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COVID-19 updated outbreak status and useful information

An updated report with useful information for the 2019-nCoV outbreak, from the Institute of Public Health, ACG and the George D. Behrakis Research Lab, HCS (March 5th, 2020)

Coronaviruses are a family of viruses that mainly affect the respiratory system. The severity of illness they cause ranges from a common cold to very serious and even fatal respiratory infections. Symptoms include cough, shortness of breath and high fever, whereas in some severe cases and depending on the virus strain, pneumonia, severe acute respiratory distress syndrome, renal failure and even death may occur. It is worth noting that SARS-CoV that was transmitted to humans from civet cats in China in 2002 and MERS-CoV transmitted to humans from camels in Saudi Arabia in 2012 also belong in the coronavirus family.

The recent outbreak that started in China in 2019 is caused by a new strain that broke the species barrier, i.e. it was transmitted from animals to humans and subsequently gained the capacity to be transmitted from human to human. This novel strain identified to humans for the first time has been named SARS-CoV-2 or 2019-nCoV. The disease, called Coronavirus Disease 2019 (COVID-19), usually mild, is manifested with cough, high fever and breathlessness, within 2-14 days post exposure; individuals at high risk for severe disease and complications are those with chronic disease conditions and immunosuppression; the risk for complications increases with age over 60 years-old and especially for those aged over 80 years.

The animal source of SARS-CoV-2, the degree of transmissibility, morbidity and mortality are still under investigation since necessary data to draw safe conclusions do not yet exist; however, estimations place mortality rate between 2%-5% with most recent 3.4% from WHO.

To date a coronavirus vaccine is not yet available neither is there a specific treatment; patients are offered symptomatic treatment and each case is dealt individually according to their symptoms and clinical presentation.

However, a race of intense scientific research is ongoing, both for vaccine development and specific medication, including testing of some already available antivirals such as those used in HIV and EBOLA virus treatment.

Preventive measures ^1,2,3, although non-specific, are highly recommended, including basic hygiene rules:

frequent hands washing with soap,
avoidance of contact with people with respiratory symptoms (cough, sneezing), basic respiratory hygiene (covering your cough and sneeze), safe use & tissue disposal, surface and device cleaning (door handles, phones, keyboards etc.)
and avoidance of crowded places.

Furthermore, it is recommended to consume safe, fully cooked food and to avoid consumption of raw animal products. Additional recommendations include the avoidance of contact with living or dead animals in local markets such as those in China.

Currently in addition to China, several other countries have announced cases of the disease, which now (as of March 3) is detected in >80 places globally (CDC) ^4,5.

Travel restrictions have been issued by the CDC for China, S. Korea, Iran and Italy; warning for high risk population has been issued for travel to Japan, while for travel to Hong Kong travelers are advised to practice preventive precaution ^1,2.

Greece having successfully detected the so called “case 0” and its contacts on February 26, presently counts 31 cases, all of whom are travelers and/or their immediate contacts. With the exception of one of them with severe pneumonia, the rest have mild symptoms. Up until March 5th, no transmission within community has been detected.

Currently Greece is still experiencing the seasonal influenza outbreak counting 277 severe cases (only 38% were vaccinated) and 77 deaths.The available influenza vaccination is the only effective prevention of influenza and is recommended to all individuals >6 months old and especially to populations at high risk for complications.

Important note: The influenza vaccination does not protect, neither is indicated against the novel coronavirus (2019-nCoV).

As the situation is constantly changing it is recommended to follow the updates and recommendations issued by the Hellenic and International Health authorities:

Greek Ministry of Health

National Public Health Organization-Greece

World Health Organization (WHO)

Centers for Disease Control and Prevention (CDC)

European Centre for Disease Prevention and Control (ECDC)