Over 100 coronavirus cases have been reported across India so far. (Express photo/Pavan Khengre)
Coronavirus (COVID-19): On March 11, the World Health Organisation officially declared coronavirus a pandemic as it has spread globally and claimed over 5,000 lives, infecting more than 31,000 people. With India reporting 107 positive cases so far, Prime Minister Narendra Modi Sunday led a video conference with leaders of eight SAARC nations to discuss a strategy to tackle Covid-19.
Many states in India have gone into shutdown mode, closing all schools, public parks, malls and theatres, in order to fight the public health emergency.
Here is a coronavirus guide with FAQ's on dos and don'ts to combat the rapidly spreading epidemic:
Coronaviruses are a specific family of viruses, with some of them causing less-severe damage, such as the common cold, and others causing respiratory and intestinal diseases. A coronavirus has many “regularly arranged” protrusions on its surface, because of which the entire virus particle looks like an emperor’s crown, hence the name “coronavirus”.
So far, there are four known disease-causing coronaviruses, among which the best known are the SARS corona virus and the Middle East Respiratory Syndrome (MERS) coronavirus, both of which can cause severe respiratory diseases.
“WHO has been assessing this outbreak around the clock and we are deeply concerned both by the alarming levels of spread and severity and by the alarming levels of inaction. We have therefore made the assessment that #COVID19 can be characterized as a pandemic,” the WHO tweeted.
Simply put, a pandemic is a measure of the spread of a disease. When a new disease spreads over a vast geographical area covering several countries and continents, and most people do not have immunity against it, the outbreak is termed a pandemic. It implies a higher level of concern than an epidemic, which the US Centers of Disease and Control Prevention (CDC) defines as the spread of a disease in a localised area or country.
There is no fixed number of cases or deaths that determine when an outbreak becomes a pandemic. The Ebola virus, which killed thousands in West Africa, is an epidemic as it is yet to mark its presence in other continents. Other outbreaks caused by coronaviruses such as MERS (2012) and SARS (2002), which spread to 27 and 26 countries respectively, were not labelled pandemics because they were eventually contained.
A boy wears a facemask while practicing skates at Marine Drive in Mumbai on Sunday. (Express photo/Ganesh Shirsekar)
Various countries have adopted various models for addressing community transmission, or for preventing it. For the time being, India has chosen to follow the Italian model of lockdown, rather than the South Korean model of free testing. For India, massive free testing in a country of 135 crore would need humongous resources.
There is no specific treatment. Patients are mostly given medicines for symptomatic relief — for example, paracetamol to bring down fever, sometimes medicines for relief from pain. Care is also taken to ensure they stay hydrated.
The mortality of the virus is a little over 3%, and for most patients the body’s own immune system succeeds in fighting the virus. This is what happened with the first three cases in India — students from Kerala, who had come back from Wuhan. They showed steady improvement with symptomatic treatment, and eventually recovered and went home.
A view of an empty movie theatre in Kochi. (Reuters)
Scientists across the world are trying to develop a line of treatment and a possible vaccine for COVID-19, the disease caused by the novel coronavirus. Even the most optimistic timelines, however, don’t see a line of treatment or vaccine arriving before next year. Meanwhile, a global effort is on to collect and analyse the genetic composition of the new virus, which would be key to developing a cure and a vaccine.
A preliminary study conducted by researchers from Peking University’s School of Life Sciences and the Institut Pasteur of Shanghai, which is under the Chinese Academy of Sciences, has found two strains of the SARS-CoV-2 virus, behind the current coronavirus infection crisis.
As per the study, one of these strains is more aggressive than the other, and was associated with 70 per cent of the analysed strains. The researchers have also said that the prevalence of the more aggressive strain decreased after January 2020.
Scientists at the National Institute of Virology (NIV) in Pune are still working to determine which strain of the virus has come to India.
“We are trying to find out about the strain in India, we should know in a few days. However if you look at that one study, they have only looked at the genes and looked at the deaths caused by each strain to decide which is less virulent, which is more,” Dr R R Gangakhedkar, head of the division of epidemiology at the Indian Council of Medical Research (ICMR), told Indian Express.
Doctors wear masks during inspection of the isolation ward at Guru Nanak Dev Hospital in Amritsar. (Express photo/Rana Simranjit Singh)
There have been cases in China, South Korea and most recently Japan, where treated patients were rediagnosed with COVID-19 after discharge. The US Centers for Disease Control and Prevention said immunity against COVID-19 is not fully understood. Signals from the previous coronavirus outbreaks have been mixed: studies on the virus that caused MERS showed people are unlikely to get reinfected within a short time of the original infection, while there were records of relapse during the SARS outbreak.
The World Health Organization (WHO) says: “It is not certain how long the virus that causes COVID-19 survives on surfaces, but it seems to behave like other coronaviruses. Studies suggest that coronaviruses (including preliminary information on the COVID-19 virus) may persist on surfaces for a few hours or up to several days. This may vary under different conditions (e.g. type of surface, temperature or humidity of the environment).”
Stay home unless you must see a doctor. No work, school or shopping. If you must come out of your room, wear a mask. And don’t share towels.
Among people told to self-quarantine, isolate themselves or stay home are people returning from parts of China and Iran, those who developed symptoms after spending time in other countries with sustained community transmission, and those with no known exposure who are sick.
School children wear protective masks following multiple positive cases of coronavirus in Maharashtra. (Express photo/Prashant Nadkar)
Amid the COVID-19 outbreak, India’s Health Ministry, organisations such as the World Health Organisation (WHO), the US Centres for Disease Control and Prevention (CDC), and UNICEF, as well as individual doctors across the world have advised people to wash their hands thoroughly — for at least 20 seconds — with soap, preferably using warm water.
It is important that you keep your hands clean at all times to prevent diseases, and especially during any viral influenza-like outbreak. You can get germs on your hands by touching anything that may have germs on it after an infected person coughed or sneezed on it, or after it came into contact with another object that was contaminated.
Go to any of the 106 medical colleges/district hospitals designated by the government as Viral Research & Diagnostic Laboratories (VRDLs). Private hospitals/clinics may or may not have the technology or expertise, and an infected person may end up only expanding their network of contacts and facilitating spread of the disease.
“We do not know if the private sector has the wherewithal. Our entire focus has been on reducing (infectious) contact and protecting people from being charged more for tests by private players. We have seen that happen during outbreaks earlier,” a senior official at the National Centre for Disease Control (formerly National Institute of Communicable Diseases), Delhi told The Indian Express.
On Wednesday, when Bhuvneshwar Kumar was asked whether Indian pacers would limit the use of spit on the ball, he said the team would follow doctors’ instructions. Amid the coronavirus outbreak, many are asking whether to pursue a sport that perhaps requires physical contact, and even recreational swimmers are wondering whether they should stay away from the pool.
In an advisory on March 5, the Health Protection Surveillance Centre of Ireland said that if recommended chlorination standards are maintained, then swimming pools are safe. “Please note also that the minimum recommended free chlorine residual depends on the type of pool or chlorination chemical used — for example spa pools (‘jacuzzis’) need a higher residual… Regardless of the type of pool, adherence to the appropriate guidelines will control risk from waterborne COVID-19 virus.”
All the state transport (MSRTC) stations in Pune are busy as several students have decided to return home. (Express photo/Pavan Khengre)
The answer is obviously “Yes” if your vacation destination happens to be China, Italy, Japan, South Korea, or Iran. The government has advised citizens to refrain from travelling to these countries. China is the epicentre of the outbreak — and the other four countries are among the worst affected. The government advisory has also asked citizens to avoid non-essential travel to all COVID-19 affected countries. That would mean at least 83 countries as of now, on every continent barring Antarctica.
If your plans are for the summer holidays, that’s still more than two months away — and it is not clear how the situation will change from now to then. If you need to soon take a call on reservations and bookings, the National Centre for Disease Control (NCDC) helpline will leave the decision to you; however, officials advise off the record that it might be a good idea to avoid non-essential travel anywhere outside the country.
The short answer is that there is no way to tell a coronavirus infection apart from the common flu. In both circumstances the symptoms that the patient shows would be cough, cold, fever, body ache etc. That is why in public health parlance the term influenza-like illnesses is used. Both common flu and coronavirus infection would come in that spectrum.
In India’s fight against the novel coronavirus disease (COVID 2019), the Union Health Ministry has issued elaborate guidelines on how to enforce “home quarantine” for a fortnight. While less stringent than being quarantined in an Army or paramilitary facility, home quarantine comes with its own set of restrictions. Here is all you need to know about such a regime, and why it is important.
Quarantine, like isolation, separates some people from others during the outbreak of a contagious disease. While isolation separates sick people from people who are not sick, quarantine separates those who were exposed to a contagious disease, and who are then observed to see if they too become sick. Home quarantine means being quarantined at home.
Exbibitors and visitors wear masks at the 'Top Thai Brands 2020' exhibition at Himachal Bhawan in Chandigarh. (Express photo/Kamleshwar Singh)
It’s not the kind of thing you want to think about while you’re in child’s pose in yoga class, when your nose is close to the mat, but after hearing how you should stop touching your face to guard against the coronavirus, you might wonder: What are the risks of transmission while working out at a gym?
The spread of the coronavirus could make even the most ardent gym rats stress out about picking up barbells. There’s a lower risk of picking up the coronavirus at a gym or health club than at a church service, for example, said Dr. David Thomas, a professor of medicine and director of the Division of Infectious Diseases at Johns Hopkins University School of Medicine. By comparison, church services may include shaking hands and being in closer proximity to people.’
A barber wears a face mask amid concerns over the spread of coronavirus in Mumbai on Sunday. (Express photo/Ganesh Shirsekar)
There is no evidence, either from the history of COVID-19 cases around the world or from the genetic evolution history of the virus itself, that there is any scope of pets (or even stray animals) contracting or transmitting the virus to humans.
Here’s what the World Health Organisation says on this: “At present, there is no evidence that companion animals/pets such as dogs or cats can be infected with the new coronavirus. However, it is always a good idea to wash your hands with soap and water after contact with pets. This protects you against various common bacteria such as E. coli and Salmonella that can pass between pets and humans.”
At his special briefing on coronavirus on Monday (March 2), Health Minister Harsh Vardhan said that as a doctor, he did not think there was any need to wear masks in order to ward off infection; observing basic cough etiquette and basic hygiene was sufficient.
Dr Harsh Vardhan echoed the advice of the United States Surgeon General Jerome M Adams, the top federal spokesperson on matters of public health, who expressed his frustration on Twitter on Saturday: “Seriously people — STOP BUYING MASKS! They are NOT effective in preventing general public from catching #Coronavirus, but if healthcare providers can’t get them to care for sick patients, it puts them and our communities at risk!”
Mumbai wore a deserted look on Sunday afternoon as all malls were close in the wake of coronavirus. (Express photo/Amit Chakravarty)
President Donald Trump, a self-described germaphobe, said Wednesday he was amazed to learn that tens of thousands of Americans died from the flu each year, contrasting that number with the 60 or so known to be infected with the coronavirus.
Since Monday, new cases of confirmed coronavirus infection in Delhi, Hyderabad and Jaipur have led to a series of precautionary measures by government and school authorities, and panic particularly among residents of the National Capital Region. Much of the panic has been spread by alarmist messages via WhatsApp.
Barring Big Bazaar, all stores were closed at Inorbit Mall in Vashi on Sunday. (Express photo/Amit Chakravarty)
The first test that samples of all suspected patients are sent for is the polymerase chain reaction (PCR) test. If that is positive, the sample is sent to the National Institute of Virology in Pune, which is the only government laboratory currently doing genome sequencing, for final confirmation. This final confirmatory test specific for the novel coronavirus was developed virtually overnight after the emergence of the disease.
As COVID-19 balloons into a global health crisis, parallels are being drawn with the Spanish influenza of 1918-19, considered the most devastating pandemic in recent history, with an estimated toll of 20-50 million lives. The focal point of that pandemic a century ago was India, where between 10-20 million died. The importance of a quick initial response cannot be overstated.