How to fight a complex, unpredictable virus

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Only quality clinical and health sciences research and innovation will provide the technological base for Bangladesh to successfully counter this and future medical emergencies. Photo: Dado Ruvis/Reuters

Professor Ahmed Abdullah Azad PhD, Secretary General, Islamic-World Academy of Sciences

Bangladesh had three-months’ notice to prepare for a possible outbreak of Covid-19 but failed to prepare for it. The authorities have tried very hard to convince everyone to use the public health measures that are known to minimise community transmission, but these have not been easy to implement in the densely populated environment of Bangladesh. Lack of coordination, insufficient testing, contradictory and inconsistent directives, and an eagerness to prematurely reopen businesses, have allowed Covid-19 to spread to all corners of the country. Large numbers of healthcare workers, policemen, journalists, transport workers, and other frontline workers, have worked tirelessly and selflessly to help stop the carnage, and in the process far too many of them have paid dearly with their lives.

With rampant infection and death rates increasing every day, and faced with the resulting economic freefall, the government has decided to divide the country into non-contiguous red, yellow and green zones, and impose lockdown in the red zones first. Till now only a very small number of red zones with the highest number of infections have been locked down on an experimental basis. More experiments will waste valuable time and further delay may see more yellow zones turning red, and more green zones turning yellow. An all-out war has to be launched against the virus in all red zones simultaneously through total lockdown (not public holiday!) enforced if required with curfews and troop deployment, together with extensive testing to identify infected individuals and their close contacts, followed up with their isolation and treatment in designated public buildings within the red zones.

The obvious weak links in fighting Covid-19 are low capacity of RT-PCR testing and ineffective contact tracing. For contact tracing, the authorities could invite young people living within a red zone to help in neighbourhood surveillance—a strategy that has worked very well in Vietnam’s fight against Covid-19. The huge numbers of tests needed in each red zone is simply not possible with RT-PCR because of the limited availability of very expensive equipment and reagents and shortage of trained personnel. To complement RT-PCR testing, the government should seriously consider the use of alternative tests that are inexpensive, rapid and not dependent on specialist equipment or personnel.

To cope with a second wave of Covid-19 in sizable parts of Melbourne (Australia), besides total lockdown a RT-PCR testing blitz has also been launched in which saliva has been substituted for throat and nose swabs. About two months back Bangladeshi media reported on a rapid antigen detection kit, developed by Gonoshasthya Kendra-RNA Biotech Ltd., that also detects SARS-CoV-2 in saliva samples. While RT-PCR test detects viral RNA, the rapid antigen test detects viral surface proteins. So, both tests should essentially provide the same information about the presence or absence of virus.

CARES is committed to giving the society the right information about the COVID -19.  Only scientific discussions by practising scientists from Bangladesh and other places are in CARES website.  Here are some new insightful suggestions from Professor Dr Jeba Seraj, an active member of CARES and a life scientist at Dhaka University. At CARES we talk science.  Engage Science in your life.   –  Wali-ul-Maroof Matin, Chairman, CARES

However, the locally-produced rapid antigen kit is claimed to provide results within 10 minutes, does not require any equipment or trained manpower, and costs only a fraction of RT-PCR. These claims should be verified independently by using the same saliva sample for both RT-PCR and rapid antigen tests. If validated and approved by DGDA, this inexpensive and simple homegrown kit would be ideal for rapid testing and follow up of a large number of people in the red zones. A rapid antibody detection kit (also developed by GK-RNA Biotech) which has been approved by DGDA for studying antibody response to Covid-19 could nicely complement the rapid antigen kit, as together, they would identify all infected individuals who have also seroconverted. The rapid antibody kit can also be used as a powerful research tool to ask and answer a number of fundamental questions about the consequences of Covid-19 infection.

Antibody testing of blood from Covid-19 patients has yielded some unexpected results. A recent study showed that 3 percent of RT-PCR positive patients failed to produce antibodies against Covid-19 and 4 percent of patients who were RT-PCR negative were correctly picked up by antibody test (Quan-Xim Long et al, Nature Medicine, April 2020). Another study from John Hopkins University also shows (Annals of Internal Medicine, 2020) that RT-PCR can produce 20 percent false negatives. This demonstrates the value of using RT-PCR/antigen test and antibody test in parallel. In another study comparing Covid-19 symptomatic and asymptomatic patients, antibody response was found to be much weaker in the asymptomatic group, and within 8 weeks of infection 40 percent of asymptomatic and 13 percent of symptomatic patients showed no antiCovid-19 antibodies in their blood (Quan-Xin Long et al., Nature Medicine, June 2020). This brings into question the prospects of long-term natural or vaccine-induced immunity.

The rapid antibody test could also be useful in selecting suitable plasma donors from among recovered patients. Analyses of 370 plasma samples from Covid-19 recovered patients showed that almost 17 percent had almost no antibody response, and while over 80 percent generated varying levels of antibody, only about 10 percent had high levels of neutralising antibodies able to neutralise a laboratory-safe Covid-19 pseudovirus (New York Blood Centre and Rockefeller University, medRxiv, 2020). The above studies show that plasma from asymptomatic and seronegative recovered patients will be of little utility, and only about 10-12 percent of the seropositive plasma will be suitable for harvesting and enrichment of strong antiCovid-19 neutralising antibodies. This could be the first step towards developing a therapeutic vaccine.

Although an effective prophylactic vaccine is highly desirable, there is no guarantee that one will be produced soon or be available to Bangladesh. Attempts to produce effective vaccines against many pathogens has failed even after years of trying, and it would not be wise to put all our eggs in the vaccine basket. It is quite possible that deliverance may come not from a preventive vaccine but from drugs as happened with HIV/AIDS. A previous op-ed (Covid-19: Taming the Beast, The Daily Star, April 14, 2020) pointed to some therapeutic approaches that Bangladeshi scientists could try using with Bangladesh’s own capabilities and strengths. Bangladeshi scientists have demonstrated that full genome sequencing is well within their capability, but instead of being in a race to be the first or who can sequence the most viral genomes, they could collaborate on trying to understand why different people react differently to Covid-19, why some infected people remain asymptomatic, and why some infected patients never produce antiCovid-19 antibodies.

The Covid-19 pandemic has exposed the very poor state and safety of our health services and hospitals, shortage of trained healthcare workers, and insufficient testing capacity needed to meet the challenge. Covid-19 has also doubled the number of “very poor” to 40 million. An annual budget in the middle of the Covid-19 pandemic would have been expected to specifically make special allocations for the health, wellbeing and rehabilitation of the poorest and most vulnerable, for improving hospital treatment and public health, and educating and training of adequate numbers of clinicians and healthcare workers.

Covid-19 is not about to disappear soon, and could come back in future in a more deadly form. Only quality clinical and health sciences research and innovation will provide the technological base for Bangladesh to successfully counter this and future medical emergencies. Unfortunately, the token increase in health and education budgets are not enough to have much impact on bringing about the above changes or building technological capacity for the future. Perhaps Covid-19 will nudge our policymakers to realise that investment in health, education and medical research today will be a lasting investment in a healthy, just and prosperous Bangladesh.

Ahmed A Azad is a retired academic and biomedical scientist, who has had a lifelong involvement in the discovery, development and commercialisation of biotech vaccines and drugs.

Email: aaazad1945@gmail.comc

Source: https://www.thedailystar.net/opinion/news/how-fight-complex-unpredictable-virus-1927713

Are Easing of Restrictions Possible?

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Zeba I. Seraj (PhD), Professor and Chair, Biochem and Mol Biol & Director cBLAST, University of Dhaka

“Lockdowns must be lifted strategically, and not all at once said WHO officials at a briefing on 13 April 2020. However, we should be careful to adopt our own guidelines considering our own unique situation in Bangladesh for gradually coming out of the lockdown. Countries where infection rate has slowed down and the numbers of infection are low can begin easing restrictions, but with care.

It is important to note that social distancing and handwashing and wearing masks even if cloth ones have to become the newer norm. Garment factories can be encouraged to make washable cloth masks for distribution all over the country at a reasonable price. (They may be able to export these too because until a vaccine is out, wearing of masks will have to be the new uniform). So we may need to wear masks for at least another year or two. Pharma companies can start making sanitizing agents for distribution to the whole country. Hospitals, tests and consistent treatments need to be in place in all diagnostic centres, big offices and factories. This can be done with the Rapid test in place which has already been established by the Abott Company in the USA. But our scientists can do this too provided that they are provided with samples. Hospital spaces and ICU units need to be expanded before lockdown is even gradually lifted. Hospitals must also ensure that protective equipment is in place and intensive care beds are on standby.

CARES is committed to giving the society the right information about the COVID -19.  Only scientific discussions by practising scientists from Bangladesh and other places are in CARES website.  Here are some new insightful suggestions from Professor Dr Jeba Seraj, an active member of CARES and a life scientist at Dhaka University. At CARES we talk science.  Engage Science in your life.   –  Wali-ul-Maroof Matin, Chairman, CARES

Coordination and training cells for social distancing and maintaining hygiene to prevent spread have to be present in all Upazilas and thanas. The IT ministry can send training videos to all mobile users.

For Bangladesh, we need to consider how to open gradually with social distancing and hygiene (including surfaces of workplaces). We will need different guidelines for different settings. For townships,

  1. Grocery and other shops. Grocery shops are already open. Other shops can gradually open with strict guidelines in place. In a fixed area, certain shops can remain open on fixed days.
  2. Construction workers and daily laborers and workers in the agricultural sectors. Construction supervisors will need to be trained first. They will need to give daily instructions to construction workers and other daily laborers. Agricultural extension worker need to be trained and then they will in turn need to train the farmers. This is a good time to reign in middlemen. The latter need to be trained on how to remain safe too.
  3. Office staff: they can also start working in shifts or on alternate days.
  4. In case of industries: they need isolation units with a few beds and their own testing facilities. They also need to keep their premises clean.
  5. Separate sets of rules have to be in place for slum areas. Disinfectants and sanitizers need to be provided to this latter category at an ever cheaper rate.

Schools, colleges and Universities can be the last ones to be opened. Meanwhile IT ministry can ensure Wi-Fi services all over the country for establishment of online classes and quizzes.

According to WHO, countries easing lockdowns should meet the following criteria:

1. The transmission is controlled.

2. Health system capacities are in place to detect, test, isolate and treat every COVID-19 case and trace every contact.

i. Tests need to be expanded quite a lot. Many university departments have the necessary machines but may need the kits.

ii. A database needs to be established for coordination of the detection and testing. CDC has given the green signal to use of saliva as a proper sample to detect Covid 19. The latter is much easier and less prone to splashing of virus-contaminated aerosols. The rapid test based on an isothermal test needs to be established. Our scientists have the capacity do this.

iii. Apps for contact tracing need to be established. And research on back-tracing of persons coming into Bangladesh from the middle of January needs to be done.

iv. Relevant scientists need to be provided with samples from different regions of Bangladesh for sequencing. Since this virus mutates a lot, its sequence will need to be known in order to determine whether any vaccine will be effective.

3.  Outbreak risks are minimized in special settings like health facilities and nursing homes.

4.  Preventive measures are in place in workplaces, schools and other places where it’s essential for people to go.

5.  Importation risks can be managed. Airports need to be controlled by the Army. All passengers kept aside until tested to be free of virus. Rapid tests need to be in place and all tested before being allowed into the community.

6.  Communities are fully educated, engaged and empowered to adjust to the “new norm”.

WHO advice is: Countries seeing their numbers stabilize should not believe the worst is over. Measures such as physical distancing and handwashing will need to stay in place even after lockdowns are lifted. “We are going to have to change our behaviors for the foreseeable future, says a WHO official. Increased capacity at health systems will also need to be maintained once restrictions are eased. “As we come out of these lockdown situations, we may see a jump back up of cases. And we don’t want to lurch from lockdown to nothing. So now is the time to be very, very careful.”

Covid-19: Taming the beast

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Professor Ahmed Abdullah Azad PhD, Secretary General, Islamic-World Academy of Sciences

The Covid-19 pandemic, caused by coronavirus SARS-CoV-2, has brought the entire world to its knees and virtually stopped all face-to-face social interactions between humans. Personal freedoms and human rights have been severely curtailed all over the world to help slow down the infection and death rates. This newly discovered coronavirus is extremely contagious, and up to 20 times more deadly than seasonal flu. Currently, the only way to reduce community spread is by maintaining good hygiene, social distance and self-isolation. In Bangladesh, it will be a challenge to implement these public health measures in congested environments, and particularly hard for disadvantaged people and casual workers who would starve if confined at home for long. A substantial portion of the government’s stimulation package must be ring-fenced for the poor and needy, otherwise the public health measures will fail.

Effective health and economic policies to counter the adverse effects of the pandemic require extensive testing for the presence of the virus in infected individuals, and people they have been in contact with. PCR- and sequence-based tests require expensive equipment and reagents, are time-consuming, and the total capacity is hardly adequate for testing all infected individuals, contact tracing and determining the infection status of health care workers. There is an urgent need for a quick, inexpensive and less-invasive blood tests for detecting anti-viral antibodies and confirming infection. A simple dot-blot blood test that provides results within 15 minutes has reportedly been developed through a joint venture collaboration between Gonoshasthaya Kendra and RNA Biotech Ltd, a company formed by a group of young researchers in Bangladesh.

If the claims for this locally developed test are validated, then the project should be treated and supported as an urgent national priority, so that adequate numbers of kits can be made available for extensive testing at the earliest. The quoted price per test is miniscule in comparison to the gene-based assays currently in use in Bangladesh and could be much lower if the recombinant antigens (the four structural proteins of the virus) were produced in Bangladesh. The imported recombinant viral antigens, produced in bacteria (E.coli), might suffice for virus detection but may not be ideal for further biological and clinical studies.

CARES is committed to giving the society the right information about the COVID -19.  Only scientific discussions by practising scientists from Bangladesh and other places are in CARES website.  Here are some new insightful suggestions from Professor Dr Jeba Seraj, an active member of CARES and a life scientist at Dhaka University. At CARES we talk science.  Engage Science in your life.   –  Wali-ul-Maroof Matin, Chairman, CARES

The above rapid test, using locally-produced recombinant antigens that more closely resemble those in the virus particle, could also be an important research tool for following antibody production and response during different phases of disease progression. If properly designed, the dot-blot assay could help identify virus-neutralising antibody in blood collected from individuals recovered from the infection. If the neutralising antibody could be purified, then its protein sequence could be reverse-engineered into a therapeutic monoclonal antibody for mass production by recombinant DNA technology. The required expertise is present in Bangladesh but the multidisciplinary technologies need to be assembled under one roof as a national core facility, a plea that has fallen on deaf ears.

It is not enough to just keep the virus at bay by social isolation. The virus-induced paralysis of normal life and enforced shutdown cannot continue ad infinitum, and countermeasures need to be contemplated. To tame and conquer the invisible beast, we need to understand its biology and molecular structure to discover its soft underbelly as a target for drug and vaccine development. Coronaviruses of innumerable types are ubiquitous in many non-primate animals. Seven of these have managed to cross over into humans. Four have been around for over a century, and cause about a third of all the seasonal colds. Three that have emerged in recent years (SARS, MERS and Covid-19) cause severe illness in humans, termed Acute Respiratory Distress Syndrome (ARDS), but SARS-CoV-2 (Covid-19 virus) is by far the most deadly and contagious.

So, how did SARS-CoV-2 emerge in humans and why is it so dangerous? The ancestor could be a bat coronavirus (88 percent sequence homology) that cannot produce disease in humans or spread from one human to another. It could have picked up these properties through genetic exchange with another coronavirus in a co-infected intermediate host such as a pangolin (an ant-eating mammal), which is a culinary delicacy and is used in Chinese medicine. It is possible that the Covid-19 virus that had finally evolved into a dangerous pathogen in pangolins passed over into a human in the wet markets of Wuhan. SARS-CoV-2 can enter human cells and spread to other humans through a molecular interplay between the viral spike protein on its surface (that gives all coronaviruses the spectacular crown-like appearance) and two vital enzymes on the surface of human cells.

The spike protein of the SARS-CoV-2 virus contains two distinct structural units. A receptor-binding domain uses a human enzyme—angiotensin converting enzyme 2 (ACE 2),as a receptor to attach the virus to the human cell surface. A second membrane-binding domain, after specific cleavage by the human enzyme Furin, can interact with and fuse the virus and cell membranes, thus facilitating virus entry into epithelial cells, and then into lung cells.This leads to infection of both the upper and lower respiratory tracts (lungs) causing ARDS, which is characterised by serious breathlessness, breakdown of cell signalling networks (cytokine storm), self-destructive immune response and massive secondary infections, ultimately leading to multiple organ failure, especially in older people with co-morbidities such as heart disease, hypertension, diabetes, kidney disease and immunodeficiencies. Less virulent and less contagious human coronaviruses either do not contain the Furin-cleavage site or possess a partial Furin-cleavage site.

Two therapeutic approaches can be tried to stop SARS-CoV-2 from infecting humans. One is to prevent or disrupt the interaction between ACE 2 and the receptor-binding domain of the viral spike protein. The other is to prevent Furin from cleaving the viral spike protein. While required expertise and facilities in structural biology and rational drug design may not be currently available, scientists in Bangladesh can target the above drug development opportunities by using expertise and resources already available to them. Molecular and cell biologists should be able to develop very specific bioassays based on the above molecular targets, and these disease-specific bioassays could be used to screen the very large libraries of indigenous medicinal plants, and isolated secondary metabolites, collected by ethnobiologists and medicinal chemists in Bangladesh. Every positive lead compound would be a potential candidate drug against SARS-CoV-2 that could be patented and developed into a new drug if the required technology platform is established as a national core facility, another plea that has gone unheeded over the last fifteen years. Hopefully, the Covid-19 pandemic will open the eyes and ears of our policymakers so that higher education, research and innovation are supported at the required levels, so that we are prepared the next time around.

Besides coronaviruses, a number of viruses have crossed over from wild animals to humans (Influenza, HIV, Ebola, Marburg) in recent years, causing very frightful diseases. Most of them have lived in animal hosts for thousands of years but in recent times, human activities have destroyed the natural habitats of their hosts and brought man and wild animals into close contact. The Covid-19 pandemic is a timely warning to the human race to not destroy the environment and natural habitats of exotic animals in the mad pursuit of profits and development at any cost.

Prof Ahmed Azad PhD, a retired molecular virologist, has been intimately involved in developing several anti-viral drugs and vaccines. After retirement (2006), he has worked with younger colleagues to help build biotechnology research capacity in Bangladesh. Email: aaazad1945@gmail.com

The writer is a founding member of CARES.

Source:  https://www.thedailystar.net/opinion/news/covid-19-taming-the-beast-1892629

কোভিড-নাইন্টিন রোগনির্ণয়ের সুবিধা-অসুবিধা

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মোহাম্মদ আশরাফ হোসেন, ফেলো হিসেবে US FDA তে ৮ বছর কর্মরত ছিলেন, ফ্লোরিডা, ইউএসএ

বিধানচন্দ্র রায় ছিলেন একাধারে বিশিষ্ট চিকিৎসক, শিক্ষাগুরু এবং পশ্চিমবঙ্গের মুখ্যমন্ত্রী যিনি ভারতরত্ন উপাধিলাভ করেছিলেন। কথিত আছে যে, কথোপকথন কিংবা পরীক্ষা-নিরীক্ষা ছাড়াই শুধু রোগীকে পর্যবেক্ষণ করেই তিনি সঠিকভাবে রোগনির্ণয় ও চিকিৎসা করতে পারতেন। বাস্তবে এমনটি খুব কমই ঘটে। সঠিকভাবে চিকিৎসা করতে রোগনির্ণয় অত্যাবশ্যক, আর সেজন্য পদ্ধতিগত সাক্ষাৎকার ছাড়াও প্রয়োজন হয় শারীরিক পরীক্ষা ও নানান ধরণের ল্যাবোরেটরী টেস্ট-এর। প্রযুক্তির অগ্রযাত্রা আর চিকিৎসা পারস্পরিক সম্পর্কিত; ডায়াগনস্টিক মেডিক্যাল ডিভাইসের মাধ্যমে এখন সাধারণ থেকে বিরল রোগ নির্ণয় করে অনতিবিলম্বে চিকিৎসা ব্যবস্থা করা অনেক সহজ হয়েছে। এর ফলে রোগ-ভোগ, জটিলতা সৃষ্টি, হাসপাতালে ভর্তি, অপারেশন ও চিকিৎসা ব্যয় সীমিতকরণের সুযোগ তৈরি হয়েছে।

অদৃশ্য শত্রু করোনাভাইরাসের সংক্রমণ থেকে কোভিড-১৯ রোগ গত তিন মাসে বিশ্বে ছড়িয়ে পড়েছে। রোগ উপসর্গের অনুপস্থিতি কিংবা লক্ষণ রোগভিত্তিক না হওয়ায় পরীক্ষা-নিরীক্ষা ছাড়া শ্বাসতন্ত্রের এ রোগ নিরূপণ করা কঠিন। অথচ এ রোগে এ যাবৎ আক্রান্ত হয়েছে ১৮ লক্ষাধিক মানবসন্তান, আর মাত্র কয়েক মাসে মৃত্যু হয়েছে ১.১ লক্ষাধিক। বিজ্ঞান-প্রযুক্তিতে অগ্রগামী, শিল্পোন্নত দেশ যুক্তরাষ্ট্রেও কোভিড-১৯ রোগ বিস্তৃত হয়েছে ব্যাপকভাবে; এ যাবৎ আক্রান্ত হয়েছে ৫.৩ লক্ষাধিক, আর মৃত্যু হয়েছে ২০.৫ সহস্রাধিক। বিশ্বব্যাপী মৃত্যুর মিছিলে শত-সহস্র যোগ হচ্ছে প্রতিদিন।

যুক্তরাষ্ট্রের প্রধান জনস্বাস্থ্য প্রতিষ্ঠান (Center for Disease Control & Prevention) সিডিসি-র নির্দেশনামতে সন্দেহভাজন সবার করোনাভাইরাসের সংক্রমণ টেস্টিং-এর প্রয়োজন নেই; শুধুমাত্র রাজ্য ও স্থানীয় স্বাস্থ্য বিভাগের নির্দেশ মেনে টেস্টিং সুপারিশ করতে পারেন সংশ্লিষ্ট চিকিৎসক। সিডিসি’র নির্দেশনা ও ফুড অ্যান্ড ড্রাগ অ্যাডমিনিস্ট্রেশন (এফডিএ) -এর সাময়িক [ত্বরান্বিত প্রক্রিয়ায়] অনুমোদন-ক্রমে কোভিড-১৯ সনাক্ত করতে কয়েক ডজন নতুন নিউক্লেয়িক এসিড-ভিত্তিক আরটি-পিসিআর ও সেরোলজি্ক্যাল টেস্ট-এর ব্যবহার শুরু হয়েছে।

আরটি-পিসিআর অ্ত্যাধুনিক মোলিকুলার বায়োলোজী প্রযুক্তি যা থার্মাল সাইক্লার ও ইলেক্ট্রফোরেসিস যন্ত্রের মাধ্যমে সম্পাদন করা হয়। শ্বাসতন্ত্র [যেমন নাসাপথ] থেকে সংগৃহিত নমুনা থেকে করোনাভাইরাসের অস্তিত্ব  সনাক্ত করা সম্ভব।  আর সেরোলজি্ক্যাল টেস্ট-এর মাধ্যমে রক্তের জলীয় অংশে উপস্থিত অ্যান্টিবডি (অর্থাৎ, করোনাভাইরাস অ্যান্টিজেন/আমিষের প্রতিরোধী আমিষ) সনাক্ত করা হয়। শুধুমাত্র প্রশিক্ষিত স্বাস্থ্যকর্মীরাই সঠিকভাবে নমুনা সংগ্রহ, সংরক্ষণ, স্থানান্তর ও পিসিআর টেস্ট  পরিচালনা করতে পারেন।  এছাড়া ল্যাবোরেটরির গঠন ও সক্ষমতাও অত্যাবশ্যক। যুক্তরাষ্ট্রে ক্লিনিক্যাল ল্যাবোরেটরির গ্রহণযোগ্যতা যাচাই করা হয় প্রাতিষ্ঠানিক (যেমন, CLIA) Certification -এর মাধ্যমে।

অত্যাধুনিক প্রযুক্তি ব্যবহার করে এসব টেস্ট থেকে গুণগত (অর্থাৎ, পযিটিভ বা নেগেটিভ) ফলাফল পাওয়া গেলেও এদের কার্যকারিতা শতভাগ নিশ্চিত নয়। সাধারণভাবে, ইলেক্ট্রফোরেসিস-এর মাধ্যমে সঠিক আকারের ডিএনএ ব্যান্ড দৃশ্যমান হলে তা কাঙ্ক্ষিত ডিএনএ অর্থাৎ টেস্ট পযিটিভ, অন্যথায় তা নেগেটিভ। একইভাবে, রোগীর দেহে পরিমিত পরিমাণে অ্যান্টিবডি (কিংবা করোনাভাইরাস অ্যান্টিজেন) থাকলে এবং যথাযথভাবে পরীক্ষা করলে টেস্ট পযিটিভ হতে পারে, কিন্তু গঠনে মিল থাকায় রক্তে কোভিড-১৯ সৃষ্টিকারী করোনাভাইরাস না থাকলেও HKU-1, NL-63, OC-43 বা L229E ভাইরাস-এর কারণে টেস্ট পযিটিভ হতে পারে। আবার রোগীর দেহে পরিমিত পরিমাণে অ্যান্টিবডি (কিংবা করোনাভাইরাস অ্যান্টিজেন) না থাকলে তা নেগেটিভ হতে পারে। ত্রূটিপূর্ণ নমুনা সংগ্রহ, তাপমাত্রা-রক্ষায় ব্যর্থতা, নমুনা-মিশ্রণ কিংবা প্রক্রিয়াগত ত্রূটির কারণে বিভ্রান্তিকর ফল পাওয়া যেতে পারে। অতএব, এসব টেস্টের কার্যকারিতা বা সংবেদনশীলতা (সেন্সিটিভিটি) প্রতিষ্ঠিত হতে সত্য/ মিথ্যা পযিটিভ ও নেগেটিভ তথ্য-উপাত্ত সংগ্রহে অভিজ্ঞতা ও সময়ের প্রয়োজন।  তুরুটি

করোনাভাইরাস টেস্টের ফলাফল বিচার ও পরবর্তী করণীয় নির্ধারণ করতে বিশেষ সাবধানতা অবলম্বন করা প্রয়োজন। সাধারণভাবে পিসিআর টেস্ট পযিটিভ সংক্রমণ নির্দেশক হলেও অ্যান্টিবডি টেস্ট পযিটিভ চলমান সংক্রমণ নির্দেশক না-ও হতে পারে; বরং তা ব্যক্তির রোগ প্রতিরোধক্ষমতা (যা আপেক্ষিক) ইঙ্গিত করে। যেমন, টিউবারকুলিন টেস্ট পযিটিভ হলে সাধারণতঃ তা অতীত যক্ষা সংক্রমণ বা বিসিজি টিকার কার্যকারিতা ইঙ্গিত করে। অপরপক্ষে, করোনা ভাইরাস টেস্টের ফল নেগেটিভ হলে ব্যক্তি রোগমুক্ত কিংবা ঝূকিমুক্ত, এমন দাবী করাও অসঙ্গত। বরং মিথ্যা-নেগেটিভ একজন বাহক মিথ্যা স্বস্তি নিয়ে অন্যদের সান্নিধ্যে এসে অজান্তেই কোভিড-১৯ রোগ বিস্তারে সহায়তা করতে পারেন।

সম্প্রতি জার্মানীর গটিংগেন ইউনিভার্সিটির দুই গবেষক Lancet ID Journal-এ প্রকাশ করেছেন যে বিশ্ব জুড়ে আক্রান্তের সংখ্যা ১ কোটি ছাড়ালেও এ যাবৎ প্রায় ৬% কোভিড-১৯ রোগ সনাক্ত হয়েছে <https://www.uni-goettingen.de/en/606540.html>। তাদের মতে শিল্পোন্নত দেশগুলিতেও গ্রহণযোগ্য পদ্ধতির অভাব, অপর্যাপ্ত কিংবা বিলম্বিত টেস্টিং ইত্যাদি কারণে সারা বিশ্বে ইটালীতে ৩.৫% আর যুক্তরাজ্য, স্পেন ও যুক্তরাষ্ট্রে যথাক্রমে <১.২%, <১.৬% ও <১.৭% সনাক্তকরণ সম্ভব হয়েছে।  কোভিড-১৯ রোগ নির্ণয়ে আজ নানাবিধ বিড়ম্বনার মুখোমুখি চিকিৎসক ও স্বাস্থসেবা প্রদানকারী ব্যক্তিবর্গ, তারই ইঙ্গিত এ লেখায়। জার্নালটি চিকিতসা গবেষকদের কাছে অত্যন্ত মূল্যবান হলেও উল্লিখিত রিপোর্ট বিশ্বাস করতে যেন কষ্ট হয়।

তবে আশার কথা, রোগতত্ত্ববিদেরা মনে করছেন, শিগগিরই করোনাভাইরাস সংক্রমণ- তথা মৃত্যুহার কমে যাবে।

 

COVID-19 infection: Origin, transmission, and characteristics of human coronaviruses

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Author links open overlay panel Muhammad AdnanShereenab1, SulimanKhana1, AbeerKazmic, NadiaBashira, RabeeaSiddiquea

Abstract

The coronavirus disease 19 (COVID-19) is a highly transmittable and pathogenic viral infection caused by severe acute respiratory syndrome coronavirus 2 (SARSCoV- 2), which emerged in Wuhan, China and spread around the world.  Genomic analysis revealed that SARS-CoV-2 is phylogenetically related to severe acute respiratory syndrome-like (SARS-like) bat viruses, therefore bats could be the possible primary reservoir. The intermediate source of origin and transfer to humans is not known, however, the rapid human to human transfer has been confirmed widely. There is no clinically approved antiviral drug or vaccine available to be used against COVID-19. However, few broad-spectrum antiviral drugs have been evaluated against COVID-19 in clinical trials, resulted in clinical recovery. In the current review, we summarize and comparatively analyze the emergence and pathogenicity of COVID-19 infection and previous human coronaviruses severe acute respiratory syndrome coronavirus (SARS-CoV) and middle east respiratory syndrome coronavirus (MERS-CoV). We also discuss the approaches for developing effective vaccines and therapeutic combinations to cope with this viral outbreak. … READ MORE

Coronavirus and Pneumonia

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(Compiled by Dr. Md. Mozammel Hoq)

Most people who get COVID-19 have mild or moderate symptoms like coughing, a fever, and shortness of breath. But some who catch the new coronavirus get severe pneumonia in both lungs. COVID-19 pneumonia is a serious illness that can be deadly.

What Is Pneumonia?

Pneumonia is a lung infection that causes inflammation in the tiny air sacs inside your lungs. They may fill up with so much fluid and pus that it’s hard to breathe. You may have severe shortness of breath, a cough, a fever, chest pain, chills, or fatigue.

Your doctor might recommend cough medicine and pain relievers that reduce fever. In the most serious cases, you may need to go to the hospital for help breathing with a machine called a ventilator.

You can get pneumonia as a complication of viral infections such as COVID-19 or the flu, or even a common cold. But bacteria, fungi, and other microorganisms can also cause it.

What is novel coronavirus-infected pneumonia?

The illness tied to the new coronavirus was originally called novel coronavirus-infected pneumonia (NCIP). The World Health Organization renamed it COVID-19, which is short for coronavirus disease in 2019.

COVID-19 Pneumonia Symptoms

A fever, a dry cough, and fatigue are common early signs of COVID-19. You may also have nausea, diarrhea, muscle aches, and vomiting.

If your COVID-19 infection starts to cause pneumonia, you may notice things like:

  • Rapid heartbeat
  • Shortness of breath or breathlessness
  • Rapid breathing
  • Dizziness
  • Heavy sweating

How Many People With COVID-19 Will Get Pneumonia?

About 15% of COVID-19 cases are severe. That means they may need to be treated with oxygen in a hospital. About 5% of people have critical infections and need a ventilator.

People who get pneumonia may also have a condition called acute respiratory distress syndrome (ARDS). It’s a disease that comes on quickly and causes breathing problems.

The new coronavirus causes severe inflammation in your lungs. It damages the cells and tissue that line the air sacs in your lungs. These sacs are where the oxygen you breathe is processed and delivered to your blood. The damage causes tissue to break off and clog your lungs. The walls of the sacs can thicken, making it very hard for you to breathe.

Who’s Most Likely to Get It?

Anyone can get COVID-19 pneumonia, but it’s more likely in people who are 65 or older. Those who are 85 or older are at the highest risk.

People who live in nursing homes or who have other health problems like these also have higher chances of more severe illness with COVID-19:

  • Moderate to severe asthma
  • Lung disease
  • High blood pressure
  • Heart disease
  • Diabetes
  • Liver disease
  • Renal failure
  • Severe obesity, or a body mass index (BMI) of 40 or higher

Someone who has a weakened immune system may be more likely to get severe COVID-19 illness, too. This includes smokers, people being treated for cancer, people who have had a bone marrow transplant, people who have HIV or AIDS that’s not under control, and anyone who takes medications that slow the immune system, like steroids.

How Is COVID-19 Pneumonia Diagnosed?

Your doctor can diagnose COVID-19 pneumonia based on your symptoms and lab test results.

Blood tests may also show signs of COVID-19 pneumonia. These include low lymphocytes and elevated C-reactive protein (CRP). Your blood may also be low in oxygen. A chest CT scan may show patchy areas of damage in both your lungs. Doctors call this “ground glass.”

Are There Treatments for COVID-19 Pneumonia?

Pneumonia may need treatment in a hospital with oxygen, a ventilator to help you breathe, and intravenous (IV) fluids to prevent dehydration.

Clinical trials are looking into whether some experimental drugs and treatments used for other conditions might treat severe COVID-19 or related pneumonia:

  • Antivirals, including remdesivir, which the FDA hasn’t approved but which was developed to treat the Ebola virus

The malaria drugs chloroquine and hydroxychloroquine, sometimes along with azithromycin, an antibiotic

COVID-19 Pneumonia Prevention

If you’re in a high-risk group for COVID-19 pneumonia, take these steps to prevent infection:

  • Wash your hands often. Scrub with soap and water for at least 20 seconds.
  • If you can’t wash your hands, use a hand sanitizer gel that’s at least 60% alcohol. Rub it all over your hands until they’re dry.
  • Try not to touch your face, mouth, or eyes until you’ve washed your hands.
  • Avoid anyone who’s sick. Stay home and avoid others as much as you can.
  • Regularly clean and disinfect surfaces in your home that you touch often, such as countertops and keyboards.

The pneumonia vaccine protects against a kind of bacteria, not the coronavirus. But it can support your overall health, especially if you’re older or have a weak immune system. Talk to your doctor about whether you should get it.

What to do if you develop Coronavirus (Covid-19) Symptoms

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If you or your neighbour/relative has cough, fever, throat pain or running nose, please do the following things frequently & regularly. Even if you don’t have those symptoms, you can follow these for prevention:

  1. Worm water with salt gargle several times a day
  2. Hot steam/vapour inhalation through nose & mouth at least 2-3 times daily
  3. Drink hot water with lemon several times daily
  4. Take ginger tea more (green tea better)
  5. Take more orange & malta daily
  6. Take some black seeds (kali jira) 2-3 times daily
  7. Take rice or bread as less as possible, avoid meat, take well-cooked fish, egg & chicken (occasional), drink milk (skimmed or fat-free)
  8. Take any type of fruits more (after washing thoroughly). Preferable fruits: orange, banana (diabetics should take less), pomegranate (anar), apple, kiwi etc,
  9. Eat all sorts of well-cooked or boiled vegetables. Preferable vegetables: tomatoes, carrots, capsicum, cauliflower, broccoli, cabbage, spinach, beans, lentils, legumes etc.
  10. For fever & pain, take Paracetamol tablet only (after food). For running nose or nose-block, take antihistamine only (ceitrizine/loratidine). For dry cough, take natural cough syrup or antitussive syrup only. For productive cough with sputum, take spectorant/mucolytic syrup only. (for appropriate drug & dose, better to consult with a registered doctor), and finally
  11. If you develop any sort of breathing difficulty/respiratory distress with the above symptoms, please immediately call the local control centre of health or call an ambulance to take you to any of the designated/assigned hospitals. Please don’t delay in case of breathing difficulty with fever & cough.

Thank you all….Stay home, stay safe & stay healthy……May Almighty protect all of us.

Writer:  Dr Mohammad Dewan, Ministry of Health, Saudi Arabia (Madinah Munawara)

COVID-19 Vaccine

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(Compiled by Dr. Md. Mozammel Hoq)

As the new coronavirus continues to spread, people around the world are anxious to know when we might have a vaccine to stop it.

What Would a COVID-19 Vaccine Do?

When you come into contact with a virus or bacteria, your body’s immune system makes antibodies to fight them off.

A vaccine forces your immune system to make antibodies against a specific disease, usually with a dead or weakened form of the germs. Then, if you come into contact with them again, your immune system knows what to do. The vaccine gives you immunity, so you don’t get sick or so your illness is much milder than it otherwise would have been.

A vaccine against COVID-19 would slow its spread around the world. Fewer people would get sick, and more lives could be saved.

How Are Vaccines Developed?

So how long could a COVID-19 vaccine take? Dozens of possible vaccines are in various stages of development around the world, according to the World Health Organization. Some have begun clinical trials. But certain things can’t be rushed, like how long it takes a person’s immune system to respond to a vaccine or the wait to check for side effects.

Even when researchers find a vaccine that works against the new coronavirus, it could be 12 to 18 months at best before it’s ready for the public. That’s only a fraction of the usual time.

Before any vaccine can be used widely, it must go through development and testing to make sure that it’s effective against the virus or bacteria and that it doesn’t cause other problems. The stages of development generally follow this timeline:

  • Exploratory stage. This is the start of lab research to find something that can treat or prevent a disease. It often lasts 2 to 4 years.
  • Pre-clinical stage. Scientists use lab tests and testing in animals, such as mice or monkeys, to learn whether a vaccine might work. This stage usually lasts 1 to 2 years. Many potential vaccines don’t make it past this point. But if the tests are successful and the FDA signs off, it’s on to clinical testing.
  • Clinical development. This is a three-phase process of testing in humans. Phase I usually lasts 1 to 2 years and involves fewer than 100 people. Phase II takes at least 2 years and includes several hundred people. Phase III lasts 3 or 4 years and involves thousands of people. Overall, the clinical trial process may stretch to 15 years or more. About a third of vaccines make it from phase I to final approval.
  • Regulatory review and approval. Scientists with the FDA and CDC go over the data from the clinical trials and sign off.
  • Manufacturing. The vaccine goes into production. The FDA inspects the factory and approves drug labels.
  • Quality control. Scientists and government agencies keep tabs on the drug-making process and on people who get the vaccine. They want to make sure it keeps working safely.

This version of the coronavirus only surfaced in late 2019, but scientists have gotten a boost from research on similar coronaviruses that cause severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). Efforts to fight those diseases played a large role in the record speed of the first COVID-19 vaccine trial that’s now underway.

Some of the companies working on vaccines are also looking for ways to ramp up production quickly when the clinical trials find one that works safely. With more than 300 million people in the United States alone, mass vaccination will be a joint effort among several companies and government agencies.

Experts say the coronavirus could turn out to be seasonal, like colds and the flu. A vaccine might not be ready until after the current pandemic is over, but it may be vital if the cycle begins again.

(WebMD Medical Reference Reviewed on April 03, 2020)

করোনাভাইরাস সংক্রমণ ও প্রতিরোধ

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গত বছরের শেষভাগে চীনের হুবেই প্রদেশের ঊহান শহরে যে ভাইরাস-সংক্রমণ শুরু হয়েছিল, ক্রমে তা দেশ-মহাদেশ পেরিয়ে আজ সারা বিশ্বের ত্রাসে পরিণত হয়েছে। করোনাভাইরাস সংক্রমণ এর বিস্তার ঘটেছে অন্ততঃ ২০০টি দেশে, আক্রান্ত হয়েছে ১০

লক্ষাধিক মানবসন্তান, আর মাত্র কয়েক মাসে মৃত্যু হয়েছে ৪৬ সহস্রাধিক; এদের মধ্যে ৩ সহস্রাধিক চীনা, ৩০ সহস্রাধিক ইওরোপীয় আর প্রায় ৬ সহস্র আমেরিকান। এ এক অদৃশ্য শত্রু যা নিয়ন্ত্রনে একরকম ব্যর্থ হয়েছে যুক্তরাষ্ট্র ছাড়াও ইওরোপের প্রধান শিল্পোন্নত দেশগুলি।

হাম, জল-বসন্ত, হার্পেস, পোলিও, ফ্লু, হেপাটাইটিস এসব ভাইরাস-জনিত রোগের কথা আমরা কম-বেশি জানি; তবে কোভিড-১৯ রোগ এর মহামারীর কারণে করোনাভাইরাস এখন সবার জানা এক আতঙকের নাম। করোনা অর্থ মুকুট; ইলেকট্রন মাইক্রোস্কোপে এই ভাইরাসকে আমিষ-এর মুকুট-বলয় পরিবেষ্টিত দেখা যায়। করোনাভাইরাস পরিবারের অপর সদস্য সার্স (SARS) ভাইরাস ২০০৩ সালে ২৬ টি দেশে মারাত্মক নিউমোনিয়ার বিস্তার ঘটিয়েছিল; তবে কোভিড-১৯-এর তুলনায় তা ছিল কিছুটা নিয়ন্ত্রনযোগ্য।

অনেকের ধারণায় ভাইরাস অতি ছোট জীব; এ ধারণা ভ্রান্ত। ভাইরাসের কোন দেহ-কোষ বা প্রাণ না থাকলেও আছে আমিষ-বেষ্টিত প্রাণ-সঞ্চালক অনু ডিএনএ অথবা আরএনএ। এরা নিজেরা বংশবিস্তার করেনা, কিন্তু প্রাণী, উদ্ভিদ কিংবা ব্যাকটেরিয়ার কোষের নিউক্লিয়াসে ঢুকে, আশ্রয়দাতার জেনেটিক সরঞ্জামের সাথে সংযোজিত হয়ে ক্রমাগত বিভাজিত হতে পারে। একইভাবে অন্যান্য কোষকে আক্রমণ করে এরা পরজীবী ধবংসযজ্ঞ চালিয়ে যায়।

জীবাণু (microbe) না হলেও আচরণে মিল থাকায় এরা মাইক্রোবায়োলোজীতে অন্তর্ভুক্ত; আর রোগ সংক্রমণ-তত্ত্বও একইভাবে প্রযোজ্য। আন্তর্জাতিকভাবে ব্যবহৃত <Biohazard বা জৈব-বিপর্যয়>- চিহ্নটির সাথে যারা পরিচিত তারা জানেন- এতে পরস্পর-সম্পর্কিত চারটি বৃত্ত আছে; প্রথম তিনটি আশ্রয়দাতা (Host), রোগসূত্র (Agent) ও পরিবেশ (Environment), আর কেন্দ্রে অবস্থিত চতুর্থ বৃত্তটি সংক্রমণ (Infection) নির্দেশ করে। বলাবাহুল্য, আশ্রয়দাতার রোগ প্রতিরোধ ক্ষমতা ও  রোগসূত্রের রোগসৃষ্টি ক্ষমতার মধ্যে শক্তি পরীক্ষায় পরিবেশ বিশেষ ভূমিকা পালন করে।

আশ্রয়দাতা, যেমন মানুষ বা পশু-পাখির দেহে বিভিন্ন ধরনের জীবাণু থাকে যারা উপকারী কিংবা নিরপেক্ষ, সুস্থ প্রাণী স্বাভাবিক প্রতিরোধ ক্ষমতাবলে সহজে আক্রান্ত হয় না। কিন্তু রোগসৃষ্টিকারী জীবাণু আশ্রয়দাতার রোগ প্রতিরোধ ক্ষমতাকে পরাস্ত করে তাকে আক্রান্ত করতে পারে। বার্ধক্য কিংবা দীর্ঘমেয়াদী রোগ, অপুষ্টি, নেশা/মাদকাসক্তি, অ্যান্টিবায়োটিক, স্টেরয়েড, অ্যান্টিক্যান্সার- জাতীয় ওষুধ  ইত্যাদি আশ্রয়দাতার রোগ প্রতিরোধ ক্ষমতা কমায়। আবার দূর্বল হলেও রোগসূত্রের সংখ্যাধিক্য শক্তি অর্জনে সহায়ক হতে পারে। ক্ষতি ও ক্ষত বিবেচনায় তা রোগ লক্ষণ বা উপসর্গ সৃষ্টি করতে পারে, আবার আশ্রয়দাতাকে উপসর্গহীন বাহক (Carrier)-এ পরিণত করতে পারে। বাহকেরা নিজের অজান্তেই রোগ ছড়াতে পারেন। কোভিড-১৯ রোগ নিয়ন্ত্রিত হলেও অতি সম্প্রতি চীনে সহস্রাধিক উপসর্গহীন বাহক সনাক্ত হয়েছে যা দুশ্চিন্তার বিষয় বটে।

কোভিড-১৯ রোগ লক্ষণ বা উপসর্গ হতে পারে শুকনো কাশি, জ্বর, শীতবোধ, শ্বাসকষ্ট, এছাড়া শরীর-ব্যথা, গলাব্যথা, মাথাব্যথা ইত্যাদি, সাথে স্বাদ ও ঘ্রাণশক্তি লোপ কিংবা পেটের পীড়াও যোগ হতে পারে। ফ্লু বা ঠান্ডা-জ্বরের সাথে উপসর্গে মিল থাকলেও সাধারণতঃ সর্দি বা বদ্ধ নাসাপথ থাকেনা। কিন্তু এসব উপসর্গ রোগভিত্তিক না হওয়ায় পরীক্ষা-নিরীক্ষা ছাড়া শ্বাসতন্ত্রের এ রোগ নিরূপণ করা কঠিন। তাই উপসর্গ দেখা গেলে অবজ্ঞা না করে সতর্কতার সাথে কর্তব্য স্থির করতে হবে।

কোভিড-১৯ রোগের সুনিশ্চিত চিকিৎসা এখনো অজানা; এর প্রতিষেধক টীকাও আবিস্কৃত হয়নি। অত্যাধুনিক বিশেষায়িত হাসপাতালেই শুধু রোগ জটিলতার চিকিৎসা সম্ভব। কিন্তু স্বাস্থ্য সেবাদানকারী সঙ্কট ও অপ্রতুল ভেন্টিলেটর যন্ত্রের কারণে শিল্পোন্নত দেশেও এ রোগে মৃত্যুহার অনেক বেশী। অতএব প্রতিরোধই সর্বোৎকৃষ্ট উপায়। আর সেকারণেই প্রত্যেকে দায়িত্ব-সচেতন হয়ে, বিশ্ব স্বাস্থ্য সংস্থার নির্দেশাবলী ও নিজ নিজ দেশের (বা রাজ্যের) সরকারী বিধান মেনে চলাই বাঞ্ছনীয়।

জৈব-বিপর্যয়-চিহ্ন বা সংক্রমণ-তত্ত্ব অনুসরণ করে আমরা সহজেই বুঝতে পারি- করোনাভাইরাস এক শক্তিধর অদৃশ্য শত্রু; এ থেকে রক্ষা পেতে মাস্ক ও অন্যান্য পিপিই ব্যবহার করে এবং বাড়িতে থেকে, পরিচ্ছন্নতা রক্ষা করে, নিয়মিত সাবান দিয়ে হাত ধুয়ে, স্যানিটাইজার/ব্লীচ ব্যবহার করে, সামাজিক দূরত্ব বজায় রেখে আমরা আক্রান্ত ব্যক্তি ও বাহকের সান্নিধ্য এড়াতে পারি। সুস্থতা রক্ষায় আমাদের পুষ্টিকর খাবার গ্রহণ, পর্যাপ্ত জলপান, বিশ্রাম আর হালকা ব্যায়াম করাও প্রয়োজন। স্বাস্থ্য সেবাদানকারী ব্যক্তি যেমন চিকিৎসক, নার্স, ল্যাব স্টাফ এছাড়া যারা বয়স্ক, স্বাস্থ্য-ঝুঁকিতে আছেন, সংক্রমণ প্রতিরোধে তাদের আরো বেশী সতর্ক থাকতে হবে।

মোহাম্মদ আশরাফ হোসেন
ফ্লোরিডা, ইউএসএ
শিক্ষাঃ এমবিবিএস- বিএসএমএমইউ, ঢাকা; পিএইচডি (মেডিক্যাল মাইক্রোবায়োলোজী) ও স্নাতকোত্তর গবেষণা- নাগাসাকি
ইউনিভার্সিটি, জাপান;
ফেলোশিপ- কেস ওয়েস্টার্ণ রিযার্ভ ইউনিভার্সিটি, ক্লীভল্যান্ড ও ইউএস এফডিএ, সিল্ভার স্প্রিং (যুক্তরাষ্ট্র);
কর্ম অভিজ্ঞতা- স্বাস্থ্যসেবা, মেডিক্যাল প্রোডাক্টস ডেভেলপমেন্ট গবেষণা ও প্রকাশণা, গবেষণা প্রশাসন, রেগুলেটরী রিভিউ, মেডিক্যাল বেসিক সায়েন্স-এ শিক্ষকতা।
বর্তমান অবস্থান- নিউ ইয়র্কে অবস্থিত বহুজাতিক মেডিক্যাল ডিভাইস কোম্পানীতে রেগুলেটরী সায়েন্স প্রফেশনাল হিসাবে কর্মরত।

Combat Coronavirus (Covid-19) Pandemic

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Know Covid-19 (Novel Coronavirus) through question and answers and be safe.

Q.  What Is COVID-19?

Coronavirus disease 2019, or COVID-19, is a disease that can cause what doctors call a respiratory tract infection. It can affect your upper respiratory tract (sinuses, nose, and throat) or lower respiratory tract (windpipe and lungs).
The COVID-19 outbreak quickly spread around the world. It spreads the same way other coronaviruses do, mainly through person-to-person contact. Infections range from mild to serious.
COVID-19 is one of seven types of coronavirus, including the ones that cause severe diseases like Middle East Respiratory Syndrome (MERS) and Sudden Acute Respiratory Syndrome (SARS). The other coronaviruses cause most of the colds that affect us during the year but aren’t a serious threat for otherwise healthy people.

Q.  What Are the Symptoms of COVID-19?

Early symptoms include:

> Fever
> Dry Cough
> Fatigue
The virus can lead to pneumonia, respiratory failure, septic shock, and death. If you notice these severe symptoms in yourself or a loved one, get medical attention right away:
> Trouble breathing or shortness of breath
> Ongoing chest pain or pressure
> New confusion
> Can’t wake up
> Bluish lips or face
If you’re exposed and infected, symptoms can show up in as few as 2 days or as many as 14. It varies from person to person
The most common symptoms and the percentage of people who have them include:
> Fever: 88%
> Dry cough: 68%
> Fatigue: 38%
> Coughing up sputum, or thick phlegm, from the lungs: 33%
> Shortness of breath: 19%
> Bone or joint pain: 15%
> Sore throat: 14%
> Headache: 14%
> Chills: 11%
> Nausea or vomiting: 5%
> Stuffy nose: 5%
> Diarrhea: 4%
> Coughing up blood: 1%
> Swollen eyes: 1%

Q.  How Do You Know if It’s COVID-19, a Cold, or the Flu?

When you have symptoms, they can be similar to a bad cold or the flu. Your doctor will suspect COVID-19 if:
> You have a fever and breathing problems and you’ve travelled to places where the virus has spread.
> You’ve been exposed to people who have it within the last 14 days.

Q.  Testing for COVID-19

Call your doctor or IEDCR (through hotlines) if you think you’ve been exposed and have symptoms like:
> Fever of 100 F or higher
> Cough
> Trouble breathing
In most states, decisions about who gets tested are made at the IEDCR or your doctor of the hospital you visit.
The test looks for evidence of the virus in your upper respiratory tract. The person giving the test puts a swab up your nose to get a sample from the back of your nose and throat. That sample goes to a lab that looks for viral material or the presence of antibody in the serum against COVID-19.

Q.  What Is the Treatment for COVID-19?

There’s no specific treatment for COVID-19. People who get a mild case need the care to ease their symptoms, like rest, fluids, and fever control. You can take medicine for a sore throat, body aches, and fever upon advice by a physician. But don’t give aspirin to children or teens younger than 19. You might have heard that you shouldn’t take ibuprofen to treat COVID-19 symptoms — the
WHO made that statement in March 2020. But they reversed it soon after and said there’s no proof that taking it causes any harm.
Antibiotics won’t help because they treat bacteria, not viruses. If you hear about people with COVID-19 getting antibiotics, it’s for an infection that came along with the disease.
Those with severe symptoms need to be cared for in the hospital.
Numerous clinical trials are underway to explore treatments used for other conditions that could fight COVID-19 and to develop new ones. Several studies are focused on an antiviral medication called remdesivir, which was first created to fight Ebola. A study in China showed that hydroxychloroquine and chloroquine, which are used to treat malaria and autoimmune conditions like rheumatoid arthritis and lupus, helped people with COVID-19 pneumonia.

Q.  Is There a Vaccine?

Not yet, but clinical trials are underway in the U.S. and in China to test vaccines for SARS-CoV-2/COVID-19.
One vaccine called mRNA-1273 (which was developed by using messenger RNA) would tell your cells to pump out a protein that will kick-start your immune system to fight the virus. It’s worked well in animals and is ready to test in humans.

Q.  What Is Community Spread?

IEDCR, Doctors and health officials use this term when they don’t know the source of the infection. With COVID-19, it usually refers to someone who gets the virus even though they haven’t been out of the country or haven’t been exposed to someone who’s travelled abroad or who has COVID-19.

Q.  How Do You Prevent the Spread?

If you’re in an area where it’s spreading, take these steps:
> Wash your hands often with soap and water or clean them with an alcohol-based sanitizer. This kills viruses on your hands.
> Practice social distancing. Because you can have and spread the virus without knowing it, you should stay at home as much as possible. If you do have to go out, stay at least 6 feet away from others.
> Don’t touch your face. Coronaviruses can live on surfaces you touch for several hours. If they get on your hands and you touch your eyes, nose, or mouth, they can get into your body.
> Clean and disinfect. You can clean first with soap and water, but disinfect surfaces you touch often, like tables, doorknobs, light switches, toilets, faucets, and sinks. Use a mix of household bleach and water (1/3 cup bleach per gallon of water, or 4 teaspoons bleach per quart of water) or a household cleaner that’s approved to treat SARS-CoV-

Q.  What Caused the New Coronavirus?

Doctors aren’t sure. Coronaviruses can affect different species of animals, in addition to people. MERS and SARS were both linked to animals. Studies show COVID-10 has ties to snakes, bats, and pangolins. Many people who got the disease early on were linked to a large live seafood and animal market in China — you might hear it called a “wet market.” The first cases may have come from animals sold in the market, then spread from person to person.

Q.  How Does the New Coronavirus Spread?

SARS-CoV-2, the virus, mainly spreads from person to person.
Most of the time, it spreads when a sick person coughs or sneezes. They can spray droplets as far as 6 feet away. If you breathe them in or swallow them, the virus can get into your body. Some people who have the virus don’t have symptoms, but they can still spread the virus.
You can also get the virus from touching a surface or object the virus is on, then touching your mouth, nose, or possibly your eyes. Most viruses can live for several hours on a surface that they land on. A study shows that the COVID-19 coronavirus can last for several hours on various types of surfaces:
> Copper: 4 hours
> Cardboard up to 24 hours
> Plastic or stainless steel: 2 to 3 days
That’s why it’s important to disinfect surfaces to get rid of the virus.

Q.  Is There More Than One Strain of SARS-CoV-2?

It’s normal for a virus to change, or mutate, as it infects people. A Chinese study of 103 COVID-19 cases suggests the virus that causes it has done just that. They found two strains, which they named L and S. The S type is older, but the L type was more common in the early stages of the outbreak. They think one may cause more cases of the disease than the other, but they’re still working on what it all means.

Q.  Are Coronaviruses New?

Coronaviruses were first identified in the 1960s, but we don’t know where they come from.
Almost everyone gets a coronavirus infection at least once in their life, most likely as a young child. In our country Bangladesh, throughout the year especially during seasons change, typical flue attack many people but treatment and recording are not maintained. In the United States, regular coronaviruses are more common in the fall and winter, but anyone can come down with a coronavirus infection at any time.
The symptoms of most coronaviruses are similar to any other upper respiratory infection, including a runny nose, coughing, sore throat, and sometimes a fever. In most cases, you won’t know whether you have a coronavirus or a different cold-causing virus, such as rhinovirus. You treat this kind of coronavirus infection the same way you treat a cold.

Q.  Have There Been Other Serious Outbreaks?

Yes, coronaviruses have led to two serious outbreaks:
Middle East Respiratory Syndrome (MERS): About 858 people have died from MERS, which first appeared in Saudi Arabia and then in other countries in the Middle East, Africa, Asia, and Europe. In April 2014, the first American was hospitalized for MERS in Indiana, and another case was reported in Florida. Both had just returned from Saudi Arabia. In May 2015, there was an outbreak of MERS in South Korea, which was the largest outbreak outside of the Arabian Peninsula.
Severe acute respiratory syndrome ( SARS ): In 2003, 774 people died from an outbreak. As of 2015, there were no further reports of cases of SARS.

For any query:
General Secretary, CARES
Dr, Md. Mozammel Hoq, Professor (Retired)
Department of Microbiology, University of Dhaka

mhoq@du.ac.bd