Bisher AKIL, MD

Coronavirus: An Update

In General Health, Infections worthy of news on March 1, 2020 at 3:53 pm

Introduction: Human coronaviruses (HCoVs) have long been considered inconsequential pathogens, causing the “common cold” in otherwise healthy people. However, in the 21st century, 2 highly pathogenic HCoVs—severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV)—emerged from animal reservoirs to cause global epidemics with alarming morbidity and mortality. In December 2019, yet another pathogenic HCoV, 2019 novel coronavirus (2019-nCoV), was recognized in Wuhan, China, and has caused serious illness and death. The ultimate scope and effect of this outbreak is unclear at present as the situation is rapidly evolving.

How deadly is it? Epidemiologists are still trying to determine exactly how deadly covid-19. About 2 percent of reported cases have been fatal, but many experts say the death rate could be lower. That’s because early in an outbreak, mild illnesses may not be reported. If only people with severe illness — who are more likely to die — seek care, the virus will appear much more deadly than it really is because of all the uncounted people with milder symptoms.

How is it spread?: The reproduction number, or “R” number, appears to be around 2.5. That means every person who is infected will pass the disease on to 2.5 other people. The influenza virus is a little lower. Measles has a much higher R number of about 18. These are averages .Covid-19 spreads similar to other coronaviruses that cause cold-like symptoms, experts have said. There have been reports of people transmitting the virus before they show symptoms, but most experts think this is probably not a major driver of new infections. What is concerning, however, is that symptoms can be mild, and the disease can clearly spread before people realize they’re sick. A report in the New England Journal of Medicine suggested covid-19 reaches peak infectiousness shortly after people start to feel sick, spreading in the manner of the flu. A study published in JAMA chronicled the case of a 20-year-old Wuhan woman who appeared to infect five relatives, even though she never showed signs of illness.

What are the symptoms? : Symptoms are primarily respiratory. Coughing and shortness of breath are common, according to the CDC. Fever is also possible. The severity of the symptoms depends highly on the patient’s age and immune system.  For the elderly and those with underlying heart disease, diabetes or other conditions, coronavirus can cause pneumonia and lead to organ failure and death. But for most people, cases have been mild, requiring little to no medical intervention.

Do we have a test?: Yes,. A kit is available from the CDC, and today the FDA licensed other tests from private laboratories.

Is there a treatment?: There is no licensed medication for the treatment of this virus. . Gilead pharmaceutical has the antiviral drug remdesivir as a possible coronavirus treatment. It is now in clinical trials in several countries, including China. It has been used at least once in the US on compassionate basis.

How do I prepare? There are some basic precautions you can take, which are the same as what you should be doing every day to stave off other respiratory diseases: Wash your hands regularly. Cover your nose and mouth when you sneeze. And when you’re sick, stay home from work or school and drink lots of fluids.. The CDC recommends washing with soap and water for at least 20 seconds after using the bathroom, before eating and after blowing your nose or sneezing. It also advises not to touch your eyes, nose and mouth and to clean objects and surfaces you touch often.   Here is a video from WHO to show to proper hand wash:

Should I wear a mask?: If you’re not already sick and you’re not a health-care worker, the short answer is no. The main point of the mask is to keep someone who is infected with the virus from spreading it to others . CDC does not recommend that people who are well wear a face mask to protect themselves from respiratory diseases. Common surgical masks block the droplets coming out of a sick person from getting into the air, but they are not tight enough to prevent what’s already in the air from getting in. There are specialized masks — known as N95 masks because they filter out 95 percent of airborne particles. The masks are difficult to use without training. They must be fitted and tested to work properly.

When will it end? Unknown; it could follow a seasonal pattern (appears in cold weather and disappears with warm weather), and to return next season. However, there is evidence that it persists in Southern hemisphere countries that already have warm weather.

What about a vaccine?: several agencies and pharmaceutical companies are working on developing a vaccine; it is not likely that vaccine will be available this year and it not likely to be used in treatment.


<<Disclaimer: This summary is  compiled from information available through medical journals (New England Journal of Medicine, The Lancet, JAMA and others),government and public health sites (CDC, DHHS and FDA) and media outlets (New York Times, Washington Post and others) . Many of the information we know now, will likely to change as we know more- BA>>

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