Globally,  the number of coronavirus cases are predicted to touch 249 million cases by March 2021. The number of infection related fatalities are expected to be around 1.8 million. The numbers are staggering and clearly indicate the gravity of the pandemic. While it is true that many countries have managed to flatten the curve and declare themselves as free from the virus, many other nations are still grappling with the pandemic. A lot of information is available online about the virus, and measures in place to diagnose and manage the condition. However, the deluge of information has also resulted in a lot of incorrect facts being presented as information. This in-depth article about coronavirus presents all the important, scientifically supported information available as on date, about the diagnosis of the infection.

A brief overview about coronavirus

The virus belongs to a large family of viruses that earlier caused illnesses in animals. Most of the coronavirus related illnesses that have affected humans are relatively recent and result in respiratory related disorders. For instance, Middle East Respiratory Syndrome and Severe Acute Respiratory Syndrome are all infections that caused respiratory complications. Covid-19 is the latest addition to the list of coronaviruses that have affected humans. While the source of the actual virus is still a matter of debate and hotly contested, the first known outbreak has been recorded to be in a province in China.

Coronavirus spreads from one individual to another, through droplets that are expelled from the infected person. This occurs through tiny droplets that are expelled when the infected person speaks, coughs or sneezes. The droplets are heavy and therefore do not travel too far. Individuals in close proximity of an infected person are at high risk of exposure when the droplets are inhaled or enter the mouth. The heavy droplets do not travel far, and the risk of exposure is primarily through inhalation of the droplets. Another possibility of contracting the virus is by touching a surface that has been contaminated, followed by rubbing the infected hands on the eyes, nose or mouth. Research is ongoing, regarding modes of transmission of the disease to conclusively establish all the various modes by which the virus spreads. As on date, the medically and scientifically accepted modes of transmission of the virus are either through inhalation or by touching a contaminated surface and then inadvertently touching the mouth, eyes or nose.

A better understanding of the symptoms of covid-19

Here is a look at the common symptoms that may be experienced when an individual contracts coronavirus. The intensity of the symptoms may vary – it could be mild, moderate or severe. Individuals with co-morbidities are at high risk, as other diseases may cause hospitalization with serious complications. Most of the fatalities associated with the disease are attributed to co-morbid conditions. Pre-existing ailments such as lung diseases, and diabetes are considered as conditions that could turn serious or fatal.

It typically takes anywhere between one to fourteen days for the symptoms to manifest in an individual. However, symptoms are known to manifest typically in around five days among most of the patients affected with the condition.

While it is known that human to human transmission is primarily through droplets from one infected person to another, it is important to understand it from a symptomatic point of view. A significant percentage of patients with the condition are asymptomatic, therefore it is virtually impossible for anyone to actually know if an individual is infected or not infected. In the absence of a clear distinction between an individual who is infected and one who is not infected, it is important to take more precautions as preventive measures.

It is easy to take precautions when in the presence of an individual who is an identified patient. In the presence of a patient who is not recognized or identified as one, there is every possibility of not taking sufficient precautions, and ending up with the infection. It is therefore necessary to understand the need for precautions all the time. This is precisely why globally there is a social requirement for every individual to wear a mask in public. Here is a look at some of the symptoms that are typically experienced by individuals who are infected. The most common symptoms that have been reported include fever, fatigue and dry cough. Some of the other less frequent and less common symptoms that have been reported include sore throat, diarrhea, pain in the joints, muscle pain, throbbing headache, conjunctivitis, sudden loss of ability to taste or to smell, abnormal discoloration of fingers and toes, and rashes on the skin. There are other serious symptoms that are indicative of a serious condition. For instance, pain in the chest or pressure on the chest, sudden loss of speech, difficulty in breathing, shortness of breath and hampered movements are all indicative of serious symptoms. Patients suffering from serious symptoms need urgent medical attention. This is required to prevent the condition from manifesting into other serious conditions. Patients with mild or moderate conditions will be in a position to handle the same at home. However, patients who have any pre-existing conditions that are regarded as comorbid, will require hospitalization or management in a medically supervised facility. Regardless of the intensity of the symptoms, it is necessary to undergo testing in order to confirm infection. It is also possible that an individual has symptoms that are due to other illnesses. In such situations, it is possible that there could be some kind of confusion, resulting in wrong assumptions of being Covid-19 positive. A proper test will help identify the presence or absence of the infection.

Symptoms such as fever or chills are relatively common in various illnesses or infections. Consequently, there is every possibility that a patient with symptoms of other illnesses are also wrongly diagnosed as Covid-19 positive. It is hence, essential to either confirm or rule out the infection through a proper diagnosis. Most of the symptoms that are associated with coronavirus are common with other kinds of infections – for instance, congestion, running nose, vomiting and nausea are all relatively common symptoms. The symptoms listed above are not conclusive in nature, and do not cover all of the possible symptoms. As the disease is new, the symptoms are being studied and collated. Therefore, it will take some time before studies clearly link symptoms with the disease.

Myths associated with the disease and its diagnosis

It is unfortunate that a large number of individuals fall prey to unsubstantiated claims about the disease, its diagnosis and its treatment. In an era where fear prompts individuals to try out any new treatment that is suggested, the possibility of believing every claim is extremely high. Social media is rife with unsubstantiated claims about diagnosing and treating the condition. Rumour mongers have had a field day spinning incredible yarns about the virus. This misinformation has led to a situation where a large number of people have tried out various methods in an effort to cure themselves. The consequence of these unsanctioned and unverified claims have been disastrous and fatal. For instance, there have been forwards in social media that the juice of lemons will help treat the condition. This is as far as possible from the truth. Similarly various herbal concoctions have been peddled in the name of treatment. In the absence of a fully sanctioned and medically supported vaccine or treatment, as on date, individuals end up opting for these dangerous options. Boosting immunity is certainly a good way of reducing the chances of infections in healthy individuals. However, that is not a guarantee of remaining uninfected. It is virtually impossible to imagine that an individual will not get infected by merely consuming immunity boosting products and substances. Individuals who are healthy will be in a better position to cope with the disease. But this does not preclude the individual from getting infected.

Performing certain exercises will definitely not help ward off the infection. However, certain positions that have been suggested by specialists are definitely a good option. For instance, individuals who have been hospitalized are most certainly to have reached a condition where the lungs fill up with fluids. In such situations, doctors have recommended adopting a plank like position in an effort to reduce the congestion as a result of the fluid in the lungs. In the absence of adequate ventilators or equipment required to help patience with fluid in the lungs, certain postures have been recommended by specialists. These are scientifically supported, proven measures that have reasonable results. However, this needs to be performed only under medical supervision or after a proper demonstration.

Other postures and traditional forms of medicine are mainly theoretical and not fully substantiated. While it is true that this is a form of influenza, it needs to be managed appropriately. The rush for a vaccine is itself proof that vaccines that are presently available or not suitable for vaccination against Covid-19. By extension, it is true that medications for managing certain conditions such as influenza, will not necessarily be effective in treating covid-19. Present management of coronavirus is mainly focussed on alleviating the symptoms experienced by patients. For instance, treatment is mainly centered around the lowering of temperature and treating of other symptoms. This coordinated management of symptoms is handled through a cocktail of medicines. In severe conditions, patients are put on ventilator support to manage all serious complications.

Myths about coronavirus have been responsible for a large number of cases. Many individuals have been under the assumption that consuming liquor would help fight the virus. Similarly many individuals have been under misconceptions that using the juice of many herbs will offer protection. While it is true that the disease has resulted in the death of more aged and comorbid patients, it is wrong to assume that younger or fully healthy patients are safe from the condition. A significant number of patients with serious complications belong to this particular age and health group. Similar number of patients from this group have also succumbed to the disease. It is therefore premature to assume  that age and health alone are sufficient to protect an individual from coronavirus.

Recovery rate of coronavirus is relatively high when managed properly. Presently, statistics reveal that globally around 80% of patients who are infected with the disease have recovered without the need for hospitalization. This effectively means that 20% of individuals require hospitalization. Patients belonging to this category are generally the aged and seriously ill patients with other comorbid conditions. Underlying medical conditions such as diabetes, cancer, high blood pressure, heart disease and lung disorders are responsible for hospitalization and complications. Among the easily discernible symptoms, loss of speech or loss of movement can actually easily indicate the onset of the infection. A sudden loss of speech or loss of movement without any symptoms that indicate other conditions, can help easily identify coronavirus infection.

Individuals who are infected with coronavirus are likely to exhibit mild symptoms in the initial stages of the infection. For instance, cough and fever could be some of the symptoms that are experienced during the initial stage. Studies are presently underway to conclusively determine if asymptomatic patients transmit the virus to others. Initial reports have indicated that asymptomatic patients can indeed transmit the virus. Therefore, it is important to take suitable preventive measures till the time that conclusive evidence rules out the possibility of asymptomatic patients transmitting the virus to others. Globally, nations have rolled out different applications that are intended to help locate individuals who have come in touch with an infected person. This is achieved by using bluetooth sensors to determine proximity of other individuals with the infected person. Contact tracing as a method to control the outbreak of the virus has been effective to a certain extent. It has helped many nations to flatten the curve effectively and prevent more numbers of individuals from falling sick.

Additionally, health care workers have been trained to identify patients who have traveled to hotspot locations. This helps determine if the patient has exposed himself or herself to the virus. For instance global hotspots have been clearly identified, and individuals who have traveled and returned from such locations need to be screened to prevent the disease from spreading further. Regardless of the contact or the condition of the individual, it is necessary to understand that all persons who have travelled and returned are expected to undergo self isolation for a period of two weeks. This is mainly intended to protect other family members from the individual and also ensure that the affected person does not end up transmitting the disease to others.

Common diagnostics used for the checking patients for covid-19

Two different methods of testing are used to determine the presence of coronavirus. One method involves the use of a swab from the throat, while the other is a swab from the nose. The samples are tested in the laboratory for the presence of the virus. Sputum is also taken as samples for testing if the patient coughs up sputum. Samples are taken as per a standard operating procedure which is intended to safeguard both the health care worker and the individual who is being tested. Special labs conduct the tests as per the standard operating procedure. Here is a detailed look at the different types of tests – swab test, nasal aspirate, tracheal aspirate, sputum test and blood test.

An indepth view of the tests and testing protocol

Globally, visuals of swab test have led everyone to believe that it is the only test that is available. However, other tests are also used to take samples for the purpose of diagnosis. The nasal aspirate test involves the use of a saline solution that is injected into the nose, following which a sample is retrieved from a light suction method. The tracheal aspirate process involves the use of a thin tube with a torch which is inserted into the mouth, which reaches the lungs from where the sample is retrieved. This tube is medically known as bronchoscope. The sputum test involves collection of sputum in a special container when it is coughed up. Blood test involves collection of blood sample from a vein in the arm.

New tests have been developed for the purpose of carrying out testing of individuals suspected to have coronavirus. These tests have helped nations to ramp up testing abilities and speed, helping prevent the transmission. As large sections of society are tested effectively and efficiently, the spread of the virus has been prevented from reaching uncontrollable proportions. It is true that many nations are still grappling with the condition, while the worst is yet to come for many other nations. However, large scale testing efforts will help to identify and isolate individuals, thereby preventing the spread of the infection.

Special rapid diagnostic tests based on antigen detection are intended to detect the antigens that indicate the presence of coronavirus. Samples from the respiratory tract help detect the viral proteins which will in turn accurately diagnose, confirm or rule out the presence of Covid-19 virus. Antibody detection diagnostics typically detect the presence of antibodies in infected patients. Various factors determine the antibody response – for instance, age, the severity of the infection, and other medications are all contributing factors to the antibody response.

The test and diagnostics are conducted in highly sterile environments with health care professionals following a standard protocol that includes wearing of personal protective equipment. The premises used for the test are sanitized frequently, and the disposables used for retrieving samples are handled with utmost care to prevent the spread of infection.

Limited discomfort may be experienced by the individual who is being tested. The insertion of the swab in the nose or throat may cause a gagging sensation as the swab is inserted deep. Nasal aspirates are also uncomfortable, by virtue of the type of testing protocol involved. All of the discomforting experiences are temporary in nature and patients are unlikely to feel any discomfort after the test has been conducted. The only exception is tracheal aspirate, where there is a possibility of infection or bleeding in a limited number of cases. Blood tests do not pose any risks, as it is similar to sampling procedures used in all other blood tests. Other than the temporary, mild pain or swelling that may be experienced due to the needle insertion, no other side effects are associated with the blood tests.

Criteria for screening of patients

Suspected coronavirus patients are tested for the infection on the basis of symptoms, travel history and/or contact tracing. For instance, individuals who report fever or symptoms of respiratory problems, are probed to determine any epidemiological link. This link refers to the travel history of the patient who may have travelled to any zone that has reported an outbreak or community transmission. This also refers to contact of the individual with other patients who are infected or in high risk category. An individual who has also come into contact with other individuals who could have been exposed to an outbreak during the previous fortnight are also considered to have an epidemiological link.

Testing protocol takes into consideration all of these parameters that include the list of countries or zones that are considered as hotspots of community transmission or local transmission. It is also possible that patients with no history of travel may have contracted the infection. This could be from other individuals who have either travelled to or from zones that have experienced outbreaks. The use of apps have also been actively encouraged in an effort to pre-empt and quickly identify individuals who have been exposed to confirmed cases of infection. The apps are installed in mobile phones, and work by identifying contacts with whom the owner of the mobile has contacted in terms of proximity. The apps work by using the bluetooth function in the mobile phones. This helps to quickly identify possible transmission and help the authorities to ensure that the infection does not spread among a large section of the population.

Differences between covid-19 and influenza

While it is true that Covid-19 is similar to influenza, there are intrinsic differences. Both coronavirus and the common flu are respiratory illnesses that are contagious in nature. Both the conditions are the result of viruses – coronavirus is attributed to SARS-CoV-2, while flu is attributed to the influenza virus. While the symptoms of both the conditions may appear to be similar, only tests will actually confirm or rule out one or the other infection.

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