This marks the second installment in our Anatomy of a Pandemic series, in which we discuss the various aspects of the COVID-19 pandemic. In this second chapter, we explore what we currently know about the disease itself, from symptom progression to incubation period and the role that asymptomatic individuals play in the transmission of disease. Our firsthand account, told from the perspective of a respiratory therapist, illustrates the severity of this disease and the frightening, yet very real, prospect of running out of medical equipment, protective gear, and hospital beds. We then discuss what we currently know about COVID-19 from a clinical disease perspective. We are joined by Dr. Colleen Kraft (interview recorded March 19, 2020), whose voice you may recognize from our first episode on coronaviruses. She helps to break down some of the disease-related questions sent in by our listeners. We wrap up the episode by discussing the top five things we learned from our expert. To help you get a better idea of the topics covered in this episode, we have listed the questions below:

1. What does “respiratory droplet” transmission mean, and how is this different from something with “airborne” transmission? (15:08)
2. What are the symptoms of COVID-19? (16:48)
3. How long is the disease course, and how does this vary between mild vs severe symptoms? (18:45)
4. What does “supportive care” mean in the context of caring for people who fall severely ill from COVID-19? (19:40)
5. How much does viral load correlate with the severity of symptoms? (20:47)
6. What is the incubation period of this disease, how long do people remain infectious, and are asymptomatic people contributing to the spread of disease? (22:22) 
7. What are the groups that are particularly at risk for severe disease? (24:00)
8. Why do children seem to be more resistant to this infection? What about children who are immunocompromised, are they at risk? (27:40)
9. What is the case fatality rate, and how might we expect it to change throughout the course of this pandemic? (29:09)
10. Are there long term complications associated with COVID-19? (31:58)
11. Is it possible to get re-infected if you get this virus and then recover? (32:54)

The full article our firsthand account came from can be found here: “A Medical Worker Describes Terrifying Lung Failure From COVID-19 — Even in His Young Patients”

COVID-19 Ch 2: Disease Transcript

References

• Lauer et al., “The incubation period of Coronavirus Disease 2019 (COVID-19) from publicly reported confirmed cases: Estimation and application” Annals of Internal Medicine March 10, 2020. https://annals.org/AIM/FULLARTICLE/2762808/INCUBATION-PERIOD-CORONAVIRUS-DISEASE-2019-COVID-19-FROM-PUBLICLY-REPORTED
• Bai, et al., “Presumed asymptomatic carrier transmission of COVID-19” JAMA Feb 21, 2020. https://jamanetwork.com/journals/jama/fullarticle/2762028
• Zhou et al. “Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study” The Lancet March 9,2020. https://www.thelancet.com/action/showPdf?pii=S0140-6736%2820%2930566-3
• Wu and McGoogan. “Characteristics of and important lessons from Coronavirus Disease 2019 (COVID-19) otubreak in China. Summary of a report of 72,314 cases from the Chinese Center for Disease Control and Prevention” JAMA February 24,2020. https://jamanetwork-com.proxy.cc.uic.edu/journals/jama/fullarticle/2762130
• Kong and Agarwal. “Chest imaging appearance of COVID-19 infection” Radiology: Cardiothoracic Imaging. Feb 13, 2020. https://pubs.rsna.org/doi/full/10.1148/ryct.2020200028
• Li et al. “Substantial undocumented infection facilitates the rapid dissemination of novel coronavirus (SARS-CoV-2)” Science March 16, 2020. https://science.sciencemag.org/content/early/2020/03/13/science.abb3221
• CDC COVID-19 response team. “Severe outcomes among patients with coronavirus disease 2019 (COVID-10)—United States, February 12-March 16, 2020” MMWR March 18, 2020.