“For most people, the coronavirus will be like any other flu or cold. Many people catch these illnesses during their lives and experience only mild symptoms,” says Dr. Carrie Lam.
For a certain amount of people: “There are no special signs or symptoms of coronavirus. In fact, that is one of the reasons why it spread so quickly,” says Dr. Kaushal M. Kulkarni, a board-certified ophthalmologist.
2.You Have a Loss of Senses
“Thirty percent of patients have a loss of smell (anosmia) and loss of taste (ageusia) as their first signs of a COVID-19 infection,” says Dr. Jonathan Kaplan. “Because of the relationship between smell and taste, the taste can also be significantly affected. It can take weeks to recover,” says Dr. Inna Husain.
3. You Have a Fever
“Coronavirus often begins with a fever of 100.4 degrees Fahrenheit within 2-14 days of exposure to an infected person,” says Dr. LaFarra Young, a pediatric pathologist, and health coach.
4. You Have a Dry Cough
One of the most common symptoms is a dry cough, which can be described as one without mucus or phlegm. “If you notice a slight cough or fever this would be reason enough to begin self-isolation allowing a couple of days to see if symptoms manifest,” says Dr. Giuseppe Aragona, a family medicine doctor. “It has been reported that the respiratory symptoms will worsen after a week, though in some cases the incubation period can be as little as two days.”
“The cough to look out for is a new, continuous cough,” reports the BBC. “This means coughing a lot for more than an hour or having three or more coughing episodes in 24 hours. If you usually have a cough, it may be worse than usual.”
5. You Have a Sore Throat or Headache
Nearly 14% of cases studied in China had symptoms of headache and a sore throat, reports WHO. The virus “travels to the back of your nasal passages and to the mucous membranes in the back of your throat,” reports Johns Hopkins. “That’s the place where symptoms—such as a sore throat and dry cough—often start.”
6. You Have Chills or Body Aches
CNN news anchor Chris Cuomo says he was shivering so much due to COVID-19 that he “chipped a tooth.” “They call them the rigors,” he said, adding that he felt like he was being beaten by “a piñata.”
Researchers at New York University also discovered aching muscles (known as myalgia) are among the factors that could signal respiratory distress caused by the coronavirus.
7. You Are Fatigued
“Some older or immunosuppressed individuals may not present with a fever, instead of presenting with other common symptoms such as sore throat, dry cough, or fatigue,” says Dr. LaFarra Young, a pathologist at King’s Daughters Medical Center. “Fatigue is a daily lack of energy; unusual or excessive whole-body tiredness not relieved by sleep,” reports WebMD. “Fatigue can prevent a person from functioning normally and affects a person’s quality of life.”
8. You Experience Shortness of Breath
Can’t get enough air in your lungs? “Extreme shortness of breath and respiratory issues are what is causing the increase in patients in the ICU. Increasing your immune system using Vitamin D can help decrease the likeliness of the spread of bacterial and viral infections,” says Dr. Geoffrey Mount Varner.
If you are struggling for air and can’t breathe, seek immediate medical attention.
9. You Have Pain in Your Chest
“Persistent pain or pressure in the chest” is one of the CDC’s “emergency warning signs”—seek medical help immediately if you feel it. This could be a symptom of the coronavirus or a heart issue, and tests can help determine the right course of action.
10. You Have Pink Eye
“Conjunctivitis, or more commonly known as pink eye, can present as a symptom of coronavirus,” says Dr. Kevin Lee. “People should be cognizant of possible aerosol transmission with the conjunctiva and through ocular secretions, like tears.”
11. You Have Diarrhea or Vomiting
Diarrhea, vomiting, and stomach pain may be more common as a symptom of COVID-19 than anticipated, according to The American Journal of Gastroenterology. Half the patients that were diagnosed complained of those issues in the study. Some patients may not even have respiratory symptoms and just digestive ones.
12. You Have a Bluish Face or Lips
This is considered one of the CDC’s “emergency warning signs” and they advise you “get medical attention immediately” if you see them. Cyanosis is the name for poor oxygen circulation in the blood that causes bluish discoloration of the skin.
13. You Feel Confused
Doctors have observed neurological symptoms, including confusion, stroke and seizures, in a subset of COVID-19 patients. If you are considered high risk, you may show rarer and more severe symptoms. The CDC considers “new confusion or inability to arouse” as an emergency warning sign. Do seek medical attention immediately if it sets in.
If you or someone you know is experiencing any of these symptoms, call your medical care provider before showing up. And to get through this pandemic at your healthiest, don’t miss these Sure Signs You’ve Already Had Coronavirus.
As the entire world is combating an unprecedented outbreak of the viral respiratory disease COVID-19, you may be wondering if it’s safe to continue taking inhalable insulin. Could it compromise your lungs? Or be rendered ineffective if you become sick?
People may be concerned because research shows that respiratory infections are more severe in those with diabetes.
We queried some of the country’s top experts and learned a lot in the process.
The short answer is that there’s no reason not to use inhalable insulin unless you are ill to the point of experiencing “acute respiratory distress” that requires hospitalization.
But there’s a lot more to know on this topic as well — including what weakens your lungs most, information on the newest inhalable insulin product under development, and how inhalable medications might be key to fighting the COVID-19 outbreak.
MannKind’s Afrezza ‘not impacted’
There is currently only one brand of inhalable insulin on the market, Afrezza, from Southern California-based MannKind Corp. The drug has been shown to be extremely effective, and quite safe in both clinical trials and real-world use since its launch in 2015.
We asked Mike Castagna, CEO of MannKind, about the interplay of colds and flu with using the Afrezza inhaler. “We don’t have any evidence that there’s an issue with absorption, and there’s no evidence that it exacerbates respiratory issues. The powder is not sitting in the lungs, but rather goes through the lungs like oxygen,” he says.
Official word from the company is: “In clinical studies, absorption of Afrezza was not impacted by upper respiratory infection (which typically includes scratchy or sore throat, sneezing, cough and runny nose).”
While Afrezza users often experience a cough at the outset of use, Castagna says they regularly work through colds and flu without issues. Some Afrezza users who experience a lot of mucus, or an extreme cough, may opt to switch to injectable insulin during the worst part of their illness, but “that’s up to you and your doctor. We don’t see absorption issues in Afrezza in upper respiratory infections,” he says.
While the predictions for COVID-19 spread are scary — up to half the U.S. population may get the viral disease — thankfully the huge majority of those cases are expected to clear up after relatively mild symptoms, including runny nose, headache, fever, and diarrhea. Experts confirm that people with diabetes are no more or less likely to contract the illness. But if they do get sick, the consequences can be more severe and exceptional care needs to be taken to keep glucose levels under control.
“I don’t want to minimize the concerns people with diabetes may have. If you have good (glucose) control, most people will be fine. If you don’t have good control, that’s when we worry,” says Castagna.
He reminds us that we all need additional insulin when we’re sick, due to the stress on the body. But generally, he says, “We don’t recommend any changes to people’s insulin management due to coronavirus — unless you are in respiratory distress. Then you should contact your doctor and get into a clinic as soon as possible.”
An expert weighs in
John Patton, one of the nation’s premier experts in inhalable medication science, is a veteran of the team that developed the world’s first inhalable insulin, Exubera, from Pfizer. He is a co-founder and now board member of Aerami, a start-up developing a new formulation of inhaled insulin (details below).
“That’s actually the most common safety question on inhaled insulin — what happens when you get cold or flu?” Patton tells Diabetes Mine. “Pfizer actually ran trials where they gave people rhinovirus to do testing. We did not find that episodic lung diseases or infections were cause for concern.”
Once that first inhalable insulin product was out on the market, “all kinds of people got the flu and there was never a serious adverse event associated with having the flu. Of course, we don’t know how many people reverted to injections when they were sick,” he says.
(Note that Exubera was pulled from the market in 2007, for business reasons having nothing to do with negative health outcomes.)
Patton makes a point of noting that when sick, you need to manage blood glucose carefully, to avoid going into diabetic ketoacidosis (DKA).
Whose lungs are at highest risk?
The people who appear to be at “enormous risk” of developing worst-case-scenario COVID-19 are smokers, whose lungs are filled with high loads of tar, Patton says.
Vaping is also suspected to make COVID-19 cases worse, although there is no solid data on this yet.
A gender gap is also emerging, where more men are being infected and dying of COVID-19 than women. One theory is that this is tied to significantly higher rates of smoking among men than women across the world. But the LA Times reports that other factors may be at play, such as a theory that the hormone estrogen may have “specific protective powers” against this virus.
Access to Afrezza should remain smooth
MannKind is also not expecting any product shortages due to the outbreak, despite the fact that they manufacture the product in Connecticut, which is currently 12th on the list of hardest-hit states.
“We have months of inventory on hand. We’re making another batch as we speak,” Castagna tells DiabetesMine. “We’re taking measures to secure safety, of workers and the product, at our factories.”
A company alert issued on March 25 reminds patients and doctors that “pharmacies can order additional supplies from wholesalers with expected delivery within 1-2 days, as usual.” They also note that patients can receive Afrezza by mail-order, and that many insurance companies are allowing 90-day refills during this time.
A healthy market for Afrezza?
The company has had difficulty gaining traction with Afrezza, because so many doctors and patients still just don’t know it’s an option, Castagna says. They currently have a user base of 6,000 to 7,000 individuals, half with type 1 diabetes and half with type 2. They don’t have specific stats on age groups but do know that 20 percent of their users are on Medicare, so presumed older; and 80 percent are on Medicaid or private insurance, which implies younger users.
Although they started out targeting type 2s, they’re now shifting almost 100 percent of their energy towards the type 1 market, a decision that was made in January 2020. Castagna points out that they now have 20 to 30 people on staff who live with type 1 diabetes themselves.
Basically, they want to prioritize their resources where they can have the most impact, he says. And people with type 1 are most keenly tuned in to achieving better time-in-range, fewer hypoglycemic episodes, and less sleep disruption. Data presented at the February 2020 ATTD international diabetes technology conference showed a 1.6 percent reduction in A1C and significant reduction of hypos using Afrezza versus injected insulins.
Castagna says they’re seeing increased demand for the product every week, “and we don’t anticipate any slowdown, other than the fact that people won’t be seeing their doctors in the coming weeks, so that will slow down prescriptions overall.”
They’re apparently achieving 70 percent approval on prior authorizations “within hours,” he says, as their CoverMyMeds program has been quite effective.
As far as COVID-19 concerns go, Castagna adds:” We’ve had zero calls as of last week from HCPs (healthcare providers) on this issue. But our reps are equipped to answer questions.”
“We don’t want people running around scared, saying, ‘I’ve got to get off my Afrezza.’ We don’t see any indication for that… A large majority of people will get COVID-19 but a large majority will not have symptoms strong enough to warrant a change in their insulin.”
If you use Afrezza and have questions, you can contact their Customer Service at 818-661-5047 or guide@mannkindcorp.com.
New inhalable insulin from Aerami
Aerami Therapeutics
We also connected with North Carolina-based Aerami Therapeutics (formerly Dance Pharmaceuticals), which is working on a next-generation inhalable insulin product.
Theirs is a fine mist aerosol formulation instead of a powder, delivered by their new inhaler device called AFINA. It will have built-in Bluetooth capability to track data and integrate with apps and platforms. The company has completed seven early stage trials to date and is now looking for a partner for their phase 3 study design with the Food and Drug Administration.
They are also working on an inhalable GLP-1 drug, which would be the first needle-free option for that type 2 diabetes drug.
About the new coronavirus, Aerami COO Timm Crowder says: “We’re seeing acute respiratory issues now with this virus which are pretty unique. It’s probably not something people have put a lot of thought into. Is this the new normal…?”
But he says their inhalable drug formulation should be perfectly safe and effective for those with “normal” cold and flu symptoms — perhaps even more so than Afrezza.
“Ours is a soft liquid, that’s shown no cough, and been very gentle on the lungs in trials. Our high peripheral deposition (HPD) insulin droplets go into the deepest part of the lungs. Even with congestion, you’re not typically going to see mucus in that part of the lung,” Crowder explains.
The AFINA inhaler is a small black square device outfitted with a light that blinks to alert the user as to how effective their inhalation technique is. It comes with a small dropper vial full of insulin mist, which has to be used to fill the inhaler before each mealtime (bolus-only) dose.
The big differentiators for this product are its precise delivery, those small droplets that go into the deep lungs, and “breath actuation,” meaning the ability to let users know how well they are absorbing the product, Crowder says.
“With our device, the aerosol droplets are only generated when the inhalation is in target range, shown by the flow sensor on the device — in other words, only when the patient inhales properly. If they’re not inhaling appropriately, the device will glow yellow, showing that no dose is being delivered. They either need to slow down or speed up their inhalation technique.”
“Also, our dosing is extremely targeted. We can control precisely where the droplets go,” he adds.
They’re not yet providing a projected launch date, and are still determining basics like whether a spirometry lung capacity test will be required to get a prescription for this inhaler (as is the case with Afrezza), or whether they will mainly target type 1 or type 2 diabetes. Human clinical trials will determine all that, Crowder says.
Despite the current worldwide respiratory virus crisis, the overall promise of inhalable medications to effectively treat conditions free of needles is huge, Crowder says.
Inhalable treatments for COVID-19?
It’s important to note that on March 17, Afrezza maker MannKind announced that the company will be shifting its pipeline to also work on three potential COVID-19 treatments with development partners. These aim to reduce replication of the virus in the lungs and delay the “inflammation cascade” that leads to acute respiratory distress syndrome. These will be in the form of dry powder inhalers that deliver the medication directly into the lungs.
Expert Patton, who is now also co-founder of iPharma, an “International Inhalation Center of Excellence” that helps develop and test new medical inhalation products, tells us that with the current COVID-19 pandemic, “people with ideas for therapies are coming out of the woodwork.”
Patton points to a paper just published by the University of California, San Francisco and international scientists listing 72 molecules that could have an impact on treating the novel coronavirus. (Among the substances listed is the diabetes drug metformin, we noticed.) Patton lauds this as “remarkable work” but cautions that this may lead to a potentially dangerous explosion of off-label use of these molecules: “People aren’t going to wait for clinical trials.”
Case in point: Just a few days ago, a man died in Arizona after self-medicating with what he thought was an experimental substance that could combat the new coronavirus that causes COVID-19.
Patton also notes that most of the ideas for new COVID-19 therapies are oral or injection prototypes, which could have toxic properties. “Ideally, they should be inhaled,” he says.
“Local lung delivery has always had extraordinarily strong potential. It offers targeted delivery, that can lower overall dose and raise the effect on the cells you want to target.”
A classic example is newer inhaled steroids used for asthma or COPD; he says. Oral or injected steroids can be quite toxic, especially in children. “They’re essentially going through the whole body. But with inhaled medications, you get targeted treatment, that only impacts the affected cells. It’s like with some drugs that can kill cancer, but they will also kill you,” Patton explains.
The benefits of inhaled steroids are enabling a high concentration of the drugs to reach only the impacted areas of the body, reducing adverse side effects and allowing for smaller, more effective dosing.
Patton is not alone in believing that inhalation devices can have a huge impact on improving healthcare.
But of course, with the cautionary note: “If you have irritated lungs or lungs that are sensitive, there’s just a physical irritation that happens with anything — even good things that are not toxic, like mother’s milk.”
The bottom line, according to Patton, is: “If you are really sick and coughing, you may not want to inhale anything.” But if your lungs are otherwise healthy, there’s no inherent danger in it
Call your primary care provider and discuss symptoms before visiting a healthcare facility or click below to find a local provider. If this is an emergency, call 911, and tell the operator you have COVID-19.
Experts have advice about how to clean your groceries.
Marco Bello/Anadolu Agency via Getty Images
The virus that causes COVID-19 can be viable for up to 72 hours on certain surfaces.
Taking extra care when handling your groceries can reduce your risk of exposure.
Experts say these simple steps can keep you safe.
The new coronavirus, SARS-CoV-2, has many people staying at home except for essential activities like seeking medical care, exercising, walking their dog, or shopping for groceries.
You can reduce your risk of exposure to COVID-19 whenever you leave your house by taking precautions such as practicing social distancing and washing your hands thoroughly and often.
Shopping for groceries, though, carries extra risk.
Not only are you near other people, but many of the products you’re buying have probably been handled by others — and possibly sneezed or coughed on.
This doesn’t mean you should give up on trips to the supermarket. That’s not really a viable option for most of us.
But you can take a little extra care when handling your groceries to avoid spreading the virus to other people and surfaces in your house.
How big of a risk are groceries?
Charlotte Baker, DrPH, MPH, an assistant professor of epidemiology at Virginia-Maryland College of Veterinary Medicine in Blacksburg, Virginia, said your biggest risk at the supermarket is coming into close contact with another person who’s sick.
That’s why it’s important to stay at least 6 feet from other people at all times.
“Do not be afraid to ask others to step back if they are too close to you in line,” said Baker. “Or wait a few moments to grab something if others are already by the item you want.”
It’s not clear, though, how much of a role produce and food packaging plays in transmitting the virus that causes COVID-19.
Still, the World Health OrganizationTrusted Source says that in addition to close person-to-person contact, people can pick up the virus by touching contaminated surfaces and then touching their eyes, nose, or mouth.
Some surfaces may pose a bigger risk than others.
A recent study in the New England Journal of Medicine found that the virus was detectable on plastic and stainless steel for up to 72 hours, and on cardboard for up to 24 hours.
Baker said when you’re at the supermarket, you should “assume all surfaces everywhere have been touched by someone who is sick.”
This includes produce and packaged foods.
“Touch just the items you intend to buy, wipe down the cart or basket handles with disinfectant wipes, and wash your hands or use hand sanitizer when you’re done,” she said.
Baker added that many people are also reducing their potential exposure by using curbside pick-up or at-home delivery. Even local food producers are offering these services.
“Some farmers markets are allowing customers to preorder foods so they are already packaged when you come pick them up,” she said, “reducing the amount of time that you need to be near other people and reducing the amount of items that you can touch.”
Cleaning your groceries at home
Whichever way you get your groceries, you’ll want to handle them carefully when you get them home. This will reduce the chance of spreading the virus to other people or surfaces in your house.
Elizabeth L. Andress, PhD, a professor of foods and nutrition at the University of Georgia, said at the very least you should wash your hands after unpacking and putting away your groceries.
If you’re concerned about potential contamination on your groceries, you can take additional steps to protect yourself.
“Some people may choose to wipe or wash cans and boxes of food before storing them to reduce possible virus content,” said Andress. You can also throw out disposable packaging.
When you’re done, she suggests that you wash any tables, countertops, or other surfaces that were touched by your groceries or grocery bags.
And wash your hands again.
The Centers for Disease Control and Prevention (CDC) offers advice for cleaning and disinfecting your homeTrusted Source during the pandemic, including which cleaners work best against SARS-CoV-2.
If you’re using cloth bags, wash them with laundry soap in a washing machine and dry them thoroughly before reusing them.
Cleaning food like a surgeon
If you or someone in your household is at higher risk for severe illnessTrusted Source from COVID-19, you might want to adopt the modified “sterile technique” recommended by Dr. Jeffrey VanWingen, a family physician practicing in Grand Rapids, Michigan, in this YouTube video.
VanWingen said that one option is to leave your groceries in your garage or porch for at least 72 hours to allow the virus to become inactive.
This isn’t possible for many people. For them, he suggests the “sterile technique.” You can also do this after letting your groceries sit outside for 72 hours.
A key part of VanWingen’s method is setting up a cleaning station to avoid contaminating your food or other surfaces in your house.
After that, it involves wiping down all packaging with a disinfectant before putting your groceries away. You can also discard packaging and transfer the food to a clean bag or container.
For fruits and vegetables, VanWingen suggests scrubbing them for at least 20 seconds with soap and water.
“If someone in your household is confirmed positive with COVID-19, showing symptoms of the disease, or awaiting the results of a test, they should take extra cleaning and disinfection steps around the home,” said Andress.
During the COVID-19 crisis, it’s important to take steps to keep your immune system in tip-top shape. Your body is designed to keep you well. Just give your body what it needs, and it will work non stop to keep you healthy, no matter what illness you may face. Your best chance at keeping the coronavirus at bay is to give your immune system a big BOOST. With this in mind, here are 6 foods that support a healthy immune system. 1. Citrus Fruits Your mother always told you to take vitamin C when you felt a cold coming on. She was right. Vitamin C helps boost the immune system by increasing the production of white blood cells. Citrus fruits to consider: grapefruit oranges tangerines lemons limes clementines Unlike other animals, our bodies don’t produce vitamin C, so we must get it from our diet. Try to eat more vitamin C-rich fruits in the coming days and weeks. 2. Red Bell Peppers If you’ve never been a fan of citrus fruits, you’re still in luck, because some vegetables have even higher amounts of vitamin C. Bell peppers contain twice as much C ounce for ounce than an orange. They are also a rich source of beta carotene, which will help keep your eyes and skin healthy. 3. Broccoli Your mother may have also told you to “eat your broccoli.” That’s because it is one of the healthiest vegetables you can eat. It’s loaded with vitamins C, A and E, plus many potent antioxidants. To get all of those beneficial nutrients, however, be sure to cook your broccoli lightly or not at all. 4. Garlic Garlic adds delicious flavor to many cuisines from around the world. And thanks to its high sulfur-containing compounds (that’s what gives it its pungent odor), it gives your immune system a nice boost. 5. Spinach Another vitamin C-rich food, spinach is also packed with numerous antioxidants and beta carotene, which may increase the infection-fighting ability of our immune systems. Like broccoli, it’s best to cook spinach as little as possible to get these health benefits. Consider eating fresh spinach salads or tossing some spinach into your citrus fruit smoothie! 6. Shellfish Did your mother make chicken soup when you were sick? Sure, but shellfish? And yet, some types of shellfish are loaded with immune-supporting zinc. And while zinc doesn’t get as much attention as vitamin C and others, our bodies require it so that our immune cells can function as intended. Consider adding more… crab clams lobster mussels … to your diet to keep your immune system in tip-top shape.
While it’s well known that the elderly and those with compromised respiratory systems are at a greater risk of contracting and dying from coronavirus, less discussed is the fact that obesity and diabetes can also make people more susceptible.
“Patients with diabetes are more susceptible to severe complications from viral infections of any kind, and as a result, are considered a high-risk population for COVID-19,” says Rocio Salas-Whalen, MD, of New York Endocrinology. “Due to the pathophysiology of diabetes, patients can take longer to heal, putting them at risk for developing complications from the virus. This is true with any type of infection in diabetes.”
The word “pandemic” stems from the Greek words “pan” (meaning “all”) and “demos” (meaning “people”). Thus, a pandemic is a widespread infectious disease, bacteria, or virus that sickens a large number of people worldwide. When a disease or illness is isolated to one region or country, it’s called an “epidemic.”
Throughout history, humans have experienced a number of pandemics, some of which have killed tens of millions of people. These pandemics include cholera, smallpox, measles, yellow fever, tuberculosis, malaria, and Ebola.
One of the most devastating and well-known pandemics is the Black Death, also known as the Plague, which swept across Europe and Asia during the mid-1300s. It’s estimated that the Plague killed 30% to 60% of Europe’s population or 75 million to 200 million people.
The influenza virus has been the cause of many pandemics. In 1918, a strain of the virus called the “Spanish flu” swept the world. The Centers for Disease Control (CDC) estimates that this virus sickened up to one-third of the world’s population (around 500 million people) and killed more than 50 million people. Some died within hours of symptom onset.
The 2019 – 2020 Coronavirus Outbreak
The World Health Organization (WHO) first learned of the 2019 to 2020 coronavirus outbreak on Dec. 31, 2019. According to NPR, experts believe the virus, named COVID-19, originated in the Hunan Seafood Market, a live-animal market in the Chinese city of Wuhan.
Coronaviruses are a family of viruses that cause a range of illnesses, from the common cold to severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). The coronavirus family is zoonotic, which means they can spread between animals and humans through close contact. The CDC reports that they also spread in similar ways. Infected people transmit MERS and SARS through the air by coughing or sneezing.
And according to experts interviewed by The New York Times, the current outbreak is increasingly likely to become a global pandemic. It’s easily transmissible through the air, and cases are spiking rapidly, especially in China, where testing kits are in short supply and there’s a backlog in hospitals and labs.
How the Coronavirus Spreads
Much is still unknown about exactly how the new coronavirus spreads and how quickly it infects others.
The CDC states that the virus spreads by respiratory droplets produced when a person coughs or sneezes. Transmission is similar to other coronaviruses, such as SARS and MERS, and the CDC believes that COVID-19 spreads as easily as the common flu virus.
Some important questions, such as whether or not a person can infect others when they show no symptoms (called “asymptomatic”), remain unanswered. However, a 2020 study published in the New England Journal of Medicine states asymptomatic transmission can occur.
Coronavirus Symptoms
COVID-19 presents a serious global public health threat and can be fatal.
The CDC believes symptoms of COVID-19 can manifest between two and 14 days after initial exposure, based both on early data and the incubation period for SARS and MERS. Symptoms for the current novel coronavirus include:
Fever
Shortness of breath
Cough
So far, people who are most at risk of developing severe complications from the novel coronavirus are the elderly and those with preexisting medical conditions like diabetes and heart disease.
Overall, the WHO estimates that the mortality rate for COVID-19 is between 2% and 3%, although that could change as the situation develops. That’s much lower than SARS, which the WHO estimates has a mortality rate of around 9.6%, and MERS, which the WHO estimates has a 34.4% mortality rate.
How to Protect Yourself From the Coronavirus
The WHO and CDC recommend you take simple steps to keep yourself and your family safe and healthy during the outbreak.
Wash your hands with soap and water for at least 20 seconds whenever you return home, after coughing or sneezing, after caring for the sick, before eating, after using the toilet, and after handling animals or animal waste.
When coughing or sneezing, use the crook of your arm to cover your mouth or use a tissue. Throw the tissue in a closed bin, and then wash your hands.
Avoid touching your eyes, nose, and mouth with unwashed hands.
Avoid close contact with people who are sick. The CDC believes the virus can spread within 6 feet, so keep at least that much distance between yourself and someone showing symptoms.
Clean and disinfect frequently touched objects and surfaces.
Follow the same guidelines for preventing other illnesses, such as the common cold and seasonal flu virus.
Pro tip: If you’re planning on traveling over the next few months, you might consider an insurance policy through Allianz Travel Insurance.
Finding Trustworthy Information on the Current Outbreak
There is plenty of misinformation online. False information quickly fuels panic and can lead to fear and hoarding behaviors, such as stockpiling face masks and food, that do more harm than good. At its worst, hoarding can lead to shortages that put medical staff at risk, such as a shortage of medical supplies.
The best way to get trustworthy, up-to-date information on the current outbreak is through the WHO’s situation reports, which they publish daily. The WHO also has a “myth busters” page where it uses scientific information to debunk ongoing myths and hoaxes about the virus.
You can also get reliable information about the outbreak occurring in the United States from the CDC.
It’s prudent to stay informed about any new outbreak. However, while media reports on the new coronavirus look and sound frightening, it’s essential to put the outbreak in perspective. For example, the CDC reports that so far this season, between October 2019 and January 2020, the seasonal flu has sickened over 19 million people in the United States, killed over 10,000 people domestically, and led to over 180,000 hospitalizations. We’re at a much higher risk of catching the flu than the new coronavirus.
How to Prepare for a Pandemic
According to Harvard Business Review, current models suggest that a pandemic might sweep the globe in three distinct waves, each lasting from a few weeks up to three months. This means that you and your family should be able to survive on your own, at home, for a significant amount of time if you have to.
Preparing for a pandemic is an important part of disaster planning and requires many of the same steps. However, there are some additional precautions you need to take in order to keep your family safe.
Pro tip: If you don’t currently have health insurance, make sure you sign up for a short-term health plan through AgileHealthInsurance. This will make sure you’re protected financially if someone in your family gets sick.
1. Be Prepared to Treat at Home
Healthcare workers will face an ethical and moral dilemma during a pandemic. Do they report to work and help care for the sick, putting themselves (and their families) at risk for infection, or do they stay home and help ensure their loved ones don’t fall ill?
According to a survey conducted by CIDRAP, almost half of healthcare workers admit that they would stay home during a pandemic. Another study, published in the journal BMC Public Health, found that 28% of healthcare professionals agree it would be acceptable to abandon their workplace during a pandemic in order to protect themselves and their families.
Even if only 10% of healthcare professionals opt to stay home during a pandemic, and another 10% fall ill themselves, that’s still a conservative 20% reduction in the medical labor force at a time when hospitals and doctor’s offices will be flooded with patients. There’s a chance that some patients won’t be able to get in to see a doctor at all.
Medication could also be hard to obtain. According to a 2006 study conducted by the Harvard School of Public Health, 43% of people believe they would have difficulty obtaining medicine should they have to stay home during an epidemic. During the 2017-2018 flu season, which turned out to be only slightly more severe than normal, the LA Times reported that pharmacies in California had medicine shortages.
Supply disruption is also a real possibility during a pandemic. In order to save on storage space and costs, most hospitals and pharmacies only keep enough medicine on hand for a few days, depending on daily deliveries to keep their supplies stocked. In addition, many life-saving medicines are now made in Asia. If a pandemic occurs, there’s a good chance that deliveries will be interrupted or halted entirely. Stores are also likely to sell out of over-the-counter medication quickly.
Stocking up now means you’ll already have what you need should a pandemic occur, and you’ll be less likely to have to leave the house for supplies, potentially exposing yourself to the virus. Consider stocking up on over-the-counter medication like:
Over-the-counter medication can be expensive, especially when you’re trying to buy it in large amounts. To save money, look for sales and coupons and only buy what you need when the price is discounted. Make sure to keep your medication rotated so it doesn’t expire by checking expiration dates every few months.
You should also have a well-stocked first aid kit in your home and know how to administer emergency first aid like stopping traumatic bleeding and administering CPR. Remember, during a pandemic, hospitals will be overcrowded, and an ambulance might not be available to take you or your family member to a hospital should you break a leg or have a heart attack, so you should be prepared to deal with these emergencies yourself. Knowing first aid is an important survival skill and could save the life of someone in your family.
Also, consider stocking up on face respirators so you’re protected if you do have to go out in public. The U.S. Food and Drug Administration recommends using an N95 respirator during public health emergencies, which you can purchase inexpensively on Amazon. The “N95” designation means that the respirator blocks 95% of tiny (0.3-micron) airborne particles.
Keep in mind that a good fit is important for adequate protection, and N95 respirators are designed for adults, not children. You will need to purchase child-sized respirators (which you can also find on Amazon) to protect your children during an outbreak.
2. Plan for a Sick Room
The CDC recommends that during a pandemic, the sick should stay in a dedicated “sick room” and use a dedicated bathroom that no one else will use.
Start thinking now about which room in your home would work best as a sick room. If the room doesn’t have a door, have an extra plastic shower curtain on hand to partition it from the rest of the house. If someone does fall ill, quarantine them to the sick room and clean the room daily with bleach.
3. Stock Up On Food, Water, & Household Supplies
The Department of Homeland Security recommends that families have at least a two-week supply of water and food to prepare for a pandemic. Supplies for a month or more are even better. Typically, you’ll need one gallon of water per person, per day, for drinking and hygiene.
Building a long-term food storage pantry means you won’t have to put yourself at risk of infection by going to the store, and you’ll be insulated from the food shortages that could very well occur during the panic of a pandemic.
So, what should you stock up on? Focus on shelf-stable foods that your family already eats and enjoys. This might include:
Rice
Dried beans, lentils, or peas
Protein bars, granola bars, or fruit bars
Canned soups, fruit, and vegetables
Peanut butter and jelly
Coffee, tea, and hot chocolate
Powdered drink mixes
Nuts and dried fruits
Beef jerky
Pasta
Instant soup mixes
Flour
Baking essentials (such as baking soda, salt, and yeast)
Sugar
Pickled vegetables
Dried milk
Evaporated or condensed milk
Trail mix
Applesauce
Comfort food (such as cookies, candy bars, and chocolate)
Oils (such as olive oil, vegetable oil, and coconut oil)
Crackers
Oats
Pancake mix
Cereal (including hot cereals like Cream of Wheat)
Chicken, beef, and vegetable bouillon cubes
Liquid seasonings (such as soy sauce, vinegar, and Sriracha)
Liquid sweeteners (such as honey, maple syrup, chocolate syrup, and agave syrup)
Spices (such as salt, onion flakes, cinnamon, and ginger)
Packaged foods (including macaroni and cheese and instant potatoes)
Canned meats (such as tuna, sardines, oysters, chicken, turkey, pork, sausage, and Spam)
Formula or baby food (for very young children)
You should also stock up on the supplies you’ll need to stay healthy at home. These items include:
Hand soap and sanitizer
Bleach or other surface cleaners
Toilet paper
Kleenex
Prescription medication
Fluids with electrolytes (like Gatorade and Pedialyte)
Garbage bags (for medical waste disposal)
Plastic gloves
Diapers (for very small children)
Again, it can get expensive if you hit the stores to stock up on all of these items at once. Instead, purchase items slowly, over time, and only when they go on sale or you have a coupon. Don’t forget to stock up on food and supplies for your pets too.
Pro tip: Make sure you download the Ibotta app before shopping for food and supplies. You will receive a $20 welcome bonus just for downloading and using the app.
Although the chance of an outage is remote, it is possible that utilities and power supplies might be interrupted or stop entirely if a large portion of the working population falls ill or has to stay home to care for sick family members. Have enough supplies to survive without power for several days or weeks, including flashlights, lanterns, a hand-crank or solar-powered radio, and the ability to cook food without electricity, such as with a solar oven cooker.
4. Make an Emergency Plan
If a pandemic is suspected, the CDC reports that it’s likely schools will close early to prevent the spread of the disease – and they could be closed for weeks or even months. How would you care for your children if you were still expected to report for work? Under what circumstances would you stop attending work in order to protect yourself and your family from illness? Do you have enough in savings to stop working for a period of time if necessary?
It’s important to ask yourself these questions before a pandemic occurs. With a plan in place, you won’t have to worry about what you’re going to do if the worst should happen.
Start thinking now about who might be able to care for your children during such an emergency. Consider other family members, friends, neighbors, or members of the community. Talk to these people beforehand to find out how you could help each other during a pandemic.
Next, find out how your company might handle work absences during a pandemic. Do you have the ability to telecommute? If not, what would you need to get started?
You should also make a list of community organizations you can contact to receive help in the form of information, medical assistance, food, and other supplies. A good place to start is the Red Cross. You might also want to talk to local officials about how they would distribute emergency assistance in your community during a pandemic.
Last, make sure you have enough in your emergency fund to survive for a period of time without a regular income.
Pro tip: If you don’t currently have an emergency fund set up, start now. Ideally, you want to have enough money to cover several month’s worth of expenses but start at $1,000. Place these funds in a high-yield savings account or somewhere like Bask Bank where you can earn valuable travel rewards. This way you’ll have easy access to the money if needed.
5. Explore Natural & Herbal Medicines
While it’s important to have over-the-counter medications on hand to treat symptoms, it’s just as important to have an herbal medicine kit in your home to complement commercial medicine. Some herbal remedies are a great frugal flu treatment and can even be more effective than store-bought medicine.
Herbs such as elderberry and oregano oil are very effective in preventing illness, as well as lessening the severity and length of an illness once it starts. They’re also great natural remedies to keep your kids healthy during a prolonged illness.
6. Practice Prevention Now
Several simple actions can dramatically reduce your risk of catching (and spreading) an infectious disease. The CDC recommends that you:
Wash your hands for at least 20 seconds with hot soapy water whenever you come back from any public place or have been around anyone who is sick.
Keep your hands away from your face, particularly your eyes, nose, and mouth.
Cover your coughs and sneezes with a tissue.
Stay home when you’re sick, and don’t go out until you’ve been fever-free for 24 hours without the use of fever-reducing medications.
Clean frequently touched surfaces and objects.
Start practicing these actions with your family today, especially if you have younger children. If you get into these habits now, they’ll be second-nature to you should a pandemic occur, reducing the risk that someone in your family will get sick.
Final Word
It can be frightening to think about experiencing a severe pandemic. Plenty of movies like “Contagion” and “Outbreak” play on these fears and show us, in terrifying detail, what it might be like if a pandemic ever became a reality. Preparing in advance is one way to alleviate some of these fears.
If you have the ability to take care of your family at home for a significant period of time, you won’t have to worry about going to the store and exposing yourself to the virus. You also won’t have to worry as much about packed waiting rooms at the doctor’s office or hospital. The more you prepare now, the more in-control you’ll be should the worst occur.
Do you have enough supplies to care for your family at home during a pandemic? What areas do you need to work in order to be prepared?
People with diabetes are not more likely to get COVID-19 than the general population.
The problem people with diabetes face is primarily a problem of worse outcomes, not greater chance of contracting the virus. In China, where most cases have occurred so far, people with diabetes had much higher rates of serious complications and death than people without diabetes—and generally we believe that the more health conditions someone has (for example, diabetes and heart disease), the higher their chance of getting serious complications from COVID-19. We expect the death rate to decline over time as we get better at detecting and treating this specific virus.
People with diabetes do face a higher chance of experiencing serious complications from COVID-19.
In general, people with diabetes are more likely to experience severe symptoms and complications when infected with a virus.If diabetes is well-managed, the risk of getting severely sick from COVID-19 is about the same as the general population.
When people with diabetes do not manage their diabetes well and experience fluctuating blood sugars, they are generally at risk for a number of diabetes-related complications. Having heart disease or other complications in addition to diabetes could worsen the chance of getting seriously ill from COVID-19, like other viral infections, because your body’s ability to fight off an infection is compromised.
Viral infections can also increase inflammation, or internal swelling, in people with diabetes. This is also caused by above-target blood sugars, and both could contribute to more severe complications.
When sick with a viral infection, people with diabetes do face an increased risk of DKA (diabetic ketoacidosis), commonly experienced by people with type 1 diabetes. DKA can make it challenging to manage your fluid intake and electrolyte levels—which is important in managing sepsis. Sepsis and septic shock are some of the more serious complications that some people with COVID-19 have experienced.
COVID-19 is different from the seasonal flu.
COVID-19 is proving to be a more serious illness than seasonal flu in everyone, including people with diabetes. All of the standard precautions to avoid infection that have been widely reported are even more important when dealing with this virus.
Recommended safety precautions are the same as for flu, such as frequent hand washing and covering coughs and sneezes with a tissue or your elbow. The CDC does not recommend the use of face masks by people who are not infected.
We encourage people with diabetes to follow the guidance of the CDC and to review how you manage sick days—preparing for a sick day can make it easier.
The risks are similar for people with type 1 and type 2 diabetes.
In general, we don’t know of any reason to think COVID-19 will pose a difference in risk between type 1 and type 2 diabetes. More important is that people with either type of diabetes vary in their age, complications and how well they have been managing their diabetes.
People who already have diabetes-related health problems are likely to have worse outcomes if they contract COVID-19 than people with diabetes who are otherwise healthy, whichever type of diabetes they have.
Manufacturers are not reporting that COVID-19 is impacting access to insulin and other supplies.
Leading manufacturers are reporting that COVID-19 is not having an impact on their current manufacturing and distribution capabilities for insulin and other supplies at this time. We are continuing to monitor the situation and will provide updates should anything change. If you are struggling to pay for insulin or know someone who is, the ADA has resources to help—visit InsulinHelp.org.
If COVID-19 is spreading in your community, take extra measures to put distance between yourself and other people to further reduce your risk of being exposed to this new virus. Stay home as much as possible.
Before you get sick, make a plan:
Gather your supplies:
Phone numbers of your doctors and healthcare team, your pharmacy and your insurance provider
List of medications and doses (including vitamins and supplements)
Simple carbs like regular soda, honey, jam, Jell-O, hard candies or popsicles to help keep your blood sugar up if you are at risk for lows and too ill to eat
If a state of emergency is declared, get extra refills on your prescriptions so you do not have to leave the house
If you can’t get to the pharmacy, find out about having your medications delivered
Always have enough insulin for the week ahead, in case you get sick or cannot refill
If you are struggling to pay for insulin or know someone who is, the ADA has resources to help—visit InsulinHelp.org
Extra supplies like rubbing alcohol and soap to wash your hands
Glucagon and ketone strips, in case of lows and highs
Have enough household items and groceries on hand so that you will be prepared to stay at home for a period of time
Talk to your health care team about the following:
When to call your doctor’s office (for ketones, changes in food intake, medication adjustments, etc.)
How often to check your blood sugar
When to check for ketones
Medications you should use for colds, flu, virus, and infections
Any changes to your diabetes medications when you are sick
Take everyday precautions:
Avoid close contact with people who are sick
Take preventive actions:
Clean your hands often
Wash your hands often with soap and water for at least 20 seconds, especially after blowing your nose, coughing, or sneezing, or having been in a public place.
If soap and water are not available, use a hand sanitizer that contains at least 60% alcohol.
To the extent possible, avoid touching high-touch surfaces in public places–elevator buttons, door handles, handrails, handshaking with people, etc. Use a tissue or your sleeve to cover your hand or finger if you must touch something.
Wash your hands after touching surfaces in public places.
Avoid touching your face, nose, eyes, etc.
Clean and disinfect your home to remove germs: practice routine cleaning of frequently touched surfaces (for example: tables, doorknobs, light switches, handles, desks, toilets, faucets, sinks & cell phones)
Avoid crowds, especially in poorly ventilated spaces. Your risk of exposure to respiratory viruses like COVID-19 may increase in crowded, closed-in settings with little air circulation if there are people in the crowd who are sick.
Avoid all non-essential travel including plane trips, and especially avoid embarking on cruise ships.
Watch for emergency warning signs:
If you develop emergency warning signs for COVID-19 get medical attention immediately. In adults, emergency warning signs include:
Difficulty breathing or shortness of breath
Persistent pain or pressure in the chest
New confusion or inability to arouse
Bluish lips or face
If you feel like you are developing symptoms, call your doctor:
Pay attention for potential COVID-19 symptoms including fever, dry cough and shortness of breath. If you feel like you are developing symptoms, call your doctor.
When you call:
Have your glucose reading available
Have your ketone reading available
Keep track of your fluid consumption (you can use a 1-liter water bottle) and report
Be clear on your symptoms (for example: are you nauseated? Just a stuffy nose?)
Ask your questions on how to manage your diabetes
If you do get sick, know what to do:
Here are some common tips, which may vary for each person:
Drink lots of fluids. If you’re having trouble keeping water down, have small sips every 15 minutes or so throughout the day to avoid dehydration.
If you are experiencing a low (blood sugar below 70 mg/dl or your target range), eat 15 grams of simple carbs that are easy to digest like honey, jam, Jell-O, hard candy, popsicles, juice or regular soda, and re-check your blood sugar in 15 minutes to make sure your levels are rising. Check your blood sugar extra times throughout the day and night (generally, every 2-3 hours; if using a CGM, monitor frequently).
If your blood sugar has registered high (BG greater than 240mg/dl) more than 2 times in a row, check for ketones to avoid DKA.
Call your doctor’s office immediately, if you have medium or large ketones (and if instructed to with trace or small ketones).
Be aware that some CGM sensors (Dexcom G5, Medtronic Enlite, and Guardian) are impacted by Acetaminophen (Tylenol). Check with finger sticks to ensure accuracy.
Wash your hands and clean your injection/infusion and finger-stick sites with soap and water or rubbing alcohol.
Know your rights:
A reminder: If you have diabetes, you have legal rights that do not go away during a health crisis like COVID-19.
Your child’s Section 504 Plan should include accommodation for extra sick days without penalty. This would apply if your child is sick or if you choose to keep him or her home from school to avoid contagion with COVID-19.
People with diabetes who are incarcerated or in police custody are entitled to appropriate and adequate medical care, and their medical needs may change during infectious disease outbreaks.
If you are concerned you are being treated unfairly because of your diabetes, contact us to seek help from our Legal Advocacy team.
For more information, please call 1-800-DIABETES (800-342-2383).Related pagesPlanning for Sick Days
The Coronavirus (CoV) is a large virus family with 7 known types.
Coronavirus got its name from the Latin word corona which means ‘crown’ or ‘halo.’
As a zoonotic virus, CoV can be transmitted among animals and people.
Coronavirus infections are rampant in the fall or winter seasons.
For now, the only treatment options for CoV patients are supportive care and symptom relief
From the 1960s, the identification of CoV is under human pathogens.
Coronaviruses in humans affect upper respiratory cells and gastrointestinal tract cells.
Around ⅓ of common cold cases traces its causes to coronaviruses.
Agricultural records showed that some CoVs also infected birds, cats, cattle, dogs, pigs, and rodents.
As per investigations, civet cats appeared to have transmitted SARS-CoV to humans.
Dromedary camels were the culprits of MERS-CoV transmission to humans.
Usually, general symptoms surface 2-14 days post-exposure.
To this date, vaccines for coronavirus protection are still not available.
As of February 3, 2020, the new nCoV has already killed over 360 people in China.
More than 17,000 patients suffer from the nCoV in over 25 countries.
A new strain called Novel Coronavirus (nCoV) has just been recently found in humans.
SARS-CoV, MERS-CoV, and nCoV are the human CoVs known to spread through contact from infected animals to humans.
In March 2003, the SARS-CoV was officially diagnosed as a global threat.
One known vital driver of SARS and MERS epidemiology is a nosocomial transmission
.
As of February 3, 2020, the source of infection of the nCoV is still unknown.
The most prominent symptoms of coronaviruses are respiratory symptoms.
Alongside it is breathing difficulties, cough, fever, and shortness of breath. However, severe cases could eventually lead to pneumonia, kidney failure, severe acute respiratory syndrome, and worst, death.
Respiratory droplets carry human coronaviruses from an infected person to people nearby.
By coughing or sneezing, an infected person could transmit the disease via close personal contact. Another way is when a person touched a contaminated object or surface and then touched the eyes or mouth afterward.
Image by Luisella Planeta Leoni from Pixabay
It is advisable to avoid close contact with people who are showing symptoms.
Other preventive measures that you can do are covering your mouth and nose when sneezing and coughing, properly cooking eggs and meat, and washing your hands regularly.
Diagnosis of coronavirus infections requires special laboratory tests.
These tests involve blood or respiratory samples and are more ideal for people with severe symptoms. In cases of infection from uncommon CoV strains like MERS, the tests should also be recommended.
The Coronaviridae family has a subfamily named Orthocorinavirinae.
Further, this subfamily has four CoV genera classifications namely Alpha-, Beta-, Delta-, and Gammacoronavirus.
4 out of the 7 CoV types cause respiratory infection.
The KHU1, 229E, OC43, and NL63 are more common than you might think. Their effects could range from mild to moderate infections like that of the common cold.
2 out of the 7 CoV types can cause severe respiratory infections.
These are the Severe Acute Respiratory Syndrome coronavirus or SARS-CoV, and the Middle East Respiratory Syndrome coronavirus or the MERS-CoV.
The discovery of the 7th type was not until 2019.
The Novel Coronavirus or 2019-nCoV first appeared in Wuhan of Hubei Province in China. Until now, public health officials are still figuring out the recently discovered coronavirus and its corresponding infection.
SARS-CoV surfaced in China back in 2002.
The SARS-causing virus immediately spread to over 24 countries in Asia, Europe, North and South America. Thankfully, SARS cases dwindled until there are no longer reported cases from all over the world since 2004.
SARS-CoV most likely originated from bats.
Image by Salmar from Pixabay
However, it spread to Chinese ferret badgers, Himalayan palm civets, and raccoon dogs at the Guangdong wet markets. Handlers or consumers got infected as well, further spreading the virus via human-to-human transmission.
Bats reportedly contain a broad range of coronaviruses.
It is crucial in the evolution of viruses, particularly the alpha- and betacoronavirus lineages. Still, there are other animal species that serve as intermediate hosts and animal reservoirs.
MERS-CoV cases trace back to residence or travels in and near the Arabian Peninsula.
First discovered in 2012, this type of coronavirus infection recorded around 2,500 infected people.
The main source for MERS-CoV was dromedary camels.
These virus animal reservoirs served as the intermediate host source for human infections of the same strain. For MERS, there have been no documented human-to-human transmission or community outbreaks apart from close contacts.
Image by Wolfgang_Hasselmann from Pixabay
The majority of MERS-CoV cases sprung from human-to-human infections in healthcare settings.
Whether the transmission is airborne, ingestion or via droplet, the accurate routes are still unclear apart from close contact. Zoonotic infections reportedly came from the consumption of raw camel milk and other camel products.
MERS-CoV could thrive on plastic and metal surfaces for up to 48 hours.
It represents the universal environmental conditions in indoor spaces like a hospital ward, especially when at 20°C and 40% relative humidity. Also, bacterial culture from air and surfaces show that MERS could survive on surfaces even several days past contact with an infected patient.
The coronaviruses are sensitive to heat.
Ultraviolet light, non-ionic detergents, liquid solvents, and oxidizing agents also affect the virions adversely. Moreover, higher temperatures or increased levels of relative humidity also decrease viability.
The H5N1 or bird flu is another type of virus that humans acquire from animals.
As the name suggests, the bird flu is an influenza virus that causes severe respiratory disease in birds. The ‘avian influenza,’ as it is also called, is highly infectious. Occasional human bird flu cases occur, but the human-to-human transmission of the infection is difficult.
Image by Bernd Focken from Pixabay
The U.S. government issued a traffic advisory at level 4 for the 2019-nCoV.
The World Health Organization declared the outbreak a public health emergency and an international concern. Hence, government officials advised residents not to travel to China.
Airlines from all over the world imposed a travel ban in an attempt to contain the spread of the 2019-nCoV from Wuhan.
Asian, European, and North American airlines canceled flights to China. Some of the institutions on the list are Air Asia, Air India, American Airlines, British Airways, Cathay Pacific, Finnair, IndiGo, Lufthansa, and United Airlines. While some either minimized or stopped flying to China entirely, others offered refunds to customers.
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