In the coming weeks, I will be publishing several articles on Covid-19 to keep us all up to date with an infection most of us barely understand. My thanks to Dr Catherine Beanland for this article which has been prepared ahead of an emergency meeting of health, business and council stakeholders in Ludlow tomorrow. Follow the #coronavirus conversation as it develops.
There is an outbreak of novel (new type) Coronavirus (2019-nCoV) in Mainland China which has now spread to many areas.
People are considered to be most infectious while symptomatic (with symptoms), however there is limited evidence that asymptomatic and pre-symptomatic people (people who are well and have no symptoms) are also able to transmit the virus.
Novel Coronavirus (new type) (2019-nCoV) what we know so far
Statistics and Death Rates
In the first big analysis of more than 44,000 cases from China, the death rate was the lowest for under 30 year olds at less than 1%. However, the death rate for:
- 60-69 year olds rate was 3% rate,
- 70-79 year olds, 8% death rate and
- over 80+ year olds had a very worrying 15% death rate.
Deaths were five times more common among people with diabetes, high blood pressure or heart or breathing problems. Deaths were more slightly more likely in men. There may also be a link of use of anti-inflammatories and the risk of complications, according to French medics.
About 26% develop severe symptoms that need intensive care unit (ITU) admission.
As a GP in Shropshire I am concerned with these figures as many of my patients are elderly.
How Contagious is it?
A new study of nine people who contracted the virus in Germany suggests that people are mainly contagious before they have symptoms and in the first week of the disease.
“The infectivity is quite high.” In one case, Patient 1 sneezed during a meeting with one person. Wendtner says: “That was enough for infection.”
In other cases, “they had simple business meetings, sitting together for 60 minutes, 90 minutes [at a table or] in front of a computer, with no physical contact – just one handshake, that’s all,”
Plummeting numbers of infectious virus after antibody production turns on “means that after about 10 days or so, you’re not likely to be infecting other people,” Khan says.
Other studies also suggest that people with very mild or asymptomatic infections don’t shed as much virus and aren’t as likely to infect other people as people with more severe cases, he says.
The team did not find evidence of the virus in blood or urine.
Researchers did detect viral RNA in faeces, but no infectious virus there. That suggests that the virus isn’t spread through stool, an unknown until now.
Clinical criteria for diagnosis or suspicion
The new study of nine people who contracted the virus in Germany suggests that people are mainly contagious before they have symptoms and in the first week of the disease. Their symptoms were:
Fever and or acute respiratory infection (e.g. shortness of breath or cough) with or without fever.
Most had coughs, but only two developed a fever, the most common symptom reported in other studies.
Most symptoms were mild and one person never developed any at all.
One patient developed severe pneumonia.
Two of the nine had runny noses, previously reported as a rare symptom of COVID-19.
Another four had stuffy noses and reported that they couldn’t smell or taste anything.