It seems hard to believe that as little as two months ago, just as the world was celebrating year end, a deadly coronavirus would quietly break out from a city in China and run rampage across 28 countries, infecting 69,270 people and causing 1,669 deaths in its wake.
It is even harder to believe that at the time of writing on 16 February, as we hold our breaths for dawn to break, yet another day would arrive to announce that the numbers are still rising.
We, in Malaysia are affected on many levels too. As a mother, I am worried. Just like you, I am worried about the safety of my family as they go about their day mingling with so much uncertainty outside. There is still so much we do not know about the disease.
A 22nd case of coronavirus infection has been confirmed in Malaysia as of 16 February 2020.
Although many sites and studies have said that the average age of people who get infected is 55.5 years, it is not true that only the elderly are at risk.
Malaysia’s 20th and 21st confirmed coronavirus cases were a businessman from Guangzhou, China and a woman who has been living in Malaysia who went back to China to visit her family for the Chinese New Year. Both are only aged 27 and 32 respectively. NST has also carried a story of a university student in China who contracted the disease. The young man said he nearly died but luckily, still lives to tell the tale. He is only 21 years old.
Malaysia’s 22nd case today is an American woman, aged 83, who was tested positive for the coronavirus when she flew in to Malaysia on February 14 after alighting from the cruise ship MS Westerdam that docked in Cambodia. Her condition was detected by thermal scanners in KLIA and she has been sent to Sungai Buloh Hospital where she is in stable condition.
The thing is ─ in this unprecedented event of global proportions, everything is affected and everyone is susceptible, maybe some more than others.
Silver Lining
But here is good news. None of the infected in our country has died so far and as Health Minister Datuk Seri Dr Dzulkefly Ahmad has said, “Infection recovery rate is high.” In fact, as of February 16, eight out of 22 patients have recovered.
This silver lining doesn’t mean we are out of the woods, however, and our government is taking all necessary precautions to prevent the spread of the virus as prescribed by the World Health Organisation (WHO). They have set up a Crisis Preparedness and Response Centre in Putrajaya and here is the contact information should you need more information:
Crisis Preparedness and Response Centre (CPRC)
Disease Control Division
Ministry of Health Malaysia
Level 6, Block E10, Complex E
62590 WP Putrajaya
Fax No: 03-8881 0400 / 0500
Telephone No: (Office Hours): 03-8881 0300
Telephone No. (After Office Hours): 013-6699 700
E-mail: cprc@moh.gov.my (Cc: dr_norhayati@moh.gov.my and drwnoraini@moh.gov.my)
Further Good News: Children Seem to be Spared, Not Affected at Birth
For mothers with pre-teen children, they can heave a sigh of relief. Findings show that children seem to have been spared from the coronavirus infection or if they do get infected, they tend not to need hospitalisation. “Chickenpox, for example, can be largely inconsequential in children, yet catastrophic in adults,” wrote the New York Times in explaining the phenomenon.
According to a peer-reviewed study on 99 coronavirus patients published in The Lancet and the American Medical Association, infections in children appear to be rare and there is no evidence that the novel coronavirus can pass from mother to baby in the womb.
Nine coronavirus confirmed women in their third trimesters of pregnancy in January 20 have since given birth via C-Section in Wuhan, China.
All the pregnancies resulted in live births. None of the infants required special pediatric treatment and none of the mothers worsened in their condition or died as a result of the birth.
However, CNBC did report that Singapore confirmed a case of a six-month-old who got infected by his parents who were both infected. Also, an infant in China tested positive for the coronavirus within 36 hours of birth. The baby had a mother who was infected.
For the most part, however, from what can be seen, the majority of children under 12 seemed not to show symptoms although children over 12 had symptoms like those of adults.
Men are More Likely to get Infected
Therefore it is you who will have to take extra care, and especially your husband as men have been found by several studies to be more vulnerable (meaning: open to attack) to the coronavirus than women. Researchers say it may be due to the presence of estrogen which makes women’s immune system respond better to infection than men, or there could be other factors yet to be discovered. Whatever the reason, men make up half to two-thirds of infected patients in China. Not all of them are elderly. Do pay attention too to your parents and other older adults in your family circle.
Developments So Far: Coronavirus has a New Name ─ COVID-19
On February 11, the World Health Organisation (WHO) gave the coronavirus a new name so that the disease no longer makes reference to places, animals or people to avoid stigma. The new name is: COVID-19.
What are Coronaviruses and What is COVID-19?
With coronavirus being the main topic of discussion these days, what is a coronavirus?
A coronavirus, says WHO, is one of many in a large family of coronaviruses (sometimes abbreviated to CoV) that cause illness ranging from the common cold to more severe diseases such as the Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV).
A novel coronavirus (nCoV), such as COVID-19, means it is a previously unheard of new strain that no one knows much about. That is why scientists and medical researchers are scrambling to find a cure or at least a vaccine to stop its further spread. Because it is so new, information on how to handle this disease may change as scientists discover more.
Coronaviruses, by themselves, are not new viruses. They circulate in a range of animals and can sometimes make the jump from animals to humans via a process known as a “spillover”, which can occur due to a mutation in the virus, or increased contact between animals and humans.
Signs of infection include respiratory symptoms, fever, cough, breathing difficulties, gastrointestinal symptoms, severe pneumonia, kidney failure and even death. It has been estimated that 20% of patients infected with COVID-19 have severe symptoms. Those with other health problems such as asthma, diabetes and cardiovascular disease are particularly vulnerable.
Why is the Virus called Coronavirus?
Coronaviruses consist of a core of genetic material, enclosed within an envelope of protein spikes, which resembles a crown (or, in Latin, corona).
Your Most Pressing Questions Answered by Experts
And now, here are your most pressing questions answered according to what the experts say.
1. When Will The Outbreak End?
- Short Answer: Hopefully, by April.
Dr Zhong Nanshan, head of the National Health Commission’s team investigating the novel coronavirus outbreak (and who won fame for combating the SARS epidemic in 2003), said on Feb 12 that the number of new cases were falling in some provinces. He forecasts the epidemic could peak later this month, then plateau, then go down, adding that it should not increase at a large scale after that peak.
“I hope this outbreak or this event may be over in something like April,” Zhong, who helped identify flaws in China’s emergency response systems during the 2002-03 SARS crisis, told Reuters.
(Zhong may be right and we are hopeful. As of February 16, China announced a drop in new virus cases in Hubei for the third straight day while other provinces apart from Hubei also marked a decline in new cases for 12 straight days).
In another interview, he told Xinhua news agency, “The SARS epidemic 17 years ago lasted nearly six months, since then we have made considerable progress in preventing and controlling major infectious diseases, so we have the confidence to effectively curb today’s outbreak.”
2. When Can a Vaccine be Developed?
- Short Answer 1: In 18 months.
“The first vaccine targeting China’s coronavirus could be available in 18 months,” said WHO Director-General Tedros Adhanom Ghebreyesus, “so we have to do everything today using available weapons.”
- Short Answer 2: In six months.
The Coalition for Epidemic Preparedness Innovations (CEPI) ─ a body established in 2017 to finance biotechnology research ─ has partnered with the University of Queensland to develop vaccines. Head of the university’s School of Chemistry and Molecular Biosciences, Professor Paul Young, said in a statement that UQ has novel technology for the rapid development of vaccines, which could provide a vaccine within six months.
“The team hopes to develop a vaccine over the next six months, which may be used to help contain this outbreak,” he said.
- Short Answer 3: As soon as it is ready.
The Chinese Center for Disease Control and Prevention (CDC) started developing vaccines against the novel coronavirus as early as January 24. On February 10, a candidate vaccine targeting the novel coronavirus began testing on animals.
The mRNA vaccine was co-developed by the CDC, Shanghai-based Tongji University School of Medicine and Stermirna Therapeutics Co Ltd. The vaccine samples were injected into more than 100 mice on February 9. A CDC official warned that the animal testing is in a very early stage of vaccine development and there are still many steps to be taken before the vaccine can be used on humans.
3. What is the COVID-19’s Incubation Period?
- Short Answer: 24 days.
Incubation period refers to the time between exposure to an infection and the appearance of the first symptoms.
The Centers for Disease Control and Prevention (CDC) earlier said the incubation period is believed to be two to 14 days.
However new research published on February 9 from Chinese scientists led by renowned respiratory scientist Dr Zhong Nanshan (the discoverer of the SARS virus), suggests it might take as long as 24 days for a person to start showing symptoms after being exposed to the COVID-19 coronavirus. The study examined 1,099 coronavirus cases from 522 hospitals across 31 provinces in China, to come up with its conclusion.
It also mentioned “super-spreaders” which are a small group of people who can transmit the infection to far more people than the majority can. In the 2003 SARS outbreak, for example, a doctor who had treated SARS patients in Guangdong infected 16 others when he traveled to Hong Kong to attend a family wedding. These super spreaders then traveled to other countries, spreading SARS into a global epidemic.
4. Can an Infected Person spread the Virus when He or She Shows No Symptoms?
- Short Answer: Apparently Yes.
It is already known that COVID-19 is transmitted from person to person. Without travelling to China, people can get infected by an infected person. Now it appears that people can transmit the coronavirus even when they are not showing symptoms.
Doctors in China have been saying that the coronavirus can be spread through an infected person who shows no symptoms. This letter, published in the New England Journal of Medicine, appears to back up what the doctors say.
The letter describes how a cluster of infections in Germany started with a traveler from Shanghai who passed the disease to her colleague during a four-day stay in Bavaria. The traveler showed no symptoms when she was in Germany.
5. How Long Can the Virus Live?
- Short Answer: Two to 10 days
The Journal of Hospital Infection published a new analysis by studying different types of coronavirus such as SARS and MERS and they have discovered that many strains can live on surfaces such as glass, plastic or metal, for as long as 10 days.
COVID-19 is a droplet-based infection and can be spread directly between people or by touching contaminated surfaces, said Eike Steinmann, Professor in the Department for Molecular and Medical Virology at the Faculty of Medicine at Ruhr-Universität Bochum, Germany and lead author of the paper.
6. Can Fresh Air, Sunshine and Malaysian Hot Weather Destroy the Virus?
- Short Answer: Yes.
Although it is said above that the virus can live for as long as 10 days, it is only possible if the condition is ideal ─ that is when the air is cold and humidity is low (dryer air). Some viruses float in the air in tiny respiratory droplets when the air is frigid but when the air is humid, these droplets pick up water, grow larger and fall to surfaces and to the ground.
That is why you are advised to keep your distance when talking to another person and to wash your hands frequently. It is to wash off the virus that you may have picked up when touching these surfaces and which you may unknowingly transfer to your face. Research has found that people touch their faces about 23 times per hour!
Unlike in Wuhan, Hubei where the weather hovers around a freezing 1°C to 3°C/54% humidity especially in January, viruses don’t do as well in hot and humid conditions where temperatures are over 30°C/80% humidity. Therefore, it is not easy for the COVID-19 coronavirus to thrive in Malaysia.
However, we do tend to stay indoors in air-conditioning to get away from the heat.
Associate Professor Hsu Li Yang, programme leader of infectious diseases at the National University of Singapore’s Saw Swee Hock School of Public Health, said air-conditioned spaces could actually help spread respiratory diseases!
“Enclosed spaces, where it is less humid and cooler, could help to spread respiratory diseases,” he explained.
To kill off the coronavirus, it is recommended to keep rooms well-ventilated by opening the windows and using fans instead of airconditioners. Also, the heat from the sun could help kill the virus.
Having said that, however, it is interesting to note that Singapore has 75 confirmed COVID-19 cases as of February 16, and rising. Most have been cluster infections from large enclosed gatherings but what is most interesting to note is the cluster infection of five Bangladeshi construction workers who got infected at a construction site. The men in their 20s to 30s have no travel history or connection to China.
7. How to Prevent Getting or Spreading COVID-19
- Wash your hands frequently
- Cover your mouth and nose when you sneeze or cough
- Avoid touching eyes, nose and mouth with your hands
- Maintain social distancing of at least 1m (3ft plus) distance between yourself and other people
- If you have fever, cough and difficulty breathing, seek medical care early
- Practice general hygiene when visiting wet markets or animal product markets
- Handle and fully cook your food. Avoid consuming raw or undercooked animal products
And there you have it.
No one knows how coronavirus COVID-19 will play out in the end but it is hoped that it will die out as predicted and the world makes a change for the better to prevent such a catastrophe from ever happening again.
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