Stevi Harman
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By: dr Stevi Harman

The world has come on halt because of the newly emerging coronavirus upper respiratory infection that is called by the name ‘COVID-19’. On March 11th 2020, the World Health Organization have declared the COVID-19 as pandemic which throws countries and its citizens in a state of panic.

The latest breaking news in Indonesia stated that the Minister of Transportation, Mr. Budi Karya Sumadi has been tested COVID-19 positive. As updated per March 15th 2020 as published by Indonesian ministry of health, Mr. Sumadi is one of the 117 people that has been tested positive of COVID-19 in Indonesia.

The sharp raise of number of people that have been tested positive caused panic and anxiety to spread. One of the main cause can be attributed to the use of medical jargons in news that might cause confusion or hyperbolic meaning of a normal situation. To avoid unnecessary anxiety, we provide you brief knowledge about the COVID-19 virus and several medical jargons.

What is The COVID-19?

The COVID-19 is a disease caused by type of corona virus which is the SARS-CoV-2. It is called COVID-19 or the novel corona virus because of a very straightforward reason, that is to mark it as the “new” corona virus.

COVID-19 derived from the term -COrona VIrus Disease – found in the year 2019. The earlier known corona virus infection that are known are the SARS-CoV (Severe Acute Respiratory Syndrome related corona virus) in 2002 and the MERS-CoV (Middle East Respiratory Syndrome corona virus) in 2012. The COVID -19 is first identified in Wuhan, China in January 20th 2020 (first case found in December 2019).

You can get infected by droplets transmission, meaning that you can get infected by being very close (approximately 1 m) with the infected, or if you touch things that have an infectious droplet (latest information showed droplet can survive outside approximately in 24 hours). It is DIFFERENT by transmission through air, which means you cant get infected by breathing the same air as the infected.

What Is Outbreak, Epidemic and Pandemic?

WHO has released statement on March 11th 2020 that COVID-19 is characterized as pandemic, underlining alarming level of spread and severity.

Pandemic is a serious state of situation, not to be taken lightly but also not to be used to spread fear. Outbreak, epidemic, and pandemic are actually terms to describe the spread of a disease. It is written in a crescendo pattern. Outbreak is a sudden sharp increase of disease incidence/new case of disease.

Epidemic is used to describe outbreaks in several places/area outside the initial area in which the outbreak was found the first time. Now, pandemic is used to describe epidemics that happen worldwide. The COVID-19 has spread to more than 60 countries by the time WHO announce its status as pandemic.

Other known pandemic is the “swine flu” pandemic in 2009 which killed at least 151,000 people worldwide during the first year it circulated and the “Hongkong flu” pandemic in 1968 which killed 1,000,000 people worldwide. Both diseases are caused by influenza virus. In comparison, until now, there are 5,390 deaths worldwide (per March 15th 2020) by the COVID 19.

What Does It Mean By Positive COVID-19?

Now, what does positive COVID-19 mean? In simpler terms, you are stated positive if you are tested positive of the SARS-CoV-2 gene replication by assigned legitimate laboratories. The specimen for the testing, minimally,is taken from the swab of the nose, throat and sputum. Note, that sputum is NOT saliva.

There are several terms of COVID-19 diagnosis : suspect, probable, confirmed, close contact. Let’s add one more, which are the COVID positive asymptomatic people. Meaning, those people that does not exhibit symptoms but be tested as positive covid-19. These people are most likely in the incubation period of the disease (for know its known that the incubation period is 2-14 days, meaning that people who are infected might not show any symptoms for maximum 2 weeks after).

Don’t worry too much as these asymptomatic people are not as contagious as those who exhibit symptoms.

(1) Suspect COVID 19 cases are those with symptoms of fever (≥ 38oC or history of fever), with respiratory symptoms such as shortness of breath, cough, sore throat, AND one of : close contact with probable/confirmed COVID 19 case OR work in/visited health care facilities with known case of COVID 19 patient OR travelled to Wuhan/countries where the infection spread;

(2) Probable COVID 19 cases are suspect cases with inconclusive laboratory examination; and

(3) Confirmed COVID 19 cases are those that are tested positive by laboratory examinations. Another important thing is that you have to be aware whether you are in the category of ‘close contact’ or not. Close contact are : (1) health care workers and cleaning service in the hospital specifically in isolation areas or even had contact with the patient/patient’s surroundings, (2) people who nurse the patient, (3) people who live together with the patient, (4) patient’s guests who had been inside the same room with the patient, (5) inside the same public transportation with the patient, (6) closely work together with the patient.

How Worried Are The Experts ?

Now, what is the most worrying thing about the COVID 19? Mainly because right now, the transmission rate is very fast and there are higher risk of severe disease to population at risk. First of all, the transmission rate is very fast, although there are no objective data with number for how high is the transmission rate until now.

However, we do know that in Indonesia, the newly confirmed case is doubled per 1 day averagely (in comparison, in Italy, it doubles in 5 days and in US it doubles in 3 days). These numbers, ofcourse will change rapidly. Secondly, the symptoms are largely mild respiratory tract symptoms, like fever (>38), dry cough, headache and muscle aches.

Most people will recover from the infection (in 2 weeks average), however it is found that severe symptoms and death occur more in people above 60 years old or those with chronic diseases such as : diabetes, hypertension, cardiovascular disease, cancer. Death occurs 2 to 8 weeks within contracting the disease. Unfortunately there is not yet vaccine for this virus to help stop the spread and no proven medicine to suppress the viral replication yet.

So, what to do next after reading all these informations above? First and most importantly, do not panic and do not spread panic. As there is not yet positive case in NTT, mainly you are still considerably safe.

If you feel sick with mild symptoms, such as: fever with cough, headache, muscle aches you better wear mask and isolate yourself at home. Keep monitoring your symptomsif your symptoms are and not worsening within 3-5 days.

Other than isolate yourself, you must limit contact with other people in your household, always wash your hands and take frequent baths, do not share household appliances with people in your house, and it is important to eat and rest well.

You should go to the hospital immediately if : (1) your existing symptoms are worsening, (2) red flag symptoms, like shortness of breath, chest pains, bluish discoloration of lips and nails, very weak/inability to get up, inability to eat, confusion; (3) you have symptoms and you are from out of town, or you work in public places such as restaurants, plane, airport, ship dock/ healthcare workers that took care of patients with the same symptoms, (4)you have symptoms and you were in contact with people who are suspected/probable/confirmed cases of COVID 19.***

Note:
Help battle hoax! Only get your information from reliable sources, such as : the website by Indonesian Ministry of Health : https://infeksiemerging.kemkes.go.id/ and World Health Organization website https://www.who.int/westernpacific/emergencies/covid-19.

References :
https://ourworldindata.org/coronavirus#the-severity-of-the-symptoms-of-covid-19