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Dr. Kebba, MD, MPH, answers your Coronavirus questions | Antara Health

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More than 80% of people with COVID19 have mild symptoms and then recover, presumably with some level of immunity to prevent reinfection from happening.

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By the time one is coughing after being infected by CoVid19, how much damage has it caused to human lungs? How long does it take to cure?

Symptoms of coronavirus infection can begin 2-14 days after a person is exposed to the virus. Most people who develop symptoms begin to have those symptoms 4-6 days after exposure. For most people, symptoms last about 2 weeks but for people with severe (requiring hospitalization and oxygen support) or critical disease (requiring intensive care unit support and mechanical ventilation), recovery time is closer to 3-6 weeks.

Most people with infection do not have any long-lasting damage done to their lungs at all. Of the small number of people that require mechanical ventilation as a result of COVID19, a small percentage of them do appear to have significant lung tissue scarring.

Since the outbreak of Covid-19 majority tend to suffer from common cold and coughs (flu- )which appears to be the sign of Covid -19, how can we term this or do we have the virus with us but now our immune system is battling it out?

Since most people have never been exposed to the novel (meaning new) Coronavirus (SARS-CoV2), once they are exposed to the virus, their bodies do not have any antibodies that would help them prevent an infection from establishing itself. So, what then happens is that the virus infects the lungs and the body starts to fight the virus by mounting an immune response. The body’s response to this new virus is what causes an infected person to experience fever and some of the other symptoms such as fatigue and joint pains. Since the battleground between the virus and a person’s immune system is mostly in the lungs, that is why coughing and difficulty breathing are also very common symptoms. Think about it as the damage that happens to a field during a battle there. No matter who wins the battle, the grass suffers and there is lots of noise and smoke. Fortunately, the noise stops and the smoke clears, and almost always, the grass grows back. This is the case for most people who get coronavirus and have symptoms.

There are some other symptoms that some people with COVID19 patients experience. Up to 30% of people with coronavirus lose their sense of taste (dysgeusia) and lose their sense of smell (anosmia). Of note, most people with COVID19 do not get a runny nose and congestion because the infection is mostly one of the lower respiratory tract (lungs).

But, for the most part, the symptoms of COVID19 are very similar to the symptoms of the common cold and the flu. The only way to figure out if a person has a cold, the flu or the coronavirus is by doing a test, which for now are only available for specific patients in Kenya. 

More than 80% of people with COVID19 have mild symptoms and then recover, presumably with some level of immunity to prevent reinfection from happening. This recovery happens because the body’s immune system can contain and eliminate the virus. Here is where the similarities between COVID19 and the flu stop. Up to 15% of people with COVID19 require some level of supportive care in a hospital. For the common flu, that number is 1-2%.

What are the chances of recovery should someone get it? Everyone is telling us how not to get it but no one is talking about what to do when you get it?

  1. The chances of recovery from COVID are very, very good. Most people recover with no long-lasting effects. In fact, more than 80% of people recover after having only mild symptoms. 

  2. Of the remaining 15% that have severe symptoms, 10% require only a short stay in the hospital and some supplemental oxygen to make sure their bodies are receiving the oxygen required to contain and control the virus. Approximately, 4% of people do require mechanical ventilation to survive. Mechanical ventilation is necessary when you are no longer able to breathe effectively on your own. Most of the people in the world that have required both supplemental oxygen and mechanical ventilation have had underlying risk factors. The common risk factors are:

    1. Age greater than 60.

    2. Underlying cardiovascular conditions (High Blood Pressure, history of heart attack or stroke).

    3. Underlying immune disorders (HIV or history of cancer treatment).

    4. Diabetes.

  3. The information we have comes mostly from China and increasingly Europe and the United States. Experts are very worried that underlying rates of HIV, TB infection and malnutrition in many African countries will make larger numbers of people susceptible to severe disease. We hope that will not be the case, but at the moment, we just don’t know.

  4. Even with these relatively high rates of hospitalization, more than 95% of people who get infected with the coronavirus recover without complications. Of those without any need for hospitalization, there do not appear to be any long-term effects of coronavirus infection and there is no evidence that lung scarring is a problem. For those that recover after requiring brief supportive care and oxygen support, it also appears that there is no evidence of long-term scarring. For those people who do require mechanical ventilation, there is evidence that lung scarring can be a problem. At this point it is unclear if that is as a direct result of the viral infection, or a result of the need for mechanical ventilation itself.

  5. If you think you have coronavirus infection because you have any of the following:

    1. Contact with confirmed or suspected case

    2. Fever, cough and difficulty breathing

Please call the following HOTLINE NUMBER: 0800721316 (toll free), 0729471414, 0732353535 and inform them of the symptoms you are having.

If you have any underlying risk factors (listed above), please let the team members know so they can take appropriate measures. The people responsible for the COVID19 response in Kenya will then decide whether your symptoms history warrants a test. If so, they will arrange for you to receive a test and be potentially transferred to an isolation facility where you can be properly cared for and monitored.

If you don’t meet criteria for a test, please plan on self-quarantining for 14 days and make sure that you know who you will call if your symptoms get worse, especially your respiratory effort (how hard it is to breathe). Call early, please do not wait until you are having worsening difficulty breathing to seek care.

If you are having symptoms, try as best as possible to isolate yourself from other members of your household and wear a mask if you must come into contact with them at a distance not less than 2 meters. The mask is to protect your family members from getting infected if you cough or sneeze. Wash hands frequently and try to minimize the amount of times you touch common surfaces in the home (i.e.: doorknobs, kitchen counters etc.). If you are having symptoms and must go out of the house, please wear a mask to protect others.

Don’t panic. Remember that the overwhelming majority of people who are infected get better on their own and the overwhelming majority of people that require hospitalizations also get better.

What should I do if I have symptoms of COVID19?

You should assume you have it. The loss of smell seems to be related to this infection. You should stay on complete isolation at least 10 days from start of symptoms AND 72 hours from last fever (without meds - side note, take Panadol, not NSAIDs like Brufen which is associated with worse outcomes) AND only with no respiratory symptoms. 

Transmission after that is very low, but not zero. So, theoretically, there is a small chance you can still transfer the virus, but it's very low. Those numbers apply to everyone in your group. Most immunologists believe that infection confers immunity, but we still don’t know how effective or long lasting that immunity will be so continue social distancing even if you feel good. The data on immunity is not yet available.

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