International Journal of Scientific Reports

Vadala R et al. Int J Sci Rep. 2020 Jul;6(7):283-285

http://www.sci-rep.com

pISSN 2454-2156 | eISSN 2454-2164

Letter to the Editor

DOI: http://dx.doi.org/10.18203/issn.2454-2156.IntJSciRep20202645

Emerging pandemic COVID-19: myths and facts

Rohit Vadala1, Isabella Princess2*

1Metro centre for respiratory diseases, Metro Multispeciality Hospital, Noida, Uttar Pradesh, India

2Department of Microbiology, Apollo Speciality Hospitals, Vanagaram, Chennai, Tamil Nadu, India

*Correspondence to

Dr. Isabella Princess,

E-mail: isadear@gmail.com

Sir,

The first theory which has established itself across the world is that COVID-19 is a “new virus”. It is rather wise to call it a “new strain” of a pre-existing coronavirus since history clearly denotes cases of coronavirus surfacing the world in past years beginning as early as mid-1960s.1,2 Including this novel strain of the virus, seven strains of coronaviruses have been commonly associated with human infections. Coronaviruses are primarily respiratory viruses causing infections ranging from mild to severe involvement of the respiratory tract. The common cold strains of coronavirus are 229E alpha coronavirus, NL63 alpha coronavirus, OC43 beta coronavirus and HKU1 beta coronavirus.3 The acute respiratory distress causing strains are severe acute respiratory syndrome (SARS) beta CoV causing SARS, MERS beta CoV causing Middle East respiratory syndrome (MERS) and the very novel COVID-19. Researchers and molecular biologists have confirmed phylogenetic relationship of COVID-19 with a 2015 Chinese bat strain of SARS CoV.4 Mutations to the surface protein as well as nucleocapsid proteins were demonstrated. These two mutations predicts the characteristics such as higher ability to infect as well as enhanced pathogenicity of COVID-19 as compared to older SARS strain. For this reason and with similarities in clinical presentation the novel strain has been named as SARS-CoV-2.5

CLINICAL IMPLICATIONS OF COVID-19

An initial study on laboratory confirmed COVID-19 cases published in The New England Journal of Medicine has been reviewed and findings are summarized.6,7

Age group: The median age group of affected individuals was 47 years with a male preponderance. Children are relatively spared with almost negligible cases of children below 15 years of age.

Case fatality: The case fatality rate within China has been estimated as 1.4-2%.

Symptomatology: The most common symptoms during presentation were fever (88.7%) and cough (67.8%). Less than 50% reported sputum production and fatigue; diarrhoea was uncommon.

Transmissibility: Risk of transmission is pretty low as compared with SARS as well as other emerging viruses. Rate of transmission was estimated to be 1.5-3.5 form infected individuals.8 Most individuals were hospitalized with good recovery without requiring ventilator support.

Comorbidity association: Severity of illness was found to be more in patients with a comorbid condition. Moreover, the presence of any coexisting illness was more common among patients with severe disease than among those with nonsevere disease (38.7% vs. 21.0%).

Diagnostic findings: On admission majority of individuals had ground glass opacity on chest computed tomography (CT) (56.4%). Hemogram in majority of about 83.2% showed lymphocytopenia.

MYTHS VERSUS FACTS

Most of the myths related to COVID-19 have been addressed in the WHO`s official website. The list of myths addressed by the WHO are summarized (Table 1).

THE WAY FORWARD

The Government in coordination with the WHO has taken stringent precautions in early screening (thermal monitoring), diagnosis, contact tracing and isolation of suspected patients. Clear instructions and helpline numbers are being circulated to the general public. Media should be controlled and supervised on information being released day in and day out thereby curtailing false alarms being released.

Until an antiviral if approved by WHO for treating COVID-19, it is a wait and watch scenario. Preparedness of Government as well as private healthcare facilities in ensuring adequate stock of masks, hand sanitizers and other Personal Protective Equipment is to be given priority. Judicious use of surgical masks is mandatory and is the need of the hour since most countries report shortage of the same. WHO has given strict recommendations on avoiding misuse of masks by individuals to prevent shortage. Other major infection control practices include hand hygiene, frequent environmental cleaning and disinfection as well as cough etiquette should be reinforced and monitored for compliance. Since global transmission has occurred due to extensive travel, people should be advised to avoid unnecessary travel especially to countries which report local transmission of this virus.

Table 1: Myths and clarification of myths related to SARS CoV 2.9
Table reproduced from source PDF page 2

CONCLUSION

The most important need at this moment is to avoid panic and spread of unnecessary information. As healthcare professionals it is imperative to conduct awareness sessions and ensure calm in the community. Stringent infection control practices are the best way for containing local transmission of virus in the society. Training and re-training healthcare workers as well as the general public can prove to be beneficial at this moment of time. Visual display of respiratory hygiene/cough etiquette, hand hygiene steps and moments will definitely help in controlling this outbreak. Sale of surgical masks as well as N95 masks can be banned or restricted for sale to the general public who are not at risk.

REFERENCES

  1. 1. WHO Situation report. Available at: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200310-sitrep-50-covid-19.pdf?sfvrsn=55e904fb_2. Accessed on 10th March 2020.
  2. 2. Update on COVID-19. Ministry of Health and Family Welfare. Available at: https://pib.gov.in/newsite/pmreleases. Accessed on 11 March 2020.
  3. 3. Lai MMC, Perlman S, Anderson LC. Coronaviridae. In: Knipe DM, Howley PM, editors. Fields Virology 5th edition. USA: Lippincott Williams & Wilkins; 2007: 1306-1310.
  4. 4. Benvenuto D, Giovanetti M, Ciccozzi A, Spoto S, Angeletti S, Ciccozzi M. The 2019‐new coronavirus epidemic: Evidence for virus evolution. J Med Virol. 2020;92:455–9.
  5. 5. Del Rio C, Malani PN. COVID-19-New Insights on a Rapidly Changing Epidemic. JAMA 2020. Available at: https://jamanetwork.com. Accessed on 07 March 2020.
  6. 6. Guan W, Ni Z, Hu Y, Liang W, Ou C, He J, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med 2020;382:1708-20.
  7. 7. Fauci AS, Lane HC, Redfield RR. Covid-19 — Navigating the Uncharted. N Engl J Med. 2020;382:1268-9.
  8. 8. Chotani RA. 2019-novel Coronavirus (COVID-19) Facts & Misconceptions. Just in Time Lecture Series, University of Nebraska Version #4: Sunday, 2020.
  9. 9. World Health Organization. Coronavirus disease (COVID-19) advice for the public: Myth busters. Available at: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/myth-busters. Accessed on 10th March 2020.