INFECTIONS CAUSED BY THE NEW CORONA VIRUS COVID-19 (CORONAVIRUS SARS-COV-2) SCIENTISTS ARE STILL SEARCHING, AND A LOT IS STILL UNKNOWN. WE SEE ONLY THE “TOP OF AN ICEBERG” AND NOT THE TOTAL EXTENT.
The research priorities focus now on epidemiology (how the transmission is, how factors cause the infection), the diagnostics (how to detect and find the true extent of the virus’ spread), and at this point, how is the best practices of managing the illness. Parallel intensive research on pathology and virulence, therapy and vaccination are going on.
Currently the testing capacities aren’t adequate. It will take weeks until we have adequate testing capacity. If screening is carried out, procedures would also have to be used which permit reliable detection.
Professor Lipsitch of epidemiology and director of the Center for Communicable Disease Dynamics stated that “recent modeling suggests that most countries’ screening procedures for travelers miss two-thirds of people with COVID-19 symptoms”.
With infected people symptoms such as fever, dry cough, runny nose and fatigue, as well as breathing problems, sore throat, headache and body aches and chills have been reported. Some suffer from nausea and diarrhea. The symptoms of the disease vary widely, from asymptomatic courses to severe pneumonia with lung failure and death. This is all relatively unspecific with symptoms that can also be attributed to other diseases. There are numerous infected people who have no symptoms so far and will not get sick either. We don’t know at this state how the virulence and severity for the healthy people is.
So, we don’t know how many people are already or will be infected. But it’s seems to be a serious infection on the global few and (probably or maybe?) more dangerous than normal flu. The good news is, that the more people who have contact with the virus over time, probably the more immunity will result. This is mainly because the virus genetics does not change (so far it looks like this).
Note: The discovery of new virus variants reveals some very virulent and highly damaging viruses, but fortunately also some viruses that are less harmful and some against which immunity develops.
The corona virus variant, which had caused SARS infections (severe acute respiratory syndrome) in China at the end of 2002 and 2003, was not harmless, but it disappeared absolutely in May 2004, even without a vaccine being developed, and the diseases or organ damage could only be treated symptomatically.
We don’t have vaccines for very many viruses, but there are various viruses or new discovered virus variants, where the absolute majority of those, who are already infected, are still undetected because the majority probably have unspecific uncomplicated symptoms – and of course are not tested in this way.
So, with the new Corona variant, we don’t know with certainty how many people are or will be infected and how many develop a serious illness after infection. This is difficult to estimate and evaluate this well at the current state, because global too few people have been examined yet respectively not so many have been infected so far that one could say this statistically for the entire population (for the healthy persons outside the risk groups). As the number increases, this will be easier to assess. As usual, the risk group will be particularly more affected; these are the older or immunodeficient people and those who have not been healthy before.
GROUPS OF RISK
Due to the higher number of cases, at this state it is only possible to give somewhat better assessments for China so far.According to the WHO, four of the five (80%) of the registered infections so far have been mild. In some of the patients, the virus can lead to a more severe course with breathing problems and pneumonia.
From the data from China, the highest risk for a serious disease and even death is seen for people over the age of 60 and people with underlying diseases, such as cardiovascular diseases, diabetes and respiratory, liver and kidney diseases and cancer. Most of the deaths occurred in China in the over 80 ages (men more often than women).
According the previous data (of the WHO), the disease appears to be comparatively rare in children and then to be mild. Also, pregnant women do not appear to have an increased risk of developing a serious illness.
Especially immunocompromised people (sick and elderly) should be particularly careful.
It is very important to take the hygiene of the hands seriously (consequent handwashing and disinfection if necessary) and to avoid the close contacts to potentially infected (that means first to people with respiratory diseases).
As long as the infection chains are not known sufficient, caution should also be exercised where more infections can occur in public places (these are the same sources as e.g. for flu).
Important measures for the personal protection as well as the protection of other persons against the infection with respiratory infections.
In addition to frequent hand washing (good hand hygiene) is helpful:
- if you have some symptoms, first contact the doctor by phone,
- stay at home from work when you are sick
- contact the hospital straight away if you are seriously ill
- be careful coughing and sneezing – in the crook of the elbow
- and keep a minimum distance (approx. 1 to 2 meters) of suspected persons
- avoid contamination through the hands, no hand should be given in greetings
- if possible, avoid public places where many people come together very closely (e.g. buses or trams, etc.)
- reduce travel to and from stricken areas – reducing or avoiding travel by plane, ship, etc., if not necessary
- it can help to wear a mouth-nose protection by coughing and sneezing person, also by person with fever, (e.g. a surgical face mask)* to reduce the risk of infecting other people with droplets (protection of other people, but no secure protection!). For optimal effectiveness, it is important that the protector is properly seated (i.e. constant worn close-fitting) and changed when wet.
- For your own protection against infection from airborne transmission (by other coughing or sneezing people) only special virus protection masks help, which then must be changed several times a day. Such will be needed in medical practices or hospitals.
*a normal mask (surgical mouth and nose protection mask) may reduce your own infection, but there is no evidence for this (by information of the WHO); so a special virus mask is different to this.
Of course, the topics of preventive medicine count here, because health means much more than the absence of illness – in other words, a very potent immune defense, which is determined by many factors of an optimally functioning organism, is important for the health anyway.
So, in addition to hygienic precautions – minimize massive contacts with sources of infection, the motto is to live healthy to strengthen the immune system :
- in terms of good balanced nutrition (see the recommendations in the context of healthy nutritional composition – Issue food pyramid)
- avoid pollutants – especially avoid smoking – also passive smoking, and of course other pollutants,
- promote metabolism (therefore adequate physical activity, healthy sport, etc.)
Closing schools and events or workplaces where larger groups can come together can help and is to be considered to affected areas for the first phases of virus’ spreading. But this should be made consequently (often more than possible) and it’s difficult to decide how long it is necessary, because the usual time of incubation may not be sufficient. It is currently assumed that the incubation period can be up to 14 days, according to the WHO it is on average 5 to 6 days.
When get kids back to school and people back to work? There may be severe economic losses or other burdens on normal medical care that must be guaranteed for other reasons.
The goal of such restriction like quarantine or closings, is to flatten the infection curve, which slows down the spread; and the systems – especially the health facilities can be better adapted to the supply bottlenecks.
However, with a highly virulent virus that remains asymptomatic in many people experience has shown that this cannot reliably prevent the spread. Spread usually runs unless immunity develops in the population or another reason weakens or eliminates the virus. As the SARS example from 2004 showed, the pandemic has ended even without a vaccine.
Usually when enough people will have been infected or vaccinated, the rising immunity in the population slows the epidemic.
Public health managers just want to slow down the spreading in this first phase and improve the chance over the time, to have a vaccine, or to be able to better estimation, where the infection is rather harmless or where it has to be rigorously precaution.
It will not be sustainable that you try so rigorous for long time to close facilities and cancel events where a lot of people can meet – this is only for limited time possible.
It’s a serious thing and seems to be more dangerous than normal flu, but we still don’t know several facts about it. So far it shows that most people won’t get serious sick, we certainly don’t need to have to panic as some are doing now.