CORONAVIRUS DISEASE 2019 (COVID-19)

Coronaviruses are a family of viruses that can cause illnesses such as the common cold,
severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS).
In 2019, a new coronavirus was identified as the cause of a disease outbreak that originated in
China.

The virus is now known as the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-
2). The disease it causes is called coronavirus disease 2019 (COVID-19).

These viruses were originally transmitted from animals to people. For instance, SARS, was
transmitted from civet cats to humans while MERS moved to humans from a type of camel.

Several known coronaviruses are circulating in animals that have not yet infected humans.

The name coronavirus comes from latin word corona, meaning crown or halo. Under an
electronic microscope, the looks like it is surrounded by a solar corona.

The number of fatalities from the new coronavirus has overwhelmingly surpassed the toll of
the 2002-2003 SARS outbreak, which also originated in China.

SARS killed about 9 percent of those it infected - nearly 800 people worldwide and more
than 300 in China alone. MERS, which did not spread as widely, was more deadly, killing
one-third of those infected. While the new coronavirus is more widespread than SARS in
terms of case numbers, the mortality rate remains considerably lower at approximately 3.4
percent, according to the WHO.

Causes

Infection with the new coronavirus (severe acute respiratory syndrome coronavirus 2, or
SARS-CoV-2) causes coronavirus disease 2019 (COVID-19).
RISK FACTORS

 Recent travel from or residence in an area with ongoing community spread

of COVID-19 
 Close contact with someone who has COVID-19 — such as when a family member or
health care worker takes care of an infected person

TRANSMISSION

1. Through droplets contamination when someone is coughing or sneezes. No evidences

that support the disease are airborne.
2. Through surface contact. E.g. table, chairs and others. The virus may remain alive for
several days in different surfaces.

NB. Wearing mask offers no protection against COVID-19, because we are more likely to
touch our faces, when we constantly adjust our masks, which is one way the disease spreads.

SYMPTOMS

Common symptoms includes

Fever
Tiredness
Dry cough

Other symptoms can includes

Shortness of breath or breathing difficults

Runny nose
Sore throat
Aches and pains
And very few people will report diarrhoea, nausea and vomiting.

In more severe cases, it can lead to pneumonia, multiple organ failure and even death.

Current the incubation period - the time between infection and the onset of symptoms - range
from two to 14 days. Most infected people show symptoms within five to six days.
However, infected patients can also be asymptomatic, meaning they do not display any
symptoms despite having the virus in their systems.

People who have underlying medical conditions such as heart diseases, lung diseases,
diabetes or who have compromised immune systems and those over 60 years old have a risk
of developing severe disease and even death.

DIAGNOSIS

To test for COVID-19, a health care provider uses a long swab to take a nasal sample. The
sample is then sent to a lab for testing. If you're coughing up saliva (sputum), that may be
sent for testing.

Test used is reverse transcriptase polymerase chain reaction Rtr-PCR.

TREATMENT

Currently, no antiviral medication is recommended to treat COVID-19. Treatment is directed

at relieving symptoms and may include:

 Pain relievers (ibuprofen or acetaminophen)

 Cough syrup or medication
 Rest
 Fluid intake

PROTOCOL FOR TREATMENT OF CONFIRMED COVID-19 INFECTION

ACCORDING TO COMMUNICABLE DISEASE CONTROL CENTER-CDC

1. Treatment of COVID-19 Upper Respiratory Tract Infection (fever, runny nose, cough
without lung infiltrates + positive PCR).
Chloroquine phosphate PO 500mg BID 5days + Oseltamivir PO 150mg BID
5days
2. Treatment of COVID-19 Pneumonia
Chloroquine phosphate PO 500mg BID 10days + Darunavir 800mg/ Cobicistat
150mg OD for 2 weeks.
 OR
Atazanavir (Reyataz) PO 400mg once daily with food for 2 weeks + Oseltamivir
PO 150mg BID 10days +/- IV Methylprednisolone 40mg 12h for 5days

SPECIMEN COLLECTION

1. Combined nasopharyngeal/oropharyngeal swab

2. If positive repeat every 3 days till negative
3. If negative repeat second test after 24hours
4. If 2 consecutive negative isolation can be discontinued.

PREVENTION

WHO and CDC recommend following precautions for avoiding COVID-19:

 Avoid large events and mass gatherings.

 Avoid close contact (within about 6 feet, or 2 meters) with anyone who is sick or has
symptoms.
 Keep distance between yourself and others if COVID-19 is spreading in your
community, especially if you have a higher risk of serious illness.
 Wash your hands often with soap and water for at least 20 seconds, or use an alcohol-
based hand sanitizer that contains at least 60% alcohol.
 Cover your mouth and nose with your elbow or a tissue when you cough or sneeze.
Throw away the used tissue.
 Avoid touching your face ( eyes, nose and mouth).
 Avoid sharing dishes, glasses, bedding and other household items if you're sick.
 Clean and disinfect high-touch surfaces daily.
 Stay home from work, school and public areas if you're sick, unless you're going to
get medical care. Avoid taking public transportation or unnecessary travel if you're sick
COPING AND SUPPORT

It's common to feel fearful and anxious during the COVID-19 pandemic. You're probably
worried that you or those you love will get sick. You may be concerned about taking care of
yourself or others who are ill.

During this time, remember to take care of yourself and manage your stress.

 Eat healthy meals.

 Get enough sleep.
 Get physical activity as you're able to, such as using exercise or yoga videos. If you're
healthy, go outside for a walk.
 Try relaxation exercises such as deep breathing, stretching and meditation.
 Avoid watching or reading too much news or spending too much time on social
media.
 Connect with friends and family, such as with phone or video calls.
 Do activities you enjoy, such as reading a book or watching a funny movie.

If you're ill with COVID-19, it's especially important to:

 Get plenty of rest.

 Drink fluids.
 Let your doctor know right away if your symptoms worsen.