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Walter Chingwaru Correspondent
A new coronavirus (2019-nCoV or Novel Coronavirus 2019), first identified in Wuhan – the capital of Central China’s Hubei Province and home to at least 19 million inhabitants – has spread to several countries around the globe.
How can we protect ourselves from this disease?

Preventive measures
The World Health Organisation (WHO) had, as of January 27, 2020, issued a set of precautionary measures to be observed in view of the ongoing Wuhan coronavirus epidemic.

It is important for health workers to keep in mind that travellers presenting signs and symptoms suggestive of respiratory infection at points of entry may be infected by diseases other than 2019-nCoV.
Follow ups on such patients may impose an additional burden on their health systems.

Common colds and flu are a common phenomenon during harsh winters of the northern hemisphere (including China). Part of the reason why such colds and flu spread easily in winter is the failure to ventilate living spaces due to the cold that characterises winters in the northern hemisphere – implying people tend to recycle air within their living spaces, hence pass the viruses that cause these diseases.

We need to know that while flu and common cold are both respiratory illnesses, they are caused by different viruses. Flu, which is short for influenza, is caused by a virus that belongs to family Orthomyxoviridae – a group that is different from Coronaviridae (or coronaviruses) where 2019-nCoV, MERS and SARS lie.

In general, flu – caused by human influenza viruses – produces symptoms that are more intense than those of common colds. Infrequently, however, flu viruses that affect birds – including A(H5N1) and A(H9N2) or swine–subtypes A(H1N1) and A(H3N2) – can change in their genetic sequences and gain the ability to enter and spread in humans. However, it must be pointed out that these animal flu viruses do not easily transmit among humans.

In view of the possibility of transmission of flu from other countries, Zimbabwe has maintained temperature screens at points of entry.

However, the country is encouraged to establish proper screening procedures at points of entry.
The country’s authorities should reinforce collaboration with airline operators for case management aboard an aircraft and to ensure accurate reporting.

Some of the WHO guidelines (2020) relating to the care of patients infected with 2019-nCoV are summarised below.

In the event that an individual is suspected to have contracted 2019-nCoV, he/she must be placed under quarantine and monitored in a hospital setting.

This would ensure both safety and quality of healthcare (in case patients’ symptoms worsen) and public health security.

However, patients presenting mild symptoms and without underlying chronic conditions such as lung or heart disease, renal failure, or immunocompromising conditions that increase the risk of developing complications, may be cared for in the home environment.

This can also be done for patients no longer requiring hospitalisation.
Below are recommendations made by WHO (2020) that are to be followed when patients are placed under home-based care:

• Place the patient in a well-ventilated room.
• Limit the number of caretakers of the patient, ideally assign one person who is in a good health without risky conditions. No visitors.
• Household members should stay in a different room or, if that is not possible, maintain a distance of at least 1 metre from the ill person (eg sleep in a separate bed)
• Limit the movement of the patient and minimise shared space. Ensure that shared spaces (eg kitchen, bathroom) are well ventilated (eg keep windows open).
• The caregiver should wear a medical mask fitted tightly to the face when in the same room with the ill person.
• Masks should not be touched or handled during use. If the mask gets wet or dirty with secretions, it must be changed immediately. Discard the mask after use and perform hand hygiene after removal of the mask.
• Perform hand hygiene (2) following all contact with ill persons or their immediate environment. Hand hygiene should also be performed before and after preparing food, before eating, after using the toilet, and whenever hands look dirty. If hands are not visibly soiled, alcohol based hand rub can be used.
• Perform hand hygiene using soap and water when hands are visibly soiled.
• When using soap and water, disposable paper towels to dry hands are desirable. If not available, use dedicated cloth towels and replace them when they become wet.
• Respiratory hygiene should be practised by all, especially ill persons, at all times – including covering the mouth and nose during coughing or sneezing.
• Discard materials used to cover the mouth or nose or clean appropriately after use.
• Avoid direct contact with body fluids, particularly oral or respiratory secretions, and stool. Use disposable gloves to provide oral or respiratory care and when handling stool, urine and waste. Perform hand hygiene before and after removing gloves.
• Gloves, tissues, masks and other waste generated by ill persons or in the care of ill persons should be placed in a lined container in the ill person’s room before disposal with other household waste.
• Avoid all other types of possible exposure to ill persons or contaminated items in their immediate environment (eg sharing toothbrushes, cigarettes, bed line etc). Eating utensils and dishes should be cleaned with either soap or detergent and water after use.
• Clean and disinfect frequently touched surfaces such as door handles, bedside tables, bed frames, and other bedroom furniture daily (use bleach – such as JIK, solution diluted 1-part bleach to 99 parts water).
• Clean and disinfect bathroom and toilet surfaces at least once daily with regular household bleach solution (1-part bleach to 99 parts water).
• Clean clothes, bedclothes, bath and hand towels, etc. Of ill persons using regular laundry soap and water or where available machine wash at 60–90 °C with common household detergent, and dry thoroughly.

Note that the above guidelines are general information only. Seek medical advice whenever symptoms that are consistent with those of 2019-nCoV – described above appear.

Professor Walter Chingwaru is an Associate Professor of Biomedicine and Microbiology or Biomedical Scientist attached to Biological Sciences Department at Bindura University of Science Education (Zimbabwe). He works within an area of research that spans Biomedicine and Microbiology, and maintains ardent interest in public health issues.
Feedback: Twitter – @walterchingwaru, Email: [email protected], Phone: +263 7777 666 06.