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#Covid19: Information guide for general Public.

This document provides information and guidance on preparing for and responding to the COVID-19 pandemic. It discusses the objectives of preventing transmission, protecting oneself and family, and maintaining a healthy lifestyle during lockdown. It covers the stages of an epidemic, definitions of isolation and quarantine, the nature and transmission of coronavirus, symptoms and diagnosis of COVID-19, treatment, prevention methods like social distancing and hygiene, guidance for high-risk groups, obligations during lockdown, and maintaining mental health.

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1 #COVID19 HOW TO PREPARE OUR CITIZENS FOR THE PANDEMIC Dr. Madhur Verma MD Assistant Professor of Community and Family Medicine All India Institute of Medical Sciences Bathinda, Punjab. Email: drmadhurverma@gmail.com *Disclaimer: The views are of the presenter and do not represent the policy of the institution. However, data has been adapted from reputed national and international sources.
2 Objectives of today’s session 1. To know about the disease in terms of its nature, routes of transmission, signs and symptoms, diagnosis and available treatment options 2. To know methods of protecting oneself and family members and what to do in case a family member becomes infected 3. To know how to maintain a healthy lifestyle during lockdown 4. To differentiate between prevalent myths and facts
3 Phases of epidemic 1. The first stage: cases of an infection are imported into a country which was not the source of the infection. 2. The second stage: when there are cases of local transmission in the country. In this stage, the trajectory of the virus can be identified from the source to all the infected individuals. 3. Third stage: Community transmission starts. It becomes hard to track the chain of transmission of the virus in a large number of cases. 4. Fourth stage of an outbreak is when an infection becomes endemic and keeps resurfacing round the year, like malaria and dengue in India.
4 Isolation vs quarantine
5 Corona virus Coronaviruses are a related group of viruses that cause diseases in mammals and birds. The name "coronavirus" is derived from Latin corona, meaning "crown". The name refers to the characteristic appearance of the virus, which have a large surface projections creating an image that resembles a crown.
6 IS IT A NEW VIRUS??? Coronaviruses were first discovered in the 1930s in an acute respiratory infection of domesticated chickens. Human coronaviruses were discovered in the 1960s. Past Outbreaks of coronavirus diseases • Severe acute respiratory syndrome (SARS)-2003 • Middle East respiratory syndrome (MERS)-2012. This time it’s the new strain of Coronavirus that was discovered in 2019 and has not been previously identified in humans.
7 COVID-19 The name of the disease is Corona Virus Disease – discovered in 2019 - COVID-19. The name of the organism that causes the disease is SARS-CoV-2. • This stands for Severe (because it is serious) Acute Respiratory Syndrome- Coronavirus (the name of the family of viruses) 2.
8 Is the coronavirus disease more severe than the flu? COVID-19 causes more severe disease than seasonal influenza and is 10 times more deadly than the swine flu. While many people globally have built up immunity to seasonal flu strains, COVID-19 is a new virus to which no one has immunity. That means more people are susceptible to infection, and some will suffer severe disease.
10 COVID 19 The incubation period of COVID 19 (time between getting the infection and showing symptoms) is 2 to 14 days. Some people with the infection, but without any serious symptoms can also spread the disease.
11 How do you get infected ? The virus travels through the respiratory droplets of an infected person. When the person sneezes or coughs, the virus is deposited on the person’s hand if the hand covers the mouth, or droplets fall on a surface when the mouth/nose is not covered. From the surface/hand, the virus will get transferred to an uninfected person’s hand and when that hand comes in touch with the nostril, eyes or mouth the virus gets inside the body.
12 How does COVID-19 spread?  Transmission can happen in two ways: • Direct close contact: one can get the infection by being in close contact with COVID-19 patients (within one Metre of the infected person), especially if they do not cover their face when coughing or sneezing. • Indirect contact: the droplets survive on surfaces and clothes for many days. Therefore, touching any such infected surface or cloth and then touching one’s mouth, nose or eyes can transmit the disease.
13 MODES OF TRANSMISSION SNEEZE/ COUGH BY INFECTED PERSON INFECTED DROPLETS GET ON YOUR HAND AND WHEN TOUCH ANY SURFACE OR PERSON VIRUS TRANSFERRED!! SNEEZE/ COUGH BY INFECTED PERSON INFECTED DROPLETS INFECTED DROPLETS GET ON YOUR HAND VIRUS TRANSFERRED!! INFECTED DROPLETS 07
15 Definition of a COVID 19 Suspect Let us remember that the suspect needs to have any one of the 5 things: 1. Any kind of fever, cough or a difficulty in breathing. 2. If the person has travelled from any place which has been an outbreak area for COVID in the last 14 days. 3. If the person has been in close contact of another person who is positive for COVID 4. A person who has tested but has not got the results 5. A person who may not have the symptoms but the lab reports come as positive.
16 Now, a Contact is: 1. Someone who is providing direct care to a person who is confirmed to be positive for COVID 2. Someone who has stayed together with a person who has been tested as positive for COVID 3. Someone who has travelled together for more than 6 hours in close space with a person who later becomes positive for COVID
17 Contact of COVID 19 The types of contacts can then be further divided into contact who are at a high risk and those who are at low risk 1. The high risk ones are those who have directly been in touch with the patient or any body fluids while taking care during home quarantine, travelled with a patient, been in the same room/house and shared utensils, etc. with the patient. 2. A low risk contact is someone who would have been in the same place but well outside the range of one meter, may have travelled in the same bus or train or flight but sat atleast 1 meter away from the person who tested positive.
ADVISORY FOR CONTACTS 1.If symptoms develop (fever, cough, difficulty in breathing), use mask, self-isolate and immediately inform designated health workers by telephone 1. Home quarantine for at least 28 days after the last exposure with the case. 2. Initiate self-health monitoring for development of fever or cough and maintain a list of contacts on daily basis. 3. Active monitoring (eg. Daily visits or telephone calls) for 28 days after the last exposure shall be done by designated health workers 18 Source: Ministry of Health and Family Welfare, Governemnt of India. Avaialble at: https://www.mohfw.gov.in/pdf/2COVID19PPT_25MarchPPTWithAnimation.pdf
19 Clinical profile of COVID-19 The Symptoms Of Covid-19 Are Fever, Cough, and Difficulty in Breathing
20 Signs & Symptoms: Appear 2-14 days after coming in contact with a case In the initial stages: • High fever • Dry Cough • Shortness of breath With increasing severity: • Diarrhoea • Severe respiratory distress • Lack of oxygenation will cause bluish discolouration of lips In some cases with severe co-morbidities, the disease can cause: • Signs of kidney failure • Respiratory failure • Death
21 Signs & Symptoms: Caution: These symptoms and signs are not exclusive for COVID-19 These may be present in other respiratory illnesses also So, there is high suspicion if along with these symptoms there is : travel from an affected area contact with a known case Having a patient of COVID-19 at home History of visit to a crowded area without precaution
22 Diagnosis and treatment of COVID19
23 • At present tests are available in laboratories only • For the sake of quality, tests should be carried out in ICMR recommended labs only • Point of care tests are not available yet Diagnosis of COVID19
24 COVID-19 testing - when and how? All individuals need not be tested, because Disease is primarily reported in Individuals with travel history to the affected areas or close contacts of positive cases. The guidelines for testing are being revised continuously, keeping in view the current case load, availability of the test kits and other logistics.
25 WHOM TO TEST ALL symptomatic people who • Had come in contact of confirmed cases • Have history of travel to areas with confirmed cases in last 14 days • Are healthcare workers • Are hospitalized patients with Severe Acute Respiratory Illness (SARI) or Influenza Like Illness (ILI) or severe pneumonia. Asymptomatic direct and high-risk contacts of confirmed cases should be tested once between day 5 and day 14 of coming in his/her contact. List of labs (Govt. & Private) can be accessed at: icmr.nic.in
26 • At present there are no medicines that can cure a person of the disease • PREVENTION IS THE ONLY SOLUTION TO THIS DISEASE AT PRESENT ! • But, spontaneous recovery is the rule, as only 2-3% diseased persons have died so far • Supportive treatment helps speedy recovery • But treatment can be given in medical supervision only Treatment of COVID19
28 Key messages for prevention of COVID-19
29 DO DO NOT • Do not hold events where people have to gather (even if it is a corner meeting with three or four friends, or an evening chat on the chaupal) • Do not go to crowded places likemarkets, shopping, melas, and parties • Do not use publictransport PREVENTION: SOCIAL DISTANCING SOCIAL Distancing: deliberately increasing the physical space between people to avoid spreading illness. • Stay at home unlessabsolutely necessary • Keep a distance of atleast one meter between yourself and another person
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31 Practice good hygiene Wash your hands frequently using soap and water: • After coming home from outside or meeting other people especially if they are ill. • After having touched your face, coughing or sneezing. • Before preparing food, eating or feeding children. • Before and after using toilet, cleaning etc.
32 Correct Technique of Hand Washing:
33 Coughing and sneezing etiquettes While coughing or sneezing cover your nose and mouth with handkerchief.  Wash the handkerchief at least daily It is preferable to cough/sneeze into your bent elbow rather than your palms. Never use the saree pallu or gamcha for sneezing into as you may use these for wiping your hands and the germs will get transferred from your hand to your nose, mouth or eyes. Practice good respiratory hygiene
34 Do not Spit or shout in public places to avoid the spread of droplets. Do not touch your eyes, nose and mouth with unclean hands. Ensure that the surfaces and objects are regularly cleaned. Practice good hygiene
35 Practice food safety Use different chopping boards and knives for raw meat and cooked foods Wash your hands between handling raw and cooked food
36 Practice food safety Sick animals and animals that have died of diseases should not be eaten
37 Practice food safety Even in areas experiencing outbreaks, meat products can be safely consumed if these items are cooked thoroughly and properly handled during food preparation
38 High Risk Groups
39 PREVENTION: HIGH RISK GROUPS High risk groups are people who are at a higher risk from severe illness if they get covid-19. They includes: PREGNANT WOMEN (As we do not know the impact of the disease on pregnancy as of yet, it is better to take care) OLDER ADULTS PEOPLE WHO HAVE UNDERLYING MEDICAL CONDITIONS LIKE: ▪On Cancer Medication ▪Heart Disease ▪Diabetes ▪Lung Disease ▪Kidney Disease
40 Be SAFE from #coronavirus if you are 60+ or if you have an underlying condition like: Cardiovascular disease Respiratory condition Diabetes Avoid crowded areas or places where you might interact with people who are sick.
41 #Coronavirus #COVID19 Other adults and people with underlying conditions Keep regular routines and schedules as much as possible or help create new ones in a new environment, including regular exercising, cleaning, daily chores, singing, painting or other activities.
42 #Coronavirus #COVID19 People with underlying conditions If you have an underlying health conditions, make sure to have access to any medications that you are currently using. Activate your social contacts to provide you with assistance, if needed.
43 #Coronavirus #COVID19 Other adults and people with underlying conditions Make sure you have up to 2 weeks of all your regular medicines that you may require.
44 #Coronavirus #COVID19 Other adults and people with underlying conditions Be prepared and know in advance where and how to get practical help if needed, like calling a taxi, having food delivered and requesting medical care.
45 Obligations of a responsible citizen of India during Lockdown
46 #MentalHealth #COVID19 #coronavirus Be INFORMED Be PREPARED Be SMART Be SAFE Be READY to fight #COVID19
47 #MentalHealth #COVID19 #coronavirus Choose a limited time each day when you will check #COVID19 updates. Constantly listening to media coverage about #coronavirus can make you more anxious and upset.
48 #MentalHealth #COVID19 #coronavirus Seek information only from trusted sources and mainly to take practical steps to prepare your plans and protect yourself and loved ones.
49 #MentalHealth #COVID19 #coronavirus COVID-19 has and is likely to affect people from many countries. Do not attach it to any ethnicity or nationality. Be empathetic to all those who are affected, in and from any country – they deserve our support, compassion and kindness.
50 #MentalHealth #COVID19 #coronavirus 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.
51 Instructions for the travelers
52 Avoid travel if you have a fever and cough If you have a fever, cough and difficulty breathing seek medical care early and share previous travel history with your health care provider
53 Insert local logo Avoid close contact with people suffering from a fever and cough Frequently clean hands by using alcohol-based hand rub or soap and water Avoid touching eyes, nose or mouth Insert local logo Avoid close contact with people suffering from a fever and cough Frequently clean hands by using alcohol-based hand rub or soap and water Avoid touching eyes, nose or mouth
54 Insert local logo When coughing or sneezing cover mouth and nose with flexed elbow or tissue - throw tissue away immediately and wash hands If you choose to wear a mask, be sure to cover mouth and nose – avoid touching mask once it’s on Immediately discard single-use mask after each use and wash hands after removing masks
55 Insert local logo If you become sick while travelling, inform crew and seek medical care early If you seek medical attention, share travel history with your health care provider
56 Insert local logo Eat only well- cooked food Avoid spitting in public Avoid close contact and travel with animals that are sick
57 Instructions for Home Quarantine
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62 Suggestions for a Healthy Lock-Down!!!
63 Stay healthy during lock down!!! Online exercise classes #BeActive #HealthyAtHome Dancing Playing active Video games Jumping rope Muscle strength and balance training
64 Be active at home during #COVID19 outbreak Looking after yourself, your family and friends is important through these stressful times. WHO encourages everyone at home to do simple and fun physical activities to stay healthy and active. #BeActive #HealthyAtHome
65 Be active at home during #COVID19 outbreak Doing any activity around the home is better than none at all. Be active during #COVID19 outbreak to maintain your heart health, muscle strength and flexibility. It is good for your mental health too! #BeActive #HealthyAtHome
66 #COVID19 March 2020 minutes moderate intensity weekly minutes vigorous intensity weekly Make more moments active This guidance is intended for non-symptomatic people. It does not replace any medical guidance in case of any health condition. Continue indoor exercise routine Perform household chores Read, draw, play music Meditate and do something relaxing Tips to stay active at home during #COVID19 outbreak
67 Tips to stay active at home during #COVID19 outbreak Regularly check your sitting posture while working from home #BeActive #HealthyAtHome Break up your sitting and stand up while working, on the phone, or watching TV WOKING FROM HOME IS CHALLENGING, I NEED TO REGULARLY STAND UP AND STRETCH…
68 #COVID19 March 2020 BOOST YOUR IMMUNE SYSTEM Good nutrition and healthy diet are essential to maintain optimal health, boost your immune system and prevent communicable and non-communicable diseases Eat a variety of foods Eat plenty of vegetables and fruit Eat less salt and sugars Eat moderate amounts of fats and oils
69 SAY NO TO TOBACCO IN THE TIME OF COVID-19... AND ALWAYS! Increased risk of serious illness due to unhealthy lungs Higher chance of transmission from hand to mouth Smoking makes you more vulnerable to COVID-19. So, stop smoking and give your lungs a chance! #COVID19 March 2020
70 Mental health during a lockdown
71 #MentalHealth #COVID19 #coronavirus It is normal to feel fearful and anxious during this time. Talking about your feelings will lessen your distress.
72 #COVID19 #coronavirus The stress and adversity during this time can increase the risk for depression. If you are feeling sad, hopeless and having thoughts of harming yourself, talk to a mental health professional or someone you trust about your feelings. It will help. #MentalHealth
73 #MentalHealth #coronavirus If someone you know is feeling hopeless and having thoughts of harming themselves because of #COVID19 - talk to them. Talking about suicide will not increase the risk and can help people in crisis process their feelings and relieve the stress.
74 #COVID19 #coronavirus Quarantine can lead to loneliness – especially for older people or people who live alone. Loneliness can contribute to poor physical and mental wellbeing. Connect with other people, through social media, telephone, and online communities, and maintain #MentalHealth.
75 #mentalhealth #coronavirus #COVID19 can be difficult for children to understand. Talk kindly to them using words they can understand and encourage them to practice healthy habits through activities such as songs and dances. This will help them feel more secure.
76 #mentalhealth #coronavirus Older people may find it difficult to stay connected during a #COVID19 quarantine. Loved ones should connect with them regularly through telephone, messaging apps, and social media to help them feel safe and secure.
77 #mentalhealth #coronavirus Care providers for older adults Share simple facts about what is going on and how to reduce risk of infection. Use words that older people with or without cognitive impairment can understand.
78 #COVID19 Amplify hopeful stories and positive images of local people who have experienced COVID-19. For example, stories of people who have recovered or who have supported a loved one and are willing to share their experiences. 78
79 #mentalhealth #coronavirus Protect yourself and be supportive to others. For example, check-in by phone on neighbours or elder people in your community who may need extra assistance. Working together as one community an help to create solidarity in addressing COVID-19 together.
80 #COVID19 #coronavirus Community resources - including civic groups, neighborhood organizations and others - can help provide psychosocial support for people living with mental health conditions during this time. We all have a role in maintaining our community's #MentalHealth.
81 STIGMA WITH COVID 19 81
82 • Fear of Falling ill and dying • Fear of losing livelihoods, not being able to work during isolation, and of being dismissed from work • Fear of being socially excluded/placed in quarantine because of being associated with the disease • Feeling powerless in protecting loved ones and fear of losing loved ones because of the virus or being separated during quarantine • Feelings of boredom, loneliness and depression due to being isolated In any epidemic, it is common for individuals to feel stressed and worried because they have: WHAT IS STIGMA?
83 The level of stigma associated with covid-19 is based on three main factors: 1. Covid-19 is a new disease about which many things are still being discovered. 2. When something is unknown people are worried which leads to fear 3. Rumours or fake news give wrong information and spreads the fear. Why is stigma associated with #COVID19?
84 Makes people hide their problems Keeps people away from accessing health services and seeking help Discourages them & may at times prevent them from adopting healthy behaviours WHAT DOES STIGMA DO?
85 As a responsible citizen, we should: • Inform that COVID 19 is a simple infection and 80% are mild cases. • Inform that Covid-19 can happen to anyone. • Comply with the LOCKDOWN and engage in relaxing activities. • Ask people to stay away from watching negative things on the TV and also fake news • Guide Whatsapp groups to help in giving hope and positive news to help people handle stress. • Use terms like people who have COVID-19 instead of “covid-19 cases” or “victims”. • Make special efforts to reach out to high risk groups including senior citizens and children. What can we do about stigma? 85
86 Work and lockdown during COVID 19 86
87 #Coronavirus Getting your workplace ready for #COVID19 Surfaces (like desks, tables) and objects (like telephones, keyboards) should be wiped with disinfectant regularly
88 #Coronavirus Getting your workplace ready for #COVID19 advise co-workers to avoid public transport and crowded places. Promote regular teleworking across your organization. Teleworking will help your business keep operating while your employees stay safe. 88
89 #Coronavirus Getting your workplace ready for #COVID19 Your employees should comply with any local restrictions on travel, movement or large gatherings. 89
90 #Coronavirus Getting your workplace ready for #COVID19 • Keep workplaces clean and hygienic • Promote regular and thorough hand washing • Promote good respiratory hygiene • Consult national travel advice before going on business travel • Advise those who are sick to stay home 90
91 COVID 19 and Pregnancy
92 All women have the right to a safe and positive childbirth experience, whether or not they have a confirmed COVID-19 infection. Respect and dignity Clear communication by maternity staff A companion of choice Pain relief strategies Mobility in labour where possible and birth position of choice
93 Before, during and after childbirth, all women have the right to high quality care. This includes: Antenatal and intrapartum Newborn Postnatal Mental health
94 I’m pregnant. How can I protect myself against COVID-19? Wash your hands frequently Put space between yourself and others Avoid touching your eyes, nose and mouth Cough or sneeze into your bent elbow or a tissue If you have fever, cough or difficulty breathing, seek care early. Call beforehand, and follow medical advice.
95 Close contact and early, exclusive breastfeeding helps a baby to thrive. A woman with COVID-19 should be supported to breastfeed safely, hold her newborn skin-to-skin, and share a room with her baby.
96 Women with COVID-19 can breastfeed if they wish to do so. They should: Practice respiratory hygiene and wear a mask Wash hands before and after touching the baby Routinely clean and disinfect surfaces
97 If a woman with COVID-19 is too unwell to breastfeed, she can be supported to safely provide her baby with breastmilk in other ways, including by: Expressing milk Relactation Donor human milk
98 MASKS, MASKS AND MASKS…..
99Image downloaded from: shorturl.at/lwBR4.
100 When to wear a Mask?
101 The use of medical masks in the community may create a false sense of security, with neglect of other essential measures, such as hand hygiene practices and physical distancing, and may lead to touching the face under the masks and under the eyes, result in unnecessary costs, and take masks away from those in health care who need them most, especially when masks are in short supply. When to use a mask Further reading: WHO Advice on the use of masks in the context of COVID-19: interim guidance, 6 April 2020 https://apps.who.int/iris/bitstream/handle/10665/331693/WHO-2019-nCov-IPC_Masks-2020.3- eng.pdf?sequence=1&isAllowed=y
102 When to use a mask However, many states and union-territories of India have made the wearing of face masks mandatory for people stepping out of their home. This has been done due to the increasing no. of asymptomatic infections, and chances of airborne transmission — in which the disease spreads in the much smaller particles from exhaled air, known as aerosols (which is still debated)- cannot be ruled out.
103
104 Rules of wearing a mask.
105
106 Myths vs. reality for COVID-19
107 Myth Facts The corona virus can be transmitted through mosquitoes. The corona virus CANNOT be transmitted through mosquito bites. Myths vs. reality for COVID-19
108 Myths vs. reality for COVID-19 Myth Facts Only people with symptoms of COVID-19 can spread the disease Even people with the COVID-19 infection but no symptoms can spread the disease.
109 Myths vs. reality for COVID-19 Myth Facts Eating garlic and drinking alcohol can prevent COVID 19 Garlic is a healthy food that has other benefits but does not protect you against the coronavirus. Eating garlic and drinking alcohol does not prevent COVID 19
110 Myths vs. reality for COVID-19 Myth Facts With the summers coming up, the coronavirus will be killed COVID-19 Has been detected in all areas, including areas with hot and humid weather. The best way to protect yourself against covid-19 is by frequently washing your hands with soap and water, covering your coughs and sneezes and avoiding crowded places.
111 Myths vs. reality for COVID-19 Myth Facts Having a bath with hot water will kill the virus The virus lives inside the body where the temperature is maintained at 37ºc and is not affected bya hot water bath that you have.
112 Myths vs. reality for COVID-19 Myth Facts Getting the pneumonia vaccine will protect you against the virus While vaccines for pneumonia will certainly protect you against other organisms that cause pneumonia, the vaccine for novel coronavirus is under development.
113 Myths vs. reality for COVID-19 Myth Facts Spraying alcohol or disinfectant over your body can prevent infection Spraying with alcohol or sanitiser on clothes and body will not prevent you from getting infection. Infection spreads when the virus enters the body through nose or mouth. Cleaning and wiping hands with alcohol is to prevent the germ from entering your system through infected hands when you touch your mouth or you eat food with infected hands.
114 Myths vs. reality for COVID-19 Myth Facts Regularly rinsing the nose with saline will prevent the infection Rinsing nose with saline has in few cases helped in containing common cold, but has no evidence to suggest it is effective against the novel coronavirus infection
115 Myths vs. reality for COVID-19 Myth Facts Coronavirus can be passed through chicken and meat There is no such evidence of coronavirus spreading through meat and poultry products. However it is always advised to have properly cooked meat and chicken.
116 Myths vs. reality for COVID-19 Myth Facts A person with coronavirus can recover fully and be no more infectious. 80% of the people have recovered from the disease without needing special treatment. But information on the virus treatment is still being researched
117 Myths vs. reality for COVID-19 Myth Facts The virus can die easily once it is out of the body We do not know about this particular virus as of now. similar viruses (SARS, MERS) survive from 8 to 24 hours depending on types of surfaces
118 For further information : Call at Ministry of Health, Govt. of India’s 24X7 control room number +91-11-2397 8046
119 THANK YOU.

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#Covid19: Information guide for general Public.

  • 1.
    1 #COVID19 HOW TO PREPAREOUR CITIZENS FOR THE PANDEMIC Dr. Madhur Verma MD Assistant Professor of Community and Family Medicine All India Institute of Medical Sciences Bathinda, Punjab. Email: drmadhurverma@gmail.com *Disclaimer: The views are of the presenter and do not represent the policy of the institution. However, data has been adapted from reputed national and international sources.
  • 2.
    2 Objectives of today’ssession 1. To know about the disease in terms of its nature, routes of transmission, signs and symptoms, diagnosis and available treatment options 2. To know methods of protecting oneself and family members and what to do in case a family member becomes infected 3. To know how to maintain a healthy lifestyle during lockdown 4. To differentiate between prevalent myths and facts
  • 3.
    3 Phases of epidemic 1.The first stage: cases of an infection are imported into a country which was not the source of the infection. 2. The second stage: when there are cases of local transmission in the country. In this stage, the trajectory of the virus can be identified from the source to all the infected individuals. 3. Third stage: Community transmission starts. It becomes hard to track the chain of transmission of the virus in a large number of cases. 4. Fourth stage of an outbreak is when an infection becomes endemic and keeps resurfacing round the year, like malaria and dengue in India.
  • 4.
  • 5.
    5 Corona virus Coronaviruses area related group of viruses that cause diseases in mammals and birds. The name "coronavirus" is derived from Latin corona, meaning "crown". The name refers to the characteristic appearance of the virus, which have a large surface projections creating an image that resembles a crown.
  • 6.
    6 IS IT ANEW VIRUS??? Coronaviruses were first discovered in the 1930s in an acute respiratory infection of domesticated chickens. Human coronaviruses were discovered in the 1960s. Past Outbreaks of coronavirus diseases • Severe acute respiratory syndrome (SARS)-2003 • Middle East respiratory syndrome (MERS)-2012. This time it’s the new strain of Coronavirus that was discovered in 2019 and has not been previously identified in humans.
  • 7.
    7 COVID-19 The name ofthe disease is Corona Virus Disease – discovered in 2019 - COVID-19. The name of the organism that causes the disease is SARS-CoV-2. • This stands for Severe (because it is serious) Acute Respiratory Syndrome- Coronavirus (the name of the family of viruses) 2.
  • 8.
    8 Is the coronavirusdisease more severe than the flu? COVID-19 causes more severe disease than seasonal influenza and is 10 times more deadly than the swine flu. While many people globally have built up immunity to seasonal flu strains, COVID-19 is a new virus to which no one has immunity. That means more people are susceptible to infection, and some will suffer severe disease.
  • 9.
    10 COVID 19 The incubationperiod of COVID 19 (time between getting the infection and showing symptoms) is 2 to 14 days. Some people with the infection, but without any serious symptoms can also spread the disease.
  • 10.
    11 How do youget infected ? The virus travels through the respiratory droplets of an infected person. When the person sneezes or coughs, the virus is deposited on the person’s hand if the hand covers the mouth, or droplets fall on a surface when the mouth/nose is not covered. From the surface/hand, the virus will get transferred to an uninfected person’s hand and when that hand comes in touch with the nostril, eyes or mouth the virus gets inside the body.
  • 11.
    12 How does COVID-19spread?  Transmission can happen in two ways: • Direct close contact: one can get the infection by being in close contact with COVID-19 patients (within one Metre of the infected person), especially if they do not cover their face when coughing or sneezing. • Indirect contact: the droplets survive on surfaces and clothes for many days. Therefore, touching any such infected surface or cloth and then touching one’s mouth, nose or eyes can transmit the disease.
  • 12.
    13 MODES OF TRANSMISSION SNEEZE/COUGH BY INFECTED PERSON INFECTED DROPLETS GET ON YOUR HAND AND WHEN TOUCH ANY SURFACE OR PERSON VIRUS TRANSFERRED!! SNEEZE/ COUGH BY INFECTED PERSON INFECTED DROPLETS INFECTED DROPLETS GET ON YOUR HAND VIRUS TRANSFERRED!! INFECTED DROPLETS 07
  • 13.
    15 Definition of aCOVID 19 Suspect Let us remember that the suspect needs to have any one of the 5 things: 1. Any kind of fever, cough or a difficulty in breathing. 2. If the person has travelled from any place which has been an outbreak area for COVID in the last 14 days. 3. If the person has been in close contact of another person who is positive for COVID 4. A person who has tested but has not got the results 5. A person who may not have the symptoms but the lab reports come as positive.
  • 14.
    16 Now, a Contactis: 1. Someone who is providing direct care to a person who is confirmed to be positive for COVID 2. Someone who has stayed together with a person who has been tested as positive for COVID 3. Someone who has travelled together for more than 6 hours in close space with a person who later becomes positive for COVID
  • 15.
    17 Contact of COVID19 The types of contacts can then be further divided into contact who are at a high risk and those who are at low risk 1. The high risk ones are those who have directly been in touch with the patient or any body fluids while taking care during home quarantine, travelled with a patient, been in the same room/house and shared utensils, etc. with the patient. 2. A low risk contact is someone who would have been in the same place but well outside the range of one meter, may have travelled in the same bus or train or flight but sat atleast 1 meter away from the person who tested positive.
  • 16.
    ADVISORY FOR CONTACTS 1.Ifsymptoms develop (fever, cough, difficulty in breathing), use mask, self-isolate and immediately inform designated health workers by telephone 1. Home quarantine for at least 28 days after the last exposure with the case. 2. Initiate self-health monitoring for development of fever or cough and maintain a list of contacts on daily basis. 3. Active monitoring (eg. Daily visits or telephone calls) for 28 days after the last exposure shall be done by designated health workers 18 Source: Ministry of Health and Family Welfare, Governemnt of India. Avaialble at: https://www.mohfw.gov.in/pdf/2COVID19PPT_25MarchPPTWithAnimation.pdf
  • 17.
    19 Clinical profile ofCOVID-19 The Symptoms Of Covid-19 Are Fever, Cough, and Difficulty in Breathing
  • 18.
    20 Signs & Symptoms: Appear2-14 days after coming in contact with a case In the initial stages: • High fever • Dry Cough • Shortness of breath With increasing severity: • Diarrhoea • Severe respiratory distress • Lack of oxygenation will cause bluish discolouration of lips In some cases with severe co-morbidities, the disease can cause: • Signs of kidney failure • Respiratory failure • Death
  • 19.
    21 Signs & Symptoms: Caution: Thesesymptoms and signs are not exclusive for COVID-19 These may be present in other respiratory illnesses also So, there is high suspicion if along with these symptoms there is : travel from an affected area contact with a known case Having a patient of COVID-19 at home History of visit to a crowded area without precaution
  • 20.
  • 21.
    23 • At presenttests are available in laboratories only • For the sake of quality, tests should be carried out in ICMR recommended labs only • Point of care tests are not available yet Diagnosis of COVID19
  • 22.
    24 COVID-19 testing -when and how? All individuals need not be tested, because Disease is primarily reported in Individuals with travel history to the affected areas or close contacts of positive cases. The guidelines for testing are being revised continuously, keeping in view the current case load, availability of the test kits and other logistics.
  • 23.
    25 WHOM TO TEST ALLsymptomatic people who • Had come in contact of confirmed cases • Have history of travel to areas with confirmed cases in last 14 days • Are healthcare workers • Are hospitalized patients with Severe Acute Respiratory Illness (SARI) or Influenza Like Illness (ILI) or severe pneumonia. Asymptomatic direct and high-risk contacts of confirmed cases should be tested once between day 5 and day 14 of coming in his/her contact. List of labs (Govt. & Private) can be accessed at: icmr.nic.in
  • 24.
    26 • At presentthere are no medicines that can cure a person of the disease • PREVENTION IS THE ONLY SOLUTION TO THIS DISEASE AT PRESENT ! • But, spontaneous recovery is the rule, as only 2-3% diseased persons have died so far • Supportive treatment helps speedy recovery • But treatment can be given in medical supervision only Treatment of COVID19
  • 25.
    28 Key messages forprevention of COVID-19
  • 26.
    29 DO DO NOT • Do nothold events where people have to gather (even if it is a corner meeting with three or four friends, or an evening chat on the chaupal) • Do not go to crowded places likemarkets, shopping, melas, and parties • Do not use publictransport PREVENTION: SOCIAL DISTANCING SOCIAL Distancing: deliberately increasing the physical space between people to avoid spreading illness. • Stay at home unlessabsolutely necessary • Keep a distance of atleast one meter between yourself and another person
  • 27.
  • 28.
    31 Practice good hygiene Washyour hands frequently using soap and water: • After coming home from outside or meeting other people especially if they are ill. • After having touched your face, coughing or sneezing. • Before preparing food, eating or feeding children. • Before and after using toilet, cleaning etc.
  • 29.
  • 30.
    33 Coughing and sneezingetiquettes While coughing or sneezing cover your nose and mouth with handkerchief.  Wash the handkerchief at least daily It is preferable to cough/sneeze into your bent elbow rather than your palms. Never use the saree pallu or gamcha for sneezing into as you may use these for wiping your hands and the germs will get transferred from your hand to your nose, mouth or eyes. Practice good respiratory hygiene
  • 31.
    34 Do not Spitor shout in public places to avoid the spread of droplets. Do not touch your eyes, nose and mouth with unclean hands. Ensure that the surfaces and objects are regularly cleaned. Practice good hygiene
  • 32.
    35 Practice food safety Usedifferent chopping boards and knives for raw meat and cooked foods Wash your hands between handling raw and cooked food
  • 33.
    36 Practice food safety Sickanimals and animals that have died of diseases should not be eaten
  • 34.
    37 Practice food safety Evenin areas experiencing outbreaks, meat products can be safely consumed if these items are cooked thoroughly and properly handled during food preparation
  • 35.
  • 36.
    39 PREVENTION: HIGH RISKGROUPS High risk groups are people who are at a higher risk from severe illness if they get covid-19. They includes: PREGNANT WOMEN (As we do not know the impact of the disease on pregnancy as of yet, it is better to take care) OLDER ADULTS PEOPLE WHO HAVE UNDERLYING MEDICAL CONDITIONS LIKE: ▪On Cancer Medication ▪Heart Disease ▪Diabetes ▪Lung Disease ▪Kidney Disease
  • 37.
    40 Be SAFE from#coronavirus if you are 60+ or if you have an underlying condition like: Cardiovascular disease Respiratory condition Diabetes Avoid crowded areas or places where you might interact with people who are sick.
  • 38.
    41 #Coronavirus #COVID19 Other adultsand people with underlying conditions Keep regular routines and schedules as much as possible or help create new ones in a new environment, including regular exercising, cleaning, daily chores, singing, painting or other activities.
  • 39.
    42 #Coronavirus #COVID19 People withunderlying conditions If you have an underlying health conditions, make sure to have access to any medications that you are currently using. Activate your social contacts to provide you with assistance, if needed.
  • 40.
    43 #Coronavirus #COVID19 Other adultsand people with underlying conditions Make sure you have up to 2 weeks of all your regular medicines that you may require.
  • 41.
    44 #Coronavirus #COVID19 Other adultsand people with underlying conditions Be prepared and know in advance where and how to get practical help if needed, like calling a taxi, having food delivered and requesting medical care.
  • 42.
    45 Obligations of aresponsible citizen of India during Lockdown
  • 43.
    46 #MentalHealth #COVID19 #coronavirus BeINFORMED Be PREPARED Be SMART Be SAFE Be READY to fight #COVID19
  • 44.
    47 #MentalHealth #COVID19 #coronavirus Choosea limited time each day when you will check #COVID19 updates. Constantly listening to media coverage about #coronavirus can make you more anxious and upset.
  • 45.
    48 #MentalHealth #COVID19 #coronavirus Seekinformation only from trusted sources and mainly to take practical steps to prepare your plans and protect yourself and loved ones.
  • 46.
    49 #MentalHealth #COVID19 #coronavirus COVID-19has and is likely to affect people from many countries. Do not attach it to any ethnicity or nationality. Be empathetic to all those who are affected, in and from any country – they deserve our support, compassion and kindness.
  • 47.
    50 #MentalHealth #COVID19 #coronavirus Honorcaretakers 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.
  • 48.
  • 49.
    52 Avoid travel ifyou have a fever and cough If you have a fever, cough and difficulty breathing seek medical care early and share previous travel history with your health care provider
  • 50.
    53 Insert local logo Avoidclose contact with people suffering from a fever and cough Frequently clean hands by using alcohol-based hand rub or soap and water Avoid touching eyes, nose or mouth Insert local logo Avoid close contact with people suffering from a fever and cough Frequently clean hands by using alcohol-based hand rub or soap and water Avoid touching eyes, nose or mouth
  • 51.
    54 Insert local logo Whencoughing or sneezing cover mouth and nose with flexed elbow or tissue - throw tissue away immediately and wash hands If you choose to wear a mask, be sure to cover mouth and nose – avoid touching mask once it’s on Immediately discard single-use mask after each use and wash hands after removing masks
  • 52.
    55 Insert local logo Ifyou become sick while travelling, inform crew and seek medical care early If you seek medical attention, share travel history with your health care provider
  • 53.
    56 Insert local logo Eatonly well- cooked food Avoid spitting in public Avoid close contact and travel with animals that are sick
  • 54.
  • 55.
  • 56.
  • 57.
  • 58.
  • 59.
    62 Suggestions for aHealthy Lock-Down!!!
  • 60.
    63 Stay healthy duringlock down!!! Online exercise classes #BeActive #HealthyAtHome Dancing Playing active Video games Jumping rope Muscle strength and balance training
  • 61.
    64 Be active athome during #COVID19 outbreak Looking after yourself, your family and friends is important through these stressful times. WHO encourages everyone at home to do simple and fun physical activities to stay healthy and active. #BeActive #HealthyAtHome
  • 62.
    65 Be active athome during #COVID19 outbreak Doing any activity around the home is better than none at all. Be active during #COVID19 outbreak to maintain your heart health, muscle strength and flexibility. It is good for your mental health too! #BeActive #HealthyAtHome
  • 63.
    66 #COVID19 March 2020 minutes moderate intensity weekly minutes vigorous intensity weekly Make moremoments active This guidance is intended for non-symptomatic people. It does not replace any medical guidance in case of any health condition. Continue indoor exercise routine Perform household chores Read, draw, play music Meditate and do something relaxing Tips to stay active at home during #COVID19 outbreak
  • 64.
    67 Tips to stayactive at home during #COVID19 outbreak Regularly check your sitting posture while working from home #BeActive #HealthyAtHome Break up your sitting and stand up while working, on the phone, or watching TV WOKING FROM HOME IS CHALLENGING, I NEED TO REGULARLY STAND UP AND STRETCH…
  • 65.
    68 #COVID19 March 2020 BOOST YOUR IMMUNESYSTEM Good nutrition and healthy diet are essential to maintain optimal health, boost your immune system and prevent communicable and non-communicable diseases Eat a variety of foods Eat plenty of vegetables and fruit Eat less salt and sugars Eat moderate amounts of fats and oils
  • 66.
    69 SAY NO TOTOBACCO IN THE TIME OF COVID-19... AND ALWAYS! Increased risk of serious illness due to unhealthy lungs Higher chance of transmission from hand to mouth Smoking makes you more vulnerable to COVID-19. So, stop smoking and give your lungs a chance! #COVID19 March 2020
  • 67.
  • 68.
    71 #MentalHealth #COVID19 #coronavirus Itis normal to feel fearful and anxious during this time. Talking about your feelings will lessen your distress.
  • 69.
    72 #COVID19 #coronavirus The stressand adversity during this time can increase the risk for depression. If you are feeling sad, hopeless and having thoughts of harming yourself, talk to a mental health professional or someone you trust about your feelings. It will help. #MentalHealth
  • 70.
    73 #MentalHealth #coronavirus If someoneyou know is feeling hopeless and having thoughts of harming themselves because of #COVID19 - talk to them. Talking about suicide will not increase the risk and can help people in crisis process their feelings and relieve the stress.
  • 71.
    74 #COVID19 #coronavirus Quarantine canlead to loneliness – especially for older people or people who live alone. Loneliness can contribute to poor physical and mental wellbeing. Connect with other people, through social media, telephone, and online communities, and maintain #MentalHealth.
  • 72.
    75 #mentalhealth #coronavirus #COVID19 canbe difficult for children to understand. Talk kindly to them using words they can understand and encourage them to practice healthy habits through activities such as songs and dances. This will help them feel more secure.
  • 73.
    76 #mentalhealth #coronavirus Older peoplemay find it difficult to stay connected during a #COVID19 quarantine. Loved ones should connect with them regularly through telephone, messaging apps, and social media to help them feel safe and secure.
  • 74.
    77 #mentalhealth #coronavirus Care providersfor older adults Share simple facts about what is going on and how to reduce risk of infection. Use words that older people with or without cognitive impairment can understand.
  • 75.
    78 #COVID19 Amplify hopeful storiesand positive images of local people who have experienced COVID-19. For example, stories of people who have recovered or who have supported a loved one and are willing to share their experiences. 78
  • 76.
    79 #mentalhealth #coronavirus Protect yourselfand be supportive to others. For example, check-in by phone on neighbours or elder people in your community who may need extra assistance. Working together as one community an help to create solidarity in addressing COVID-19 together.
  • 77.
    80 #COVID19 #coronavirus Community resources- including civic groups, neighborhood organizations and others - can help provide psychosocial support for people living with mental health conditions during this time. We all have a role in maintaining our community's #MentalHealth.
  • 78.
  • 79.
    82 • Fear ofFalling ill and dying • Fear of losing livelihoods, not being able to work during isolation, and of being dismissed from work • Fear of being socially excluded/placed in quarantine because of being associated with the disease • Feeling powerless in protecting loved ones and fear of losing loved ones because of the virus or being separated during quarantine • Feelings of boredom, loneliness and depression due to being isolated In any epidemic, it is common for individuals to feel stressed and worried because they have: WHAT IS STIGMA?
  • 80.
    83 The level ofstigma associated with covid-19 is based on three main factors: 1. Covid-19 is a new disease about which many things are still being discovered. 2. When something is unknown people are worried which leads to fear 3. Rumours or fake news give wrong information and spreads the fear. Why is stigma associated with #COVID19?
  • 81.
    84 Makes people hide theirproblems Keeps people away from accessing health services and seeking help Discourages them & may at times prevent them from adopting healthy behaviours WHAT DOES STIGMA DO?
  • 82.
    85 As a responsiblecitizen, we should: • Inform that COVID 19 is a simple infection and 80% are mild cases. • Inform that Covid-19 can happen to anyone. • Comply with the LOCKDOWN and engage in relaxing activities. • Ask people to stay away from watching negative things on the TV and also fake news • Guide Whatsapp groups to help in giving hope and positive news to help people handle stress. • Use terms like people who have COVID-19 instead of “covid-19 cases” or “victims”. • Make special efforts to reach out to high risk groups including senior citizens and children. What can we do about stigma? 85
  • 83.
    86 Work and lockdownduring COVID 19 86
  • 84.
    87 #Coronavirus Getting your workplace readyfor #COVID19 Surfaces (like desks, tables) and objects (like telephones, keyboards) should be wiped with disinfectant regularly
  • 85.
    88 #Coronavirus Getting yourworkplace ready for #COVID19 advise co-workers to avoid public transport and crowded places. Promote regular teleworking across your organization. Teleworking will help your business keep operating while your employees stay safe. 88
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    89 #Coronavirus Getting your workplace readyfor #COVID19 Your employees should comply with any local restrictions on travel, movement or large gatherings. 89
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    90 #Coronavirus Getting your workplace readyfor #COVID19 • Keep workplaces clean and hygienic • Promote regular and thorough hand washing • Promote good respiratory hygiene • Consult national travel advice before going on business travel • Advise those who are sick to stay home 90
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    91 COVID 19 andPregnancy
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    92 All women havethe right to a safe and positive childbirth experience, whether or not they have a confirmed COVID-19 infection. Respect and dignity Clear communication by maternity staff A companion of choice Pain relief strategies Mobility in labour where possible and birth position of choice
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    93 Before, during andafter childbirth, all women have the right to high quality care. This includes: Antenatal and intrapartum Newborn Postnatal Mental health
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    94 I’m pregnant. How canI protect myself against COVID-19? Wash your hands frequently Put space between yourself and others Avoid touching your eyes, nose and mouth Cough or sneeze into your bent elbow or a tissue If you have fever, cough or difficulty breathing, seek care early. Call beforehand, and follow medical advice.
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    95 Close contact andearly, exclusive breastfeeding helps a baby to thrive. A woman with COVID-19 should be supported to breastfeed safely, hold her newborn skin-to-skin, and share a room with her baby.
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    96 Women with COVID-19 canbreastfeed if they wish to do so. They should: Practice respiratory hygiene and wear a mask Wash hands before and after touching the baby Routinely clean and disinfect surfaces
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    97 If a womanwith COVID-19 is too unwell to breastfeed, she can be supported to safely provide her baby with breastmilk in other ways, including by: Expressing milk Relactation Donor human milk
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    99Image downloaded from:shorturl.at/lwBR4.
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    101 The use ofmedical masks in the community may create a false sense of security, with neglect of other essential measures, such as hand hygiene practices and physical distancing, and may lead to touching the face under the masks and under the eyes, result in unnecessary costs, and take masks away from those in health care who need them most, especially when masks are in short supply. When to use a mask Further reading: WHO Advice on the use of masks in the context of COVID-19: interim guidance, 6 April 2020 https://apps.who.int/iris/bitstream/handle/10665/331693/WHO-2019-nCov-IPC_Masks-2020.3- eng.pdf?sequence=1&isAllowed=y
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    102 When to usea mask However, many states and union-territories of India have made the wearing of face masks mandatory for people stepping out of their home. This has been done due to the increasing no. of asymptomatic infections, and chances of airborne transmission — in which the disease spreads in the much smaller particles from exhaled air, known as aerosols (which is still debated)- cannot be ruled out.
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    107 Myth Facts The coronavirus can be transmitted through mosquitoes. The corona virus CANNOT be transmitted through mosquito bites. Myths vs. reality for COVID-19
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    108 Myths vs. realityfor COVID-19 Myth Facts Only people with symptoms of COVID-19 can spread the disease Even people with the COVID-19 infection but no symptoms can spread the disease.
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    109 Myths vs. realityfor COVID-19 Myth Facts Eating garlic and drinking alcohol can prevent COVID 19 Garlic is a healthy food that has other benefits but does not protect you against the coronavirus. Eating garlic and drinking alcohol does not prevent COVID 19
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    110 Myths vs. realityfor COVID-19 Myth Facts With the summers coming up, the coronavirus will be killed COVID-19 Has been detected in all areas, including areas with hot and humid weather. The best way to protect yourself against covid-19 is by frequently washing your hands with soap and water, covering your coughs and sneezes and avoiding crowded places.
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    111 Myths vs. realityfor COVID-19 Myth Facts Having a bath with hot water will kill the virus The virus lives inside the body where the temperature is maintained at 37ºc and is not affected bya hot water bath that you have.
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    112 Myths vs. realityfor COVID-19 Myth Facts Getting the pneumonia vaccine will protect you against the virus While vaccines for pneumonia will certainly protect you against other organisms that cause pneumonia, the vaccine for novel coronavirus is under development.
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    113 Myths vs. realityfor COVID-19 Myth Facts Spraying alcohol or disinfectant over your body can prevent infection Spraying with alcohol or sanitiser on clothes and body will not prevent you from getting infection. Infection spreads when the virus enters the body through nose or mouth. Cleaning and wiping hands with alcohol is to prevent the germ from entering your system through infected hands when you touch your mouth or you eat food with infected hands.
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    114 Myths vs. realityfor COVID-19 Myth Facts Regularly rinsing the nose with saline will prevent the infection Rinsing nose with saline has in few cases helped in containing common cold, but has no evidence to suggest it is effective against the novel coronavirus infection
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    115 Myths vs. realityfor COVID-19 Myth Facts Coronavirus can be passed through chicken and meat There is no such evidence of coronavirus spreading through meat and poultry products. However it is always advised to have properly cooked meat and chicken.
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    116 Myths vs. realityfor COVID-19 Myth Facts A person with coronavirus can recover fully and be no more infectious. 80% of the people have recovered from the disease without needing special treatment. But information on the virus treatment is still being researched
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    117 Myths vs. realityfor COVID-19 Myth Facts The virus can die easily once it is out of the body We do not know about this particular virus as of now. similar viruses (SARS, MERS) survive from 8 to 24 hours depending on types of surfaces
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    118 For further information: Call at Ministry of Health, Govt. of India’s 24X7 control room number +91-11-2397 8046
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