SARS CoV2 and COVID19
Coronavirus disease 2019 (COVID-19) is a disease caused by severe acute respiratory syndrome coronavirus 2 (SARS CoV-2). SARS CoV-2 is in the same genus as SARS-CoV and MERS-CoV, all 3 being coronavirus responsible for the current and, in the case of SARS-CoV and MERS-CoV, previous outbreaks.
COVID19 first appeared in Wuhan China, presenting as a severe respiratory infection. Due to its high transmissibility and the inter-connectedness of our current world, it quickly spread across the globe, affecting 192 countries at the time of this writing. In a totally susceptible population, 1 case of COVID-19 may spread to 2-3 other person. The mode of spread is mainly by respiratory droplets, and less so through contact surfaces. Global reported cases have exceeded 100 million and deaths exceeded 2 million. WHO has declared COVID a global pandemic in March 2020. In view of its mode of spread, clusters have arisen more easily in settings of close contact and through activities related to forced respiratory exhalations. (for example, singing, shouting, cheering)
The average incubation period is about 5-7 days. After the incubation period, a few clinical presentations are possible. In many patients, fever, cough, sputum production, sore throat and loss of smell anosmia follow the incubation period and those symptoms improve over 5-7 days. In the most severe group, initial symptoms described above is followed by increasing shortness of breath and rapid respiratory failure requiring hospitalized care. In some other patients, a completely asymptomatic course ensues and the patient is unaware of infection.
The 3 commonly available diagnostic tests that are commercially available for COVID-19 area as follows namely COVID-19 PCR, COVID antigen testing and COVID-19 serology. The COVID-19 PCR extracts respiratory secretions and tests them for the presence of genetic material of the SARS CoV-2 virus. COVID antigen test extracts respiratory secretions and detects parts of the COVID virus. It is slightly less accurate than the PCR test but gains the advantage of a faster time to getting results and is easier to perform than the PCR test. The COVID-19 serology test for the presence of antibodies against SARS CoV-2 in the patient’s blood. The results of both tests must be interpreted carefully by qualified medical professionals.
For the majority of COVID-19 patients, no specific antiviral treatment is required as they are either asymptomatic or mildly symptomatic. Patients presenting with life threatening disease would require expert medical care. Therapeutic options like remdesivir (anti-viral), steroids and monoclonal antibodies have been used in appropriate settings and are largely reserved for the most severe patients.
Basic infection control measures like social distancing and mask wearing are effective methods of containing the outbreak and effective prevention for the individual. Contact tracing seeks to limit secondary spread and has proven successful in many settings. New highly effective vaccines are now available and encouraged in many countries, but face substantial logistic challenges in global administration.