corona virus
Infectious Diseases

Panorama of Coronavirus Infection (COVID-19)

Written by
Dr. Lochana
and medically reviewed by Dr. Anshul Varshney

Published on Mar 12, 2020 and last reviewed on Apr 3, 2020   -  19 min read

What is Corona or COVID-19?

Corona is a virus that belongs to the vast range of virus families. COVID-19 is known as Coronavirus disease. Since it was identified in the year 2019, it is named as COVID-19 . It causes mild to severe symptoms. Mild ones may be cold and cough, whereas severe ones include a 3 to 4 % mortality rate. Though there are different sources of transmission, mainly it occurs through direct contact with the person infected with corona or from animals. The transmission occurring from animals is called zoonotic transmission.

What Is the Disease Caused By Corona Named as?

The disease caused by the new coronavirus is named coronavirus disease (COVID-19). And the Coronavirus Study Group of the International Committee on Taxonomy of Viruses named the virus, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2).

The Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS-CoV) are other variants of coronavirus.

What Are Its Causes?

  • The reason why corona has been able to spread rapidly is that it is an air-borne infection.
  • It can spread through the droplets expelled from cold and cough.
  • Coronavirus can stay on the surfaces of different objects and when you happen to touch them you have the possibility of getting infected.
  • Animals such as cat, camel, bat, snake, and rat are known to transmit the new coronavirus.

Routes of Transmission From COVID-19 Patients:

  • Symptomatic Transmission - The transmission from a person who is experiencing symptoms. Preliminary data shows that COVID-19 gets primarily transmitted by symptomatic people through:
    • close contact with respiratory droplets.
    • direct contact with an infected person.
    • contact with contaminated surfaces or objects.

    The person sheds maximum numbers of the COVID-19 virus through the nose and throat during the early course of the disease (first 3 days of symptoms).

  • Pre-symptomatic Transmission - During the incubation period, that is the time taken for the virus to cause symptoms, some infected people can be contagious. This period is also called the pre-symptomatic period. Some small number of cases have reported pre-symptomatic transmission.
  • Asymptomatic Transmission- Transmission from a person who exhibits no symptoms even after being infected with the virus is called asymptomatic transmission. There have been a few laboratory-confirmed infected patients who are truly asymptomatic. But, there is no evidence that shows asymptomatic transmission of COVID-19.

Was Coronavirus Engineered in a Lab?

Based on the analysis of the data from the public genome sequence of SARS-CoV-2, researchers did not find any evidence suggesting that the virus was engineered in a lab. Scientists concluded that based on the genome sequence, the following two are the possible origin of the virus:

  • The virus evolved through natural selection in a host (non-human) and then spread to humans. This is how both SARS and MERS spread to humans through direct exposure to civets and camels. It was proposed that bats are most likely the reservoir for SARS-CoV-2, as it closely resembles a similar bat coronavirus.
  • This theory proposes that a non-infectious form of the virus spread to humans from an animal host. In humans, this virus then evolved to its current infectious state.

What are the symptoms of corona?

Fever
Fever
Cold
Cold
Cough
Cough
Sore throat
Sore throat
Breathing difficulty
Breathing difficulty
Headache
Headache

The new coronavirus can affect different people in different ways. It results in respiratory illness that makes people develop mild to moderate symptoms. It may take one day to two weeks (14 days) to show the symptoms. The common symptoms include:

  • High fever. Your body temperature will increase at first to fight the virus.
  • Shivering and sweating. As the body’s defense mechanism increases the temperature, the efforts to fight the virus may fail and additional symptoms such as shivering and sweating may arise. This is the time you should begin to isolate yourself and stay at home.
  • Shortness of breath and chest pain will develop.
  • Body weakness and tiredness.

It can also result in:

  • Cold and runny nose.
  • Pneumonia.
  • Muscle aches and pains.
  • Vomiting and diarrhea.
  • Dry cough and sore throat.

If you exhibit mild symptoms and are otherwise healthy, then self-isolate yourself and contact a COVID-19 testing center or hospital.

When to See a Doctor?

In case you develop the following warning signs or symptoms of COVID-19, get immediate medical attention:

  • Breathing troubles.
  • Persistent chest pain or pressure.
  • Confusion.
  • Lips and the face turn bluish.

COVID-19 Vs. Influenza:

Both COVID-19 and influenza (the flu) result in respiratory illness, but still, there are some differences in the two viruses and the way they spread.

How Are They Similar?

The disease presentation is similar. Such as both viruses:

  • Cause asymptomatic or mild respiratory symptoms to severe infection and death.
  • Are transmitted by contact with respiratory droplets.

This is why the same hand hygiene and good respiratory hygiene will help prevent both these infections.

How Are They Different?

The important difference is the speed of transmission. The serial interval (the period between two successive cases) for influenza is 3 days, and that of COVID-19 is 5 to 6 days. This means that the flu spreads faster than the new coronavirus. The median incubation period (the period for symptoms to show up after infection) for influenza is also shorter.

For COVID-19, the reproductive number (the number of infections from one infected individual) is between 2 and 2.5, which is higher than for influenza.

Majority of influenza transmission in the community is from children, whereas the initial data for COVID-19 shows that children are less susceptible than adults. The number of cases are low in the 0-19 age group. Further studies in China also suggest that adults infect children, rather than the opposite.

The percentage of critical cases is more with COVID-19 as compared to the flu. The data shows that 80 % of infections are mild or show no symptoms, 15 % of infections are severe, and 5 % of patients are critical and require ventilation. The mortality rate for COVID-19 (3 to 4 %) is also higher than seasonal influenza (below 0.1 %).

People that are more prone for severe infection for influenza are:

  • Children
  • Pregnant women.
  • Elderly.
  • Those with chronic medical conditions or who are immunosuppressed.

And that for COVID-19 are:

  • Older age.
  • Those with underlying conditions (diabetes, lung disease, cancer, hypertension, etc.).

Has the outbreak of corona become pandemic?

The World Health Organization declared the Coronavirus (COVID-19) outbreak as a pandemic one (prevalence of a disease all throughout the country or world). The number of patients affected outside China has risen by 13-fold. Many health organizations have declared that Coronavirus (COVID-19) is more deadly than flu. After Influenza this is the biggest pandemic disease reducing the population.

How Many Cases Are Confirmed?

Click here to know the data on the raise of COVID-19 cases globally.

How Can We diagnose?

There are specific laboratory tests to detect coronavirus. They are swab test, nasal and tracheal aspirate test, sputum test and hematological tests. In the swab test, a cotton swab is placed inside the nose or throat and studied. In nasal aspiration method, a saline solution is inserted into the nose and the sample is removed with mild suction. Tracheal aspirate is collected using a bronchoscopy instrument that goes into the lungs. Sputum test collects samples when the sputum is expelled during coughing or sneezing.

The collected specimens are then tested using viral RNA detection. This directly detects SARS-CoV-2 viral RNA through PCR (polymerase chain reaction). As this test is still very new for COVID-19, the true clinical sensitivity is still unknown. Thus, a negative test does not completely rule out the possibility that the person was infected previously. Despite this, this test is being most commonly used now.

The other option being serological tests. These detect immunoglobulins in the blood. It detects the presence of antibody-antigen in the host who has been exposed to the virus. The benefit being, it can also detect previous infections in patients who have already recovered. These tests are still being developed.

Chest radiography or computed tomography (CT) to diagnose the status of lungs. Thermal scanners are used in many places to determine the increased temperature in humans. However, this will not detect people with infection.

Saliva Test

Instead of using a deep nasal swab to collect a sample for testing, Andrew Brooks developed a new test that only requires the patient to spit into a cup. According to new research (Yale School of Public Health), saliva samples give more accurate and consistent results. This study also found that saliva testing can show actual results for people with a mild infection, who sometimes test negative with nasal swabs.

The test method used now involves uncomfortable deep nasal swabs, which makes the patient cough or sneeze. This increases the risk of the healthcare provider, collecting the sample, getting infected. As both swab tests and PPE are limited, the new saliva test can help immensely. The FDA is now allowing people to collect saliva samples at home and send it for testing. This method will increase patient access to testing for the new coronavirus.

What can we do for prevention?

Coronavirus (COVID-19)  Prevention
  • Avoiding physical contact with everyone is a basic measure of prevention. But still, avoiding contact with everyone can be challenging sometimes. In such cases, it would be dignified for a person to give a wave of hand and elbow bump instead of a handshake or hug. Elbow bump is a way of greeting a person informally by touching two people’s elbow. This culture came into practice during the outbreaks of flu.
  • One can use a face mask. But, if you do not have the symptoms of the coronavirus, then it is not advisable to use face masks as they attract more polluted substances.
  • Practice hand hygiene. Washing hands with soap, water, and any other alcoholic rubs are essential. Wipe the wet hands with a clean and dry towel. Soap and water might not be available all the time, so it is best to carry a hand sanitizer with a minimum of 60 % alcohol content in it. Develop the habit of washing hands thoroughly before and after eating food. It is highly essential to clean your hands after using restrooms.
    Corona wash steps
  • Covering mouth and nose while coughing and sneezing will help. The infected clothes or handkerchief should be disposed properly.
  • Meat and eggs should be cooked completely.
  • Disinfect the objects that are constantly used and then wipe the objects properly.
  • Health care personnel should depend on more protective equipment. The use of facemasks is mandatory for the doctor and nurse who is taking care of the patient.

How to Use Face Masks?

Corona how to use mask
  • If you have to take care of the infected person, it is wise to wear a face mask. Before wearing it, make sure you wash your hands with alcohol based cleansers.
  • If the mouth mask is not used correctly, it can become a source of infection rather than a protecting guard.
  • Hold the metal strip on top of the mask and place it on your nose bridge.
  • Put on the elastics behind the ears or tie the strings. It should cover your nose, mouth and chin.
  • To remove the mask, remove the elastics securely. Do not touch the front of the mask as there are high chances of contamination.
  • After removing the mask, discard it in a closed bin.
  • Never reuse these masks.
  • If you accidentally touch the front portion of the mask, wash your hands thoroughly.
  • If the mask becomes humid or wet during usage, replace the mask.

What Are the Common Misconceptions Around Corona?

What Is the Impact on the Economy?

There has been a huge challenge for health care workers and this challenge has increased to greater volumes due to the demand for gloves, masks, goggles, gowns, aprons, face shields and respirators.

The economic growth has very much reduced because many factories in China are shutting down. In the northern part of Italy, a major firm that makes automotive parts across European countries had to shut down. As the supply chain gets disrupted, it has been a difficult situation for the United States and other developing countries to substitute for the loss of supply.

Not only factories, but many software and smartphone manufacturing companies are also facing great downfall. Multinational companies that were dependent on Chinese consumers had to totally close down their company. The economic value has become very uncertain and the stock market value has decreased. A decline in economic growth has occurred in two ways.

  • The first reason is that consumers all over the world, especially consumers from China and the United States who had been working in factories and companies lost their jobs. Because of this poor income, it is difficult for their family to invest in all their demands. The rate at which they purchase new products and eat foods have reduced dramatically. They fear that buying new goods will increase their exposure to the virus.
  • The second one is that travel to China and the United States have become very minimal. Many Chinese passengers are not traveling to the United States for business purposes. Tickets to China were canceled on a mass level during the virus outbreak. The revenue from air travel has put downward pressure on economic growth. Americans panic very much about Coronavirus (COVID-19) and they have reduced so much of their expenditure.
Economic Advice

Spreading of the virus through goods and toys made in China is not true. If you feel a particular area is infected with the new coronavirus, it is ideal to wipe it with disinfectant. After cleaning, make sure you wash your hands with soap and water.

Travel Advice
  • If you have traveled recently from China, Iran, South Korea or Italy in the past two weeks, it is advised to stay indoors so that you do not infect others. Do not use public transportation as there will be many citizens and so the chances of getting and spreading of infection might increase.
  • Travel if it is really important. Avoid traveling for adventures until the fear of the virus has subsided.

What Is the Treatment?

Antibiotics drugs cannot help. Antiretroviral drugs are known to contribute to the treatment. As of now, there is no proper treatment established. But treating only the symptoms are known to have better clarity for doctors.Antibiotics and Antiviral drugs cannot help. Anti-retroviral drugs are known to contribute to the treatment. As of now, there is no proper treatment established.

The "Solidarity Clinical Trial,” which is an international trial that is trying to find an effective treatment for COVID-19, and has been launched by the World Health Organization (WHO) and its partners. This trial will compare the effectiveness of the following four treatment options:

  • Remdesivir - This drug was previously tested for Ebola, and has given promising results in the treatment of MERS and SARS in animals. Which is why it is believed that it might be effective against COVID-19.
  • Chloroquine and Hydroxychloroquine - Used to treat malaria and various rheumatological conditions. Small studies conducted in China and France show possible benefits against pneumonia caused by COVID-19, but this has to be still confirmed by various drug trials.
  • Lopinavir or Ritonavir - These are antiretroviral drugs used for HIV infection. They might also be effective against COVID-19, but the studies so far are inconclusive.
  • Interferon-beta-1a - This is a drug used in the treatment of multiple sclerosis. As there is no sufficient evidence about how effective these drugs are, WHO advises physicians against administering these drugs to COVID-19 patients. Nobody should take any of these drugs as a way to prevent or treat this infection. It can cause serious damage to your body and can also be potentially fatal. There are more than 20 companies pursuing vaccines for coronavirus.

What Is Home Quarantine?

In a health care center, the term quarantine refers to a duration of time when a person is isolated from other people in order to avoid the spreading of a particular disease. In-home quarantine, all the individuals are ordered to stay at home by their respective nations to prevent the spreading of disease.

Corona Stay Home

Home quarantine also includes a person who are not affected. This is done to prevent excessive transmission in the community. In a non-clinical setup, home quarantine also includes isolation of someone who is suspected to be infected (might be with COVID-19). It extends for a period of 14 days.

What Are the Safety Measures to Be Followed at Home?

Corona fight
  • Maintain a distance of one meter from your family members.
  • If any member of your family returned from travel, it is important to allocate a specific separate room for them. This will include separate bathrooms and restrooms. They should wear a mask all the time. Provide separate soap, towels, utensils, drinking glasses and bedding for the suspected person. Only the assigned member should look after the affected individual. They should check the temperature of an isolated person regularly. If he develops any symptoms, then report immediately to the hospital.
  • Stay in well-ventilated rooms.
  • Kids, elderly and pregnant women should stay totally away from the affected people.
  • In places where sanitation facilities are not available, use alcohol-based sanitizers for a duration of 20 seconds.
  • At home, use soap and water to wash your hands regularly.
  • Avoid touching your eyes, nose, and mouth without washing your hands.
  • Use your non-dominant hand. If you are a right-hander, use your left hand for opening doors, transportation, and bathrooms. This practice will prevent yourselves from touching your face, as you tend to touch your nose and mouth with your dominant hand. If you are a left-hander, then use your right hand.
  • Use disposable gloves and masks only. Do not re-use it.
Tips for Kids
  • Educate the kids about Coronavirus, its causes, and symptoms in a way they better understand.
  • Monitor the activities of kids.
  • Ask them to follow proper sanitation methods and emphasize on regular handwashing with soap and water. Avoid giving alcohol-based sanitizers to children
  • Do not allow them to play with the neighboring kids. Teach them about the importance of social distancing.
  • Engage the kids to involve in indoor games.
  • Help them bathe twice.
  • Avoid touching your eyes, nose, and mouth without washing your hands.
  • Isolate the pet animals at home and do not allow the children the play with them
  • Parents should make sure the children are eating only fresh foods.
  • Do not allow the children to go to dusty places.

How Important Is Social Distancing?

  • When there is an outbreak, and it is known to spread through direct contact with others, it is a wise decision to maintain a distance from others. This practice will reduce physical contact with others.
  • Shaking hands should be avoided completely.
  • Use the alternative method to greet people.
  • Avoid social gatherings, functions, movie theatres, malls, restaurants, religious places, and marriages.
Emerging Doubts
How long does the virus survive on someone's dress and skin?

All fabrics can be contaminated by respiratory droplets that may contain the coronavirus. Scientists say that the droplets will dry over time, and the virus might become inactive, but all this depends on the humidity and temperature.

Preliminary information about the COVID-19 virus suggests that it can survive on someone's dress or skin for a few hours to many days. So, make sure you wash and disinfect your hands and clothes properly.

Outside a host, at what temperature does the virus die?

The spread of other strains of coronaviruses did wane during summer, as people are more exposed to sun rays, which can kill viruses. But, according to the CDC, it is still not known whether the spread of COVID-19 will be affected by hot temperatures. Investigations are on to learn more about this virus.

How is an infected patient's dress, bedsheets, pillow covers, and things used by him/her cleaned?

WHO recommends machine washing patient's dress, bedsheets, and all the linens used by him or her with warm water (60 to 90° C) with laundry detergent. The clothes should then be dried under sunlight.

If washing machines are not available, then clothes have to be soaked in hot water and soap and use a stick to stir the clothes in water and avoid splashing. Then the clothes should be soaked in 0.05 % chlorine for around 30 minutes. After which the linens should be properly rinsed and then dried under sunlight.

What if someone who is infected or not infected but has not cleaned their hands, touches food
  • Should we discard it?
  • Will the virus die after a while, if yes, how long would it take?
  • should we heat it and have it? If yes, to what temperature?

It is still not clear whether the new Coronavirus (COVID-19) spreads through eating food touched or contaminated by an infected person. The virus has been detected in the stool of some infected people, so currently, the possibility of the infection being transmitted through infected food cannot be ruled out. So, it is better to discard the food than to risk it.

The virus will most likely be killed during cooking, which is not true for raw fruits and salads.

We do not know the exact temperature at which the virus dies, so reheating it would not be the best idea.

Can UV disinfection lamp be used to clean objects like wallets, currency, mobile phones, etc.?

UV-C ultraviolet light is being used to disinfect hospital equipment, walls, floors, currency, and mobile phones, as the other strains of coronaviruses have shown to be sensitive. But it is still not certain if UV lights can kill the novel coronavirus. Avoid using UV light to disinfect your skin, as it can irritate it.

Is Dettol useful in disinfecting? If yes, can it be diluted in water and used as a hand sanitizer?

According to the company, Dettol has been effective against other strains of coronaviruses. As COVID-19 is structurally similar to these strains, they expect it to be 99.99 % effective also. But only after health authorities release the new strain will Dettol test its efficacy. 1:2 diluted mixture of Dettol can be used as a sanitizer and disinfectant.

Is salt or saltwater effective in sanitizing things like milk packets, vegetables, etc., that come from outside?

Salt or saltwater might not disinfect fruits and vegetables, but it will help remove 75 to 80 % pesticide residues.

At what stage will an infected person spread the virus to others?

According to the CDC, a person infected with the new Coronavirus (COVID-19) is most contagious when he or she shows the most symptoms (symptomatic). But, there have been reports of the virus spreading from infected people even before they start showing signs.

Experts Words On Corona?
Frequently Asked Questions

Q1. Can I Possibly Get COVID-19?

ANSWER:
The outbreak of COVID-19 is increasing and many regions are in danger zones. Avoiding travel to these regions can help you. Avoid social gatherings and crowded places. Also, there is no proper finding that younger or older people can get it. So mothers of babies do not have to worry about it.

Q2. Should I Consider COVID-19 Seriously?

ANSWER:
The first thing to do for any outbreak of disease is to stay calm. Creating too much panic and obsession with a disease is not good for your mental health. Since it has caused the death of a huge number, it is common for a person to develop fear. Just a thorough hand-washing with proper soap or scrubs can do the needful.

Q3. Is There Any Vaccine for Coronavirus?

ANSWER:
Till now, there is no particular vaccine for COVID-19. However, those showing symptoms should be admitted to the hospital and should be given proper care.

Q4. What Is the Incubation Period for COVID-19?

ANSWER:
The incubation period is the time for which the symptoms take to arise. It takes around one day to two weeks.

Q5. Is Receiving a Package From the Affected Area Safe?

ANSWER:
You can very well send and receive parcels. The possibility of a virus being contaminated over the area is very less. Also, the virus cannot be proved to stay for a long period of time in the same place. The contamination through goods traveling from such long distances may not be true.

Q6. What Are the Things I Should Follow?

ANSWER:
Avoid smoking. Wearing multiple masks will increase the risk of infection. Taking antibiotic medication is not going to act against this viral disease. Washing hands regularly is a must-do thing.

Q7. What Is the Source of Coronavirus?

ANSWER:
Bats are known to be the main source of these viruses. Many species of animals are known to be the cause of COVID-19. The virus -Middle East Respiratory Syndrome Coronavirus (COVID-19) (MERS-CoV) is known to get transmitted from animals living in desert-like camels, and the Severe Acute Respiratory Syndrome Coronavirus-1 (SARS-CoV-1) is known to get transmitted from civet cats.

Q8. Are Children More Affected by COVID-19?

ANSWER:
A large study was conducted in China for children under 18 years of age. Only 2% of them were affected. So, it might be that younger people are not easily affected. People who are already having Pneumonia or any other health condition are known to be affected more.

Q9. Does the Influenza Vaccine Protect Against COVID-19?

ANSWER:
Influenza and Coronavirus (COVID-19) are two different viruses. The seasonal influenza vaccine is not known to protect against COVID-19.

Q10. Will A Vaccine for Coronavirus (COVID-19) Be Available?

ANSWER:
Many pharmaceutical companies are doing a wide range of research to find a solution for the novel Coronavirus. This may take up to a month’s time as it has to go for extensive research and testing for it to be fully beneficial and safe.

Q11. What Should I Do If I Recently Returned From Travel?

ANSWER:
Travelers should avoid contacting healthy people after the return. Initially, they have to keep an eye on their health status for 14 days. If they notice any symptoms, they should call a doctor online or through telephone. If the symptoms get severe, it is vital for the patient to visit the hospital and take the respective health protocols

Q12. Can Vitamin D Reduce the Risk of Getting COVID-19?

ANSWER:
Some research shows that healthy levels of vitamin D and taking vitamin D supplements keep the immune system healthy and protect against various respiratory illnesses. Vitamin D is needed for the proper functioning of the immune system, and it protects the body against microorganisms. This vitamin is so essential that its deficiency increases the risk of respiratory illnesses such as asthma, tuberculosis, COPD, etc.
Based on this, vitamin D might even protect us from COVID-19, but there is no evidence to support this claim. However, as various studies have linked healthy levels of vitamin D in protecting against viral and bacterial respiratory infections, it is best to get your vitamin D levels tested and start vitamin D supplements.
 


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