In Focus

COVID-19: Fact Check

Towards the end of 2019, a novel coronavirus was identified to be the causative agent of a cluster of pneumonia cases in Wuhan, China. It spread quickly, resulting in an epidemic throughout China, followed by an increasing number of cases in other countries around the world. In February 2020, the World Health Organization (WHO) designated the disease COVID-19, which stands for coronavirus disease 2019.
Since the first reported cases from Wuhan, China, more than eighty thousand COVID-19 cases have been identified in China; among these are both laboratory-confirmed and clinically diagnosed cases in the Hubei Province. A joint WHO-China fact-finding mission assessed that the epidemic in China peaked between January and early February 2020. However, since then outbreaks in more than 190 countries have been reported.



Transmission
Person-to-person transmission of COVID-19 occurs primarily through respiratory droplets. By droplet transmission, virus is released in the respiratory secretions and when a person with infection coughs, sneezes, or talks, he or she infects others when there is direct contact of the virus with mucous membranes; infection can also occur if a person touches an infected surface and then touches his or her eyes, nose, or mouth. 
Droplets typically do not travel more than six feet and do not remain in the air for long. However, given the current uncertainty regarding transmission mechanisms, airborne safety measures are recommended routinely in some countries and in the setting of certain high-risk procedures in others.
Clinical Features
Incubation period: The incubation period for COVID-19 is thought to be within fourteen days following exposure, with most cases occurring around 4 to 5 days post exposure.
Spectrum of illness severity: The spectrum of symptomatic infection ranges from mild to critical, while most infections are not very severe. Specifically, a report from the Chinese Center for Disease Control and Prevention (CCDCP) included approximately 44,500 confirmed infections with an estimation of disease severity:

  •     Mild pneumonia was found in 81%.
  •     Severe disease (e.g., with difficulty in breathing) was found in 14%.
  •     Critical disease (e.g., with respiratory failure or multi-organ dysfunction) was reported in 5% cases.
  •     The overall case fatality rate was 2.3 %; no deaths were found among noncritical cases.

As per joint WHO-China fact-finding mission, the fatality rate ranged from 5.8% in Wuhan to 0.7% in the rest of China. Most of the fatal cases have occurred in patients with old age or underlying medical illness.
Asymptomatic infections: There have been reports of asymptomatic infections but their frequency is not known.
Preventing Exposure in the Community 

  •     Conscientious and frequent washing of hands, especially after touching surfaces in public. Use of hand sanitizer that contains at least 60% alcohol is a reasonable option if the hands are not visibly dirty.
  •     Respiratory hygiene and etiquettes such as covering the cough or sneeze.
  •     Avoiding touching the face (in particular, eyes, nose, and mouth).
  •     Avoid large gatherings/crowds (particularly in poorly ventilated spaces) if possible and avoid close contact with ill individuals.
  •     Cleaning and disinfecting objects and surfaces that are frequently touched.

Older adults and individuals with chronic medical illnesses should also adhere to these precautions. People are encouraged to practice social distancing by staying at home as much as possible in a community where COVID-19 is prevalent.
For people without respiratory symptoms, wearing a medical mask is not recommended even if COVID-19 is prevalent in the community. Wearing a mask does not decrease the importance of other general measures to prevent infection, and it may result in unnecessary cost and supply problems. Individuals who are caring for patients with suspected or documented COVID-19 at home, however, should wear a tightly fitted medical mask.
Individuals who develop an acute respiratory illness (e.g., with fever and/or respiratory symptoms) should be encouraged to stay at home for the duration of the illness. Some may warrant evaluation for COVID-19. 



Mental Health and Psychosocial Considerations during COVID-19 Outbreak
● COVID-19 has and is likely to affect people from many countries. Show empathy to those who are affected. They deserve our support, compassion and kindness.
● Do not refer to people with the disease as ‘COVID-19 cases’, ‘victims’, ‘COVID-19 families’ or the ‘diseased’. They are ‘people who have COVID-19’, ‘people who are being treated for COVID19’, ‘people who are recovering from COVID-19’ and after recovering from COVID-19 their life will go on as usual with their jobs, families and loved ones. 
● Minimize watching, reading or listening to fake news that cause anxiety; seek information only from reliable and official sources and that too to take practical steps to prepare plans and protect yourself and your loved ones.
   Protect yourself and be supportive to others. Helping others in time of need can benefit the person receiving support as well as the helper.
● Find opportunities to amplify positive and hopeful stories of people who have defeated the virus.
● Honor caretakers and healthcare workers supporting people affected with COVID-19 in your community. Acknowledge the role they play to save lives and keep your loved ones safe.


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