Pathologist Offers Understanding and Tips on Avoiding Coronavirus

Noted pathologist and molecular virologist James Robb, MD, is warning the general public of the strong possibility of the coronavirus being “widespread in the US” by late March and April.

“The current projections for its expansion in the US are only probable, due to continued insufficient worldwide data,” Dr. Robb said in a “Dear colleagues” letter first published in late February.

“I was one of the first molecular virologists in the world to work on coronaviruses (while a professor of pathology at UC San Diego in the 1970s),” said Robb, who has published some of the earliest descriptions of coronaviruses and co-wrote the chapter on coronaviruses in the book “Comprehensive Virology.”

“I was the first to demonstrate the number of genes the virus contained. Since then, I have kept up with the coronavirus field and its multiple clinical transfers into the human population (e.g., SARS, MERS), from different animal sources.”

With the growing concerns regarding the worldwide outbreak of the coronavirus — including several deaths attributed to the virus being reported in the state of Washington, Robb is offering his advice on the precautions to take against catching the influenza strain that still remains a fearful mystery to much of the populous.

That advice — primarily take the same precautions you do during every influenza season, which often runs from October to April.

“This virus is spread in large droplets by coughing and sneezing,” the doctor stated in his letter. “This means that the air will not infect you! BUT all the surfaces where these droplets land are infectious for about a week on average — everything that is associated with infected people will be contaminated and potentially infectious.

“The virus is on surfaces and you will not be infected unless your unprotected face is directly coughed or sneezed upon. This virus only has cell receptors for lung cells (it only infects your lungs) The only way for the virus to infect you is through your nose or mouth via your hands or an infected cough or sneeze onto or into your nose or mouth.”

Robb listed several ways to protect yourself, adding “these are the same precautions I currently use during our influenza seasons, except for the mask and gloves.”

First of all, avoid handshakes. Instead,“use a fist bump, slight bow, elbow bump, etc.,” the doctor said. And, “you should also use your knuckle” to touch light switches and elevator buttons, and lift the gasoline dispenser with a paper towel or use a disposable glove.

He also suggests opening doors with your closed fist or hip. “Do not grasp the handle with your hand, unless there is no other way to open the door. That is especially important on bathroom and post office/commercial doors,” Robb said.

The doctor advises people to use disinfectant wipes at stores when available — including wiping the handle and child seat in grocery carts — and to wash your hands with soap for 10-20 seconds and/or use a greater than 60% alcohol-based hand sanitizer “whenever you return home from ANY activity” that involves locations where other people have been. You should also keep a bottle of sanitizer at your home entrances and in your cars.

When possible, Robb said, try to cough or sneeze into disposable tissue and discard. Use your elbow only if you must. “The clothing on your elbow will contain infectious virus that can be passed on for up to a week or more,” he said.

To prepare for a possible wide scale outbreak, Robb suggests “stocking up” on surgical masks to avoid touching your nose and/or mouth. “We touch our nose/mouth 90 times a day without knowing it,” Robb points out. “This is the only way this virus can infect you — [again] it is lung-specific. The mask will not prevent the virus in a direct sneeze from getting into your nose or mouth — it is only to keep you from touching your nose or mouth.”

You should also stock up on hand sanitizers, latex or nitrile gloves, zinc lozenges. “(The lozenges) have proven to be effective in blocking coronavirus (and most other viruses) from multiplying in your throat and nasopharynx,” Robb said. Use the lozenges as directed several times each day when you begin to feel any “cold-like” symptoms beginning. “It is best to lie down and let the lozenge dissolve in the back of your throat and nasopharynx,” he said.

Robb concluded his letter by saying he hopes that this pandemic will be reasonably contained. “But I personally do not think it will be,” he said.

“Humans have never seen this snake-associated virus before and have no internal defense against it. Tremendous worldwide efforts are being made to understand the molecular and clinical virology of this virus,” he said.

“Unbelievable molecular knowledge about the genomics, structure, and virulence of this virus has already been achieved. But, there will be NO drugs or vaccines available this year to protect us or limit the infection within us. Only symptomatic support is available.”

Dr. James Robb received his MD degree at the University of Colorado and took a residency in pathology, as well as training in molecular biology, at Yale University. He has worked for the National Institutes of Health, and been a consulting pathologist at the National Cancer Institute. He is board certified in anatomic pathology, clinical pathology, cytopathology, and dermatopathology.