Diagnostics Transmissibility The disease How it all started Global spread

No diagnostic tests are currently licensed for

COVID-19 except under emergency use
regulations. All are under evaluation.
01 DROPLET TRANSMISSION
Evidence to date indicates that
COVID-19 is spread primarily through
respiratory droplet transmission, directly
02 VIRAL REPLICATION
Active viral replication occurs in the
upper respiratory tract as well as the lungs.
Early studies suggest the virus may also
01 COMMON SYMPTOMS
02
INFECTION
01 WHO is notified about a cluster of
27 pneumonia cases of unknown
aetiology and 0 deaths in the city of
Wuhan, China
03 China shares the
genetic sequence
of the virus
05 Cumulative 9 826 cases of
COVID-19 in 20 countries and 213
deaths confirmed (of which 9 720
cases and all deaths in China)
07 WHO characterizes COVID-19 as a
pandemic in view of international
spread & an alarming lack of action

and through droplet contamination of

surfaces and hands.
replicate in the gastrointestinal tract but
faecal-oral transmission is not yet evident.
Most common symptoms are fever, dry cough,
fatigue, sputum production, shortness of breath,
Disease ranges from asymptomatic to
severe illness and death
countries,
31 DEC 2019 11 JAN 2020 31 JAN 2020 11 MAR 2020 territories & areas
muscle/joint pain, sore throat & headache. Some
have confirmed

13TOMINs
mild cases present with:
cases of COVID-19

03 INCUBATION TIME Incubation time (time between infection & first symptoms) ranges from 1 to 14
days, with an average of 5 to 6 days. More than 97% of people experience symptoms within 14 days. loss of smell loss of taste red eyes rash

3 HOURs
LAB

88% fever 07 JAN 2020 30 JAN 2020 29 FEB 2020 31 MAR 2020 Drugs
TE

ST Exposure Symptom onset Recovery Recovery

IN
G TIME
MILD/ 68% cough
Nucleic Acid Amplification Tests (NAATs)
Most are Real Time Reverse Transcriptase
MODERATE
2 weeks 38% fatigue 02 The virus is reported by
China to be a new type
of coronavirus
04 IHR Emergency Committee
meets. WHO declares a
Public Health Emergency of
06 Cumulative 85 403 confirmed cases
in 54 countries & 1 international
conveyance. 2 924 deaths in 7
08 Cumulative 750 890 confirmed
cases in 202 countries & 1
international conveyance. 36 405
Currently, there are no antiviral drugs licensed for treating COVID-19. Research is
ongoing to determine if existing drugs can be re-purposed for treating COVID-19.

MOST COMMON SYMPTOMS OF COVID-19

Polymerase Chain Reaction-based tests SEVERE 19% shortness of breath International Concern countries & 1 international in 121 countries & 1 international WHO is coordinating the large multi-country Solidarity Trial to evaluate four promising
candidate drugs/regimens:
(Real time RT PCR). NAAT test times from 5-6 days 3 weeks 6 weeks (PHEIC) conveyance. 93% of cases & 97% of conveyance
13 minutes to 3 hours. Requires specific 15% muscle / joint pain deaths in China
instrumentation. For diagnosis of current
14% sore throat
01
infection & acute phase of disease. Originally developed

04 VIRAL SHEDDING
The highest viral loads occur around
the time of symptom onset and starts to
05 PRE-SYMPTOMATIC
Most transmission occurs when
symptoms are present. Estimates of the
14%
11%
headache
chills
Remdesivir for Ebola

decline shortly thereafter. contribution of pre-symptomatic

5%
transmission vary and are under further nausea / vomiting
AT-A-GLANCE Updated: 22 May 2020 02 Lopinavir / Ritonavir Combination anti-HIV drug

15 investigation. 5% nasal congestion

4% diarrhea

COVID-19: Interferon Beta has antiviral

L AT E

MINUTES
06 KEY PARAMETERS 1% haemoptysis 03 Lopinavir / Ritonavir
+ Interferon Beta properties
RA

Basic reproductive rate or R0

FL
1%

What we know now

L

OW
TEST is the number of people on average conjunctival congestion
that are infected by one person in a
04
Source: China, February 2020
Antimalarial drug with
Antibody detection tests completely susceptible population. Most Chloroquine
Detects specific IgG and IgM antibodies
against the virus. Amenable to rapid test
format such as lateral flow device. Test time
estimates of R0 (December 2019 – May
2020) are between 2 and 4. 03 DISEASE SEVERITY & HEALTH SYSTEMS
antiviral properties

approximately 15 minutes. Not useful for Clinical onset interval is the time
To date, the impact on health systems is 20% of cases require hospitalization & 5% require intensive care.
COVID-19 is an infectious disease caused by the most recently Dozens of potentially re-purposable drugs are in various trial stages.
diagnosis in acute phase of disease as between the onset of symptoms in
antibody response is not detectable in first successive cases in a chain of Up to 10% of cases can occur in healthcare workers. discovered coronavirus. This new virus and disease were unknown
week of illness. May be used to detect those transmission. In most studies, the
40% before the outbreak began in Wuhan, China in December 2019.
who have had prior infection.
Population-based serological studies
average time is between 4 and 5 days.

Case Fatality Ratio (CFR) is the

MILD DISEASE Public health & social measures
ongoing in 6 countries. -3 -2 -1 0 1 2 3 4 5 6 7 8 9 10 proportion of episodes of illness that are 40% Photo credit:

Days after symptom onset

fatal. The global (Dec 2019-May 2020)
crude CFR is 7%.
MODERATE DISEASE
(including pneumonia)
Centers for Disease
Control and Prevention
(CDC)
Immune response Antibodies to the COVID-19 virus (both IgM and IgG) start to
appear between 1 to 2 weeks after symptom onset after which
Case-finding, isolation
& treatment
Physical & social distancing
(at least 1 metre)
15% there is a slow, steady decline in viral load. Some patients may still
Contact-tracing & quarantine Reduce crowding
UNDER Basic reproductive rate (RO)
SEVERE DISEASE
(requiring oxygen) Vaccines AT LEAST
be infectious after improving clinically & may require further
isolation after hospital.
Frequent cleaning Protect vulnerable groups
5% Infection
DEVELOPMENT
0 1 2 3 4
CRITICAL (intensive
care & ventilation)
VACCINE DEVELOPMENT IS BEING 1–2 SYMPTOMS

VIRUS DETECTABLE
Hand hygiene & other
Source: China, February 2020
ACCELERATED
years personal measures
away EARLY ANTIBODIES (IgM)

04 05
Clinical onset interval There are a number of candidate LATE ANTIBODIES (IgG)
vaccines at the pre-clinical stage.
Antigen detection tests 0 1 2 3 4 5 6
Detects viral antigens & could be useful HIGH RISK LOW RISK For a COVID-19 vaccine to be
for diagnosis of acute infection. Also Risk of severe disease rises with age and in those Contact studies indicate children and young adults successfully developed, evaluated,
amenable to rapid test formats such as Case Fatality Ratio (CFR) with underlying medical conditions such as also become infected but are less likely to become manufactured and deployed to scale
lateral flow device. Ongoing in more than hypertension, diabetes, cardiovascular disease, seriously ill. They can also transmit infection. Rarely, may take at least 1 – 2 years.
50 countries 0 1% 2% 3% 4% 5% 6% 7% 8% 9% 10% chronic respiratory disease & cancer. children can progress to serious illness. Incubation period Updated: 22 May 2020
©2020 World Health Organization