How social distancing can reduce the spread of COVID-19?

There is simple math behind the power of social distancing.

Generally, each COVID-19 patient can directly infect ~2.5 others. There are ~5 days between one infection and next, so each infected person can indirectly infect 244 others in a month. By practicing social distancing, one can reduce the transmission by half, so each person infects 1.25 others, leading to only 4 more cases in a month!

Does using Vitamin C help in fighting against COVID-19?

While there are some anecdotal reports that support the beneficial effects of vitamin C in COVID-19,  no comprehensive clinical trial has shown the effects of consuming vitamin C in this disease.

Do vitamins and supplements help in reducing COVID-19 symptoms?

While vitamins and supplements might not help in reducing the chance of getting COVID-19, according to Dr. Walter Willett, a professor at the Harvard T. H. Chan School of Public Health, there is some reason to hypothesize that some vitamins and supplements could reduce the risk and severity of COVID-19 because of benefits seen for other viral or respiratory disease.

Source:  told USA TODAY.

https://www.usatoday.com/story/news/factcheck/2020/03/24/coronavirus-fact-check-could-vitamin-c-cure-covid-19/2904303001/

Could COVID-19 be airborne?

According to a study published by NIH, scientists found that SARS-CoV-2, the virus that causes COVID-19, can be detected in aerosols for up to three hours.

Source: https://www.nih.gov/news-events/nih-research-matters/study-suggests-new-coronavirus-may-remain-surfaces-days

What conditions increase the chance of death due to COVID-19?

Advance age seems to be the most important factor determining the death rate due to COVID-19

Other common conditions that may increase the chance of death due to COVID-19 include:

Cardiovascular disease =>11 folds higher death rate than the general public
Diabetes = >8 folds higher death rate than the general public
Chronic respiratory disease = 7 folds higher death rate than the general public
Hypertension =>6 folds higher death rate than the general public
Cancer =>6 fold higher death rate.

Source:

https://www.cebm.net/covid-19/global-covid-19-case-fatality-rates/

Do older people have higher chance of death due to COVID-19?

Generally yes.

Here is the chance of death due to COVID-19 based on age in 1,000 COVID-19 patients:

≤ 9 years = 0 death

10 to 19 years= <2

20 to 49  years = >3

50 to 59 years = ~13

60 to 69. years = 36

70 to 79 years = 80

≥80 years = 148

Does drinking alcohol prevent us from getting COVID-19?

No. There is no valid data to support this.

Will the coronavirus (SARS-CoV2) go away in the summer?

Not enough research has been done to support this. In addition, even if it goes away in the Summer, it can come back later in Autumn (like the flu).

What is the difference between an epidemy and a pandemy like COVID-19?

While an epidemy is a rise in the number of disease cases in an area at a given time, a pandemy occurs when the disease occurs worldwide.

What is the difference between a virus and a bacteria?

Both bacteria and viruses are microscopic organisms that might be able to cause diseases. While bacteria can divide by themselves, viruses need the host cells to divide.

How the coronavirus (SARS-CoV2) causing COVID-19 is transmitted in humans?

So far three mechanisms of transmission have been identified:

1. Droplet, produced during coughing or sneezing.
2. Fomit transmission (e.g. surfaces infected with viral particles).
3. Fecal-Oral; A number of studies suggest that the viral particles could be found in human stool and the lack of proper hygiene may lead to new infections.

How long the coronavirus (SARS-Cov-2) survives on hard surfaces?

This may vary according to the type of the surface. However, it could be from a few hours to several days. A recent study published by NIH mentioned scientists found that SARS-CoV-2, the virus that causes COVID-19, can be detected in aerosols for up to three hours and on plastic and stainless steel surfaces for up to three days.

Source: https://www.nih.gov/news-events/nih-research-matters/study-suggests-new-coronavirus-may-remain-surfaces-days

What are the similarities between influenza and COVID-19?

They both lead to respiratory diseases. Additionally, both viruses are transmitted through contact, droplets, and fomites.

How many people can be infected by a person carrying SARS-CoV2?

According to the WHO, the number of secondary infections generated from one infected person is between 2 to 2.5. This may vary according to context and time.

Is COVID-19 more lethal than influenza?

Yes. The death rate for seasonal influenza is only 0.1% (1 in 1,000). However, 3-4% of people with COVID-19 may die.

What percentage of individuals infected with the coronavirus (SARS-CoV2) become symptomatic?

According to the WHO, 80% of people with SARS-CoV-2 infection show mild symptoms or remain asymptomatic. 15% show severe infection requiring oxygen, and 5% become critically ill and may need ventilation.

What is the shedding time for the coronavirus (SARS-Cov2)?

Shedding time is defined as the time between the initial inoculation to when the patient becomes negative.

Viral shedding has been reported to be between 8-37 days in COVID-19 patients that survived the disease. In those that did not survive, the shedding continued till death.

What is the incubation time for COVID-19?

Up to 14 days.

It seems that the higher the risk factors, the lower the number of viral particles needed to cause the disease.

What mechanism makes COVID-19 lethal?

Somehow, during transfer of virus from bats to pangolins and then humans, it gained the ability to use its spikes to bind to angiotensin-converting enzyme 2 (ACE2). The virus uses this receptor to enter into the cells, where it can reproduce.

Angiotensin is a hormone that is able to cause vasoconstriction and elevate blood pressure.

The ACE2 receptors are found in lungs, heart, and the gasterointestinale system. The virus is able to enter the cells in these systems and cause cell death.

Why washing my hands with soap is so effective in destroying the coronavirus (SARS-CoV2)?

It goes back to structure of the virus. SARS-CoV-2 is a single stranded RNA virus. The name (corona) comes from solar crown, it is the largest genome size among RNA viruses.

A large number of spikes are have been found on a lipid protein. Since soap can bind to lipids with one head and to water with another head, it is very effective in destroying the virus.

What happens when the COVID-19 test is negative but still there is some suspicion?

If the first test is negative but the suspicion remains, several samples from different locations are collected and tested until consistent results are produced.

Is the severity of COVID-19 symptoms age-dependent?

The answer is yes at least in China. However, a large number of countries report severe pneumonia in younger individuals.

The median age in 138 COVID-19 patients in Wuhan was 56 years (between 42-68 years).

Could blood and stool carry the coronavirus (SARS-CoV-2)?

SARS-Cov-2 virus RNA has been detected in both blood and stool of COVID-19 patients. However, it is not known whether these specimens contain the infectious virus.

When and where COVID-19 was first reported?

Late November (2019) and early December a cluster of pneumonia was reported in Wuhan, a city in the Hubei province in China that later was linked to the coronavirus (SARS-Cov-2).

What are COVID-19 signs and symptoms?

The presence of SARS-Cov-2 in humans has been linked to the following signs and symptoms:

It must be noted that not all symptoms have to be present to suspect COVID-19 and a large number of other diseases could also lead to these symptoms. Only a professional healthcare provider can establish the cause of these signs and symptoms.

• Fever
• Fatigue
• Dry Cough
• Myalgia
• Dyspnea
• Pneumonia
• Sore Throat
• Rhinorrhea
• Gastrointestinal Symptoms may include loss of appetite, Diarrhea, Vomiting, Abdominal pain
• Eye conditions including:
• Photophobia
• Irritation
• Conjunctival injections
• Water discharge

Can the coronavirus (SARS-CoV2) be man-made?

Not likely. Genetic analysis of the SARS-Cov2 does not support the idea that the virus is made in the laboratory. Careful studies suggest that the virus has moved from bats (Rhinolophus affinis bat) to Malayan pangolins and then to humans.

What happens if a close contact with a COVID-19 patient occurs?

If a contact develops symptoms, the following steps should be taken:

• Notify the receiving medical facility that a symptomatic contact will be arriving.
• While traveling to seek care, the contact should wear a medical mask.
• The contact should avoid taking public transportation to the facility if possible; an ambulance can be called, or the ill contact can be transported in a private vehicle with all windows open, if possible.
• The symptomatic contact should be advised to perform respiratory hygiene and hand hygiene and to stand or sit as far away from others as possible (at least 1 metre) when in transit and when in the health care facility.
• Any surfaces  that become soiled with respiratory secretions or other body fluids during transport should be cleaned with soap or detergent and then disinfected with a regular household product containing a 0.5% diluted bleach solution.

Source: Home care for patients with COVID-19 presenting with mild symptoms and management of their contacts

Interim guidance

17 March 2020

How to effectively manage my COVID-19 contacts?

Persons (including caregivers and HCWs) who have been exposed to individuals with suspected COVID-19 are considered contacts and should be advised to monitor their health for 14 days from the last day of possible contact.

A contact is a person who is involved in any of the following from 2 days before and up to 14 days after the onset of symptoms in the patient:

• Having face-to-face contact with a COVID-19 patient within 1 meter and for >15 minutes;
• Providing  direct care  for patients with  COVID-19 disease without using proper personal protective equipment;
• Staying in the same close environment as a COVID-19 patient (including sharing a  workplace, classroom or household or being at the same gathering) for any amount of time;
• Travelling in close proximity with (that is, within 1 m separation from) a COVID-19 patient in any kind of conveyance;
• and other situations, as indicated by local risk assessments.

A way for caregivers to communicate with a healthcare provider should be established for the duration of the observation period. Also, health care personnel should review the health of contacts regularly by phone but, ideally and if feasible, through daily in-person visits, so specific diagnostic tests can be performed as necessary.

The health care provider should give instructions to contacts in advance about when and where to seek care if they become ill, the most appropriate mode of transportation to use, when and where to enter the designated health care facility, and which IPC precautions should be followed.

How to prepare your home for a patient with COVID-19?

A professional healtcare provider must be consulted in all cases.

Patients and household members should be educated about personal hygiene, basic infection prevention measures, and how to care as safely as possible for the person suspected of having COVID-19 to prevent the infection from spreading to other close contacts.

• Place the patient  in a well-ventilated  single room (i.e. with open windows and an open door)
• Limit the movement of the patient in the house and minimize shared  space.
• Ensure that shared spaces (e.g. kitchen, bathroom, etc) are well ventilated.
• Household members should stay in a different room or, if that is not possible, maintain a distance of at least 6 feet from the ill person (e.g. sleep in a separate bed).
• Limit  the number  of caregivers.  Ideally, assign one person who is in good health and has no underlying chronic or immunocompromising conditions.
• No visitors should not be allowed until the patient has completely recovered and has no signs or symptoms of COVID-19.
• Perform hand hygiene after any type of contact with patients or their immediate environment.
• Hand hygiene should also be performed before and after preparing food, before eating, and after using the toilet. If hands are not visibly dirty, an alcohol-based hand rub can be used. For visibly dirty hands, use soap and water.
• When washing hands with soap and water, it is preferable to use disposable paper towels to dry hands. If these are not available, use clean cloth towels and replace them frequently.
• To  contain  respiratory  secretions, a  medical masks should be provided to the patient and worn as much as possible, and  changed daily. Individuals who cannot tolerate a medical mask should use rigorous respiratory hygiene; that is, the mouth and nose should be covered with  a disposable paper tissue when coughing or sneezing. Materials used to cover the mouth and nose should be discarded or cleaned appropriately after use (e.g. wash handkerchiefs using regular soap or detergent and water).
• Caregivers should wear a medical mask that covers their mouth and nose when in the same room as the patient. Masks should not be touched or handled during use. If the mask gets wet or dirty from secretions, it must be replaced  immediately with a new clean, dry mask.
• Remove the mask using the appropriate technique – that is, do not touch the front, but instead untie it. Discard the mask immediately after use and perform hand hygiene.
• Avoid direct contact with body fluids, particularly oral or respiratory secretions, and stool. Use disposable gloves and a mask when providing oral or respiratory care and when handling stool, urine, and other waste. Perform hand hygiene before and after removing gloves and the mask.
• Do not reuse masks or gloves.
• Use dedicated linen and eating utensils for the patient; these items should be cleaned with soap and water after use and may be re-used instead of being discarded.
• Daily clean and disinfect surfaces that are frequently touched in the room where the patient is being cared for, such as bedside tables, bed frames, and other bedroom furniture. Regular household soap or detergent should be used first for cleaning, and then, after rinsing, regular household disinfectant containing 0.1% sodium hypochlorite (i.e. equivalent to 1000 ppm) should be applied.
•  Clean and disinfect bathroom and toilet surfaces at least once daily. Regular household soap or detergent should be used first for cleaning, and then, after rinsing, regular household    disinfectant containing 0.1% sodium hypochlorite should be applied.
• Clean the patient’s clothes, bed linen, and bath and hand towels using regular laundry soap and water or machine wash at 60–90 °C with common household detergent, and dry thoroughly. Place contaminated linen into a laundry bag. Do not shake soiled laundry and avoid contaminated materials coming into contact with skin and clothes.
• Gloves  and protective  clothing (e.g. plastic  aprons) should be used when cleaning surfaces or handling clothing or linen soiled with body fluids. Depending on the context, either utility or single-use gloves can be used. After use, utility gloves should be cleaned with soap and water and decontaminated with 0.1% sodium hypochlorite solution. Single-use gloves (e.g. nitrile or latex) should be discarded after each use. Perform hand hygiene before putting on and after removing gloves.
• Gloves, masks, and other waste generated during home care should be placed into a waste bin with a lid in the patient’s  room before disposing of it as infectious waste.e The onus of disposal of infectious waste resides with the local sanitary authority.
• Avoid other types of exposure to contaminated items from the patient’s immediate environment (e.g. do not share toothbrushes, cigarettes, eating utensils, dishes, drinks, towels, washcloths, or bed linen)
• Medical masks are surgical or procedure masks that are flat or pleated (some are shaped like a cup); they are held in place by strings that tie around the back of the head.
• The local sanitary authority should adopt measures to ensure that the waste is disposed of at a sanitary landfill and not at an unmonitored open dump.

Source: Home care for patients with COVID-19 presenting with mild symptoms and management of their contacts. Interim guidance. 17 March 2020.
© World Health Organization 2020. Some rights reserved. This work is available under the  CC BY-NC-SA 3.0 IGO licence.

What is the origin of the coronavirus (SARS-Cov2)?

While bacteria can live without a host, viral particles need to attack the cells and use their machinery to reproduce.

The virus is called SARS-CoV-2. It is a member of a family of coronaviruses. So far there are 7 known coronaviruses that can infect humans.

SARS-CoV, MERS-Cov, and SARS-CoV2 lead to severe diseases in humans.

HKU1, NL63, OC43, and 229E have been associated with milder maladies in humans.

Gene Sequencing shows a significant similarity between humans SARS-CoV-2 to bat’s SARS-Cov-like viruses.

The virus can bind to the ACE2 receptor in pigs, ferrets, cats, and some non-human primates.

What causes COVID-19?

COVID-19 stands for CoronaVirus Disease-19 and is caused by betacoronavirus. Alpha corona descended from bat gene virus and has been linked to feline corona and canine corna. There are 7 known coronaviruses that have been linked to human disease so far. Beta coronavirus also comes from bat gene visus and has been lined to human SARS and MERS. Both alpha and beta can infect humans. The SARS-Cov-2 virus has 96% similarity to RaTG13 virus in bats.