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Coronavirus and India: FAQ of What We Know So Far
The Wire Science
The Wire Science

Coronavirus and India: FAQ of What We Know So Far

13/03/2020

What is the novel coronavirus?

The novel coronavirus, as the name suggests, is a new strain of coronavirus. Coronaviruses are types of viruses whose surfaces are dotted by crown-like structures, visible under a microscope.

The first case of the novel coronavirus was reported from China, and the infection was likely contracted in early December 2019. The viruses that cause infectious disease outbreaks typically jump from an animal to a human, thanks to a new mutation, after which they circulate among humans for as long as transmission remains sustainable.

We still don’t know which animal, or animals, the new coronavirus came from but scientists suspect based on genetic studies that snakes and civets were involved in the transmission chain.

Is the virus ‘natural’ or was it bio-engineered?

It is extremely unlikely that the virus was bio-engineered or synthesised, and extremely likely to be of natural origin.

It is a zoonotic virus, which means it spread from non-humans to humans. Perhaps the most famous zoonotic disease among humans is AIDS, caused by the human immunodeficiency virus that ‘jumped’ from primates in Africa to humans in the first half of the 20th century.

What are the symptoms?

The symptoms of a novel coronavirus infection, according to the US Centres for Disease Control and Prevention (CDC), are:

Two to 14 days after exposure

  • Fever
  • Cough or dry cough
  • Shortness of breath or difficulty breathing

The following are considered “emergency warning signs”:

  • Shortness of breath or difficulty breathing
  • Persistent pain or pressure in the chest area
  • Bluish lips or face
  • Confusion or difficulty arousing [or dizziness]

What should I do if I have the symptoms?

If you think you have any of the symptoms listed above, contact your doctor or visit one at the nearest hospitals to make sure you’re right.

Because the symptoms are fairly similar to that of a common cold, a doctor’s advice is necessary. Also, only doctors can approve tests.

State governments have set up telephone numbers for people in each state to contact regarding infections and treatment:

What is COVID-19?

COVID-19 is the name of the disease caused by the new coronavirus. It stands for ‘coronavirus disease 2019‘.

The name of the virus itself is SARS-CoV-2. The WHO devoted considerable attention in the circumstances to finalising this name, which you can read about here.

What does ‘flatten the curve’ mean?

Say it’s a cold winter day and you’re inside a room with an object that emits heat. There are two settings on the object: to release all the heat in a short period of time, i.e. in a burst, or to continuously release a smaller amount of heat over a longer period of time. Which one will you pick?

The second setting is the wiser option – and it’s the same with an infectious disease outbreak. It’s better to have the new coronavirus spread such that the number of people being hospitalised is a steady stream spread out over a longer period than a burst of a large number of people hospitalised over a shorter period.

This preference is called ‘flattening the curve’. The ‘curve’ stands for the plot of the number of people requiring hospitalisation versus time.

If the burst scenario plays out, for example because a local population didn’t maintain proper infection control practices, the number of people requiring hospitalisation at any given time is likely to exceed the available capacity, placing more people’s lives at risk.

Also read: Maybe Unvaccinated People Shouldn’t Be Allowed to Fly

What samples are required to test for COVID-19?

If a test has been approved, a medical worker will collect a swab of the cells in your upper and lower respiratory tracks, and a blood sample. According to the CDC, the samples will be stored at 2-8º C and shipped to a testing lab.

At the lab, cells from the swab and blood will be isolated and loaded onto a PCR machine. PCR stands for polymerase chain reaction, which is a series of chemical reactions used to amplify genetic material present in the cells over the course of a few hours.

The material is then checked for the presence of nucleotide sequences that are unique to the new coronavirus. If a match is found, the sample is considered to have tested positive for COVID-19.

Researchers at the lab will also check the samples for the presence of other variants of influenza.

Where do the tests happen?

There are currently 52 associate centres around India that have been permitted by the government to test for coronavirus infections, and are led by the National Institute of Virology, the nodal institute in Pune.

Is the test free?

Yes. All COVID-19 tests being conducted at government laboratories are free of cost.

Private laboratories are not allowed to conduct these tests.

What happens if I test positive?

If you test positive, you will be hospitalised until doctors can ascertain you no longer have COVID-19.

Is COVID-19 fatal?

The potential severity of a COVID-19 infection depends on your age. According to the World Health Organisation,

For COVID-19 virus, initial data indicates that children are less affected than adults and that clinical attack rates in the 0-19 age group are low. Further preliminary data from household transmission studies in China suggest that children are infected from adults, rather than vice versa. While the range of symptoms for the two viruses is similar, the fraction with severe disease appears to be different. For COVID-19, data to date suggest that 80% of infections are mild or asymptomatic, 15% are severe infection, requiring oxygen and 5% are critical infections, requiring ventilation.

Similarly, on the count of mortality,

For COVID-19, our current understanding is that older age and underlying conditions increase the risk for severe infection. … While the true mortality of COVID-19 will take some time to fully understand, the data we have so far indicate that the crude mortality ratio (the number of reported deaths divided by the reported cases) is between 3-4%, the infection mortality rate (the number of reported deaths divided by the number of infections) will be lower. … However, mortality is to a large extent determined by access to and quality of health care.

According to the CDC, “Compared to patients not admitted to an intensive care unit, critically ill patients were older (median age 66 years versus 51 years), and were more likely to have underlying co-morbid conditions (72% versus 37%).”

India is already a dirty country. Does that mean my immune system is stronger?

No. In fact, if you live in dirtier environs, your immune system is likelier to be more fatigued instead of more toughened.

Do medical insurance policies cover COVID-19?

Yes. The Insurance Regulatory and Development Authority of India instructed all insurers via a notice on March 4, 2020, to cover all claims pertaining to hospitalisation due to coronavirus and medical expenses incurred due to treatment of coronavirus. The notice is available to read here.

Can I travel?

Try not to, especially abroad and even more especially to countries that have a high burden of coronavirus cases. If you are planning to travel, please make sure it is essential before booking your tickets.

Also read: India’s Hospitals Have an Infection Problem. Could Accreditation Be the Way to Go?

Is there a way to treat a coronavirus infection?

There is no one thing you can do – like take a vaccine shot – to get rid of a COVID-19 infection if you already have it. This is why prevention is very important.

The CDC reported,

Approximately 20-30% of hospitalised patients with COVID-19 and pneumonia have required intensive care for respiratory support. … Among critically ill patients admitted to an intensive care unit, 11–64% received high-flow oxygen therapy and 47-71% received mechanical ventilation. Some hospitalised patients have required advanced organ support with endotracheal intubation and mechanical ventilation (4–42%). A small proportion have also been supported with extracorporeal membrane oxygenation (ECMO, 3–12%).

What can I do to keep myself and others around me safe?

The CDC recommends the following measures (quoted verbatim):

  • Clean and disinfect high-touch surfaces in your house
  • Wash your hands with soap and water for 20 seconds, especially after blowing your nose, coughing or sneezing; after using the restroom; before eating or preparing food; after contact with animals or pets; and before and after providing routine care for another person who needs assistance
  • Cover your mouth and nose with a tissue when you cough or sneeze
  • Throw used tissues in a lined trash can
  • Avoid touching your eyes, nose, and mouth with unwashed hands
  • You should not share dishes, drinking glasses, cups, eating utensils, towels, or bedding with other people or pets in your home
  • Clean any surfaces that may have blood, stool, or body fluids on them

Finally, “The decision to discontinue home isolation precautions should be made on a case-by-case basis, in consultation with healthcare providers and state and local health departments.”

Should I wear a mask?

Please don’t wear a mask unless you’re sick yourself, and even if you’re sick, please report to the nearest hospital. If you’re not sick, don’t wear a mask. Healthcare workers like doctors and nurses need masks more than you because they regularly work in close proximity to sick people, and it’s important for consumer demand to not cause a shortage in hospitals, clinics and testing facilities.

As Mahesh Devnani, an associate professor of hospital administration and joint medical superintendent at PGIMER, Chandigarh, wrote for The Wire Science,

It is important for the general public in India to understand that, currently, there is no need for them to wear masks or hoard personal protective equipment (PPE). These products are aimed at frontline health workers who risk their lives while performing their duty to save the lives of infected patients. A shortage of PPE will in turn risk the lives of these brave workers and could even affect our overall response, since successfully responding to an outbreak depends on the availability of uninfected frontline health workers. In fact, studies have shown that the availability of PPE and drugs for health workers increases their willingness to respond to infectious disease outbreaks.

Should I use a hand-sanitiser?

A hand-sanitiser is likely to be effective only if it contains more than 60% alcohol. However, if you have access to soap and running water, go for that instead. Soap is far more effective than hand-sanitisers because its chemical properties allow it to rapidly destroy viruses on your skin.

Palli Thordarson, a professor of chemistry at the University of New South Wales, recently published a Twitter thread outlining the virtues of using soap. At last count, the thread had been retweeted nearly 45,000 times.

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