articles/Coronavirus-19 - Actionable and evidence-backed Information - Part 1

Coronavirus-19 - Actionable and evidence-backed Information - Part 1

Reviewed by: Dr Saurav Das

While there is a lot of misinformation around Covid-19, we hope to bring a series of resources to highlight evidence-backed actionable and succinct information. This is first in the series. 

1. Avoid social gatherings whenever possible. Avoid exposing family members to work clothing or shoes. Regularly wash clothes and keep them away in a bin. 

2. Maintain hand hygiene, wash thoroughly - soap bars and handwash are equally helpful. Prefer soap and alcohol-based handwash over OTC sanitizers. 

3. Be cognizant of your hands touching your face and avoid it until they are sanitized. 

4. Clean and disinfect frequently touched objects and surfaces using a regular alcohol-based household cleaning spray or wipe. 

5. Self-quarantine if you have traveled in areas where infections have been recorded or if you are suffering from symptoms as listed below. 

6. The main symptoms are cough, shortness of breath, fever, fatigue. Symptoms generally appear in 2 to 14-day window. 

7. Covid is usually spread by close contact - touch or through respiratory droplets from coughing on sneezing, touching infected surfaces. But new research is indicating that the virus can stay airborne for some time, under conducive weather conditions. 

8. Do wear masks, if you are exhibiting symptoms or are caring for someone with symptoms. 

9. Older people especially those aged above 60 and who have a history of immune issues, cardiac, respiratory conditions, kidney issues are way more susceptible than younger, fitter populations. But younger people can also succumb, perhaps due to genetic predisposition. 

10. A single negative test may not rule out the infection. The amount of virus varies from day to day and the PCR test which looks for virus RNA can thus give a false negative. 

11. Patients can be infectious and yet not exhibit symptoms. 

What are the unknowns -

1. Are patients at risk for secondary infection once the symptoms have subsided? In time we would have antibody tests to answer this. 

2. Is warmer weather, higher humidity going to lower the spread ie would the virus spread exhibit seasonality? Higher humidity would lessen the chance of transmission via air. Also, in warm weather, the mucous in our nose in its fluid form, forms a barrier to the virus. We also tend to cluster indoors in winters. Would the virus remain viable and have a second coming in winter? Most pandemics historically have exhibited two waves of infections. 

3. Would we able to develop vaccines in the meantime? Given we have much better Biotech resources than we had 20 years back and China the epicenter of the pandemic has been at the forefront of medical sciences, we can hope to cull this down. 

4. What is the death rate - is it as low as 0.6% as in South Korea, which has established the best, walk-in, free testing for all, and thus covering the whole gamut of infections, from those that are mild to severe?

5. What existing antiviral therapies can help manage the symptoms or to help recover? There is some evidence that drugs developed for SARS could be effective, trials are underway.  In the absence of proven drug therapy, supportive care, such as supplementary oxygen, fluids, and antibiotics guard against secondary bacterial infections.

6. Can Governments, Employers stay ahead of the virus by establishing healthy trust and communication with citizens and limiting public gatherings, wok from home programs? 

7. If the Covid-19 is like the family of coronavirus, it could survive over a week on so on inanimate surfaces, under average heat and humidity ie especially airconditioned indoor settings. 

Myths that are circulating -

1. Obviously apart from the above measures, food habits and other recommendations (garlic, drinking more water, sesame oil, vit C, silver, alcohol, saline spray, recommendations of "gurus", sitting in the sun, exposing oneself purposefully to artificial UV light) which immune one against the virus or kill it are a fraud. 

2. The R0 of the infection is claimed to be 2.5-5.5. While this doesn't mean that we will have millions of infections, as it is claimed to be. SARS, for example, had a similar R0 and infected "only" thousands. We don't know yet, if like SARS and MARS, 2019-nCOV will have super-spreader events, which are critical in spreading the infection to millions. With patients now being isolated one day after showing symptoms, we could look at a lower R0. 

3. Pets, packages from the infected regions are unlikely to transmit infection. However, just to be safe, wash your hands and give your pets regular baths. 


Best resources on prevention Measures -

Measures one can take to maximize safety in all societal settings -

How to wash hands properly, measures to take when using public facilities - 

How to wash hands properly 

Track new infection zones here - Updated more frequently than WHO, CDC. 

MAP of Spread

How to go about using the mask properly, if at all 

Masks have limited efficacy if not worn properly and can give the wearner a false sense of security. Also, the masks are most effective - N95, P2, FFP2, KF94 or above - ie masks that are at least effective in stopping 94%+ of particulates are not easy to breathe through.

Why it is critical to avoid nonessential gatherings -

[The study is still under peer review and was redacted by Practical Preventive Medicine Journal without giving a reason. An update will be posted soon.]


Research, Clinical Management Resources for Doctors - 


Source: Detailed Cornovirus Dashboard by DoctorSpring Here

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