Overview

Coronaviruses have been known to mankind for years and they cause a wide range of illnesses from mild flu to serious infections like severe acute respiratory syndrome (SARS) and the Middle East respiratory syndrome (MERS). This novel form of coronavirus was first identified in Wuhan city, China in December 2019.

This novel form of coronavirus is named severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) and the disease that it causes is called coronavirus disease 2019 or Covid-19. It’s an infectious disease that mostly affects the respiratory tract and lungs. The virus has an ability to spread very quickly and since December 2019 when it was first identified it has reached almost every part of the world. In fact, according to John Hopkin’s university count the virus has infected more than 5.5 million across the world and the number is increasing exponentially.

Keeping the unprecedented spread of the virus in view and the overwhelming impact that it had across the world, WHO declared it a global pandemic in March 2020.

If you are looking for live coronavirus updates and statistics please scroll down.

What are the sign and symptoms of Coronavirus (Covid-19)?

According to WHO, the incubation period for Covid-19 is 2-14 days. However, most people develop the first signs of the disease on the 5^th or 6^th days of infection. Symptoms for COVID-19 can be vague and manifest differently for different patients. There are many patients who are asymptomatic and still carry the infection. However, in general, the most common coronavirus symptoms are,

Fever
Dry Cough
fatigue

Other less common symptoms are,

Body aches
Headache
Sore throat
Diarrhea
Conjunctivitis
Loss of smell and taste
Skin rashes
Discoloration of fingers and toes

Most patients (about 80%) do not develop serious complications and recover on their own within a couple of weeks. Yet, there are some patients who experience life-threatening complications (usually after two weeks) and manifest severe symptoms. These are,

Breathlessness
Chest pain
Loss of mobility and speech

The question is how dangerous is coronavirus?

The virus may cause severe respiratory symptoms and can cause death in some cases. Please WHO guidelines for the prevention of COVID-19 because there is no treatment available.

What is the incubation period for coronavirus?

According to WHO, the incubation period for Covid-19 is 2-14 days but the signs and symptoms may appear on the 5th or 6th days of the infection. You can check the signs and symptoms of coronavirus disease above.

Myth Buster: Alcohol can kill coronaviruses and thus should be used orally to cleanse the body. Alcohol is an effective disinfect at a very high concentration of 70% or more. Though it can be safely used topically, ingesting alcohol at this concentration will result in massive damage to the epithelial lining of the GI tract and may lead to mortality. In fact, many have already died of alcohol intoxication in Nigeria when it was used prophylactically against COVID-19.

Who are at the most risk?

It is true that anyone can have the infection, some people are more at risk to contract the infection than others. These are,

People have recent travels history especially to places where the virus is more prevalent
People who are in direct contact with infected individuals or have someone in their families or surrounding areas with the virus
Healthcare professionals are at the front line of the Covid-19 fight and thus it makes them vulnerable to have an infection because of continuous exposure.
Those employees who work in businesses that have to remain open across the clock like grocery stores
People who share the same living spaces in correctional centers, shelter homes, prisons, old age homes, etc
People who live in the congested area
Homeless people.

Myth Buster: Young and healthy people do not have to worry about COVID-19 as it only affects old people and those with comorbidities. It is true that aged people of 65 years and more and those with pre-existing health conditions are at high risk from COVID-19 but it does mean that the infection will not harm young and healthy people. Thousands of healthy and young people have lost their lives to coronavirus (COVID-19) across the world and the numbers are kept on increasing.

Who is more likely to develop serious complications?

Covid-19 is a novel illness and we do not have enough information on its risk factors. However, thus far, it has been seen that most aged people and patients with existing health conditions are likely to develop serious illness. Some of the known risk factors are,

According to the center for disease control and prevention (CDC), 59% of the infected with age 65 or above requires hospitalization and the mortality rates are almost 11% which is significantly higher than in any other age group
People with compromised immune systems are more prone to develop serious life-threatening complications. Also, the duration of the infection may be longer in such patients than in others. Immunity is weakened by chemotherapy, HIV, organs transplant, bone marrow transplant, use of medications such as corticosteroids and hereditary factors.
Patients with pulmonary problems such as asthma and COPD are advised to take extra care as COVID-19 can manifest severe complications in such patients
People with heart problems could be at greater risk from COVID-19 as it affects lung function which in turn puts extra pressure on the heart to supply enough oxygen to all parts of the body.
There is not sufficient test data to support the claim but generally diabetic patients find it difficult to fight viral infections. High blood glucose levels make it an ideal environment for viral proliferation.
Severe obesity is another pre-existing risk factor that could increase mortality rates.

Myth Buster: If you can hold your breath for 10 seconds it means that you do not have COVID-19. Covid-19 does affect the breathing of patients in severe cases but it doesn’t mean that people who can hold their breath for 10 seconds can be ruled out for COVID-19. Holding the breath doesn’t suggest anything about the illness and it may depend on various other factors.

How is coronavirus transmitted?

Coronavirus (SARS-CoV-2 ) is a highly contagious virus that can spread from person-to-person in a number of ways.

Droplets transmission: Infected people have a significant load of viruses in their bodies and they cough, sneeze, or talk they release droplets. Healthy people in the nearby (approximately 6 feet) can inhale these virus-laden mucus drops through their mouth or nose and thus develop the infection. According to CDC this the major form of virus transmission and thus the social distancing of at least 6 feet is so much emphasized.
Aerosol transmission: Smaller virus-laden respiratory droplets (<5 micrometers) can remain suspended in the air for hours and can disperse nearby within closed premises by the air current. These suspended droplets are when inhaled lead infection.
Transfer from contaminated surfaces and objects: People can also get infected by touching surfaces and objected that are contaminated with the virus by people carrying the virus. People when touching their face after coming in contact with a contaminated object like a doorknob, they transfer the virus to their bodies either through mouth, nose, or eyes. A study at Nebraska University finds that 76% of personal belongings of people at the university were contaminated with the SARS-CoV-2.
Oro-fecal transmission: This is not yet certain that feces can have the virus but some researches have revealed that when infected people do not care for proper toilet hygiene they can contaminate surfaces or transfer the virus to other people through direct contact.

Community transmission: Apart from person-to-person mode of COVID-19 spread, people have also contracted the virus from communities where they live. They cannot track back the virus to any single person who could have infected them and are believed to have the infection from anywhere in the community.

Does coronavirus cause death?

In most cases, COVID-19 doesn’t cause death but in severe cases which is 3-5% of total cases are fatal and cause death. So for the death toll is around 400,000 but it is increasing with each passing day.

Myth Buster: The SARS-CoV-2 coronavirus can be transmitted through houseflies. Houseflies do not carry the COVID-19 virus and they cannot transmit it to humans. Most humans get the COVID-19 infection through inhaling air droplets from infected persons or touching contaminated surfaces and then touching their hands to face.

How long the virus survive on objects and surfaces?

SARS-CoV-2 can survive for hours and even days on different surfaces. The duration of survival mainly depends on the type of material that surfaces are made from. Research is ongoing to better understand the phenomenon. A study in the New England Journal of Medicine (NEJM) was published which studied the incubation of viruses on different surfaces in a controlled environment. The results were presented as following,

Plastic surface – shampoo bottles, electric button, ATM cards, keyboards, Duration is 3-7 days
Stainless steel – doorknobs, industrial containers, keys: Duration is 3-7 days
Cardboards – delivery boxes, milk packing: Duration is 24 hours
Glass – drinking glasses, windows, gadget screens: Duration is 4 days
Wood – furniture, storage shelves: Duration is 2 days
Papers – money bills, tissues, newspapers: Duration is 4 days
Copper – pennies, cookware: Duration is 4 hours
Ceramics – mugs, dishes: Duration is 5 days.

Myth Buster: Hot and humid weather will end the pandemic. The rise in temperature and humidity do not affect SARS-COV-2 and it has been evident from the exponential increase of COVID-19 cases in middle and south Asian countries despite temperatures in the early forties and humidity almost 50%.

What can I do to protect myself from Coronavirus?

SARS-CoV-2 is a navel virus that is deadly, highly contagious, and does not have any cure as of yet. The best line of defense against the virus right now is prevention. WHO recommends a certain set of preventive measures which people need to take very seriously in order to protect themselves and avoid spreading the virus to others. These are,

Follow social distancing: People are advised to stay indoors and avoid public gatherings. You can have the infection even by just talking to an infectious person or contaminating your hands with something they have used and then touching your face with these dirty hands. If it is absolutely necessary to go outside than a social distance of 2 meters (6 feet) should be kept all the time.
Wash your hands regularly: Washing your hands with soup thoroughly will eliminate any viral contamination that you may have on your hands. People are best advised to wash hands after touching anything that could have the virus or before touching their faces. Washing hands should be thorough and at least for 20 seconds. In case there is no visible dirt on hands or soup and water is not available, people can also use alcohol-based hand sanitizers to disinfect their hands.
Do not touch your face: Predominantly SARS-CoV-2 can enter your body from contaminated surfaces and objects is by touching face with hands. The virus from hands can easily enter your mouth, nose, and eyes and create an infection.
Maintain respiratory hygiene: SARS-CoV-2 mainly infects the respiratory tract and when infected persons sneeze and cough, they release the virus-laden mucus into the air as droplets. It is, therefore, highly important to cover the face with a bent elbow or tissue papers when people sneeze and cough. Care should also be taken to carefully wash arms after coughing and sneezing into them as it may contain a virus. If it is tissue papers that are used so it must be trashed properly so that it should not pose a danger of infection to others.
Wear a mask: It is every individual’s responsibility to wear a mask to prevent or slow down the spread of the virus in the community. Masks greatly reduce the chances of spreading SARS-CoV-2 to other people particularly in people in the first two days of their infection and asymptomatic patients. Ideally, people should be wearing the N95 mask which provides the maximum protection against SARS-CoV-2 but as they are in limited supply and it should mainly be reserved for doctors. Surgical masks are now available in sufficient quantities in most parts of the world and they serve the purpose effectively. If nothing is available people can always make their own face mask from thickened clothes at home but they should be kept as a final resort.
Avoid crowded places: It almost gets impossible to maintain that minimum distance to avoid spreading of the virus once you’re in large crowds. Crowds can be of any sort like congregational prayers, relaxing on beach, or community festivals.
Disinfect objects and surfaces: surfaces such as countertops, working and food tablets, etc can be contaminated with the virus and it is important to regularly sanitize them. This gets particularly important when some working place is shared by different employees like in grocery stores. Each time shift changes a suitable sanitizer spray should be used on all surfaces to avoid the spread. Also, the virus can survive for days on certain objects like cell phones, laptops, keys, and using it without sanitization will expose people to high infection risk.
Keep yourself updated with the latest information and guidelines on the pandemic: Covid-19 is a navel illness and research has been going on to gather new information to fight the infection more effectively. It is imperative for people to regularly follow their respective governments’ guidelines and information from health bodies to better understand the fight against COVID-19 and protect themselves.
Know when to seek medical help and self-isolate: If anyone has developed symptoms of COVID-19, they should inform the authorities as soon as they can and went through the screening process to confirm the presence of illness. As most hospitals are overcrowded with COVID-19 patients, it is highly likely for hospitals to turn away COVID-19 patients with mild symptoms to stay at home and quarantine themselves. Patients should stay at home and avoid any contact with anyone and carefully monitors. If patients develop severe like breathing problems, pressure in the chest, or any other secondary complications like heart problems they should visit hospitals as soon as they.

Myth Buster: Adding red pepper to food will protect against the Covid-19 virus. There has been no such study or reports that affirm the claim that red pepper can be of any use in protection against SARS-CoV-2. Red pepper as a spice does make food tasty and flavorsome, but they do not prevent or treat Covid-19.

Epidemiology of Coronavirus

Covid-19 has already become a global pandemic reaching all parts of the world. According to John Hopkins University statistics, the global number of confirmed cases stands at 6,528,544 while the total number of deaths is 386,392. These numbers are constantly updated and we say many thousands die every day and lot more getting the infection.

As COVID-19 is spreading at a different pace in different countries and the mortalities rates vary among different countries and ethnic groups, it is difficult to accurately predict a case fatality rate for the virus which is uniform across the world and holds true for the everyday changing aspect of the pandemic.

Case fatality rates (CFR) is the proportion of deaths from a certain pandemic against the total number of confirmed infectious case in a given period of time. It gives us an idea about the chances of a person can die from the infection. According to the website Our World in Data CFR for COVID-19 depends on the data received every day from various countries. The CFR for COVID-19 over the past few months has varied from 4% – 7.28% with the peak fatality day coming on 25^th Feb 2020. As of today 4^thJune, the CFR is 6% worldwide.

Latest CFR (4/06/2020) for various hit massively by the COVID-19 are,

France – 19.13%
Belgium – 16.23%
Italy – 3%
UK – 14.2%
Netherland – 12.7%
Canada – 8%
USA – 5.8%
Brazil 5.6%
China – 5.5%
Iran – 5%
Turkey – 2.77%
India – 2.08%
Pakistan – 2.01%
Australia – 1.4%
Russia – 1.2%

The fatalities rates have been very high in European countries where tens of thousands of people have succumbed to COVID-19.

At the moment the world has about 6,528,544 cases in which about 3 million cases have either recovered or died and almost the same number of cases are active.

The latest number of cases in 10 most affected countries are,

USA – 1,902,768
Brazil – 584,562
Russia – 441,108
Spain – 287,406
UK – 279,856
Italy – 233,836
India – 217,265
Germany – 184,425
Peru – 178,914
Turkey – 166,642

Myth Buster: Chloroquine and Hydroxychloroquine, two antimalarial drugs, have been found to treat Covid-19 with greater efficacy. Like many other drugs, these two antimalarial drugs were also studied for its efficacy against SARS-CoV-2 and after many clinical trials, it was found these drugs do not possess any antiviral properties against SARS-CoV-2. In fact, they showed such severe adverse effects especially for heart patients that WHO stopped using them for any further clinical trials.

Gender-based analysis

From all the available data on COVID-19, it has been inferred that men are more likely to develop the infection and die from the infection when compared to women. Specific reasons are to be investigated but some scientists believe it has something to do with the genetic makeup of both the genders where women develop more potent immunity against foreign pathogens than men. A study by the Chinese center for disease control and prevention found that in 44,672 confirmed cases fatality rates for men were 2.8% with only 1.7% for women. Also, in another study in Italy published that in a total of 1,561 patients needing hospital care for their severe COVID-19 symptoms, 82% of the patients were men.

How is coronavirus diagnosed (COVID-19)?

Covid-19 screening is aimed at identifying the presence of SARS-CoV-2. It is not necessary for everyone to undergo the COVID-19 screening process and people should look for guidelines from state authorities or local health bodies on when and how to screen themselves for infection.

Based on the type of detection method used, COVID-19 tests can identify either is it an active infection or previous infection.

1. Viral (active) infection test: This test is performed by taking samples from nostrils or oral saliva. SARS-CoV-2 are present in the upper respiratory tract in huge numbers and confirmation of the virus in these samples means that the patient is having an active ongoing infection.

Polymerase chain reaction (PCR) is the method through which most viral tests for SARS-CoV-2 are performed. The genetic material from the sample is broken down and then amplified thousands of times to study and match it with existing data for the virus.

The result of the PCR test can be expected in 48-72 hours.

If the result is positive: Patients with positive viral tests are advised to isolate themselves from others and carefully monitor their symptoms. If the symptoms worsen, the patient has comorbidities or is of 65 years or older, they need to be admitted to hospital under professional care they fully recover.

If the result is negative: the negative test result means that the patient did not have an infection by the time the sample was taken. The patient can still contract COVID-19 and needs the care to protect himself.

2. Antibodies (past) infection test: blood samples are taken from suspected people to detect the presence of antibodies in serum. Antibodies against COVID-19 infection are produced in blood after 1-3 weeks. FDA confirms that IgM antibodies against SARS-CoV-2 can easily be detected. The time when the test sample was taken may define test results. People with active infection can have negative results if the infection is in the early days and the antibodies have not to be developed. Likewise, those with positive results may not be having an infection but antibodies from past infection which is already recovered.

If the result is positive: If the result is positive and the patient is having symptoms of COVID-19, the doctor will prescribe a viral test for the presence of active infection. If there are no symptoms then it means the result is probably showing old infection. Either way, patients need to take care and take all precautions to protect themselves against COVID-19 as it is not entirely sure that repeat infections are possible or not.

If the result is negative: Negative test results with no symptoms more likely means that you do not have an infection but if patients develop symptoms they are advised to take viral tests.

Myth Buster: 5G cellular network spread Coronavirus (COVID-19) viruses. This is one of the made-up stories where many believed that the latest 5G mobile networks can spread the virus far and wide. Viruses or any pathogens for that matter cannot spread to the radio or any other waves. Most African countries do not have 5G technology and yet the virus is spreading there like any part of the world.

How is COVID-19 treated?

There is no specific cure for COVID-19 and care that patients have in hospitals is mostly symptomatic treatment. FDA has tried and is trying various available drugs for efficacy against COVID-19 but so far they don’t have any success. Antibiotics are effective against viruses and they are only used in hospitals when COVID-19 patients develop a secondary bacterial infection.

Some of the symptomatic management options are,

NSAIDs like acetaminophen and ibuprofen are used for body pain and fever
Supplements like vitamin C and D are used to boost the immune response
Cough syrup ( both antitussive and expectorant) is used to relieve cough and extract sputum if there is any
Lots of liquid and juices to keep the body hydrated
Nebulization of saline solution or bronchodilators
Any other respective medical care for complications to arise.

Myth Buster: Ibuprofen worsens COVID-19 complication and is no longer recommended to be used in Coronavirus (COVID-19) management. There has been no scientific data or research that shows that ibuprofen has shown adverse effects in COVID-19 patients and WHO does not advise against the use of ibuprofen in COVID-19

Patients are also advised to take maximum rest and have enough sleep to give their bodies to heal and fight off infection.

Medically Reviewed By Manzoor Ahmad (Pharm-D)

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