Recent news of the outbreak of coronavirus in China is making headlines and worrying many of us. The first case was reported on 31st December at Wuhan, and since then cases have cropped up all over, including Kerala, India.
By the way, if you wish to watch a video on Coronavirus, scroll to the bottom of the page.
In the last few weeks, I have had a few patients walk into the clinic with features suggestive of a simple viral infection. Naturally, they are worried about coronavirus, given the recent news.
I thought I would share with you a brief overview of this virus, what you need to look out for, and how you can prevent yourself from catching this virus.
What Is Coronavirus?
Coronavirus is a class of viruses found in both animals and humans.
There are already well-known cases of coronavirus infections around the world. The Middle Eastern Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS) are coronavirus infections. You may have read about the SARS virus a few years ago causing a similar panic.
While the virus is in the same class as the SARS virus, it is not the same in the way it affects humans.
The current coronavirus that is affecting people in China is the 2019-nCoV, also called the ‘novel’ coronavirus. It is called so as there have never been any reported cases of such a viral infection in humans.
Right now, the virus is called COVID-19 – The COrona VIrus Disease from 2019.
How Did Humans Get Infected?
It is still not clear how humans ended up getting infected with this virus.
However, it is believed that the virus originated from a live animal market in Wuhan – a place where they sold rabbits, snakes, and other animals.
While the first few cases were transmitted from animals to humans, not all affected have been to this market. This has now led to the understanding that it is spreading from human to human.
This is still not completely clear, and we do not know if people who just carry the virus can pass it on to another person if they don’t exhibit all the symptoms of the disease.
Who Is At Risk?
This remains unclear as well. Elderly patients or those with high blood pressure and diabetes seem to be at a higher risk, mostly because their immunity is low. People with cancer, those on chemotherapy, those with HIV and a history of multiple infections are also at high risk.
In the reported cases in China, less than 1% of them are children (<9 years) that are affected.
However, if children begin to get infected, then shutting schools and taking appropriate measures to limit viral spread becomes an important strategy.
The mortality rate of coronavirus is 2%. Normal seasonal flu has a mortality of just under 1%. SARS had a mortality of 10%.
What Are The Symptoms Of Coronavirus To Look Out For?
It is believed that symptoms of COVID-19 appear 14 days after being exposed to the virus. In some cases though, fever and other symptoms have appeared as early as 6 days following exposure.
Symptoms of coronavirus infection include fever (almost all have this), cough and breathing difficulty. Muscle pains may also be noticed.
As you can see, these symptoms are no different from those seen in a simple viral infection.
However, a chest x-ray can help distinguish this infection to others to an extent. On an x-ray, this infection causes patchy shadowing (what doctors call ‘infiltrates’), which is the cause of the breathing difficulty.
Also, those with a viral infection usually have a runny or blocked nose. This is not seen in Coronavirus infections.
What does this mean?
Firstly, if you have any of these symptoms, it does not mean you have coronavirus infection. We only suspect this problem if you have traveled to China recently, or if you have been in contact with someone who has been confirmed to have this infection.
So don’t panic!!
In those who are mildly infected, complete recovery takes place within 2 weeks. More serious infections resolve in 4 to 6 weeks.
When you see your doctor, make sure you mention any recent travel history to them.
Diagnosis And Treatment Of Coronavirus
Specimens collected from the upper respiratory tract, including the oral cavity and nasal cavity, can help detect the virus. This is usually a nasal or oral swab test.
Blood tests have some role, and a type of cell called lymphocyte reduces in number. This is called lymphopenia. Liver enzymes might be mildly elevated.
However, none of these blood values are specific to coronavirus infection. This means that even these values are low or high as described, it does not confirm the condition.
Sputum examination may help but it is not very useful really.
The virus is detected using a test called a polymerase chain reaction. Also called viral PCR, this test works on the principle of multiplying the viral DNA in a controlled environment. It is a little expensive and time-consuming.
Treatment strategies are generally conservative, and there is no specific treatment as such that helps.
Patients will require ICU admission and isolation. Hospital-based infection control guidelines are followed during treatment, and family members are expected to abide by them.
Intravenous fluids, medicine drips to support blood pressure and continuous monitoring are the basic treatments needed.
Steroids have a limited role, though a requirement for this will be made on a case by case basis. Antibiotics do not help as this is a viral infection, not a bacterial one.
There are some simple steps you can take to prevent coronavirus infection. These are detailed on the World Health Organisation webpage as well. I have summarised them here.
Wearing a mask may only have limited benefits in preventing the infection from being transmitted or being caught.
In fact, you are less likely to catch the infection if you follow the preventive steps above.
Basically, don’t go rushing out to find a mask – it is only helpful for those with active infections to prevent spread to others. It is also recommended you wear a mask if you are taking care of someone infected with the virus.
If you are wearing a mask, first wash your hands with soap and water and follow appropriate hygiene precautions. The mask should be fitted over the nose and mouth, and no gap should be present between the face and the mask (do note that this might be difficult for children, as they might feel suffocated).
Do not keep touching the mask.
Do not reuse masks. Once you have removed it, dispose and it and use another one. When taking off the mask, take care to remove it from behind and not touch the mask itself.
Firstly, don’t panic. If you have traveled to China in the recent past, or have been exposed to anyone with suspected Coronavirus infection, make sure you see your doctor as soon as possible.
As promised earlier, here is a video on Coronavirus COVID-19
Images courtesy vecteezy.com
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