COVID-19: lessons from a physician who survived swine flu
Tuesday, March 10, 2020

Coronaviruses were first identified in the 1960s. The name corona comes from Latin, and it means crown.

These viruses have a crown-like appearance on their surface, thus the name coronaviruses. Coronaviruses are zoonotic viruses.

They spread from animals to humans. Animal vectors have included bats, cats, and camels. Seven types of coronaviruses that infect humans have been identified to-date: The Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV, from 2003 in Southern China), the Middle East Respiratory Syndrome Coronavirus (MERS-CoV, from 2012 in Jordan and Saudi Arabia), that we heard a lot about; and the 229, NL63, HKUT, and OC43 that were documented in the literature but did not make the headlines like SARS and MERS.

The seventh type is the newly identified 2019-nCoV. 2019 stands for the year the virus was discovered, n for novel and CoV for coronavirus (this is how pathologists identify microorganisms).

2019-nCoV was first identified in Wuhan, China. The name has been updated to COVID-2019 referring to Corona Virus Disease 2019.

Many things are unknown about COVID-19. From the data that is currently available, as of February 28, the virus has been identified in all five continents.

The Center for Disease Control (CDC) USA has declared COVID-2019 as a pandemic (an epidemic that spreads across several regions of the world and affects many people). We wake up to increasing numbers every day.

If interested, keep an eye on the CDC and World Health Organization websites. It appears that COVID-19 spreads through respiratory droplets. When an infected person coughs or sneezes, the droplets get in the air, and another person in close contact can breathe them in. The droplets can also land on objects, and if a person touches these objects and daubs their face, they can contract the virus.

It has been estimated that the incubation period (the time the virus takes to develop in the human body and show symptoms) is about two weeks.

Clinical manifestations vary from simple colds to severe infections. Early symptoms are fever, cough, a runny nose, nasal congestion, myalgia (muscle pain), and fatigue—typical symptoms of the common cold.

Nausea, vomiting, or diarrhea have been documented, as well. Severe symptoms include shortness of breath, difficulty in breathing, worsening cough, and persistent fever.

These are signs of pneumonia, which appear to be the most frequent manifestation in patients infected with the COVID-19.

It has been reported that many of the infections are not severe. However, about 20 per cent of confirmed patients had a severe illness and required intensive care.

Coronaviruses are diagnosed by RT- PCR (reverse-transcriptase polymerase chain reaction) test and the immunofluorescence antigen detection assay with samples collected from the nose, mouth, and the throat.

Currently, there is no effective treatment or vaccine. Establishing the diagnosis is of limited utility in suspected patients in clinical settings.

However, confirming the diagnosis is critical to understand the behavior of COVID-19. We need to study the epidemiology of this virus to limit or control its transmission and develop medicines and vaccines.

Patients infected with the virus should receive appropriate care to relieve and treat their symptoms.

Antibiotics won't help; this is not a bacterial infection. Everyone is susceptible to COVID-19, children, adults, and older people.

However, some people are at higher risk, such as people taking care of infected persons––therefore, it spreads among family members. The other groups at high risk are caregivers or healthcare workers.

Veterinarians are also at high risk. Infants, young children, pregnant women, older people, and people with pre-existing medical conditions such as asthma, diabetes, autoimmune diseases, and cancer are more susceptible. They are at high risk of becoming severely ill.

Proper handwashing with soap and water is the preventive measure. Cough or sneeze into a tissue or your elbow (see the picture attached). Wash hands after sneezing, so that you do not pass the cold around.

I know we greet each other by shaking hands, so let us wash our hands frequently. If you present any of the severe cold symptoms or feel very sick, seek healthcare. If you are at home, wash your hands and wear a mask so that you do not infect anyone else.

Feel free to ask your doctor where you can buy masks and how to wear them properly.

This is also a reminder not to eat untested meat or meat from a sick or dead animal.   

In 2009 I was infected and diagnosed with the Swine flu or H1N1 influenza while on duty.

I spent seven days in quarantine. It was not a pleasant experience. To my colleagues, doctors, and nurses, please protect yourselves always, especially if you work in an emergency room. Always remember to ask all your patients about their history of recent travel.

WATCH THE NEWS to know how this pandemic is evolving; epidemiology is in the news! Carefully observe the parents of your pediatric patients too.

Sometimes they are way sicker than their children.

To those who travel outside of the country, please abide by the airport's screening rules and allow healthcare providers to test you.

It is for your good and the good of people you live with, and of the people, you will be in contact within the following days.

Be kind and answer our questions about your travel history. We need to make a proper diagnosis and treat you accordingly.

I know some establishments may not have appropriate washing stations; employers need to step in to fix this. Kandagira ukarabe is a useful handwashing technique, by the way.

 I hope that we can revisit the lessons we learned during the 2009 Swine flu epidemic to inform decision making in this round of the coronavirus epidemic.

There is no need to panic, let us WASH OUR HANDS and be prepared.

The author is a medical doctor