Novel coronavirus (COVID-19)

Coronaviruses a group of viruses that can make humans and animals sick. Some coronaviruses cause illness similar to the common cold, while others cause more serious diseases, such as Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS).

A novel (new) coronavirus, identified in Wuhan City in China in December 2019, was named SARS-CoV-2. This coronavirus has caused a global infectious disease pandemic (COVID-19) since early 2020.

Like other viruses, SARS-CoV-2 changes over time. These changes, known as mutations, can have an effect on:

• speed of virus spread;
• severity of illness;
• effectiveness of testing, vaccines and treatment;
• public health and social strategies.

Some people recover from COVID-19 but continue to experience long-term symptoms. This is known as 'long COVID'.

Causes

COVID-19 is caused by infection with the novel coronavirus (SARS-CoV-2). This is most likely to occur person to person through:

• close contact with someone who has COVID-19 or goes on to develop COVID-19 within approximately the next two weeks;
• touching contaminated objects or surfaces (such as door handles or tables), and then transferring the virus to the mouth or face.

 

Infection methods of COVID-19

SARS-CoV-2 is spread through droplets and virus particles that are released into the air when an infected person breathes, talks, laughs, sings, coughs or sneezes. Tiny infectious particles can linger in the air, especially in crowded or poorly ventilated indoor spaces.

Symptoms may appear within two to 14 days of coming into contact with someone who has COVID-19. This is known as the incubation period. In most people, symptoms appear within five to seven days of exposure.

A person with COVID-19 may be contagious from two days before symptoms appear, and remain contagious for 10 to 20 days. Most people are contagious for seven to 10 days.

About 3 to 17% of people with COVID-19 develop a complication known as acute respiratory distress syndrome (ARDS). This can result in severe symptoms requiring admission to hospital or breathing support via a ventilator.

Signs and symptoms

COVID-19 has similar symptoms to other viral infections. The most common symptoms are:

• fever or chills;
• cough;
• fatigue or tiredness;
• loss of taste or smell;
• congestion or runny nose;
• sore throat.

Less common symptoms include:

• headache;
• muscle aches;
• diarrhea, nausea or vomiting;
• skin rash, or discolouration of the fingers or toes;
• red or irritated eyes.

Serious symptoms include:

• shortness of breath;
• loss of speech or mobility;
• confusion;
• chest pain.

 

Common symptoms of COVID-19

Methods for diagnosis

When to test for COVID-19

Testing for COVID-19 is recommended if you:

• develop symptoms, such as a fever and/or cough;
• do not have symptoms but have come into contact with someone who has COVID-19;
• are asked to take a test for medical reasons (such as on admission to hospital, or prior to medical or surgical treatment).

How to test for COVID-19

Antigen tests are used to detect a COVID-19 infection as quickly as possible. They can be self-administered at home, or used by a healthcare professional at a clinic or hospital.

Nucleic acid amplification testing (NAAT) is a laboratory test used to detect or confirm COVID-19 infection. This test is commonly done with a reverse-transcription polymerase chain reaction (RT-PCR) assay, to detect the SARS-CoV-2 virus in a sample taken from your upper respiratory tract. This test is also known as a PCR test.

What else to consider

While COVID-19 is of concern, it's important to remember that symptoms such as fever, cough, sore throat or tiredness can also be signs of a common cold or other respiratory illness - not necessarily COVID-19.

Methods of management

Management of COVID-19 can vary depending on the severity of illness, level of individual and herd immunity, and availability of resources.

If you think you may have COVID-19, or you've been in contact with someone who has COVID-19, you should take an antigen test or NAAT (e.g. PCR test).

If the test is positive, it's recommended that you isolate, according to your symptoms, as follows:

• if you have no symptoms, or your symptoms are improving - isolate for five days;
• if your symptoms are not improving after five days - continue to isolate until you're fever-free for 24 hours (without medication) and your symptoms are improving;
• if you have moderate or severe symptoms - isolate for 10 days (and consult your healthcare provider if further guidance is needed).

Please note that antigen tests can deliver an inaccurate result, particularly if the test is taken early before the virus has become detectable. If you test negative but have symptoms, it's recommended that you take another antigen test at least five full days after your exposure.

Other infection-control measures you may wish to consider include:

• wearing a high-quality mask to protect others from becoming infected;
• telling your recent contacts that they may have been exposed;
• contacting your healthcare provider, community health center or pharmacy to learn more about your treatment options.

 

Methods of managing COVID-19

Methods of treatment

There is no specific treatment for coronaviruses, including COVID-19. Contact your healthcare provider if you have questions or concerns about your personal treatment needs.

Treatment of symptoms

If you experience mild symptoms, you can treat COVID-19 in a similar way to a seasonal flu, by:

• resting at home;
• taking acetominophen or ibuprofen to relieve pain and fever;
• staying hydrated;
• taking cough medicine, if needed;
• monitoring your symptoms;
• seeking medical help if you're concerned.

If you experience severe symptoms, you may need to be treated in hospital. Call an ambulance if your oxygen levels are low and you're short of breath. Most symptoms can be treated with supportive medical care.

Medications

The Food and Drug Administration (FDA) has approved certain medications for the treatment of COVID-19, including:

Medications in tablet form

• molnupiravir (Lagevrio)
• nirmatrelvir and ritonavir (Paxlovid)

These oral antiviral medications are available to those with mild to moderate symptoms, who are at high risk of progression to more severe disease. They must be taken within five days of developing symptoms.

Medication for infusion

• remdesivir (Veklury) - for those hospitalized with moderate to severe COVID-19

Remdesivir infusion is given over three consecutive days and must begin within seven days of developing symptoms.

Medications not approved for use

Antibiotics, ivermectin and hydroxychloroquine are not effective treatments for COVID-19.

Potential complications

Some people experience ongoing symptoms for weeks or months after recovering from COVID-19 infection. This is called chronic COVID or 'long COVID'. Nearly one third of adults in the US who have been infected with COVID-19 have reported experiencing symptoms that have lasted for three months or more.

The most common symptoms of 'long COVID' are:

• fatigue;
• shortness of breath;
• changes in sense of smell and/or taste;
• chest pain;
• lack of sleep;
• headache.

Medical research is being conducted around the world on the immediate and long-term health effects of COVID-19. It's currently uncertain how long symptoms may last..

Prognoses

Most people with mild to moderate COVID-19 recover with general treatment. Among those who become infected, it's estimated that:

• 81% experience mild symptoms;
• 14% develop severe illness requiring admission to hospital;
• 5% become 'critical'.

COVID-19 appears to have a lower rate of death (mortality) than SARS and MERS. Mortality may be changing as the pandemic progresses.

• ventilation due to severe acute respiratory distress syndrome (ARDS);
• comorbidities (such as obesity, COPD, hypertension, diabetes, kidney disease, renal replacement therapy, and cancer);
• markers of inflammation and blood clotting.

Prevention

Vaccination is a safe and effective way to reduce the severity of COVID-19, and to prevent hospitalization and death.

In combination with vaccination, a number of other personal preventive strategies can also help to prevent the spread of COVID-19 infection. These strategies include:

• wearing a mask;
• social/physical distancing;
• staying home/avoiding close contact with others if you feel sick;
• covering your nose and mouth when coughing or sneezing;
• disposing of tissues;
• frequent handwashing with soap and water;
• using an alcohol-based hand sanitizer.