There is still a lot to be learned about COVID-19. But as Illinois begins to reopen in Phase 3 of the Restore Illinois plan, one thing is for certain, COVID-19 is still prevalent.

“We don’t have a vaccine or a medication that for sure will treat COVID-19, so I think even though we’re going to be moving into this next phase and things are going to be opening up, we still really need to be social distancing as far as trying to stay six feet from other people,” Christie Clinic’s Dr. Jeanelle Murphy said.

While Phase 3 guidance provided by the Illinois Department of Public Health allows for gatherings of fewer than 10 people, Murphy said that it is still important for people to remember that they should stay within their family groups. If they choose to expand that group, they need to wear a mask when not six-feet apart.

“Even though we’re opening back up and the numbers are slowing, they’re still there; we’re still getting a bunch of new cases every day,” she said. “So, we’re still at risk. I feel like we definitely cannot go out and just act like everything’s fine and the virus is gone.”

Summer allows for opportunities that the colder months do not. Restaurants will be able to host outdoor seating, parks remain open and farmers markets are popping up here and there.

Murphy said outdoor gatherings, like barbecues, run a lower risk of COVID-19 transmission than indoor gatherings do.

“The virus definitely spreads easier inside than it does outside,” Murphy said. “So probably a little bit less of a concern if you’re getting together at a park than if you’re getting together inside somebody’s home. I think gathering outside would be much more preferred at this point.

“And again, if you’re not going to wear a mask then trying to stay six feet away from people that do not live in your home that is still the case even with these gatherings.”

This is important because 35-percent of people with COVID-19 do not show symptoms of having the virus. Murphy said even in two-person gatherings, if one is infected and transmits the virus to another person, that person could then transmit it to 2.5 to 3 people.

When meeting face-to-face with someone outside the home, Murphy best practice is to wear a mask.

Research has shown, though, that not all masks are created equal. The best mask for non-medical professionals is one made of multiple layers, preferably one silk and one cotton layer.

“As far as we know, COVID-19 is transmitted via droplets,” Murphy said. “And droplets are larger and they’re spread when somebody is coughing or sneezing, somewhat when they’re talking as well. So a mask, even a cotton mask is going to catch a majority of droplets.

“(The mask) is going to help when that person is talking; it’s going to help prevent the other person from inhaling in the droplets and therefore getting the virus.”

But what is unknown at this point is if the virus can be transmitted through aerosol droplets, tiny respiratory droplets that can remain suspended in the air.

“Cotton and silk together is very effective,” Murphy said. “That’s going to significantly decrease transmission, even for aerosol.”

Murphy said that “in an ideal world, we would not be opening up yet because there is still a virus out there” but looking at the whole picture including the economic impact is also important.

Reports of depression and anxiety are on the rise as business owners grasp with the reality of closing their doors and adults, who have never had to file for unemployment, have had to do so within the last two months.

Those who have never struggled with mental health issues may be now.

Murphy said a change in personality: someone who is usually outgoing becoming withdrawn, loss of appetite, confusion or extreme anxiety, such as cleaning all the time, are characteristics that may signal someone needs additional help.

“Doctors are open, family doctors are open, pediatricians are open,” she said. “You can definitely call and get advice. Counselors are offering telehealth and phone visits right now.”

The Illinois Department of Human Services has also set up a text line  (to help those struggling with with stress related to the COVID-19 pandemic. To access that line text TALK or HABLAR to 552020.

People seeking assistance will remain anonymous and will provide only their first name and zip code, which enables the service to link you to a counselor in your area who is knowledgeable about available local resources.

Murphy said that if a loved one has suicidal thoughts, they need to get immediate help at the ER.

She added that people should continue to feel comfortable seeking routine medical care, including vaccinations, and if they have an emergency, they should seek help in the ER.

“I feel like so many people have been kind of ignoring symptoms that they shouldn’t be because they’re afraid of the virus,” she said. “People still need to get medical care like always, we just call it head first.”

Being cognizant of the need to restart the economy, Murphy said that it’s important to go slowly.

“We should not go crazy, which is why Illinois has done it in phases,” Murphy said. “We’re not just going to all of a sudden open up school and open up the churches and open up restaurants, because that would be catastrophic.

“We’re going into the next phase where we’re going to open up businesses that were previously closed. We’re going to be allowing some get togethers with people outside of your home.

“The virus is still there and if we go crazy and we do not socially distance and we take off our masks, if we just forget about the virus, then it’s going to explode again. And we’re going to have to close again, because we do not have a vaccine and we do not have a medication that’s readily available and that works well.”

Still mitigating the impact on hospitals so everyone can continue to get adequate medical care is the goal.

Pritzker set up the Restore Illinois plan to move forward and backwards based on five metrics: positivity rate less than 20%, percent change in positivity rate, percent change hospital admissions, medical/surgical beds available, ICU beds available and ventilators available.

The medical advice all along has been to socially distance and wash your hands with soap and water for 20 seconds or use hand sanitizer regularly.

The addition of wearing a mask was not a change in direction, but rather scientists learning more about how the virus is spread and what people can do to protect one another.

As medical professionals continue to learn more about COVID-19, a novel (new) virus, they are also trying to provide guidelines and information to the public in a responsible manner.”

Murphy said it is still important for people to trust the scientific community, including the CDC.

“We didn’t even know that wearing a face mask for the general public was going to be helpful,” she said. “Originally, the CDC didn’t think that we should wear masks, but then they completely changed that because it was found out that 35% of people don’t even have symptoms.

“So certainly having everybody wear a mask could potentially prevent a significant spread.It’s normal in science to change your mind as you learn more and that’s a good thing.”

A week ago, the CDC reiterated their findings that coronavirus does not ‘spread easily’ from touching surfaces or objects. Murphy said that medical professionals have known that the virus can live on surfaces, including plastic and metal for days.

“But what we don’t know is even though the virus is present will cause infection,” she said. “We don’t know that.

“The CDC really didn’t change their mind on that they’re just saying,” Murphy said. “(Touching surfaces is) not the main way that it’s spread. Can it spread from surfaces Yes, but we don’t really know to what extent.

“It could be a dead virus; we just don’t know yet. So that’s the problem with this virus is that there so many things we still don’t know at this point.”

Like the CDC, Murphy still suggests that people wash their hands frequently and do not touch their eyes, nose or mouth. She also said that people with immunodeficiencies might want to wipe down their containers with Clorox wipes as an added precaution.

“Again that’s not the main way that it spreads so it’s a lot less likely someone’s going to get COVID-19 from their groceries, they’re much more likely to get it from somebody that is in the store,” she said.

Researchers are also looking into if the virus may or may not spread through fecal matter. At this time, it does not appear that COVID-19 can be spread through the shedding of fecal matter through untreated water, like in a lake or river.

Murphy said that people are more likely to become infected with COVID-19 by being in close contact with an infected person.

“In other states pools are open,” she said. “If people decide to go to pools, they’re probably pretty safe in the water, as long as they stay six feet away from other people who are not living with them.”

As gyms reopen, visitors should also be cognizant of how close they are to other people working out. Gyms are allowed to hold outdoor sessions with no more than 10 people or one-on-one training in Phase 3. Murphy said that if while working out, a six-foot distance cannot be maintained, then a mask needs to be worn.

“Obviously when you’re wearing a mask you’re more likely to get short of breath, you’re not going to be able to exercise the way that you normally would because you are going to run out of breath faster,” she said.

“There’s different symptoms to watch out for like feeling dizzy or feeling overly short of breath, you need to stop. And, if necessary, take off your mask and take a break.

“If you can exercise outside and you can stay six feet away from people that are not living in your household, you don’t have to wear a mask.”

Murphy said it will probably take a full year of watching COVID-19 to fully understand how it acts during different seasons. Medical professionals do understand some about COVID-19 from its predecessors SARS and MERS, which have been around for nearly 20 years.

One aspect that doctors won’t have the answers for soon are the long term effects that COVID-19 has on the body.

With 5.8 million cases worldwide, including 1.7 million in the United States, according to John Hopkins University, Murphy continues to said people still need to be very cautious and remember that COVID-19 is still prevalent.

“Even though it’s opening up I think people still need to take it and follow all recommendations,” she said.

That recommendation extends to other states where guidelines may be different.

“If you go to another state and you’re not socially distancing there, and you pick it up, then come back here, that’s another case here, and then you’re going to spread it to three more people here.

“Still socially distance, six feet away from people, still wash your hands a lot and still wear a mask.

“I still think it’s important to follow the overall rules, and until we have a vaccine or a good treatment we just need to be careful.”

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The annual race, originally scheduled for April 23-25 was set to be rescheduled sometime in October. 

“We had good reason to believe we would be able to reschedule our three-day event later in the year,” Christie Clinic Illinois Marathon Co-directors Jan Seeley & Mike Lindemann wrote in a press release. “As we move into our third month since the start of the pandemic and after speaking with numerous local government and health officials, it is clear that is no longer a viable option. Ensuring the safety and well-being of everyone involved in our race will always be our top priority.

“The size, scope, and impact of the COVID-19 pandemic finds communities like Champaign-Urbana in an ongoing state of uncertainty, with no clear picture of what the coming months will look like.”

Runners who wish to will be able to participate in a virtual option in 2020.

Registration for the event will be open from May 14-June 30 and will include a marathon, half-marathon, virtual 10K, virtual 5K, Virtual Mile, alongside full I-Challenge, Mini I-Challenge and Half I Challenge.

Runners can also defer their 2020 registration to the 2021 or 2022 race weekends, which are scheduled for April 29-May 1, 2021 and April 28-30, 2022.

The deadline to decide on either of three available options is May 31.

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As many as 93 children have presented in New York with a new pediatric multi-system inflammatory syndrome, likely linked to COVID-19 — and five children may have died of the condition.

Some children are also experiencing Kawasaki-like symptoms and COVID Toes.

The three conditions can present at different times during the COVID-19 infection, according to Christie Clinic’s Dr. Jeanelle Murphy.

COVID Toes, causing the toes to turn a purple or red color, could be an early signal of a COVID-19 infection.

“They don’t cause any symptoms like any pain or anything, but some people have complained of pain,” Murphy said.

While medical professionals aren’t certain what is causing COVID Toes, they are witnessing symptoms that are in line with inflammation that causes blood clots.

Murphy said doctors are thinking “it’s like micro clots or clots in the small blood vessels on the toes.”

COVID Toes may be a symptom that signals it’s time to have a child tested for COVID-19.

Murphy said that children, known as “super spreaders,” remain in the group least likely to present with symptoms of COVID-19. Those who do have symptoms, are most likely to present with fever, dry cough and shortness of breath.

Children, though, are more likely to also have symptoms of diarrhea and vomiting associated with COVID-19.

According to the CDC, only 1.7-percent of children worldwide present with symptoms.

But concern is growing over very small clusters of children who have been hospitalized or died from complications believed to be associated with COVID-19.

Many of the children have tested positive for COVID-19 or had the antibodies.

At least 11 states are reporting that children are not presenting with typical COVID-19 symptoms. Instead, children of all ages are experiencing rashes, swollen neck glands, cracked lips, swelling of hands and feet, and redness in both eyes (conjunctivitis or red eye).

Because children have presented with symptoms not in line with those thought to be the hallmark COVID-19 symptoms, the New York State Dept. of Health is working in partnership with the CDC to develop national criteria to help medical professionals identify, track and respond to help children exhibiting symptoms.

Christie Clinic’s Dr. Jeanelle Murphy said that while there is still much to learn, and that the CDC is studying it. This development is something parents should pay attention to.

“They haven’t officially said this is due to COVID-19, but it’s very likely, and they’re studying it further,” Murphy said. “So most of the kids tested positive for either COVID, RNA (COVID genetic material) or they’ve had COVID antibodies; some positive, but not all of them.”

Originally, it was thought that COVID-19 would most likely adversely affect those over 65 or with underlying health conditions. But now medical professionals are concerned because the children who have been reported to have the new pediatric multi-system inflammatory syndrome did not have secondary conditions.

The pediatric multi-system inflammatory syndrome or Kawasaki-like symptoms are more likely to present after a child has run its course with COVID-19, many times going symptom-free.

“Whether or not the kiddo has symptoms, they could go on to develop the pediatric multi system inflammatory syndrome weeks later,” Murphy said. “So, the thought is that if this syndrome is due to COVID-19, it’s not directly a result of the virus, but rather the immune response to the virus.

“It’s basically the immune system kind of going crazy after the infection has resolved. So they often aren’t acutely infected, it’s the immune system later on kind of attacking itself.

“The immune system is basically attacking these kids’ blood vessels and hearts.”

The result has been death due to heart failure in some of the children.

Murphy said it is not unusual for a child’s or young adult’s immune system to overreact to infection; this is why children often spike a fever if they have an infection, even a cold.

A surge in strokes among adults in their 30s and 40s has caused additional concern in how inflammation associated with COVID-19 affects the body’s ability to respond.

While an adult’s immune system can handle infection better than a child’s, younger adults have a higher immune response than older adults. This causes high amounts of inflammation.

“The inflammation leads to the blood clotting,” Murphy said.

“These young people with COVID-19, they’re getting large clots in large arteries in the brain which is taking out a good portion of the brain function.

“So there’s severe strokes that we normally do not see in people in their 30s and 40s. But since COVID has come into play here, we’re seeing a lot more strokes in young people.”

Murphy said that there is still much to be learned about the novel virus.

In the early days of learning about the virus, it was compared to the flu, but Murphy said COVID-19 is “definitely a lot worse than the flu.”

Without a vaccine, the mortality rate of COVID-19 is five times that of the flu.

She added that no one knows about what immunity to COVID-19 looks like. Murphy does not recommend purposely exposing a child to COVID-19 in hopes of building immunity.

“We don’t even know if everybody is going to develop immunity to it, we’re just starting to do the antibody testing,” Murphy said. “Because we don’t understand what the immunity of COVID-19 really means, is it just seasonal; is it life; is that a few years; I do not recommend purposely infecting kids. I think that could be really dangerous.”

A mother, Murphy said that she understands how hard it is to keep children socially distanced, but that adhering to the stay-at-home order and keeping children protected is the best practice.

“It goes for all ages. It’s not just adults,” she said.

“Right now kids really shouldn’t be within six feet of anybody without a face covering with anybody other than their family with whom they live.

“I think we definitely need to be social distancing as much as we can.”

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A cruise ship quarantined with passengers on board, elevated travel precautions, reports of fatalities and talk of a pandemic have captivated news reports for months, with an escalation in both national and local reports in the weeks since the first case of the coronavirus was confirmed within the United States.

Coronaviruses, a specific family of viruses, known to make up one-third of the upper respiratory infections (or common cold) during cold and flu season, has a novel, or new, strands that can cause more severe disease in humans.

“Essentially this is a new virus, although it is related to other coronaviruses that we have previously identified,” Christie Clinic’s Dr. Michael Kuhlenschmidt said. “Technically speaking, this is a betacoronavirus in the same subgenus as the virus that caused the SARS outbreak in early 2003. This virus does seem to share similarities with the SARS (severe acute respiratory syndrome) virus.

“In fact, it has been suggested that the virus that causes COVID-19 be designated SARS-CoV-2 because of this similarity.”

According to the World Health Organization, SARS was first identified in 2002 in the Guangdong province of southern China. An epidemic of SARS affected 26 countries and resulted in more than 8,000 cases and 774 deaths before it was contained in 2003.

Another novel coronavirus MERS (Middle East respiratory syndrome) was first reported in 2012.  The World Health Organization reports that since 2019, 2,494 cases and 858 deaths have been reported.

According to live update work by John Hopkins University, on Jan. 22 there were 77 COVID-19 cases worldwide whereas on March 5, there are 97,771 cases and 3,346 deaths.

Dr. Kuhlenschmidt said that the person-to-person transmission rate suggests that it mimics the way that influenza spreads: respiratory droplets through coughing and sneezing or contact with contaminated surfaces.

Symptoms of COVID-19 resemble those of a cold, but people with a more serious infection present with a significant fever, shortness of breath, and severe cough.

“Pneumonia seems to be the most common severe manifestation of COVID-19,” Dr. Kuhlenschmidt said. “The virus was first identified in Wuhan City, China after investigation into an unusual cluster of cases of severe pneumonia.”

Although the primary source of COVID-19 is still unknown, Dr. Kuhlenschmidt said that it shares a great deal of similarity to certain bat coronaviruses.

“It appears that bats are the primary source, although it is uncertain if there is another intermediate host involved,” he said.

“Since this coronavirus is novel or new to humans, our natural immunity to this virus is lacking.”

Dr. Kuhlenschmidt said that each year the coronavirus, a common virus, may cause up to one-third of the upper respiratory infections (or common cold) during cold and flu season.

“The vast majority of these virus strains are mild and do not cause severe illness,” he said. “For example, the typical coronaviruses are often less severe than influenza, however there have been exceptions.”

Like most coronaviruses and influenza, Dr. Kuhlenschmidt said the “virus seems to cause more severe infection proportional to age with the oldest population being the highest risk.

“It appears that this virus does not cause significant illness in young children less than 10 years old, although it is critical to restate that we still do not know everything about this virus and all people, including children, should take precautions,” he said.

“As with many respiratory viruses including influenza, people with chronic medical conditions, specifically lung disease such as COPD or asthma, chronic heart disease, or diseases that affect the immune system, are at particularly high risk for severe infection from COVID-19.

“Infection in nursing homes is a major concern.”

Dr. Kuhlenschmidt suggests that those presenting with mild symptoms should avoid going to the doctor or emergency room.

“COVID-19 is still rare in the U.S. and it is far more likely that symptoms are due to another seasonal virus including influenza,” he said.

“However, in situations such as travel to an at-risk country within 14 days of the start of symptoms (China, South Korea, Italy, Iran, Japan) or direct exposure to a patient confirmed to have COVID-19, it is important to get tested. In this situation, call your medical provider’s office. They may test you without an appointment in an effort to reduce the spread of the virus. You may also be directed to the Public Health Department.

“Waiting rooms and hospitals are a perfect place to spread the virus to someone else, or have it passed to you. Testing can often be arranged if you meet certain criteria. Your doctor or other healthcare provider can offer guidance.”

Healthcare providers use a nose or throat swab to test for the specific genetic sequence of the coronavirus.

“Virus swabs are available at any clinic, but specific testing is done with help from the Public Health Department/CDC,” he said.

But if symptoms are severe, such as high fever or shortness of breath, especially with the risk factors described previously, seek care in the emergency room.

“These are signs of possible severe infection that may require hospitalization,” Dr. Kuhlenschmidt said. “As medical providers, we are making every effort to keep patients out of the emergency room unless it is likely that a patient may need hospital admission for treatment.”

The rapid spread of COVID-19 and the death-rate is causing pause among healthcare professionals.

“In terms of case fatality rate (or percentage of infected people who die from the infection) this appears to be a deadlier virus that other seasonal viruses including influenza,” Dr. Kuhlenschmidt said. “The case fatality rate of COVID-19 appears to be around 2%, but this is highly dependent on age and other health conditions. This rate of 2% does mirror the SARS epidemic from the early 2000’s, which is not surprising given the similarities.

“For context, the case fatality rate of influenza is significantly less than 1% (probably around 0.1% although certain influenza strains are deadlier). However, it should be noted that the case fatality rate of COVID-19 may actually be lower than initial estimates due to under-reporting of mild disease. Most patients who are tested have severe symptoms which may make the disease appear deadlier than it is.

“There is still much more we need to learn about this virus before drawing any confident conclusions.”

There is one thing that health care professionals are sure of: hand washing is the human’s best tool to prevent the spread of COVID-19.

“This goes back to basics,” Dr. Kuhlenschmidt said. “The most important interventions to prevent the spread of the virus are all things we learned in grade school. Wash your hands frequently, don’t cough on other people, stay home when you are sick, and avoid contact with other people who are sick.

“We don’t have a vaccine available and there is no anti-viral.  Prevention is key and can dramatically reduce the spread of this virus.”

He also said facemasks probably won’t work, but they likely don’t hurt, either.

“Facemasks might help prevent transmitting the virus to someone else if you are sick and wear one,” Dr. Kuhlenschmidt said.

He, like others, is hopeful that like influenza and the common cold, cases of COVID-19 will subside with warmer weather.

“This is still unclear though and I would say that it is too early to tell. From what we know of this virus currently, it can reasonably be expected to be seasonal,” he said.

Regardless, Dr. Kuhlenschmidt said that COVID-19 is a significant public health threat that should be respected.

“However, as we all know, disinformation and rumor cause a great deal of panic and harm.  It is important to follow valid sources for updates such as the CDC.

“Again, in ideal circumstances, if we were to experience an outbreak here locally, having the flexibility to stay home and avoid public places would help.

“Common sense preparations including stocking up on basics would be reasonable. However, it is far too early to tell what impact from this virus we will see here in the U.S. There are more cases reported daily, but at this point, it is still rare in the U.S.”

Rural Champaign County Schools

Local school districts are monitoring the spread of COVID-19 closely, with a steady stream of emails to parents to help them understand how the coronavirus might impact the student population.

St. Joseph-Ogden’s superintendent Brian Brooks said that the district will continue to take the same precautions that it does to contain the spread of influenza, colds, stomach viruses, and other sicknesses.

“We clean and sanitize our building/classrooms daily,” Brooks said. “We have also sanitized our buses more than once already as well.”

Heritage’s Superintendent Tom Davis said Influenza A or B have not impacted student attendance in the district this winter.

“We had one small spike of absences back in January but that was about it,” Davis said. “We are staying aware of what’s in the media and also Illinois in particular.”

Superintendents in St. Joseph, St. Joseph-Ogden, Heritage, Mahomet-Seymour, Prairieview-Ogden and Oakwood school districts are following guidance provided by the Centers for Disease Control, the Illinois Department of Public Health, and the Champaign-Urbana Public Health Department:

Some of the recommendations that have been given to all schools are:

• Wash hands often with soap and water for at least 20 seconds.  If soap and water are not available, then use an alcohol-based hand sanitizer.

• Avoid touching eyes, nose, and mouth with unwashed hands.

• Avoid close contact with people who are sick.

• Stay home when you are sick. This is very important not only for the Coronavirus, but we are also seeing influenza and stomach virus cases with students and staff.

• Cover your cough or sneeze with a tissue then throw the tissue in the trash. Do not cover your mouth/nose with your hands when coughing or sneezing.

• Clean and disinfect frequently touched objects and surfaces.

Brooks included that there is zero reason at this time to consider cancelling school due to the coronavirus.

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