COVID-19 (coronavirus disease): The old and the new questions

Updated: 4 days ago



The same article is also available in Nepali and Hindi


What is coronavirus and COVID-19?


Coronavirus is a type of respiratory virus (a virus that infects breathing passage like nose, throat, and lungs). The name is derived from the crown-like shape of the virus (corona in Latin means crown). Other respiratory viruses are influenza (flu virus), parainfluenza, measles, rhino (the common cold virus), etc. Coronavirus has been present for a long. The first coronavirus was discovered in the late 1920s. Types of coronaviruses were also associated with the outbreak of severe acute respiratory syndrome (SARS) in 2003 in China and Middle East respiratory syndrome (MERS) in 2012 in Saudi Arabia. At the end of 2019, people in Wuhan in China started becoming sick with flu-like symptoms. it was discovered to be due to a new type of coronavirus. Since the new type of coronavirus was discovered in 2019, it was called COVID 19 (short for coronavirus disease-2019) The virus spreads easily and has affected people all over the world since then.


If there are so many respiratory viruses, why only COVID-19 is spreading so fast?


As we might recall from our school days, there are micro-organisms (microbes in short) everywhere in our surroundings. They include bacteria, viruses, protozoa, and fungi. They are visible only with powerful microscopes. In fact, viruses are visible only with the most powerful electron microscopes. Many of these microbes are harmless but some are harmful (commonly called germs). Whatever be the case we are constantly exposed to them. The entry of the germ does not mean the person will develop symptoms. Example, in the case of poliovirus only about 1% develop symptoms and the remaining 99% are totally symptom-free. . In fact, we carry many harmless as well as harmful germs in our body. Especially in mouth, nose, intestine and skin. Infection occurs when the germ enters the part of the body where they are not supposed to be there, like blood and lungs. But the disease occurs only when the germ proliferates and cause harmful effect to that particular organ, which leads to symptoms. In other words, only when infection leads to symptoms, it is called disease. In both asymptomatic and those who are diseased, immunological or immunity cells in our body actively fights the infection (In asymptomatic people, the cells probably fought very well or the germs entered were too few that prevented symptoms from developing). So in effect, the immunity cells get trained with the exposure to the germs. In subsequent exposures, the cells fight more rapidly and more ferociously so that the disease does not occur or if it occurs it is mild. As we are constantly exposed to germs, we have developed immunity against them.

Now, the COVID-19 virus is totally a new virus and no one was exposed to it previously and hence no one was immune so it is spreading very fast. However only around 20% become symptomatic with the fatal disease in 1.5% (Indian data).



How Does Coronavirus (COVID-19) Spread?


People can catch COVID-19 from others who have the virus even if they don't have any symptoms. This happens when an infected individual breathes, talks, sneezes, or coughs, sending tiny droplets into the air. These can land in the nose, mouth, or eyes of someone nearby, or be breathed in. The risk is highest when people are closer than 6 feet away. People also might get infected if they touch an infected droplet and then touch their own nose, mouth, or eyes.


What are the symptoms of COVID-19?


After an incubation period (time taken for symptoms to occur after the entry of the virus into the body) of 1 to 14 days, COVID-19 can cause a fever, cough, and breathlessness. Some people might have:


  • symptoms of a cold such as a sore throat, congestion, or a runny nose

  • chills

  • muscle pain

  • headache

  • a loss of taste or smell (this is more specific of COVID-19)

  • nausea or vomiting

  • diarrhea

  • tiredness and general body ache

The virus can be more serious in some people. But some people have no symptoms at all.

So, who are vulnerable to get the serious disease? I am worried that there are children in my home.

  1. Elderly- the disease is more likely to be serious with the increasing age. On the other hand children and babies are mostly asymptomatic or have mild disease.

  2. Diabetes and high blood pressure. The disease is worse in uncontrolled diabetes and high blood pressure.

  3. Long term illness of any organ like liver, lungs, kidney, heart, blood or cancer.

  4. In case of immuno-compromised due to long term illness or due to drugs like steroids and anti-cancer agents (contrary to popular belief, children having cold every few months is expected and is not a sign of low immunity)


I am having fever, cough and cold. I am really worried that it is corona? What should I do?

We all had similar illnesses in past (before corona pandemic). Common cold or flu also mimics corona. First isolate yourself, follow social distancing, hand hygiene and wear mask. This helps in preventing spread of all viruses (not only corona). If you belong to the vulnerable group or are breathless visit your nearest hospital or flu-clinic. However, do not go (or take your child) to the emergency room with mild symptoms. Read "Covid times- when to treat a child with fever at home and when to visit a doctor?"


I have to go to hospital for some other reason. But I am worried that doctors will order corona test for me.

According to the latest ICMR (Indian Council of Medical Research) guidelines only symptomatic people are tested. Also, doctors have been doing tests for many ailments for decades. For example, if someone needs surgery usually blood counts, live and kidney function tests are routinely done. In short, I mean to say if you really need to visit the hospital for other reasons you must visit.


What is a vaccine? How will it prevent me from getting corona?


As I said before, our immunity cells get trained on fighting with a bacteria or virus when it gets exposed to that particular germ. Vaccines are either killed or severely weakened bacteria or viruses. When administered to someone they mimic infection and stimulate and train our immunity cells to fight the germ. However, they are incapable to cause disease. In the future when the real germ infects, the immunity cells fight it acts as if seeing the germ for the second time. However, some vaccines need two or more doses to be effective.


Usually it takes anywhere from 7 to 10 years to produce a new vaccine. However because many countries are pushing for it, covid 19 vaccine is expected to be available to the general public much sooner.

Does everyone need to be immune to prevent further spread of corona?


Usually if 70 to 80% of people are immune due to natural infection or vaccination the further transmission is prevented as people actively spreading Infection will be much less than immune. This will also prevent asymptomatic carrier state. This state is called herd immunity.

Since I already got cured from corona infection, do I need to wear mask and follow social distancing?

Yes you do, due two reasons.

1. As I said before, prior exposure to the virus primarily prevents disease to occur, and may not prevent infection or carrier state. If you harbour coronavirus, you might spread it to more vulnerable people. Suppose you touch a droplet and go to your home, you can transmit the infection to others.

2. Occasionally, our immunity cells “forgets” to fight corona and hence you can get second episode of COVID-19 disease. There are reports of such an occurrence.

The same reason dictates that you follow all guidelines of prevention like social distancing, wearing masks and hand hygiene, even if you think you are young and fit. Of these, social distancing, by avoiding going out of house unless it is necessary is the most effective and practical. Also, we must remember that lockdown has been lifted due to economic reasons, improvement in cure rate and also our hospitals are more prepared to handle cases. Corona is still the same. These steps also help to prevent infection with other viruses like flu virus and common cold virus and TB.


I just had a baby. Can people come visit?


For young infants, avoiding all respiratory viruses is important. I suggest you to avoid random visitors. Also you might try keeping naming ceremony to a later date when he or she is at least 6 months old. Even then allow only a few visitors and follow all preventive measures viz social distancing, regular handwashing, encouraging visitors to wear masks, and not visiting if they feel ill.



My child is due for vaccines. Is it safe to be immunized during the pandemic?



Yes. Routine vaccination should be kept up to date. Delaying them could put your child at risk for common and serious childhood infections. However, try to get it done from Integrated Child Development Services (ICDS) centre or Primary Health Centres (PHC) or other places where crowding is less.


How to educate my children about corona?


It is hard for children and teenagers to cope with the pandemic and social distancing norms.

  1. Reassure your children that frontline workers are working hard to keep everyone safe and healthy.

  2. Find out what they know about what is happening. Correct any misinformation. (I had a 5 year old girl coming to me worried that she has got corona disease, in spite of not having any symptoms and not coming into contact with any infected person).

  3. Be honest, but positive. Reinforce that they are unlikely to get sick, but it is still important that they do their part to protect themselves and their families, especially the vulnerable group.

  4. Screen time has increased due to social distancing. Be mindful of your child’s exposure to the news especially social media. Is is a better idea to watch news (if at all) with parents.

  5. Encourage creative activities without phone, TV or computer.

When will the corona end?

I don't think anyone has the answer (if someone gives you the specific answer, he probably does not know himself). However, I feel that it will last few years till herd immunity state is achieved either by natural infection (or perhaps by vaccination). The reliable websites for COVID-19 information are of the Centre for Disease Control (CDC) and Prevention, the World Health Organisation (WHO) and the Indian Council for Medical research (ICMR).



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