Covid 19

Q. What are the symptoms of COVID-19?

A. Symptoms can include fever, cough and shortness of breath. In more severe cases, infection can cause pneumonia or breathing difficulties. More rarely, the disease can be fatal.

These symptoms are similar to the common flu (influenza) or the common cold, which are a lot more common than COVID-19. So, even if you do have similar symptoms, you may not have COVID- 19. Influenza (common flu) has a much higher mortality particularly among the very young and the very old. So, immunizing your loved ones in that age group against the common flu (through the annual quadrivalent flu vaccine) is an excellent idea.

Currently, you will you be tested for COVID -19 only if there is a strong suspicion for the infection. These maybe due to travel history to high risk areas; or contact with those who have such travel history who have actually tested positive.

Q. How does coronavirus spread?

A. What we need to understand is that COVID -19, spreads human-to-human through droplet and contact spread. This means that coughing, sneezing, and nasal secretions of those infected, are what will cause the infection. Surfaces and objects that come in contact with these infected secretions, can infect others. Under most circumstances, the amount of infectious virus on contaminated surfaces is likely to have decreased significantly by 72 hours, but this again depends on;

● the surface the virus is on

● whether it is exposed to sunlight

● environmental conditions such as temperature and humidity

● exposure to cleaning products

Q. How long does the virus live on different surfaces?

A. The virus has a different lifespan over different surfaces.

a) Air – 3 hours

b) Copper – 4 hours

c) Cardboard – 24 hours

d) Steel – 2-3 days

e) Polypropylene plastic – 3 days

Q. Are young children vulnerable?

A. This is a new virus and we do not know enough yet about how it affects children or pregnant women. We know it is possible for people of any age to be infected with the virus, but so far there have been relatively few cases of COVID-19 reported among children.

Q. What about pregnant women?

A. There is little data to suggest that pregnant women are more vulnerable or that the children born to them will be affected, but it is still a very new disease, so it does make sense to take more precautions.

Q. Is the hype regarding the Coronavirus justified?

A. Absolutely. While it is true that the virus will result in a flu-like or pneumonia-like picture in most healthy adults, its effects on elderly (>70yrs), and those with other serious illnesses (Diabetes, Asthma, COPD, Bronchitis) are more severe. The severity of illness and chance of even death are increased in these people. So even if you catch the infection and are fine, you could end up passing the illness to the elderly and very young in your family and in the families of those you work and live with.

If that were not enough, look at how exponentially the disease has spread. The first case was reported on the 17th of November 2019. Now, just four months later, it has spread all over the world, the statistics suggest that while it took us 3 months to reach 10,000 cases, in the last month alone, the virus has spread far and wide to now have infected over 2,00,000 people globally.

Q. How do we protect ourselves and our families?

A. Simple measures implemented vigorously can help contain if not completely stop the spread of the disease. They are as follows.

1. Wash your hands frequently. Regularly and thoroughly clean your hands with an alcohol-based hand rub or wash them with soap and water.

Why? Washing your hands with soap and water for 20 seconds or using an alcohol-based hand rub kills viruses that may be on your hands.

The picture given below will show you how to effectively wash your hands.

2. Maintain social distancing. Maintain at least 1 metre (3 feet) distance between yourself and anyone who is coughing or sneezing.

Why? When someone coughs or sneezes, they spray small liquid droplets from their nose or mouth which may contain the virus. If you are too close, you can breathe in the droplets, including the COVID-19 virus if the person coughing has the disease.

The picture below will show you the power of social distancing in reducing the spread of the disease.

3. Avoid touching eyes, nose and mouth.

Why? Hands touch many surfaces and can pick up viruses. Once contaminated, hands can transfer the virus to your eyes, nose or mouth. From there, the virus can enter your body and can make you sick.

4. Make sure you, and the people around you follow good respiratory hygiene. This means covering your mouth and nose with your bent elbow or tissue when you cough or sneeze. Using your hands to cover your mouth and nose while coughing and sneezing is not advisable as then your hands can spread the virus through contact with surfaces. Dispose of used tissues immediately.

Why? Droplets spread virus. By following good respiratory hygiene, you protect the people around you from viruses such as cold, flu and COVID-19.

5. What surfaces should you be wary of and what should you disinfect?

To make your life simple, just remember, anything that is touched by unknown people is bad for you. That includes but is not restricted to lift switches, doorknobs, doorbells, handles, railings, window panes, seats and bars in the public transport system, pens, playground or gym equipment, milk packets and vegetables.

And what to disinfect is simpler, anything you can! For example, the lifts in housing societies can be wiped down as can doorknobs and doorbells at home.

Anything that you have no control over, try not to touch, to touch with you elbows, feet, the back of your hands and most importantly, do not touch your face (or anyone else’s face for that matter) after that, till you wash your hands.

6. Stay home if you feel unwell. If you have a fever, cough and difficulty breathing, seek medical attention and call in advance.

Why? Calling in advance will allow your health care provider to quickly direct you to the right health facility. (Kasturba Hospital in Mumbai, Naidu Hospital in Pune). This will also protect you and help prevent spread of viruses and other infections. You must remember that hospitals are unlikely to admit you or even test you for COVID-19 unless your symptoms are severe. You will be advised ‘home quarantine’ i.e. will be asked to stay at home, along with your family members who may also have the same symptoms. Stay at home if you begin to feel unwell, even with mild symptoms such as headache and slight runny nose, until you recover.

Why you shouldn’t go to a hospital is simple. You are likely to infect other patients in the whose immunities are weakened by disease, you are likely to contract some other infection from them, and if you need to be admitted for COVID-19, you need a separate hospital with isolation facilities, not your nearby hospital!

The ICMR recommends a 14-day quarantine for those who have history of travel to areas where the infection is already established and who are exhibiting symptoms. If you or your family members develop serious symptoms, only then will hospitalization be required.

7. Do not shake hands, hug to greet people.

This is an excellent time to start saying ‘Namaste’

8. Avoid touching railings, doorknobs and other objects that could have come in contact with infective secretions.

If you do end up touching them, wash your hands clean with soap and water, or alcohol-based rubs if water is not accessible, and avoid touching your face.

9. Avoid unnecessary travel to places where large numbers of people have already tested positive for COVID - 19, or crowded places such as concerts, malls, tournaments etc.

10. Should you meet a few close friends to spend time?

Currently, given the situation we are in, (Stage 2 – where COVID -19 only spreads by contact with those infected) if you do maintain social distancing, ensure good respiratory hygiene, it does not seem to be a problem to meet just a few people. But remember, no hugs, kisses. handshakes or fist bumps. Namaste all the way!! If we do move to stage 3, Skype, Google Duo and WhatsApp video calls would be a better way to hang out.

11. Since the children are home all day, can they play outside in the gardens or play areas?

That would not be a really good idea. It is difficult to tell children to not touch things on the playgrounds or in gardens. Social distancing is also likely to be a difficult concept for them. If you are fortunate enough to live in a place where playground objects are regularly and repeatedly wiped clean and there aren’t too many children, you could consider it.

If your child is having mild respiratory symptoms, seek medical care, and follow the instructions from the health care provider. Otherwise, as with other respiratory infections like the flu, keep your child well rested at home while symptomatic, and avoid going to public places, to prevent spread to others.

This is a really good time good time to teach children, good hand and respiratory hygiene practices for school and elsewhere, like frequent handwashing (see below), covering cough or sneeze with a flexed elbow or tissue, then throwing away the tissue into a closed bin, not touching their eyes, mouths or noses if they haven’t properly washed their hands.

12. When to use a mask?

If you are healthy, you only need to wear a mask if 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 in combination with frequent hand-cleaning with alcohol-based hand rub or soap and water.

Before putting on a mask, clean hands with alcohol-based hand rub or soap and water. Cover mouth and nose with mask and make sure there are no gaps between your face and the mask.

Avoid touching the mask while using it; if you do, clean your hands with alcohol-based hand rub or soap and water.

Replace the mask with a new one as soon as it is damp and do not re-use single-use masks.

To remove the mask: remove it from behind (do not touch the front of mask); discard immediately in a closed bin; clean hands with alcohol-based hand rub or soap and water.

13. Do we need to stock up and use N-95 masks?

N -95 masks, which if properly fitted, block "at least 95%" of very small test particles, though they do not completely eliminate the risk of illness, as per the FDA. These masks are recommended for healthcare providers coming in contact with infected patients. No face mask is advised for people who don't work in health care settings where coronavirus poses a risk.

14. Should we stock up on sanitizers?

Not really. Handwashing is way more effective in dealing with this virus, whose, crown or ‘corona’ will dissolve with the soap, rendering it ineffective and then allowing it to flush down the drain with the water. Hand sanitizers are useful when you do not have water at hand. They do not work on visibly dirty hands or against pesticides and chemicals. They are better when used in a hospital setting where your healthcare providers hands are likely to have germs but no dirt. Be careful when you buy sanitizers though, the important thing is to ensure that the alcohol concentration is more than 60%. Any less and it is ineffective.

So, the key thing to remember is wash your hands but remember to be careful with what you do with the napkins or towels you use to wipe your hands after! The virus can remain active on fabrics for 3 hours.

15. Other Precautions:

● Exercise hand hygiene even when cooking. While food cannot directly transmit the virus, it could have infected secretions on it. Wash all fruits, vegetables, chopping boards, knives and all utensils carefully before use.

● Wash hands with soap and water after using the toilet. Though not as common as droplet, spread has been seen even through faeco-oral route.

16. Myth Debunking:

a) Should we stop eating Chinese?

No!!! As long as you wash and clean the vegetables and meats carefully, eating Chinese food should not be a problem. If you are ordering it from a restaurant though, make sure you wash your hands and transfer the food into a clean container before you eat. That’s where the virus is likely to sit.

b) Should you stop eating non- vegetarian food?

Again no. Wash the meat carefully before you cook it and then you are good.

c) If alcohol-based sanitizers can stop the spread, can alcohol consumption kill the virus?

Unfortunately for all those who like their alcohol, no! Since you require 60% alcohol or more, most alcohols meant for consumptions do not fit the bill. Anyway, if that is your belief, you might want to try and rinse your throat with soap water!

Like we said before, it works better. * sarcasm *

d) Will wearing gloves help?

If you wear gloves and remember to take them off before you touch your face, you will protect yourself. But you will create a lovely surface where the virus and other bacteria would love to grow. So, you will transmit the bacteria from your office to the train and from the to your homes and effectively help in spreading COVID-19 all over the city! So not a good idea either.

All in all, though there is little cause for alarm, maintenance of hand hygiene is a must to contain this pandemic and keep your loved ones safe.

Stay Home, stay Healthy, stay Safe…

Help Flatten the Curve…

Guest Blog Credit :

Dr Gauri Gangakhedkar Anaesthesiologist and researcher KEM hospital Mumbai