Part I: Contagion
Dr. Antoine Aoun, Associate Professor at the Notre Dame University-Louaize (NDU) Faculty of Nursing and Health Sciences (FNHS) and University Physician, has compiled the most up-to-date information on COVID-19 from the American Academy of Family Physicians (AAFP), United States Centers for Disease Control and Prevention (CDC), UpToDate 2021, and the World Health Organization (WHO) to answer the most pressing questions on the pandemic. The following questions cover recent data on the symptoms of COVID-19, infection cases in pregnancy, and who is most at risk.
What are the possible symptoms of COVID-19?
Symptoms include: Fever, cough, sore throat, shortness of breath, chills, fatigue, headache and difficulties with sense of smell or taste.
Some people have digestive symptoms like nausea or diarrhea. There have also been some reports of rashes or other skin problems. Symptoms usually start 5 days after a person is infected with the virus. But in some people, it can take up to 2 weeks for symptoms to appear. Some people never show symptoms at all.
For most people, symptoms will get better within 1 or 2 weeks. Some people with COVID-19 continue to have some symptoms for weeks or months. While children can get COVID-19, they are less likely than adults to have severe symptoms.
Who is at risk for getting seriously ill?
It depends on the infected person’s age and health. In some people, COVID-19 leads to serious problems like pneumonia, not getting enough oxygen, heart problems, or even death. This risk increases with old age and health problems like serious heart disease, chronic kidney disease, diabetes, chronic obstructive pulmonary disease (COPD), sickle cell disease, obesity, HIV infection, asthma, cystic fibrosis, or high blood pressure.
What are the alarming signs for COVID-19?
The most common alarming signs are difficulty breathing, persistent pain or pressure in the chest, confusion, inability to wake up or stay awake, and bluish lips or face. If someone shows any of these signs, seek emergency medical care immediately.
Can infected pregnant women pass the virus to their babies?
Experts think it might be possible for a baby to get the infection while still in the uterus, but this is very uncommon. Even when it does happen, most babies do not get very sick. It is also possible to pass the virus to the baby during childbirth or after the baby is born.
Can COVID-19 cause problems with pregnancy?
Pregnant women who get COVID-19 might have an increased risk of preterm birth. This is when the baby is born before 37 weeks of pregnancy. Preterm birth can be dangerous, because babies who are born too early can have serious health problems. This risk seems to be highest in people who get very sick and have pneumonia as a result of COVID-19.
Can women with confirmed or suspected COVID-19 breastfeed?
Women with confirmed or suspected COVID-19 can breastfeed if they wish to do so. Transmission of virus through breast milk and breastfeeding has not been detected to date. There is no reason to avoid or stop breastfeeding. Infected women who do breastfeed should:
- Wash hands frequently with soap and water or use alcohol-based hand rub and especially before touching the baby;
- Wear a medical mask during any contact with the baby, including while feeding;
- Sneeze or cough into a tissue. Then dispose of it immediately and wash hands again;
- Routinely clean and disinfect surfaces that mothers have touched.
It is important to replace medical masks as soon as they become damp and dispose of them immediately. Masks should not be reused or touched in the front.
What about the new COVID-19 variants??
Multiple COVID-19 variants are circulating globally:
In the United Kingdom, South Africa and Brazil, new variants have emerged with an unusually large number of mutations. These variants seem to spread more easily and quickly than others, which may lead to more cases of COVID-19. Currently, there is no evidence that these variants cause more severe illness or increased risk of death. However, an increase in the number of cases will put more strain on health care resources, lead to more hospitalizations, and potentially more deaths. Rigorous and increased compliance with public health mitigation strategies, such as vaccination, physical distancing, use of masks, hand hygiene, and isolation and quarantine, will be essential to limiting the spread of COVID-19 and protecting public health.
Can people get reinfected from COVID19?
The protection someone gains from having had the virus, called “natural immunity”, varies depending on the disease and from person to person. Because this virus is new, we do not know how long natural immunity lasts. Current evidence suggests that getting the virus again – reinfection – is uncommon 90 days after the first infection with the COVID-19 virus.
Part II: Prevention
In this second article answering questions on COVID-19, Dr. Antoine Aoun, Associate Professor at the Notre Dame University-Louaize (NDU) Faculty of Nursing and Health Sciences (FNHS) and University Physician, uses the most up-to-date information on COVID-19 from the American Academy of Family Physicians (AAFP), United States Centers for Disease Control and Prevention (CDC), UpToDate 2021, and the World Health Organization (WHO) to answer how to prevent and treat the virus.
How can COVID-19 be prevented?
Practice social distancing – sometimes called “Physical Distancing”. It is important to avoid contact with people who are sick. It is best to stay home as much as you can. When you do need to go out, try your best to stay at least 2 meters away from other people.
Remember that social distancing means staying away from all people who do not live in your household, so avoiding gatherings and crowds is essential.
Wear a face mask when you need to go out. Make sure your mask covers your mouth and nose. You can buy cloth masks and disposable (non-medical) masks. In most cases, experts recommend leaving medical and surgical masks for health workers. Cloth masks work best if they have several layers of fabric. When you take your mask off, make sure you do not touch your eyes, nose, or mouth. And wash your hands after you touch the mask. You can wash cloth masks with the rest of your laundry.
Wash your hands with soap and water often. This is especially important after being out in public or touching surfaces that many other people also touch, like door handles or railings. The risk of getting infected by touching items like this is not well documented, but is probably not very high. Make sure to wash your hands with soap for at least 20 seconds, cleaning your wrists, fingernails, and in between your fingers. Then rinse your hands and dry them with a paper towel you can throw away. If you are not near a sink, you can use a hand sanitizing gel to clean your hands. The gels with at least 60 percent alcohol work the best. But it is better to wash with soap and water if you can.
Avoid touching your face, especially your mouth, nose, and eyes.
Avoid traveling if you can. Any form of travel, especially if you spend time in crowded places like airports, increases your risk.
What should I do if someone at home has COVID-19?
If someone at home has COVID-19, there are additional things you can do to protect others:
- Keep the sick person away from others: the sick person should stay in a separate room, and use a different bathroom if possible. They should also eat in their own room. Experts also recommend that the person stay away from pets in the house until they are better.
- Have them wear a mask: the sick person should wear a mask when they are in the same room with other people.
- Wash hands: wash your hands with soap and water often.
- Clean your house often, using the following methods: Wear disposable gloves when you clean and when you have to touch the sick person's laundry, dishes, utensils, or trash. Wash your hands after removing your gloves; regularly clean things that are touched a lot. This includes counters, bedside tables, doorknobs, computers, phones, and bathroom surfaces, clean things in your home with soap and water, but also use disinfectants on appropriate surfaces. Some cleaning products work well to kill bacteria, but not viruses, so it is important to check labels.
How is COVID-19 currently treated?
Many people will be able to stay home while they get better. But people with serious symptoms or other health problems might need to go to the hospital.
Mild illness – Mild illness means symptoms like fever and coughing, but not trouble breathing. Most people with COVID-19 have mild illness and can rest at home until they get better. This usually takes about 2 weeks, but it is not the same for everyone. Self-isolation means staying home and apart from other people, even the people you live with. Experts are advising people to be cautious of products claiming to prevent, treat, or cure COVID-19. As with a cold or the flu, drink fluids and get plenty of rest. If you are having trouble breathing, seek immediate medical care.
Severe illness – If you have more severe illness with trouble breathing, you might need to stay in the hospital, possibly in the intensive care unit (ICU). While you are there, you will most likely be in a special isolation room. Only medical staff will be allowed in the room, and they will have to wear special gowns, gloves, masks, and eye protection.
You might need extra oxygen to help you breathe easily. If you are having a very hard time breathing, you might need a breathing tube and a ventilator.
Dexamethasone is a corticosteroid that can help reduce the length of time on a ventilator and save lives of patients with severe and critical illness.
Results from the WHO’s Solidarity Trial indicated that remdesivir, hydroxychloroquine, lopinavir/ritonavir and interferon regimens appear to have little or no effect on 28-day mortality or the in-hospital course of COVID-19 among hospitalized patients.
Azithromycin has also not been shown to offer any clear benefit in the treatment of COVID-19. Currently there are insufficient data to recommend either for or against the use of ivermectin for the treatment of COVID-19.
Can micronutrient supplements (like vitamin C and zinc) prevent or cure COVID-19?
No. There is currently no evidence on the efficacy of micronutrient supplementation for the prevention of COVID-19 in healthy individuals or for the treatment of COVID-19. Micronutrients are critical for a well-functioning immune system and play a vital role in promoting health and nutritional well-being. Wherever possible, micronutrient intakes should come from a nutritionally balanced and diverse diet, including fruits, vegetables, whole grains, legumes, nuts and healthy animal source foods.
Are vitamin D supplements needed if individuals are not exposed to sunlight due to lockdowns?
Vitamin D can be made in the skin by exposure to sunlight or obtained through the diet from natural sources (such as salmon, tuna and mackerel, fish liver oils, beef liver, cheese and egg yolks), or from vitamin D-fortified foods. In situations where individuals’ vitamin D blood level is already low or where foods rich in vitamin D are not consumed, and exposure to sunlight is limited, a vitamin D supplement may be considered.
What can I do to cope with stress and anxiety?
It is normal to feel anxious or worried about COVID-19. It is also normal to feel stressed or lonely when you cannot do your normal activities or see friends and relatives. You can take care of yourself by trying to:
- Take breaks from the news.
- Get regular exercise and eat healthy foods.
- Find activities that you enjoy and can do at home.
- Stay in touch with your friends and family members.
- Several studies showed that prayer and contemplation improve mental health.
For more information on the pandemic, check part I.
Part III: Vaccination
In the third and final article on questions about COVID-19, Dr. Antoine Aoun, Associate Professor at the Notre Dame University-Louaize (NDU) Faculty of Nursing and Health Sciences (FNHS) and University Physician, explores the vaccination and what to expect from it using the most up-to-date information on the virus from the American Academy of Family Physicians (AAFP), United States Centers for Disease Control and Prevention (CDC), UpToDate 2021, and the World Health Organization (WHO).
Why should I get the COVID-19 vaccine?
If you get COVID-19, the vaccine will probably also keep you from getting sick or severely ill. The vaccine will also help protect other people around you, including those who are at higher risk of getting very sick or dying. When a lot of people have been vaccinated, the virus will stop spreading so quickly. This decline will allow everyone to get back to normal life more quickly, but only if enough people get the vaccine.
Do I still need the vaccine if I have had COVID-19?
Experts recommend getting vaccinated even if you had COVID-19 in the past. People who get COVID-19 develop antibodies that likely provide some protection against getting infected again. But it is not known exactly how long antibodies last after a person recovers.
Is the vaccine safe?
COVID-19 vaccines have been developed very quickly but they had to go through the same process as other vaccines to test their safety. This involved running "clinical trials" with lots of people who volunteered to try the vaccine. The volunteers included adults of all ages and ethnicities. During these trials, researchers studied how well the vaccines work and how many people had side effects. The results were reviewed by experts who do not work for the drug companies that made the vaccines. These experts agreed that the vaccines are safe and effective enough to be given to the public.
Even after people start getting the vaccine, researchers will continue to study how it works. They will learn more about how long a person is protected after getting a vaccine, and how well vaccination is working to slow the spread of COVID-19.
Side effects are common, especially after the second dose of the vaccine. They can include: pain where you got the shot, fever, fatigue and headache. While these side effects can be annoying, they should not last longer than 1 or 2 days.
Severe allergic reactions are rare, and the person getting the vaccine should be monitored for 15 to 30 minutes to make sure they do not have an allergic reaction.
How does the COVID-19 vaccine work?
There are several COVID-19 vaccines being developed. They work in slightly different ways.
In the United States, the first two COVID-19 vaccines became available in late 2020. Both are a type of vaccine called an "mRNA vaccine." mRNA refers to genetic material from the virus that causes COVID-19. This genetic material is used in the vaccine. It gives the body instructions to make a specific piece of protein that is normally found on the virus. In response, the immune system then makes antibodies that can recognize and attack the virus, preventing about 95% of infections.
When will the pandemic end?
The pandemic will be controlled when we have "herd immunity." This is when enough people are immune to a disease that it can no longer spread easily. When vaccines are widely available, this is the best way to make people immune.
Trying to reach herd immunity without vaccines would involve allowing lots of people to get infected on purpose. But this would be dangerous. Even though most people with COVID-19 do not get seriously ill or die, some do – even young and healthy people. And people who do not get very sick can easily spread the infection to someone who might.
To get to herd immunity, lots of people need to get vaccinated. The more people who get vaccinated, the sooner we will be able to get back to normal life.
For more information on the pandemic, check part I and part II.