There’s a hush on the horizon- an uneasy one. The culprit this time is Novel Coronavirus or COVID 19- a deadly virus that has struck terror in the hearts of governments across the world and in the hearts of the common man.
A sense of Deja-vu prevails for we’ve been there before– once when the SARS (Severe Acute Respiratory Syndrome) virus traveled across the globe in 2002-03 and again when another coronavirus- MERS emerged in 2012. While the former infected more than 8000 people and killed about 800, the latter infected about 2,500 people while being responsible for 900 deaths.
The coronavirus disease named COVID 19 is an entirely new strain of the virus that has emerged and has claimed tens of thousands of lives. Wuhan, the largest city and capital of Hubei Province in Central China, has been in the news for all the wrong reasons since December 2019. It’s officially cited as being the epicenter of COVID 19.
Today, coronavirus disease or COVID 19 has become a pandemic. The virulence has spread across America, Europe, south-east Asia, South America, and even Africa, claiming victims, right, left and center. The number of those infected and the number of the dead and dying is gathering monumental proportions even as the medical fraternity grapples with it, trying to control the spread.
What are coronaviruses?
Coronaviruses belong to a group of viruses that generally target animals, but many of them have jumped the gap, transferring their attention to humans. Although COVID 19 is genetically related to SARS, it is very different from either SARS or MERS.
The disease is flu-like and those affected may have a dry cough, fever and could experience shortness of breath. Sometimes, these symptoms are so mild that in many cases they are ignored or regarded as a case of mild influenza and treated symptomatically. This is why COVID 19 has been harder to control.
In severe cases, the virus has caused kidney and organ failure and triggered severe respiratory problems. If the virus infects the gastrointestinal system, the patient could suffer from nausea, diarrhea, indigestion and other complications. Organ and respiratory failure can be fatal and lead to death.
How did the outbreak happen in Wuhan?
Initially, it was thought that the seafood market in that city could be the source of the new coronavirus. However, the first patient (on Dec 1, 2019) was in no way connected with that market.
A hypothesis is being floated that the ‘wet market’ in Wuhan that dealt with living and dead animals, fish and birds could be a possible cause. Standards of hygiene are difficult to maintain in an area where livestock and animals are tightly packed and also slaughtered. The risk of disease is high and so is the transmission from animals to humans. Another theory blames bats for infecting live animals and livestock sold in Wuhan
How is the virus transmitted?
The coronavirus is a respiratory virus- meaning that its usual points of entry are the nose, eyes, and mouth. When an infected person sneezes or coughs, there is a red flag all around. The virus can affect people in a couple of ways-
- droplets can come into direct contact with you and enter your respiratory tract
- it can transfer itself to you when you touch something that a carrier has recently touched and then inadvertently touch your face, eyes, nose or mouth
Once this happens, the inevitable takes place. Initially, the virus stealthily travels to the anterior parts of the nasal passage and from there moves insidiously to attack the mucous membranes, located at the back of the throat. The virus begins its work- it triggers a sore throat and a dry cough and you develop a fever.
If not tackled in time, the virus does further damage by working its way down the airways to the lungs. It begins to inflame the membranes there. The lungs cease to function properly and you find it difficult to breathe. The situation is just perfect for pneumonia to set in.
When do symptoms surface?
The trouble with this coronavirus is that its onset can be slow and sometimes symptoms don’t appear for two weeks. That’s why the quarantine period is regarded as 14 days- a fairly safe margin. This would mean that if the virus has infected you- you should know for certain within this period. On the other hand, though, you could be symptomatic within two days itself. Studies conducted by researchers at Johns Hopkins School of Public Health indicate that symptoms generally surface in about five days.
How is the disease diagnosed?
This is the difficult part because if you’re only mildly affected, you may just appear to have a very bad cold or a slight attack of flu. This is something so common that most people tend to ignore it. Just a physical examination cannot show whether you’re infected or not.-only a lab test will do that.
Once COVID19 became a reality, many laboratories began to work overtime to develop means to detect it. These are some of them-
Sputum and blood tests
- Swab tests are conducted on sputum from the lungs, mucus from the nose and inside of the throat. A long, thin swab is used inside the nose and then extends to the nasopharynx (behind the nose and the upper part of the throat)
- Blood test samples are subjected to a blanket test that identifies all varieties of the coronavirus. Gene sequencing tests are also conducted to identify markers of this new virus
- Nasal aspirates– a saline solution is injected into the nose and then removed using suction. This saline is then tested for the virus.
- Tracheal aspirate– bronchoscopes are inserted into the lungs and samples of sputum are collected
- Commercial and molecular assays are in the offing
- New rapid tests claim to offer results very quickly but they are subject to approval
Who needs to be tested?
- If you have traveled to countries where the coronavirus is rampant or if you have been in close contact with anyone that has traveled to such infected countries- testing is a must.
- Those that have a severe cough, shortness of breath and high fever
- Those that exhibit mild symptoms but have health conditions like diabetes, heart, lung, and kidney disease are very vulnerable
- Those that work in healthcare and are in direct contact with patients
How to remain safe?
- Social distancing is a must. Avoid close contact with the ‘possibly infected’. Avoid being in the midst of crowds- you don’t know who is affected and who isn’t. Try and maintain a distance of at least 2 meters between you and the other person
- Minimize your outings- go only if you really have to and wear a mask
- Wash your hands often- you cannot beat good old soap and water. If you are outside, use a sanitizer but wash your hands with soap and water for at least 20 seconds once you return home
- Try not to touch your face, mouth or eyes- for these are vulnerable entry points for the virus
- Maintain hygiene- wipe door handles, doorknobs, phones, and other “high-touch” surfaces to keep them clean. Wash all cooking utensils and dishes after every use. Don’t share such items
- Eat healthily, remain hydrated and keep your immune system strong and healthy
- If you are infected, go into self-quarantine and follow rules
Treatment for COVID-19
As this is a new coronavirus that has strangled the world, there are no drugs to combat COVID19. Antibiotics act on bacteria but are ineffectual against viruses. Many drugs that have treated SARS and MERS are being used to reduce the severity of the virus. A vaccine is currently being tested but it will take some time before it can be used on patients.
If you, unfortunately, happen to be a victim of COVID 19, stay positive and follow your doctor’s advice to the T. Your healthcare provider may prescribe antibiotics to counter possible bacteria co-infection.
Depending on the severity of the disease, it can take anything between 2-6 weeks for a cure. Don’t be in a hurry to resume normal activities after treatment. Be in touch with your physician and go along with their instructions.
The virus has already taken a deadly toll and valuable lives have been lost. At the time of writing, more than a million people have been infected and more than 60,000 have lost their lives. WHO, Centers for Disease Control and other health organizations are currently monitoring the situation.
Healthcare institutions across the world are battling as never before to contain COVID 19. The availability of PPE (personal protection equipment), ventilators, and test kits is in short supply. Labs and those companies manufacturing equipment and kits are being strained to the utmost.
Ongoing developments for testing
Recently (April 2, 2020), the FDA (Food and Drug Administration) has authorized a test (produced by Cellex) that doesn’t focus on the virus’ presence in the throat or nose. Instead, the test looks for antibodies in the venous blood of a patient. Results are available in about 20 minutes and only certified labs can carry out the test. The Centers for Disease Control and Prevention are working hard to develop antibody tests for the virus.
The logic behind the test is that when the virus infects a person, the immune system begins to work producing antibodies to counter the infection. The presence of antibodies is a good indication of whether an infection has set in or not. The downside though, is that such antibodies are not produced immediately. Hence the test may not be suitable for patients that are currently infected. At best, the test will reveal whether the person has already been infected with COVID 19 and whether he is currently a carrier or not.
Bosch is in collaboration with Irish company Randox laboratories Ltd to develop a rapid test that can be used directly by the healthcare institutions. The Bosch device is expected to help the medical fraternity to test not only for COVID 19 but also for influenza (A&B) and other respiratory diseases.
The deadly COVID 19 is on a rampage- do your bit to remain safe and also help those that cannot fend for themselves. STAY HOME, STAY SAFE!