Coronavirus: symptoms, diagnosis and prevention

With the coronavirus officially being declared a pandemic by the World Health Organisation (WHO), you may be feeling very nervous about how it will continue to progress. Whilst we can’t fully predict the future, we can recognise that some things are certain, such as the symptoms that present, including fever, a dry cough and a general feeling of being unwell.

In most people, the manifestation of coronavirus is mild, but there are a few important steps that you can take to prevent yourself from catching the virus and from passing it onto others.

Dr Syed Husain is a leading consulting respiratory physician and an honorary senior clinical lecturer at King’s College London. He is currently on the frontline when it comes to managing patients with suspected coronavirus, or dealing with patients requiring admission to hospital with corona virus-related pneumonias, or respiratory problems in the UK. Dr Husain has kindly taken the time to explain everything that he knows about the virus so far; from symptoms, diagnosis and prevention, to sharing his overall professional advice.
 

What can you tell us about the coronavirus?

Coronavirus (COVID-19) is a new strain of virus that was first identified in Wuhan City, China in January 2020. A coronavirus is a type of single-strand RNA virus. As a group, coronaviruses are common and known across the world.

The incubation period of COVID-19 is between two and 14 days. This means that if a person remains well 14 days after contact with someone with confirmed coronavirus, the disease is not transmitted.
 

What are the symptoms of coronavirus?

The following symptoms may develop within the 14-days after exposure to someone who has COVID-19 infection. The commonest signs include:

• Cough
• Fever
• Fatigue

Less common symptoms of COVID-19 include:

• Sputum (mucus) production
• Difficulty in breathing
• Muscle or joint pain
• Sore throat
• Headache
• Chills
• Nasal congestion
• Diarrhoea
• Blood when coughing
• Conjunctival congestion

The most severe symptoms, including pneumonia, affect people with a weakened immune system, such as the elderly and those with pre-existing long-term conditions like diabetes, cancer or chronic lung disease. These patients may require hospitalisation.
 

How is coronavirus spread?

From what we know about other coronaviruses, the spread of COVID-19 is most likely to happen when there is close contact (within 1-2 metres distance) from an infected person. It is likely that the risk increases the longer that someone has close contact with someone carrying the virus.

Droplets, termed respiratory secretions, are produced when an infected person coughs or sneezes. This is likely to be the most important means of transmission.

It is also possible that someone may become infected by touching a surface or object that has been contaminated with respiratory secretions and then touching their own mouth, nose and eyes. For example, someone might touch a doorknob or shake hands with someone who is infected and then touch their own face.
 

How can we prevent spread of infection?

Currently, as this article was published in March 2020, there is no vaccine to prevent COVID-19. We can, however, help to prevent the spread of the respiratory virus by:

• Washing your hands often and for more than 20 seconds with soap and water.
• Use hand sanitiser (60% alcohol) if handwashing facilities are not available, which is particularly important after using public transport.
• Do not touch your face, eyes and mouth.
• Avoid handshaking and greeting people closely.
• Cover your mouth or nose if you cough or sneeze with a tissue and dispose of the tissue in the bin or down the toilet. (Catch it, bin it, kill it!)
• If you feel unwell you should stay home and do not attend work or any education or childcare setting for at least 7 days.
• Avoid close contact with people who are unwell.
• Clean and disinfect frequently-touched objects and surfaces.

Pupils, students, staff and visitors should wash their hands:

• Before leaving home
• On arrival at school
• After using the toilet
• After breaks and sporting activities
• Before food preparations
• Before eating any food, including snacks
• Before leaving school

Most importantly, everyone should adhere to the following:
 

• Avoid travel to countries with COVID-19 cases.
• Avoid public places and gatherings.
• No cruise ship travels especially for the elderly and the venerable adults
   

How is coronavirus diagnosed by a doctor?

When a doctor suspects COVID-19, they take sample swabs from the nose, throat and deeper respiratory samples, which are then packaged and sent safely to a laboratory. Public Health England can provide a result from this specific virus on the same working day. In a hospital setting, test results are back within 48-hours.
 

How can we stop spreading coronavirus?

It is incredibly important to practice good respiratory and hand hygiene. Face masks for the general public are NOT recommended to protect them from infection as there is no evidence of benefit from their use outside of healthcare environments.

Healthcare personnel should use a face mask that is fitted-to-size and respirators would be more useful especially to healthcare workers with beards.

People who have returned from ‘Category 1 specified countries/areas’, which include Wuhan city and Hubei province, Iran, Daegu, Cheongdo, or Italy, in the last 14 days should self-isolate. This includes avoiding attending an education setting or work until 14 days after they return.

People who have returned from ‘Category 2 specified countries/ areas’, which include Cambodia, China, Hong Kong, Japan, Laos, Republic of Korea, Singapore, Taiwan, Thailand and Vietnam, in the last 14 days are advised to stay at home if they develop symptoms. All other pupils or students and staff should continue to attend school or university, including their siblings attending the same or a different school (unless advised not to by public health officials).
 

How can other healthcare professionals take care when it comes to coronavirus?

Healthcare workers whose possible exposures do not require exclusion from work should be advised. They should:

• Continue to practice or work as normal while asymptomatic.
• Monitor their own health and make contact with the healthcare service by calling 111, or their direct point of contact, if they become unwell.
• Inform occupational health and their line manager if symptomatic and need to be excluded from work.

​If you are worried about your symptoms, or those of a child or colleague, please call the NHS on 111. Do not go directly to your GP or other healthcare environments.

Dr Syed Husain is a highly-experienced physician who holds a specialist interest in respiratory diseases, including asthma, lung cancer and pulmonary fibrosis. You can book an appointment with Dr Husain via his Top Doctor’s profile if you are living with any of these conditions and would like his expert advice. Please do not book an appointment if you think you have symptoms of coronavirus and call the NHS 111 phone number instead.

Acknowledgement: I would like to acknowledge the work of Syed Ammar Husain Medical Student from Hull & York Medical school for his help in formulating this useful article