Chapter 1

COVID-19 in a Nutshell

IN THIS CHAPTER

Investigating the ins and outs of COVID-19

Living in a post-pandemic world

Getting healthy after being sick with COVID-19

Trying to predict COVID-19’s future

In the winter of 2019, an unknown virus started making people sick in Wuhan, China. Within weeks, scientists identified the virus as SARS-CoV-2 and saw it spread beyond Wuhan. The viral infection quickly snowballed into one of the most transformative global events of the 21st century: the 2020 COVID-19 pandemic.

The pandemic wasn’t just a health problem; it penetrated every facet of societies across the world. The pandemic revealed vulnerabilities in healthcare systems, stoked public fears and mistrust of ever-changing public health policies, and caused millions of deaths worldwide. At the same time, people rose up to meet the challenges. Communities came together to support one another emotionally and logistically. Healthcare and essential workers kept medical facilities, stores, and other infrastructure operating, despite enormous obstacles.

As an Infectious Diseases specialist since 1991, I worked through the HIV, H1N1, SARS, smallpox, and Ebola epidemics, and I was also on the frontlines for COVID-19. In this book, I cover the basics of COVID-19, from its insidious beginnings to its widespread ramifications. I also give you my own personal insight and experience as a medical worker during this pandemic.

Going Over the Basics

The amount of information to know about COVID-19 can feel overwhelming because you can find just so much of it out there — plus, some of it changes from time to time, while scientists discover more about the disease.

In this section, I give you a quick glance at the foundation of COVID-19, from the basic science of the virus, to how people transmit it, to uncovering why this virus remains a concern for people worldwide.

Recognizing COVID-19 and global responses

COVID-19 is a highly contagious respiratory illness caused by a coronavirus (a large family of respiratory viruses) called SARS-CoV-2. Here’s what the name COVID-19 means:

• COVI: Coronavirus
• D: Disease
• 19: 2019 (the year it was discovered)

A lot of evidence suggests that the virus started in animals in Wuhan, China, and jumped to humans in late 2019. (If you want to read more about how scientists think that jump happened, turn to Chapter 3.) Although doctors now have several ways to treat the virus, new variants of COVID-19 continue to emerge, making COVID-19 an ever-present global health concern.

COVID-19 affects each person differently. Some individuals experience mild symptoms, such as fever, cough, and fatigue, while others experience more severe manifestations, such as pneumonia, respiratory failure, and in some cases, even death.

Because of the severity of symptoms and the death toll resulting from the 2020 COVID-19 pandemic, most countries’ governments (at country-wide and local levels) enacted public health policies and practices to contain its spread, including

• Widespread testing, which was often available free of charge during the height of the pandemic
• Isolation measures for people who had the disease
• Quarantine measures for people exposed to the virus
• Public safety practices, such as social-distancing and wearing masks

Also, governments and agencies supported the rapid development of vaccines to offer protection against COVID-19.

To read more on the global impact of the pandemic, turn to Chapter 4.

Understanding who’s most vulnerable

Adults over the age of 65 and individuals who have underlying health conditions have a higher risk for contracting and experiencing severe illness or complications from COVID-19. Common comorbidities (conditions or diseases that occur simultaneously with another) that make people more vulnerable to the virus include

• Chronic respiratory diseases
• Compromised immune systems
• Diabetes
• Heart disease
• Obesity

Additionally, factors such as poverty, inadequate access to healthcare or nutrition, crowded living situations, and language and cultural barriers can also heighten people’s susceptibility to becoming ill with COVID-19.

Grasping the global concern

You’d be hard pressed to find a corner of the globe that COVID-19 hasn’t touched. Maybe some remote villages and isolated tribes have remained unscathed, but for the majority of cities, towns, and villages around the world, COVID-19 became a huge health crisis during 2020 and 2021.

As of this writing, governments, public health agencies, doctors, and scientists have gotten the virus under control enough that the World Health Organization (WHO) no longer considers it a pandemic (meaning it’s an illness spread across many regions around the world at the same time, disrupting public health, the economy, and daily life). Still, you can expect COVID-19 to remain a part of life because

• People can easily spread the SARS-CoV-2 virus to each other through coughs, sneezes, or even just talking in close proximity.
• International travel allows people from all countries to potentially spread viruses, turning isolated outbreaks into widespread contagion within weeks.
• The SARS-CoV-2 virus has the potential to cause severe illness and hospitalizations for some people — and if not managed well, may overwhelm healthcare systems and cause a high number of fatalities again.
• Scientists continue to study and find out more about the original virus, and all of the variants that continue to emerge. Future variants may not be responsive to vaccines and prevention.

The truth is, the world will most likely see another pandemic, even if it’s not COVID-19. To discover some of my ideas and suggestions for how countries around the world can prevent and prepare for the next pandemic, visit Chapter 14.

Knowing how COVID-19 spreads

People infected with COVID-19 primarily transmit it to others through aerosol or respiratory droplets that they emit when they cough, sneeze, talk, or breathe on someone else. If you’re infected and in close physical contact with another person, that person may inhale droplets that you exhale.

Additionally, people can contract the virus by having an infected droplet land on their hands and then touching their face, particularly their eyes, nose, or mouth.

Turn to Chapter 5 if you want further detail about how people transmit COVID-19, including information about the difference between aerosol and droplet transmission, how surfaces aren’t the danger that we in the medical community once thought they were, and the characteristics of superspreader events.

Coping with COVID-19

COVID-19 isn’t going anywhere. As of this writing, most people can look at COVID-19 as a minor health concern, but that doesn’t mean people should become complacent. Stay up to date on the latest about symptoms, prevention, and treatment to ensure that the world doesn’t see a repeat of a pandemic like the one in 2020.

In the following sections, I give you information about the basic symptoms to watch for, as well as recommendations on minimizing the spread of COVID-19, getting tested if you think you do have it, seeking treatment, and managing Long COVID if you have to.

Surveying the symptoms

The trickiest part of diagnosing (and treating) COVID-19 may be that its symptoms vary so widely in severity and duration — and they’re often similar to or the same as other illnesses, such as a cold or the flu. Everyone experiences the onset and progression of symptoms, typically...