Coronavirus / COVID-19

Early containment and prevention are crucial to stop and control disease outbreak

The new coronavirus has spread outside China and started to emerge and move from one country to another, until it has become a global concern due to its rapid transmission and spread among people. Every day we hear about new coronavirus cases in countries and the new disease been declared a public health emergency of international concern (PHEIC) by the World Health Organization.

The World Health Organization said the coronavirus outbreak that has swept from China to a number of countries in Asia, the Middle East, and Europe is not yet a pandemic, but it urged countries to prepare for its arrival on the assumption that a declaration may come.

Director-General Tedros Adhanom Ghebreyesus said countries should be working to protect health workers, engaging groups that are at highest risk—for instance, the elderly—and striving to contain spread of the virus to the highest degree possible to slow its arrival in countries that don’t have the means to respond to its threat.

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).

Middle East respiratory syndrome (MERS) is a viral respiratory disease caused by a novel coronavirus (Middle East respiratory syndrome coronavirus, or MERS‐CoV) that was first identified in Saudi Arabia in 2012.

Coronaviruses are a large family of viruses that can cause diseases ranging from the common cold to Severe Acute Respiratory Syndrome (SARS).

Hundreds have now died from the COVID-19 virus, which first appeared in the Chinese city of Wuhan in December 2019. Tens of thousands of cases have been confirmed in China, and experts say they expect the numbers to rise further.

Like the flu, COVID-19 is spread primarily via respiratory droplets—little blobs of liquid released as someone coughs, sneezes, or talks. Viruses contained in these droplets can infect other people via the eyes, nose, or mouth—either when they land directly on somebody’s face or when they’re transferred there by people touching their face with contaminated hands.

Because respiratory droplets are too heavy to remain suspended in the air, direct person-to-person transmission normally only happens when people are in close contact—within about six feet of each other, according to the US Centers for Disease Control and Prevention (CDC). It could also occur in a medical setting, if someone has to handle respiratory secretions such as saliva or mucus from an infected person.

According to studies assessing the environmental stability of other coronaviruses, the severe acute respiratory syndrome coronavirus (SARS-CoV) is estimated to survive several days in the environment, and the Middle East respiratory syndrome-related coronavirus (MERS-CoV) can withstand more than 48 hours at average room temperature (20°C) on plastic and metal surfaces.

The analysis of 22 studies reveals that human coronaviruses such as Severe Acute Respiratory Syndrome (SARS) coronavirus, Middle East Respiratory Syndrome (MERS) coronavirus or endemic human coronaviruses (HCoV) can persist on inanimate surfaces like metal, glass or plastic for up to 9 days, but can be efficiently inactivated by surface disinfection procedures with 62–71% ethanol, 0.5% hydrogen peroxide or 0.1% sodium hypochlorite within 1 minute. As no specific therapies are available for SARS-CoV-2, early containment and prevention of further spread will be crucial to stop the ongoing outbreak and to control this novel infectious thread.

Transmission of coronavirus infection

The virus is thought to spread mainly from person-to-person: Between people who are in close contact with one another (within about 6 feet) or through respiratory droplets produced when an infected person coughs or sneezes. These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs. It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes, but this is not thought to be the main way the virus spreads.

Cold- or flu-like symptoms usually set in from 2–4 days after a coronavirus infection and are typically mild. However, symptoms vary from person-to-person, and some forms of the virus can be fatal. Symptoms include sneezing, runny nose, cough, fatigue, fever and sore throat. At the end of the first week, the disease develops and enters a more serious stage that closely resembles the symptoms of SARS, which is severe pneumonia, leading to difficulty breathing, kidney failure and weakening of the heart muscle, while death often occurs due to lung problems.

Misconceptions

The panic that has afflicted societies around the world has led to widespread misconceptions about how this virus spreads among people.

One of the misconceptions is that the new coronavirus is transmitted through mosquito bites, which is not true. The virus is transmitted through direct contact with respiratory droplets of an infected person (generated through coughing and sneezing), and touching surfaces contaminated with the virus. The COVID-19 virus may survive on surfaces for several hours, but simple disinfectants can kill it.

Some believed that cold and snow could kill the emerging coronavirus, which is completely false information because snow cannot transmit the emerging virus, as the normal human body temperature ranges between 36.5 and 37 degrees Celsius, regardless of external temperature or weather. The risk of developing an emerging coronavirus (2019-nCoV) as a result of contact with things, including coins, banknotes, or credit cards, is very low.  Initial information indicates that the emerging corona virus (2019-nCoV) can survive on the surfaces for a few hours or more. And something can be exposed to contamination of the virus emerging from the person infected with infection in the event of coughing, sneezing or in contact with it. The risk of infection with the emerging coronavirus, as a result of contact with things, including coins, banknotes, or even credit cards, is very low if the rules of hand hygiene are properly adhered to. Cleaning your hands frequently with an alcohol-based hand sanitizer or washing them with soap and water is the best way to protect yourself from the virus.

Wrong concept: Droplets secreted by a person when coughing or sneezing can transmit the emerging corona virus (2019-nCoV) for a distance of up to 8 meters.

Fact: Respiratory droplets reach one meter from the person who coughs or sneezes.

When infected persons sneeze or sneeze, the virus is transmitted in droplets that can travel a certain distance from that person.  Hence, it is necessary for the patient not to leave the house and isolate himself in a well-ventilated room even if they have no symptoms. Among the misconceptions is that UV sterilizers can kill the new coronavirus, which is false. UV lights should not be used to sterilize hands or other parts of skin as UV radiation can cause skin irritation and allergic reactions. Spraying the body with alcohol or chlorine will not eliminate viruses that have already entered your body. It may even be harmful to clothing or mucous membranes (such as the eyes and mouth). However, both alcohol and chlorine may be beneficial for disinfection of surfaces but they should be used according to appropriate recommendations. 

Relation between the emerging coronavirus and SARS or MERS virus

The Wuhan coronavirus, also known as SARS-CoV-2 or 2019-nCoV, is a close relative to the severe acute respiratory syndrome (SARS) virus that caused an outbreak in 2003 (SARS-CoV-1), as well as the Middle-East respiratory disease virus (MERS-CoV) that emerged in 2012. All of these viruses cause flu-like symptoms and, frequently, pneumonia. SARS was discovered in 2002 in mainland China and spread to a number of other countries. It infected a little more than 8,000 people, and killed 774 people. No cases of SARS have been reported worldwide since 2004.

The Middle-East respiratory disease virus (MERS-CoV) was first discovered in 2012 in Saudi Arabia affecting more than 1,200 people, 449 of whom died. The disease still affects some people from time to time, mainly in the countries of the Middle East.

Protective Measures

The World Health Organization has shared some basic protective measures against the new coronavirus. Regularly and thoroughly clean your hands with an alcohol-based hand rub or wash them with soap and water.

Maintain at least 1 metre (3 feet) distance between yourself and anyone who is coughing or sneezing. When someone coughs or sneezes they spray small liquid droplets from their nose or mouth which may contain virus. If you are too close, you can breathe in the droplets, including the COVID-19 virus if the person coughing has the disease. Avoid touching eyes, nose and mouth because hands touch many surfaces and can pick up viruses. Once contaminated, hands can transfer the virus to your eyes, nose or mouth. From there, the virus can enter your body and can make you sick. Make sure you, and the people around you, follow good respiratory hygiene. This means covering your mouth and nose with your bent elbow or tissue when you cough or sneeze. Then dispose of the used tissue immediately. Droplets spread virus. By following good respiratory hygiene, you protect the people around you from viruses such as cold, flu and COVID-19.

Facemasks should be used by people who show symptoms of COVID-19 to help prevent the spread of the disease to others. The use of facemasks is also crucial for health workers and people who are taking care of someone in close settings (at home or in a health care facility).

Health workers are at the front line of any outbreak response and as such are exposed to hazards that put them at risk of infection with an outbreak pathogen (in this case COVID-19). Hazards include pathogen exposure, long working hours, psychological distress, fatigue, occupational burnout, stigma, and physical and psychological violence.

Health worker rights include that employers and managers in health facilities assume overall responsibility to ensure that all necessary preventive and protective measures are taken to minimize occupational safety and health risks, provide information, instruction and training on occupational safety and health, including refresher training on infection prevention and control(IPC); use, putting on, taking off and disposal of personal protective equipment(PPE); provide adequate supplies (masks, gloves, goggles, gowns, hand sanitizer, soap and water, cleaning supplies) in sufficient quantity to healthcare or other staff caring for suspected or confirmed.

What is the PCR test?

Polymerase chain reaction (PCR) analysis is a laboratory technique. The purpose of PCR testing is to find small amounts of DNA in a sample, using a process known as amplification. During PCR amplification, the DNA of interest is copied repeatedly until there is enough of it for analysis and detection. 

Current tests for SARS-CoV-2, the virus that causes COVID-19, look for genetic material of the virus, for instance in saliva or nasal, oral, or anal swabs, using the polymerase chain reaction (PCR). However, they only give a positive result when the virus is still present. The tests can’t identify people who went through an infection, recovered, and cleared the virus from their bodies.

Thermal Sensors

Chinese authorities are using infrared thermometers to screen people for the illness, as the devices have become synonymous with trying to contain deadly outbreaks. Airports have instituted temperature checks to identify potential patients and prevent the virus’s spread. To do this, many governments and businesses rely on thermometer guns — devices that use infrared sensors to measure a person’s surface temperature without touching their skin. There are several factors that can affect the reading of thermal imaging devices, including the person’s activity immediately before the test, the timing of the test, and the device’s distance from the person concerned, as well as significant changes in temperature outside the body. If the goal is to search for a viral infection, it is important to have a sufficiently sensitive instrument to detect tiny changes in temperatures, to ensure the best results.

Sufficient number of pixels (spatial resolution) is required for a thermal camera to accurately measure the skin surface temperature. With the limited amount of pixel resolution available, this poses a challenge when imaging a subject, even at a modest distance. Most cameras deployed for elevated body temperature screening have a resolution around 320 x 240 pixels or 640 x 512. This is very low when compared to traditional surveillance cameras.