What you should know about COVID-19
A new member of the coronavirus family was first identified in December 2019. Over the past several months this new or novel coronavirus has spread around the world causing a global pandemic. This virus, COVID-19, is very contagious and causes mild to severe flu-like symptoms, especially affecting the respiratory organs and heart. Almost two million people have been infected worldwide and more than 100, 000 have died.
To fight the spread of the virus, people around the world have been called upon to observe “social distancing”, to “shelter in place”, and to proactively practice heightened personal hygiene. Everyone is concerned.
Coronaviruses are a large family of viruses that can cause disease in both humans and animals. In humans, coronaviruses are known to cause respiratory infections ranging from colds to more serious illnesses such as SARS (Severe Acute Respiratory Syndrome), which caused many infections in Asia in 2002–04, and MERS (Middle East Respiratory Syndrome), which was first recognised in 2012.
This new virus was unknown before the first outbreak was identified in Wuhan, China last December.
The virus and its effects are still being studied. What is known so far:
- The most common symptoms of COVID-19 are fever, fatigue, and a dry cough.
- Some patients may have aches and pains, nasal congestion, runny nose, sore throat or diarrhoea. These symptoms are usually mild and begin gradually.
- Some people are carriers, but do not feel unwell or experience any symptoms. About 80 percent of those infected recover without any special treatment.
- About 1 in 6 people COVID-19 become severely ill and has difficulty breathing. Older people and those with medical problems such as high blood pressure, heart problems or diabetes are more likely to develop serious illnesses.
To date, there is no vaccine and no medicine to treat COVID-2019 specifically. Researchers are working on possible vaccines and drug treatments, but clinical trials, production, and getting the drugs to market will take time.
Antibodies from people who have successfully recovered from COVID-19 are being tried as a possible treatment to help people recover more quickly.
Although there is no specific treatment yet, there are many ways to relieve the symptoms. Those who are seriously affected should seek medical attention. Most patients recover thanks to supportive care.
Public health practices are being used to control person-to-person transmission of the virus:
- ISOLATION and QUARANTINE
- SOCIAL DISTANCING
- COMMUNITY CONTAINMENT MEASURES to reduce social interactions
How it is spread?
From person to person. People can catch COVID-19 from others who have the virus. The disease can spread through microscopic droplets spraying from the nose and when a person with COVID-19 coughs, sneezes, or even exhales.
From infected surfaces. These droplets land on surfaces wherever an infected person happens to be. Other people touch these surfaces, then infect themselves by touching their eyes, nose, or mouth. Studies suggest that coronaviruses remain active on surfaces for a few hours or up to several days depending on the conditions (e.g. type of surface and ambient temperature/humidity). To protect yourself from possible infection when away from home you can, for example, open doors with your shoulder and touch keypads with a pen. You can also wipe the surface of any object you bring into the house from outside with a disinfectant or leave it in the sun for 72-hours to self-sanitize.
By inhaling microdroplets. When we cough or sneeze, we often expel saliva and mucus that we can see, but we also produce ‘invisible’ microdroplets when we talk or breathe heavily, which is how the virus spreads. A person who is infected with COVID-19 will constantly be shedding the virus, even if they are asymptomatic. Anyone who comes into contact with an infected person is at risk of infection. This is most countries recommended keeping at least 2 meters (6 feet) from other people until the shelter-in-place order has been lifted.
Protective measures
You can reduce your chances of becoming infected and spreading COVID-19 by taking some simple precautions:
Wash your hands regularly and thoroughly (for at least 20 seconds) with soap and water. When this is inconvenient an alcohol-based hand sanitizer is also effective.
Soap dissolves the fatty lipid layer that holds the virus together. Washing with soap and water is the best and easiest way of staying virus-free. Alcohol-based hand sanitizers work similarly and are a good substitute when on the move.
Maintain a distance of at least 2 metres (6 feet) between yourself and others, especially anyone who is coughing or sneezing. When a person coughs or sneezes, microscopic droplets of liquid spray from their nose and mouth. If the person has been infected, these droplets will contain the COVID-19 virus. If you are close enough, you will breathe in these droplets.
Avoid touching your eyes, nose, and mouth. Hands touch many surfaces and we can’t know if something we are touching has come into contact with virus. COVID-19 can remain active for varying amounts of time on different surfaces—several days on metal and plastic, 24 hours on cardboard. Once contaminated, hands can transfer the virus to your eyes, nose, or mouth, from where it can enter your body and make you sick.
Practice good respiratory hygiene. Cough or sneeze into a tissue or your bent elbow. Dispose of the used tissue immediately. By practicing good respiratory hygiene, you protect the people around you from viruses such as colds, flu, and COVID-19.
Should I wear a face mask?
Face masks/respirators have become a symbol for COVID-19. Although opinions about the usefulness of wearing masks differ, most authorities now agree that wearing a mask in public is better than not wearing one.
- Healthcare workers on the front lines working with COVID-19 patients should wear medical masks/respirators.
- COVID-19 patients should wear face masks to protect others from infection.
- The general public (healthy people) are now being encouraged to wear masks, even if they are not medical grade respirators, because even homemade masks will reduce transmission and keep you from touching your face.
Because medical staff in many places lack personal protective equipment (PPE), many people have begun sharing simple patterns online for masks that can be easily made at home.
COVID-19 can be transmitted before the onset of symptoms. If all of us, including those who are asymptomatic and don’t know they are contagious, wear face masks in public, we can reduce the casual transmission of the virus.
Improper use of face masks, such as not changing disposable masks, could jeopardise the protective effect and even increase the risk of infection. Cloth masks can be washed in soap and water or left in the sun for 72 hours to self-sanitize so they can be used repeatedly. If you are an essential worker, keep several masks so you always have a clean mask at hand.
Stay home if you feel unwell. Follow the directions of your local health authority. National and local authorities have the most up to date information on the situation in your area.
If you do have a fever, a dry cough, and difficulty breathing, seek medical attention and call in advance. Calling in advance will allow your health care provider to quickly direct you to the right health facility. This will also protect you and help prevent spread of viruses and other infections.
Avoid crowded places such as supermarkets and public transportation where the concentrations of the virus are likely to be higher. Many countries have imposed a strict quarantine, closing public areas such as theatres and restaurants, postponing public events and sports games, and imposing restrictions on assembly and movement. But we all must make the effort to keep our distance from others, in order to prevent ourselves from becoming infected and not to pass the infection on to others.
Avoid travel, especially if you are an older person or suffer from diabetes, heart disease, or respiratory illness. Many countries have closed their borders and have restricted non-essential travel since mid-March. As the shutdown continues the economy suffers. While some are protesting these restrictions, essential workers who don’t have the option to stay at home because they take care of the sick or keep supply chains moving, are already at greater risk of infection. Stay home if at all possible.
The pandemic is unpredictable, and the situation changes quickly, so check regularly for the latest news! Keep up to date on the latest COVID-19 hotspots (cities or local areas where COVID-19 is spreading widely). Reliable information is published regularly and updated by the World Health Organization on its website www.who.int
Healthcare workers caring for patients with COVID-19 and anyone who has travelled recently or suspects they have been in contact with someone with COVID-19, should follow the protective measures described above and take additional precautions.
Should you begin to feel sick:
Self-isolate by staying at home. Even mild symptoms such as headache, low grade fever (37.3 C or above), and slight runny nose, should be taken seriously and treated until you recover. If at all possible, have someone bring you essential supplies, but if going out is unavoidable, be sure to wear a mask to avoid infecting others. Avoiding contact with others and keeping visits to medical facilities at a minimum will allow these facilities to operate more effectively and help protect you and others from possible COVID-19 and other viruses.
If you develop a fever, a cough, and have difficulty breathing, seek medical advice promptly. These symptoms signal respiratory infection or other serious condition. If you need medical assistance, call your provider in advance and let them know about any recent travel or contact with travellers. Calling in advance will allow your health care provider to direct you to the facility best suited to take care of your needs and help prevent the possible spread of COVID-19 and other viruses.
This pandemic almost feels like war!
COVID-19 first appeared at the end of last year in mainland China, with the geographical focus of the initial outbreak in Hubei Province in the city of Wuhan and quickly grew to epidemic proportions. A few months later, the number of COVID-19 cases was growing rapidly around the world. The World Health Organization declared it a pandemic on 11 March. The virus has now been detected in almost all countries of the world (185 as of 14 April). The largest numbers of cases have been reported in the US, Europe, and Iran, while the geographical spread of the virus continues.
Almost 2 million cases have been reported worldwide and over 125 thousand people have died due to coronavirus disease 2019 (COVID-19) caused by the new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
The world economy is also being severely affected—many people have lost their jobs and their incomes due to the enforced quarantine. This is something no one could have imagined until a few months ago. Many commentators are comparing this situation to war, but this enemy is visible only under a microscope.
Three scenarios of disease spread that differ by scale:
- outbreak—small, but unsual; focussed in one area
- epidemic—bigger and spreading; no longer contained to a small area
- pandemic—international and out of control
Doesn’t history bring experience?
Of course, pandemics have occurred before. Tens of millions of humans have succumbed to viruses that have spread throughout the world. But we can only fight what we know, and each new virus brings new challenges.
SARS
In November 2002, almost 18 years ago, another member of the coronavirus family appeared in Yunnan Province in China. It is zoonotic (caused by a pathogen that has jumped from non-human animals to humans) in origin, thought to have spread from horseshoe bats to civets and then to humans. eventually infecting more than 8000 people in 26 countries and killing 774. The disease it caused was called severe acute respiratory syndrome corona virus (or SARS CoV-1) because of the symptoms it caused. This epidemic came to an end in August 2003, thanks to draconic measures implemented immediately after the virus was detected. No vaccine has yet been developed to combat SARS.
SARS and its ‘cousin’, COVID-19 (SARS CoV-2), have a lot in common: both viruses were first detected in animals and spread to humans after crossing the species barrier. And both viruses cause non-specific, flu-like symptoms, making them difficult to detect quickly.
However, there are also clear differences. While both diseases have about a 10% mortality rate, COVID-19 is has a longer incubation period, and is more easily transmissible and more severe than SARS.
Because symptom-free carriers are “invisible”, they are difficult to recognise. As a result, they are not quarantined and pass on the infection without being aware of it. So far, mortality rates for COVID-19 are much higher than for SARS. Some scientists estimate that millions will die before COVID-19 runs its course.
H1N1 or Swine Flu
Swine Flu was the popular name for the H1N1 virus that was responsible for a pandemic in 2009–10. H1N1 became a type of seasonal flu and is now included in the annual flu vaccine.
This virus was first detected in Mexico and eventually infected at least 700 million people worldwide. Across the globe, an estimated 151,700 to 575,400 people died from the virus, yet H1N1 is considered less infectious than COVID-19.
The World Health Organization declared the swine flu pandemic officially over on 10 August 2010.
Unlike COVID-19, the relatively small number of H1N1 cases that led to serious illness or death were mostly in children, young adults, and pregnant women—particularly those with underlying health problems. The main risk groups for COVID-19 are the elderly and people with chronic disease.
Spanish flu
The flu pandemic of 1918 was one of the most terrifying experiences of the 20th century. Estimates vary on the exact number of deaths caused by the disease, but it is thought to have infected a third of the world’s population and killed at least 50 million people in 6 months, making it the deadliest pandemic in modern history.
Researchers later discovered what made this flu so deadly: a combination of three genes enabled the virus to weaken its victims’ bronchial tubes and lungs, leaving them susceptible to bacterial pneumonia.
The outbreak began in Europe in the final months of World War I, and it is now believed that the war contributed to the spread of the virus.
The virus spread rapidly among the exhausted and malnourished soldiers, and infection was fuelled by the close contact of living in barracks and fighting in the trenches. Some patients experienced chills, fever, and fatigue, but recovered after a few days, while others fell seriously ill and died.
Countries participating in the war didn’t want more bad news to influence performance and so hushed up the disease. Spain, however, was neutral and had no reason to keep quiet, which led newspapers to dub the virus the Spanish Flu.
When the war ended, infected soldiers returned home, thus propagating the disease worldwide. Young people between the ages of 20 and 40 were most severely affected by the virus, turning their immune systems against them in a way that is unusual for the flu, but older and younger people suffered as well. At least 10% of all patients died.
Although the Spanish Flu killed millions, claiming more lives than World War I, it eventually led to improvements in public health. New strategies were developed in response to the terrible suffering. Measures such as education about the spread of infections, improved sanitation, broad testing, and quarantine are still being implemented today to combat the spread of similar diseases.
According to the current data, COVID-19 is slightly more infectious than Spanish flu. If it continues on its current trajectory, it will be almost twice as deadly. However, there is much that infectious disease specialists still don’t know about the virus. Exactly how deadly and contagious COVID-19 is, and what its long-term effects might be, is still unknown.
