Coronaviruses are a large family of viruses that are common in people and many different species of animals, including camels, cattle, cats, and bats. Rarely, animal coronaviruses can infect people and then spread between people such as with MERS-CoV, SARS-CoV, and now with this new virus (named SARS-CoV-2).

The SARS-CoV-2 virus is a betacoronavirus, like MERS-CoV and SARS-CoV.  All three of these viruses have their origins in bats. The sequences from U.S. patients are similar to the one that China initially posted, suggesting a likely single, recent emergence of this virus from an animal reservoir.

Early on, many of the patients at the epicenter of the outbreak in Wuhan, Hubei Province, China had some link to a large seafood and live animal market, suggesting animal-to-person spread. Later, a growing number of patients reportedly did not have exposure to animal markets, indicating person-to-person spread. Person-to-person spread was subsequently reported outside Hubei and in countries outside China, including in the United States.

 HOW DOES CORONAVIRUS SPREAD?

COVID-19 is a new disease. Health experts are still learning the details about how it spreads. The virus is thought to spread mainly from person-to-person.

• Close contact with another (within about 6 feet).
• Through respiratory droplets produced when coughing and sneezing.
• Touching an object or surface with the virus on it, then touching your mouth, nose, or eyes.

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PREVENTION

To prevent the spread of the coronavirus and other infectious illnesses, please follow good hygiene practices including:

	Wash your hands often with soap and water for at least 20 seconds especially after you have been in a public place, or after blowing your nose, coughing, or sneezing. If soap and water are not readily available, use a hand sanitizer that contains at least 60% alcohol. Cover all surfaces of your hands and rub them together until they feel dry.  Avoid touching your eyes, nose, and mouth with unwashed hands.
	Avoid close contact with people who are sick. Put distance between yourself and other people if COVID-19 is spreading in your community. This is especially important for people who are at higher risk of getting very sick.
	Clean AND disinfect surfaces, buttons, handles, knobs, and other frequently-touched places. This includes tables, doorknobs, light switches, countertops, handles, desks, phones, keyboards, toilets, faucets, and sinks. If surfaces are dirty, clean them: Use detergent or soap and water prior to disinfection.
	Cover your mouth and nose with a tissue when you cough or sneeze or use the inside of your elbow. Throw used tissues in the trash. Immediately wash your hands with soap and water for at least 20 seconds. If soap and water are not readily available, clean your hands with a hand sanitizer that contains at least 60% alcohol.
	Top If you are sick:  You should wear a facemask when you are around other people (e.g., sharing a room or vehicle) and before you enter a healthcare provider’s office. If you are not able to wear a facemask (for example, because it causes trouble breathing), then you should do your best to cover your coughs and sneezes, and people who are caring for you should wear a facemask if they enter your room. If you are NOT sick: You do not need to wear a facemask unless you are caring for someone who is sick (and they are not able to wear a facemask). Facemasks may be in short supply and they should be saved for caregivers. DSHS discourages “stocking up” on facemasks.
	Stay home if you are sick, except to get medical care.

SYMPTOMS

For confirmed infections, reported illnesses have ranged from infected people with little to no symptoms (similar to the common cold) to people being severely ill and dying. The following symptoms may appear 2-14 days after exposure.

• Fever
• Cough
• Shortness of breath/difficulty breathing

WHAT TO DO IF YOU FEEL SICK

General population: If you are in generally good health and have a mild illness, stay home, and take care of yourself like you would for the flu. If symptoms worsen, call your doctor.

At-Risk Populations: If you are 65 years or older and/or have other medical problems like heart disease, lung disease, diabetes, high blood pressure or cancer – and have fever or symptoms – call your doctor. If you are not sick enough to be hospitalized, you can recover at home. Follow your physician’s instructions or refer to CDC guidance for how to take care of yourself at home. 

Your doctor will help make the decision whether you should get tested for coronavirus. Some public health labs in Texas are now testing, and local or regional health departments must approve each test.

If you develop emergency warning signs for COVID-19 get medical attention immediately. 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

TRAVEL UPDATES

If you plan to take any trips soon, in or outside the U.S., please always check the CDC website for guidance, and plan accordingly. The guidance is changing almost daily.

Currently, the CDC has issued a Level 3 Warning that travelers avoid all nonessential travel to China, South Korea, Iran, and Italy.

The US Department of State has also issued a Level 4 Travel Warning that travelers do not travel to China due to the novel coronavirus outbreak.

The CDC has issued a Level 2 Travel Warning for travelers to practice enhanced precautions when traveling to Japan.

The CDC has issued a Level 1 Travel Warning for travelers to practice usual precautions when traveling to Hong Kong.

The CDC also recommends that all travelers reconsider cruise ship voyages to or within Asia.

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WORKING WITH THE PUBLIC

Many of us work with the public and we want to provide information and resources that can help you. Please use the CDC and Texas Department of State Health Services (DSHS) Coronavirus webpages as reliable sources of information. Those websites will also list helpful tips specific to the workplace, like keeping commonly used surfaces such as doorknobs, keyboards, remote controls, desks, wiped down by employees before each use.