All you need to know about New Coronavirus COVID-19

0

Virus and disease

1. What is a Coronavirus?

Coronaviruses are a large family of viruses known to cause diseases ranging from the common cold to more serious diseases such as Middle Eastern Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS).

They are positive-stranded RNA viruses, with a crown-like appearance under an electron microscope. The subfamily  Orthocoronavirinae  of the Coronaviridae family   is classified into four genera of coronavirus (CoV): Alpha-, Beta-, Delta– and  Gammacoronavirus . The betacoronavirus  genus   is further separated into five subgenres (including  Sarbecovirus ).

Coronaviruses were identified in the mid-1960s and are known to infect humans and certain animals (including birds and mammals). The primary target cells are the epithelial cells of the respiratory and gastrointestinal tract.

To date, seven Coronaviruses have proven to be able to infect humans:

  • Common human coronaviruses: HCoV-OC43 and HCoV-HKU1 ( Betacoronavirus)  and HCoV-229E and HCoV-NL63 ( Alphacoronavirus) ; they can cause common colds but also serious lower respiratory tract infections.
  • Other human Coronaviruses ( Betacoronavirus) : SARS-CoV, MERS-CoV and 2019-nCoV (now called SARS-CoV-2) ..

2. What is a new Coronavirus?

A new Coronavirus (nCoV) is a new strain of coronavirus that has never previously been identified in humans. In particular, the one called SARS-CoV-2 (previously 2019-nCoV), has never been identified before being reported in Wuhan, China, in December 2019.3. What is SARS-Cov-2?

The virus causing the current coronavirus epidemic has been called “severe acute respiratory syndrome coronavirus 2” (SARS-CoV-2). This was announced by the International Committee on Taxonomy of Viruses  (ICTV)  which deals with the designation and naming of viruses (i.e. species, genus, family, etc.). The name is indicated by a  group of experts  specifically appointed to study the new coronavirus strain. According to this pool of scientists, the new coronavirus virus is the brother of what caused Sars (SARS-CoVs), hence the chosen name of SARS-CoV-2.

4. What is COVID-19?

The disease caused by the new Coronavirus has a name:  “COVID-19”  (where “CO” stands for corona, “VI” for virus, “D” for disease and “19” indicates the year in which it occurred). The WHO Director General Tedros Adhanom Ghebreyesus announced it on February 11, 2020, during a briefing with the press during a break in the extraordinary Forum dedicated to the virus  .

5. Is the new Coronavirus the same as SARS?

No. the new Coronavirus (now referred to as SARS-CoV-2 and formerly named 2019-nCoV) belongs to the same family of acute severe respiratory syndrome (SARS) viruses but is not the same virus.

The new Coronavirus, responsible for respiratory disease now called COVID-19, is closely related to SARS-CoV and is genetically classified within the Betacoronavirus Sarbecovirus subgenus.

6. Why did the new coronavirus appear? (SOURCE: ISS)

The appearance of new pathogenic viruses for humans, previously circulating only in the animal world, is a widely known phenomenon (called spill over) and it is thought that it may also be at the basis of the origin of the new coronavirus (SARS- CoV-2). The scientific community is currently trying to identify the source of the infection.

7. Where can I find more information on the new Coronavirus?

Symptoms

1. What are the symptoms of a person infected with a Coronavirus?

It depends on the virus, but the most common symptoms include fever, cough, breathing difficulties. In severe cases, the infection can cause pneumonia, severe acute respiratory syndrome, kidney failure and even death. 2. How dangerous is the new virus?

Like other respiratory diseases, new coronavirus infection can cause mild symptoms such as a cold, sore throat, cough and fever, or more severe symptoms such as pneumonia and breathing difficulties. It can rarely be fatal.

Generally the symptoms are mild and slow in the beginning. Some people become infected but do not develop symptoms or malaise.

Most people (around 80%) recover from the disease without requiring special care. About 1 in 6 people with COVID-19 become seriously ill and develop breathing difficulties.

The people most susceptible to severe forms are the elderly and those with pre-existing diseases, such as diabetes and heart disease. At the moment the mortality rate is around 2%. (WHO source)

3. What is the difference between the flu symptoms, a common cold and the new Coronavirus?

The symptoms are similar and consist of cough, fever, cold. However, they are caused by different viruses, therefore, in case of suspicion of Coronavirus, it is necessary to carry out laboratory tests to confirm the diagnosis.4. How long does the incubation period last?

The incubation period represents the period of time that passes between the infection and the development of clinical symptoms. It is currently estimated that it varies between 2 and 11 days, up to a maximum of 14 days.

Transmission mode

1. Can Coronaviruses and the new Coronavirus be transmitted from person to person?

Yes, some Coronaviruses can be transmitted from person to person, usually after close contact with an infected patient, for example among family members or in a healthcare setting.

The new Coronavirus responsible for respiratory disease COVID-19 can also be transmitted from person to person through close contact with an infected case.

2. How is the new Coronavirus transmitted from person to person?

The new Coronavirus is a respiratory virus that mainly spreads through close contact with a sick person. The primary way is the breath droplets of infected people, for example through:

  • saliva, coughing and sneezing
  • direct personal contacts
  • hands, for example by touching contaminated (not yet washed) hands with mouth, nose or eyes

In rare cases, infection can occur through faecal contamination.

Normally respiratory diseases are not transmitted with food, which in any case must be handled respecting good hygiene practices and avoiding contact between raw and cooked food.

Studies are underway to better understand how the virus is transmitted.

3. What is the definition of close contact? (source ECDC)

  • Healthcare professional or other person employed in the assistance of a suspected or confirmed case of COVID-19, or laboratory staff involved in the treatment of SARS-CoV-2 samples.
  • Having been in close contact (face to face) or in the same closed environment with a suspected or confirmed case of COVID-19.
  • Living in the same house as a suspected or confirmed case of COVID-19.
  • Having traveled by plane in the same row or in the two previous or subsequent rows of a suspected or confirmed case of COVID-19, traveling companions or carers, and crew members assigned to the section of the plane where the case indicates he was seated (if the index case has a severe symptomatology or has moved within the plane indicating greater passenger exposure, consider all passengers seated in the same section of the plane or throughout the plane as close contacts).

The epidemiological link may have occurred within a period of 14 days before or after the onset of the disease in the case under consideration.

4. How to handle close contact of a confirmed COVID-19 case?

On the basis of the Ordinance “Further prophylactic measures against the spread of the infectious disease COVID-19 ‘of 21 February 2020, the territorially competent health Authorities must apply to the close contacts of a confirmed case the measure of the quarantine with active surveillance, for fourteen days. 

5. Can the new Coronavirus infection be contracted from a person without symptoms (asymptomatic)?

According to currently available data, symptomatic people are the most frequent cause of the virus spreading. WHO considers new Coronavirus infection infrequent before symptoms develop.

6. Who can get the infection?

People who live or have traveled to areas infected with the new Coronavirus may be at risk of infection. Currently the new Coronavirus is circulating in Asia and Europe where the highest number of cases are reported. In other countries, the majority of reported cases recently traveled to China. Few other cases occurred in those who lived or worked closely with infected people in China.

7. Is it true that you can contract the new coronavirus (SARS-CoV-2) through contact with the bus handles or on the subway by being close to a person who coughs? (ISS)

Based on the available data, it is considered highly unlikely that an infection could occur through the bus handles or on the subway. Instead, it is certain that we are in the middle of the flu season. Therefore, if symptoms such as fever, cough, sore throat, headache and, in particular, breathing difficulties appear, you should consult your doctor. However, to prevent infections, including respiratory infections, it is good practice to wash your hands frequently and carefully after touching potentially dirty objects and surfaces before bringing them to your face, eyes and mouth.

8. Are healthcare professionals at risk from a new Coronavirus?

Yes, they can be, as healthcare professionals come into contact with patients more often than the general population does. The World Health Organization (WHO) recommends that healthcare professionals apply appropriate prevention and control measures for  infections in general and respiratory infections in particular.

Surfaces and hygiene

1. How does the new Coronavirus spread?

The new coronavirus is a respiratory virus that spreads mainly through contact with the breath droplets of infected people, for example when they sneeze or cough or blow their nose. It is therefore important that sick people apply hygiene measures such as sneezing or coughing in a handkerchief or with their elbows flexed and throwing used tissues in a closed basket immediately after use and washing hands frequently with soap and water or using alcoholic solutions. .

2. What are the rules for hand disinfection / washing?

Hand washing and disinfection are the key to preventing infection. You should wash your hands often and thoroughly with soap and water for at least 60 seconds. If soap and water are not available, an alcohol-based hand sanitizer (alcohol concentration of at least 60%) can also be used.

3. How long does the new Coronavirus survive on surfaces?

Preliminary information suggests that the virus may survive several hours, even if it is still under study. The use of simple disinfectants can kill the virus by canceling its ability to infect people, for example disinfectants containing 75% alcohol (ethanol) or 1% chlorine based (bleach).

4. Is it safe to receive parcels from China or other countries where the virus has been identified?

Yes, it is safe. WHO has said that people who receive parcels are not at risk of contracting the new Coronavirus because it is unable to survive on surfaces for long.

Pets

1. Can people get new Coronavirus infection from animals?

Detailed investigations have found that, in China in 2002, SARS-CoV was transmitted from civet cats to humans and, in Saudi Arabia in 2012, MERS-CoV from dromedaries to humans. Numerous known coronaviruses circulate in animals that have not yet infected humans. As surveillance improves around the world, more Coronaviruses are likely to be identified.

The animal source of the new Coronavirus has not yet been identified. It is assumed that the first human cases in China are derived from an animal source.

2. Can I get the infection from my pet?

No, there is currently no scientific evidence that pets, such as dogs and cats, have contracted the infection or can spread it.

It is recommended to wash your hands frequently with soap and water or using alcoholic solutions after contact with animals.

3. Are imports of animals or animal products from China possible?

Due to the presence of some contagious animal diseases in China, only a few live animals and unprocessed animal products are authorized for import into the European Union from China.

There is no evidence that any of the animals, or products of animal origin, authorized to enter the European Union pose a health risk to EU citizens due to the presence of SARS-CoV-2 in China.

4. Is it possible to import food products from China?

As with imports of animals and animal products, due to the animal health situation in China, only a few food products of animal origin are authorized for import into the EU from China, provided that they meet strict health requirements and are have been checked.

For the same reasons, travelers entering EU customs territory are not allowed to carry meat, meat products, milk or dairy products in their baggage.

Prevention and treatment

1. Is there a vaccine for a new Coronavirus?

No, being a new disease, there is still no vaccine and to make an ad hoc one the times can also be relatively long (it is estimated 12-18 months).

2. What can I do to protect myself?

Stay informed on the spread of the epidemic, available on the WHO website  and take the following personal protection measures:

  • wash your hands often with soap and water or alcohol-based solutions to get the virus out of your hands
  • keep a certain distance – at least one meter – from other people, especially when they cough or sneeze or if they have a fever, because the virus is contained in saliva droplets and can be breathed at close range
  • avoid touching your eyes, nose and mouth with your hands if you have a fever, cough or breathing difficulties and have recently traveled to China or if you have been in close contact with a person who has returned from China and has respiratory disease.  
  • if you have a fever, cough or breathing difficulties and have recently traveled to China or if you have been in close contact with a person who has returned from China and suffers from respiratory disease, report it to the free number 1500, set up by the Ministry of Health. Remember that there are several causes of respiratory diseases, and the new coronavirus may be one of them. If you have mild symptoms and have not recently been to China, stay at home until symptoms are resolved by applying hygiene measures, which include hand hygiene (wash your hands often with soap and water or alcoholic solutions) and ways respiratory (sneezing or coughing in a tissue or with the elbow flexed, use a mask and throw the used tissues in a closed basket immediately after use and wash your hands).

3. Is the virus transmitted through the food route?

Normally respiratory diseases are not transmitted with food, which however must be handled respecting good hygiene practices and avoiding contact between raw and cooked food.4. Do I have to wear a mask to protect myself?

The World Health Organization recommends wearing a mask only if you suspect you have contracted the new Coronavirus and are experiencing symptoms such as coughing or sneezing or if you are caring for a person with suspected new Coronavirus infection (recent trip to China and respiratory symptoms) . The use of the mask helps to limit the spread of the virus but must be adopted in addition to other measures of respiratory and hand hygiene. It is not useful to wear multiple overlapping masks.

5. How should I put on and remove the mask?

Here’s how to do it:

  • before putting on the mask, wash your hands with soap and water or with an alcoholic solution
  • cover your mouth and nose with the mask making sure it fits tightly on your face
  • avoid touching the mask while you wear it, if you touch it, wash your hands
  • when it gets wet, replace it with a new one and do not reuse it; in fact they are single-use masks
  • remove the mask by taking it from the elastic and do not touch the front of the mask; throw it immediately in a closed bag and wash your hands.

6. Is there treatment for a new Coronavirus?

There is no specific treatment for disease caused by a new coronavirus. Treatment should be based on the patient’s symptoms. Supportive care can be very effective. Specific therapies are being studied.

7. Can antibiotics help prevent new Coronavirus infection?

No, antibiotics are not effective against viruses, but only work against bacterial infections.

Diagnosis

1. Do you privately undergo blood tests or other biological samples to know if you have contracted the new coronavirus (SARS-CoV-2)?

No. There are currently no commercial kits to confirm the diagnosis of new coronavirus infection. The diagnosis must be made in the regional reference laboratories, on respiratory clinical samples according to the Real Time PCR protocols for SARS-CoV-2 indicated by WHO. In case of positivity to the new coronavirus, the diagnosis must be confirmed by the national reference laboratory of the Istituto Superiore di Sanità.

Transfusions and transplants

1. I am a blood donor. How should I behave? 

The blood can be donated only if you are in good health, therefore even a simple cold or sore throat, without any connection to the Coronavirus, would be the cause of temporary exclusion.

Remember that it is good to wait 28 days before going to donate if:

you recently returned from a trip to the People’s Republic of China,
you think you have been exposed to the risk of Coronavirus infection,
you have carried out therapy for SARS-CoV-2 infection (for documented infection or the appearance of symptoms compatible with infection with SARS-CoV-2

When you go to donate always warn the doctor selecting your movements, especially if in one of the areas affected by the new Coronavirus.

It also informs you if you have been diagnosed with the infection or if you have had symptoms associated with those caused by the Coronavirus (fever, cough, breathing difficulties) even when the symptoms in question have already been resolved following or not following a therapy ; the doctor in charge of the selection, who will visit you, may decide to temporarily suspend you from the donation.

If you have already donated, remember to contact your Transfusion Service in case of symptoms associated with those caused by Coronavirus.

Pregnancy

1. Are pregnant women more susceptible to infections or have a higher risk of developing a severe form of COVID-19?

There is no scientific data on the susceptibility of pregnant women to the virus. Pregnancy involves changes in the immune system that can increase the risk of getting viral respiratory infections, including SARS-CoV-2. In addition, pregnant women may show an increased risk of developing a severe form of viral respiratory infections.

It is recommended, even for pregnant women, to take normal preventive actions to reduce the risk of infection, such as washing your hands often and avoiding contact with sick people.

2. What are the effects of COVID-19 during pregnancy?

There are no scientific data reported on the effects of COVID-19 during pregnancy. Cases of miscarriage have been observed in the event of infection during pregnancy by other related coronaviruses [SARS-CoV and MERS-CoV] while the presence of high fever during the first trimester of pregnancy may increase the risk of congenital defects.

3. Can pregnant women with COVID-19 transmit the virus to the fetus or infant?

From the limited data in the literature, cases of transmission of infection from other coronaviruses (MERS-CoV and SARS-CoV) from mother to child have not been reported. Recent data regarding babies born to mothers with COVID-19 indicate that none of them tested positive. Furthermore, SARS-CoV-2 was not detected in the amniotic fluid.