WE ANALYZED 3.74 MILLION WORDS OF CONTENT AND 4 DIFFERENT CASE STUDIES OF
TOTAL 44,909 CONFIRMED CASES

Here’s What We Learned
About Coronavirus Disease 2019

(COVID-19)

CHAPTER 1:

Understanding Coronavirus

Since the past, humans have encountered many types of viruses, epidemics, and pandemics, and are currently battling an outbreak of a deadly disease called Coronavirus Disease 2019 (COVID-19).

Coronavirus disease 2019 (COVID-19) was first reported in Wuhan, China, on 31 December 2019. On 30 January 2020, the Director-General of the World Health Organization (WHO) declared the outbreak of COVID-19 a public health emergency. And on 11 March 2020, COVID-19 was declared a global pandemic by the WHO.

To better understand the Coronavirus Disease 2019 (COVID-19), here at healthroid, we analyzed 3.74 million words of content, smashed them together, shook them up, and came up with some astonishing insights. Our focus was to understand exactly how Coronavirus spreads and how it can affect your health.

And now it’s time to share what we discovered.

In this comprehensive guide, you will learn everything you need to know about COVID-19, from SARS-CoV-2 basics to COVID-19 symptoms to its spread to its prevention to its treatment.

And by the end of this guide, you will get answers to all the questions that are arising in your mind right now.

So without further ado, let’s dive right in.

What is a Coronavirus?

People without thinking and without studying are making comments on social media that “coronavirus is just a common cold.”

Yes, cold is an early symptom of novel coronavirus infection, but that does not mean that coronavirus is just that. Therefore, to understand the coronavirus completely, it is important to know its history first.

Coronavirus is a family of viruses, which, when viewed from the microscope, crown, or halo-like spikes are seen on their surface.

According to the Centers for Disease Control and Prevention (CDC), the first human coronavirus was seen in the mid-1960s. After that, seven such coronaviruses have been identified that can infect humans.

The four coronaviruses that are common and not too dangerous are:

229E (alpha coronavirus)
NL63 (alpha coronavirus)
OC43 (beta coronavirus)
HKU1 (beta coronavirus)

These four viruses usually cause common cold in humans, and almost all people, at least once in their lives, are definitely infected with one or more of these viruses.

Coronavirus fact: There is no cure for the common cold.

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Then, three coronaviruses can cause great harm to humans:

SARS-CoV (beta coronavirus)
MERS-CoV (beta coronavirus)
SARS-CoV-2 (virus strain that causes COVID-19)

Let us first tell you about these three diseases in brief:

Severe Acute Respiratory Syndrome (SARS), a viral respiratory illness caused by the SARS-CoV virus, was first seen in China in 2003.

Middle East Respiratory Syndrome (MERS), a viral respiratory illness caused by the MERS-CoV virus, was first seen in Saudi Arabia in 2012.

Corona Virus Disease-2019 (COVID-19) is an infectious disease caused by novel coronavirus (SARS-CoV-2), was first seen in Wuhan, China, in mid November 2019.

Coronavirus fact: We are still in the mid stages of the COVID-19 outbreak, and unlike any other common cold, there is currently no medication or vaccine available to prevent or treat this new virus.

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You must be thinking, how dangerous is this COVID-19 outbreak, and how much should you worry about it?

Well, for this analysis, we analyzed some worst coronavirus outbreaks in history and compared them with the current ongoing COVID-19 outbreak.

For your information, below we are listing the ten worst virus outbreaks of history so far:

Name	Year	Infected	Death	Fatality Rate
Marburg	1967	590	478	81%
Ebola	1976	33,687	14,693	44%
Nipah	1999	496	265	53%
SARS	2002	8,098	774	10%
H5N1-Bird Flu	2003	861	455	53%
A(H1N1)pdm09	2009	~1 Million	~203,000	1 to 10,000 Deaths/ 100,000 People
MERS	2012	2,494	858	35%
H7N9-Bird Flu	2013	1,568	616	39%
Seasonal Flu	Yearly	~1 Billion	290,000- 650,000	10 Deaths/ 100,000 People
COVID-19	2019-Ongoing	7,092,919	406,207	5.72%

Severe Acute Respiratory Syndrome (SARS), which was first identified in 2002, had about 8098 people infected, of which around 774 people died. This coronavirus outbreak had a fatality rate of about 10 percent.

Similarly, about 2494 people were infected with the Middle East Respiratory Syndrome (MERS), which was first identified in 2012, out of which around 858 people died. The fatality rate of this coronavirus outbreak is much higher than SARS, which is close to 35 percent.

And currently, 7,092,919 people have been infected from the ongoing Corona Virus Disease-2019 (COVID-19) from December 2019 to June 8, 2020, out of which about 406,207 have died. And COVID-19 currently has a fatality rate of around 5.72%.

And if we compare these three coronavirus outbreaks then we get the following data:

COVID-19 has the highest number of coronavirus infections, followed by SARS and MERS.
COVID-19 also has the highest number of coronavirus deaths, followed by SARS and MERS.
COVID-19 has the lowest fatality rate among all coronavirus infections.
When comparing coronavirus infections against one another, COVID-19 is the most widely spread virus in less time.

Although the fatality rate of COVID-19 is lower than that of SARS and MERS, the nature of this virus indicates that it is growing very rapidly.

To understand the increasing number of infections from the COVID-19 outbreak, we have created a line graph for you.

According to the WHO’s COVID-2019 situation reports, the number of people affected on January 21, 2020, which was 282, the same number increased to 76,769 on February 21, 2020, next month, and not only that, this number was later expanded to 4,893,186 in just four months.

That means about a 17351% increase in the number of infected people in just 4 months.

Isn’t that HUGE?

Well, don’t look at the digits, but try to understand how fast the number of people infected with COVID-19 is increasing by looking at the graph.

Day by day, along with the number of people infected with COVID-19, the number of dead is also increasing.

According to the same situation report of WHO, the number of people who died from COVID-19 which was only 3 on January 21, the same number increased to 2247 on February 21 next month and not only this, in just four months, the number of dead has touched the figure of 323,256.

Which shows a fatality rate of about 6.60 percent.

Coronavirus update: The death rate which was close to 2.5 percent in the initial 4 weeks has now risen to 6.60 percent.

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Here is the line graph which describes the current situation very well:

COVID-19 Worldwide Current Situation

This line graph displays the current confirmed cases (in blue), deaths (in red), and recovered cases (in green).

The WHO has repeatedly underlined the importance of “flattening the curve” in order to tackle the coronavirus outbreak. But looking at the curve, it does not seem that the situation is under control.

In fact, as of now, out of every 100 infected people, at least 6 to 7 people are dying due to COVID-19.

You may find this fatality rate lower than SARS and MERS, but the pace with which COVID-19 is infecting people, it is possible that in the coming few months, tens of millions of people will be affected by this virus. (which is actually happening)

In fact, the World Health Organization has said that it may take about 18 months to prepare a COVID-19 vaccine.

This means that all countries will have to use their already available resources until the vaccine of COVID-19 is made.

So in such a situation, the responsibility of protecting yourself from infection remains your own. And how you can prevent your coronavirus infection, we will mention it in the upcoming chapters of this guide.

So let’s move ahead now.

Where Did This New Coronavirus Come From?

In late December 2019, China’s public health officials informed the World Health Organization about an unknown virus that is causing diseases like pneumonia in people.

And the following week, on 7 January, the WHO announced that the pneumonia outbreak in Wuhan city of China is due to a newly emerging virus of the coronavirus family. They also added the virus is spreading rapidly in and out of the city.

Since then, medical scientists around the world have been trying to find out where the new coronavirus came from. Many of them believe that the origin of this outbreak can be the Huanan Seafood Wholesale Market.

COVID-19 Update: China informed the WHO about the disease in late December 2019. However, there's now evidence which suggests it actually began in November.

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Which Animal Transmitted the Virus to Humans?

According to a report by The Lancet, as of January 2, 2020, in Wuhan, 41 patients admitted to the hospital were found to be infected with COVID-19, and 27 of them had direct contact with the Huanan Seafood Wholesale Market.

Researchers believe the COVID-19 infection spread to humans from animals being sold in Huanan Seafood Wholesale Market.

In further observation, samples of animals of the market were also taken between January 1 to January 12. And at the end of the month, the Chinese Center for Disease Control and Prevention made it clear that 33 out of 585 animal specimens were infected with the coronavirus.

Even after discovering that COVID-19 has been transmitted from animal to human, it is unclear what type of animal the virus originated from.

A research team from China, looking at the genetic code of the virus, claimed that the coronavirus came from snakes. While in another analysis, it was found that the genetic sequence of this new virus matches 96 percent of the coronavirus found in the bats.

Considering both these analyses, for coronavirus outbreak, either of the snakes and bats can be considered as a culprit. And, since some snakes eat bats, bats are probably supposed to be the origin.

But, to be fair, snakes and bats have not tried to spread this disease, but humans have bought them from live animal markets to feed their hunger and have themselves become the victim of infection.

Therefore, to not have such outbreaks in the future, it is necessary to ban such live animal markets across the world.

COVID-19 Update: On February 7, 2020, researchers in Guangzhou, China, suggested that pangolins can be the most probable animal source of the coronavirus outbreak.

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Pangolins Can Be Potential Intermediate Host Between Bats and Humans for Coronavirus Spread

Researchers have already suggested that COVID-19 originally came from bats. But the virus was probably transmitted to humans by another animal.

Yes, you heard that right.

In a research jointly conducted by Shen Yongyi and Xiao Lihua of South China Agricultural University in Guangzhou, shows that pangolins are the potential intermediate host for a new type of coronavirus. According to their research, the genetic sequence of the virus found in pangolins had 99% similarity with the genetics of new coronavirus.

Whether the pangolin was the species at which coronavirus jumped, it’s not clear. So in a study, virome data sets of pangolins and bats were reanalyzed in which it was found that the samples of bats were more similar to the SARS-CoV-2 virus than to the pangolin coronavirus.

Therefore, it is certain that the primary origin of coronavirus are bats. But if we believe that pangolins are also involved in coronavirus spread then, the virus may have jumped from bats first into pangolins and later from pangolins into humans.

But what is the connection between Pangolins and China? Let’s understand:

Pangolins are the only mammals wholly-covered in scales- which they use to protect themselves from predators in the wild.

In China, traditional medicines are made from scales of Pangolins, which are used to treat problems like arthritis, menstrual pain, and skin conditions. Not only this, pangolin meat and blood are considered a delicacy in China.

This is why Pangolins are in high demand in China.

But do you know that Pangolins are a very rare and endangered species of mammals? They are one of the protected species under national and international laws. In China, if a person is found selling Pangolins in any way, he can be imprisoned for up to 10 years.

So the question arises that despite such strict rules, how are the people of China fulfilling the demand for rare and endangered Pangolins?

Well, the answer is very simple: illegal poaching and trafficking of Pangolins.

According to the South China Morning Post, the population of pangolin has decreased by 90 percent in China from 1960 to 2004, due to the commercialization of pangolin.

Although officially, it is not possible to sell pangolin in the Hunan seafood wholesale market. But it may be possible that due to the high demand for pangolin, people are selling them in the market illegally.

And what if the illegally sold pangolins are already infected with coronavirus? Yes, it is possible.

According to a research report published on 24 October 2019, coronavirus is probably responsible for killing a large number of Malayan pangolins.

So it is possible that the pangolins being sold in the market may be one of them which may not have died at that time but have been infected with the coronavirus.

Therefore, looking at the facts, it can be concluded that in the Hunan Seafood Wholesale Market, people were illegally selling “coronavirus infected pangolins” along with other animals without the intention of harming anyone.

And accidentally, the coronavirus outbreak happened from there.

And if, in reality, illegal animal trade is the reason for the coronavirus outbreak, then it will be challenging to get to the root of the virus outbreak because people may have already erased all the evidence from the market for fear of being caught in illegal trading.

CHAPTER 2:

People Most Vulnerable To Coronavirus

Who are Most at Risk of Coronavirus?

Looking at the first cases of COVID-19, it seemed that the disease is not as severe as SARS and MERS. But the increasing number of confirmed cases of COVID-19 and evidence of human-to-human transmission of the virus proved that the novel coronavirus (SARS-CoV-2) is more contagious than the other two coronaviruses SARS-CoV and MERS-CoV.

To find out how dangerous this coronavirus is for different individuals, China’s health officials released a report in which they conducted in-depth study of 44,672 confirmed cases of COVID-19 in Mainland China as of February 11, 2020.

To our knowledge, this is the first most significant study since the coronavirus outbreak.

And now it’s time to share what they discovered. Here’s the summary of their key findings:

Out of 44,672 confirmed cases, a total of 1,023 people died with a fatality rate of 2.3 percent.
In the list of confirmed cases, persons aged 50–59 came in first place with 22.4%, persons aged 60–69 came in second place with 19.2%, and persons aged 40–49 came in third place with 19.2%.
Among confirmed cases, 51.4% were male and 48.6% were female.
There were 25.2% of confirmed cases who were facing some pre-existing medical conditions.
In confirmed cases, 22.0% of people were labor or farmers, and 20.6% were retired people.
Only 4.7% of the 44,415 confirmed cases were those who had a critical coronavirus infection.
The elderly population was more among those who die from virus infection. Of which 30.5% were aged 70–79, 30.2% were aged 60–69, and 20.3% were above 80 years.
Only 36.2% of the people who died from virus infection were women, and the remaining were men.
46.1% of the people who died from virus infection were those who had retired.
Among those who died from virus infection, 39.7% of people were suffering from hypertension, 22.7% of people with cardiovascular disease, and 19.7% of people with diabetes.
Among people 80 years or above, the fatality rate was found to be the highest at 14.8%.
The report found men’s fatality rate to be 2.8% and women’s fatality rate of 1.7%.
Compared to other occupations, the fatality rate of retirees was found to be the highest at 5.1%.
People suffering from cardiovascular disease were found to have the highest fatality rate of 10.5%, compared to other diseases.

We have detailed data and information on the analysis below.

Detailed Breakdown of the Analysis:

The analysis included a total of 72,314 unique records as of February 11, 2020, out of which 44,672 cases were confirmed to be infected with the coronavirus.

According to the analysis, out of 44,672 confirmed cases, a total of 1,023 deaths occurred at a 2.3% fatality rate.

To better understand the pattern of SARS-CoV-2, below, we have explained the analysis with the help of graphs in 7 different parts. Which are as follows:

Age
Sex
Occupation
Province
Wuhan-related exposure
Pre-Existing Medical condition
Case severity

Analysis by Age:

In the analysis, there are 9 different classes of people according to age, in which 0–9 years, 10–19 years, 20–29 years, 30–39 years, 40–49 years, 50–59 years, 60–69 years, 70–79 years, and ≥80 years old people are included.

The study shows people aged 30 years to 79 years are the top in the list of confirmed cases of COVID-19.

According to the study, 50–59 years is the most COVID-19 affected age group (with 22.4% of people). While, 60–69 years (19.2%), 40–49 years (19.2%), 30–39 years (17.0%) age groups are also fairly affected.

However, if you look up the graph, not by confirmed cases but by death cases, you’ll get a completely different number.

The study shows people aged 50 years and above are the top in the list of death cases of COVID-19.

70–79 years by far is the age group with most coronavirus deaths (with 30.5% of people). While, 60–69 years (30.2%), ≥80 years (20.3%), 50–59 years (12.7%) age groups are also popular in the same list.

Next, taking into account the confirmed cases and death cases of COVID-19, we calculated the fatality rate of different age groups.

The study calculated the fatality rate according to the age of the people. The fatality rate was found to be higher in older people and lower in younger people.

≥80 years is the age group with most coronavirus fatalities (with 14.8% of people). And 0-9 years is the age group with the least coronavirus fatalities (with 0.0% of people).

Key conclusion: Studying all the graphs suggests that elderly people are probably at the highest health risk from COVID-19.

Analysis by Sex:

In this analysis, including both male and female, their confirmed cases, death cases, and fatality rates are studied separately.

The study did not find much difference in confirmed cases of men and women. Males represent the majority of confirmed COVID-19 cases (51.4%), followed by female cases (48.6%).

However, if you look up the graph, not by confirmed cases but by death cases, you’ll get a completely different number.

The study shows males are the top in the list of death cases of COVID-19. 63.8% of people who died from COVID-19 are male, and 36.2% are female.

Next, taking into account the confirmed cases and death cases of COVID-19, according to sex, we calculated the fatality rate of both genders.

The study calculated the fatality rate according to the sex of the people. The fatality rate was found to be higher in males and lower in females.

Key conclusion: Studying all the graphs suggests that males are probably at the highest health risk from COVID-19.

Analysis by Occupation:

In the analysis, there are 5 different classes of people according to the occupation, in which service industry, farmer/laborer, health worker, retiree, and other/none people are included.

Other/none by far is the most coronavirus-infected occupation (with 45.9% of people). While, Farmer/laborer (22.0%), Retiree (20.6%), Service industry (7.7%), Health worker (3.8%), occupation groups are also fairly infected.

However, if you look up the graph, not by confirmed cases but by death cases, you’ll get a completely different number.

The study shows Retiree are the top in the list of death cases of COVID-19.

Retiree, is the occupation group with most COVID-19 deaths (with 46.1% of people). Other/none (37.5%), Farmer/laborer (13.6%), Service industry (2.2%), and Health worker (0.5%) occupation groups are also popular in the same list.

Next, taking into account the confirmed cases and death cases of COVID-19, we calculated the fatality rate of different occupation groups.

The study calculated the fatality rate according to the occupation of the people. The fatality rate was found to be higher in Retiree.

Retiree by far is the occupation group with most coronavirus fatalities (with 5.1% of people). And Health Worker is the occupation group with the least coronavirus fatalities (with 0.3% of people).

Key conclusion: Studying all the graphs suggests that retirees are probably at the highest health risk from COVID-19.

Analysis by Province:

In this analysis, including Hubei and other provinces, their confirmed cases, death cases, and fatality rates are studied separately.

The study found a considerable difference between confirmed cases of Hubei and other provinces. Hubei represents the majority of confirmed COVID-19 cases (74.7%).

The study shows people related to Hubei are the highest in the list of death cases of COVID-19. 95.7% of people who died from COVID-19 are related to Hubei, and only 4.3% are related to other provinces.

Next, taking into account the confirmed cases and death cases of COVID-19, according to the province, we calculated the fatality rate of Hubei and other provinces.

The study calculated the fatality rate according to the province of the people. The fatality rate was found to be higher in Hubei (2.9%) as compared to other regions (0.4%).

Key conclusion: Studying all the graphs suggests that people related to the Hubei province are probably at the highest health risk from COVID-19.

Analysis by Wuhan-Related Exposure:

In the analysis, a total of 37,269 patients are included in 2 different classes. First, those who have contact with Wuhan and the others who have no connection with Wuhan.

The study finds a considerable difference between confirmed cases of people who have contact with Wuhan and the others who have no connection with Wuhan. People with Wuhan-related exposure represent the majority of confirmed COVID-19 cases (85.8%).

The study shows that people who have contact with Wuhan are the highest in the list of death cases of COVID-19. 92.8% of people who died from COVID-19 had contact with Hubei, while only 9.2% did not.

Next, taking into account the confirmed cases and death cases of COVID-19, according to Wuhan-related exposure, we calculated the fatality rates.

The study calculated the fatality rate according to the Wuhan-related exposure of the people. The fatality rate was found to be higher in people who have contact with Wuhan (2.7%) as compared to the people who didn’t (1.2%).

Key conclusion: Studying all the graphs suggests that people who have direct contact with Wuhan are probably at the highest health risk from COVID-19.

Analysis by Pre-Existing Medical Conditions:

In the analysis, there are 6 different classes of people according to pre-existing medical conditions, in which a total of 20,812 people with Hypertension, Diabetes, Cardiovascular disease, Chronic respiratory disease, Cancer (any), and None medical conditions are included.

The study shows people with no medical condition are the highest in the list of confirmed cases of COVID-19.

Hypertension, is the most common pre-existing medical condition (with 12.9% of people). While, Diabetes (5.3%), Cardiovascular disease (4.2%), Chronic respiratory disease (2.5%), and Cancer (0.5%) medical conditions are also fairly common.

However, if you look up the graph, not by confirmed cases but by death cases, you’ll get a completely different number.

The study shows people with Hypertension are the highest in the list of death cases of COVID-19.

Hypertension, is the pre-existing medical condition with most coronavirus deaths (with 31.9% of people). While, Cardiovascular disease (18.3%), Diabetes (15.9%), Chronic respiratory disease (6.3%), and Cancer (1.2%) medical conditions are also popular on the same list.

Next, taking into account the confirmed cases and death cases of COVID-19, we calculated the fatality rate of different medical conditions.

The study calculated the fatality rate according to the medical condition of the people. The fatality rate was found to be higher in people with Cardiovascular disease.

Cardiovascular disease by far is the pre-existing medical condition with most coronavirus fatality rates (with 10.5% of people), followed by Diabetes (7.3%), Chronic respiratory disease (6.3%), Hypertension (6.0%), and Cancer (5.6%).

Key conclusion: Studying all the graphs suggests that people with pre-existing medical conditions such as Cardiovascular disease, Diabetes, Chronic respiratory disease, Hypertension, and Cancer are probably at the highest health risk from COVID-19.

Analysis by Case Severity:

In the analysis, there are 3 different classes of people according to case severity, in which a total of 44,415 people with Mild, Severe, and Critical cases are included.

The study shows people with mild case severity are the top in the list of confirmed cases of COVID-19.

Mild severity has the most COVID-19 cases (81.4% of people) followed by Severe (13.9%), and Critical (4.7%) cases.

However, if you look up the graph, not by confirmed cases but by death cases, you’ll get a completely different number.

The study shows people with mild case severity are the top in the list of confirmed cases of COVID-19.

Mild severity has the most COVID-19 cases (81.4% of people) followed by Severe (13.9%), and Critical (4.7%) cases.

However, if you look up the graph, not by confirmed cases but by death cases, you’ll get a completely different number.

The study calculated fatalities according to the case severity of the people and saw fatal outcomes only in those suffering from critical case severity.

Key conclusion: Studying all the graphs suggests that people with critical case severity are probably at the highest health risk from COVID-19.

Result of the Study:

This case study has told us a lot about the people who are most vulnerable to SARS-CoV-2. We found this case study interesting because it contains 44,672 confirmed cases of COVID-19, which is much larger in number than any other study.

Here’s the result of the study in short:

Most COVID-19 vulnerable gender: Male
Most COVID-19 vulnerable age: 50+
Most COVID-19 occupation: Retiree (which are usually old people)
Most COVID-19 vulnerable pre-existing medical conditions: Cardiovascular Disease, Chronic Respiratory Disease, Hypertension and Diabetes

Researchers found in the study that this SARS-CoV-2 is highly contagious. It has spread extremely rapidly from a single city to the entire country within only about 30 days.

We learned a lot about coronavirus from this study, and we hope you did too.

We have also discussed the pattern of the coronavirus in detail, here in the Chapter 8: Coronavirus Case Studies.

And now is the time to move to the next chapter.

COVID-19 Fact: Chinese research finds, people with blood type 'A' are at highest risk of coronavirus infection and people with blood type 'O' are at least risk.

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CHAPTER 3:

COVID-19 Symptoms

What Are The Symptoms Of COVID-19?

Since COVID-19 is still a new disease, doctors are still in its research and are learning new things about it daily.

A study conducted at around 138 patients at Zhongnan Hospital of Wuhan University found that among those infected with the new coronavirus, about 99% of people had a fever. At the same time, more than half experienced fatigue and a dry cough, and about one-third of the people experienced muscle pain and difficulty breathing.

In confirmed cases of COVID-19, symptoms range from mild to severe, starting with a cold and fever. As symptoms are similar to the flu, the disease becomes more challenging to detect. Most common symptoms of COVID-19 may include:

Fever
Fatigue
Dry cough
Shortness of breath
Myalgia
Pneumonia

Less common symptoms of COVID-19 may consist of:

Runny Nose
Nausea
Vomiting
Dizziness
Diarrhea
Sore throat
Headache
Passing out

The complete list of symptoms is still under analysis.

Prevention is always better than cure. If you have a cough, fever, or you have been in close contact with an infected person or a major outbreak area, get yourself tested for coronavirus infection immediately.

When to consult a doctor: If you are experiencing any of these symptoms, and you have recently been in a major outbreak area, you need to seek medical advice immediately.

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How Long Will It Take for the Symptoms to Appear?

According to the Centers for Disease Control and Prevention (CDC), symptoms of COVID-19 can take between 2 and 14 days to appear.

But a study published in the Journal of the American Medical Association (JAMA) found a patient’s incubation period to be 19 days long.

In that study, a 20-year-old woman who previously lived in Wuhan came to Anyang on January 10, after the virus outbreak. Three days later, she went to meet a sick patient (who was not infected with coronavirus) at Anyang District Hospital, along with five members of her family.

On January 17, one of the woman’s family members complained of fever and a sore throat. The following week, the other four relatives also complained of fever and shortness of breath. After that, all those relatives were admitted for investigation at the Fifth People’s Hospital on January 26.

And the investigation revealed that all the family members are infected with coronavirus, and the only woman who came in contact with those people from Wuhan was their 20-year-old relative.

Initially, when the woman was medically tested for coronavirus, no infection was detected. But when the woman was tested again one day later, the infection was detected, but the woman was still not showing any symptoms of COVID-19.

Doctors later revealed that the woman’s incubation period was 19 days long.

Besides, Zhong Nanshan, a Chinese scientist who underwent the discovery of SARS, also conducted a research in which he studied 1,099 laboratory-confirmed patients from 552 hospitals and took a median incubation period of 3 days (range, 0 to 24 days).

COVID-19 Incubation Period: A person can carry and transmit COVID-19 without showing symptoms from 1 to 24 days.

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CHAPTER 4:

Coronavirus Transmission

How the COVID-19 Spreads?

The events of the last few months have made it clear that SARS-CoV-2, first seen in Wuhan, China, is now making tens of millions of people sick worldwide.

As the virus outbreak develops day by day, the information related to it continues to change.

We’ve been following and providing the latest updates on COVID-19 since its outbreak.

Now we are going to tell you how this virus spreads. This information is based on studies conducted until June 7, 2020. But this information can be further developed based on scientific researches happening over time.

Here are the Reasons for the COVID-19 Spread:

COVID-19 spreads from one person to another, similar to other respiratory diseases such as the flu. Here are the possible ways of spreading coronavirus:

Transmission of the virus through droplets/particles.
Transmission of the virus through contaminated surfaces.
Transmission of the coronavirus through human feces.
Transmission of the virus through saliva.
Transmission of the virus through urine.

Transmission of the Virus Through Droplets/ Particles:

Droplet/ particles transmission is the leading cause of virus spread from person to person. When you cough or sneeze, you send droplets into the atmosphere, and others may fall ill when exposed to those infected droplets.

Transmission of the Virus Through Contaminated Surfaces:

If you cough or sneeze after being infected, your droplet falls on a surface and contaminates it. So later if a person comes in contact with that surface and touches his mouth, nose, or eyes, then he can fall ill.

Transmission of the Virus Through Human Feces:

Poor hand washing is a major cause of fecal-oral virus transmission. If you use the bathroom after being infected and do not take care of hygiene, then everything you come in contact with is contaminated by your feces. So later if a person comes in contact with those things and touches his mouth, nose, or eyes, then he can fall ill.

Transmission of the Virus Through Human Saliva:

If you are kissing someone or sharing food in the same plate, if the person is infected with coronavirus, then the virus can easily be transmitted orally from their saliva, even if they aren’t currently experiencing any symptoms.

Transmission of the Virus Through Urine:

The virus can be easily spread from person to person through infected person’s urine. There can be many ways of getting an infection this way. For example: If you use the same tap after going to the toilet that the person infected with coronavirus has previously washed his hands, then chances are that you too may be infected with the same virus later.

COVID-19 Fact: Many people mistakenly believe that COVID-19 is airborne, that it spreads through the air, but it is actually spread by droplets and particles of infected individuals.

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CHAPTER 5:

Coronavirus Protection

How to Protect Yourself From COVID-19?

COVID-19 is still affecting many people worldwide. Most people who become infected recover after experiencing mild illness, but there is always a possibility of infection by them. Therefore, it is important to take care of your health to avoid infection.

There are many things that you can do for your self-protection with the COVID-19. According to the World Health Organization, to keep yourself safe, you need to keep the following things in mind:

Should I Wear a Mask to Protect Against the COVID-19?

There’s a fun fact about medical masks that you probably won’t know.

Medical masks are used to prevent infected people from spreading the virus, not to prevent an uninfected person from getting infected.

Now you must be thinking that if this statement is true then why are all people being asked to wear face coverings of clothes in public?

Well, the simple answer to this is that experts are learning more about COVID-19 every day, and because of this, the guidelines on how to prevent the transmission of coronavirus are also changing.

Until recently, experts did not know the extent to which people with COVID-19 could spread the virus before symptoms appeared. There is a large proportion of the population who are asymptomatic carriers of COVID-19 and are propagating the virus. This simply means that no one can really determine the impact of asymptomatic cases until more testing is done. That is, people without symptoms can inadvertently spread the virus to others, so everyone should cover their nose and mouth in public.

What Type of Face Mask Should You Wear?

For Healthcare Workers:

If you are one of a healthcare workers—the people who are in closest contact with highly contagious patients, you should use N95 masks or surgical masks.

The N95 is the best face mask as it can filter tiny particles up to 95%, which may possibly contain the virus. However, N95 respirators are not able to provide full protection to children and people with facial hair as it is not designed for them.

According to the FDA, you may use the following types of N95 respirators at the time of public health medical emergencies:

3M™ Particulate Respirator 8670F
3M™ Particulate Respirator 8612F
Pasture Tm F550G Respirator
Pasture Tm A520G Respirator

Due to the high demand for N95 respirators, this mask is disappearing from the local market so it is not recommend for general public to wear N95 respirators. Those are critical supplies that must continue to be reserved for health care workers and other medical first responders.

For General Public:

Those of you who do not care for COVID-19 patients should wear homemade cloth masks in public. These types of masks do not prevent healthy people from getting sick, but they can definitely prevent sick people from infecting other people. For example, if you cough or sneeze, a cloth mask can help prevent droplets from circulating in the air. Also, cloth masks can help reduce the spread of COVID-19 by people who have the disease but don’t realize it.

How to Put On And Use Mask?

For Healthcare Workers (N95 and Surgical Masks):

If you wear a mask, then you should know how to use it, how long to use it, and what to do with it after use. According to WHO, masks are put on, used, taken off, and disposed of in this way:

Step 1: Before using a face mask, wash both your hands thoroughly with soap, and if the soap is not available, then use hand sanitizer.

Step 2: Find the metal strip of the face mask, adjust it well above your nose bridge, and stick the elastic strings behind your ears. (While doing this, make sure your mouth, nose, and chin are covered well.)

Step 3: If you feel like moisture in the face mask, remove it from the face by holding it with elastic strings and throw it in a closed dustbin. (While doing this, note that you are not touching the front of the face mask as it may be contaminated.)

Step 4: Repeat Step 1 and Step 2 to wear a new dry face mask. (Never use single-use face masks again.)

Here is the video by WHO which shows the proper technique to put on a face mask in detail:

For General Public (Cloth Face Coverings):

Cloth face masks should be worn in public settings such as grocery stores and especially in areas of significant community-based transmission, where social distancing is difficult to maintain. Here are some pointers for wearing and taking off a cloth mask:

Step 1: Before using a face mask, wash both your hands thoroughly with soap, and if the soap is not available, then use hand sanitizer.

Step 2: Tie it behind your head or use ear loops and make sure your mouth, nose, and chin are covered well.

Step 3: Remove it from the face by untying it or lifting off the ear loops. (While doing this, note that you are not touching the front of the face mask as it may be contaminated.)

Step 4: Place covering in the washing machine and wash your hands immediately.

Here’s a video by Consumer Reports which shows some simple steps to make sure you are wearing a cloth mask correctly:

The CDC has provided instructions on how to make a mask using just a bandana, old t-shirt, or square cotton cloth. This will help you to make sew and no-sew cloth face coverings easily at home.

Currently, the N95 and surgical face mask are only recommended for infected patients and health professionals dealing with those patients. And cloth face covering is advised for the general public yet.

According to a study, masks are successful in preventing infection only when they are used with frequent hand washing. Therefore, while using masks, it is important to clean your hands from time to time with soap or sanitizer.

Key conclusion: Staying at home is the best option for the safety of yourself and others from COVID-19. If you can’t do that, then making homemade masks is better than nothing.

CHAPTER 6:

Diagnosis and Tests

Here’s How Coronavirus Tests Work

Coronavirus (COVID-19) testing has been a major point of discussion and concern during the pandemic. But why is there so much focus on testing?

Well, for quick identification of cases, prompt treatment for those and immediate isolation to prevent the spread, the COVID-19 testing is very important. We now have two main kinds of tests available for COVID-19:

Molecular Test: A molecular test tells you if you have a current infection.
Serological Test: Serological is an antibody test that tells you if you had a previous infection.

We will discuss about both testing methods in detail below:

1. Molecular Test

This is a first type of diagnostic test that tells you if you have a current infection by looking for parts of the virus itself. In this test a long swab is used to collect sample, including physical pieces of coronavirus, from the back of the nose where it meets the throat.

To determine whether a nasopharyngeal sample is positive for the coronavirus, bio-technicians use three different molecular test techniques. Which are:

Reverse transcription polymerase chain reaction
Isothermal amplification assays
Antigen test

Reverse Transcription Polymerase Chain Reaction

Viruses such as SARS-CoV-2 contain only RNA, not DNA. Therefore, after a sample collection of a person, the extracted RNA is converted into DNA with the help of reverse transcription.

After that with the help of polymerase chain reaction, the converted DNA sample is amplified to a large enough amount to be examined in order to determine if it matches the genetic code of SARS-CoV-2.

This whole technique is called Reverse transcription polymerase chain reaction (RT-PCR).

Most RT-PCR tests can take anywhere from a few hours to a few days. But the FDA has recently begun giving the Emergency Use Authorization (EUA) for rapid diagnostic PCR tests that can produce results in less than an hour. Examples of authorized rapid diagnostic PCR tests include the following:

Abbott (Can detect SARS-CoV-2 in as little as 5 minutes)
Mesa Biotech (Can detect SARS-CoV-2 in as little as 30 minutes)
Cepheid (Can detect SARS-CoV-2 in as little as 45 minutes)

In addition, the FDA has also granted Emergency Use Authorization (EUA) for tests that collects saliva instead of using a traditional nasal swab. It is believed that this will reduce the risk for healthcare professionals and will be much more comfortable for patients to collect their own samples more efficiently.

To make testing easier, the FDA has recently authorized at-home coronavirus test kits, with the help of which you can find out if you currently have COVID-19 without leaving home. Examples of authorized at-home coronavirus test kits include the following:

Pixel (Collects nasal swab)
Hims (Collects saliva)
Vault Health (Collects saliva)

According to the German virologist, Christian Drosten, RT-PCR test performed with the help of throat swabs is reliable only in the first week of illness. Later the virus can disappear in the throat while it grows in the lungs. Samples of people whose illness has been more than a week can be obtained from deep airways with the help of suction catheter or from sputum.

Isothermal Amplification Assays

Like PCR, isothermal amplification methods are used to amplify RNA. However these methods are much faster than PCR as they do not involve repeated cycles of heating and cooling the sample.

These tests typically detect amplified virus sequences using fluorescent tags, which are read with specialized machines. Unlike PCR, these methods do not require expensive reagents or instruments, which aids in cost reduction for coronavirus detection.

Here are main differences, if we compare both PCR and Isothermal Amplification based methods of viral RNA detection. [Table adapted from Nguyen et al (2020)]

PCR	Isothermal Amplification Methods
Bulky and cumbersome	Smaller, simpler, portable
Specialized thermal cyclers required	Only a heat block is required
4-8 hours until result	1 hour until result
Requires skilled technicians	Requires no specific skill
Requires an additional reverse transcription step	Can be performed directly on RNA
Unstable reactions prone to inhibitors requiring purification steps	Stable and inhibitors tolerated, and thus purification steps not required
Detects DNA	Detects DNA and RNA
Tested on patient samples	Less tested on patient samples

Antigen Test

An antigen test is a new type of diagnostic test designed for rapid detection of the virus that causes COVID-19.

In the antigen test, samples of patients are collected with the help of nasal swab. The antigen test looks for proteins from the surface of the virus present in the collected samples and bind to the strips and gives a visual readout. In the case of coronavirus, these are usually proteins from surface spikes.

One of the main benefits of antigen testing is the speed of testing, which can provide results in minutes. The positive results obtained from antigen tests are highly accurate. But there are more chances of getting negative results wrong, so before deciding the treatment, negative results obtained from antigen test should be confirmed with the help of PCR test.

If we compare the three tests together, we find that PCR tests require much time, energy and trained personnel. And isothermal amplification methods can process only one sample per machine at a time. But antigen test has the ability to do 300 million tests a day at a low cost.

2. Serological Test

Another approach of test is serology (or antibody) test which identify people who were infected and have already recovered from COVID-19, including those who did not know they were infected.

When a person comes into contact with the virus, his body develops antibodies to fight the invading virus, which can take several days to more than a week. Antibodies are simply proteins made by the immune system in response to an infection and are specific to that particular infection.

In response to infection, immune system produce antibodies including IgM and IgG. According to the FDA, IgM antibodies produced in response to SARS-CoV-2 become detectable in the blood several days after the initial infection. IgG antibodies typically become detectable in the blood 10 to 14 days after initial infection, and peak after 28 days.

Because the body takes time to develop antibodies, serological tests are not useful for quickly identifying whether a patient currently has COVID-19. Rather antibody tests can be used to identify individuals who have had an infection and are recovered.

Some countries are considering issuing immunity passports or risk-free certificates for individuals who have antibodies against COVID-19 so that they can travel again or go to work. But, According to the WHO, it is still unclear that people who have recovered from COVID-19 and have antibodies are protected from a second infection. In such a situation, the use of such certificates may increase the risk of continued transmission. Therefore, even if you are recovered, it is still important to follow the COVID-19 safety guidelines.

Who Should Be Tested For COVID-19?

Molecular test is used to find out if you currently have COVID-19 infection. But not all require this test.

The first reason for this is that most people have mild illness and can recover at home without medical care and there is no need to get them tested. Apart from this, another reason is that the availability of testing is still limited, so not all can be tested.

We are going to share some recommendations with you on COVID-19 testing. But keep in mind, ultimately, decisions about testing are at the discretion of your state and local health departments.

Priorities For COVID-19 Testing

If you belong to one of these groups, you should get tested for coronavirus:

People with potential COVID-19 symptoms, including: fever, cough, shortness of breath, chills, muscle pain, new loss of taste or smell, vomiting or diarrhea, and/or sore throat.
People who have been in close contact with coronavirus positive cases.
People who live in or have regular contact with high risk settings like healthcare facilities, homeless shelters, correctional facilities and migrant farm work camps.
Essential workers whose jobs make social distancing hard. Including healthcare workers, first responders and front line workers.

Clinicians should determine by themselves whether the patient’s signs and symptoms resemble COVID-19 and whether the patient should be tested.

Although the supply of tests is increasing, it can be difficult to find a place to test. So if you have symptoms of COVID-19 and want to get tested, call your healthcare provider first.

COVID-19 Test Results

If COVID-19 Test is Positive and You Are the One Who is Sick:

Do not leave your home, except to get medical care.
As much as possible separate yourself from other people and pets in your home.
Monitor your symptoms continuously and follow the care instructions from your healthcare provider.
Seek emergency medical care immediately if you have trouble breathing, chest pain or pressure, confusion, or your face or lips are turning blue.
Call ahead before visiting your doctor so that they can protect themselves and other patients.
Always wear a cloth face covering, over your nose and mouth if you are around other people or pets. (even at home)
When you cough or sneeze, cover your mouth and nose with a tissue and throw away the used tissue in a dustbin.
Wash your hands often with soap with clean running water for at least 20 seconds.
Use an alcohol-based hand sanitizer with at least 60% alcohol if soap and water are not available.
Do not share your personal household items with other people in your home.
Wash your personal household items thoroughly after using them with soap and water.
Clean and disinfect all “high-touch” surfaces like personal room and bathroom everyday by yourself.
Use separate bathroom and toilet if possible.

If COVID-19 Test is Positive and You Are the Caregiver:

Make sure that the sick person is following all the above mentioned guidelines.
Make sure that the person who is ill is consuming lots of fluids as well as resting.
Do everything possible to bring the sick person’s grocery, medicine and other needs to their doorstep.
If the condition of the sick person is not improving or the condition is worsening further, contact his doctor immediately.
The caregiver should never be someone who is at high risk for COVID-19.
You should always give food to the sick person in a separate room if possible.
You should always ask the sick person to put on a cloth face covering before entering the room.
You may also wear a cloth face covering when caring for a person who is sick.
Wash your hands often with soap and water for at least 20 seconds and ask everyone at home to do the same.
Use an alcohol-based hand sanitizer with at least 60% alcohol if soap and water are not available.
Avoid touching your eyes, nose, and mouth with unwashed hands.
If possible, urge the sick person to clean their own space.
Do not share bathroom with the person who is sick.
If sharing a same bathroom, ask the sick person to clean and then disinfect after each use.
Wear disposable gloves while handling dirty laundry and throw disposable gloves in the trash after each use and wash hands afterwards.
Keep monitoring your health for COVID-19 symptoms and ask your family members to do the same.

If COVID-19 test is negative:

If your COVID-19 test is negative, it does not mean that you will not get sick. The test result simply means that you did not have COVID-19 at the time of the test. Therefore, whether the result for your COVID-19 test is positive or negative, you should always take preventive measures for yourself and others.

CHAPTER 7:

COVID-19 Treatment

Here’s The Exact Status of COVID-19 Vaccines and Treatments

COVID-19, which started from Wuhan city of China, has now spread its footprint all over the world. According to WHO, around 213 countries around the world are currently vulnerable to coronavirus, and more than 5.9 million people are infected with the coronavirus. So far, 402,283 people have died, and 3,373,551 people have also been treated.

Now the question arises that if no country has any medicine available for the treatment of coronavirus, so how are so many people recovering from all over world?

Well, COVID-19 is currently being treated with drugs that are already approved for other conditions, or have been tested on other viruses.

With the continued growth of COVID-19 cases worldwide, many companies are working on antiviral drugs and other companies are working on vaccines that can be used against the disease.

Currently, three drugs have received the Emergency Use Authority (EUA) from the Food and Drug Administration (FDA), which includes the anti-malarial drugs chloroquine and hydroxychloroquine, anti-viral remdesivir and Fresenius Kabi Propoven 2%.

How Long Can It Take to Develop a Drug That Works Against COVID-19?

It would not be right for us to say that the drugs that work against COVID-19 will soon be available in the market. Drug development is actually a very long process in which a drug has to pass from initial discovery to laboratory and animal testing to clinical trials in people.

On average, it takes at least ten years for a new medicine to complete the journey from initial discovery to the marketplace, with clinical trials alone taking six to seven years on average.

Here are the stages of a drug development:

Basic research and drug discovery
Preclinical testing
Clinical trials
Post approval research and monitoring

1. Basic Research and Drug Discovery

This phase includes the initial phase of research, in which researchers try to discover an investigative drug and
then do initial testing of that drug in the laboratory. This first phase of the process itself takes about three to six years. By the end, the researchers hope to identify a promising drug candidate that can be further studied in lab, animals and then humans.

2. Preclinical Testing

In this phase laboratory and animal tests are performed to determine whether the drug is safe for human testing. Through these techniques, scientists try to understand how medicine works and what possible side effects the drug can have on humans. Preclinical testing is very important before being allowed to study the candidate drug in humans.

3. Clinical Trials

This phase consists of three phases of clinical trials, each with its own specific goals and requirements. The clinical trials process is both expensive and time-consuming, and ends more often in failure than success. Only 12 percent of the candidates who are included in the clinical trials phase get approval. And from beginning to end, the clinical trial phase takes an average of six to seven years. Here are the three phases of clinical trials:

Phase I: In this phase, the candidate drug is tested on a small number of healthy people and people with a disease (usually 100 or less) to identify drug safety and detect side-effects.
Phase II: In this phase, the candidate drug is is given to 100 to 500 patient volunteers with a disease to identify its possible side-effects and to analyze optimal dose strength.
Phase III: Phase III trials are costliest and longest trials, in which the candidate drug is is given to 1,000 to 5,000 patients across to world. This phase helps to ensure proper use of the drug and also helps to determine whether the drug is safe and effective. It also provides information about possible interactions with other drugs, and specific dosage instructions.

4. Post Approval Research and Monitoring (Phase IV)

In this stage, drugs become available to patients after the successful completion of discovery, preclinical testing, and clinical trials. But the FDA still requires that companies conduct extensive post-approval research on approved drugs to monitor safety and long-term side effects as long as they stay on the market.

Key conclusion: If we take all the above facts into account, then according to this COVID-19 drug or vaccine will take about 10 years to be made. But in the case of COVID-19, scientists have received a lot of boost from the researches running on SARS and MERS that could accelerate the development of the first COVID-19 vaccine.

Experts also say that coronavirus can become seasonal as a cold and flu. And perhaps a vaccine may not be ready until the current pandemic ends.

Antiviral Drugs Being Tested Against the COVID-19

As the coronavirus disease 2019 (COVID-19) spreads, efforts are being made to reduce the transmission. While many scientists are working on developing a coronavirus virus vaccine, others are busy testing existing antiviral drugs.

Vaccines are only effective when administered prior to infection, but antiviral drugs can treat people who already have infection. The following existing antiviral drugs are being tested against COVID-19:

Remdesivir

Remdesivir is an antiviral drug developed by the biopharmaceutical company Gilead Sciences. In 2014, remdesivir was presented and then rejected as a cure for the ebola virus. But now in 2020, the drug is being seen as an option to treat COVID-19.

In late April, Gilead Sciences announced that one of its tests had been “terminated” due to low enrollment. But few days later, the company announced that in a trial of the antiviral drug remdesivir by the National Institute of Allergy and Infectious Diseases “has met its primary endpoint.”

In its context, the Director of NIAID, Dr. Anthony Fauci reported that people who used the drug remdesivir during the treatment of COVID-19 recovered in 11 days. In contrast, those who did not use remdesivir during treatment recovered within 15 days.

At the same time, another study published in The Lancet found that those who took remdesivir in clinical trial showed no benefit compared to others who took placebo.

Despite of conflicting results, on May 1, the FDA authorized the remdesivir under EUA for emergency use.

Kaletra

Kaletra is a combination product that contains two medications: lopinavir and ritonavir. Kaletra is basically used to treat HIV, but currently its clinical trials are being conducted to see if it also works against SARS-CoV-2.

A study that appeared in the journal Med by Cell Press on May 4 found that the Kaltera drug did not improve outcomes in people with mild or moderate COVID-19.

Also, another study which was published in the New England Journal of Medicine on May 7 found that the drug is not effective for people with severe COVID-19.

However, a study published in The Lancet found that people who were given drug combinations with the two other drugs ribavirin and interferon beta-1b took less time to clear the virus from their bodies.

Favipiravir

Favipiravir is an antiviral medication used to treat influenza in Japan and in some countries outside the United States. According to a news report, medical authorities in China have confirmed that a drug (favipiravir) used in Japan to treat influenza is effective in coronavirus patients.

On May 30, Russia’s Ministry of Health also approved the drug favipiravir for COVID-19 treatment, after initial testing showed hospitalized patients who took pills recovered more quickly.

Arbidol

Arbidol is an antiviral medication used to treat influenza in Russia and China. Although some Russian studies have shown it to be effective, it is not approved for use in other countries. It is also not approved by the FDA for the treatment or prevention of influenza.

The drug was tested with kaletra as a treatment for COVID-19, but researchers reported that the two drugs did not improve the condition of hospitalized patients with mild to moderate cases.

Other Treatments

In addition to antivirals, scientists are also looking into other ways to fight coronaviruses or treat COVID-19. Some of which are as follows:

Hydroxychloroquine and Chloroquine

Hydroxychloroquine and chloroquine are two drugs that have been used for several decades to treat malaria, recently making headlines as a potential treatment for coronavirus disease (COVID-19).

These drugs received Emergency Use Authorization (EUA) from the FDA in late March but in late April, the FDA issued a warning against the use of both hydroxychloroquine and chloroquine outside medical facilities.

A report by The Lancet found that patients who were being given hydroxychloroquine or chloroquine were dying at higher rates than others who were not being given the same dose.

Subsequently in late May, the World Health Organization announced that it was halting the clinical trials of hydroxychloroquine due to safety concerns.

Blood Plasma Transfers

When a person is infected with a novel coronavirus and is recovered, the person’s immune system produces antibodies to help fight the virus. According to doctors, if antibody-infused blood plasma is given to a newly ill person, in whose body antibodies are not present, it can help to improve those people more quickly.

The FDA has announced a process to conduct tests on an experimental treatment for medical facilities that use the blood plasma of people recovering from COVID-19.

Monoclonal Antibodies

Monoclonal antibodies (mAbs or Moabs) are man-made proteins that are created in the lab and act like human antibodies in the immune system. These drugs stimulate the immune system to attack the virus.

Eli Lilly and AbCellera, which collected 500 unique antibodies from recovered COVID-19 patients, have now begun the first human trials of an antibody drug against COVID-19.

Stem Cells

The stem cell therapy is a potential new therapy to battle SARS-CoV-2 that causes COVID-19. COVID-19 affects different people in different ways. Some severe cases of COVID-19 develop acute respiratory distress syndrome (ARDS). The stem cell treatment could potentially benefit people who are suffering from ARDS and require ventilators.

A company Athersys Inc. has begun a phase II/III clinical trial. While the other company Mesoblast is enrolling people with moderate to severe ARDS into a phase II/III clinical trial.

Immunosuppressants

In some people suffering from COVID-19, due to an overreaction of the body’s immune system, its starts releasing large amounts of small proteins called cytokines which causes “cytokine storm”. Scientists believe that it is due to this “cytokine storm” that some people develop ARDS and who then need to be placed on ventilators.

The FDA has approved a device that filters cytokines from patients’ blood.

In addition, to quell the cytokine storm several immunosuppressants including baricitinib– a drug for rheumatoid arthritis, CM4620-IE– a drug for pancreatic cancer, and IL-6 inhibitors are being tested in clinical trials.

Vaccines Under Development

Vaccines give you immunity to a disease without you getting sick first. A vaccine basically trains the immune system to recognize a disease-causing germ (in this case SARS-CoV-2) and respond by making special proteins (called antibodies) that help destroy the germ.

That way, if you ever encounters with the same disease germ in the future, your immune system quickly destroys it before it gives you a chance to get sick.

According to the WHO, there are more than 100 projects in the world focused on developing a vaccine for coronavirus. And as of May 11, eight candidate vaccines are being tested in clinical trials in people. Information about some projects is as follows:

Moderna

Moderna is an American biotech company focused on drug discovery and drug development based exclusively on messenger RNA (mRNA).

In March, the company began testing its mRNA vaccine during phase I clinical trial in 45 healthy volunteers aged 18 to 55. During testing volunteers were getting two shots 28 days apart. In mid-May, the company announced that all 45 participating volunteers had produced antibodies with the help of the vaccine at this initial clinical stage.

In early May, the company received permission from the FDA to begin a Phase II study of its mRNA vaccine.

After Phase II, the company is hoping to begin Phase III clinical trials in July. And if this mRNA vaccine succeeds in the Phase III clinical trial, the FDA has assured the company to fast-track regulatory review of the vaccine.

Inovio

Inovio Pharmaceuticals is an American biotech company focused on the discovery, and development, of synthetic DNA products for treating cancers and infectious diseases.

The company has developed a potential vaccine for SARS-CoV-2 and has also enrolled 40 healthy volunteers for Phase I clinical trial.

Before the start of COVID-19, the company was working on a DNA vaccine for MERS, another coronavirus-causing disease, and that made it much easier to prepare the vaccine for SARS-CoV-2.

The company is preparing to begin a II/III clinical trial of the vaccine in the summer of this year.

University of Queensland in Australia

Researchers of University of Queensland are developing a potential vaccine by growing viral proteins in cell cultures. On April 9, the university announced that the UQ team will partner with the Dutch company, Viroclinics Xplore, on the crucial pre-clinical studies.

The University received funding and support from the Coalition for Epidemic Preparedness Innovation (CEPI) to develop a COVID-19 vaccine.

They began preclinical trials in early April and the preclinical analysis revealed that the vaccine candidate raised significant levels of antibodies to neutralize the virus.

University of Oxford in England

The university began clinical trial in late April with more than 500 participants in partnership with a pharmaceutical company called AstraZeneca. The vaccine used in clinical trial uses a modified virus to trigger the immune system.

The company reported in mid-May that the vaccine was effective against COVID-19, while it was given to six monkeys during clinical trial. The company hopes to begin next stages of clinical trials by the middle of this year.

Oxford officials said that the potential vaccine has an 80 percent chance for success in clinical trials and they could deliver 30 million doses by September.

Other Pharmaceutical Companies

Johnson & Johnson’s Janssen Pharmaceutical Companies are also putting efforts to develop a vaccine candidate through an expanded collaboration with the Biomedical Advanced Research and Development Authority (BARDA).

Apart from this, the drug maker Sanofi Pasteur is also working with BARDA to produce a vaccine that will protect people from new coronavirus.

Another biotech company, Pfizer, says they will have a COVID-19 vaccine ready by the end of October. Pfizer has teamed up with a German pharmaceutical company BioNTech to develop a vaccine. Their initial clinical trial with 200 participants has already given good signals and they have begun human trials in the United States in early May.

Traditional Chinese Medicine is Used On COVID-19 Patients in China:

China, the world’s most populous country, which previously had the highest number of COVID-19 cases, has now flattened the COVID-19 curve and almost won fight against the SARS-CoV-2.

The current recovery rate of COVID-19 patients in China is around 94.3% and now there are negligible cases.

Despite being the most populous country in the world, how did China curb COVID-19? Is China doing something different from other countries? Well, the answer is YES.

And that’s what we are going to reveal in this chapter.

Traditional Chinese Medicine (TCM) has played an important role in the prevention and control of COVID-19 in China. TCM has been used to reduce fever and increase the body’s immunity on more than 90 percent of China’s COVID-19 patients.

To get a better understanding of TCM’s role in COVID-19 prevention and treatment, we reached Tsao-Lin E. Moy, an acupuncturist and Chinese medicine expert. Tsao-Lin told us that as of February 2 in China, the official use of traditional Chinese medicine was mandated as part of a protocol: prevention, treatment, and recovery with antivirals. She also shared a study with us that tells us how people infected with coronavirus are being treated with the help of TCM in China.

Case Study: How Exactly COVID-19 is Currently Treated in China with TCM

To further improve the treatment of COVID-19 patients, The COVID-19, Prevention, and Control Headquarters asked medical institutions to give priority to Traditional Chinese Medicine along with Western Medicine. They issued a notice stating that all designated medical institutions in Wuhan will ensure that all infected patients take Chinese medicine before midnight (24:00) on February 3, 2020. And indeed, the mandated use of TCM during treatment played an important role in pandemic prevention and control.

During this time, specific TCM wards were established in the designated hospitals, and besides, the TCM team collectively participates in the treatment.

Symptoms before giving TCM to patients were:

All the patients were so weak that they did not even have the strength to moan.
Most of the patients treated were severely ill.
Many of them had a high fever, a thick white coating on the tongue, slippery and wiry pulse, bowel incontinence, and no gesture in the face due to extreme weakness.

Herbal formulations were given to the patients according to the TCM pattern of the person as prescribed by the medical experts on January 30, 2020.

And February 1, 2020, after 2 days of use of TCM, the following differences in symptoms were seen in patients:

The fever of some patients reduced, and the number of people with high fever also decreased.
Thick white coating in the tongue of the patients was now quite thin.
Bowel movements of patients now were coming to normal.
Now the patients had the energy to speak up to five sentences.
Now the problem of cough was much less in patients than before.
Now many patients could sit and perform qigong exercises or meditate.

Two days after this, on February 3, 2020, eight confirmed patients were discharged from Wuhan Jinyintan Hospital who were either treated with traditional Chinese medicine or either with a combination of traditional Chinese medicine and Western medicine The details of the discharged patients were as follows:

There were 4 females and 2 males.
Six of the patients were severe, and two were mild cases.
The discharged patients were aged between 26 and 68 years.
Along with improving the symptoms of discharged patients, their mental state was also found to improve.

For the complete recovery of the discharged patients, they were given 2 weeks of Chinese herbs doses. The patients were also told how to use the medicine with appropriate exercise and proper diet plan.

The next day, in the report on February 4, 2020, it was found that the use of Traditional Chinese Medicine (TCM) had significantly improved the condition of about 50 people in the ward.

Most people believe that traditional Chinese medicine has helped prevent and treat COVID-19, and they are also eager to learn more about it. But they do not have much information about Traditional Chinese Medicine (TCM). Therefore, we are now going to share with you the exact formulas of TCM used by China in treating 90 percent, COVID-19 patients.

We have details and additional data on Traditional Chinese Medicine (TCM) below.

Recommended Formulas, Acupuncture and Moxibustion Protocols for Treatment of Coronavirus (By TCM experts):

TCM experts have recommended some formulas, acupuncture and moxibustion protocols for prevention and treatment of COVID-19 which are as follows:

Prevention Phase
Influenza Phase
Pneumonia Phase
Recovery Phase

#1. Prevention Phase:

Suitable for: Prevention of pneumonia due to viral infections, and the flu.

Pneumonia Prevention Formula:

Herb	Dose
Radix Astragali	15g
Rhizoma Atractylodis Macrocephalae (dry fried)	10g
Radix Saposhnikoviae	10g
Rhizoma Dryopteridis Crassirhizomatis	10g
Flos Lonicerae Japonicae	10g
Pericarpium Citri Reticulatae	6g
Herba Eupatorii	10g

Acupuncture Treatment for Prevention Phase:

It aims to strengthen the immune system, reduce early symptoms, and shorten the duration of the virus.

Points: ST 36, CV 6, CV 12

Methods and Frequency:

ST 36 on both sides for 15 minutes.
CV 6 or CV 12 for 10 minutes. (alternating from treatment to treatment)
Twice a day, once in the afternoon and once at night.

#2. Influenza Phase:

Diagnosis: Wind-Cold Invading the Exterior

Clinical Manifestations: Onset of fever (mostly low-grade fever), aversion to cold and fear of cold, chills, headache, ticklish throat, soreness of muscles of limbs, no sweat or night sweats.

Examination: Lung CT negative. Tongue is pale, coating is white and thin. Floating pulse

Treatment Strategy: Expel Wind, Release the Exterior; Clear Heat, Detoxify

Herbal Formula: Kudzu Decoction or Bupleurum and Kudzu Decoction to Release the Muscle Layer

Flu Formula #1:

Herb	Dose
Radix Puerariae Lobatae	15g
Herba Ephedrae	10g
Ramulus Cinnamomi	6g
Radix Paeoniae Alba	15g
Rhizoma Zingiberis Recens	10g
Radix et Rhizoma Glycyrrhizae	10g
Fructus Jujubae	10g
Flos Lonicerae Japonicae	20g
with headache, add Radix Angelicae Dahuricae	15g
with dry or ticklish throat, add Rhizoma Belamcandae	15g

Diagnosis: Toxic Heat Attacking the Lung

Clinical Manifestations: Fever, aversion to cold, sore and dry throat, dry cough, scanty sputum, sore and painful muscles in the limbs, weakness, headache.

Examination: CT scan reveals both lungs to have scattered ground-glass opacity (GGO). Tip and sides of the tongue are red; thin white or yellow tongue coating. Floating and rapid pulse.

Treatment Strategy: Expel Wind, Release the Exterior; Clear Heat, Detoxify

Herbal Formula: Honeysuckle and Forsythia Powder and Clear Epidemics and Overcome Pathogenic Influences Powder

Flu Formula #2:

Herb	Dose
Flos Lonicerae Japonicae	10g
Fructus Forsythiae	10g
Herba Schizonepetae	10g
Fructus Arctii	10g
Herba Menthae	10g
Radix et Rhizoma Glycyrrhizae	10g
Herba Lophatheri	10g
Rhizoma Phragmitis	25g
Rhizoma Coptidis	6g

Diagnosis: Damp Cold in the Lung

Clinical Manifestations: Aversion to cold, fever or absence of fever, dry cough, dry throat, fatigue, weakness, chest stuffiness, epigastric distention, nausea, diarrhea. Pale tongue, white greasy coating, slippery pulse.

Treatment Strategy: Expel Wind, Release the Exterior; Dispel Damp Cold

Damp Cold Formula #1:

Herb	Dose
Rhizoma Atractylodis	15g
Pericarpium Citri Reticulatae	10g
Cortex Magnoliae Officinalis	10g
Herba Pogostemonis seu Agastaches	10g
Fructus Tsaoko	6g
Herba Ephedrae	6g
Rhizoma et Radix Notopterygii	10g
Rhizoma Zingiberis Recens	25g
Semen Arecae	10g

Acupuncture Treatment for Mild and Moderate Cases:

The purpose is to reduce the severity of symptoms, shorten the duration, and alleviate emotional burden.

Points: LI 4, LR 3, ST 36, CV 8

Method and Frequency:

LI 4 and LR 3 bilaterally for 15 minutes.
ST 36 bilaterally for 10 minutes.
CV 8 with a moxa box for 15 minutes.
Twice a day, once in the morning and once in the afternoon.

#3. Pneumonia Phase:

Diagnosis: Shaoyang Syndrome with Damp

Clinical Manifestations: Fever, which is more pronounced in the afternoon, alternating chills with fever, cough, absence of wheezing, bitter taste in the mouth, dry mouth, chest stuffiness, stifling sensation, chest and hypochondriac fullness and distention, irritability, nausea or vomiting, no appetite, weakness. Similar to the beginning stage of pneumonia.

Examination: CT scan reveals both lungs to have multiple scattered or large pieces of ground-glass opacity (GGO). Slightly red tongue, thick and greasy, white or yellow coating, slippery, rapid pulse.

Treatment Strategy: Harmonize Shaoyang Syndrome, Clear Damp-Heat

Herbal Formula: Minor Bupleurum Decoction with Three-Nut Decoction or Sweet Dew Special Pill to Eliminate Toxins

Pneumonia Formula #1:

Herb	Dose
Radix Bupleuri	24g
Radix Scutellariae	9g
Rhizoma Zingiberis Recens	10g
Rhizoma Pinelliae	12g
Semen Armeniacae Amarum	15g
Fructus Amomi Rotundus	10g
Semen Coicis	30g
Herba Lophatheri	15g
Talcum	15g
Rhizoma Smilacis Glabrae	30g
Radix et Rhizoma Glycyrrhizae	10g

Diagnosis: Damp Heat Afflicting the Lung

Clinical Manifestations: Low-grade fever or absence of fever, dry cough, scanty sputum, dry and sore throat, fatigue, weakness, poor appetite, chest stuffiness, epigastric distention, nausea or vomiting, loose stool.

Examination: CT scan reveals both lungs to have multiple scattered or large pieces of ground-glass opacity (GGO). Pale or pink, puffy tongue with teeth marks. White or greasy white coating. Soft or slippery pulse.

Treatment Strategy: Transform Dampness, Detoxify; Disperse the Lungs and Expel Pathogens

Herbal Formula: Ephedra, Apricot Kernel, Coicis, and Licorice Decoction, Minor Sinking into the Chest Decoction and Tsaoko and Anemarrhena Decoction

Pneumonia Formula #2:

Herb	Dose
Herba Ephedrae	20g
Semen Armeniacae Amarum	10g
Semen Coicis	30g
Rhizoma Coptidis	6g
Rhizoma Pinelliae	10g
Pericarpium Trichosanthis	10g
Fructus Tsaoko	10g
Rhizoma Anemarrhenae	10g
Herba Houttuyniae	15g
Radix et Rhizoma Glycyrrhizae	10g
Fructus Amomi Rotundus	9g

Diagnosis: Toxic Stagnation Obstructing the Lung

Clinical Manifestations: Cough, stifling sensation, stuffiness and distention in the chest, asthma and wheezing that worsens with exertion, accelerated respiration, thirst, irritability, reddish yellow urine.

Examination: CT scan reveals both lungs to have multiple scattered or large pieces of ground-glass opacity (GGO). Fibrotic changes of the lung are also visible. Dark purplish tongue, yellow dry tongue coating or thick and greasy yellow coating, rapid, slippery pulse.

Treatment Strategy: Detoxify, Arrest Wheezing; Transform Blood Stasis and Open Collaterals

Herbal Formula: White Tiger plus Ginseng Decoction) with Four Wild Decoction

Pneumonia Formula #3:

Herb	Dose
Gypsum Fibrosum	30g
Rhizoma Anemarrhenae	10g
Rhizoma Dioscoreae	15g
Radix Panacis Quinquefolii	5g
Rhizoma Smilacis Glabrae	30g
Radix Rumicis Obtusifolii	10g
Rhizoma Bolbostemmatis	10g
Rhizoma Achyranthes Sylvestris	10g
Lignum Sappan	10g
Eupolyphaga seu Steleophaga	10g
Vascular Citri Reticulatae	15g
Semen Raphani	20g
Semen Descurainiae seu Lepidii	15g
Retinervus Luffae Fructus	30g

Diagnosis: Closed Interior and Abandoned Exterior Syndrome

Clinical Manifestations: Mental incoherence, irritability, burning or heat sensation in the chest and abdomen, cold extremities, accelerated respiration and need for assisted breathing, scarlet purple tongue, dry yellow or yellowish brown coating, floating, forceful pulse that is empty in the deep level, or rootless.

Treatment Strategy: Open the Closed, Consolidate the Abandoned, Detoxify, Rescue Reversal

Herbal Formula: Frigid Extremities Decoction plus Ginseng, taken with Calm the Palace Pill with Cattle Gallstone and Purple Snow Powder

Pneumonia Formula #4:

Herb	Dose
Radix et Rhizoma Ginseng	10g
Radix Aconiti Lateralis Praeparata	10g
Serve with	Calm the Palace Pill with Cattle Gallstone and Purple Snow Powder

#4. Recovery Phase:

Clinical Manifestations: Absence of fever, dry cough, chest stuffiness, shortness of breath, shortness of breath upon exertion, dry mouth, weakness.

Examination: CT reveals inflammation begins to subside as well as pulmonary interstitial changes. Pale red tongue, thick or greasy coating, thread, rapid pulse.

Treatment Strategy: Tonify Qi, Nourish Yin, Tonify Lung and Open the Collaterals

Herbal Formula: Glehnia and Ophiopogonis Decoction

Pneumonia Formula #5:

Herb	Dose
Radix Glehniae seu Adenophorae	15g
Radix Ophiopogonis	15g
Fructus Schisandrae Chinensis	15g
Radix et Rhizoma Ginseng	12g
Semen Raphani	15g
Retinervus Luffae Fructus	15g
Vascular Citri Reticulatae	15g
Fructus Perillae	12g
Bulbus Fritillariae Thunbergii	12g
Semen Armeniacae Amarum	12g
Radix Scutellariae	15g
Radix et Rhizoma Glycyrrhizae	10g

Acupuncture Treatment for The Recovery Phase:

The Purpose is restore Lung and Spleen functions and the body’s zheng (upright) qi.

Points: GV 14, BL 17, BL 13, ST 36 or LU 6.

Method and Frequency:

Moxa all points for 15 minutes.
Once a day.

We’d like to thank John Chen for compiling and translating the data that made this study possible. We also want to give a shout out to Michael Norris for digging deep into the data and making it easy to understand and digest.

And for those that are interested, here are links to our study methods.

Keep in mind that you do not have to use the above formulas in place of Western medicines, preferably you have to work towards effective treatment using both Western and Chinese medicine.

Also, patients are advised not to use Chinese medicine for self-treatment and should not consider Chinese medicine as the only treatment. As the condition of all patients may vary, the use of Chinese medicine is not advised without consulting licensed medical practitioners.

COVID-19 Control: How China Defeated Coronavirus Pandemic

While the whole world is fighting a deadly war with coronavirus that causes COVID-19, there are some countries which were previously vulnerable to the virus, are now doing a better job in defeating it.

China, which was at the forefront of the number of coronavirus confirmed cases, is now leading the list of most recovered cases. According to the data, China has recovered about 94.7% of the total infected cases, which is actually very admirable.

As the number of new cases falls, life in China is slowly returning to normal, and workers are gradually getting back to their jobs. Besides, schools, factories, public places, and tourist places have also reopened in China. This means that China’s intentions and objectives regarding COVID-19 are finally proving to be effective.

And this points to the obvious question, which is, how did they do it?

Well, to find out how China did this, we contacted some experts in the medical world and asked them some questions in its context. We interviewed the following people to know more about China’s pro-active steps to control coronavirus:

Tsao-Lin E. Moy, acupuncturist and Chinese medicine expert
Dr. Kate Tulenko, a physician and China health expert
Dr. Rishi Desai, Chief Medical Officer of Osmosis and Former CDC Officer
Dr. Kaushal Kulkarni, a US-based board-certified physician (Ophthalmologist)

And talked about the following:

What methods did China take to control the coronavirus?
How china traced every single COVID-19 case?
During a lockdown, how people were getting extra food and supplies?
Did China’s lockdown specifically work?
What are the lessons for other countries?
Are COVID-19 cases coming to an end in China?

And the answers that we got in our expert’s session are as follows:

1. What methods did China take to control the coronavirus?

One thing that China and Asia incorporate is the use of Traditional Chinese medicine (acupuncture, herbs, bodywork, food, movement, etc.) this is in addition to the use of antivirals. In Chinese and Asian culture, family and community play a central role as are mindfulness of health. It shows with Traditional Chinese Medicine (Daoist) practices woven into the culture. Foods, teas, home remedies, herbs, exercise, mind-body practices (TaiChi & QiGong), acupuncture, herbal medicine, massage, Feng shui, and divination.

The Chinese relied heavily on "residential committees" who are members of the Communist Party that oversee every neighborhood. They did a complete lockdown and tested everyone door to door. They also banned the sale of Tylenol, Motrin, and aspirin and did regular temperature checks. Anyone with a fever was re-tested. All positive people, regardless of symptoms, were taken to central quarantine. They also shut down transportation and closed roads. Citizens were required to have a pass to exit and enter their neighborhoods. No one from outside a neighborhood was allowed to enter.

China aggressively tried to flatten the curve by placing a major lockdown in the Hubei province and then issued a similar lockdown in other regions within China. Authorities forced residents to stay at home except for essential activities like going to the pharmacy or getting groceries. Some communities enforced a system by which there was only one entrance and exit, and everyone passing through were screened for symptoms of COVID 19. If anyone in the community tested positive, the community as a whole might be quarantined.

2. How china traced every single COVID-19 case?

Tracking down every single person that has tested positive for the COVID-19 is a top priority; there are temperature testing checkpoints. It requires complete cooperation and compliance with the health authorities. China uses mass surveillance and facial recognition to monitor (spy) on their subjects as well as having a sophisticated healthcare system. This is how people were tracked and monitored with who they had contact. This has saved many lives.

China used geodata from people's cellphones, but this method could only work there. If we want to use geodata in countries like the US, then it will be considered illegal. In addition to the use of geodata, China also used classic contact tracing to identify infected people in which if someone is confirmed as infected with a virus, contacts are traced by asking about the person's activities.

China started to do contact tracing to identify folks that may have been exposed to COVID-19, but this was really done best by South Korea. To flatten the curve, South Korea implemented mass testing that was free, easy, and accessible. They offered drive-through testing stations, where people were tested inside their car. They also had phone booth-like testing areas where the person walks in, gets tested, and walks out.

One of the ways China was able to control the coronavirus and track cases is with an antibody test. The antibody test is a quick, 10 minute fingerstick blood test that tells you if you have active infection, or if you are immune to it. If they are immune (meaning they were already exposed to the virus and their body has produced antibodies to it), they can theoretically re-enter the workforce and society.

3. During lockdown, how people were getting extra food and supplies?

The technology and food delivery service got coordinated to help people get food and supplies, it’s not perfect, but mass tracking of the population also helped to funnel needs.

Some people, such as elders living alone, were provided with food. Otherwise, people were allowed to go grocery shopping every few days. Some neighborhoods did bulk purchasing of food on WeChat and had it delivered.

Community and state officials of China took on the responsibility of delivering extra food and supplies to individuals that were in quarantine.

4. Did China’s lockdown specifically work?

Yes, it did and is working, as we see that China is starting to emerge from restrictions and people going back to work.

Yes! After only 2 months, they are down to almost no new cases a day.

Yes - it absolutely worked. The pandemic curve began to improve with fewer new cases each day, and within two weeks, China had gotten over the worst of it.

5. What are the lessons for other countries?

The public needs to take responsibility for their health. That will prevent many of the chronic illnesses that lead to susceptibility to killer viruses and influenza.

Act quickly and boldly with lockdowns, mass testing, central quarantines, and public mask-wearing. This is currently the best way to prevent community virus spread.

Every country needs to isolate - to flatten (and shrink) the curve. China did this across the board with strict policies and enforcement, whereas South Korea did this by extensive testing and isolation of individuals.

6. Are COVID-19 cases coming to an end in China?

For now, it looks like the new cases are slowing, but the virus is novel, and that means cautious optimism.

Yes, slowly. China now has some imported cases and are requiring all Chinese citizens who return to China from abroad to quarantine for 2 weeks.

Yes, things have gotten a lot better in China. There are more imported cases in China, so China is focused on things like a 2-week quarantine for anyone coming into the country.

Since South Korea is also doing very well in the context of coronavirus, after this, we asked the experts to throw light on the important efforts being made by South Korea.

In response to this Dr. Desai said “In terms of testing, based on the March 20th data, the US lags far behind with only about 135,000 people tested, which works out to 1 out every 2424 people, roughly 15 times less than South Korea – despite both countries having their first confirmed case on January 19th. Unfortunately, the US data doesn’t include testing done by private companies, but as of late March, testing has been well-documented to be woefully inadequate in most parts of the US, requiring days to get a result of being unavailable altogether.”

With this, Dr. Kate Tulenko said, “What we learn from South Korea is that democracies can defeat this virus if that act early and decisively. People might need to give up some rights (such as the right to data privacy) to facilitate contact tracing. But these temporary reductions in rights will lead to a faster return to normal life and a robust economy.”

Finally, Kate Tulenko said that for countries facing new outbreaks, they should focus on social distancing, respiratory and hand hygiene, mass public mask-wearing, mass testing and contract tracing, and central quarantine of all COVID-19 positive patients.

We learned a lot in this chapter about China and South Korea’s efforts against COVID-19, and we hope you did too.

And now is the time to move to the next chapter.

CHAPTER 8:

Coronavirus Case Studies

Case Studies: Pattern of Coronavirus Infection

In this chapter, you are going to see two case studies to understand how coronavirus affects your body.

First, you will see a case study of 138 hospitalized patients and learn about their clinical characteristics.

Then you will see what symptoms the first 99 COVID-19 infected patients of Wuhan Jinyintan Hospital displayed.

Case Study #1: Clinical Characteristics of 138 Hospitalized Patients

In December 2019, the novel Coronavirus outbreak began in Wuhan, China. The number of cases was increasing rapidly, but information on clinical characteristics shown by the suffering patients was limited.

Therefore, between January 1 and January 28, 2020, at the Zhongnan Hospital of Wuhan University, a detailed study of the cases of 138 hospitalized patients was done, which was later published in JAMA on February 7, 2020.

Here's the Summary of Their Key Findings:

The study includes 138 hospitalized patients aged 22–92 years whose median age was 56 years.
Of the 138 hospitalized patients, 75 (54.3%) were male, and 63 (45.7%) were female.
Out of 138 hospitalized patients, 102 (73.9%) were admitted in isolation ward and 36 (26.1%) in ICU.
ICU patients were older in age than non-ICU patients. The median age of ICU patients was 66 years, and the median age of non-ICU patients was 51 years.
Of the 138 hospitalized patients, 64 (46.4%) already had one or more pre-existing medical conditions. Hypertension (31.2%), diabetes (10.1%), cardiovascular disease (14.5%), and malignancy (7.2%) were the most common pre-existing conditions.
The most common symptoms at the onset of the disease were fever (98.6%), fatigue (69.6%), dry cough (59.4%), myalgia (34.8%), and dyspnea (31.2%).
Out of 138 hospitalized patients, 57 (41.3%) people caught the virus infection in the hospital. Out of which 17 patients (12.3%) were already admitted in the hospital, and 40 were health care workers (29%) of the same hospital.
The study suggested rapid person-to-person transmission of the virus. On average, each patient was spreading the infection to 2.2 others.

Here’s the detailed breakdown of the study:

Detailed Breakdown of the Study:

To understand the pattern of coronavirus infection with this case study, below, we have explained the study with the help of graphs in 3 different parts. Which are as follows:

Sex
Comorbidities
Signs and symptoms

Analysis By Sex:

In this analysis, including both male and female, their ICU and Non-ICU cases are studied separately.

In total, hospitalized patients, males represent the majority with 75 infected cases (54.3%), followed by 63 female cases (45.7%).

After this, to understand the pattern better, we divided the total cases into two parts ICU patients and non-ICU patients.

In the ICU case, 22 males (61.1%) and 14 females (38.9%) had to be transferred to the Intensive Care Unit for further treatment.

In the Non-ICU case, 53 males (52%) and 49 females (48%) were treated in isolation wards.

Key conclusion: Studying all the graphs suggests that men are probably at the highest health risk from coronavirus infection.

Analysis By Comorbidities:

In this analysis, we separately studied ICU and non-ICU cases of hospitalized patients admitted to Zhongnan Hospital, according to the comorbidities.

The study revealed that 64 out of 138 patients (46.4%) had one or more pre-existing medical conditions.

In total, hospitalized patients, Hypertension medical condition is common in majority of infected cases 43 (31.2%). Followed by 20 Cardiovascular Disease cases (14.5%), 14 Diabetes cases (10.1%), 10 Malignancy cases (7.2%), 7 Cerebrovascular Disease cases (5.1%), 4 COPD cases (2.9%), 4 Chronic Kidney Disease cases (2.9%), 4 Chronic Liver Disease cases (2.9%) and 2 HIV infection cases (1.4%).

After this, to understand the pattern better, we divided the total cases into two parts ICU patients and non-ICU patients.

In the ICU case, Hypertension, is the most common pre-existing medical condition (with 58.3% of people). Cardiovascular disease (25.0%), Diabetes (22.2%), Cerebrovascular Disease (16.7%), Malignancy (11.1%), COPD (8.3%), and Chronic Kidney Disease (5.6%) medical conditions are also fairly common.

In the Non-ICU case, Hypertension, is the most common pre-existing medical condition (with 21.6% of people). Cardiovascular disease (10.8%), Diabetes (5.9%), Malignancy (5.9%), Chronic Liver Disease (3.9%), Chronic Kidney Disease (2.0%), HIV Infection (2.0%), Cerebrovascular Disease (1.0%), and COPD (1.0%) medical conditions are also fairly common.

Key conclusion: Studying all the graphs suggests that people with medical conditions such as Hypertension, Cardiovascular disease, Diabetes, and Malignancy are probably at the highest health risk from coronavirus infection.

Analysis By Signs and Symptoms:

In this analysis, we separately studied ICU and non-ICU cases of hospitalized patients admitted to Zhongnan Hospital, according to the signs and symptoms.

The study revealed early signs and symptoms of all hospitalized patients.

In total hospitalized patients, the most common symptom at onset of illness was fever (98.6%), followed by Fatigue (69.6%), Dry Cough (59.4%), Anorexia (39.9%), Myalgia (34.8%), Dyspnea (31.2%), Expectoration (26.8%), Pharyngalgia (17.4%), Diarrhea (10.1%), Nausea (10.1%), Dizziness (9.4%), Headache (6.5%), Vomiting (3.6%) and Abdominal Pain (2.2%).

After this, to understand the pattern better, we divided the total cases into two parts ICU patients and non-ICU patients.

In the ICU case, the most common symptoms at the onset of illness were Fever (100%), Fatigue (80.6%), Anorexia (66.7%), Dyspnea (63.9%), and Dry Cough (58.3%). And less common symptoms were Myalgia (33.3%), Pharyngalgia (33.3%), Expectoration (22.2%), Dizziness (22.2%), Diarrhea (16.7%), Nausea (11.1%), Headache (8.3%), Vomiting (8.3%), and Abdominal Pain (8.3%).

In the Non-ICU case, the most common symptoms at the onset of illness were Fever (98.0%), Fatigue (65.7%), Dry Cough (59.8%), and Myalgia (35.3%). And less common symptoms were Expectoration (28.4%), Pharyngalgia (11.8%), Diarrhea (7.8%), Headache (5.9%), Dizziness (4.9%), and Vomiting (2.0%).

Key conclusion: Studying all the graphs suggests that fever, Fatigue, dry cough, myalgia, and dyspnea are the most common early signs of SARS-CoV-2 infection.

Result of the Study:

This case study has told us a lot about the pattern of coronavirus. We found this case study interesting because it focused mainly on the early symptoms of the COVID-19.

Here’s the result of the study in short:

Most COVID-19 vulnerable gender: Male
Most COVID-19 vulnerable age: 60+
Most COVID-19 vulnerable pre-existing medical conditions: Hypertension, Cardiovascular Disease, Diabetes and Malignancy
Most common COVID-19 symptoms: Fever, Fatigue, Dry Cough, Myalgia, and Dyspnea.
SARS-CoV-2 mode of transmission: Person-to-person
SARS-CoV-2 reproduction number: on average, 2.2

The study also revealed that patients who are mildly ill in the beginning can see major changes in their illness in a week. Patients can see the following changes in their illness:

Day 1 to 4: Mild signs and symptoms
Day 5 to 6: Shortness of breath
Day 7: Medical care in a hospital required
Day 8: Severe difficulty breathing

Doctors also found in these studies of patients that coronavirus infection is accompanied by pneumonia, which has effects in many parts of the body such as the blood clotting system, heart, kidney, liver, and lungs.

We learned a lot about coronavirus from this study, and we hope you did too.

We’d like to again thank JAMA for providing the data that made this research possible.

And now is the time to move to the second case study of coronavirus.

Case Study #2: Clinical Characteristics of 99 Confirmed Cases

Between January 1 and January 20, 2020, at the Wuhan Jinyintan Hospital, a detailed study of the cases of 99 confirmed cases was done, which was later published in The Lancet on January 30, 2020.

All data of the study was obtained from the patients’ medical records. And if any data was missing or unclear, the researchers clarified the data by direct communication with attending doctors and other health care providers.

Here’s the Summary of Their Key Findings:

Out of 99 confirmed cases, 11 people died, 31 were discharged, and 57 were still hospitalized.
In the list of confirmed cases, persons aged 50–59 came in first place with 30%, persons aged 60–69 came in second place with 22%, and persons aged 40–49 came in third place with 22%.
Among confirmed cases, 68% were male, and 32% were female.
There were 51% of confirmed cases that were already facing some pre-existing chronic medical illnesses.
In confirmed cases, 64% of people were self-employed, 19% were retired, 15% were employees, and 2% were agricultural workers.
23% of the 99 confirmed cases had a critical coronavirus infection and were transferred to the intensive care unit.
Among confirmed cases, 40% of people were suffering from cardiovascular and cerebrovascular diseases, 13% of people with endocrine system disease, 11% of people with digestive system disease, 1% people with a malignant tumor, and 1% people with nervous system disease.
The most common symptoms at the onset of the disease were fever (83%), cough (82%), shortness of breath (31%), muscle ache (11%), confusion (9%), headache (8%) and sore throat (5%).
The less common symptoms at the onset of the disease were rhinorrhoea (4%), chest pain (2%), diarrhoea (2%), and nausea-vomiting (1%).
90% of the 99 confirmed cases had more than one sign or symptom.
All 99 people had pneumonia. 75% of them had bilateral pneumonia, and 25% had unilateral pneumonia.
Out of all 99 confirmed cases, 76% had oxygen therapy, 76% had antiviral treatment, 71% had antibiotic treatment, 27% had intravenous immunoglobulin therapy, 19% had glucocorticoids, 17% had mechanical ventilation, 15% had antifungal treatment, 9% had CRRT, and 3% had ECMO.

We have detailed data and information on the analysis below.

Detailed Breakdown of the Study:

To understand the pattern of coronavirus infection with this case study, below, we have explained the study with the help of graphs in 8 different parts. Which are as follows:

Age
Sex
Occupation
Chronic medical illness
Clinical outcome
Signs and symptoms
Pneumonia
Treatment

Analysis By Age:

In the analysis, there are 9 different classes of people according to age, in which ≤39 years, 40–49 years, 50–59 years, 60–69 years, and ≥70 years old people are included.

The study shows people aged 40 years and above are the top in the list of confirmed cases of coronavirus infection.

50–59 years is the most coronavirus-infected age group (with 30% of people). 60–69 years (22%), 40–49 years (22%), and ≥70 years (15%) age groups are also fairly infected.

And, the median age of all confirmed cases is 55·5 years.

Key conclusion: Studying all the graphs suggests that elderly people are probably at the highest health risk from coronavirus infection.

Analysis By Sex:

In this analysis, including both male and female, their confirmed cases are studied separately.

In total confirmed cases, males represent the majority with 67 infected cases (68%), followed by 32 female cases (32%).

Key conclusion: Studying all the graphs suggests that males are probably at the highest health risk from coronavirus infection.

Analysis By Occupation:

In the analysis, there are 4 different classes of people according to the occupation, in which agricultural workers, self-employed, employees, and retired people are included.

The study shows self-employed are the tp in the list of confirmed cases of coronavirus infection.

Self-employed, by far, is the occupation group with most coronavirus confirmed cases (with 64% of people). Retired (19%), Employee (15%), and Agriculture worker (2%) occupation groups are also popular in the same list.

Key conclusion: Studying all the graphs suggests that self-employed persons (the people who have to do a lot of social dealing with others) are probably at the highest health risk from coronavirus infection.

Analysis By Pre-Existing Chronic Medical Illness:

In the analysis, there are 6 different classes of people according to pre-existing chronic medical illness. In which people with Cardiovascular & cerebrovascular diseases, Digestive system disease, Endocrine system disease, Malignant tumor, Nervous system disease, and Respiratory system disease, chronic medical illness are included.

The study revealed that 50 out of 99 patients (51%) had one or more pre-existing chronic medical illnesses.

In total confirmed cases, Cardiovascular & cerebrovascular diseases chronic medical illness represent the majority with 40 infected cases (40%). Followed by 13 Endocrine system disease cases (13%), 11 Digestive system disease cases (11%), 1 Malignant case (1%), 1 Nervous system disease case (1%), and 1 Respiratory system disease case (1%).

Key conclusion: Studying all the graphs suggests that people with pre-existing chronic medical conditions such as Cardiovascular & cerebrovascular diseases, Endocrine system disease (diabetes), and Digestive system disease are probably at the highest health risk from coronavirus infection.

Analysis By Clinical Outcome:

In the analysis, there are 3 different classes of people according to clinical outcome. In which people who remained in the hospital, who were discharged, and who died have been included.

The study shows that as of 25 January, 31 (31%) patients had been discharged, and 11 (11%) patients had died, and another 57 (58%) patients were still in the hospital.

Key conclusion: The study of all graphs suggests that coronavirus infection is probably very dangerous, as only 31 percent of the 98 people were discharged.

Analysis By Signs and Symptoms:

In this analysis, we studied all confirmed cases admitted in Jinyintan Hospital, according to the signs and symptoms.

The study revealed early signs and symptoms of all confirmed cases.

In total confirmed cases, the most common symptom at onset of illness was fever (83%), followed by cough (82%), shortness of breath (31%), muscle ache (11%), confusion (9%), headache (8%), sore throat (5%), rhinorrhea (4%), chest pain (2%), diarrhoea (2%) and nausea & vomiting (1%).

Key conclusion: Studying all the graphs suggests that fever, cough, shortness of breath, and muscle ache are the most common early signs of coronavirus infection.

Analysis By Pneumonia:

In this analysis, we separately studied unilateral pneumonia and bilateral pneumonia cases of confirmed cases admitted in Jinyintan Hospital.

In total confirmed cases, bilateral pneumonia represents the majority with 74 infected cases (75%), followed by 25 unilateral pneumonia cases (25%).

Key conclusion: Studying all the graphs suggests that coronavirus infection causes pneumonia in all patients.

Analysis By Treatment:

In this analysis, we studied all confirmed cases admitted in Jinyintan Hospital, according to the treatment they received.

In all confirmed cases, the most common treatments of illness were antiviral treatment (76%) and oxygen therapy (76%). Followed by antibiotic treatment (71%), intravenous immunoglobulin therapy (27%), glucocorticoids (19%), mechanical ventilation (17%), antifungal treatment (15%), continuous renal replacement therapy (9%), and extracorporeal membrane oxygenation (3%).

Key conclusion: Studying all the graphs suggests that antiviral treatment, oxygen therapy, and antibiotic treatment are the most common treatments of coronavirus infection till now.

Result of the Study:

This case study has told us a lot about the pattern of coronavirus. We found this case study interesting because it focused mainly on treatments of the COVID-19.

Here’s the result of the study in short:

Most COVID-19 vulnerable gender: Male
Most COVID-19 vulnerable age: 50+
Most COVID-19 vulnerable occupation: Self-employed (the people who have to do a lot of social dealing with others)
Most COVID-19 vulnerable pre-existing chronic medical illness: Cardiovascular & Cerebrovascular Diseases, Endocrine system disease (such as Diabetes) and Digestive system disease
Most common COVID-19 symptoms: Fever, Cough, Shortness of Breath, and Muscle Ache.
Most common COVID-19 treatments: Antiviral Treatment, Oxygen Therapy, and Antibiotic Treatment

Doctors found in the study that in coronavirus infection, all people get pneumonia, which becomes more severe over time, and that made their bodies less capable of fighting the virus.

The study also revealed that the first two deaths occurred of men who had no serious health issues, but they were long-term smokers. Both of them were experiencing severe breathing problems due to coronavirus infection, and eventually, they died due to lung-related complications.

We learned a lot about coronavirus from this study, and we hope you did too.

We’d like to again thank The Lancet for providing the data that made this research possible.

And now is the time to move to the next chapter.

CHAPTER 9:

Coronavirus Rumors vs. Facts

COVID-19 Rumors vs. Facts: Biggest Coronavirus Myths Busted

Just as the outbreak of coronavirus has caused a storm of infection in people around the world, there has been a flood of articles about the outbreak on social media. Unfortunately, in this flood of articles, it can be difficult for a common man to separate facts from rumors.

And during a viral outbreak, rumors and misinformation can spread unnecessary fear and panic among people.

So here at Healthroid, we have compiled a long list of the biggest myths about the novel coronavirus and the associated disease COVID-19 to discover the truth and explain how these rumors are misleading.

Let’s dive right in.

‣ Myth: "This coronavirus was developed in a biological warfare lab and intentionally leaked."

Fact: No, no part of this rumor is correct. Scientists around the world continue to look at the origin of the virus until now. Scientists believe that coronaviruses likely originated from bats, just like many other viruses that have recently emerged in humans from wildlife.

‣ Myth: "An ultraviolet disinfection lamp can kill the new coronavirus."

Fact: No, according to WHO, UV lamps should not be used to sterilize hands, or other areas of skin as UV radiation can cause skin irritation.

‣ Myth: "China lied about coronavirus case numbers."

Fact: The truth is that no one is aware of the exact figures of coronavirus cases in China. By the way, if history is seen, China has messed up the data in other coronavirus epidemics in the past. According to The Epoch Times, some leaked documents reveal that the real figures in the Shandong Province of China are up to 52 times higher than the reported figures.

‣ Myth: "The coronavirus can be killed with a hand dryer."

Fact: It is essential to take care of the hygiene of your hands to protect yourself from coronavirus. For this, you need to wash your hands from time to time with alcohol-based hand sanitizer or soap and running water. Yes, after that, you can dry your hands with the hand dryer.

‣ Myth: "A vaccine is ready for the novel coronavirus that was patented many years ago."

Fact: There is no patent for the recently discovered new coronavirus. The wrong information was given in a Facebook post that a person named Jacob Rothschild owns the patent for Novel Coronavirus, which was later proved wrong by the Fullfact website by fact-checking. Instead, according to The Verge, the coronavirus vaccine will take a long time to come because vaccine development has just started from scratch.

‣ Myth: "Thermal scanners are effective in detecting people infected with the new coronavirus."

Fact: Thermal scanners cannot detect whether someone is infected with a coronavirus. Thermal scanners work only to measure the rise in the body temperature (fever) of people due to viral infection, whether it is a new coronavirus or any other virus. It takes 2 to 14 days for a person suffering from coronavirus to show symptoms. In such a situation, if a person is infected but is not showing signs of fever, then Thermal scanners also do not provide any information about the coronavirus infection.

‣ Myth: "Lysol and Clorox products can kill the novel coronavirus."

Fact: Popular brands Lysol and Clorox have mentioned in their labeling, they have a 99.9% effectiveness against human coronavirus. Yes, products like Lysol and Clorox are effective in disinfecting the previously seen (old) human coronavirus. Still, these products are equally effective against novel (new) coronavirus that has not been proven yet.

‣ Myth: "Spraying alcohol or chlorine all over your body can kill the coronavirus."

Fact: No, according to the WHO, if the virus has already entered your body, then the virus will not die by a spray of alcohol or chlorine. In fact, spraying can damage your mucous membranes (i.e., eyes, mouth). You need to be careful as both alcohol and chlorine are used to disinfect the surfaces with appropriate advice.

‣ Myth: "China sought court approval to kill 20,000 coronavirus patients."

Fact: An article published on the website AB-TC claimed that the Chinese government was seeking approval from the country’s Supreme People’s Court to kill 20,000 coronavirus patients to prevent the virus from spreading further. But a US-based fact-checking website Snopes proved the claim to be absolutely false by fact-checking. According to Snopes, this website has a history of spreading misinformation, and this website is full of junk news.

‣ Myth: "It is not safe to receive a letter or a package from COVID-19 affected area."

Fact: No, this is not true at all. According to the WHO, people who are receiving a letter or a package from COVID-19 affected areas are not at risk of contracting the new coronavirus. Previous analyzes have shown that coronavirus cannot survive for a long time in objects such as letters or packages.

‣ Myth: "Traces of coronavirus have been found in some Asian foods that people have to avoid eating."

Fact: Some time ago, a post on social media was viral that in some Asian foods, traces of coronavirus have been found. Those foods include wagyu beef, Yakult, Nongshim Onion Ring snacks, Mi Goreng instant noodles, Lipton peach-flavored iced tea, fortune cookies, two varieties of rice, and Red Bull. In the post, it was being claimed that the statement has been confirmed by the New South Wales Ministry of Health. But later, the New South Wales Ministry of Health rejected this claim in a tweet and said that this post is fake and did not originate from NSW Health or any related institution.

‣ Myth: "Pets at home can spread the new coronavirus."

Fact: Currently, there is no evidence that pets such as dogs or cats can be infected with the coronavirus. However, if you come in contact with any animal, you should always wash your hands thoroughly with soap. By taking care of your hygiene, you can protect yourself from bacteria like E.coli and Salmonella, which are easily transferred from animals to humans.

‣ Myth: "You can get coronavirus from drinking Corona Beer."

Fact: No, not at all. There is no link between coronavirus and corona beer. You cannot be infected with coronavirus by drinking Corona beer. Unless you share a bottle or glass of beer with a coronavirus infected person.

‣ Myth: "Vaccines against pneumonia protect you against the new coronavirus."

Fact: No. According to WHO, vaccines against pneumonia do not provide protection against the new coronavirus. The coronavirus is very new and different, so it requires a separate vaccine. Researchers around the world are engaged in the manufacture of the coronavirus vaccine. Although these vaccines are not effective for coronavirus, vaccination against respiratory diseases is highly recommended to protect your health.

‣ Myth: "Coronavirus can spread by farting."

Fact: No, in reality, it is not possible. The Center for Disease Control and Prevention (CDC) of Beijing’s Tongzhou district has written a long article in their WeChat account in which they have clarified that farts cannot infect you unless you smell the fart of a pantless patient closely.

‣ Myth: "Regularly rinsing your nose with saline can help prevent infection with the new coronavirus."

Fact: No, according to the WHO, there is no evidence that regular cleaning of the nose with saline has prevented people from coronavirus infection. Regularly cleaning the nose with saline helps people recover quickly from the common cold, but this has not been found in the case of respiratory diseases.

‣ Myth: "Coronavirus infection is just a common cold or flu."

Fact: The symptoms of the new coronavirus are similar to those of the common cold or flu, but the two diseases are very different from each other. People also often compare COVID-19 to the flu, but we have a vaccine for prevention and medications to treat the flu. But there is no such treatment or vaccine available in the case of COVID-19.

‣ Myth: "Eating garlic can help prevent infection with the new coronavirus."

Fact: No, this is not true. There is no doubt that garlic is a healthy food that can kill microorganisms or can at least stop their growth. However, there is currently no evidence that people have been saved from the new coronavirus by eating garlic.

‣ Myth: "Warm weather will slow down the coronavirus."

Fact: It is true that some other viruses, such as common cold and flu, spread less in the summer season than in the winter season. But we cannot exactly compare this new coronavirus to other viruses because much more is yet to be known about its communication, severity, and investigation. So, unfortunately, it is difficult to know whether the hot weather will slow down the new coronavirus.

COVID-19 Update: Coronavirus can survive in both hot and humid climates: WHO

Tweet

‣ Myth: "Putting on sesame can help block the new coronavirus from entering your body."

Fact: No, sesame oil does not kill the new coronavirus. According to the WHO, some chemical disinfectants such as bleach/chlorine-based disinfectants, either solvents, 75% ethanol, peracetic acid, and chloroform, are effective in killing coronavirus in surfaces. But those chemical disinfectants should not be used in the skin as it can be dangerous.

‣ Myth: "Chicken soup will stop the coronavirus."

Fact: It is not correct to say that chicken soup will stop the coronavirus; instead, it is right to say that chicken soup helps in fixing the mood of a sick person. Studies have shown that the ingredients of chicken soup, such as chicken, carrots, and garlic, boost the body’s immune system. Additionally, chicken contains high amounts of the amino acid tryptophan, which helps to produce a neurotransmitter called serotonin, which makes the sick person feel comfortable.

‣ Myth: "New coronavirus affects only older people."

Fact: No. According to the WHO, people of all ages can be infected with the new coronavirus. However, older people and people with pre-existing medical conditions (such as asthma, diabetes, heart disease) have a higher chance of getting infected with the new coronavirus than others. Therefore, all people, whether they are children, or adults, or older people, all need to take the same precaution to protect themselves.

‣ Myth: "Eating kimchi can prevent a coronavirus infection."

Fact: No, this statement is false. A few weeks ago, Kimchi, a Korean staple dish made from fermented cabbage, chili peppers, and garlic, was famous all over the internet. People were claiming that eating Kimchi can prevent a coronavirus infection. But later, South Korea’s Health Ministry disproved this claim and said, “Kimchi provides no protection against the new type of coronavirus. The best way to prevent the novel coronavirus is to wash hands frequently.”.

‣ Myth: "Antibiotics are effective in preventing and treating the new coronavirus."

Fact: No, antibiotics only act against bacteria and not viruses. And since COVID-19 is a disease caused by a coronavirus, in this case, antibiotics cannot be used in any way to prevent or treat it. However, if you are hospitalized for COVID-19, and you also have a bacterial infection, then, in this case, you may need antibiotics.

‣ Myth: "Cow dung and urine are effective cures for COVID-19."

Fact: No. Cow dung and urine are only excreta, which have nothing to do with coronavirus. No scientific study has been revealed so far that talks about the antiseptic properties of cow dung and urine. Therefore, it is complicated to say whether cow dung and urine can protect us from infection of any virus-like coronavirus.

‣ Myth: "Drinking a bleach solution (also known as MMS, or Miracle Mineral Solution) will prevent you from getting the coronavirus."

Fact: No. There is no scientific evidence that drinking bleach, MMS, or other sodium chlorite products will help prevent disease. Instead, the FDA has stated in one of its posts that the use of sodium chlorite products is dangerous, so it should be stopped immediately.

CHAPTER 10:

Coronavirus Frequently Asked Questions

COVID-19 Frequently Asked Questions and Answers

Want to find out more about the Coronavirus Disease 2019 (COVID-19)?

Got questions? We’ve got answers!

Below you’ll find answers to the questions we get asked the most about the novel coronavirus.

What is the SARS-CoV-2?

Novel Coronavirus (SARS-CoV-2) is a new virus in the coronavirus family that has never been seen before.

Are there more types of coronavirus?

Yes, there are seven types of coronavirus.

The four coronaviruses that are common and not too dangerous are:

‣ 229E (alpha coronavirus)
‣ NL63 (alpha coronavirus)
‣ OC43 (beta coronavirus)
‣ HKU1 (beta coronavirus)

Other three coronaviruses that can cause great harm to humans are:

‣ SARS-CoV (beta coronavirus)
‣ MERS-CoV (beta coronavirus)
‣ COVID-19 (previously known as 2019-nCoV)

What is COVID-19?

COVID-19 is the official name of the disease caused by a novel coronavirus (SARS-CoV-2). In COVID-19, ‘CO’ stands for ‘corona,’ ‘VI’ for ‘virus,’ ‘D’ for disease, and ‘19’ for the year 2019.

Are 'COVID-19' and '2019-nCoV' different?

No. ‘COVID-19’ and ‘2019-nCoV’ are the different names of the same disease. Formerly, the disease caused by novel coronavirus was referred to as ‘2019-nCoV’, but on February 11, 2020, the World Health Organization renamed the illness to ‘COVID-19’.

Where did novel coronavirus infection begin?

Wuhan, the capital of Central China’s Hubei province.

What is the source of coronavirus?

Researchers believe the COVID-19 infection spread to humans from animals. And animals suspected of spreading the virus are pangolins, bats, and snakes.

What are the symptoms of COVID-19?

Most common symptoms of COVID-19 may include:

‣ Fever
‣ Fatigue
‣ Dry cough
‣ Shortness of breath
‣ Myalgia
‣ Pneumonia

Less common symptoms of COVID-19 may consist of:

‣ Runny Nose
‣ Nausea
‣ Vomiting
‣ Dizziness
‣ Diarrhea
‣ Sore throat
‣ Headache

The complete list of symptoms is still under analysis.

How does the coronavirus spread?

The coronavirus spreads from person-to-person.

What are the most likely ways of spreading the virus?

‣ First, when a sick person releases small droplets of saliva or mucus from his mouth or nose while coughing or sneezing, and some other people near him come in direct contact with those droplets.

‣ Second, when small droplets of saliva or mucus released by a sick person land on objects and surfaces, which is later touched by someone.

Can the coronavirus be transmitted through the air?

Studies so far have shown that coronavirus spreads only through exposure to respiratory droplets.

Can a person without symptoms spread coronavirus?

Many people who are infected with coronavirus initially show no symptoms or very mild symptoms; by looking at them, it may seem that they are completely healthy. So it is possible to get coronavirus infection from asymptomatic people.

Can coronavirus be spread through food, including refrigerated or frozen food?

Coronavirus is generally believed to spread from person-to-person via respiratory droplets. There is currently no evidence to support the food-related transmission of coronavirus. However, it is important to always wash your hands with soap and water before cooking or eating.

How can I help protect myself and prevent the spread of coronavirus?

You can reduce the chances of getting infected or spreading coronavirus by taking a few simple precautions. Properly washing your hands is one of the most important things you can do to help prevent and control the spread of coronavirus. Visit the COVID-19 Protection Section to learn more about how to protect yourself from COVID-19.

How likely am I to be infected with the coronavirus?

It depends on where and with whom you are. If you are in an area or with a person where the virus outbreak has just started gaining momentum, there is a higher risk of infection from coronavirus.

For whom is coronavirus more dangerous?

Researchers are still learning about how coronavirus affects people. However, some research has shown that older people and individuals with pre-existing medical conditions develop more severe illnesses than others.

Should I get tested for coronavirus?

You should get tested of coronavirus, if:

‣ you are feeling sick with fever, cough, or difficulty breathing.
‣ have been in close contact with a coronavirus infected person.
‣ you live in or have recently traveled from an area with the ongoing spread of coronavirus.

Are antibiotics useful in preventing and treating coronavirus?

No, antibiotics only act against bacteria and not viruses. And since COVID-19 is a disease caused by a coronavirus, in this case, antibiotics cannot be used in any way to prevent or treat it.

Is there any vaccine or medicine available for the prevention and treatment of coronavirus?

No vaccine or medicine has been developed yet for the prevention and treatment of coronavirus.

Should I wear a mask to protect myself from coronavirus?

There is a large proportion of the population who are asymptomatic carriers of COVID-19 and are propagating the virus. So everyone should cover their nose and mouth in public.

What is the incubation period of coronavirus?

The incubation period means the time between a person being infected with the virus and showing symptoms after the infection. According to most studies, the incubation period of coronavirus is from 1 day to 24 days.

Can pets spread coronavirus?

No, there is no evidence so far that a pet has been infected with coronavirus or a pet has spread coronavirus.

How long can the coronavirus survive on an object or surface?

It is not sure how long the coronavirus can survive on a surface. But studies suggest that this novel coronavirus, like any other coronavirus, can remain on a surface for a few hours to a few days.

Is it safe to get a package from COVID-19 affected areas?

Yes, firstly, there is very little chance of an infected person to contaminate a package. Subsequently, after transferring the package in different conditions and temperatures, the chances of infecting a person are nearly zero.

CHAPTER 11:

Coronavirus Outbreak in Real-time

COVID-19 in Real Time: Here's How the Coronavirus is Spreading Rapidly

The World Health Organization (WHO), Johns Hopkins University, and other institutions have created useful dashboards to track COVID-19 outbreaks worldwide, where you can easily access real-time statistics on active cases, deaths, and recoveries of Coronavirus Disease 2019.

Apart from this, we have also published a data tracker on Healthroid with detailed and accurate information about COVID-19 cases worldwide.

Healthroid's Real-Time Data:

Here is an interactive web-based world map to track COVID-19 statistics in real time.

If you are on the desktop, move the mouse cursor over the location to see the data. Apart from this, if you are on mobile or tablet, touch above the location to see the figures.

An interactive web-based dashboard to track COVID-19 in real time.

To identify new cases, we monitor various twitter feeds, online news services, and direct communication sent through the dashboard.

Zoom inZoom out

0> 30000

Here are the figures that shows the current country-wise confirmed cases, death cases and recovered cases of COVID-19. All countries are listed in the table from top to bottom based on the number of confirmed cases, just scroll the table to see the cases of other countries.

COVID-19: Situation update worldwide

Country

Cases

Deaths

Recovered

Total

The table given below shows the increase in the number of confirmed cases, death cases and recovered cases and the rate of increase in the last 24 hours. All countries are listed in the table from top to bottom based on the number of confirmed cases. If the name of your country is not in the table, search for the required name with the help of search bar.

Country	Cases	24h	Deaths	24h	Recovered	%	Active	Tests

Johns Hopkins's Real-Time Data:

Here is a dashboard published and hosted by Johns Hopkins University that shows the number and location of confirmed COVID-19 cases, deaths, and recoveries in all affected countries.

In this dashboard, you can filter COVID-19 confirmed cases, death cases, and recovered cases by country/region.

If you are unable to see this dashboard in mobile phones, then a mobile-friendly version of the embedded panel is available here.

World Health Organization's Real-Time Data:

The World Health Organization (WHO) has also published a dashboard similar to that of Johns Hopkins. This real-time dashboard also provides information about confirmed cases and death cases of COVID-19 worldwide.

If you want to see information about COVID-19 cases of a specific country/region, you can filter the data from the right top corner.

Healthmap and Other Contributor's Real-Time Data:

The University of Oxford, Healthmap, Harvard Medical School, Boston Children’s Hospital, Northeastern University, Oxford Martin School, together with several other contributors, have prepared a data map of COVID-19 outbreak cases worldwide by taking help from government reports and news media.

The specialty of this data map is that by clicking on its map, you can easily find the data of confirmed cases of a particular location.

Also, if you click the “Animate Spread” button on the map, you can see in the animation how the coronavirus is making its mark around the world.

COVID-19 Fact: This is the first time in history when a global virus outbreak data has been opened in this way to the world.

Tweet

CHAPTER 12:

What's Next?

What Will Happen Next?

The coronavirus outbreak has now spread to six continents out of the total seven continents of the world, except Antartica.

It is known that coronavirus is increasing its speed. Apart from China, coronavirus has spread its foot in many big countries like India, Italy, Iran, South Korea, Spain, Germany, France, and USA.

The World Health Organization (WHO) issued a global public health emergency warning on January 30, 2020, for the sixth time in its history regarding coronavirus outbreak. Here is a quick look at the other five outbreaks, in which the warnings of the global public health emergency were issued in the past.

Swine Flu (2009): Killed up to 203,000 people worldwide.
Polio Infection (2014): 359 reported cases worldwide.
Ebola (2014): 11,315 death cases reported in six countries.
Zika Virus (2016): The geographical range of Zika virus has steadily increased in 2016.
Ebola (2018): 2,196 death cases reported worldwide.

The WHO defines the global public health emergency as “an extraordinary event which is determined to constitute a public health risk to other states through the international spread of disease and to potentially require a coordinated international response”.

The WHO declares a disease as global public health emergency only when such a situation arises which is “serious, sudden, unusual or unexpected”.

And this is actually happening. In fact, an immediate international action is required, in the case of the novel coronavirus.

Coronavirus is Now a Pandemic

The WHO, by issuing a global public health emergency warning, had expressed concern about a situation, it is now in front of all of us.

Now, World Health Organization has declared the coronavirus outbreak a global pandemic. According to WHO, the reason for declaring coronavirus as pandemic is its “uncontrolled spread”.

What is a Pandemic? How is It Different From an Epidemic?

“A pandemic is an epidemic outbreak that occurs on at least two continents at the same time.”

So, what’s an epidemic?

Well, both pandemic and epidemic terms are used interchangeably during the outbreak of a disease according to its spread.

If the spread of a disease extends to only one continent, it is called epidemic. If at the same time, if the disease spreads in more than one continent, then epidemic itself is called pandemic.

In short: Epidemic is an outbreak that occurs in only one continent and Pandemic is an outbreak that occurs in more than one continent.

Some example of Epidemics are:

Indian Swine Flu Outbreak (2015): Killed up to 2,035 people.
Western African Ebola Virus Epidemic: Killed up to 11,300 people.
Plague Outbreak in Persia (1772-1773): Killed up to 2 million people.
Iceland’s Great Smallpox Epidemic (1707-1709): Killed up to 18,000 people.

Some example of Pandemics are:

Black Death Plague in Europe, Asia, and North Africa (1331-1353): Killed between 75-200 million people.
Flu Pandemic Worldwide (1889-1890): Killed up to 1 million people.
Spanish Flu Pandemic Worldwide (1918-1920): Killed up to 100 million people.
HIV/AIDS Pandemic Worldwide (1960-Present): Killed up to 30 million people.

As you can see, diseases are divided into epidemic or pandemic categories not based on the number of deaths but according to the spread of the diseases. So you do not need to panic unnecessarily by hearing the word pandemic.

Yes, that’s true that a coronavirus outbreak has caused pandemic first time in history. And virus is proving itself to be much more contagious than other coronaviruses like SARS and MERS.

But, so far, looking at the virus outbreak, it seems that the goal of the virus is not mass killing, but mass replication. This does not mean that you do not have to take COVID-19 seriously.

Keep in mind coronavirus is serious and you also need to be serious to prevent it.

CHAPTER 13:

Let's Unite to Fight Coronavirus

You Can Help Prevent COVID-19

Do you know that a coronavirus infected person can infect at least two more people?

Yes, you heard that right.

Now imagine if 100 people have coronavirus infection, but they are not showing symptoms, and in the absence of information, they are wandering around you openly.

And if each one of those 100 people infects two others, then the total number of infected people will immediately rise to 300. Whose calculation is as follows:

100 old infected people*2= 200 new infected people
300 (Total new infected people)= 100 (old infected people) + 200 (new infected people)

If 100 infected people can do so many infections, then what if the number is 1000 or 10,000?

Isn’t that frightening? Yes, it is.

Challenge

You may be wondering what you can do in such a situation? Neither you are a doctor nor a medical professional.

Well, the best thing you can do now is to stay informed and keep others informed as well. And that’s what the #AwarenessIsCure Challenge is all about.

The motive of the #AwarenessIsCure Challenge is to promote awareness of the COVID-19. Here’s the simple one-step process:

Share this Coronavirus guide with the hashtag on your social media profiles and then nominate others to do the same.

Rules for this challenge are straightforward:

First, within 24 hours of being challenged, participants have to share this guide with the #AwarenessIsCure hashtag on their social media profiles.

Then, the participant can nominate a minimum of three other people to participate in the challenge.

Everyone has the ability to contribute to protect themselves and to protect others. Let us together spread this guide to people at a rate higher than the spread rate of coronavirus. Let’s share this guide with other people so that those who are still unaware of the coronavirus also know the right way to deal with it.

Let’s unite to fight the coronavirus.

And finally we would just like to say that awareness is the cure at the moment. So the more people you can make aware, the more you can slow down the spread of coronavirus.

You can use the below buttons to share the guide.

WE ANALYZED 3.74 MILLION WORDS OF CONTENT AND 4 DIFFERENT CASE STUDIES OF TOTAL 44,909 CONFIRMED CASES

Here’s What We LearnedAbout Coronavirus Disease 2019

(COVID-19)

Contents

CHAPTER 1:

Understanding Coronavirus

What is a Coronavirus?

Where Did This New Coronavirus Come From?

Which Animal Transmitted the Virus to Humans?

Pangolins Can Be Potential Intermediate Host Between Bats and Humans for Coronavirus Spread

CHAPTER 2:

People Most Vulnerable To Coronavirus

Who are Most at Risk of Coronavirus?

Detailed Breakdown of the Analysis:

Analysis by Age:

Analysis by Sex:

Analysis by Occupation:

Analysis by Province:

Analysis by Wuhan-Related Exposure:

Analysis by Pre-Existing Medical Conditions:

Analysis by Case Severity:

Result of the Study:

CHAPTER 3:

COVID-19 Symptoms

What Are The Symptoms Of COVID-19?

How Long Will It Take for the Symptoms to Appear?

CHAPTER 4:

Coronavirus Transmission

How the COVID-19 Spreads?

Here are the Reasons for the COVID-19 Spread:

Transmission of the Virus Through Droplets/ Particles:

Transmission of the Virus Through Contaminated Surfaces:

Transmission of the Virus Through Human Feces:

Transmission of the Virus Through Human Saliva:

Transmission of the Virus Through Urine:

CHAPTER 5:

Coronavirus Protection

How to Protect Yourself From COVID-19?

Wash Your Hands

Use Hand Sanitizer

Don't Touch Your Face

Avoid Close Contact With People Who Are Sick

Stay Home

Cover Up When You Sneeze Or Cough

Disinfect Surfaces And Clean Objects

Avoid Hugging, Kissing, And Shaking Hands

Get The Flu Shot If You Haven't Already

Drink Plenty Of Fluids

Get Enough Sleep

Cook Meat And Eggs Thoroughly

Should I Wear a Mask to Protect Against the COVID-19?

What Type of Face Mask Should You Wear?

For Healthcare Workers:

For General Public:

How to Put On And Use Mask?

For Healthcare Workers (N95 and Surgical Masks):

For General Public (Cloth Face Coverings):

CHAPTER 6:

Diagnosis and Tests

Here’s How Coronavirus Tests Work

1. Molecular Test

Reverse Transcription Polymerase Chain Reaction

Isothermal Amplification Assays

Antigen Test

2. Serological Test

Who Should Be Tested For COVID-19?

Priorities For COVID-19 Testing

COVID-19 Test Results

If COVID-19 Test is Positive and You Are the One Who is Sick:

If COVID-19 Test is Positive and You Are the Caregiver:

If COVID-19 test is negative:

CHAPTER 7:

COVID-19 Treatment

Here’s The Exact Status of COVID-19 Vaccines and Treatments

How Long Can It Take to Develop a Drug That Works Against COVID-19?

1. Basic Research and Drug Discovery

2. Preclinical Testing

3. Clinical Trials

4. Post Approval Research and Monitoring (Phase IV)

Antiviral Drugs Being Tested Against the COVID-19

WE ANALYZED 3.74 MILLION WORDS OF CONTENT AND 4 DIFFERENT CASE STUDIES OF
TOTAL 44,909 CONFIRMED CASES

Here’s What We Learned
About Coronavirus Disease 2019