As I write this the world is in the grip of a global pandemic which we thought it was ready for, but fresh cases of transmission are popping up all over the world. The first human to human transmissions have occurred within Australia. For the individual, there is no need to panic, but there is good reason to be informed and prepared.
This article tries to cover the disease with some depth and details. I try and explain the facts behind the facts and figures and what they might mean for you.
What's up with the name?
When the coronavirus first appeared it didn't have a name, instead it was called the new or novel corona virus, with corona viruses being a family of viruses that are distinguished by a crown (or in Latin, corona) of proteins. Because that is confusing it has been given the official name Coronavirus disease 2019 or COVID-19 for short. That is the name of the disease, but the virus' name is actually Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), but generally, everyone will talk about the disease and not the virus.
Image courtesy of Alissa Eckert @ CDC Public Image Library
So yes, there have been other coronavirus diseases before with the most notable being SARS which was prevalent in 2002 and 2003. But these viruses are actually pretty common, and you may have had a coranvirus disease before if you had a viral caused common cold.
How much is known about the disease?
Medical information is rarely exact, especially when there is a new disease. With many diseases people can be a carrier without knowing about it, other people can have natural resistance and there can be lots of unusual or unexpected aspects to the disease. The information provided in this article comes from a range of sources, but expect changes and updates, but in reality, a lot of detailed information about the disease may not be known for months or even years.
How dangerous is the Coranavirus?
The media and public reaction tend to range from fear-mongering through to complacency. Many people will quote the fact that the disease only kills a little over 2% of people that get the disease. This is much less than things like SARS, MERS and Ebola. This is true, but 2% when it comes to people dying, it still pretty high and it is nearly 20 times higher than the seasonal flu.
Also when people are looking at this 2% figure, they fail to include the fact that 25% need medical intervention. Each person who needs to be hospitalised means that hospital resources are tied up on Coronavirus not on treating other illnesses.
There the biggest issue with this disease is how widely, rapidly and quickly it can spread. If the Coronavirus is not contained then it could infect at least 30% of the population. Some estimates go up to 70%. In other words, yes, only a small percentage of people will die from the disease, but large numbers will need to be hospitalised, and others quarantined. Then the fact that so many people could get the disease makes this something to be concerned about.
If unchecked and widespread in the population of Australia, it could mean millions of people requiring hospital treatment, and Australia only has around 100,000 hospital beds. This is why it is so important to contain the spread of the disease.
So how is it transmitted?
It is a respiratory disease, which means it is mainly transmitted in airborne water droplets from coughs and sneezes, which are then breathed in by another person. Though it can also be transmitted in other ways as well. A common way for a disease like this to spread is where someone sneezes on a surface or touches a surface with a hand that they sneezed on, and you touch that surface, then bring your hand up to your mouth or nose.
A simple sneeze can spread a disease far and wide. Image courtesy of James Gathany at the CDC Public Health Image library
There may be other ways that the disease is transmitted, but they will be less important. For example, the virus has been detected in faecal matter, which means it could also be transmitted this way. This happened with SARS but required a situation where sewage pipes were leaking into water pipes in a poorly maintained Hong Kong apartment building.
What are the symptoms?
A large number of diseases have similar symptoms. For most people, it will start with a headache and fever, which may progress to include, coughs, shortness of breath, and in some cases, upper respiratory track signs such as sneezing and a running nose, as well as diarrhoea. For around 75% of people, it will be like a really bad flu, but some people will go on to develop pneumonia, suffer multiple organ failure and in around 2 or 3% of cases, death.
So let's make this perfectly clear. The most basic symptoms of the disease are the same as many other diseases. A higher than normal temperature or cold-like symptoms should be checked out as quickly as possible.
Why is it spreading so quickly and easily?
Other similar diseases, including 2003s SARS, were contained very effectively. But COVID-19 seems unstoppable. The reasons for this are numerous and it will take years of analysis by medical and epidemiological experts to understand fully. The main reasons are that it is very infectious, can cause minor symptoms in people who then spread the disease and often the spread in some countries is associated with one incident where it is transmitted to many people.
There are other reasons as well. Some are related to the disease, such as asymptomatic carriers, people whose incubation period is longer than expected and it seems that once you are infected you could get infected again.
Other reasons are about international public health. It only takes one community or area to slip up, and it can get into a country. We can look at Iran where they seem to have engaged in a cover-up. After all, their assistant health minister went on TV coughing and sweating to tell everyone that the Coronavius was under control in Iran, then was later diagnosed with the disease. Then highly conscientious countries like South Korea and Japan, that dealt effectively with other similar diseases in the past, have had the disease move into the community.
What this tells us, no matter how well organised health authorities are, there is some reasonable chance that the disease will spread into the community. Australia took extraordinary steps very quickly, closing flights for people coming from China and putting many people in quarantine. Yet despite these efforts, it has started to spread.
So what can I do to protect myself?
Even though the disease is starting to be transmitted in the community, at the moment in Australia, there is little cause for panic. Feel free to panic if you want, I know that can relax some people, but in reality, it doesn't do much good. However, it is important to keep a regular eye on the news.
First of all, face masks are not that effective a form of protection. Cloth surgical masks are designed to capture water droplets from the person wearing them, not filter out airborne particles. Having said that, they can provide a small amount of protection from airborne particles and can stop you from touching your mouth and nose. But as they become wet from your breath they lose their effectiveness. So they need to be changed every hour. Generally, there is no recommendation for people to be wearing these masks.
The best use for surgical masks is to reduce the likelihood
that someone with a respiratory illness will spread the disease. So you can protect yourself at home or in the workplace, by immediately getting someone with even mild symptoms to wear a mask.
There is another type of face mask, the P2 or N95 masks. P2 is the European designation and N95 the US standard, but they are essentially the same. These masks are used to filter out fine particles from the air and were issued to communities affected by bushfire smoke. Their drawback is that they don't work well if they don't fit your face, such as men with beards and kids. Unfortunately, while they do provide some protection it is not perfect. These masks can be bought at hardware stores as well as at pharmacies.
Another recommendation is to regularly wash your hands when you are in public places. The best way is good old fashioned soap. They need to be scrubbed all over for around 20 seconds, then properly dried, as wet hands are more likely to carry disease. Then there are those ever-present alcohol hand disinfectants. Many companies will put them at the reception desk. Now while these can kill 99% of germs in laboratory conditions, their success rate is lower in the real world. If you can wash your hands with soap and water, that is best, but if not, then an alcohol disinfectant can also be used.
Because the disease can be spread by touching, it is recommended that you avoid shaking hands, and European style kissing to greet people should also be avoided. For people working in public places, extra vigilance is required when cleaning public spaces. Clean meeting room tables, reception desks etc regularly.
One of the key ways that you can protect yourself is to limit your overall exposure to the disease. Lots of people are cancelling holidays especially to regions that have the disease in the community. The main source of information on whether you should travel to a particular country or region can be found through DFAT Smarttraveller alerts.
With community transmission, it is recommended that you avoid going to public places. The more people in a place or event the higher your exposure will be. So sporting matches, concerts and so on would expose you to the most number of people while going to a restaurant would have a lower level of exposure. Obviously, if you lock yourself in your house and never come out, you are less likely to catch this or any disease. But still, it is no excuse to not go out, and definitely no excuse to enjoy a nice Chinese or Iranian meal.
What if I think I am infected?
If you have the basic symptoms, then isolate yourself from other people, when you have contact with others, wear a mask, and contact your doctor or hospital. Don't just go to see your doctor as you could spread the disease. When you contact them, they will provide information for you about what to do and make any necessary arrangements.
If you have come into contact with someone with the disease or believe that you might have been exposed, such as recent travel to a country that has a high incidence of the disease, then the first thing to do is isolate yourself. Next contact your doctor or health authorities. Once again, they will advise you on what to do. The main thing that they will do in the situation is quarantine and test you regularly. Some people, especially when practical, just self-quarantine. This might involve arranging to work from home for the standard incubation period. It is usually best to talk to health authorities about this and follow their recommendations.
Doctors can't certify that you are free from the disease, only that you have been tested and that there wasn't a positive result. The thing is, during the incubation period you might not test positive, so they can't clear you.
There are lots of cures and prevention tips on the internet, do they work?
If you look online you will see a lot of people saying that they have a cure or preventative solution. Most of these are just made up. A lot of the alternative health area is full of people either being very naive or just straight out lying. Then, of course, the internet is a place of trolls. Bleach might kill the disease, but it is poison, so internet recommendations to drink bleach are just someone's crazy idea of a joke.
There are a lot of suggestions, such as boiling garlic. Yes, there are foods that can help your immune system, but they don't really work. Yes, the stronger your immune system the better, but herbal remedies do less for you than just a healthy diet and not getting too stressed. No matter how strong your immune system is, you can still get Coronavirus.
What else can I do to prepare?
I have already written about having emergency supplies, which is actually a pretty good idea regardless. The Coronavirus has the potential to disrupt global supply chains. In Australia, when it comes to food, most of our food is grown at home. But you might expect some shortages. There is also the possibility of panic buying as well.
Medicines can be more of a problem. A lot of medications are imported into Australia and China has become a growing manufacturer of medicines. With many cities on lockdown and people unable to return to work, manufacturing supply chains have been disrupted. For this reason, it makes sense to keep a reasonable supply of medicine at home. Talk to your doctor about extended prescriptions and buy reasonable amounts of what you need. Don't panic buy or horde, but realise that you don't want to be caught out low on medicine you need to stay alive to find that stocks have run out.
Is there a cure or a vaccine?
At the moment, the Coronavirus is treated with supportive care. That is, they don't have any antiviral drugs to treat the disease, but they provide treatment to help your body fight the disease, survive and recover.
Of course, there are agencies all around the world, local, international, private and government, working on both treatments and vaccines. It normally takes years to bring a new medicine to the point where it can be released, but in a crisis like this, approval and release will be fast-tracked. Even so, it could be months at the earliest, and years at the latest, before anything is ready. Which is why prevention and containment is the most important strategy.
In Australia the main source of news will be Health.gov.au. You can also look at your local state-based information, as health and emergency responses are run through state-based authorities.
If you are travelling abroad or have friends or loved ones living abroad, you need to look at both the World Health Organisation information and each country's local information. The best I have seen is from South Korea, where they can track cases in a great deal of information even down to local suburb information.
Mainstream media provides a good source of information, but the more fear and panic that they create, the more people tune in or click, and the more money they make. This means that they always talk about the worst of every situation.
Social media is where your friends share random stories that they saw online that was specifically designed with one goal in mind, get people to share it on social media. This means you can pretty much discount what your aunt said you must read to save your life.
What are the global effects of the disease going to be?
The world is better prepared today than even 20 years ago to handle a pandemic. Airports have temperature scanners, most countries have protocols and many different things have been learned, especially since SARS. But this disease has already spread so widely that it has impacted on the global economy. The global economy was already heading towards a debt crisis and a pandemic is enough to trigger this matter.
For the individual, it means personal financial measures associated with a recession. This includes avoiding taking on high levels of debt, making sure your investments are focused on the safe rather than risky, and generally being more frugal. Don't forget that you can do a lot to help by spending your money locally. You might cancel your plans for an overseas holiday, but you can still take a local one to boost the local tourism industry and even help out communities affected by drought, fire and flood.
At a smaller and more local scale, it is already having an impact on certain industries supply chains. With factories shut down in China, a lot of goods are not being manufactured, at the same time, industries that relied heavily on Chinese tourists or students are struggling.
Whenever providing advice about preparing for emergencies and disasters, the most common response is that it might never happen. Often with good preparation and prevention, it doesn't. Being informed and ready is never a bad thing.
The Coronavirus situation is constantly changing. With any epidemic health authorities are trying to control, treat and understand the disease all at the same time, which is not an easy thing to do. Yet we shouldn't be panicking. A calm and responsible response is going to be the most effective.
A calm well researched article - thank you Roy, I hope many people read it.
After the latest toilet roll stockpiling we do need to inject some perspective in this matter which is serious but should not stop our lives. Marina