1. Covid

Infectious disease specialist Dr Leong Hoe Nam on things to know about COVID-19 and our thoughts

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As scientists and doctors all over the world race against the clock to search for a vaccine for this mysterious pneumonia-like disease, more than 2,600 have succumbed to the coronavirus. [1]

Here, in Singapore, we’ve managed to top the coronavirus charts as having the most cases of the COVID-19 virus, second only to China – the very place that sparked off this pandemic. [2] In February, our government raised the risk assessment of the disease to the DORSCON orange in an attempt to contain the virus. Unfortunately, many Singaporeans interpreted the signal as something else entirely – a time for frenzied stock ups in preparation for an apocalypse.

We’ve gone from swiping up all the masks and hand sanitizers from all pharmacies nationwide to panicked mass hoarding of toilet paper, instant noodles and other supplies.

A lot of this fear stems from the fact that the virus is not only deadly, but it is also something unknown. To date, we still do not know exactly how infectious it is, how to treat it, how it would mutate in the future, etc etc.

We heard this amazing interview with Dr Leong Hoe Nam on ONE FM 91.3 that was just brimming with so much expert knowledge that we had to share it here with you. Dr Leong is an infectious disease specialist in Mount Elizabeth Novena Hospital and he is also a SARSvivor – he contracted (and thankfully recovered from) the SARS virus during the 2003 pandemic as a result of treating the first SARS victim in Singapore. [3]

“What exactly is COVID-19?”

SARS-CoV-2 Coronavirus

The COVID-19 disease is caused by a highly pathogenic, highly-virulent novel coronavirus named SARS-CoV-2 virus. [4]

Coronavirus is a large family of viruses that can infect both humans and animals. The origins of this specific coronavirus strain that causes the COVID-19 disease has been linked to illegally traded wildlife at Wuhan’s seafood market, which sells exotic life animals including bats, rabbits and snakes.

Similar to COVID-19, the previous SARS and MERS outbreaks were also caused by coronaviruses; however, they were of different strains altogether. Therefore, even if you have contracted SARS or MERS before like Dr Leong, your body would not know how to fight this novel infection, i.e. you are not immune to the COVID-19. [3]

“How come we don’t already have a vaccine for the COVID-19, given our past experience battling coronaviruses (SARS, MERS)?”

Coronaviruses tends to mutate easily – a slight change in the genetic component can alter the virus completely, including how it behaves and what kills it. There are hundreds of different viral mutations, thus it is nearly impossible to predict which virus strain will cause the next pandemic. [5]

Thus, it is only after the outbreak of COVID-19 that scientists and doctors can now work on developing the vaccine for this specific, identified virus strain that is now affecting the world on a global scale.

That said, we do have the virus’ prototype for the SARS-CoV-2 from our previous experiences with SARS and MERS. This gives our scientists and doctors a headstart when developing the treatments for COVID-19 this time round. [6]

“What are the treatments currently available for the COVID-19 disease?”

Doctors around the world are trying out various cocktails of antiviral drugs (e.g. anti-HIV and antimalarial drugs) to treat the COVID-19 disease. These are still undergoing the ‘testing’ and ‘clinical trials’ phase, therefore, their effectiveness is still unproven. [7]

For now, high-quality medical care and plenty of hydration is still the best alternative for patients who have been diagnosed with COVID-19. Fortunately, this has been proven to be effective in a majority of the COVID-19 cases found in Singapore and other countries with first-world medical facilities. We’re also very lucky we have no deaths as of now.

“If I had undergone the ‘4 in 1 influenza vaccine’, will I be protected from COVID-19?”

No, your influenza vaccine is ineffective against COVID-19 because these diseases are caused by entirely different coronavirus viral strains. [8]

That being said, getting a flu jab would help reduce your risk of getting sick, i.e. contracting the common cold, coughs and flu and being shunned by the public. So if you are considering getting a flu jab, go ahead. It’ll also be helpful for healthcare workers as it would free up their time to focus on actual COVID-19 cases.

“How do I know if I have COVID-19? What are the symptoms I should look out for?”

Symptoms of covid 19 includes headache, cough, muscle pain, shortness of breath, difficulty breathing, fever and fatigue
Symptoms of COVID-19 disease

It’s really difficult to differentiate the symptoms of COVID-19 from the symptoms of common cold like cough and flu. [9] These symptoms include fever, cough, sore throat and muscle ache. [10]

Progressively after Day 5, a COVID-19 patient would feel increasingly breathless as the virus would be attacking the lung tissue, causing it to fail. At this point of time, the disease would have progressed to a severe or critical stage.

“How is the COVID-19 disease transmitted from person to person?”

Although it’s not conclusive, COVID-19 is generally transmitted through secretions or body fluids, for example, when an infected person coughs or sneezes [12]. Another way the virus can be transmitted is through contact with a contaminated surface and then touching various “entry portals” on our eyes, noses, mouths. This is why it’s important to avoid touching our faces and washing our hands with soap more frequently to prevent this.

The virus is also known to like the cold. In other words, the virus also stays alive longer in cold temperatures, i.e. air-conditioned rooms. This increases the chances of transmittance between more people. Conversely, the virus dislikes heat and dies out quickly in hot temperatures, i.e. outdoors. It is for this reason that it’s recommended to stay out of aircon areas during this time. Fortunately, the virus cannot stay alive out of the body for too long without a host – in general, about 30 to 60 minutes.

“Fighting the COVID-19: Social distancing and good ol’ soap and water”

taking care of your hygiene by washing your hands frequently helps to fight off the spread of covid-19

As the saying goes, prevention is better than cure. It’s always good to be on the safe side and minimise social activities, especially large scale events. Since the government’s announcement of the DORSCON orange, large scale events such as the NATAS travel fair, K-pop concerts have been cancelled. [12]

Under DORSCON orange, small-scale event organizers in Singapore are also informed to conduct temperature checks, take down details and contact numbers to facilitate contact tracing if required.

Otherwise, the best and simplest way to combat the virus is to wash your hands regularly with good old soap and water for at least 20 seconds, according to the Center for Disease Control and Prevention (CDC). Humming the “Happy Birthday” song twice while washing your hands will do the trick [13].

If you do not have access to soap and water, you can opt for alcohol-based hand sanitizers, making sure to rub your hands for 20 seconds so that all parts of your hands get some of those TLC too! [14]

“Should I wear a mask? What mask should I wear?”

To prevent mask hoarding and depletion of masks, PM Lee Hsien Loong had to step in to say that there is no need to wear one if one is not ill, since there has been no proof that COVID-19 can be transmitted via airbone means. [15]

Four doctors have come together and stepped up to advise people to wear face masks even if they are not unwell. They wrote that it would be safer for two people wearing face masks and communicating with each other, as this would constitute a two-barrier protection, helping to prevent the spread of the virus if any.

While these two seem like opposing viewpoints, there is definitely truth in both parties’ words.

We definitely agree that there is no need for everyone to be panicking and purchasing face masks in bulk to wear them every day. If your work does not require you to be front-desk facing or on-the-go, meeting with a lot of people outside, then it seems to us that there is no need to wear a mask. Even if your coworker does have COVID-19, your face mask probably wouldn’t give you much immunity in your air-conditioned office either.

But if you are a healthcare worker or if you are client-facing or your job requires you to meet with many different people every day, we do think there is some merit to wearing a face mask as some form of protection.

At the end of the day, face masks do not provide 100% protection against the virus, so it’ll be wise to also practice the good old-fashioned hand wash every now and then to keep the virus at bay!

Read more about Top 10 questions about COVID-19 – answers by experts compiled.

References

[1] World Health Organisation (2020). Coronavirus disease 2019 (COVID-19): Situation Report 36, from https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200225-sitrep-36-covid-19.pdf?sfvrsn=2791b4e0_2

[2] Ministry of Health (2020). Risk assessment raised to Dorscon Orange, from https://www.moh.gov.sg/news-highlights/details/risk-assessment-raised-to-dorscon-orange

[3] Rubaashini, S. (2020). Doctor previously infected with SARS says masks help in prevention of Wuhan virus but Singapore govt notes otherwise, from https://www.theonlinecitizen.com/2020/02/04/doctor-previously-infected-with-sars-says-masks-help-in

[4] Centers for Disease Control and Prevention (2020). CDC grows SARS-CoV-2, the virus that causes COVID-19, in Cell Culture, from https://www.cdc.gov/coronavirus/2019-ncov/about/grows-virus-cell-culture.html

[5] Beall, A.. The global fight against coronavirus, from https://www.bbc.com/future/article/20200210-coronavirus-finding-a-cure-to-fight-the-symptoms

[6] Mukherjee, S. Y. (2020). SARS treatments could help with the new coronavirus. Why were they shelved?, from https://fortune.com/2020/02/18/coronavirus-sars-vaccine-development/

[7] Clinical Trials Arena (2020). Coronavirus Covid-19: Chloroquine data; Japan to trial HIV drug, from https://www.clinicaltrialsarena.com/news/coronavirus-covid-19-choroquine-data/

[8] Lai, L. (2020). askST: Can the flu vaccine protect me against the new coronavirus?, from https://www.straitstimes.com/singapore/health/askst-can-the-flu-vaccine-protect-me-against-the-new-coronavirus

[9] Diamond F. (2020), CDC Seeks to Test Some with Flu-Like Symptoms for COVID-19, from https://www.infectioncontroltoday.com/hai-types/cdc-seeks-test-some-flu-symptoms-covid-19

[10] Centers of Disease Control and Prevention (2020), 2019 Novel Coronavirus (2019-nCoV), from https://www.cdc.gov/coronavirus/2019-ncov/about/symptoms.html

[11] Ministry Of Health Singapore (2020). Frequently Asked Questions (FAQs), from https://www.moh.gov.sg/covid-19/faqs

[12] Phua R. (2020). Novel coronavirus in Singapore: Major events cancelled due to outbreak, from https://www.channelnewsasia.com/news/singapore/novel-coronavirus-singapore-major-events-cancelled-12417726

[13] Centers of Disease Control and Prevention (2020). When and How to Wash Your Hands, from https://www.cdc.gov/handwashing/when-how-handwashing.html

[14] Khoo B. K. (2020). Do homemade hand sanitisers actually work? We ask the doctors, from https://cnalifestyle.channelnewsasia.com/wellness/homemade-hand-sanitiser-effective-doctors-advice-12397274?cid=facebook_keywee-cnalifestyle-sg_paid_15042019_cnamkt-lifestyle&kwp_0=1569540&kwp_4=4704842&kwp_1=1993568&fbclid=IwAR0jWE2qzFJIefLhx86tKmISy9bAtqf15FXIyrELGLZFGWr

[15] Kurohi R. (2020). Wuhan virus: PM Lee Hsien Loong calls for calm, urges public not to spread rumours, from https://www.straitstimes.com/singapore/wuhan-virus-pm-lee-calls-for-calm-urges-public-not-to-spread-rumours

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