Unprecedented in the history of mankind, Corona is now a synonym of fear and death. Everyone is in the pursuit of gathering information on corona however, fake and irrelevant news/ contents are rather increasing fear and panic. This information #Coronapedia_Nepal is a humble effort of SATSOM E-Learning Nepal (Nepal’s largest family of E-learners) in collaboration with vayodha Hospitals. This is a part of “The Corona Corner” which is manifested and operated by Sakriya Sath (Non Goverment organization in Nepal).

Please read this, pass on your further queries and don’t forget to share this information.

Rupen Kayastha
Satsom E-Learning Nepal

What are coronaviruses?

Coronaviruses are a large family of viruses with some causing less

severe common cold to more severe diseases such as severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome
(MERS). The SARS-CoV-21 is a coronavirus very similar to the one that caused SARS.

Many coronaviruses are zoonotic, meaning they are transmitted from animals to humans however, the transmission and origin of corona is yet to be confirmed.

While the SARS coronavirus is thought to be an animal virus from an as-yet-uncertain animal reservoir, perhaps bats, that spread to other animals (civet cats) and first infected humans in the Guangdong province of southern China in 2002, the MERS coronavirus was passed on from dromedary camels to humans in Saudi Arabia in 2012.

There is evidence that the SARS-CoV-2 has also been transmitted from bats.

Understanding the disease

The World Health Organisation has declared COVID-19 to be a pandemic. The symptoms of COVID-19 appear within two to 14 days after exposure and include fever, cough, a runny nose and difficulty in breathing.

How does the disease spread?

It primarily spreads through the respiratory droplets of infected people. If a person touches a surface or object that has been infected by the virus and then touches his own mouth, nose, or eyes, he may get infected.

Who is affected?

While people of all ages can be affected by the disease, people aged 80 and above are at the highest risk of dying due to COVID-19, according to case records analysed by the Disease Control and Prevention Centers in China and South Korea. Victims of the virus with pre-existing medical conditions such as cardiovascular disease and diabetes have a higher fatality rate than others. Also the rate of fatalities was relatively higher for retirees.

What are the symptoms?

Nepal government is yet to draft its authentic guidelines however, early recognition of COVID-19 patients are those who come in with Severe Acute Respiratory Infection (SARI) who also have a history of foreign travel or close contact with another COVID-19 patient.

“COVID–19 may present with mild, moderate, or severe illness; the latter includes severe pneumonia, ARDS [Acute Respiratory Distress Syndrome], sepsis and septic shock.”

How can it be detected?

The virus can be detected using a PCR test6. A PCR or polymerase chain reaction test is DNA-based and can quickly tell if someone harbours the virus.

What is the treatment?

There is no current evidence from randomised controlled trial to recommend any specific treatment for suspected or confirmed COVID-19 patients. No specific anti-virals are recommended for treatment of those suffering from respiratory ailment due to lack of adequate evidence from medical literature.

In India, the Union Health Ministry guidelines has recommended use of anti-HIV drug combinations Lopinavir and Ritonavir on a case-to-case basis depending upon the severity of the condition of a person having coronavirus infection.

The Ministry recommended Lopinavir-Ritonavir for high-risk groups: patients aged above 60, suffering from diabetes mellitus, renal failure, and chronic lung disease and are immuno-compromised.

However, the use of Lopinavir-Ritonavir in PEP regimens for HIV is also associated with significant adverse events which many times leads to discontinuation of therapy.

The guidelines advise the treating doctors to closely monitor patients with severe acute respiratory infection for signs of clinical deterioration, such as rapidly progressive respiratory failure and sepsis, and apply supportive care interventions immediately.

“Application of timely, effective, and safe supportive therapies is the cornerstone of therapy for patients that develop severe manifestations of COVID-19,” it said.
Potecting yourself against COVID-19

Guidelines by the World Health Organization specify that one of the ways to reduce the risk of infection is by regularly and thoroughly cleaning one’s hands with an alcohol-based hand rub or washing them with soap and water. Regular washing becomes important as the virus tends to be viable from hours to more than a day on different surfaces that are regularly touched with hands.

Washing with soap

The grime on our hands contains innumerable viruses and bacteria. Washing with water without using soap helps reduce the amount of microbes but does not remove most of the virus and bacteria completely. Using soap, therefore, becomes far more effective in removing microbes.

Viruses such as coronavirus, influenza-causing viruses, Ebola, Zika have their genetic material encased in a layer of fat called the lipid envelope8. Soap molecules are pin-shaped with a head that is water-loving (hydrophilic) and a tail that is oil-loving (oleophilic). Being oleophilic, the tail portion of the molecule tends to have an affinity for and ‘competes’ with the lipids in the virus envelope. Since the chemical bonds holding the virus together are not very strong, the long oleophilic tail gets inserted into the envelope and tends to have a ‘crowbar’ effect that breaks the lipid envelope of the virus. The tail also competes with

the bond that binds the RNA and the lipid envelop thus dissolving the virus into its components which are then removed by water.

Alcohol-based hand sanitisers

Like soap, the alcohol present in hand sanitisers dissolve the lipid envelope, thus inactivating the virus. In addition, the alcohol also tends to change the shape or denature the mushroom-shaped protein structures that stick out of the lipid envelope. The mushroom-shaped protein structures help the virus to bind to special structures found on human cells and enter the cells. To be effective, the sanitisers should contain at least 60% alcohol.

Unlike soap lather, the alcohol does not come in contact with all parts of the hand. So care needs to be taken to use sufficient sanitiser to increase the coverage. Unlike water, alcohol run does not remove the dead viruses from the hand. While a sanitiser can quickly reduce the number of microbes, it does not get rid of all types of germs, and is “not as effective when hands are visibly dirty or greasy”.

Using a mask

Medical masks help prevent the spread of coronavirus infection. If worn properly, masks may be effective in preventing transmission of coronavirus. An article published in the Journal of the American Medical Association (JAMA) says there is no evidence to suggest that masks worn by healthy individuals can help prevent infection.

But a 2010 study says: “Mask wearing was associated with reduced secondary transmission and should be encouraged during outbreak situations.”
Even the World Health Organization says wearing a medical mask is “one of the prevention measures to limit spread of certain respiratory diseases, including novel coronavirus (SARS-CoV-2), in affected areas”.

Transmission through droplets from coughing and sneezing is one of the major routes of virus spread. When worn correctly, a mask can reduce the risk of inhaling droplets containing the virus.

With many studies showing that people infected with novel coronavirus transmit the virus even before symptoms show up, it may be prudent to wear a mask especially when the virus is spreading in the community. In a country like Nepal, maintaining at least one metre distance can be a challenge, especially when there is no way of knowing who is infected till such time the person starts showing visible symptoms.

Social distancing

The WHO says that you should maintain at least 1 metre (3 feet) distance between yourself and anyone who is coughing or sneezing. This is because 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,” says the WHO.

Avoid touching eyes, nose and mouth

Hands can pick up viruses as they come in contact with many surfaces. It can then transfer the virus to your eyes, nose or mouth. From there, the virus can enter your body and can make you sick.

Practise respiratory hygiene

Cover your mouth and nose with your bent elbow or tissue when you cough or sneeze. Then dispose of the used tissue immediately.

Some common queries answered

Are there differences between symptoms caused by the flu and COVID-19?

Cough and cold could mean an allergy. A fever with cough and cold is a symptom of the flu. When you have fever with a cough which is complicated by breathlessness, it is a symptom of Coronavirus infection and you must call your doctor to rule it out.

How effective are thermal scanners in detecting people infected with the new coronavirus?

Thermal scanners are effective in detecting people who have developed a fever (i.e. have a higher than normal body temperature) because of infection with the new coronavirus. However, they cannot detect people who are infected but are not yet sick with fever. This is because it takes between 2 and 10 days before people who are infected become sick and develop a fever.

Can a person exposed to Coronavirus transmit it to others if he/she uses a swimming pool?

Highly unlikely. The Coronavirus is a droplet infection. It has to be inhaled to cause the disease. Chlorination of swimming pools to recommended levels can certainly inactivate any virus, including COVID-19.

Should people avoid eating meat-based food to prevent transmission?

It is a respiratory virus and not a food-borne one. Coronavirus has nothing to do with food or pet animals or eating chicken and mutton. People can eat whatever they want and how much ever they want.

Is there a link between a person’s immunity and COVID-19 transmission?

Coronovirus is one of the weakest family of viruses. The deaths caused so far or people affected could have been ones with less immunity like children or the elderly. Sometimes, the virus enters a person’s lungs and causes pneumonia. People with vulnerable immunity like the elderly succumb to this. For young people with good immunity, the effects of the virus may not be too strong but if you are someone with comorbid conditions like diabetes or cardiac disease, or if you are on immunosuppresive drugs, then the risk of infection is severe.

Are there any home remedies to treat COVID-19?

Home remedies and treatment other than allopathy is not proven science. The best thing is precaution only. You must keep away from a patient who coughs and sneezes. If you are coughing, you need to cover your face with a mask and not spread the droplets around. COVID-19 spreads through droplets.

Are antibiotics effective in preventing and treating the new coronavirus?

No, antibiotics do not work against viruses, only bacteria. The new coronavirus (2019-nCoV) is a virus and, therefore, antibiotics should not be used as a means of prevention or treatment.

However, if you are hospitalized for the 2019-nCoV, you may receive antibiotics because bacterial co-infection is possible.

Do vaccines against pneumonia protect you against the new coronavirus?

No. Vaccines against pneumonia, such as pneumococcal vaccine and Haemophilus influenza type B (Hib) vaccine, do not provide protection against the new coronavirus. The virus is so new and different that it needs its own vaccine.

Although these vaccines are not effective against 2019-nCoV, vaccination against respiratory illnesses is highly recommended to protect your health.

Myths around COVID-19

There have been several myths around the disease, like consuming more garlic, curry leaves or cow’s urine would treat or protect one from the disease.

The World Health Organisation has busted such misleading claims. On garlic, WHO said it is a healthy food that may have some antimicrobial properties but there is no evidence that it has prevented people from contracting the 2019 nCoV.

Here are some other myths and the WHO’s response to them:

Myth: “COVID-19 virus can be transmitted in areas with hot and humid climates”

From the evidence so far, the COVID-19 virus can be transmitted in ALL AREAS, including areas with hot and humid weather. Regardless of climate, adopt protective measures if you live in, or travel to an area reporting COVID-19. The best way to protect yourself against COVID-19 is by frequently cleaning your hands. By doing this you eliminate viruses that may be on your hands and avoid infection that could occur by then touching your eyes, mouth, and nose.

Myth: The new coronavirus can be transmitted through mosquito bites.

To date there has been no information nor evidence to suggest that the new coronavirus could be transmitted by mosquitoes. The new coronavirus is a respiratory virus which spreads primarily through droplets generated when an infected person coughs or sneezes, or through droplets of saliva or discharge from the nose. To protect yourself, clean your hands frequently with an alcohol-based hand rub or wash them with soap and water. Also, avoid close contact with anyone who is coughing and sneezing.

Help numbers

COVID-19 Sample test contact persons at NPHL, Teku, Kathmandu:
1) Dr. Shrawan K. Mishra: 9851168220
2) Dr. Ranjit Shah: 9872701465
3) Mr. Rajesh K. Gupta: 9851239988
4) Mr. Dinesh Thapa Magar: 9823168540 (Nights only)
5) Mr. Naresh Thapa Magar: 9803152149 (Nights only)

Further Information links
https://livemandu.com/archives/14211
https://livemandu.com/archives/14200
https://livemandu.com/archives/14221
https://livemandu.com/archives/14029
https://livemandu.com/archives/13986
https://livemandu.com/archives/13995
https://livemandu.com/archives/13930