It has been fewer than three months since a novel coronavirus emerged in Wuhan, a city in China. Since then, till date, it has infected over 95,000 people globally, killing over 3000 people.
Most cases reported were from mainland China and a joint WHO-China fact-finding mission estimated that the epidemic in China peaked between late January and early February 2020.
As of March 6, 2020, there have been 31 reported cases of coronavirus in India.
What is coronavirus ?
According to WHO, coronaviruses are a group of RNA viruses that can cause illnesses ranging from common cold, fever to more complicated respiratory illnesses such as severe acute respiratory syndrome (SARS) and the middle east respiratory syndrome (MERS). The 2019 novel coronavirus is one of the seven members of its family that is known to infect humans, and third in the past three decades to spread from animals to humans.
The virus causes COVID-19 (Coronavirus disease 2019), which is a respiratory illness that can spread from person to person. The virus that causes COVID-19 is designated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
How does it spread?
According to CDC (Centers of Disease Control and Prevention), the virus is thought to spread between people who are in close contact with one another (six feet and within). It could spread through the respiratory droplets produced by a cough or a sneeze from an infected person resembling the spread of influenza. Novel coronavirus (SARS-CoV-2) does not spread through particles in air, and hence not airborne.
Though not the main way the virus spreads, COVID-19 can also spread if a person touches a surface or object that has the virus on it, and then touching their own nose, mouth or possibly their eyes as well.
What are the symptoms of COVID-19?
In the reported cases so far, patients have had mild to severe respiratory illness, with symptoms of fever, cough and shortness of breath. In addition to the respiratory symptoms, some cases even reported gastrointestinal symptoms such as nausea and diarrhoea, but are relatively uncommon. Some cases may be asymptomatic too.
In more severe cases, the complications might include pneumonia in both lungs, multiple organ failure, and even death.
The incubation period is thought to be within 14 days after exposure, with most cases occurring approximately five to seven days following exposure. As per the reports from UpToDate, onset of fever and respiratory symptoms occurred approximately three to six days after presumptive exposure to the SARS-CoV-2 virus.
If you experience one or more of this coronavirus symptoms, seek a medical help immediately.
Management and diagnosis of COVID-19
The approach to initial management of COVID-19 should focus on early recognition of the suspect cases, immediate isolation and disease control measures. The primary possibility of COVID-19 are considered in patients with fever and lower respiratory tract symptoms who –
- Reside or travel from places where the transmission is reported within 14 days
- Have had close contact with a patient who is confirmed or suspected to have COVID-19 within 14 days
Testing for SARS-CoV-2 (the virus that cause COVID-19) is done in addition to testing other respiratory pathogens. According to the CDC recommendations, collection of specimens from the upper respiratory tract (nasopharyngeal and oropharyngeal swab) and if possible, the lower respiratory tract (sputum, tracheal aspirate, or bronchoalveolar lavage) is done. Additional specimens such as stool or urine may also be collected.
The collected samples are then tested for SARS-CoV-2 RNA, which is detected by polymerase chain reaction (PCR) test.
Though there is no specific treatment available for COVID-19, the first step in managing it is by ensuring appropriate infection control. The treatment is now done depending on the severity of the disease, and the WHO classifies the treatment based on the clinical syndromes –
Uncomplicated illness (patients with uncomplicated upper respiratory tract infection), mild pneumonia, severe pneumonia, acute respiratory distress syndrome, sepsis and septic shock.
Where have the cases been reported?
More than 80,000 COVID-19 cases have been reported in China. The majority of the cases are from Hubei province and its surrounding provinces and numerous cases have been reported in other parts of China as well.
The cases initially occurred from travellers within China, but local transmission has driven smaller outbreaks in some locations outside China including South Korea, Japan, Iran, Italy and Vietnam. Increasing number of cases are being reported in over 70 countries across all continents except Antarctica.
There are 31 confirmed cases as of now (March 6th 2020) in India, and it began with three cases that were first reported in Kerala. All three cases have been cured and discharged from the hospital recently.
Is there a vaccine?
Researchers are working on developing a vaccine, and currently, there is no vaccine to protect against COVID-19. The best way to prevent the disease is to follow everyday preventive actions and ensuring personal hygiene.
What can you do to prevent it?
As the cases of coronavirus infection are increasing, and can spread easily, it is important to follow sufficient hygienic measures to stay away from it. Here are some everyday preventive actions you can take, to avoid catching the SARS-CoV-2 coronavirus disease –
- Avoiding close contact with people who are sick
- Avoid touching your eyes, nose and mouth frequently
- Wash your hands often with soap for at least 20 seconds. If soap and water are not available, use alcohol-based hand sanitizers, containing at least 60% alcohol
- Avoid crowded places like railway and bus stations, malls, airports, movie theatres etc,
- If you come across people with cough, maintain a distance of at least 6 feet and advise them to wear masks
- Avoid touching common surfaces in public places, like bars of the stairs, benches, railings etc,
- After visiting public places, change your clothes and put the worn ones in the washing area
- Drink warm water and do regular warm water gargles
If you are sick (experiencing dry cough, fever or sore throat),
- Stay home and take rest. It also helps contain the spread of infection if one is infected. It does not mean you have coronavirus infection, but it is recommended just for precaution.
- Consult a physician while at home, and follow what they recommend.
- Cover your mouth and nose when you cough or sneeze with a tissue, and safely dispose the tissues.
- Ensuring hygiene – clean and disinfect frequently touched objects and surfaces in common areas.
At your workplace, WHO recommends to,
- Make sure your workplaces are clean and hygienic – surfaces (eg – desks and tables) and objects (eg – keyboards, devices, telephones) need to be cleaned regularly with disinfectants.
- Recommend your employer to keep sanitizing hand rub dispensers in prominent places at your workplace.
- If someone is coughing or having a runny nose in your workplace, advise them to wear a mask.
- You can work from a remote location (home) if possible for isolation.
- If planning for business trips, seek travel advice from an expert & check the status of infection in that place.
When to meet a doctor?
If you have traveled to the infected countries recently, or had contact with someone who is suspected or infected, or feel sick with cough, fever or difficulty in breathing within 14 days, you should call for medical help.
If you have traveled from an infected country, it is important for the physician to know about the transmission rate in the country you had travelled from.
COVID-19 and cancer
There is no proven connection between COVID-19 and cancer. But, people suffering from cancer and undergoing treatment may have a weaker immune system, and hence, could have an increased susceptibility to COVID-19 infection and complications.. These people are recommended to be extra cautious and stay indoors, to prevent being infected.
What is being done to stop or control the spread of COVID-19?
Chinese authorities have effectively sealed the cities of Wuhan and Huanggang. People from these regions are not allowed to move outside except for special reasons.
- Passengers from 12 countries are being screened before they enter India. The countries include Nepal, Vietnam, Malaysia and Indonesia.
- India has also restricted the export of 26 active pharmaceutical ingredients and formulations including antibiotics, vitamins and hormones including Paracetamol, Tinidazole, Metronidaxole, Vitamins B1, B6, B12 and hormone progesterone with immediate effect.
- The government of Telangana has allocated INR 100 crores to prevent the spread and contain a possible outbreak. All the hospitals are asked not to delay the incoming cases, and three designated hospitals are set up for isolating the patients.
- Over 25,000 passengers have been brought under community surveillance. In addition, over five lakh passengers are being screened at airports and over 12,000 people at major and minor seaports.
- The government has suspended all the regular visas granted on or before March 3 to Italy, Iran, South Korea and Japan, for those who have not entered the country. For Japan and South Korean nationals, the advisory also suspended visa on arrival (VoA) issued by March 3.
- Travelers from the Republic of Korea, Iran and Italy, and other people with such travel history are quarantined for 14 days on arrival to India.
- Air India and other Indian airlines have suspended flights to China and Iran.
The cases are continuously increasing, and the rate of new cases of COVID-19 outside of China has outpaced the rate in China. Onco.com hence recommends everyone to follow preventive measures, and maintain personal and respiratory hygiene. If you have traveled from countries of increased susceptibility rate, you should meet a clinician immediately and get yourself screened.