Coronavirus Disease 2019 (COVID-19) Pandemic
by Kruti Vora
Edited by Harish Moorjani, M.D.
Coronavirus disease 2019 (COVID-19) is a newly identified respiratory disease caused by the novel coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The SARS-CoV-2 virus, a single stranded RNA virus, may spread via respiratory droplets, similar to the way that influenza virus is transmitted.
The first reports of COVID-19 came from Wuhan, China, at the end of 2019. Since then, cases have been reported around the world, with notable outbreaks in South Korea, Italy, Iran, and Japan. On March 18, 2020, the World Health Organization (WHO) reported that there were 207,855 confirmed cases of COVID-19 with 8,648 deaths reported around the world. Further, as of that date, the United States reportedly had 7,087 cases with 97 deaths; testing limitations at that time likely underrepresented the total number of infections.
The WHO has been concerned about the spread and severity of disease and declared COVID-19 to be a pandemic on March 11, 2020. Massachusetts declared a state of emergency on March 10, 2020. The disease has impacted many facets of daily life around the world and has caused economic downfall, school shutdowns, overwhelmed hospitals, and quarantine in harder-hit communities.
Spread of the Virus
Viral droplets spread via coughing, sneezing, or talking or by touching an infected surface and then touching the face can cause infection. Droplets can spread some 6 feet from an infected person and can stay in the air for approximately 3 hours. After the COVID-19 virus infects someone, it incubates for 2-14 days. That person may experience symptoms for about 4-5 days after the initial exposure. Many symptoms of COVID-19 overlap with those of influenza infection, the common cold, or other viral pneumonias or respiratory illnesses.
People who develop COVID-19 most likely experience fever, fatigue, and dry cough. Some patients may have shortness of breath, a productive cough, runny nose, or body aches. Those with more severe disease may experience difficult breathing and inability to breathe in enough oxygen. Critically ill people may experience respiratory failure, shock, or organ dysfunction.
Anyone can be infected with COVID-19. Current data indicate that children and young adults typically have not had symptoms or have had mild disease. Patients at higher risk of more severe illness have been older and have been diagnosed previously with heart disease, lung disease, or diabetes.
Testing for COVID-19
The only way to know if someone is infected with COVID-19 virus is if someone who is experiencing symptoms is tested. These test kits are becoming more available. COVID-19 testing requirements vary by hospital, and the guidelines are changing rapidly as new tests emerge and the number of cases evolves.
Managing COVID-19 Infections
Patients with suspected COVID-19 must be immediately isolated to prevent further spread of disease. Currently, treatment strategies include supportive care to alleviate symptoms. For mild disease, get plenty of rest, use acetaminophen for aches and pains, and increase fluid intake. The WHO recommends that ibuprofen not be used. There is no recommendation about use of the pain reliever naproxen, but since its actions in the body are similar to those of ibuprofen, its use probably should be avoided. Some patients with more serious breathing issues may need supplemental oxygen administration; in more severe cases, intubation and mechanical ventilation may be required.
Researchers are currently working to develop a vaccine for COVID-19, although testing of such a biological may not be completed before 2021. Trials on antiviral treatments (eg, the ebolavirus treatment remdesivir) also are being conducted. Use of hydroxycholoroquine/chloroquine with or without azithromycin, interferon α1β, or the interleukin-6 inhibitor tocilizumab are also being investigated as potential treatments.
Helping Yourself and Others Against COVID-19
To keep healthy:
Wash your hands thoroughly with soap and water and for at least 20 seconds frequently.
Avoid touching your face.
Properly cover your nose and mouth if you cough or sneeze.
Disinfect surfaces that are frequently touched.
Follow the travel guidelines from Centers for Disease Control and Prevention and your local institutions.
If you are feeling healthy...
You may be carrying COVID-19 even if you don’t have any symptoms. Social distancing can help you to avoid catching the illness yourself and spreading it to others, including individuals who could become very sick from infection. Keep at least 6 feet away from other people, wash your hands frequently, avoid unnecessary travel and social gatherings, do not dine out at restaurants, and limit gatherings to fewer than 10 people.
If you are feeling ill...
Stay at home from school or the workplace and wear a mask. Stay away from the elderly, people with other health conditions, and others at high risk of being infected. Take note of your body temperature. If your symptoms worsen, seek medical attention. Call your doctor before traveling to a healthcare facility to prevent exposure to yourself and others to the virus. Call 911 for medical emergencies.
ABOUT THE AUTHOR
Kruti Vora is a third year medical student at Harvard Medical School who is part of the HMS Covid Response Team, leading a committee of 60+ students to develop COVID-19 educational materials for the general public. You can follow her team’s work on Instagram/Twitter @FutureMDvsCOVID.
ABOUT THE EDITOR
Harish Moorjani, M.D.
Harish Moorjani is an infectious disease consultant in Briarcliff Manor, New York. He has been providing care to patients with infectious diseases in a community based patient centric model for 25 years. Currently, he is one of the heroes, on the frontline, battling the Covid-19 virus.
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