COVID-19

COVID-19   Like many other countries, Bangladesh is now started seeing more cases of COVID-19, it might sound like less number of positive cases and late diagnosis. We all need to keep in mind that, this has been same in all other countries including USA, where this slow rate of diagnosis has been pushed so much within a week that crossed the maximum number of diagnosis/day/week than any other countries. One obvious question is why to do this diagnosis even everybody is saying there is no specific treatment? Whether a person is diagnosed or not, only one recommendation is ‘STAY HOME’. We might not be aware that early diagnosis of COVID-19 is critical, before spreading to the community and now this phase has been passed in Bangladesh. So, why still diagnosis is needed? Diagnosis is still critical in global point of view. This means COVID-19 has a clear ‘incubation time’ within human as a host. This means following incubation (14 days) there could be possibly two outcomes: some may get sick showing symptoms or some may remain healthy. Remember this 14 days incubation should start theoretically “when people locked in one place”, which is realistically impossible due to the fact that we would not listen that all at once. Because of that we lost track where to set the clock. As a result, instead of 14 days, it might go longer. But still, under this situation, once we know the number of cases in the country, we would be able to see the ‘PEAK’ of cases in next couple of weeks. If we all are very obedient, this will soon be turning around. This means the number of new cases will be lower. “Flattened COVID-19 curve” what that tells? This is a good news for any country because under ‘HOME STAY’ condition there is less spread because virus didn’t find new host. So, locating this time point will tell us approximately when we probably can mentally be ready to open the country. Now, you can assume how critical this data is for a country because any mistake or lack or enough data will significantly affect the future. Who should perform this duty? This should be under direct supervision of Bangladesh Primer Minister with a task force#1 built with Research scientists, few doctors and supervisor of law-enforcement groups. Since there are number of labs around the country getting samples and performing diagnosis tests, all results should be sent to the task force for visualization of COVID-19 progression. Task force#2: Only the Research Scientists will be in this task force for better coordination, accumulation of results and presentation. They need to perhaps discuss more often because of the nature of this tests. Accurate sampling, testing and safety all need to be monitored by the group of scientists by teleworking.   Monitoring diagnostic test results and expectations: COVID-19 diagnostic kits for 100 samples do not mean to successfully run 100 samples. Why? In Bangladesh context, this is super critical to understand that a test kit to be used for 100 samples should not put pressure on the lab workers to generate 100 results in your final report. Govt. People also need to understand that very well. You are running samples from patients that are with different amounts of viral load. This means some samples though had symptoms might be with very low amount of material and could give confusing results. So lab workers need to repeat the test. They should not be driven by any force that we don’t have enough reagents and whatever data you got tell us it is positive or negative. If that happens would be a total disaster. So, Kits made for 100 samples (#100 just give a number for a comparison) would never generate 100 test results as final. It will be always less. This is the reality. If the Diagnosis test becomes a nightmare? Below seems to be a qPCR amplification chart. I believe it is from recent COVID-19 infected patient samples. It’s clear from the amplification curve but sounds like almost no amplification >35cycles. If that data was used to demonstrate positive case, this is unreliable. Who is in the frontline of performing this test, needs to be careful and make sure whatever kit you are using you are reproducing your positive curve provided by the kit. Make sure your negative samples not get amplified. It is expected to have data like below in each of your tests but important NOT to draw conclusion. It is really important to be supervised by each of the diagnosis results by experts. Unfortunately this test takes lots steps and need to be done carefully. Ct cycle needs to be taken as an key to determine the positive or negative due to variation in the template concentration coming from all different patients. One critical thing when it goes to many hands and dealing with lots of samples, a little amount of DNA contamination from other samples could also lead that high Ct. values. So, consensus should be to repeat that samples for the sake of patients.        

COVID-19 spreads from person to person in close immediacy, almost like other respiratory illnesses. Public health expert SAID Prepare for coronavirus, but don’t terrify.The new coronavirus continues to spread around the world, prompting governments to step-up efforts to contain the increase of the disease it causes, officially referred to as COVID-19. How is that the coronavirus spreading? The coronavirus – referred to as COVID-19 – spreads from person to person in close proximity, almost like other respiratory illnesses, like the flu. Droplets of saliva or mucus – from an infected person are dispersed within the air or on surfaces by coughing or sneezing. These droplets can inherit direct contact with people or can infect those that pick them up by touching infected surfaces then their face. According to researchers, coughs and sneezes can travel several feet and stay suspended within the air for up to 10 minutes. It is not yet known how long the virus can survive outside a host but, in other viruses, it ranges from a couple of hours to months. Transmission is of specific concern on transport, where droplets containing the coronavirus could pass between passengers or via surfaces like aeroplane seats and armrests. The maturation period of the coronavirus, the length of time before symptoms appear, is between one and 14 days. Although not yet confirmed, Chinese health authorities believe the virus are often transmitted before symptoms appear.” Can people be immune to the novel coronavirus? Viruses that spread rapidly usually come with lower mortality rates and vice versa. As the virus is a completely new strain, it’s believed that there’s no existing immunity in anyone it’ll encounter. Some level of immunity will naturally develop over time, but this suggests that those with compromised immune systems, like the elderly or sick, are most in danger of becoming severely ill or dying from the coronavirus. Although the entire number of deaths has now exceeded those recorded during the 2002-2003 outbreak of severe acute respiratory syndrome (SARS), the present death rate is much less than that of SARS. The coronavirus death rate stands at 2.4 percent, while SARS killed 9.6 percent of these infected. What is being done to prevent the spread, and when will a vaccine become available? China has placed Wuhan and entirely a dozen other cities under lockdown, affecting quite 60 million people, although this has not prevented the virus from spreading to all or any of China’s provinces. As the number of complete cases continues to climb, businesses and countries are taking increasingly drastic action. Person-to-person transmission has been confirmed in numerous countries, which WHO emergency chief Michael Ryan has called a “great concern”. Even with recent advances in medical technology, it’s unlikely a vaccine might be available for mass distribution within a year. This means that public health measures to contain the spread are going to be crucial to contain the outbreak. Restrictions on movement won’t stop the spread of the disease entirely but will slow its progress and delay for areas that have avoided infection to organize . it’ll also limit the strain on health infrastructure by reducing the amount of infections at anybody time, said Krause. Globally, quite 95,000 people are diagnosed with the disease, the  majority in China, with 3,015 deaths in China and 267 deaths across the world , many in Italy and Iran.Global economic losses could reach $347bn The new coronavirus outbreak could end in global economic losses of up to $347bn, consistent with a report by the Asian Development Bank (ADB). The minimum losses are projected at $77bn, or 0.1 percent of worldwide gross domestic product (GDP) while the utmost losses represent 0.4 percent of worldwide GDP, the ADB said. Some pet owners in China are fitting their dogs with tiny face masks, but Gray said there’s no — actually , it’s probably fairly distressing for the pet and will cause them to panic. Instead, pet owners should stick with the basics: good hygiene. Both WHO and gray said owners should wash their hands with soap and water after touching pets. Gray said if dog owners are particularly concerned, they will wipe their dog’s paws with antiseptic wipes after they need had a walk outside — but they should lookout to not overdo it, as wiping too much can dry out a dog’s paws. “I know dogs will not be infected, but if the virus goes on their skin or fur, it will stay there. So if we are careful, I think it’s OK Basic protective measures against the new coronavirus Stay conscious of the newest information on the COVID-19 outbreak, available on the WHO website and through your national and local public health authority. COVID-19 remains affecting mostly people in China with some outbreaks in other countries. most of the people who become infected experience mild illness and recover, but it can be more severe for others. lookout of your health and protect others by doing the following: Wash your hands frequently Regularly and thoroughly clean your hands with an alcohol-based hand rub or wash them with soap and water. Why? Washing your hands with soap and water or using alcohol-based hand rub kills viruses which will get on your hands. Maintain social distancing Maintain a minimum of 1 meter (3 feet) distance between yourself and anyone who is coughing or sneezing. Why? When someone coughs or sneezes they spray small liquid droplets from their nose or mouth which can contain viruses. If you’re too close, you’ll inhale the droplets, including the COVID-19 virus if the person coughing has the disease. Avoid touching eyes, nose, and mouth Why? Hands touch many surfaces and can pick up viruses. Once contaminated, hands can transfer the virus to your eyes, nose, or mouth. From there, the virus can enter your body and may cause you to sick. Practice respiratory hygiene Make sure you, and the people around you, follow good respiratory hygiene. Make sure to cover your mouth and nose together with your bent elbow or tissue once you cough or sneeze. Then eliminate the used tissue immediately. Why? Droplets spread viruses. By following good respiratory hygiene you protect the people around you from viruses like cold, flu and COVID-19. If you’ve got fever, cough, and difficulty breathing, seek medical aid early Stay home if you are feeling unwell. If you’ve got a fever, cough, and difficulty breathing, seek medical attention, and call in advance. Follow the directions of your local health authority. Why? National and native authorities will have the most up so far information on things in your area. Calling beforehand will allow your health care provider to quickly direct you to the proper clinic. this may also protect you and help prevent the spread of viruses and other infections. Stay informed and follow the advice given by your healthcare provider Stay informed on the newest developments about COVID-19. Follow the advice given by your healthcare provider, your national and native public health authority, or your employer on the way to protect yourself et al. from COVID-19. Why? National and native authorities will have the foremost up so far information on whether COVID-19 is spreading in your area. they’re best placed to advise on what