By Dr Hameem Fayaz and Dr Rizwan Ali Khan
The world is reeling under a pandemic caused by a disease we call as COVID-19 and every single human, no matter who and where, is concerned about it. It’s been almost there for months before the first case was reported and it doesn’t show any signs of stopping to date. Generally these new viruses, the coronas, are self limiting and have in the past caused some outbreaks but never have they taken over the world like they have now.
The term corona means halo or disc shaped like the sun, and given that the coronaviruses are a family of viruses which are characteristically enveloped RNA viruses, the term corona refers to the prominent halo of spikes protruding out of the envelope. These viruses are an important cause of common cold all around the world.
Background
In November 2002, there was an outbreak in china of an atypical pneumonia called SARS (Severe Acute Respiratory syndrome) which infected almost 8300 humans and resulted in death of 785 individuals. Then again in Saudi Arabia and its neighboring countries in 2012, a new type of disease emerged causing a rather severe pneumonia called Middle East Respiratory Syndrome (MERS). Both these diseases were caused by coronaviruses CoV-SARS and CoV-MERS respectively. Bats are considered to be the natural reservoirs of both the viruses.
The newest member of the coronavirus: COVID-19.
It was in late 2019 when the first case of covid-19 was confirmed in Wuhan, a city in Hubei province of china by the World Health Organization’s china office. That’s why the suffix 19 gets attached to the disease caused by coronavirus called as COVID-19 now. This virus causes an atypical pneumonia after causing sore throat, fever and a persistent dry cough in the beginning. The disease for now doesn’t have a specific medicine but efforts are being made around the world to produce a drug or a vaccine against it at the earliest.
This virus is new to humans and is believed to have an animal reservoir as well but is not identical to the previous two coronaviruses. The genetic sequence in this one is sars-CoV-2 as shared by Chinese officials managing to isolate it so that the other countries could develop kits to diagnose it. The gene sequence of the CoV-SARS is different to this new novel sars-CoV-2 although both appear to have similar clinical findings and modes of transmission.The diagnosis is done by isolating the virus via RT-PCR (Reverse Transcription Polymerase Chain Reaction).
Transmission
COVID-19 is transmitted by droplets and respiratory aerosols. The size is on the higher side which makes the coronaviruses inhalable. Human to human transmission of the virus takes place within a range of 6 feet or when an infected person coughs or sneezes.
Thevirus takes 2-14 days in the body to produce symptoms in a person, which is called its incubation period.
Symptoms
Most common of the symptoms that appear early are fever with a mild sore throat. With time a person develops dry cough, the body temperature risesraises more and one may also encounter a headache or diarrhea. The symptoms get worse if medical attention is not sought and the person gets severe sore throat, high grade fever, persistent dry cough and difficulty in breathing. This marks the inception of pneumonia in the infected person and calls for urgent medical help. In severe cases, infection can cause pneumonia, severe acute respiratory syndrome, kidney failure and even death.
Myths and facts about COVID-19
Myth: All this social distancing is an overreaction. The virus won’t cause much damage.
Fact: If we don’t see many infections (we hope so), it actually will prove that social distancing worked. Not that the virus was never a big deal.
Myth: COVID-19 cannot be transmitted in areas with hot, humid climates.
Fact: Evidence shows it can be transmitted in all areas.
Myth: Antibiotics help in preventing and treating the novel coronavirus.
Fact: No antibiotics work against viruses.
Myth: Novel Coronavirus lives in the throat. So drink lots of water so the virus is to pushed virus into the stomach where the acid will kill it.
Fact: Virus may gain entry via throat but it penetrates into the cells. You can’t wash it away. Excessive water will only make you run to the bathroom more often.
Myth: Novel Coronavirus will go away in summer months.
Fact: Previous pandemics didn’t follow weather patterns. Plus as we enter summer, there’ll be winter in the southern hemisphere. The virus is global already.
Myth: Smoking kills the virus.
Fact: Smokers are at more risk than non-smokers.
Prevention:
As per the WHO recommendations:
Wash your hands before eating, after eating, before and after you touch your face, after sneezing or coughing or blowing your nose with soap for at least 20 seconds thoroughly.
Preferably, use an alcohol based sanitizer with at least 60% alcohol content.
Cough or sneeze into your elbows, do not use hands.
Avoid touching your mouth, nose and eyes with unwashed hands.
Avoid contact with a person with a travel history to an infected area.
Avoid close contact with a sick person you suspect to have contacted the virus.
Do not mingle into crowds and don’t travel unless not deemed necessary.
What to do if you have symptoms and think you are infected?
Do not panic. Isolate yourself and contact the emergency healthcare officials in your area.
Maintain a better hygiene until a team arrives or you get a call to get yourself tested.
The symptoms are expected to worsen in the elderly age group, notify the authorities on time of appearance of the initial symptoms in an elderly patient.
Do not use public transport, ride sharing or ride hailing cabs.
Do not enter crowded places or attend gatherings or ceremonies.
Practice physical distances from others as much as possible and designate your room as a ‘sick room’, preferably use a separate bathroom, if available.
Wear a facemask at all times.
Cover your mouth and nose while sneezing and coughing with a tissue or fabric cloth and dispose them off immediately. Wash your hands after.
Follow the instructions displayed for infected individuals when you enter a healthcare facility.
The disease has a death rate of less than 5% around the world as of now and usually causes mortality in elderly people or already sick individuals. The idea is to contain and limit the spread of the virus until a vaccine or a specific drug is produced to cure it.
Community participation in a pandemic of this scale is the need of the hour. Community awareness programs have been launched all over the globe via print, electronic and social media platforms to maximize the reach to the general public so that the virus can be encountered and further infections don’t occur.
As long as the goal to contain the virus is not achieved, the general public shall be informed to stay away from crowded places, especially hospitals and other healthcare facilities unless it’s an emergency. Hospitals and healthcare facilities are known to spread infections like these as people to people contact is more with potential spreaders of the virus roaming among the public visiting for medical consultations.
Hameem Fayaz graduated from Ayoub Medical College, Abotabad, Islamabad, Pakistan, in 2020. Rizwan Ali Khan is a postgraduate trainee at FCPS.
