All you need to know about novel coronavirus (COVID-19)…Busting myths and stating facts..!!

We as parents normally depend on famous social media sites and forwarded posts regarding any new issues in our day to day life especially if it is about a contagious infection/ disease (instead of looking at genuine health advisories). Same is happening now again with the novel coronavirus infection. Lots of posts regarding what all to do in this infection have been circulating around creating confusions. With now the disease finally reaching India, a panic has set in with parents trying all sorts of measures to protect their kids. But is this panic justified? Are there any therapies for the infection? Do alternative medicines work and similarly lots of other queries.

This is just an attempt to clear the common myths and simply stating the actual facts.

What is COVID-19 infection?

Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV).

A 2019 novel coronavirus ( earlier called as 2019-nCoV; now renamed as COVID-19) is a new strain that has not been previously identified in humans and has now been identified in Wuhan, China.

They are zoonotic, meaning they are transmitted between animals (cats, camels and bats) and people. But now human to human transmission is occurring.

What are the common symptoms of COVID-19 infection?

The most common symptoms of COVID-19 are fever, tiredness, and dry cough. Some patients may have aches and pains, nasal congestion, runny nose, sore throat or diarrhea. These symptoms are usually mild and begin gradually.

Some people become infected but don’t develop any symptoms and don’t feel unwell (subclinical infection).

Most people (about 80%) recover from the disease without needing special treatment.

Around 1 out of every 6 people who get COVID-19 becomes seriously ill and develops difficulty breathing which can lead to severe acute respiratory syndrome, kidney failure and even death ( As of now the fatality rate is around 2%). If you notice any breathing difficulty, immediately seek medical attention.

High risk groups include older people, and those with underlying medical problems like high blood pressure, heart problems or diabetes etc. Although few cases have been reported in very young children, but there is no evidence that children are more susceptible unless they have any underlying health condition or chronic illness.

How is COVID-19 spread ?

A person can catch COVID-19 from others who have the virus through small droplets from the nose or mouth which are spread whenever that person coughs or exhales (droplet infection). These droplets land on objects and surfaces around the person. Other people then catch COVID-19 by touching these objects or surfaces, then touching their eyes, nose or mouth. It can also be acquired if the person breathes in droplets from an infected person. This is why it is important to stay more than 1 meter (3 feet) away from a person who is sick.

Should I as a parent be worried about Coronavirus?

If you are not in an area where COVID-19 is spreading, or if you have not travelled from one of those areas or have not been in close contact with someone who has and is feeling unwell, chances of your child getting the infection are low. However, it’s understandable to feel stressed and anxious about the situation especially if it comes to kids. It’s a good idea to get the correct facts to help you accurately determine the risks so that you can take reasonable precautions. And the best way is to discuss with your pediatrician.

However, if you are in an area where there is an outbreak of COVID-19 you need to take the risk of infection seriously. Follow the advice issued by your national health authorities.

Is there any prevention strategy which can be followed?

There is currently no vaccine to prevent COVID-19 infection (although trials are going on, but its not yet for human use).

So the best way to prevent infection is to avoid being exposed to this virus.

WHO’s /CDC’s standard recommendations are as follows (which include hand and respiratory hygiene, and safe food practices):

• Frequently clean hands by using soap and water especially when hands are visibly soiled. In case when soap is not available, then alcohol based hand rubs or sanitizers (that contain at least 60% alcohol) can be used. The normally marketed sanitizers which are not alcohol based are not of much use. Avoid touching your eyes, nose, and mouth with unwashed hands.
• Follow good respiratory hygiene. When coughing and sneezing cover mouth and nose with flexed elbow or tissue – throw tissue away immediately and wash hands; Don’t use handkerchief.
• Avoid close contact with anyone who has fever and cough (maintain distance of at least 1 meter from any individual with proven/suspected COVID-19 respiratory symptoms)
• If you have fever, cough and difficulty breathing, seek medical care early and share previous travel history with your doctor; if any. Stay at home unless to get medical care and separate yourself from other people in your home.
• For a person with no symptoms, a medical mask is generally not required, as no evidence is available on its usefulness to protect non-sick persons, unless you are taking care of an infected individual or are in close contact with him.
• Avoid sharing household items and avoid contact with pets and other animals.
• Avoid crowded places.
• When visiting live markets in areas currently experiencing cases of novel coronavirus, avoid direct unprotected contact with live animals and surfaces in contact with animals;
• The consumption of raw or undercooked animal products should be avoided. Raw meat, milk or animal organs should be handled with care, to avoid cross-contamination.

Who should be tested for COVID-19 infection?

If you develop a fever and symptoms of respiratory illness, such as cough or shortness of breath, within 14 days after travel from a country where infection is spreading, or if you have had close contact with someone showing these symptoms who has recently traveled from that area, you should visit your doctor and mention your recent travel or close contact.

Your healthcare professional will determine if you need to be tested for COVID-19 and will refer to an appropriate government facility for diagnosis.

Is there any treatment available?

There is no specific antiviral treatment recommended for COVID-19 infection. There is no role of antibiotics (please don’t self medicate). People infected with COVID-19 should receive supportive care to help relieve symptoms. For severe cases, treatment should include admission to hospital and care to support vital organ functions. Off lately, an antiviral drug is being explored for the same with promising results.

Is there something which should not be done?

• Taking traditional herbal remedies: Till date no conclusive evidence has been there to support their roles. Its my point of view, rest is upto you to decide.
• Wearing multiple masks
• Taking self-medication such as antibiotics

What is the role of masks ?

 

With the current information available, it is suggested that the route of human-to-human transmission of COVID-19 is either via respiratory droplets or contact. Any person who is in close contact (within 1 meter) with someone who has respiratory symptoms (e.g., sneezing, coughing, etc.) is at risk of being exposed to potentially infective respiratory droplets.

Medical masks are surgical or procedure masks that are flat or pleated (some are like cups); they are affixed to the head with straps. Or they can be – a particulate respirators (N95/N99) with certain specifications like at least as protective as a US National Institute for Occupational Safety and Health (NIOSH)-certified N95, European Union (EU) standard FFP2, or equivalent.

If medical masks are worn, appropriate use and disposal is essential to ensure they are effective and to avoid any increase in risk of transmission associated with the incorrect use and disposal of masks.

The following information on correct use of medical masks derives from the practices in health-care settings:

• Place mask carefully to cover mouth and nose and tie securely to minimize any gaps between the face and the mask;
• While in use, avoid touching the mask;
• Remove the mask by using appropriate technique (i.e. do not touch the front but remove the lace from behind);
• After removal or whenever you inadvertently touch a used mask, clean hands by using an alcohol-based hand rub or soap and water if visibly soiled
• Replace masks with a new clean, dry mask as soon as they become damp/humid;
• Do not re-use single-use masks;
• Discard single-use masks after each use and dispose of them immediately upon removal.
• A cloth (e.g. cotton or gauze) masks are not recommended under any circumstance.

General Advice:

Wearing a medical mask is one of the prevention measures to limit spread of certain respiratory diseases, including COVID-19, in affected areas.

But remember, that use of a mask alone is insufficient to provide the adequate level of protection and other equally relevant measures should be adopted. If masks are to be used, this measure must be combined with hand hygiene and other measures to prevent the human-to human transmission.

Wearing medical masks when not indicated may cause unnecessary cost, procurement burden and create a false sense of security that can lead to neglecting other essential measures such as hand hygiene practices.

Furthermore, using a mask incorrectly may hamper its effectiveness to reduce the risk of transmission

Individuals with respiratory symptoms:

To contain respiratory secretions, a medical mask should be provided to the individual and worn as much as possible, if it can be tolerated. For individuals who cannot tolerate a medical mask, he/she should rigorously apply respiratory hygiene, i.e.

• Cover mouth and nose when coughing or sneezing with disposable paper tissue.
• Dispose of the material after use.
• Clean hands immediately after contact with respiratory secretions;
• Improve airflow in living space by opening windows and door as much as possible.

Relatives or caregivers to individuals with suspected COVID-19 infection with mild respiratory symptoms should: –

• Perform hand hygiene frequently, using alcohol-based hand rub if hands are not visibly soiled or soap and water when hands are visibly soiled;
• Keep distance from affected individual as much as possible (at least 1 meter);
• Wear a medical mask when in the same room with the affected individual;
• Dispose of the material immediately after use. Clean hands immediately after contact with respiratory secretions;
• Improve airflow in living space by opening windows as much as possible.

In Health Care Facilities

Individuals with respiratory symptoms should:

• Wear a medical mask while waiting in triage or waiting areas or during transportation within the facility;
• Wear a medical mask when staying in cohorting areas dedicated to suspected or confirmed cases;
• Do not wear a medical mask when isolated in single rooms but cover mouth and nose when coughing or sneezing with disposable paper tissues.
• Dispose them appropriately and perform hand hygiene immediately afterwards.

Health care workers should:

• Wear a medical mask when entering a room where patients suspected or confirmed of being infected with 2019-nCoV are admitted and in any situation of care provided to a suspected or confirmed cases;
• Use a particulate respirator with appropriate standards, when performing aerosol generating procedures.

P.S. : A word about how to wear the mask. It is always worn with the colored site out and the part containing metal support up. There is no other way to wear them despite what has been circulating on social media.

I have tried to answer most of the questions which are circulating. If you still have any doubt, kindly free to contact me.

Stay safe, stay healthy!!

Dr Garima| themoppetsclinic 🙂

Sources:

1. WHO update on novel coronavirus, 2020
2. CDC advisory, 2020