know and prevent

1. DR. SHASHI BHUSHAN KR. GUPTA
VISMAYA .V

2.  1. INTRODUCTION
 2. EPIDEMIOLOGY
 3. CLINICAL CHARACTERISTICS
 4. PREVENTION
 5. TREATMENT AVAILABLE
 6. MYTHS
 7. GENERAL DOUBTS

3.  VIRUS: word is derived from SANSKRIT, “vis” ,
meaning poison.
It refers to any infectious agents that
replicates only inside living organism.
Modes of transmission: it can be transmitted in
humans from another animal species, from
plants or vertically from mother.
Transmission from humans occur through
aerosols, fomites, droplets, feco-oral and
contaminated body fluides like urine,
sputum,blood or sexual contacts.

4.  Zoonotic virus: virus which gets transmitted
to humans from other arthopods or species.
Humans are generally not affected but due
to mutation in virus humans become
accidental host of virus. Depending upon
pathogenicity and secondary transmission in
humans such infection causes epidemics in
humans.
 Various examples are HIV-1,2, HTLV-1,2,3,4,
SARS-CoV-1, SARS-CoV-2

5.  Corona viruses
constitute the
subfamily
Orthocoronavirinae
in the family
Coronaviridae. They
are enveloped
viruses with a
positive sense
single-stranded RNA
genome .

6.  Outbreak Virus type Deaths
 2003 severe acute respiratory syndrome
outbreak SARS-CoV 774
 2012 Middle East respiratory syndrome coronavirus
outbreak
MERS-CoV Over 400
2015 Middle East respiratory syndrome outbreak in
South Korea
MERS-CoV 36
 2018 Middle East respiratory syndrome outbreak
MERS-CoV 41
 2019–20 coronavirus pandemic
SARS-CoV-2 At least 8778

7.  Bats are known as a natural reservoir of
various human pathogenic viruses.
 Other hosts are palm civets, raccoon dog,
Pangolins, Bamboo rats, dromedary camels,
Snake, turtle
 In 2005, horseshoe bats were identified as a
natural host of SARS-rCoVs.
 Other domestic animals sheep, goats, a cow,
and donkeys may also be involved in
transmission

8.  In December 2019, a cluster of pneumonia cases,
caused by a newly identified β-coronavirus, occurred
in Wuhan, China.
 This coronavirus, was initially named as the 2019-
novel coronavirus (2019-nCoV) on 12 January 2020 by
 World Health Organization (WHO). WHO officially
named the disease as coronavirus disease 2019
(COVID-19)
 Coronavirus Study Group (CSG) of the International
Committee proposed to name the new coronavirus as
SARS-CoV-2, both issued on 11 February 2020. The
 Chinese scientists rapidly isolated a SARS-CoV-2 from
a patient within a short time on 7 January 2020 and
came out to genome sequencing of the SARS-CoV-2

10. As per WHO declared as public health
emergency of international concern on 30th
January.
As on 20th march, 17:30, total number of
confirmed cases counted to 209839, and
total number of deaths to 8778.
It has already spread to 169 countries.

11.  After remaining confined to wuhan, china
the majority of cases currently are from
european countries, united states and middle
east countries particularly iran.
 Death has been reported from most of the
countries.

12.  Indian scenario
As per ministry data on 20th march,9:00 am
total number of active cases are 171, with
total number of casualty counting to 4.
Total number of discharged and cured cases
were 19.
The cases are particularly high in Maharashtra,
Delhi and Karnataka. However cases has
been reported from most states of country.

14. Common Clinical Manifestations
 Fever (88.7%),
 Cough (67.8%),
 Fatigue (38.1%),
 Sputum Production(33.4%),
 Shortness Of Breath (18.6%),
 Sore Throat(13.9%), And
 Headache (13.6%) .
 Gastrointestinal Symptoms, With Diarrhea
(3.8%) And Vomiting (5.0%).

15. A. SUSPECT
 Person with the history of
1. Fever
2. Cough
3. Respiratory distress And any of the following
A history of travel to China during the 14 days prior to symptom
onset
Or
• The disease occurs in a health care worker who has been working
in an environment where patients with severe acute
respiratory infections are being cared for without regard to
place of residence or history of travel
Or
• The person develops an unusual or unexpected clinical course,
especially sudden deterioration despite appropriate treatment,
without regard to place of residence or history of travel, even
if another aetiology has been identified that fully explains the
clinical presentation

16. B. Probable
• A person with acute respiratory illness of any degree
of severity who, within 14 days before onset of
illness, had any of the following exposures:
a. Close physical contact with a confirmed case of
Covid-19 infection, while that patient was
symptomatic Or
b. A health care facility in a country where hospital
associated Covid-19 infections have been reported Or
c. Direct contact with animals (if animal source is
identified) in the countries where the Covid-19 is
known to be circulating in animal populations or
where human infections have occurred as a result of
presumed zoonotic transmission.

17. C. Laboratory
• Patients that meet the case definition are
tested positive with specific real time RT-PCR
test for Covid-19
• Two consecutive negative PCR tests at least
24 hours remain gold standard for viral
clearance and that recommended basis for
discharge

18.  Acute Respiratory Distress Syndrome (ARDS)
 Arrhythmia,
 Shock
 Acute Kidney Injury,
 Acute Cardiac Injury,
 Liver Dysfunction
 Secondary Infection

19.  ELDERLY MALE
 MEDICAL COMORBIDITIES LIKE hypertension,
chronic obstructive pulmonary disease,
diabetes, cardiovascular disease)
 LABORATORY MARKERS Neutrophil Count, D-
dimer, Blood Urea, And Creatinine Levels
were HIGHER significantly, and the
lymphocyte counts continued to DECREASE.
 Additionally, inflammatory factors
(interleukin (IL)-6, IL-10, tumor necrosis
factor-α (TNF-α) increase,

20.  The Case fatality rate (CFR) for Hubei
province of China is 4.3%
 Other regions of China and other countries =
0.18%.
 Secondary attack rate (SAR)=1.3%
 Intensive care needed for 26%

22.  Most of the patients tested for covid-19
tested negative for any viral or bacterial
infection.(44%)
 Common viral infection was Influenza –A.
(28%)
 Bacterial infection like legionella,
streptococcus pneumoniae and mycoplasma
were also positive in tested patients.
 Only 2.4% were positive for covid-19.

23.  Wash your hands frequently
Regularly and thoroughly clean hands with an
alcohol-based hand rub or wash them with
soap and water.
 Why? Washing your hands with soap and
water or using alcohol-based hand rub kills
viruses that may be on your hands.

24.  Maintain social distancing
 Maintain at least 1 metre (3 feet) distance
between yourself and anyone who is
coughing or sneezing.
 Why? When someone coughs or sneezes they
spray small liquid droplets from their nose or
mouth which may contain virus. If you are
too close, you can breathe in the droplets,
including the COVID-19 virus if the person
coughing has the disease.

25.  Avoid touching eyes, nose and mouth
 Why? Hands touch many surfaces and can
pick up viruses. Once contaminated, hands
can transfer the virus to your eyes, nose or
mouth. From there, the virus can enter your
body and can make you sick.

26.  Practice respiratory hygiene
 Make sure you, and the people around you,
follow good respiratory hygiene. This means
covering your mouth and nose with your bent
elbow or tissue when you cough or sneeze.
Then dispose of the used tissue immediately.
 Why? Droplets spread virus. By following
good respiratory hygiene you protect the
people around you from viruses such as cold,
flu and COVID-19.

27.  If you have fever, cough and difficulty
breathing, seek medical care early
 Stay home if you feel unwell. If you have a fever,
cough and difficulty breathing, seek medical
attention and call in advance. Follow the
directions of your local health authority.
 Why? National and local authorities will have the
most up to date information on the situation in
your area. Calling in advance will allow your
health care provider to quickly direct you to the
right health facility. This will also protect you
and help prevent spread of viruses and other
infections.

28.  Stay informed and follow advice given by your
healthcare provider
 Stay informed on the latest developments about
COVID-19. Follow advice given by your
healthcare provider, your national and local
public health authority or your employer on how
to protect yourself and others from COVID-19.
 Why? National and local authorities will have the
most up to date information on whether COVID-
19 is spreading in your area. They are best
placed to advise on what people in your area
should be doing to protect themselves.

29. Protection measures for persons who are in or
have recently visited (past 14 days) areas
where COVID-19 is spreading
 Follow the guidance outlined above.
 Stay at home if you begin to feel unwell,
even with mild symptoms such as headache
and slight runny nose, until you
recover. Why? Avoiding contact with others
and visits to medical facilities will allow
these facilities to operate more effectively
and help protect you and others from
possible COVID-19 and other viruses.

30.  If you develop fever, cough and difficulty
breathing, seek medical advice promptly as
this may be due to a respiratory infection or
other serious condition. Call in advance and
tell your provider of any recent travel or
contact with travelers. Why? Calling in
advance will allow your health care provider
to quickly direct you to the right health
facility. This will also help to prevent
possible spread of COVID-19 and other
viruses.

31.  When to use a mask
 If you are healthy, you only need to wear a
mask if you are taking care of a person with
suspected 2019-nCoV infection.
 Wear a mask if you are coughing or sneezing.
 Masks are effective only when used in
combination with frequent hand-cleaning
with alcohol-based hand rub or soap and
water.
 If you wear a mask, then you must know how
to use it and dispose of it properly.

32.  How to put on, use, take off and dispose of a mask
 Before putting on a mask, clean hands with alcohol-
based hand rub or soap and water.
 Cover mouth and nose with mask and make sure
there are no gaps between your face and the mask.
 Avoid touching the mask while using it; if you do,
clean your hands with alcohol-based hand rub or soap
and water.
 Replace the mask with a new one as soon as it is
damp and do not re-use single-use masks.
 To remove the mask: remove it from behind (do not
touch the front of mask); discard immediately in a
closed bin; clean hands with alcohol-based hand rub
or soap and water.

34. FOR MAKING HAND SANITIZER
 • Ethanol=835 ml
 • Hydrogen Peroxide=40 ml
 • Glycerol=15 ml
 • Sterile water=110ml
 Total=1000ml

35.  Focus is on symptomatic management
 Respiratory support according to severity of
Pneumonia Caused by COVID-19
 WHO recommends extracorporeal membrane
oxygenation (ECMO) to patients with
refractory hypoxemia.
 convalescent plasma and immunoglobulin G
may be delivered to some critical cases

36.  Antiviral drugs and systemic corticosteroid
treatment like neuraminidase inhibitors
(oseltamivir, peramivir,zanamivir, etc),
ganciclovir, acyclovir, and ribavirin, as well
as methylprednisolone [46, 75] for influenza
virus, are invalid for COVID-19 and not
recommended.

37.  REMDESIVIR has been reported to treat the
first US case of COVID-19 successfully
 Chloroquine is a repurposed drug with great
potential to treat COVID-19
 Viral loads of a COVID-19 patient in Korea
significantly decreased after
lopinavir/ritonavir treatment
 Arbidol, and Shufeng Jiedu Capsule (SFJDC, a
traditional Chinese medicine)

39.  COVID-19 virus can be transmitted in ALL
AREAS, including areas with hot and humid
weather. So regardless of climate, adopt
protective measures if you live in, or travel
to an area reporting COVID-19
 No reason to believe that cold weather can
kill the new coronavirus

40.  Taking a hot bath will not prevent you from
catching COVID-19. Actually, taking a hot
bath with extremely hot water can be
harmful, as it can burn you.
 No evidence to suggest that the new
coronavirus could be transmitted by
mosquitoes. The new coronavirus is a
respiratory virus which spreads primarily
through droplets generated when an infected
person coughs or sneezes, or through
droplets of saliva or discharge from the nose

41.  Hand dryers are not effective in killing the
2019-nCoV. To protect yourself against the
new coronavirus, you should frequently clean
your hands with an alcohol-based hand rub or
wash them with soap and water.

42. Can an ultraviolet disinfection lamp kill the new
coronavirus?
UV lamps should not be used to sterilize hands or
other areas of skin as UV radiation can cause skin
irritation.
How effective are thermal scanners in detecting
people infected with the new coronavirus?
Thermal scanners are effective in detecting people
who have developed a fever (i.e. have a higher
than normal body temperature) because of
infection with the new coronavirus.

43.  However, they cannot detect people who are
infected but are not yet sick with fever. This
is because it takes between 2 and 10 days
before people who are infected become sick
and develop a fever.

44.  WHO ARE CALLED CONTACTS
• Close contacts: Passengers of same flight
sitting at the same row and two row in front
and behind the patient.
• Other Contacts: Passengers of same cabin

45.  DURATION OF QUARANTINE
14 days from the last day of contact with
confirmed or probable cases

46. Can spraying alcohol or chlorine all over your
body kill the new coronavirus?
No. Spraying alcohol or chlorine all over your
body will not kill viruses that have already
entered your body. Spraying such substances
can be harmful to clothes or mucous
membranes (i.e. eyes, mouth). Be aware
that both alcohol and chlorine can be useful
to disinfect surfaces, but they need to be
used under appropriate recommendations.

47.  Vaccines against pneumonia, such as
pneumococcal vaccine and Haemophilus
influenza type B (Hib) vaccine, do not
provide protection against the new
coronavirus.
 Although these vaccines are not effective
against 2019-nCoV, vaccination against
respiratory illnesses is highly recommended
to protect your health

48. Can regularly rinsing your nose with saline
help prevent infection with the new
coronavirus?
No. There is no evidence that regularly rinsing
the nose with saline has protected people
from infection with the new coronavirus.

49.  Can eating garlic help prevent infection
with the new coronavirus?
 Garlic is a healthy food that may have some
antimicrobial properties. However, there is
no evidence from the current outbreak that
eating garlic has protected people from the
new coronavirus.

50.  Does the new coronavirus affect older
people, or are younger people also
susceptible?
 People of all ages can be infected by the new
coronavirus (2019-nCoV). Older people, and
people with pre-existing medical conditions
(such as asthma, diabetes, heart disease)
appear to be more vulnerable to becoming
severely ill with the virus.

51.  Are antibiotics effective in preventing and
treating the new coronavirus?
 No, antibiotics do not work against viruses,
only bacteria.
 However, if you are hospitalized for the
2019-nCoV, you may receive antibiotics
because bacterial co-infection is possible.

52.  Are there any specific medicines to
prevent or treat the new coronavirus?
 To date, there is no specific medicine
recommended to prevent or treat the new
coronavirus (2019-nCoV).

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