The Virus Called Corona

by Ulimmachukwu Osele

There are a lot of expectations to be met at the beginning of a new year. The new year is an opportunity for a fresh start irrespective of past mistakes. Banks, schools, organizations, businesses, governments and individuals prepare for the new year. Goal-setting is largely synonymous with a new year. I myself was caught on the new year resolutions bandwagon. On the 1st of January 2020, I penned down my new year resolutions and on the top of my list was a trip to a country every month. I love traveling and this was a perfect opportunity to start a travel blog. It has been over three months since the first case of COVID-19. I want to throw punches and blows at the virus called Corona; my greatest enemy of all time! It stole my trip as fast as it was written.

Coronaviruses (CoV) are a large family of viruses that cause illness ranging from common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV). Coronavirus disease (COVID-19) is a new strain that was discovered in 2019 and has not been previously identified in humans. Transmission of some coronaviruses is between animals and people, but the current strain of the virus spreads from person to person. Its exact source is yet to be ascertained. According to the investigations carried out by the China Center for Disease Control, the incubation time of the virus is between 3 days to 2 weeks.

COVID-19 (coronavirus disease 2019) as named by the World Health Organization (WHO) on the 11th of February, 2020 was first detected in the city of Wuhan, Hubei Province, China, where citizens came down with a pneumonia of unknown cause in December 2019. Further investigation by the WHO led to the discovery of COVID-19. The Director-General of the WHO, Dr. Tedros Adhanom Ghebreyesus, on the 30th of January, 2020 declared the outbreak a Public Health Emergency of International Concern (PHEIC) as it had spread to over 18 countries. The efforts of the WHO to nip the spread in the bud proved abortive as the novel virus is very contagious and spreads like wildfire, affecting over 114 countries with more than 118,000 cases and over 4,000 deaths. This resulted in the declaration of COVID-19 as a pandemic on the 11th of March 2020. 
The situation reports as of the 7th of April 2020, showed that there are over 1,247,244 confirmed cases and 69,213 deaths in 211 countries, areas or territories across the West Pacific Region, European Region, South-East Asia Region, Eastern Mediterranean Region, Region of the Americas and the African Region. The global threat level of COVID-19 is “very high”. Several public health measures like: awareness-campaigns in the public, early diagnosis and management of cases, implementation of health measures for travelers, contact tracing, isolation, social distancing measures and infection prevention and control in healthcare Settings are being implemented globally to mitigate the force of the spread.

The major way by which the infection spreads is through the respiratory droplets produced when an infected person coughs or sneezes into the atmosphere. The virus can last for up to 28 days on surfaces, depending on the temperature of the environment, making the spread from contaminated surfaces to humans a major channel for the spread of the virus. Because of this, recommendations to prevent infection spread include: regular hand washing with soap or the use of alcohol-based hand sanitizers where handwashing cannot be accessed, proper disinfection of frequently touched surfaces, covering the mouth and nose with a paper towel (which should be properly disposed) when coughing and sneezing or coughing into one’s flexed elbow, proper use of face masks and other personal protective equipment by health workers when taking care of COVID-19 positive patients, cooking meat and eggs thoroughly, avoid close contact with anyone showing symptoms of respiratory illness such as coughing and sneezing. Symptomatic diagnosis of COVID-19 is difficult because the symptoms are flu-like. Common signs include fever, cough, shortness of breath and breathing difficulties. In more severe cases, the infection can cause pneumonia, severe acute respiratory syndrome, kidney failure, and even death.

The Stay at home order was enforced by jurisdictions nationwide to contain the spread of COVID-19. Violation of this order could result in civil penalties. The importance of social distancing at this point cannot be overemphasized as human to human contact is the major means of transmission. The Stay at Home Order introduced shutting down of schools, religious houses, businesses and organizations, and this is dealing a huge blow to the world’s economy. Nigeria is not left out, especially as the global demand for oil decreases. Organizations, students and employees have adjusted to working from homes, online lectures and online shopping etc.

Healthcare workers at the frontline of combating the virus are at a greater risk of getting infected. Issues arising include: a dearth of Personal Protective Equipments (PPEs) such as N95 or FFP3 masks, eye protection, gowns, and gloves, insufficient number of ventilators, overcrowding of clinics and isolation centers leading to reduced manpower and long working hours. The WHO and her partners called for the urgent investment of nurses on the 7th of April while marking the World Health Day because nurses represent over 70% of the health and social workforce.

Currently, there are no vaccines or antiviral medications available for the prevention or treatment of COVID-19. Strategies for the management of the virus include: symptomatic treatment, oxygen therapy, mechanical ventilation if resistance to oxygen therapy in respiratory failure occurs, on the contrary, hemodynamic support for cases of septic shock. 
Although no antiviral medication has been discovered, there are several propositions for treatment, such as Lopinavir/ ritonavir (400/100 mg every 12 hours), chloroquine (500mg every 12 hours), and hydroxychloroquine (200mg every 12 hours). Further studies are being carried out to determine the effectiveness of these medications. The use of humanized IgGI monoclonal antibody, tocilizumab and RNA polymerase inhibitor, remdesivir are still undergoing clinical studies. There are also scientific researches leading to the development of a vaccine for the coronavirus.

Despite the tough situation we are faced with, several campaigns and challenges have been established by the World Health Organization to unite the world in combating coronavirus.

• Pass the message to kick out coronavirus campaign by WHO and FIFA: The campaign promotes five steps: hand washing, coughing etiquette, avoid touching your face, physical distance and staying home if unwell.
• Together at home online concert by Chris Martin: A no-contact series that aims to drive physical distancing and taking action
• Safe hands challenge to promote clean hands in order to fight the virus by washing with soap or the use of a hand sanitizer. Heads of states, footballers and actors were involved in this challenge.
• Be ready challenge which calls on individuals, businesses and the government to be prepared
• COVID solidarity response funds to raise funds to combat COVID-19
• Health at home: This offers ways to stay fit and healthy while confined at home.

In this COVID-19 pandemic, special attention is also given to children. A project, My Hero is you, by the Inter-Agency Standing Committee Reference Group on Mental Health and Psychosocial Support in Emergency Settings, has been carried out. It is a children’s storybook on how kids can fight COVID-19. There are also online resources and tools available e.g. Child Protection Resources Menu for COVID-19.

Am I still angry at the virus called Corona? Yes, I definitely am. I am angry that a mere microorganism has the entire world on a standstill. The globe is hanging on only a thread of hope. Pathetic! Is there anything I can do to help combat it? Yes, there definitely is. By adopting the standard recommendations to contain the spread, sharing correct, adequate and timely information and providing my services as an essential worker, I can help the world stay safe, one person at a time. In the meantime, I will join a challenge and so should you.

Up to date information in COVID-19 can be found at:
- The WHO Novel Coronavirus situation board
- The John Hopkins Center for Systems Science and Engineering site for Coronavirus Global Case COVID-19

References
World Health Organization (2020). COVID-19 quick links [Online]. Available at: https://www.who.int/emergencies/diseases/novel-coronavirus-2019 (Accessed: 7th April 2020)

Cascella M, Rajnik M, Cuomo A et al. Features, evaluation and treatment Coronavirus (COVID-19) March, 2020

Ulimmachukwu Osele is the Public Health Coordinator, Pharmaceutical Society of Nigeria-Young Pharmacists Group (PSN-YPG), Lagos Chapter, Nigeria.