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Coronavirus: Global Public Health Emergency

On 31 December 2019, a cluster of viral lung infections of unknown cause were reported to the World Health Organization (WHO).  These arose from Wuhan, a city in China, with a link to a food and live animal market, suggesting that the virus originated from animals and was transmitted to humans.  Since then, human-to-human transmission has occurred. 

On 7 January 2020, tests lead to the identification of a novel virus (a new strain that has not been identified in humans before), named the novel Coronavirus or “2019-nCoV” for now.  Coronaviruses are a family of viruses causing infections ranging from the common cold to more severe respiratory conditions.  They get their name from the crown-like structures found on the surface of the virus, which resemble the points of a crown, or “corona” in Latin. 

On 30 January 2020, the World Health Organization declared the coronavirus outbreak a Global Public Health Emergency.

What are the symptoms of the infection? 

Until now reported cases have ranged from infected people with little to no symptoms to severe illness and death.  Symptoms can include fever, cough, shortness of breath and general body pains. 

It is important to note that these are non-specific symptoms seen in a variety of common respiratory infections and in the absence of any possible exposure to 2019-nCoV within the last 14 days, there should be little anxiety that one has contracted the virus.  Possible exposure at this stage is considered to be:

•    Travel to China (any province);

OR

•    Having visited or worked in a facility treating patients infected with 2019-nCoV;

OR 

•    Having been in close contact with a confirmed or probable case of 2019-nCoV infection.

How long does it take for symptoms to show?

Most patients develop symptoms within 2-13 days, but currently anyone with possible exposure should be monitored for 14 days. 

How dangerous is the virus?

The majority of cases, thus far, have been classified as mild by the WHO and more people have recovered from the infection in hospital than have died from it in hospital.  The mortality rate for reported, confirmed cases is approximately 2%.  Risk factors for developing severe infection seem to include older age, a history of smoking and certain underlying chronic diseases. 

Can I get screened for 2019-nCoV? 

The private laboratories and the National Institute for Communicable Diseases (NICD) are currently not offering direct-to-public screening for 2019-nCoV.  A person would need to be referred by a healthcare provider and should have been assessed as meeting a specific set of criteria as published and updated by the NICD as the outbreak progresses. 

What if I have a history of possible exposure and develop symptoms within 14 days?

Limit your contact with other people and immediately seek medical attention.  Wherever possible, contact the healthcare provider and/or facility you intend to visit before you arrive so that they can take precautionary measures to protect staff and other patients, and potentially already direct you to a more appropriate facility or level of care, if necessary. 

Is there a cure or a vaccine? 

There is no cure at this stage and treatment is supportive; there is also not a vaccine for 2019-nCoV.  

What is the difference between a suspected and confirmed case? 

A suspected case is where an individual may have suspicious symptoms and exposure history to suggest possible infection but has not yet been tested.  A confirmed case is where the patient has actually tested positive for the virus through laboratory tests.  At the time of writing, there have been no confirmed cases in South Africa. 

Steps to reduce your risk of transmitting a respiratory infection

1.    Cover your mouth and nose with a tissue or your flexed elbow when coughing or sneezing;

2.    Immediately dispose of your used tissues in the nearest waste bin;

3.    Wash your hands with an alcohol-based hand rub after blowing your nose, coughing or sneezing, or after touching possibly contaminated objects;

4.    Avoid close contact with people suffering from acute respiratory infections; and

5.    Practice frequent handwashing, especially after direct contact with ill people or their environment

Responsible sourcing and dissemination of information

It is recommended that people only access and disseminate information directly from reputable, expert sources and do not contribute to the sharing of unconfirmed or unverified statements or “news” via social media or messaging platforms. 

1.    Recommended reading for additional general detail on the virus and infection: https://www.who.int/news-room/q-a-detail/q-a-coronaviruses

2.    For regular updates on the number of cases, deaths and countries affected: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports, http://who.maps.arcgis.com/apps/opsdashboard/index.html#/c88e37cfc43b4ed3baf977d77e4a0667

3.    For regular updates on the situation and recommendations locally, the National Institute of Communicable Diseases (NICD) can be followed via their website http://www.nicd.ac.za/diseases-a-z-index/novel-coronavirus-infection/, and/or on Twitter at https://twitter.com/nicd_sa. 

What measures does Intercare have in place? 

Intercare is collaborating with other healthcare organizations nationwide and has developed and implemented protocols in both its Primary Care centres and Hospitals to identify and appropriately manage any suspected case of 2019-nCoV, which may present to a facility.  

References

The information has been gleaned from various communication platforms of the WHO and NICD, including their websites, statements, publications, training materials and press conferences. 

Statistics, screening criteria, and recommendations may change as the outbreak evolves and the above mentioned sources should be monitored for such updates.