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  • Coronavirus Reports: What We Know, and What We Don't

    Every day there are new developments in the spread of coronavirus — also known as COVID-19 — but there are also debates among experts on how the disease is spread and its impact on people who become infected. While overall risk of catching the disease is low, health care professionals are at higher risk. APTA reminds PTs and PTAs to follow precautions for reducing the spread of infectious diseases — an important aspect of health care to be mindful of at all times, not just during periods of high risk.

    Since the disease first appeared in Wuhan, China, in December 2019, it has affected over 92,000 people in more than 70 countries on every continent. As of the afternoon of March 3, the Johns Hopkins University coronavirus tracker registered 108 COVID-19 cases in the United States, including six deaths.

    Note: at this time all APTA national events are continuing as scheduled. Contact APTA member services if you have questions related to attendance of an upcoming event.

    As with all public health situations, we primarily rely on the Centers for Disease Control and Prevention, the Occupational Health and Safety Administration, and the U.S. Office of the Surgeon General for the best information and preventive strategies.

    Here is a roundup of what is being reported by public health and infectious disease experts:

    The World Health Organization says risk of global spread "very high." (Bloomberg)
    On Monday, March 2, WHO increased its warning of global spread and impact risk from "high" to "very high." In response to the disease's spread, many countries have tightened border controls, restricted flights, shut down schools, and cancelled large events. (The CDC provides a travel update webpage.)

    The average infected patient spreads the virus to 2.2 others. (NEJM)
    Researchers in China estimate that on average individuals with COVID-19 have been spreading the illness to at least 2 people, compared with 3 with SARS. Authors write, "Measures to prevent or reduce transmission should be implemented in populations at risk." According to the CDC, among travel-related U.S. cases there has been "no sustained person-to-person transmission" of symptomatic COVID-19.

    The mortality rate is estimated around 3.4%, but some say it may be less than that. (Reuters)
    While the current mortality rate from COVID-19 is approximately 3.4%, some experts say that the mortality rate could be much lower because many carriers with mild or no symptoms may not be identified.

    Experts are unsure why some recovered patients appear to become reinfected. (Reuters)
    In confirmed cases in Japan and China, some recovered patients have again tested positive for COVID-19 but were not contagious. Experts are uncertain whether these are new infections. People could become reinfected because they didn't build up enough antibodies while they were infected the first time, but it's also possible that the virus could lie dormant and symptoms could reappear again later.

    Debate still is under way about transmission via hard surfaces. (Reuters)
    While experts agree that the virus is mainly transmitted by respiratory droplets in the air — coughing or sneezing on a person — research is ongoing on whether hard surfaces are a significant route of transmission. CDC Director Robert Redfield told Congress, "On copper and steel it's pretty typical, it's pretty much about two hours, but I will say on other surfaces — cardboard or plastic — it's longer, and so we are looking at this." (WHO recommends disinfecting any hard surfaces.)

    The Surgeon General discourages masks for non-health care providers. (CNN Health)
    U.S. Surgeon General Jerome Adams, MD, MPH, asks the public to stop buying face masks to prevent COVID-19 infection. According to Adams, it results in a shortage for the health care providers who need them, and people who wear them incorrectly could actually increase their chance of being infected.

    To keep abreast of evidence-based news on COVID-19, here a few free reputable sources:

    A Space Odyssey: Architects and PTs Talk Clinic Design

    When architect Maryam Katouzian says "one size does not fit all" in terms of physical therapy clinics, Lauren Lobert, PT, DPT, likely couldn't agree more. Katouzian is part of the architectural team that designed the Ivy Mountain Musculoskeletal Center, a 194,000-square-foot facility for the University of Virginia now under construction. Lobert, meanwhile, is the proud owner of a 1,300 square-foot clinic repurposed from a strip mall clothing store in Brighton, Michigan.

    Yet Katouzian and Lobert have a common vision: creating the most effective spaces for patients, no matter the scale of the endeavor.

    This month in PT in Motion magazine: "Designing for the Future" a Q&A session featuring six individuals — a mix of PTs, architects, and executives — who have been involved in creating or recreating clinic spaces. Those spaces range not only from large to small clinics, but from multifacility plans to a clinic subarea devoted to patients’ family and caregivers. In one case, the project even involved downsizing.

    Interviewees answer questions about their overall goals when designing the new space, use of architects in the process, involvement of patients in design, and lessons learned along the way. The range of perspectives and approaches makes it clear that the one-size-doesn't-fit-all concept applies to far more than just square footage.

    "Designing for the Future" is featured in the March issue of PT in Motion magazine and is open to all viewers — pass it along to nonmember colleagues to show them one of the benefits of belonging to APTA.