facility that TFHS might recommend you utilize if you experience certain symptoms of COVID-19 is by referral only. The testing process involves a swab from the nostril, which, Weis said, will provide results from the testing labs they partner with in “approximately four to seven days,” (though personal testimony has been that it sometimes takes longer).

Remember, it’s our local medical warriors that stand between a major catastrophe and a crisis we can handle and get back on our feet. Tahoe Forest Health System shared that 11 out of the system’s 1,050 employees have tested positive for COVID-19, and are home self-isolating. Weis explained in an interview with Truckee Tahoe Radio that the hospital screens employees each day and asks illness questions. If someone is ill, they’re required to go home. Based on what other countries are seeing, Weis said as much as 15% of a total population infected could be healthcare workers.

Capacity-wise, Weis said TFHS has surge capacity up to 44 beds, with 12 ventilators.

“We have an amazing team who loves this region!” Weis said of his staff. “They are holding up well. We are working hard to keep all team members safe.”   


Meet Jane Doe, a resident of Truckee. Unbeknownst to Jane, a recent trip to the gas station resulted in her acquiring the novel coronavirus by touching a metal surface, where the virus had lived for two days after contact with a host, and becoming infected. Though Jane does her best to practice social distancing measures and abide by the ‘stay at home’ directive, she still manages to spread the disease in the coming days before she realizes her symptoms are more than the allergies she thought they were.

During a trip to the grocery store on a Monday morning, Jane left her grocery cart parked against a curb after storing her food in the back of her car. While shopping, Jane touched her face frequently while pushing the cart around (turns out, we all do it all the time). The next person who uses the cart ends up becoming infected with COVID-19.

In an attempt to spend time out in nature, Jane went for a short hike with her dog around the Martis Creek Wildlife Area two days later, on Wednesday afternoon. At one point, another dog came over to say hi. When the other dog’s owners come to retrieve their dog, they chatted with Jane for a few minutes in close proximity (within 6 feet). Jane sneezed, but mentioned she’s experiencing allergies and the couple shouldn’t worry. The two owners of the other dog become infected after inhaling her airborne respiratory droplets.

The good Samaritan that she is, Jane has been delivering groceries and supplies to three senior couples living in Kings Beach who are extra cautious about leaving their homes. Despite her efforts to use hand sanitizer and wash her hands often and thoroughly, on Thursday morning she unknowingly passes the disease on to two of these couples when transferring goods; a small cough here, a runny nose there.

Jane is all about supporting local businesses during this time, and decides to order takeout from her favorite restaurant in Tahoe City Friday evening for dinner. Though she’s quick to enter and leave the establishment, she gives a small cough before she swipes her credit card, using her hand holding the card to block the cough, then enters her zip code and digitally signs for her food at the cash register with her finger. The person working the register, and three customers after Jane become infected with COVID-19.

Eleven people in the Truckee/North Tahoe community are infected with COVID-19 through various interactions with Jane Doe over the course of five days. With the reproduction number (the number of secondary infections) between 2 and 2.5, those 11 people may go on to unknowingly infect an additional 22 to 27.5 people, and so on.