COVID19 Transmission& Points to ponder - Har Ashish Jindal

1. COVID -19
Transmission & Precaution points

2. The Content
• Overview of Corona Virus
• Transmission with points to ponder of 2019 nCoV

3. Current Situation

4. What are coronaviruses?
• Named after wreath-shaped protrusions on the envelope of the virus.
• Unsegemented
• Single stranded positive Strand RNS virus
• diameter of 50 to 200 nm.
6 types of coronaviruses :known to infect humans.
• 229E and NL63 (of alphacoronaviruses),
• OC43 (of betacoronaviruses),
• HKU1, Middle East Respiratory Syndrome Coronavirus (MERS-CoV),
• Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV)

5. What is novel Corona Virus?
• 60 to 140 nm in diameter.
• RNA genome
• nucleocapsid protein encapsulates the viral genome
• can be used as a diagnostic antigen.
• WHO called it 2019-nCoV while the International Committee on the
Taxonomy of Viruses (ICTV) named it SARS-CoV-2.
• their genetic sequence homology revealed -many similarities with
SARS-CoV -classified as a beta-coronavirus.

6. Wild animals linked to novel corona
• novel coronavirus and a coronavirus found in bats,
which is 85% or higher, it is speculated that bats are
the natural hosts of the novel coronavirus.
• likely to have intermediate hosts between bats and
humans yet unknown to us.
• Precaution point: one should refrain from
consumption of uninspected wild animals or
uncooked food such as meat sold by roadside sellers.

7. How do coronaviruses transmit from animals to
humans?
• Transmission from bats to humans might have occurred after
mutation via an intermediate host(s).
• The genomic sequence analysis showed a more than 85% homology
between the novel coronavirus and a coronavirus in bats.
• Intermediate hosts between bats and humans, which have not been
confirmed yet.
• Animal-to-human or human-to-human transmission relies mainly on
two routes:
• contacts
• droplets.

8. NOVel coronaviruses in different environments
• temperature and humidity - limiting factors
• NOVEL CORONA SENSITIVE TO
• UV RAYS –COMMENT: Busses to be disinfected with UV rays; Disinfecting and
isolating used banknotes using UV lights in its efforts to combat the coronavirus;
Smart UV elevator disinfection system. UV LAMPS SHOULD NOT BE USED TO
STERILIZE HANDS OR OTHER AREAS OF SKIN AS UV RADIATION CAN CAUSE SKIN
IRRITATION.
• OZONE GAS-proven to kill the SARS coronavirus and since the structure of the new
2019-nCoV coronavirus is almost identical to that of the SARS coronavirus, it is
relatively safe to say that it will also work on the new coronavirus though it must be
noted that there is no studies to date except one that is current ongoing n China at
the Institute of Virology In Hubei with regards to this. Progress of that study has
shown that it works and the study should be concluded by the end of this week and
officially published in the journal Virology.
• There are more than 17 scientific studies that show Ozone gas is able to destroy the
SARS co coronavirus

9. Novel CORONA in different environments
• Sustained heat at 132.8ºF (56*C) for 30 minutes: This temperature is not reached.Hence
high probability the virus will stay during hot and humid climate.
COMMENT: Slow and long cooking, Non vegetarian should eat fully cooked foods.
• Ether: Polyethylene glycol???
• Alcohol: Keep an alcohol concentration of around 70% to kill coronaviruses. Vinegar, tea
tree oil, and other natural products are not recommended for fighting not recommended
for fighting coronaviruses.
COMMENT: SANITIZE HANDS/ CELL PHONES: Solutions of 70% alcohol should be left on
surfaces for 30 seconds (including cellphones—but check the advice of the phone
manufacturer to make sure you don’t void the warranty) to ensure they will kill virus. 60%
alcohol, and Lysol about 80%; these are all effective against coronaviruses.
• NO, DRINKING WILL NoT KILL IT
• No. Spraying alcohol or chlorine all over your body will not kill viruses that have already
entered your body. Spraying such substances can be harmful to clothes or mucous
membranes (i.e. eyes, mouth). Be aware that both alcohol and chlorine can be useful to
disinfect surfaces, but they need to be used under appropriate recommendations

10. How resilient are coronaviruses in different
environments?
• Chlorine disinfectants, peracetic acid, chloroform,and other lipid
solvents: ALL KILL THE VIRUS- SOAP(Not necessary antibacterial),
DETERGENTS, Toilet disinfectants (Lysol)
• https://www.epa.gov/pesticide-registration/list-n-disinfectants-use-
against-sars-cov-2
• Chlorhexidine kills novel corona:
• Chlorhexidine mouth wash??- 0.2% chlorhexidine
• Chlorhexidine Alcohol Free is available at pH 5.1
(COMMENTS-advisability a question mark – corrosive to teeth on excess use)

11. Environment Conditions and COVID 19
• Avoid Air conditioners in closed rooms , cars and
automobile vehicles
• Respiratory hygienic measures; masks; cough sneeze in
elbow not in hands,; keep a tissue and napkins near you
and disposable bad to use it an throw it in medical waste
• Steam for 30 minutes – humidified steam that may be
unable kill the virus -It's very difficult to achieve the
standards of humidity, temperature, length of time,
and sterility that you need to completely sterilize
something at home.
• Hands are touched every where – it is estimated we
touch are face 23 times in an hour i.e nearly 577 time in
a day. Hence Hand Wash with soap and water / SANITIZE
• The boiling of water cooking minimium of 15 minutes
at temperature higher than 75*C for minimum of 15
minutes may minimize the chances to come in
contact with the virus
REMARKS

12. Environment Conditions and COVID 19
REMARKS
Nonwoven fabrics :
Medical isolation gowns, surgical gowns, surgical drapes and covers,
surgical masks, surgical scrub suits,caps, medical packaging: porosity allows
gas sterilization, gloves shoe covers,bath wipes, wound dressings,drug
delivery. Plasters,Filters, gasoline, oil and air – including HEPA filtration
water, coffee, tea bags ,liquid cartridge and bag filters vacuum bags,
allergen membranes or laminates with non woven layers. Nonwoven
geotextile containers (sand bags) are used for soil stabilizers ,diaper stock,
feminine hygiene, and other absorbent materials, carpet backing, primary
and secondary Composites,marine sail laminates, table cover laminates
chopped strand mat ,backing/stabilizer for machine embroidery packaging
where porosity is needed, Shopping bags, insulation (fiberglass
batting),acoustic insulation for appliances, automotive components, and
wall-panelling, pillows, cushions, mattress cores, and upholstery padding,
batting in quilts or comforters,consumer and medical face masks mailing
envelopes,tarps, tenting and transportation (lumber, steel) wrapping,
disposable clothing (foot coveings, coveralls), weather resistant house
wrap,cleanroom wipes, potting material.
DISPOSAL, AVOID REUSAGE,
OR USE AFTER
STERLIZATION/WASH IT
WITH DETERGENT- AS
APPLICABLE

13. • Plastics – 4 hours
Environment Conditions and COVID 19
REMARKS
DISPOSAL, AVOID REUSAGE,
OR USE AFTER
STERLIZATION/WASH IT
WITH DETERGENT- AS
APPLICABLE
USE APPROPRIATE DISINFECTANT FOR VARIOUS SURFACES

14. VIRULENCY OF COVID 19
• Incidence of corona virus infection is prevalent in winter and spring.
• Incubation period for coronaviruses is usually 3 to 7 days.
• 2019-nCoV is a coronavirus that underwent antigenic mutations.
• The incubation period of the virus is as short as 1 day but no longer
than 14 days. But some reported cases had an incubation period of
up to 24 days.(Wuhan case)
• Highly infectious and can be fatal

15. VIRULENCY OF COVID 19
• SPECTRUM:
• Mild -especially for children and young adults.
• Serious illness- about 1 in every 5 people (possibly)-need hospital care. It is
– Hence – PANIC for people to worry about how the COVID-19 outbreak
will affect them and their loved ones.
• People with chronic diseases or compromised immunity are more likely to
get infected
• Aged over 60 years, and people who have underlying medical conditions
such as diabetes, heart disease, respiratory disease or hypertension are
among those who are at greater risk of developing severe or critical illness
if infected with the virus the disease progresses relatively quickly and the
symptoms are more severe

16. Immunity to COVID19
• Still research is on but a speculation says - COVID-19 antibodies will
remain in a patient’s system for “two to three years,” based on what’s
known about other coronaviruses, but it’s too early to know for
certain.
• The degree of immunity could also differ from person to person
depending on the strength of the patient’s antibody response.
• Younger, healthier people will likely generate a more robust antibody
response, giving them more protection against the virus in future.
• But in CHINA previously positive cases have again been found to be
positive

17. SARS/ MERS/ COVID19
• SARS- fatality rate is about 10%; symptoms of SARS
include fever, cough, headache, muscle pain, and other
symptoms of respiratory infection
• MERS: case fatality rate is about 40%.symptoms:fever
with tremors, coughing, shortness of breath, sore
muscles and gastrointestinal symptoms such as diarrhea,
nausea, vomiting or stomachache.
• COVID19- case fatality rate is about 1-3% but in elderly
can reach to 10-20%; symptoms fever, if not have fever,
with only chills and respiratory symptoms, which can
occur together with mild dry cough, fatigue, poor
breathing, diarrhea etc;runny nose, sputum and other
symptoms are rare.

18. TRANSMISSSION OF COVID 2019
• Environmental conditions: air pollutants, overcrowding in confined
spaces, humidity, indoor hygiene, seasons, and temperature.
• Accessibility and effectiveness of health care services and infection
prevention measures: Accessibility and availability of vaccines and
health care facilities, and isolation capabilities.
• Host factors: age, smoking habits, transmissibility, immune status,
nutritional status, previous infection or co-infection of other
pathogens, and overall health.
• Pathogen characteristics: routes of transmission, infectivity,
virulence, and microbial population (inoculation size)

19. Prevent COVID 19: Control the source of
infection:
• When coughing or sneezing, the patient with acute respiratory diseases
should cover their nose and mouth with the arm or other materials
(handkerchiefs, paper towels, or masks) to reduce droplet transmission.
After exposure to respiratory secretions, perform hand hygiene
immediately, and wash hands frequently in daily life.
• Personal precautions :
• Maintain a balanced diet, ensuring adequate nutrition, and maintaining oral health
can help prevent against infection.
• Exercise regularly to boost immunity.
• Quit smoking, limit alcohol consumption, and stay in good spirits.
• Ensure indoor ventilation: natural ventilation and/or use of exhaust fans for better
airflow.
• Get vaccinated for other disease / respiratory illnesses if available

20. Epidemiological characteristics
Infectivity 2 days before the onset of the disease.
• In China, at the early stage of the epidemic,
• the average incubation period- 5.2 days
• the doubling time of the epidemic was 7.4 days, i.e., the number of people
infected doubled every 7.4 days
• the average continuous interval (the average interval time of transmission
from one person to another) - 7.5 days
• COMMENT: Medical personnel may stay on work for 7 days and take a
break for quarantine 14 days
• The basic regeneration index (R0) - 2.2-3.8, meaning that each patient
infects 2.2-3.8 people on average.

21. Epidemiological characteristics
Main average intervals:
• Mild cases -the average interval from onset to the initial hospital visit
was 5.8 days, and that from onset to hospitalization 12.5 days;
• Severe cases, the average interval from onset to hospitalization was 7
days and that from onset to diagnosis 8 days;
• Fatality cases- the average interval from onset to diagnosis was
significantly longer (9 days), and that from onset to death was 9.5
days.

22. Routes of transmission of Novel CORONA
• droplet generally refers to a water-containing particle with a diameter
greater than 5 µm.(Droplets can enter mucosal surfaces within a
certain distance(typically 1 m).
• Coughing, sneezing or talking.
• During invasive respiratory tract procedures, such as suctioning or
bronchoscopy, tracheal intubation, cough-stimulating movements
including changing positions in bed or patting backs, cardiopulmonary
resuscitation,

23. Who can be a considered close contact?
• Persons who have contact with a patient who is confirmed or suspected
with infection of Covid19 including the following situations.
• Those who live, study, work or have other forms of a close contact with a
patient.
• Medical personnel, family members or others who have had a close
contact with a patient without taking effective protective measures during
diagnosing, treatment, nursing and visiting.
• Other patients and their accompanying people sharing the same ward with
an infected patient.
• Those who shared the same transportation or elevator with the patient.
• Those who are deemed as such through on-the-spot investigations.

24. References
• https://www.who.int/docs/default-source/wrindia/situation-report/india-
situation-report-10.pdf?sfvrsn=48298da5_2
• https://www.who.int/india/emergencies/india-situation-report
• https://www.who.int/emergencies/diseases/novel-coronavirus-
2019/advice-for-public/myth-busters
• https://pib.gov.in/newsite/pmreleases.aspx?mincode=31
• The corona virus Prevention Hand book – 101 science based tips that could
save your life:Wang Zhou -2020
• Coronavirus:outbreak, allthe secrets reveled about the COVID 19 –
Pandemic- Osler, Sideny-2020
• https://www.epa.gov/pesticide-registration/list-n-disinfectants-use-
against-sars-cov-2