UPDATED: Mar. 15, 2020
If the speed and spread of the coronavirus pandemic has you deeply concerned, please know that we are right there with you.
Last week, President Trump banned travelers coming from Europe. Tom Hanks and Rita Wilson, who have been filming in Australia, told the world they have tested positive for the coronavirus. And the NBA suspended the season after a Utah Jazz player tested positive for COVID-19.
That all happened on the same day that the World Health Organization officially declared a pandemic.
So, believe us, our heads are spinning too.
One very important way we can all combat fear is to get prepared. That's what we are here to help you do. So here's our promise to you. We will:
- Do our best to bring you the most recent and accurate information
- Explain what's happened so far, using language that we hope you understand (but let us know if we are falling short).
- Continue to update this comprehensive explainer as new information becomes available
- Answer your questions
So here's what we know so far:
A "Public Health Emergency of International Concern" was declared on Jan. 30, 2020 by the World Health Organization over an outbreak of a new, deadly, novel coronavirus which began in Wuhan City, China.
The virus was identified as SARS-CoV-2, which causes a disease called COVID-19 (which is an abbreviation of "coronavirus disease 2019").
On Mar. 4, L.A. County declared a local and public emergency, and Governor Gavin Newsom made the call to declare an emergency for the state of California on the same day.
On Mar. 11, WHO made it official: COVID-19 is a pandemic.
SARS-CoV-2 is in the family of coronavirus pathogens that usually cause short-lived illnesses.
They get their name because of how they look, which is spiny around the edges, like a crown. And some coronaviruses are scarier than others. Scientists are still trying to figure out how dangerous this new (or "novel") coronavirus is.
"Most people get infected with these viruses at some point in their lives," according to the Centers for Disease Control and Prevention.
Symptoms may include fever, cough, difficulty breathing, runny nose, and headache. But they can vary in severity. Thousands of people have died, but "other patients have had milder illness and been discharged," the CDC said.
On Sunday, March 15, Gov. Gavin Newsom called for far stricter guidelines in the state. He asked that all seniors and people with underlying conditions to be isolated at home as a precaution against the ongoing coronavirus pandemic.
- Advising all people 65 or older to self-isolate at home
- Bars, brew pubs and wineries should shut down
- Restaurants should be at no more than 50% occupancy
Newsom said called wineries, bars and brewpubs "nonessential function" of the state. He said he believed restaurants should continue to operate far under capacity to serve those unable to cook at home.
The main message from national and local health officials is: don't panic. But L.A. is taking precautions.
L.A. Mayor Eric Garcetti said on March 15 that he planned to implement an eviction moratorium -- moratoriums on the shut off of utilities are already in place.
County officials declared a local and local public health emergency on March 4. The declaration, in part, was a way to "enhance our ability... to seek future reimbursement from both the state and federal government, should the funding become available," said the Director of L.A. County's Department of Public Health, Barbara Ferrer PhD, MPH, MEd.
L.A. County announced its first death from COVID-19 on March 11 -- a woman over 60 with underlying health conditions who was visiting friends in the area, Ferrer said. She was not a resident, and she had an extensive travel history over the past month, including a long layover in South Korea.
The first possible community spread case -- meaning the source of infection is unknown -- was announced at a press briefing on March 9. Since then, Public Health has announced nine more cases of likely community spread, bringing the countywide total to 10.
At that time, Ferrer said the department was recommending "that people with underlying health conditions, pregnant women, and people who are elderly should adopt some social distancing practices immediately. And this would include avoiding non-essential travel, avoiding public gatherings or places where large groups of people are congregating, and avoiding event venues."
Coronaviruses generally jump from person to person on the droplets from coughs and sneezes.
The CDC's current best guess is that the incubation period for novel coronavirus -- that's the time from exposure to when symptoms first start showing up -- is somewhere between two and 14 days.
Federal health officials are stressing the importance of good hand hygiene.
Locally, the L.A. County Department of Public Health has guidance for travelers, health care workers, school administrators, colleges and universities, employers, parents of young kids, ships, congregate living, faith based organizations and more (and it's also stressing the importance of hand washing).
One study -- not yet peer reviewed -- has found that COVID-19 can live up to three hours in the air, up to 24 hours on cardboard and up to two to three days on plastic and stainless steel.
That doesn't mean anyone has contracted the coronavirus through breathing it in the air or touching a contaminated surface, scientists involved in the study said.
The research does show that "aerosolized transmission" is "theoretically possible," study leader Neeltje van Doremalen of the National Institute of Allergy and Infectious Diseases told the Associated Press.
A team from the National Institutes of Health, Princeton and UCLA conducted the study. Its findings were published Mar. 9 on a site where researchers can quickly share their work before it's published.
Common symptoms can include: low-grade fever, body aches, coughing, nasal congestion, runny nose, sore throat.
Severe symptoms can include: high fever, severe cough, shortness of breath, persistent chest pain or pressure, confusion, bluish lips or face
These Symptoms may appear 2-14 days after exposure. However, some people infected with the virus have no symptoms.
And there also may also be additional symptoms to what we've listed above.
If you think you might have been exposed, or have COVID-19 symptoms, call your doctor for next steps. If you experience severe symptoms, get immediate medical attention.
Here's the bad news. Barbara Ferrer, director of the L.A. County Department of Public Health, told us: "We don't have conclusive evidence on that."
She said that "in general you can be protected when you've had an infection, but not always. We're just going to have to wait for the researchers and the scientists to let us know what they're finding out about that."
They might. But they're not a for sure way of protecting yourself. The problem is that most surgical masks are loose-fitting and those pesky respiratory droplets can slide through the gaps. Still, some studies have shown that masks and respirators can reduce the risk of infection.
The N95 surgical mask is probably the most effective.
Clorox Multi Surface Cleaner + Bleach is on the list. So is Lysol Brand Clean & Fresh and dozens of other consumer products.
"Coronaviruses are enveloped viruses, meaning they are one of the easiest types of viruses to kill with the appropriate disinfectant product," according to the EPA. "Consumers using these disinfectants on an enveloped emerging virus should follow the directions for use on the product's master label, paying close attention to the contact time for the product on the treated surface (i.e., how long the disinfectant should remain on the surface)."
As far as keeping your hands virus-free, the CDC says hand-washing for at least 20 seconds is still your best bet. If that's not possible, it recommends using an "alcohol-based hand sanitizer with at least 60% alcohol."
Hospitals are preparing for a possible surge of patients and making sure there are areas set aside where people can be quickly isolated.
Those could be "designated rooms where these patients are going to be evaluated so that both the patient and the healthcare worker are safe and they feel safe while doing that," said Dr. Neha Nanda, a medical epidemiologist with USC Health System.
Nanda said ideally, patients would be checked out in negative pressure rooms. Those are rooms that prevent cross contamination. But they aren't always available.
Dr. Nancy Gin with Kaiser Permanente Southern California said facilities that don't have the special rooms might opt to set up temporary isolation units.
"Then you can put up tents, much like you see tents for events or a wedding reception, you can use those same kinds of tents to help to cordon off individuals," Gin said.
On March 13, Los Angeles Unified School District canceled in-person classes, sending half a million kids home, effective Monday, March 16, with coursework moved online.
Teachers received an email from Supt. Austin Beutner saying the district would be closed for two weeks "while we evaluate the appropriate path forward."
In the email, Beutner also announced a plan to open 40 family resource centers to provide weekday care for children, starting Wednesday, March 18, "from 6 a.m. to 6 p.m. with trained professionals."
LAUSD is the largest K-12 district to shut down so far, and it's one of the largest employers in the region to suspend normal operations.
A long list of other local districts are also shutting down -- including Long Beach Unified, the state's third largest district, which has cancelled classes for more than 70,000 students for five weeks.
Legally, you can travel within the United States if you're already here -- the CDC has not issued any advisories or restrictions on domestic trips (that's not something they generally do).
But just because you can travel doesn't mean you should. Being in crowds and in areas where COVID-19 is spreading may increase your risk of exposure. You may also unknowingly put other people at risk during your travels. The CDC has a list of things to consider before you take that trip.
For international plans, the U.S. State Department wants you to "reconsider travel." On March 11, it issued a global Level 3 health advisory. That's the department's second-highest warning -- Level 4 is "do not travel."
If you do decide to go abroad, keep in mind that you may be subjected to a quarantine when you arrive, or when you return.
Here's what the L.A. County Department of Public Health is recommending:
- Have provisions that will last a few days (water, food, essential hygiene, etc.)
- Get immunized against the flu. This will relieve what could be a highly stressed healthcare system
- Stay home when you're sick (don't wait until you are VERY sick)
- Make sure you are using a robust, regular cleaning schedule for frequently touched surfaces
- Wash your hands frequently
At a press conference on March 4, Ferrer said she was recommending simple "social distancing" measures.
"Use verbal salutations in place of handshakes and hugs," Ferrer said. "Don't share utensils cups and linens. And whenever possible, try to keep six feet between you and other people that you don't know at large events."
It's also a good idea to have ibuprofen or acetaminophen on hand to help with fever. You can read more about what you should have on your shopping list with our guide here.
Not all, but many (and counting).
Below is the official mandate from Gov. Gavin Newsom's office, and the recommendations from state health officials and Dr. Barbara Ferrer, director of the L.A. County Department of Public Health, as of Mar. 12 through the end of the month.
- Events with 250 or more people should be canceled or postponed.
- Smaller events should be canceled or postponed if the venue can't accommodate social distancing.
- Avoid gatherings or places where you can't keep a 6-foot distance from other people.
- Avoid gatherings or places where there will be 50 or more people.
- Avoid gatherings or places where there will be 10 or more people if you are pregnant, immunocompromised or elderly.
City and county leaders announced new rules for themselves at a press conference on March 12. The changes were framed as precautionary steps designed to protect the community and the most vulnerable among us.
New protocols include:
- No more than 50 visitors in city buildings at a time
- Events and conferences held on city property must have fewer than 50 people.
- Non-essential travel by city and Los Angeles Sheriff's Department employees is canceled
- City Hall is closed to all non-city employees
- Hand-washing and sanitizing facilities available at all city properties
- 911 operators will screen callers about COVID-19 exposure to help reduce the risk to first responders
- County Emergency Operations Center is moving to Level 1 (which means it will be fully staffed with leaders and experts from every county department, as well as with outside experts)
- Stay home if you're sick (or think you might be, even if you only have mild symptoms).
- Wash your hands frequently.
Los Angeles is working to put at least 165 hand-washing stations near large encampments around the city. But there's no centralized city policy steering that effort. Rather, individual departments and elected members of the city council have moved to do this on their own with their own budgets.
Meanwhile, homelessness outreach workers and case managers are still interacting with people on the street.
Speaking confidentially to LAist for fear of losing their jobs, multiple people employed by government and nonprofit organizations expressed concerns about their potential for spreading the virus among the vulnerable population. But shutting down shelters, drop-in centers, food banks, and other resources, they said, would leave homeless people with even fewer resources than they currently have.
- Quarantine: a separation for people who have a contagious disease, have symptoms consistent with a contagious disease, or were exposed to a contagious disease. A person's movements are restricted when they are quarantined.
- Isolation: a less restrictive separation that keeps people who are sick away from people who are not sick.
- Self-Isolation: a voluntary action to stay at home by people who are sick (or are likely to be sick) and are experiencing mild symptoms.
- Self-Quarantine: a voluntary action to stay at home by people who may have been exposed but are not experiencing symptoms.
- Social Distancing: keeping your distance from other people. The distance reduces the risk of breathing in droplets that are produced when an infected person coughs, sneezes or in some cases, breathes. It can also mean cancelling events or gatherings.
On March 13, President Trump announced at a news conference that millions of tests were expected to be available within a month, including at drive-thru test sites.
The same day, the Department of Health and Human Services announced that it will fund two companies to develop 1-hour diagnostic tests: DiaSorin Molecular and QIAGEN. DiaSorin's test, the department says in a press release, could be ready in six weeks; QIAGEN's could be ready in 12 weeks.
The president also announced that Google was going to quickly develop a coronavirus screening website to direct people to testing locations.
However, according to a tweet that followed from Google Communications, it's Verily (a division of Google's parent company), not Google, that's building something. And the thing it's building is a tool to help triage people for COVID-19 testing in the Bay Area. The company said it was in the early stages of development.
On March 12, Dr. Barbara Ferrer, director of the L.A. County Department of Public Health, announced that L.A. County's lab tested 100 people during the previous week and a half.
There is a significant backlog -- "we're swamped," she said, and encouraged people to use commercial labs that have recently started offering tests. Commercial labs have tested 120 people so far in the county.
The county is in the process of submitting an application to the Food and Drug Administration for drive-thru testing.
L.A. public health officials made a recommendation to local healthcare providers on March 11 that lab testing be restricted to people with "severe disease or an increased probability" based on exposure or travel history.
Providers have been encouraged by the L.A. Department of Health to use their checklist when evaluating people for COVID-19.
Here's the exact testing criteria -- a combination of "Clinical Features" and "Epidemiologic Risk Factors" -- for the L.A. County Department of Public Health Laboratory, as of March 11.
Fever *or* signs/symptoms of lower respiratory illness (e.g. cough, shortness of breath) AND Any person (including healthcare workers) who in the last 14 days before symptom onset has had close contact with a suspect of laboratory-confirmed COVID-19 patient.
Fever *and* signs/symptoms of lower respiratory illness (e.g. cough, shortness of breath) AND Any healthcare worker without an alternative diagnosis (e.g., negative molecular respiratory panel)
Fever *and* signs/symptoms of a community-acquired lower respiratory illness (e.g. cough or shortness of breath) requiring hospitalization AND A history of travel from affected geographic areas* in the last 14 days before symptom onset *or* radiographic findings compatible with a viral pneumonia and no alternative diagnosis
Part of a cluster of 2 or more cases of an acute respiratory illness within a 72-hour period AND Congregate living setting with a large proportion of older adults and persons with comorbid medical conditions (e.g. skilled-nursing facility, senior assisted living facility, homeless shelters)
This evaluation and testing strategy, according to the notice, would be "reassessed and possibly revised," in the case of "widespread community transmission."
President Trump emphasized at the March 13 news conference that officials don't want people to take the test unless they're exhibiting symptoms.
The CDC says to contact your state health department with questions about testing.
MERS (Middle East Respiratory Syndrome) and SARS (Severe Acute Respiratory Syndrome) are two members of the coronavirus family that tend to make people sicker. "About 3 or 4 out of every 10 patients reported with MERS have died," according to the CDC. And SARS was responsible for a global outbreak in 2002-2003 that killed 774 people.
"The novel coronavirus is more genetically-related to SARS than MERS," said Dr. Messonnier.
But scientists don't know yet if novel coronavirus will act the same way as SARS or MERS; they're using information from both pathogens to guide their research.
Dr. Messonnier said the novel coronavirus "does look like it may be somewhat similar to a bat coronavirus." But she said researchers will need to conduct more genetic sequencing before she can be confident of how the virus started.
Some researchers think pangolins might have transmitted the new coronavirus to humans. But we just don't know for sure yet.
Mar. 5, 2020: This article was updated with the most current information available about COVID-19 and confirmed cases in Los Angeles.
Mar. 9, 2020: This article was updated with Dr. Ferrer's remarks about the first possible case of community transmission.
Mar. 11, 2020 10:55 a.m.: This article was updated to include WHO's pandemic classification, "qualified" disenfectants, and updated case figures.
Mar. 11, 2020, 2:18 p.m.: This article was updated with details about the first related death in Los Angeles County.
Mar. 11, 2020 3:48 p.m.: This article was updated with details from a preliminary report about how long the virus can live.
Mar. 11, 2020 4:40 p.m.: This article was updated with a new section of community questions.
Mar. 12, 2020 6:44 p.m.: This article was updated with information about community spread, symptoms, quarantine, homelessness, social distancing, event cancelations, L.A. County announcements, and local testing numbers.
Mar. 13, 2020 10:03 a.m.: This article was updated with LAUSD school closure information.
Mar. 13, 2020 1:54 p.m.: This article was updated with community spread numbers.
March 13, 2020 8:41 p.m.: This article was updated with information about test availability, testing criteria, travel, reinfection, and homelessness.
Robert Garrova, Paul Glickman, Lisa Brenner, Megan Erwin, Brian Frank, Megan Garvey, Kyle Stokes, and Adriene Hill, Mike Roe, Matt Tinoco, and Stephanie Ritoper contributed to this story.
This article was originally published on January 28, 2020.