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  1. What is the cause of Covid-19?

Covid-19 stands for Corona Virus Disease in 2019. Coronaviruses are a family of viruses that have been known to cause respiratory illnesses in the past. Examples are MERS (Middle Eastern Respiratory Syndrome) caused by MERS CoV and SARS (Severe Acute Respiratory Syndrome) caused by SARS CoV. The spread of these viruses was curtailed at the outbreak locations and hence were prevented from spreading globally. The current virus shares 85% of its genome with SARS and hence the virus is named SARS CoV-2. The infectivity of SARS was less but fatality was higher. SARS CoV-2 has a high infectivity rate but less fatality than SARS and ten times more fatality than Common cold. 2. How did it appear in Wuhan, China? Covid-19 is a zoological disorder – a disorder that jumped from animal species to humans. It was previously unknown to cause disease amongst human beings and hence no human on the earth has immunity to the virus and this makes all susceptible to the infection.

2. How did it appear in Wuhan, China?

Covid-19 is a zoological disorder – a disorder that jumped from animal species to humans. It was previously unknown to cause disease amongst human beings and hence no human on the earth has immunity to the virus and this makes all susceptible to the infection.

TRANSMISSION

In China, there are wet markets where live exotic animals are killed and sold. The early cases of the disease in China had visited this market hence the virus is said to be originated from there Earlier SARS outbreak was also linked to the same wet market. The virus seems to have jumped from Bats to Pangolins to Humans. Pangolins are the most trafficked wild animals in China and are one of the endangered species. Numerous studies are still going on to understand their origin

  1. What are the symptoms?

Following are the common symptoms2

Age is an important factor affecting the severity of the disease. Children are less likely to need intensive care units and have less fatality rates. This difference needs more clarity and not yet fully understood.

 

Another factor that affects severity is pre-existing disorders. The disease poses a higher threat to people suffering from such conditions.

  1. How does it spread?

It spreads by small respiratory droplets that are released by sneezing, coughing or talking by the infected person. An asymptomatic patient may spread it too.

These droplets can travel up to six feet and survive on surfaces for longer. It survives 24 hours on paper and cardboard and 72 hours on plastic and steel. In a hospital setting it may spread by aerosols- tiny particles generated from droplets.

  1. How is it diagnosed?

A swab is taken from the back of the nose or mouth by a cotton-tipped stick. This swab residue is tested for the genetic material of the virus by RT-PCR (Reverse Transcriptase Polymerase Chain Reaction). The test results take approximately 24 hours to reach the suspected patient.

There are ongoing researches for detecting it by Blood samples which will be faster and easier. Some rapid antibody tests are also available but not very reliable.

  1. What is the treatment?

Respiratory viral illnesses usually have no specific anti-viral treatment. Antibiotics do not help with viral infections. But viral infections tend to lower the immunity of the body causing bacterial infections for which antibiotics are prescribed.

For Covid-19 too, no specific drug is available. The treatment includes drugs for fever, cold and prophylactic antibiotics. Most of the cases (80%) can recover without any breathing difficulty with supportive treatment as mentioned above. If the patient has breathing difficulty, then he needs hospitalization and ventilator support.

  1. How can I protect myself against it?

Hand hygiene– Soap denatures the cell-wall of the virus and renders it ineffective for infecting. But this can only happen with proper foam and mechanical scrubbing; hence 20 seconds are mandatory for disinfection. Please follow the steps to wash properly.

Cough etiquette– As the virus spreads by droplets, it is of utmost importance to cover your mouth and nose while coughing and sneezing. This also forms the basis for the government’s guidelines that mandates everyone to wear a mask/handkerchief. If everyone wears a mask, the spread by droplets will decrease drastically. Social Distancing– Many aspects of the virus are unknown and every day newer information is coming up. Till everything is verified, the best way to prevent the disease is by staying at home. Through various statistical models, it has been predicted that social distancing can slow the spread of the virus in the community. If the cases occur less in number and frequency at a time, the health care system can treat without being overburdened. If the cases occur in large numbers in a short period of time, the hospitals will be overwhelmed and not able to save many patients. This is in nutshell- flattening the curve.

  1. How do I buy grocery safely?

As the virus survives 72 hours on plastic, the best thing to do after buying groceries is to put away the packages for 3 days in the unused area of the house. For perishables items, packages may be washed with soap and water. For vegetables and fruits, emptying them from the bags and washing them with just water before cooking will suffice. Cooking kills the virus, also the disease spreads by droplets and not by food. So wash hands before and after cooking as well as eating.You may check out the video for detailed steps after buying groceries.

  1. When will this end?

Herd immunity-the resistance to the spread of a contagious disease within a population that results if a sufficiently high proportion of individuals (70-90%) are immune to the disease after being infected and recovery or through vaccination. When the herd immunity is reached in the community, numbers of cases start coming down and eventually become zero.

The vaccines have been developed in different countries against COVID-19 but after development, they need to undergo various stages of clinical trials for effectiveness and safety. This takes normally 7-8 years and even if this is fast-forwarded, we are at least one year away from the effective and safe vaccine. Based on this, social distancing and personal preventive measures are the best options until the vaccine is available. The social distancing measures needed may vary over time and will not always need to be as strict as our current shelter-in-place laws.

Most virologists opine that immunity against Covid-19 will be short-lived. This means that it is likely to become endemic – which means we would see seasonal peaks of infection of this disease. But could it change its virulence? Some researchers think that it may become less deadly. Others have argued that it could mutate to become more lethal or it may not change at all as it is spreading widely and change brings it no benefit.

  1. What are the ongoing research about Treatment and Vaccine?

Treatment The drug that is being considered to be effective against SARS-CoV2 is Chloroquine/Hydroxychloroquine4. It is an anti-malarial drug that has a certain mechanism of action against respiratory illnesses. The results are expected to be out by May-2020. Antiviral drugs like Remdevesir, Ritonavir, Lopinavir and Interferon Beta 1a are also being studied for the cure of Covid-195. Plasma therapy is being considered for this disease. It involves separating antibodies from the recovered patient’s blood and injecting it into the patient6. This therapy will be very expensive and its effectiveness in treating COVID-19 infections is still under the scanner.

Vaccine

Currently, vaccine research is in its earliest stages. Different vaccines are being tested for their efficacy and safety. As I mentioned, we are at least one year away from its full availability.

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Author

– Dr. Shaily Surti

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