With everything that’s happening with the COVID-19 coronavirus, and stories in the news of all the things happening, it can seem a bit overwhelming if you don’t fully understand the ins and outs of what this outbreak actually means for you. We’re not all doctors with in depth knowledge of this subject, after all, and the tabloids certainly aren’t helping with the usual sensationalism that they like to take advantage of. So, with that in mind, we put together our own explainer to make sure you know what’s what, and whether you should be worried about the whole situation.
Coronavirus (also referred to as COVID-19) is a disease caused by the novel virus SARS-CoV-2 which belongs to the Coronavirus family. It was first reported to the World Health Organisation in December 2019 when a viral pneumonia of unknown cause was diagnosed in Wuhan, China.
A novel virus refers to a virus strain that has not been seen/identified before. Novel viruses can emerge from a number of sources; such as mutations causing new strains of previously identified viruses or, as in the case of COVID-19, viruses that have spread from animals into humans.
Viruses that spread between animals and humans are classified as zoonotic and are very common. Current estimates suggest that 3 out of every 4 new or emerging infectious diseases in humans originate from animals. In fact, many of the most recent epidemics we have seen have come from zoonotic coronaviruses: SARS – originating in Horseshoe Bats (but infecting Civets as an intermediary) – and MERS – which present studies suggest may have originated in Camels.
Despite several reports suggesting otherwise, scientists have yet to pinpoint the origin species for the virus causing COVID-19, although the first infections have been linked to a live animal market. Without knowing the origin species, it is difficult to pin down exactly how the virus spread from animals into humans (is it from contact? Is it from eating infected meat?) and it remains tricky to prevent new outbreaks moving forward.
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It has been confirmed that COVID-19 is spreading from person-to-person. Using what is already known about other coronaviruses and observation of COVID-19 infection – scientists believe that the virus that causes COVID-19 is being spread through respiratory droplets from coughs, sneezes, or exhaling. This is the same transmission route as many other respiratory viruses like influenzas (which cause the flu) and rhinoviruses (which cause colds).
Like many other similar coronaviruses, it is likely that the COVID-19 causing virus cannot survive for long on surfaces or at room temperatures.
There are three main symptoms of COVID-19:
These symptoms are similar to other respiratory illnesses like the common cold and the flu. If you’re currently experiencing these symptoms but haven’t been in contact with anyone with COVID-19 and haven’t travelled to a high-risk area (you can find these listed on the NHS COVID-19 Advice for Travellers pages), it’s more likely you have another respiratory infection. You should only be concerned if you are experiencing these symptoms and have been in one of these higher-risk situations.
If you are experiencing the symptoms above and think you have COVID-19, have been in contact with someone else with COVID-19, or have travelled to one of the high-risk areas in the past 14 days the NHS advice is to:
In no circumstances should you go to the GP, pharmacy or hospital if you do think you are infected, as this will further the spread of COVID-19. The NHS 111 service can offer the same level of medical advice and support as any of these other services.
Due to the route of transmission for the COVID-19 causing virus, and the route by which coronaviruses bind and enter human host cells via receptors we all have – everyone is potentially at risk of contracting the virus and developing COVID-19. This is why everyone needs to be vigilant and practicing good infection control (more on that below) to minimise their risk.
At present, there are no treatments for the COVID-19 causing virus and so recovery from infection is very much down to each individual’s immune system. The largest epidemiological study of COVID-19 cases so far suggests that more than 80 per cent of people experienced mild illness symptoms, with a lethality of the COVID-19 causing virus at about 2.3 per cent.
There are certain groups who appear to be more at risk of developing more severe illness. Those who are elderly, or individuals with underlying health conditions such as cardiovascular diseases, diabetes, chronic respiratory diseases and hypertension have all were identified to be at a higher risk in this study.
This study does not give us the complete picture and we may find that these statistics on severity, lethality, and risk factors alter as more research is carried out. This is why many health organisations are using much broader guidance about risks of infection in children, pregnant individuals, and those who are immunocompromised based on what was observed in other coronavirus outbreaks.
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The best ways to reduce your risk of infection from the COVID-19 causing virus is pretty simple: follow the same tips you do for flu prevention.
Heading up this list is washing your hands thoroughly: ideally this should be washing your hands for at least 20 seconds with soap and water (which is about the length of time it takes you to sing Happy Birthday twice). You can see the recommended approach to cleaning your hands here on the NHS website. If you don’t have access to soap and water, use >60% alcohol hand-sanitiser for the interim. You should wash your hands every time you go to the bathroom, before and after handling food, nose, after touching animals, and after you use public transport. If your hands are not clean, don’t touch your eyes, nose or mouth as this could expose you to a number of germs – not just the COVID-19 causing virus.
Additionally covering your mouth and nose with either a tissue or your sleeve when coughing or sneezing is recommended as this prevents any infective droplets from getting into the air. If you use a tissue, you should put these in the bin immediately. And again: wash your hands after.
Though at present it is believed that the COVID-19 causing virus cannot survive for long on surfaces outside the body, it is still considered best practice to disinfect surfaces that are regularly touched like doorknobs and work surfaces.
Finally, you should avoid close contact with individuals who have COVID-19 or travelling to areas that are considered high-risk if you can. The GOV.UK website can give you travel information for every country.
Contrary to popular belief masks are not helpful in preventing infection and shouldn’t be used unless specifically recommended by a doctor. The number of people buying masks are now creating shortages in healthcare settings where they would be beneficial.
You don’t need a face mask. Image by Ashutosh Goyal from Pixabay
There are currently over 80,000 individuals with a COVID-19 diagnosis in over 50 countries across the world with the World Health Organisation (WHO) currently classifying it as an epidemic though they have said “we’re on the precipice of a pandemic”. Ultimately this makes it sound incredibly worrying – but is it really?
The answer to this is both yes and no.
At present, what we know about the COVID-19 virus suggests that it is both more infective than flu. Typically each individual who has the flu infects a further person (called the R0), whilst COVID-19 causing virus has an R0 of two. Despite more individuals being infected, majority of people who have COVID-19 only experience mild symptoms (>80%) which is much like what is seen in flu infections. However, for those who are elderly or have other health conditions that leave them more at risk of more severe COVID-19 infections – like cardiovascular diseases or chronic respiratory diseases – having a higher infection rate is a greater cause for concern as they are more likely to come into contact with the infection.
As well as being more infective than flu, the virus that causes COVID-19 is more lethal. Seasonal flu usually has a death rate of 0-1-0.2 per cent (strain dependent) whilst current data suggests that there is a 2.3 per cent lethality in COVID-19 cases. As with above, this lethality disproportionately affects those who are elderly or have other health conditions – which again makes it a greater cause for concern in these populations.
Whilst the COVID-19 outbreak is statistically more worrying than the flu, if you compare it to another novel coronavirus outbreaks, like SARS in 2002, it’s not quite as alarming. SARS was both more infective (R0 of between 2 and 4) and deadly (9.6%).
The reason we cannot simply just brush off the COVID-19 outbreak – or indeed any viral outbreak – is due to the uncertainty around it. As there still are many unanswered questions about the COVID-19 causing virus, we can only make predictions on how the outbreak will progress according to what we do know about the virus and what has been observed in other coronavirus outbreaks. Ultimately the statistics around infectivity, proportions with mild vs. severe illness, and lethality could change over the forthcoming days as more cases get identified and more research is carried out. There is also the fact that as of yet there is no treatment or vaccine for COVID-19, which means there are variable illness severities and outcomes, which is an uncertainty no one would want to expose themselves to willingly.
At present the best thing for this COVID-19 outbreak is to control the transmission – which means as many people as possible following the guidance issued by WHO and Public Health England around reducing infection risks and potential self-isolation – whilst research continues to help us fill in the remaining blanks needed for the development of a long-term prevention plan.
Dr Natt Day is a former researcher in infectious respiratory diseases and has a PhD in Infection and Immunity from the University of Southampton. She currently works in public engagement with research.
Featured Image by effelle from Pixabay