Corona

What you need to know about coronavirus (COVID-19)

The coronavirus has Europe’s and the rest of the world’s attention. Never before has a pandemic been declared of such global dimension. The coronavirus, which causes the disease COVID-19, has claimed many victims. Within a matter of weeks, more than 200,000 people have fallen ill due to the virus, sometimes with fatal consequences.  

The flu and coronavirus have similar symptoms, namely fever and respiratory problems. It can be tricky to tell the two apart based on the symptoms in order to determine who is infected and who isn't. This makes it easier for the virus to spread.  

As a result, many people feel insecure. They are concerned about their health or have virus-related questions. On this page, you can read more about the coronavirus: how to recognise it, what medicines are available for coronavirus, and what you can do to prevent infection or treat the symptoms. 

What causes coronavirus? 

The novel coronavirus belongs to the same family of viruses as severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). When seen under a microscope, the outer edge of the coronavirus particles has a crown or ‘corona’ of spikes. Hence the name ‘coronavirus’. Because the novel coronavirus is a new variant, we don't know exactly how the virus behaves. What we do know is that it can make people very ill. The virus enters the body and multiplies. This causes symptoms, in particular respiratory problems, which can lead to pneumonia. 

The virus appears to have originated from animals. The COVID-19 outbreak started in China, in a Wuhan food market where wild animals, like bats, are traded. Coronaviruses are known to jump from animals to humans, so it’s thought that the first people infected with the disease contracted it from contact with animals. This was the case with SARS and MERS, and is probably also the cause of COVID-19. The novel coronavirus is highly contagious, which means it spreads easily from person to person. It is currently estimated that, on average, one infected person will infect between two and three more. The virus seems to be transmitted mainly via respiratory droplets that people sneeze or cough. 

How do I recognise coronavirus? 

People infected with coronavirus don’t always fall ill. A majority of those infected will only have mild symptoms such as a nose cold. Others develop mild flu-like symptoms. The World Health Organization (WHO) has analysed the symptoms of corona patients in China. Based on this information, a list of coronavirus symptoms has been compiled. The most common symptoms are: 

  • Fever. 
  • Dry cough. 
  • Tiredness. 
  • Productive cough. 
  • Chest tightness or shortness of breath. 
  • Sore throat, headache, muscle pain. 

A smaller number of patients also developed the following symptoms: nausea, nasal congestion, diarrhoea, or coughing up blood. 

Is coronavirus deadly? 

Most people recover from the disease without needing special treatment. In these cases, staying home for 14 days until the symptoms clear up (self-isolate) is enough. Some people who get COVID-19 become seriously ill. These patients develop severe pneumonia and breathing problems that require hospitalisation. People who are likely to develop serious illness are often older people and those with underlying medical problems.  

Only a small percentage of seriously ill patients die due to coronavirus. Elderly people or people with an underlying (serious) condition are most at risk of being infected and developing severe or even lethal illness. The chances of young, healthy people dying due to coronavirus complications are extremely slim. 

Who has a higher risk of getting coronavirus? 

In most cases, healthy people with good immune systems manage to fight off coronavirus infection. They tend to develop mild symptoms or no symptoms at all if the virus enters their bodies. However, there are also people with compromised immune systems. For instance, people with an underlying medical condition or elderly people. This group is more likely to develop more severe symptoms.  

People who fall within the high-risk group include: 

  • The over-70s. 

People who suffer from one of the following conditions:  

  • Abnormalities and dysfunctions of the respiratory tract and lungs. 
  • Chronic heart disease. 
  • Diabetes mellitus. 
  • Severe kidney disease leading to dialysis or kidney transplant. 
  • People with reduced resistance to infections due to, for example:  
  • Use of medication for autoimmune diseases. 
  • Organ transplant. 
  • Haematological diseases (blood diseases). 
  • Congenital or later immune disorders requiring treatment. 
  • Chemotherapy and/or radiation in cancer patients. 
  • HIV infection. 

If you are in this high-risk group, you should avoid contact with other people. Stay home as much as possible, especially if you feel unwell or have cold or flu-like symptoms. If you have a fever (38 degrees Celsius or higher), a cough and difficulty breathing, seek medical attention and call in advance. 

How can I prevent catching coronavirus?  

You can reduce your chances of being infected or spreading COVID-19 by taking some simple precautions. It is important that you follow the guidelines of your local public health authority: 

  • Keep other people at a distance as much as possible. Limit contact with others (social distancing) and maintain at least 1.5 metres distance between yourself and others. 
  • Wash your hands regularly. 
  • Cough or sneeze on the inside of your elbow. By sneezing or coughing in your arm you reduce the chance of the virus getting on your hands and onto surfaces (e.g. door handles) or infecting others by touching them. 
  • Use paper tissues to blow your nose. Dispose of tissues directly after use and wash your hands. 

It is also very important to keep your immune system strong. Make sure you get plenty of rest, eat healthily and try to incorporate exercise into your daily routine. Nutritional supplements can be used to supplement your diet with extra vitamins and/or minerals. 

What should I do if I’m infected with coronavirus? 

Have you become sick despite having taken all the necessary precautions? If you have only mild symptoms, you can treat the illness as you would the common cold or flu. Over-the-counter products can help to alleviate your symptoms. A healthy lifestyle also helps your body to recover quicker. A few tips:  

  • Painkillers help lower fever and reduce pain. Preferably use paracetamol. Paracetamol has the least side effect potential compared to other painkillers.  
  • A nasal spray opens up your airways to help you breathe more easily. Try a salt-water solution first. Salt-water solutions can be used long term and are also safe for use in children. Nasal sprays that contain medication should not be used for more than a few days. 
  • Cough syrup and throat lozenges ease a sore throat and also help to suppress coughing. Sucking on plain hard candy or a piece of liquorice may also provide temporary relief. 
  • Drink plenty of water and make healthy and varied food choices. 
  • Make sure you get plenty of rest. Your body needs sleep to fight the infection. 

In addition, it is also very important to avoid contact with others for as long as you have symptoms. This way, you reduce the chance of the coronavirus spreading. Stay at home and try to separate yourself from people that live in your home as much as possible. Use clean towels, dish clothes and bed linen as often as possible and wash dirty laundry regularly. One day after the symptoms are over, you may assume that you are no longer contagious.  

However, if you haven’t been tested for coronavirus, it is also possible that you’ve had the regular flu. It is therefore important that after your flu-like symptoms have passed you continue to follow the government’s guidelines to help prevent the spread of coronavirus (i.e. social distancing, limiting social contacts, sneezing/coughing in elbow, washing hands). 

When should I call the doctor if I have coronavirus symptoms? 

If your symptoms get worse, it may be necessary to consult a doctor. You should in any case seek medical attention if your health and breathing problems get worse. Special risk groups (anyone older than 70, people with chronic health conditions or people with weakened immune systems) are extra vulnerable if they are infected with COVID-19 and should contact a doctor immediately if they have a fever with coughing or breathing problems. Stay at home and contact a doctor by telephone. If needed, the doctor will come to your home to see you. 

How is coronavirus treated? 

If you are not ill but may be infected, for example because you’ve been in contact with an infected person or at risk of coming down with COVID-19, you should self-isolate (self-quarantine). This means that you should stay home for 14 days from the first day of possible infection. This way, you reduce the chance of spreading the virus to others. 

If you have symptoms but are not very ill, you should also self-isolate. Only people with severe symptoms are hospitalised, if needed. Practising self-quarantine means that you are not allowed to go outside until you’ve completely recovered and are no longer contagious to other people. If you feel better and do not have any symptoms for 24 hours, you can safely assume that you are cured and can no longer infect others. 

Are there any medicines for coronavirus? 

To date there is no official cure for the novel coronavirus. There is also no vaccine yet, but scientists around the world are working hard to develop one. It is expected to take between 12 and 18 months until a vaccine against the novel coronavirus is widely available. 

In the meantime, doctors can treat the symptoms of coronavirus with familiar medicines such as fever suppressants and anti-inflammatory drugs. In addition, experimental trials with other medicines, such as:

  • The antimalarial medicine; Chloroquine 
  • Remdesivir; virus inhibitor 
  • Plaquenil; anti-inflammatory drug also used in rheumatic disorders
  • Hydroxychloroquine; agent against autoimmune diseases
  • Ritonavir/Lopinavir; antivirals against HIV infections 

These antiviral medicines have shown to be effective in treating the coronaviruses SARS and MERS, and may also be a potential promising treatment for COVID-19. 

Use of chloroquine for coronavirus 

At present, doctors are only using the antimalarial medicine chloroquine and the antiviral medicine remdesivir for treating severely ill patients in intensive care units. This is because the effectiveness of these medicines has not yet been clinically proven. Scientists are currently testing these existing medications against COVID-19 in laboratories. However, to determine their efficacy these anticoronavirus medicines must be extensively tested in humans. 

Although the results seem promising, the general public cannot yet use these antiviral medicines and chloroquine to treat coronavirus. Of course, chloroquine is available as a treatment for malaria. 

Are there any alternative treatments available? 

Right now all you can do to treat coronavirus is manage the symptoms until an official medicine for COVID-19 becomes available. This could be the antimalarial medicine chloroquine, or perhaps scientists will find another medicine to treat COVID-19. Currently studies are being done in doctors and nurses to test whether a century-old vaccine against tuberculosis (TB) can rev up the human immune system, allowing it to better fight the coronavirus. We will have to wait for a vaccine to prevent infection altogether. Scientists say this will take at least 18 months to develop.  

In the meantime, while the world waits for vaccines and medications, we can take action to slow the spread of the virus. This is where basic principles such as good hygiene and social distancing come in. These shielding measures are critical in order to protect vulnerable people in our communities, too. 

Sources

De Visser, E. (2020, 19 March). Experimenteel medicijn beschikbaar voor coronapatiënten (Experimental medicine available for coronavirus patients). Consulted on 19 March 2020 on https://www.volkskrant.nl/wetenschap/experimenteel-medicijn-beschikbaar-voor-coronapatienten~b0b975f8/  

Fang, L., Karakiulakis, G., & Roth, M. (2020). Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection? The Lancet Respiratory Medicine. https://doi.org/10.1016/s2213-2600(20)30116-8  

Keulemans, M. (2020, 20 February). Het middel tegen het coronavirus bestaat misschien al lang (Coronavirus treatment might already exist). Consulted on 19 March 2020 on https://www.volkskrant.nl/wetenschap/het-middel-tegen-het-coronavirus-bestaat-misschien-al-lang~b27d1816/?referer=https://www.google.com/  

Nederlands Huisartsen Genootschap. (2020, 18 March). Ik denk dat ik het nieuwe coronavirus heb (I think I may have caught the novel coronavirus) | Thuisarts. Consulted on 19 March 2020 on https://www.thuisarts.nl/nieuw-coronavirus/ik-denk-dat-ik-nieuwe-coronavirus-heb#ik-heb-klachten-wat-nu  

RIVM. (2020a, 18 March). Nieuw coronavirus (COVID-19) (Novel coronavirus - COVID-19). Consulted on 19 March 2020 on https://www.rivm.nl/coronavirus/covid-19  

RIVM. (2020b, 18 March). Vragen & antwoorden nieuw coronavirus (COVID-19) (Novel coronavirus (COVID-19) questions & answers). Consulted on 19 March 2020 on https://www.rivm.nl/coronavirus/covid-19/vragen-antwoorden#eigengezondheid  

RTL Nieuws (2020, 18 March). Hoe weet je of je het coronavirus al hebt gehad? (How do you know if you've had the coronavirus?) Consulted on 19 March 2020 on https://www.rtlnieuws.nl/nieuws/nederland/artikel/5061301/corona-update-coronavirus-testen-vraag-genezen-covid

Assessed by:

Dr Wouter Mol, General practitioner
Registration number: BIG: 9057675501

Dr Wouter Mol studied medicine at the University of Groningen. From 2002 to 2003, he served as a resident in neurology, and from 2003 to 2005 he served his residency training in internal medicine and emergency medicine. Wouter Mol has been working as a GP since 2005.