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COVID-19 Infection Prevention and Control

By Dr. Anoop Kumar Malhotra in Emergency Medicine

Jul 27 , 2020 | 3 min read

COVID 19 disease pandemic (coronavirus disease) is caused by a novel coronavirus which is found usually in bats and other mammals. It first emerged as a cluster of cases from a wet animal market in Wuhan, China in December 2019. Although, there are a few case reports which might suggest the virus was in circulation as early as November 2019. 

The virus spreads primarily via respiratory droplets during close face-to-face contact. Moreover, prolonged exposure to an infected person (being within 6 feet for at least 15 minutes) is associated with higher risk for transmission, while brief exposures to asymptomatic contacts are less likely to result in transmission. 

Transmission of the virus through fomites (touching a surface with the virus on it) is another possible mode. Aerosols (smaller droplets that remain suspended in air) also have been shown to transmit the virus, but only in laboratory settings. Infection can be spread by asymptomatic, pre-symptomatic, and symptomatic carriers. 

The time from exposure to symptom onset for COVID-19 is approximately 5 days. The majority of individuals who develop symptoms will do so in around 11days of infection. The most common symptoms in hospitalized patients are fever, dry cough, shortness of breath, fatigue, and nausea/vomiting or diarrhoea. Loss of smell and taste also develops during the course of the disease and treatment. There are uncommon neurological presentations that mimic diseases like stroke (cerebrovascular accident). 

Most of the population in India tend to have an asymptomatic or mildly symptomatic course. They might not even come to know they have the virus, and that’s the disquietude every doctor or healthcare worker when someone dismisses COVID 19 as being a trivial disease. Even asymptomatic and pre-symptomatic carriers can spread the disease, leaving the elderly and immunocompromised patients at risk of contracting the virus and ending up with a fatal disease. 

So, how can we protect ourselves from getting infected? How do we assure that we do not pass it on to the elderly or immunocompromised in our family? How do we as, healthcare providers, be assured, that we are not bringing the virus into our homes? 

These are some of the things each & every individual can do in order to limit spread: 

1) Avoid unnecessary travel/going to crowded places: Try to limit travel as much as possible. Organize and schedule visits to markets for groceries and daily needs. 

2) Mask: A simple surgical mask or homemade cloth mask will suffice. Ensure it covers the mouth and nose adequately.

3) Avoid touching eyes, nose, and mouth: As these routes provide easy transmission to the virus. 

4) Maintain 1 metre distance (social distancing) while interacting with other individuals irrespective of whether they are symptomatic or not. This limits the spread from asymptomatic individuals also. 5) Follow good respiratory hygiene: When sneezing or coughing, do so into the fold of your elbow to minimize droplet spread. 

6) Maintain a balanced diet: Foods rich in vitamin A, C & E provide antioxidants which help boost the immune response and help the body fight off infections. Vitamin D protects the respiratory tract & reduces the risk of an inflammatory storm following viral pneumonia. Among micronutrients, zinc and selenium are beneficial in preventing viral binding and replication. High protein in the diet provides critical energy to help the immune system fight off disease. Experts say that it’s not just one nutrient which helps, but a well-rounded balanced diet which aids in maintaining adequate nutrition and a healthy immune system. 

7) Hand hygiene: helps interrupt transmission of the virus and other micro-organisms. The ideal hand washing duration should be for 20 seconds at a frequency of every 20 minutes or use alcohol based hand sanitisers.

 8) If you have a fever, cough and difficulty breathing, seek medical attention. Try to call before arriving at a medical facility. 

COVID 19 has completely altered how our society functions. It has changed the fabric of a ‘healthcare worker-patient’ interaction. The warm and caring touch has given way to hand gestures and video consultations. During this pandemic, it is not only the healthcare workers & essential workers who are fighting the virus, but each & every individual who follows these basic set of rules, help in ‘breaking the chain’ and ‘flattening the curve’.