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Coronavirus- our duties to prevent and halt the outbreak

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Dr. Talat Nasim

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28th-Mar-2020       
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What is the coronavirus disease?
 The coronavirus disease is an infected disease caused by a new virus called coronavirus. This virus belongs to the coronaviridae family. Other members of this family are severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV).
Symptoms of coronavirus disease:
The virus can cause minor illnesses in majority of people. However, older people with various conditions including, diabetes, cancer, high blood pressure, kidney disease, the viral attack can be fatal. Increased rate of infection of the virus has been observed in those over the age of 60 and the highest mortality rate for those above 70.Patients infected with the virus can develop symptoms including a fever (37.8 degrees Celsius), persistent cough, persistent sneezing, runny nose, sore throat and shortness of breath. In addition, patients may have pneumonia and acute respiratory distress syndrome.
Why are older patients more affected?
In older people, the immune system is weak, so the incidence of the virus infection is higher. Moreover, older people suffer from complex diseases including diabetes, cancer, high blood pressure and kidney disease which weaken their immune system.Some experts think that ACE inhibitor drugs ('pril' drugs) and angiotensin receptor blockers ('sartan' drugs) can increase the transmission of the virus,
but it is not yet well-proven. Many of the elderly patients, especially those with heart failure, take these drugs.
Which patients are more likely to get infected by the virus?
Patients described below are more likely to be infected with the virus:
1.  Those who have organ transplants
2. People who suffer from various types of cancer
3. Patients with cancer who receive chemo therapy and lung cancer patients who receive radical radiotherapy
4. Blood, bone marrow cancers such as leukaemia, lymphoma or myeloma patients who are seeking treatment for cancer
5. Cancer patients who are receiving immunotherapy and antibody treatments
6. Cancer patients who are taking medications such as protein kinase inhibitors or PARP inhibitors that can affect the immune system
7. Patients wherebone marrow or stem cells have been transplanted in the last six months or are still taking immunosuppression drugs
8. People suffering from various respiratory conditions such as cystic fibrosis, asthma and chronic obstructive pulmonary disease(COPD)
9. People with rare hereditary diseases that increase their chances of transmission of the virus (such as homozygous sickle cell disease)
10. People who are taking immunosuppression therapy that increase the likelihood of their virus infection
11. Pregnant mothers and those who have heart disease
How does this virus spread?
The virus spreads from one body to another through cough, sneezing, talking and touching of the infected person.
What should be done to prevent the virus?
Since the virus spreads through humans, we have to take measures to protect ourselves as well as others.
1. Wash your hands with soap for 20 seconds and keep yourself clean
2. Do not touch the face, eyes, ears and nose with hands
3. Do not go to public places where 2 or more people meet
4. Stay away from the infected and/or sick people
5. Stay in a room with good air circulation
6. If possible, arrange separate toilets for older people. If this is not possible, ensure that the elderly use the toilet first
7. Arrange separate towels, glasses and cups for older people for their own use and do not share them with other family members
8. Do not invite guests for 2-3 months
9. Older people shouldstay at home for the next 2-3 months
10. Eat normal foods, exercise moderately, and drink plenty of water
11. Protect older people (parents, grandparents). If possible, deliver foods to their room in such that they can stay inside the room. This is to minimise viral contamination.  Pay special attention not to infect them.
12. Stay away from those above 70 andfrom the patients described above as they can be infected by you.
13. Be happy.
Treatments
Anti-viral drugs and vaccines have not yet been discovered. However,a drug called favipiravirhas been tested in a small number of viral infected patients, whichshowed good results. In addition, hydroxychloroquine and azithromycin have also elicited beneficial effects. Neuraminidase inhibitors and arbidol have also been tested and showed good results. However, it is important to remember that these medications have been tested in a small number of patients and they have not been approved for the treatment of coronavirus yet.
It has been recommended to take the medication that patients are currently taking for various diseases including diabetes, cancer, high blood pressure and kidney disease. If they get sick for some reason, during this time, they should seek advice from a doctor.
Some believe that ibuprofen and other non-steroidal anti-inflammatory medications (NSAIDs) promote the infection of the virus, which has not been well-proven. In this case, you may wish to take paracetamol instead of ibuprofen, provided that this has been advised by a doctor.
It is important to note that our knowledge of coronavirus research is limited. Scientists from various countries have been working hard, aiming to understand the underlying mechanisms of viral infection for better diagnosis, in order to develop vaccines and treatments. Therefore, it is essential that people refrain from using any kind of medicine without the doctor's advice.
Author. Dr. Talat Nasim is a Bangladeshi born British scientist and university teacher. His research interests focus on the area of translational medicine.

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