How do I know if it is COVID-19 or just the common flu?
A COVID-19 infection hasthe same signs and symptoms as the common cold and you can only differentiatethem through laboratory testing to determine the virus type. However, nasaldischarge has been found less common in COVID 19. A travel history to areaswith documented COVID infection or contact with a COVID positive person shouldarouse the suspicion for COVID. This is also true for healthcare workersworking in areas where COVID positive cases and suspects are kept.
What are the symptoms of COVID-19?
The most common symptomsare fever, dry cough and shortness of breath. Some patients may have aches andpains, nasal congestion, runny nose, sore throat or diarrhoea. These symptomsare usually mild and begin gradually. Some people become infected but don’tdevelop any symptoms and don’t feel unwell. Most people (about 80%) recoverfrom the disease without needing special treatment. Around 1 out of every 6people who get infected becomes seriously ill and can develop complicationslike respiratory and renal failure. Data reported till now have shown thatcomplications are commoner in older people, and those with underlying medicalproblems like high blood pressure, chronic lung and heart problems or diabetes.
Are patients with heart disease, diabetes or hypertension at increased risk to get coronavirus infection?
No, people with hypertension, diabetes or heartdiseases are at no greater risk of getting the infection than anyone else.
Among people with above diseases is there an increased risk ofsevere illness or complications once infected?
The majority (80%or more) of people diagnosedwith COVID-19 will have mild symptoms of a respiratory infection (fever, sorethroat, cough) and make full recovery. Some of the people with diabetes,hypertension and heart diseases may develop more severe symptoms andcomplications. Therefore extra care is advised for these patients.
How does COVID-19 spread?
People can catch COVID-19from others who have the virus. The disease can spread from person to personthrough small droplets from the nose or mouth which are spread when a personwith COVID-19 coughs or sneezes and a person in vicinity inhales these exhaleddroplets. This is why it is important to stay more than 1 meter (3 feet) awayfrom a person who is sick.
These droplets can alsoland on objects and surfaces around the person. Other people then catchCOVID-19 by touching these objects or surfaces and then touching their eyes,nose or mouth.
Is it in air around areas where a positivecase is housed?
There are some unconfirmed indications of thevirus being transmitted through aerosols. However precautions for airborneinfection are recommended only for settings in which aerosol generatingprocedures are performed. These include healthcare settings like intubations,nebulizations, bronchoscopic procedures, etc. There has been a single study inwhich virus has been grown from the stool of a single specimen. However, thereare no reports of feco-oral transmission of the disease.
Can Corona viruses be spread through street/pet dogs, cats orother animals or mosquito bites?
There is no evidence that mosquito bites spread COVID 19 virus. The exact mode of transmission is unclear as yet. It is believed that the virus is seen in bats and from bats it jumped to some intermediary animal and from them jumped to the humans. This intermediate host has been variably postulated to be snakes, other sea food animals or even pangolins. However these are only conjectural and no definite evidence exists. There has been a single episode of a cat having gotten the infection from her master. There is no need for discarding pets based on current evidence.
What are the important steps you can do to prevent acquiring orspreading infection?
We need to practice social distancing and handhygiene:
Social distancing is extremely important:
a. Avoid contact with someone who shows symptomsof possible COVID-19 – anyone having a cold or cough or fever.
b. Avoid non-essential travel and use of publictransport. Observe the lockdown as strictly as possible.
c. Avoid public places, crowds and large familyget togethers. Lockdown should not mean family get togethers or partying. Weshould keep in touch with friends and relatives using phone, internet, andsocial media.
d. Avoid routine visits to hospitals / Labs. forminor problems. Contact hospital or healthcare facilities by phone or helplinenumber if possible. If you are regularly checking like blood sugar, INR, CBC,etc. please contact the doctor over phone if possible and try and avoid ahospital as much as possible.
2. Hand hygiene:
a. Avoid handshakes and touching face with hands
b. Wash your hands with soap and waterfrequently – do this for at least 20-30 seconds and systematically to clean allparts of the hand, not leaving any area unwashed.There are a number ofpictorial or video demonstrations of the correct methods of hand washing whichshould be adopted/
c. Alcohol based hand-sanitisers are alsouseful. The use of non-alcohol based sanitizers is not proved and thesanitizers should contain at least 70% alcohol.
d. Avoid touching possibly contaminatedareas/objects –toilet doors, door handles etc.
e. Wash hands after touching potentiallycontaminated surfaces like steering wheels, car handles, key chains, wallets,mobile phones, etc.
f. Health care workers need to practiceinfection control measures as dictated by their level of exposures and theassociated risk. This forum would be inappropriate for detailed discussion ofthe same.
Everyone out there is looking for a mask andmost are wearing one. Is it needed?
According to the WHO, forindividuals without respiratory symptoms, a medical mask is not required, as noevidence is available on its usefulness to protect non-sick persons. The modeof transmission is when someone sneezes or coughs on you and if there is none,the mask isn’t necessary. However, masks are being worn in some countries accordingto local cultural habits, say for prevention of pollution in China, HongKong etc. If masks are used, best practices should be followed on how to wear,remove, and dispose of them and on hand hygiene action after removal.
Masks are not recommendedfor common people unless they are caring for someone who is a patient. Howeverif the masks are left for healthcare workers, it would certainly be better.
What needs to be kept in mind while wearinga mask?
- If you are healthy, you only need to wear a maskif you are taking care of a person with suspected COVID 19 infection.
- Wear a mask if you are coughing or sneezing.
- Masks are effective only when used incombination with frequent hand-cleaning with alcohol-based hand rub or soap andwater.
- If you wear a mask, then you must know how touse it and dispose of itproperly.
- Before putting on a mask, clean hands withalcohol-based hand rub or soap and water.
- Cover mouth and nose with mask and make surethere are no gaps between your face and the mask.
- Avoid touching the mask while using it; if youdo, clean your hands with alcohol-based hand rub or soap and water.
- Replace the mask with a new one as soon as it isdamp and do not re-use single-use masks.
- To remove the mask: remove it from behind (donot touch the front of mask); discard immediately in a closed bin; clean handswith alcohol-based hand rub or soap and water.
- Avoid stockpiling masks if you don’t need one.If you do, someone who needs it like a healthcare worker could be missing outon one. The whole globe is falling short of masks. Iso let us reserve it forthose who need it the most.
People are also surgical wearing gloves while out on roads?
No. Latex gloves do not protect you from gettingCorona. People concerned about the transmission of infectious diseases shouldprioritize good personal, respiratory and hand hygiene. People using gloves mayparadoxically have a false sense of security and as such may turn that muchcomplacent to hand washing which is paramount.
Can spraying alcohol or chlorine all over your body kill the newcoronavirus?
No. Spraying alcohol or chlorine all over yourbody will not kill viruses that have already entered your body. Spraying suchsubstances can be harmful to clothes or mucous membranes (i.e. eyes, mouth). Beaware that both alcohol and chlorine can be useful to disinfect surfaces, butthey need to be used under appropriate recommendations.
Will taking a bath with very hot water prevent the virus fromattacking me?
Taking a hot bath will not prevent anyone fromcatching COVID-19. Our body temperature remains around 36.5°C to 37°C,regardless of the temperature of our bath or shower. Actually, taking a hotbath with extremely hot water can be harmful, as it can burn you.
Can regularly rinsing your nose with saline help preventinfection with the new coronavirus?
If I do Wudhu 5times a day, am I protected?
No. There is no evidence that regularly rinsingthe nose with saline water has protected people from infection with the newcoronavirus. Just rinsing the nose and gargling may not be effective forreducing transmission. While these are useful measures, additional provedmeasures need to be undertaken to mitigate transmission.
Can eating garlic help prevent infection with the newcoronavirus?
Garlic is ahealthy food that may have some antimicrobial properties. However, there is noevidence from the current outbreak that eating garlic has protected people fromthe new coronavirus.
Is it going togo away in 3 weeks as suggested in some reports?
I don’t think so. If we look at the dynamics ofthe infection in China and Italy, it took nearly 8 weeks for the cases to leveloff and register a consistent decline. If we follow a similar trend, then wecould be in for a longer haul than just the middle of April. There are someestimates that India would peak somewhere in the 3rd or 4th week of April. If thoseestimates prove right, then we would be looking at more prolonged battle withthe disease than just the first or second week of April. I think we are yet topeak and we should peak in another 2-3 weeks from now. While I say that, I hopeand pray that I am proved “wrong”.
Arethere any specific medicines to prevent or treat the new coronavirus?
There are a number of drugs that have beenrepurposed for use against COVID 19. These include antivirals against influenzaand HIV, antimalarials like hydroxychloroquine, antibiotics like azithromycinand various experimental agents. While there are some claims of success of suchagents, the evidence is weak and not supported by robust clinical trials. FDAhas recently approved the use of convalescent plasma for patients with COVID oncompassionate grounds. We are looking at obtaining regulatory approvals for thesame as well.
Areantibiotics effective in preventing and treating the new coronavirus?
No, antibiotics do not work against viruses
Iam vaccinated against influenza and pneumonia? Can I still get pneumonia byCOVID 19? By when do we expect a vaccine?
Yes. Routine vaccines such as pneumococcal vaccine, Influenza andHaemophilus influenza type B (Hib) vaccine, do not provide protection againstthe new coronavirus. The COVID 19 virus is a new virus and will need its ownvaccine. Researchers are trying to develop a vaccine against 2019-nCoV. Somecandidate vaccines are available and in fact some human trials have alreadystarted. However it will be about a year to year and a half before safety andefficacy data are available before the vaccines can be put to human use. Thatis a long way away as yet.
Can COVID-19 virus can be transmitted in areas with hot and humid climates or will the activity reduce with ensuing higher temperatures in summer?
From the evidence so far, the COVID-19 virus can be transmitted inALL AREAS, including areas with hot and humid weather. Areas with warmgeographies at present have also reported cases and as such it is not definiteif the ensuing warm climate will have an impeding effect on the viruscirculation. This emphasizes that regardless of climate, we must adoptprotective measures.
Howeffective are thermal scanners in detecting people infected with the newcoronavirus?
Thermal scanners are effective in detecting a febrile person.However, they cannot detect people who are infected but are not yet sick withfever. This is because it takes between 2-14 days before people who areinfected become sick and develop a fever.
So many positive cases of COVID19 in Kashmir,did our airport screening fail?
It seems so, because all of our positive cases have not comefrom those who were asymptomatic and then quarantined but from those whosneaked out of the airport filter through whatever means and the contacts ofthose index cases. Even when the quarantine of more than 1700 guests has beenundertaken at a huge cost to the exchequer as well as to the exhaustion of theresources, none of them have reported symptoms. You can yourself gauge thesuccess of the exercise. Further there are people who came through other routeslike road, trains, etc where screening was more permissive. Guidelines do notmandate quarantine of asymptomatic individuals. Let us just say that thisexercise was a “good intention gone wrong”.
Was our quarantine protocol correct?
We have bodies like the WHO, CDC or the MOHFW that draft technicalpolicies based on technical inputs from experts. I would impress upon theauthorities to follow these guidelines in letter and spirit so that we do notinvent our own guidelines that results in inappropriate use of men andresources. Our quarantine policies have been criticised for being unscientific.If we follow guidelines, then we are not only following a laid out procedure,we are also insulating ourselves from disheartening critique when we are tryingour best to follow procedures that we believe are in the best interests of thesociety.
Numbers aregrowing, are we prepared?
In one single word, ‘No’. Actually nobody is. Idon’t want to create panic but if the evolved health care systems like that ofthe US and many European countries can get overwhelmed, our systems stand nochance if we get similar kind of numbers. Our manpower, healthcareinfrastructure, hospital bed density, etc are no match to theirs andconsidering our population density, poverty and consequential compromise ofhygienic practices, we could face a greater onslaught of the virus and oursystems are bound to crumble. Our resources are grossly insufficient despitehuge efforts by the administration. There lay the importance of a public drivencampaign for reducing transmission rather than an authorities driveninitiatives.
A lot of talk about areas in Kashmir beingdemarcated as “red zones”, “yellow zones”. Is it right todo so?
It is an administrative decision and best left to the wisdom ofthe administrators. I am sure they would have gotten enough technical expertisefor demarcating these as such. Generally countries are classified andcolor coded as such:
GREEN ZONES: Countries or localities without confirmed cases orwith a few infected travelers arriving from other countries
YELLOW ZONES: Countries or localities with a few cases oflocal transmission, but without clusters of community transmission (e.g.Germany)
ORANGE ZONES: Countries or localities adjacent to Red Zones orwith small clusters (e.g. Japan)
RED ZONES: Countries or localities that have sustained communitytransmission (e.g. China, USA, Iran, Spain, Italy)
The administrators have probably used the same classification toclassify the areas to prioritizeappropriate public health response.
If public health response is to be geared up for large areas, you candefinitely use some color coding to prioriotize the enhancement of yourresponse based on the disease epidemiology of the smaller sub-areas. China didit.
A lot is being written and circulated about COVID19. How does one knowwhat to believe and what to ignore?
COVID19 infodemic is as big a threat as COVID19 epidemic. We arefighting two wars together.
Please follow credible sites like those from CDC,WHO, ICMR or MOHFW. This info medic can be very dangerous and breedsmisperceptions and wrong practices. Don’t follow dictats of Whatsappuniversities and twitterati. Medical professionals should follow societyguidelines and credible journal sites.