3.CORONAVIRUS EXPLAINED- diagnosis, treatment and containment .

What is the diagnosis of COVID-19 ?

Infection by the virus can be provisionally diagnosed on the basis of symptoms. Although confirmation is ultimately by reverse transcription polymerase chain reaction (rRT-PCR) of infected secretions or CT imaging. A study comparing PCR to CT in Wuhan suggests CT is significantly more sensitive than PCR. Though less specific, with many of its imaging features overlapping with other pneumonias and disease processes. But the American College of Radiology recommends that to screen for or as a first-line test to diagnose COVID-19 .

What is the treatment for COVID-19?

There are no specific antiviral medications for COVID-19, but development efforts are underway, including testing of existing medications. Taking over-the-counter cold medications, drinking fluids, and resting may help alleviate symptoms. Depending on the severity, oxygen therapy, intravenous fluids, and breathing support may be required. But the use of steroids may worsen outcomes. Meanwhile investigation is going on several compounds for use in treating COVID-19. These compounds are useful for treating other viral diseases.

There is no available vaccine, but various agencies are actively developing vaccine candidates.They are using previous work on SARS-CoV because SARS-CoV & SARS-CoV-2 both use ACE2 receptor to enter human cells.

Investigation is going on three vaccination strategies. First, researchers aim to build a whole virus vaccine. The use of such a virus, be it inactive or dead, aims to elicit a prompt immune response of the human body to a new infection with COVID-19. A second strategy, subunit vaccines, aims to create a vaccine that sensitises the immune system to certain subunits of the virus. In the case of SARS-CoV-2, such research focuses on the S-spike protein that helps the virus intrude the ACE2 enzyme receptor. While a third strategy is that of the nucleic acid vaccines (DNA or RNA vaccines, a novel technique for creating a vaccination). Testing these experimental vaccines for safety and efficacy is essential.

On 16 March 2020, the first clinical trial of a vaccine started with four volunteers in Seattle. The vaccine contains a harmless genetic code copied from the virus that causes the disease.Antibody dependent enhancement has been suggested as a potential challenge for vaccine development for SARS-COV-2, but this is controversial.

What are the control strategies?

Strategies in the control of an outbreak are containment or suppression, and mitigation. Containment occurs in the early stages of the outbreak and aims to trace and isolate those infected as well as introduce other measures of infection control and vaccinations to stop the disease from spreading to the rest of the population. Also contact tracing is done in order to identify possible source and potential victims.  When it is no longer possible to contain the spread of the disease, efforts then move to the mitigation stage: measures are taken to slow the spread and mitigate its effects on the healthcare system and society.

A combination of both containment and mitigation measures may be undertaken at the same time. Suppression requires more extreme measures so as to reverse the pandemic by reducing the basic reproduction number to less than 1. Part of managing an infectious disease outbreak is trying to decrease the epidemic peak, known as flattening the epidemic curve. This decreases the risk of over burdening of health services and provides more time for development of vaccines and treatments .



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