Covid-19 Disease ;The perspective of a Frontline health worker ....( Overview or the situation thus far )

Working in the consulting room

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Introduction

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• On 31st Dec 2019
  WHO (China Country Office) was informed of cases of Pneumonia of unknown cause detected in Wuhan City ,Hubei Province of China .

• 7th January 2020
  Causative organism was identified as
  novel Coronavirus (2019-nCov)

• 12th Feb 2020
  The nCov was named as
  Severe Acute Respiratory Syndrome Coronavirus 2(SARS CoV 2) .
  The virus is a new strain of corona virus that has not been previously identified in humans.

This is not the first time we are recording Coronavirus epidemics in some parts of the world ..

In 2002 SARS CoV detected in China
In 2012 there was the MERS CoV (Middle East respiratory syndrome) (also known as Camel flu) first reported from Saudi Arabia and then to other countries in Middle East
UAE ,Iraq ,Oman,Bahrain,Kuwait and so on

Covid 19 was declared as a Public health emergency of international concern on the 30th Jan 2020 ..
And declared a pandemic on the 11th March 2020

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Mode of transmission

Though the disease has been said to be zoonotic ,no animal reservoir has been identified yet (dx transmitted from animals to humans eg rabies ,bird flu ,anthrax, mers ,Ebola ,cryptosporidiosis )

Current spread is from person to person
So via respiratory droplets from sneezing,talking ,coughing ,exhaling etc
Or from contaminated hand or objects

Incubation period is ranging from 2-14 days

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Clinical features

Fever,cough,shortness of breath,sore throat ,fatigue ,hyposmia ,anosmia ,ageusia

Non specific signs like diarrhea

Clinical spectrum is from mild to critically ill

Complications include Acute Respiratory Distress syndrome(ARDS) ,renal failure,sepsis,septic shock ,erectyle dysfunction,Disseminated Intravascular Coagulation ....

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Diagnosis :

PCR (polymerase chain reaction test)
Other Rapid Diagnostic Tests based on immune response are also available

Treatment :Predominantly supportive
Ranging from Hydroxychloroquine or chloroquine phosphate for mild cases

Moderate
As in Mild plus Azithromycin or Doxycylcine

Sev disease

As in moderate plus
Plasma from covid 19 recovered patient with significant amounts of Anti sars CoV 2 antibodies (IgG and IgM)

And Methyl prednisolone

And Remdesivir

When it becomes critical with ARDS ,Cytokine Release syndrome ,or Disseminated intravascular coagulopathy
Tocilizumab as a single dose

Prevention of covid 19 measures

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1. Avoiding overcrowding (stay at home campaigns) to limit ur risk of exposure

2. Wearing of face mask(several types of masks are available to suit our various risk levels ,cloth mask ,surgical mask,KN95 etc

3. Frequent hand washing to remove virus from stained hands Hands touch too many surfaces and can quickly pick up viruses. Once contaminated, hands can transfer the virus to your face, from where the virus can move inside your body.

4. Sanitizer: if it is difficult to wash hands ,appply sanitizer as and when u touch surfaces or shake hands but it’ is better to avoid hand shaking altogether..Inovative ways to greet using other parts have since emerged and it is highly recommended to use the head alternatives

5. Eat well to boost ur immune system...balances diet plus fruits and vegetables...Vitamin c plus zinc tablet the best on the market helps to boost immune system and which does not even allow it he virus to launch itself within u or even if it does it can’t cause any severe disease

6. Do medical checkups to determine how health you are.You May never know you have any underlying condition

7. Vaccinate in the upcoming nationwide vaccination exercise .Ghana for example has taken delivery of some 600,000 vaccines late last month .The AstraZeneca(Oxford ,British but being produced in large amounts by vaccine power houses in India borrowing the technology from The English) (India alone produces 60% of the worlds vaccine needs (BBC news reality check team) and Sputnik from Russia (92% efficacy from clinical trial ) BBC

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We will end today’s session here and continue another time.

Thanks for reading !

Sources

Ghana health service
Ministry of health -Ghana
World health Organization

References

MOH Ghana(2020) Provisional Standard Treatment Guidelines for Novel Coronavirus Infection ,Covid-19 Guidelines for Ghana.Version 1.0 Retrieved 21 July 2020 from
https://www.moh.gov.gh/wp-content/uploads/2016/02/Covid-19-STG-June-2020-1.pdf

WHO.(2020,May27) Clinical management of COVID-19 Interim Guidance. Retrieved May 20,2020,from World Health Organization :
https://www.who.int./publications/I/item/clinical-management-of-covid-19