Protect yourself against the new coronavirus

Coronavirus.
Source Wit et al., 2016.
This outbreak started at the end of December 2019 in Vuhan City, China. The virus quickly analyzed, and was found to be different from any previously known human viruses. It was identified as a coronavirus, and named 2019-nCoV (novel coronavirus). The new strain is closely related to the viruses that cause common cold, SARS or MERS. The most common typical symptoms are fever, cough and breathing difficulties [1].

There is quite limited information about the new strain, but it is quite well documented what we should do to generally avoid respiratory virus infections. World Health Organization (WHO) published advices for the public on how to reduce the risk of coronavirus infection [2]:
  • Clean your hands frequently;
  • Proper cough and sneeze hygiene;
  • Social distancing (avoid contacting other people when you are sick, or at risk of acquiring the virus);
  • If you have symptoms, seek medical care early;
  • In coronavirus-infected areas, avoid contacts with farm and wild animals;
  • Avoid the consumption of raw or undercooked meat, milk or eggs.

Let us elaborate on the above-mentioned protective measurements, in an order of importance:

Hand hygiene
Hands can be cleaned by soap under running water via hand washing or by applying alcohol-based hand rubs. Both are effective against the virus. If your hands are visibly soiled, especially with mucus, apply soap and water. Keep in mind, that hand cleaning can only be effective, if the whole hand surface is covered with handrub or with soap. If any part of the hand missed, the virus can survive there. Based on previous studies, the most frequently missed areas are thumbs, fingertips and the back of the hands [3, 4]. The WHO have a 6-step protocol, how to clean your hands.



Proper caught and sneeze hygiene
When you caught or sneeze, cover your mouth and nose with a tissue. Throw the tissue immediately and wash your hands thereafter. If you do not have a tissue at hand, cover your face with your elbow. These measures can prevent droplets releasing to the air. If you have symptoms, it is a good idea to wear a face mask [5].
If you are not sick, you can also wear a face mask. This can filter the air, and remove droplets. It is really important that face mask should cover both mouth and nose. Once you put it on, do not touch it, as the filtered droplets accumulate on it, neither touch your face underneath. Wash your hands after you remove the face mask, and do not use it multiple times [6].

Social distancing
In case of an outbreak, try to avoid contacting other people, especially people with symptoms. The virus can transmit form human to human. Reducing the number of contacts, the risk of contamination also decreases. That is why Hong Kong schools will remain closed until February, the reason why Shanghai’s Disneyland was closed, or the Beijing’s lunar new year festival events were cancelled [7, 8]. Unfortunately, it is not really possible to avoid all contacts, especially in large cities, like Wuhan.
Wuhan City. Source: Pixabay


Avoid animals
In the last decades, it happened twice that a previously unknown coronavirus caused pandemic. In 2002, the SARS-CoV (severe acute respiratory syndrome) virus appeared. Over a year, more than 8000 people were infected with SARS in 27 countries, and almost 800 of them died. The pandemic was ended in 2003, due to the efficiently coordinated international measures. The source of the virus was probably a live-animal market in China. 10 years later, in 2012, a novel coronavirus, MERS-CoV (Middle East respiratory syndrome) emerged in Saudi Arabia. By 2016, the MERS virus infected 1700 people in 27 countries, and 624 (37%) of them died.
In both cases, the virus was originated from bats. Baths are the reservoir a wide range of coronaviruses. The virus can transfer from bats to other animals, and finally to humans [9]. 
The emergence of SARS-CoV and MERS-CoV. Sorce: Wit et al., 2016.

Epidemic happens, when the virus mutated and becomes able to humantohuman transmission. Probably, the same thing happened in case of the 2019-nCoV. A new paper published in the Lancet in 2020 compared the genetic code of the new virus to other coronaviruses [10].

Phylogenetic trees of coronaviruses. Source: Chan et al. 2020

The phylogenetic tree, or cladogram on the picture is like a family tree for viruses. The closest they are the most likely they are relatives. As it seen from the figures, the closest relatives of the new virus are also bat coronaviruses [11]. We have limited information, how the virus gets transmitted to humans. The Wuhan live animal market probably was a center of the outbreak, where wild, exotic and farmed animals were held together [12]

In a study published in the Lancet, more than 200 healthcare workers caring patient with SARS were investigated. They were asked about the use of mask, gloves, gowns and hand washing. Only 69 of them reported that they used all the 4 measures, and thus none of them became infected. 13 healthcare workers become infected with SARS, all of them omitted at least one protective measures [13]. As this study demonstrated, if you apply the appropriate protective measurements correctly, there is a great chance to avoid getting infected.

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