What is CoVid-19 (Coronavirus), how does it Kill humans and what can the healthcare professionals do to help and what can we do to try to help ourselves?

The coronavirus is named thus as it has a  “Crown of protein “,  “Co” for “Corona “ and “ V” for Virus and there are several variants. The new virus was first identified on 29^th Dec 2019 was named “2019 Novel Virus “, “2019nCoV”. Most colds and flus are rhino viruses, and influenza virus causes a “flu”, such as Spanish Flu which killed millions of people.

The new virus has a protein capsid with  “RNA” and “DNA” inside. The protein coat, capsid is what helps the virus to survive outside the body for several days.

The virus has transmitted to humans from animals and is a Zoonotic infection similar to the SARS.

The 2019 Noval Virus now appears to have the same severity as SARS 2013 when  2% of people who were infected died.

The virus which we saw in 2013 and it came from a wild cat.  China has banned the trade in wild animals.

The virus has mutated and can pass into humans transmitted via small droplets as they go through the air and they will be breathed in. But the capsid protein coast allows the virus to stay in a hibernating state, dormant on surfaces for several days. There are different reports of how long a period the virus can survive for out of a host but it is believed to be between 5 and 14 days.

This is part of the reason many countries are suggesting self-isolation to contain the spread of the infection and also to protect the precious  healthcare resources to ensure the most vulnerable patients are treated.  In the UK we are being advised to stay at home if we have symptoms. “Self-isolate “  In addition, we are now being advised not to ring “111” unless we are not coping with our symptoms.

The NHS,  “ Catch it “ “ Bin it “ and “ Kill it “  and the advice on washing your hands for at least 20 seconds ensuring that the back of the hands and in between the fingers are washed, should be followed at all times.

The virus targets many areas of the body but the main side effect which kills humans is Pneumonia,  which is localised in the lungs or, Acute Respiratory Distress Syndrome, ARDS, where the whole of the lung may get inflamed and the lungs are filled with fluid. The patient will quickly become hypoxic and require to be hospitalised and in the worst-case ventilated.

The CoVid virus from the information which has been shared from China will take up to ten days before the patient requires ventilation and maybe symptomless for four or five days after infection. There are varied reports of the exact number of days between infection and symptoms present.

The novel coronavirus attacks the 600 million alveoli in the lungs. The alveoli increase the surface area of the lungs so that oxygen can pass into the bloodstream efficiently and the reoxygenated blood circulates in the body and save patients becoming hypoxic. 

A ventilator will be required to help the patient breath, and the patient needs to be supported until the fluid goes away and they can breathe unsupported.

A lot can be done if it is caught early and they are ventilated.

Bill Gates raised concerns about the risk of a viral infection causing a pandemic after the Ebola epidemic. Ebola was contained well due to the way Ebola is transmitted. It is not an airborne virus and brave Healthcare professionals found the patients and treated as many as possible. His view is we need to go to war on the virus and use all the technology available to learn and to share knowledge. This virus requires a global response.

Let’s look at the main systems of the virus.

1. 90% get a high temperature and will feel cold and shivery. So, we should keep warm as viruses do not like pyrexia and a higher temperature helps the body to fight the virus.
2. 76% developed a cough.
3. 55% difficulty in breathing and severe bronchitis is inflammation of the bronchi.
4. Pneumonia attacks the alveoli and this is a complication of the new corona virus and it can lead to ADR. Fluid builds up in the alveoli, the breathing is rapid and his body becomes hypoxic. If an x-ray is carried out it will show a solid lung. From China’s data, it has been stated that the person may have been infected for up to 7- 8 days prior to presenting to hospital and the time from infection to requiring ventilation is 10 .5 days.
5. 44 % experience a Myalgia – an ache in their muscles and become very fatigued.
6. 8% develop a headache.
7. 3% develop diarrhoea so there is a need to buy toilet roll after all!
8. Some patients develop leukopenia, a reduction in white blood cells and Lymphopenia also can present. The body will try to increase both lymphocytes and leukocytes.

Learns which have been gleaned from treating patients in the past on ventilators which may result in a better prognosis.

1. Early in 2000, it was noticed that a Low Tidal Volume when used rather than a High Tidal Volume helped to reduce the inflammation of the lungs and improved the exchange of gases. But the patient responding to the increase in levels of carbon monoxide try to breath more quickly.
2. To help with this patients are put into a paralytic state by good respiratory nurses.
3. Prone positioning for 17 to 18 hours also was effective at reducing patient mortality seen in 2013.

Health care professionals need to:

1. Avoid touching without PPE.
2. Wash their hands more often.
3. Isolate patients and wash down the rooms after the patient has been in there.

But what can you do to help yourself? Twenty top tips:

1. Eat as well as you can.
2. Get a good night’s sleep.
3. Boost your immune system by getting gentle exercise.
4. Eat if you like and ensure you keep hydrated.
5. The body may go catabolic, look out for symptoms.
6. Do not visit people at risk, phone them and keep in touch that way.
7. Work from home if you can.
8. Avoid public transport.
9. Keep a safe distance from people.
10. Money and credit cards are dirty so wash your hands after touching it.
11. Keypads are dirty.
12. Door handles can be dirty.
13. Consider wearing gloves and removing them when you return from your shopping.
14. When washing your hands and ensure that the backs of your hands and between the fingers are included in the process.  A minimum of 20 seconds should be required to wash your hands properly.
15. Hygiene is vital and we should not place our hands near our face.
16. Self-isolate yourself if you or your family begin to show symptoms.
17. Do not let people in if you think you are infected or your visitor may be, keep in touch by phone instead. Keep warm and keep the temperature up, keep want to try not to take antipyretics.
18. Stay away from elderly relatives.
19. Get your history ready and think about who you have been in touch with.
20. Avoid public transport.

Remember symptomless people can pass the virus on Pro-domal phase. People may be infectious and thus asymptomatic carriers without knowing.

There is inconsistent advice stating that people can be contagious for 5 to 14 days it is not clear. The screening for pyrexia is not as effective as in the pro-domal phase people are asymptomatic. Just because you do not have a temperature does not mean that you are not infectious.