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Do’s and Dont’s Novel Coronavirus

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by Dr.Madhav Prabhu

Concerns are now being raised about a new global epidemic that is knocking at our doorsteps the coronavirus infection. With India recording our first few confirmed cases and many more suspects we can no longer ignore this threat.

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The recent epidemic which originated in Wuhan China was first recorded in December 2019 and due to Chinese policy was then ignored or rather downplayed but the authorities. Soon though it came to light that this was not just an ordinary virus but a novel one. Let us first understand what a novel virus is.

We have often heard the saying a known enemy is better, similarly with viruses a known virus is better to handle. A novel virus is one that has previously not caused infections in humans, whose genetic sequence is unknown and not much information is available about its epidemiology.

The Coronavirus in question is an RNA virus named as 2019 nCOV and belongs to the genus Betacoronavirus, subgenus Sarbecovirus. The virus was first discovered in humans who worked and handled seafood in the fish markets of Wuhan. The subgenus subtype is common in bats so that source of spread cannot be ruled out.

Every viral family has viruses that are specific to a species, for example, the influenza virus has strains that can affect pigs, birds and so on and hence called porcine or avian. Normally they do not breach the species barrier and stay in their own species. The problems start when there is contact between species, so when human virus comes in contact with bat virus, they undergo changes that we call mutations and thus a new virus is produced which can cross species barriers and since the species is never exposed to it, it will cause serious manifestations and hence the name novel. A similar story seems to be the case with 2019 n COV.

So being a novel virus, there is absolutely no memory that the body’s immunity has against this virus, thus like an unknown enemy, we do not know the strategy this virus will adopt and nothing can stop it from wreaking havoc. Also since we never came across this virus, there is no vaccine against it a process which takes roughly their years once the genetic sequence is known

Now coming to the most important problem, since 2019 nCOV is a new virus we do not know what its incubation period is. The incubation period of a virus is the time from which the patient acquires the virus to the point when symptoms first appear. For 2019 nCOV the incubation period is from two to four weeks, mostly fourteen days. That means the patient can be harboring the virus and yet be completely asymptomatic for two to three weeks, during which he is capable of transmitting this virus to others.

Imagine the consequences of this, somebody sitting next to you may transmit the virus to you yet both of you may not know that this has happened.

ncov1This is why the world community is worried. The solution that countries usually adopt is to keep the patient in a closed setting till the incubation period is over, this is called quarantine.

However, as it is apparent from above they may already be patients who have entered the country with a virus in incubation since December 2019. India is such a country that, we may not know what the patient died of and the death may never be reported.

The problem, however, does not stop here, there is a social media campaign to label any and every source as a mode of spreading the virus, but there are only a few verified. The virus usually spreads by aerosols which are tiny droplets that are suspended in air while you sneeze or cough when a person closes by inhales these droplets before they fall he can acquire the infection.

The other route suspected is thorough feces because the virus is shed in stools. There is also a twist in the story, the virus is also spread by fomites, these fomites are nothing but inanimate objects which the patient touches after touching his nose or on surfaces he has coughed on. The virus stays on the object for up to twenty-four hours or even more in moist surfaces like carpets. When another person touches this object and takes it to his nose or eyes the virus is spread to him. Thus you make not have even seen the person who has transmitted the virus to you as he may have left it there hours before. That’s why never take your hands to your face without washing them.

Looking at India we are in a perfect setting for the virus to spread, we don’t keep travel records, the disease is treated by everyone including housewives, quacks and shop keepers, there is no reporting of diseases and there is no accountability.

We are also not equipped to handle a health emergency as evidenced by the epidemics of JE which kills innocent children every year in the north. So the best way out would be to take care of yourself and prevent the spread of the virus. Certain universal precautions need to be taken especially in social interactions and personal hygiene.

So what do we do to prevent the virus from spreading?

First, as of now human to human contact is the only way of the virus spreading, that too through droplets and possibly through stools. So important is to stay away from exposure, for this you should know which patient is likely to have an infection. Most of the patients present like flu. Fever, cough, breathlessness, and body ache are the cardinal symptoms of the disease, sometimes expectoration and diarrhea are also possible, these symptoms are common for many diseases especially in winters. Sometimes a patient can develop severe manifestations in the form of pneumonia and these are the patients with acute respiratory distress syndrome, who may succumb to the disease.

Now knowing how the patients present and knowing the mode of transmission the ways to protect yourself would be obvious.

Stay at least one meter that’s three feet away from a patient who has the above symptoms, so as to avoid droplets.

A mask usually an N90 would be an additional precaution. Since you cannot avoid fomites make it a habit not to bring your hands to your nose, mouth or eyes if you have touched likely surfaces.

Carry an alcohol-based hand sanitizer and use it every time you are likely to touch your face.

Wash your hands thoroughly before you eat your food.

A seven-step hand wash technique is advocated by doctors for cleaning hands with soap.

Avoid contact with sick animals and wash hands every time you visit a meat market or fish market.

If you eat non-veg food, cook the meat well and eat boiled and not barbeque meat if possible.

Government of India Department of Ayush has issued an advisory with a role for traditional medicines, but these are debatable and should not make you complacent with universal preventive measures.

If you develop symptoms suggestive of infection, do not panic, keep yourself warm, hydrate yourself, take complete rest and keep yourself indoors. Take help immediately from a qualified medical practitioner and do not delay treatment. Take care of yourself, be very careful but do not be scared and do not panic. Together we can keep ourselves and our country safe.

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