COVID-19, short for coronavirus disease 2019, is an infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). SARS-CoV-2 is a newly identified pathogen that has not previously been seen in humans and is highly contagious. Though it belongs to the same category of viruses as SARS coronavirus (SARS-CoV) and influenza viruses, SARS-CoV-2 is a different strain with its own characteristics.
How does COVID-19 spread?
Because COVID-19 is a new virus, nobody has prior immunity to it, meaning the entire human population is prone to infection.
COVID-19 is primarily spread via respiratory droplets when people cough or sneeze. Scientists have yet to understand how easily and sustainably the disease can spread among people. Based on available evidence, researchers do not think that airborne spread is a major transmission route.
Individuals over age 60 are also at the highest risk of developing a severe case of COVID-19, while children do not seem to be at a higher risk than adults.
There are currently no reports about how susceptible pregnant women may be to COVID-19 or about the transmission of the virus through breast milk.
What are the symptoms of COVID-19?
Common symptoms of COVID-19 begin two to 14 days after exposure. They include fever, tiredness, and dry cough. Other symptoms include sputum production, shortness of breath, sore throat, headache, myalgia (muscle pain) or arthralgia (joint pain), chills, vomiting, and nasal congestion. Less frequent symptoms include diarrhea, hemoptysis (coughing up blood from the respiratory tract), and conjunctival congestion.
Most of these symptoms are usually mild, and about 80% of people who get the virus will typically recover without needing any special treatment. However, about 1 in 6 patients become seriously ill and develop breathing difficulties.
What tests are available?
The CDC has developed a diagnostic panel that is available to CDC-qualified laboratories in the U.S. The U.S. Food and Drug Administration (FDA) has not approved this test but has made it available under a special emergency use authorization.
Apart from the tests made available by the CDC, several new tests are being continuously developed. One such recently available test is the cobas SARS-CoV-2 test developed by Roche Diagnostics. The cobas test has also received emergency use authorization from the FDA. The U.S. Department of Health and Human Services is funding the development of two other diagnostic tests that can detect the presence of SARS-CoV-2 within one hour.
An updated list of the various manual and automated tests that are available or are currently in development can be found here.
Samples for initial diagnostic testing include swabs from the upper respiratory tract such as the nose and throat and, if obtainable, from the lower respiratory tract such as the sputum.
A positive test result means infection with SARS-CoV-2 is confirmed. In such a situation, doctors place the patient under isolation. While a negative test indicates the absence of the virus, there is still a likelihood of false negatives, especially in the early stages of infection, where the number of viruses is too low to be detectable. A negative test in a person who clearly shows COVID-19-like symptoms mostly indicates that SARS-CoV-2 is not the cause of his or her illness.
What general preventive measures should people take?
The following simple preventive measures can help minimize the spread of COVID-19:
- Wash your hands often with soap, lathering both the front and the back of the hands and fingers for at least 15 to 20 seconds. If soap is not available, use a hand sanitizer that contains at least 60% alcohol. The European Centre for Disease Prevention and Control produced a poster detailing effective handwashing.
- Avoid close contact with someone who is ill. (Maintain a distance of at least 6 feet, or 1.8 meters).
- Stay at home if you are sick.
- Use a tissue to cover your mouth and nose if you cough or sneeze and dispose of it properly afterward.
- Disinfect surfaces and objects you touch frequently.
- Avoid touching your eyes, nose, and mouth with unwashed hands.
The CDC does not recommend that healthy people wear a face mask. Only healthcare professionals and caregivers working with COVID-19 patients should also wear face masks.
What extra precautions should cystic fibrosis patients take?
COVID-19 affects the epithelial lining of the lungs, which is already damaged in conditions such as cystic fibrosis (CF). Doctors recommend that CF patients wear a labeled N-95 face mask. This can filter out respiratory droplets potentially carrying the virus. However, those with prior respiratory problems should only wear face masks when necessary as they can make breathing more difficult.
Other preventive measures CF patients should take to minimize the risk of getting COVID-19 include:
- Stocking up on necessary medications and supplies that can last for a few weeks.
- Avoiding crowds and non-essential travel.
- Staying at home as much as possible.
If symptoms of a viral infection appear and patients have traveled to a high-risk area in the past 40 days, they should self-isolate at home for 14 days. They should maintain their daily care regimens and speak to their healthcare providers for any specific queries about their personal health.
It is important to remember that most patients with respiratory diseases typically recover from COVID-19.
Advice for family members and caregivers
Family members and caregivers of people with chronic diseases such as CF should take appropriate precautions and take extra care to avoid bringing COVID-19 home. They should constantly monitor patients and stock medicines and other necessary supplies that can last for several weeks. Storing extra non-perishable food can help minimize trips to the grocery store.
If they show symptoms of COVID-19, they should avoid coming in contact with the patient until the self-isolation period is complete.
What should sick individuals do?
If symptoms are present and a COVID-19 diagnosis is confirmed, patients should follow these steps to prevent the spread of the infection:
- Stay at home, preferably in a separate room not shared with others, and isolate yourself, with the exception of getting medical care.
- Avoid public areas and public transport.
- Limit contact with pets and animals.
- Avoid sharing personal items.
- Cover coughs and sneezes with tissues and dispose of them properly.
- Sanitize hands regularly.
- Disinfect surfaces such as phones, keyboards, toilets, and tables.
People should call ahead before visiting the hospital for an appointment. This way, the hospital can take necessary steps to prevent the spread of the infection.
Is there a treatment?
There are currently no vaccines available for human coronaviruses including COVID-19. This makes the prevention and containment of the virus very important.
Are there any potential new therapies?
The first clinical trial of a possible treatment for COVID-19 has begun in the U.S. The National Institute of Allergy and Infectious Diseases is sponsoring a randomized, controlled Phase 2 trial to evaluate the safety and efficacy of the broad-spectrum anti-viral treatment remdesivir by Gilead Sciences to treat the disease.
Gilead has also launched two Phase 3 trials to evaluate remdesivir’s safety and efficacy in adults with COVID-19. These trials aim to recruit approximately 1,000 patients across Asia and other countries. Gilead is supplying remdesivir free of charge for two other trials in China.
Other treatments being investigated for COVID-19 include a novel mRNA-1273 nanoparticle-encapsulated vaccine (NCT04283461), thalidomide (NCT04273581), sildenafil (NCT04304313), eculizumab (NCT04288713), recombinant human interferon-alpha 1 beta (NCT04293887), bevacizumab (NCT04305106), and antibodies from cured patients (NCT04264858), among others.
A complete list of all ongoing clinical trials pertaining to COVID-19 is available here.
Researchers are also looking at new synthetic biology approaches by using self-assembling nanoparticles coated with viral antigens that can precisely target SARS-CoV-2. This approach can potentially overcome some of the limitations of conventional vaccines such as short shelf-life and viral evolution.
Last updated: March 19, 2020
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