Severe acute respiratory virus-2 (SARS-CoV2) is responsible for the severely contagious disease called coronavirus disease-2019 (COVID-19). This novel virus was first detected in Wuhan province of China in December 2019. The exact origin of the virus is attributed to Huanan “wet” market that sells live animals.
The virus is a zoonotic disease, and the Chinese horseshoe bats as the initial hosts before it transmitted to humans. Since its identification in December 2019, the disease has already spread to 185 countries around the world including Nigeria and other sub-Saharan countries. It is estimated that 2.3 million people have confirmed Coronavirus and about 153,379 people have died from this disease as of April 17th, 2020. Nigeria has about 493 confirmed cases and 17 deaths. The hardest-hit countries are currently all in the western world with the top five countries being, United States (leading) followed by Spain, Italy, France and Germany. It was declared a pandemic disease by the World Health Organization (WHO) in February of 2020.
While there have been prior severe respiratory viral illness outbreaks like SARS (severe acute respiratory syndrome) in 2003 and MERS-Cov (middle east respiratory syndrome) in 2012, coronavirus is by far the most contagious disease and has resulted in significant amounts of infected persons and death from the disease. Similar to the other respiratory virus that can cause “catarrh” or the common cold, this virus spreads from infected person to healthy person via expelled droplets in the air. The expelled droplets come about when a person coughs or sneezes.
These viral droplets can travel up to 1.8 meters (six feet). Another major form of transmission is fomite transmission and can occur when a healthy person touches a surface already touched by an infected person and then touches their nose, mouth or eyes. Interesting enough, this virus can survive on surfaces for a long time. It can survive on cardboard for 24 hours and on plastic and stainless steel for 72 hours. Recently, the medical community has discovered that asymptomatic infected people can still spread this virus just through normal breathing.
The most common symptom is fever in about 90% of infected persons followed by cough, tiredness (myalgias) and shortness of breath. Other additional symptoms include not being able to smell or taste the food. 81% of infected persons will have mild symptoms and not require hospitalization. Moreover, their symptoms would improve with normal cold remedies. About 19 % of infected persons will become severely ill and require hospitalization and out of that 19% person, 5% will be critically ill and require intensive care.
Older age and underlying medical conditions like hypertension, diabetes and heart disease are the biggest risk factors for death. The risk of dying from the disease was <1% in infected persons less than 50 years of age and then jumps to 8% in 70-79 years and 14% in 80 years or greater. Unfortunately this is a disease that kills the elderly at a very high rate and most especially if they already have underlying medical conditions. This is not to say, it does not affect young people, about 5% of severely ill persons are less than 20 years of age and some have died from the disease.
The most common cause of death is respiratory failure (inability to breathe). Cardiac complications due to weakened heart function (heart failure) and dangerous heart rhythms can occur and lead to death. Management of these severely ill persons is very resource-intensive. They need ventilators to assist with breathing until the lungs have recovered. The impact of a similar epidemic currently going on in Europe and the United States would be extremely devastating and catastrophic in West African countries given lack of properly functioning health infrastructure.
Prevention and disease containment are the best ways to currently address the coronavirus pandemic, given that there is no vaccine or research-proven curative therapy. These measures include:
- Frequent handwashing and social distancing if possible.
- Wearing facemask and it does not have to be a medical-grade mask, covering the face with cloth or scarf may suffice if in close-quarter areas(less than 1.8 meters from the nearest persons).
- If possible, limiting going outside or being in overcrowded areas.
- If you have symptoms, cover your mouth when you cough or sneeze and stay home to avoid spreading the infection to other healthy persons.
- Increased community testing and contact tracing are ideal but may not be feasible in poorer health systems.
In addition to these physical measures to reduce the spread of coronavirus, it is also important to practice self-wellness. Remember physical distancing does not mean social isolation, connect with loved ones via phone calls and text messages. Maintain healthy spiritual health and focus on positive thoughts. In conclusion, the novel coronavirus has progressed rapidly to a world pandemic within a short amount of time. There are still a lot of unknowns about this virus, and the long-term risk associated with it. There are still active ongoing research efforts to learn more and hopefully contain/completely eradicate the outbreak. Until that happens, preventive measures remain the focal means to mitigate the health risk.
· John Hopkins arcgis.com
· Africa CDC COVID-19 updates
Ifeoma Onuorah Ezenekwe is an Assistant Professor with the Division of Cardiology at Emory University School of Medicine Atlanta Georgia since 2017. Prior to joining Emory University, she worked as an attending cardiologist at the WJB Dorn VA, Columbia South Carolina where she also held the title of Clinical Assistant professor with the University of South Carolina Medical school. Dr Onuorah Ezenekwe obtained her Bachelor's of Science in nursing from the University of Texas Medical Branch Galveston graduating with high honors. She completed her medical school training at the University of Texas, San Antonio and was inducted into Alpha Omega Alpha honor society (AOA) at graduation. She completed her Internal Medicine residency training at the prestigious John Hopkins’s Osler training program in Baltimore Maryland and General Cardiology Fellowship at Thomas Jefferson University Hospital, Philadelphia Pennsylvania.