Michael Abrahams | Coronavirus: be vigilant and don’t panic

As COVID-19 spreads across the globe, many questions are being asked about its origin, spread and consequences. Hopefully, the following information will be of value.

The name ‘coronavirus’ is derived from the Latin word corona, which means ‘crown’ or ‘halo’, as the virus particles, when viewed through an electron microscope, appear to be surrounded by a crown, because their surfaces are covered by club-shaped protein spikes.

Coronaviruses (CoV) were first discovered in the 1960s and are a large family of viruses that cause illness ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV).

‘Coronavirus disease 2019’ (abbreviated ‘COVID-19’) is caused by the virus ‘SARS-CoV-2’, which is referred to as ‘novel’, as it is a new strain that was discovered in 2019 and has not been previously identified in humans.

Coronaviruses are zoonotic, meaning they are transmitted between animals and people. For example, investigations revealed that SARS-CoV was transmitted from civet cats to humans and MERS-CoV from dromedary camels to humans. Many of the patients at the epicentre of the COVID-19 outbreak in Wuhan, Hubei Province, China had some link to a large seafood and live animal market, suggesting initial animal-to-person spread, before the virus began to be transmitted via person-to-person contact.

The disease is now a pandemic, meaning a disease epidemic that has spread across a large region, such as multiple continents, or worldwide. It has now been detected in over 120 countries and continues to spread.

On January 30, 2020, the International Health Regulations Emergency Committee of the World Health Organization (WHO) declared the outbreak a “public health emergency of international concern”. People catch COVID-19 from others who are infected with the virus. The disease can spread through droplets from the nose or mouth when a person with COVID-19 coughs, sneezes or even exhales. These droplets land on objects and surfaces around the person, and other people then catch COVID-19 by touching these objects or surfaces, then touching their eyes, nose or mouth. People can also catch COVID-19 if they breathe in droplets from a person with COVID-19 who expels them.

LOW RISK

The risk of catching COVID-19 from someone with no symptoms at all is very low. A good friend of mine recently returned from a trip to London. A few days after his return he was contacted by health officials and informed that the passenger he sat beside for the entire nine-hour flight was Jamaica’s first COVID-19 case: patient zero.

He has no symptoms and called me while I was writing this article to inform me that his test just came back negative. On the other hand, some of the people who came in contact with her after she developed symptoms are now ill.

The incubation period, the time from exposure to development of symptoms, ranges from one to 14 days, with an average of five to six days.

The commonest symptom is fever, which is present in approximately 90 per cent of patients, followed by dry cough (70 per cent), fatigue (40 per cent), sputum (thick mucus coughed up from the lungs) (30 per cent) and shortness of breath (20 per cent).

Some persons may develop only mild symptoms, while in others, severe illness such as pneumonia, severe acute respiratory syndrome, kidney failure and even death can occur. On average the disease lasts two weeks, but for severe and critical cases it may continue for three to six weeks.

People at greatest risk are older adults, with risk increasing by age, and people who have serious chronic medical conditions such as heart disease, hypertension, diabetes, lung disease, compromised immune systems, for example, cancer patients on chemotherapy, and transplant patients on immunosuppressive therapy.

On the other hand, children are at very low risk. In China, out of nearly 45,000 confirmed cases through February 11, there were no deaths in children under age 10, and there was only one death in someone younger than 20. Also, there have been no reported deaths in pregnant women.

The problem with children, however, is that although their symptoms are mild if they get infected, schools can be a breeding ground for the disease, and they may return home and pass on the virus to older family members. Hence the rationale for shutting schools.

A PATTERN

We have no idea how long the pandemic will last. What we do know is that outbreaks such as this follow a pattern where the number of cases reaches a peak, and then decreases.

Also, what we have the power to do is reduce the peak, or “flatten the curve”. We can do this by taking measures to lower the rate of infection so that the epidemic is spread out over time such that the peak demand on the healthcare system is lower.

If a large number of people get sick at the same time, our health system will be overburdened and unable to cope, increasing the risk of severe morbidity and death. For example, about a quarter of severe and critical cases will require mechanical ventilation. There are less than 50 ventilators in Jamaica. They are not all vacant now, and several will be unavailable for severe COVID-19 cases, as they are already being used or will be designated for other critically ill patients.

Our behaviour will determine the spread of the disease, and it comes down to vigilant hygiene and social isolation.

ACTIONS TO TAKE

Wash your hands frequently with soap and water, if possible, as soap kills the virus. If washing is not possible, use an alcohol-based hand sanitizer (with 70 per cent alcohol) or rubbing alcohol.

Cover your mouth and nose with your bent elbow or tissue when you cough or sneeze. If tissue is utilized, it must be discarded immediately after use. Avoid touching your eyes, nose and mouth. Wear a mask if you are ill with COVID-19 symptoms (especially coughing) or looking after someone who may have COVID-19.

Perhaps the most important advice is to maintain social distancing. Stay at home as much as you can, and when you encounter and greet others, avoid kissing, hugging and shaking hands. Maintain at least a three- to six-foot distance between yourself and anyone who is coughing or sneezing or avoid them altogether if possible.

Stay at home if you begin to feel unwell, even with mild symptoms such as headache and slight runny nose, until you recover. If you have a fever, cough and difficulty breathing, seek medical attention. Call in advance and tell your provider of any recent travel or contact with travellers.

The power to control the spread of this disease lies within us.

- Michael Abrahams is a gynaecologist and obstetrician, comedian and poet. Email feedback to columns@gleanerjm.com and michabe_1999@hotmail.com, or tweet @mikeyabrahams