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Joaquim Chaves Saúde | Coronavirus (COVID-19) – Frequent Questions

27/03/2020

27/03/2020

Joaquim Chaves Saúde | Coronavirus (COVID-19) – Frequent Questions

What is a Coronavirus?

Coronaviruses are a family of viruses that commonly cause mild flu-like illness in humans. In some cases, pneumonia may occur. Infection by the novel coronavirus, called COVID-19, has particular characteristics that distinguish it from previous ones due to how rapidly it spreads and the higher percentage of severe cases.


What is the source of the virus?

Coronaviruses are a family of viruses. Some cause illness in humans and others, like the canine and feline coronaviruses, only infect animals. Animal coronaviruses rarely infect people. This is the case with COVID-19. This situation has occurred sporadically with other previous coronavirus epidemics.


How does it spread?

COVID-19 spreads from close personal contact with people infected with the virus, or through contaminated surfaces and objects.

The virus that causes COVID-19 spreads easily in the community. Many people are contaminated without knowing how transmission occurred. They may have been contaminated by people who are infected and do not display symptoms.

COVID-19 spreads mainly from PERSON-TO-PERSON contact through droplets projected from the nose or mouth when coughing or sneezing. Those infected droplets can land directly in the mouth, nose and eyes of people close by, or land on surfaces and remain there, infecting the hands of other people who, by touching their mouth, nose and eyes, carry the virus to new people.


Other transmission routes:


a) faeces and urine - through aerosol particles or contact;

b) saliva.


Aerosol contamination is possible when people are exposed to high concentrations of aerosols containing the virus, for extensive periods and in relatively closed environments.

Considering that COVID-19 (SARS-CoV-2) was isolated in faeces and urine, special attention should be given to human waste to avoid direct contact and/or contamination of the environment.


Can pets spread the COVID-19 virus?

According to information from the World Health Organisation (WHO), there is no evidence to date that pets such as cats and dogs may have been infected and can therefore spread the COVID-19 virus.


Can food, namely frozen and refrigerated products, spread the COVID-19 virus?

Although infection is possible through the contamination of food packaging when, from the hands, the virus enters the mouth, nose and eyes, this is by no means the principal transmission route of the virus. Due to poor survivability of the virus on surfaces, the risk of the virus spreading from food that is packaged, refrigerated and transported for days, seems very low.


However, as a precautionary measure, the World Health Organisation (WHO) and ASAE (Economic & Food Safety Authority) in Portugal, published the following guidelines for food preparation and consumption. We highlight the following good hygienic practices:


  • Extensive and frequent hand washing (with soap and water for at least 20 seconds), followed by adequate drying, avoiding cross-contamination (for example closing the faucet using a paper towel rather than the hand that opened it before washing);

  • Properly disinfect countertops and work surfaces using suitable products;

  • Avoid contamination between raw and cooked food;

  • Cook and serve food at suitable temperatures and wash raw food properly;

  • Avoid sharing food or objects between people during meal preparation and consumption.

What is the incubation period?

The incubation period (time between exposure to the virus and appearance of symptoms) is estimated to be between 2 and 14 days.

Transmission by asymptomatic carriers is still under investigation.


How long can a person infected with COVID-19 infect others?

An individual who is actively sick with COVID-19 can infect others. This is why these patients must be isolated from the community both in hospital and at home (depending on the gravity of their condition), until their health improves and they are no longer at risk of infecting other people.


How long a person remains sick varies greatly, therefore the decision to end isolation is assessed on a case by case basis, based on medical criteria, preventive and public health needs, the initial degree of severity and lab results.

The CDC (Centers for Disease Control and Prevention) criteria to terminate quarantine are based on individual assessment and are as follows:


  • Absence of fever without using fever medication;

  • Absence of symptoms, namely cough;

  • Negative laboratory test in at least 2 consecutive respiratory collections within a 24-hour period.

A patient who terminates isolation is considered not to constitute a risk of infection to others.


Who is at risk of COVID-19 infection?

EVERYONE! The virus has no nationality, age or gender, therefore we are all at risk of infection from this novel coronavirus. All of humanity is a target.

Those who are at greater risk ofserious illnessfrom COVID-19 are the elderly and people with chronic diseases (ex.: heart disease, diabetes and lung disease).

The entire population is susceptible to infection by COVID-19 (SARS-CoV-2), including children.


What are the symptoms of COVID-19?

All people with acute respiratory complaints of


- persistent cough or aggravation of regular cough or

- fever (temperature ≥ 38°C) or

- dyspnoea/difficulty breathing (shortness of breath)


are considered suspicious and should phone the SNS24 hotline (808 24 24 24) or, as a complement, the hotlines created for this purpose by local healthcare centres (USF-Unidades de Saúde Familiar or UCSP-Unidades de Cuidados de Saúde Especializados).


How can I identify a suspicious case?

Person has acute respiratory infection (sudden onset of fever or cough or difficulty breathing), without any other aetiology to explain the condition+History of travel or residence in areas with active community spread, in the 14 days prior to the appearance of symptoms;

OR

Person has acute respiratory infection+Contact with a confirmed or probable case of infection with SARS-CoV-2 or COVID-19, in the 14 days prior to the appearance of symptoms;

OU

Person has severe acute respiratory infection, requiring hospitalisation, without any other aetiology.


How can I protect myself?

In the affected areas, the World Health Organisation (WHO) recommends respiratory hygiene and etiquette to reduce exposure and transmission of the illness:

Cover your nose and mouth when sneezing or coughing (with a tissue or your elbow, never your hands; always discard the tissue after use);

Wash your hands frequently. Hands should always be washed after blowing your nose, sneezing, coughing, or after direct contact with sick people; Hand washing should be thorough and last 20 seconds, rubbing hands using plenty of soap or an alcohol-based solution (70°);

Avoid close contact with people who suffer from respiratory infection;

Avoid touching your face with your hands;

Avoid sharing personal objects or food you have touched.


How can I fight the virus?

The virus is effectively destroyed by:


  • UV ultraviolet rays;

  • exposure to temperature of 56°, for 30 minutes;

  • alcohol (75°);

  • disinfectants containing chlorine-bleach;

  • ether solvents;

  • others such as: peracetic acid and chloroform.

Chlorohexidine does not effectively eliminate the virus.


Should I wear a facemask to protect myself?

Given the current situation in Portugal, wearing a facemask for individual protection is not recommended for people who do not display symptoms. Doctors and other healthcare professionals recommend wearing a mask in the following situations:


  • People with symptoms of respiratory infection (cough or sneezing);

  • People suspected of COVID-19 infection;

  • People who provide healthcare to people suspected of COVID-19 infection.

Is there a treatment and vaccine for the Coronavirus?

Treatment for infection with this novel Coronavirus focuses on the signs and symptoms presented and, above all, on treating complications. Because this is a novel virus, a vaccine has not been produced yet, and research is under way to develop one.


Are antibiotics effective to prevent and treat a Coronavirus?

No, antibiotics are not effective against viruses, only bacteria. COVID-19 is a virus, therefore antibiotics should not be used to prevent or treat it. This will not produce positive results and may help increase resistance to antimicrobials.


What should I do if I have had close contact with someone with COVID-19 but I do nothave symptoms?

If you do not have a fever, cough or difficulty breathing, you should:


  • Avoid close contact with people for 14 days because you may be incubating the illness despite not displaying symptoms yet;

  • Measure your temperature twice a day, paying attention to any rise in temperature, cough or difficulty breathing.


What should I do if I have had close contact with someone with COVID-19 but I dohave symptoms?

If you have a fever, cough or difficulty breathing, you should:


  • Phone the SNS 24 hotline – 808 24 24 24and follow their instructions;

  • Avoid close contact with other people.


Should I be tested for Coronavirus?

All cases of suspected infection with the novel coronavirus should be submitted for laboratory investigation. If you have symptoms such as fever, cough and/or difficulty breathing and have been in contact with a person diagnosed with COVID-19, stay at home and contact the SNS24 hotline (808 24 24 24).

After contacting the hotline and based on the symptoms and inquiry, the healthcare professionals will determine if COVID-19 testing is necessary.

Preferably, the diagnosis should be carried out in the “Rede Portuguesa de Laboratórios para o Diagnóstico do SARS-CoV-2” (Portuguese Network of Laboratories for SARS-CoV-2 Diagnosis), the complementary network of private laboratories or at Instituto Nacional de Saúde Doutor Ricardo Jorge (INSA).

If your test is positive, you may only terminate isolation when, in the absence of symptoms, the result of 2 tests within a 24-hour interval, are negative.


Is it possible to have a negative test result and later a positive test result?

A negative test only means that, at that moment, the virus was not found in that person’s respiratory sample. It is not an absolute guarantee that the person does not have the illness because, in the early stages of COVID-19, the test result may still be negative.

If a person has respiratory symptoms such as cough and fever but the test is negative, this means that the COVID-19virus is notresponsible for the current illness.


I’m pregnant. Am I at greater risk of infection or of having serious complications with COVID-19?

There is still no concrete data on the susceptibility of pregnant women to the COVID-19 virus.

Physiological changes during pregnancy may make women more susceptible to viral infections like COVID-19. Compared with the general population, they may also be at greater risk of serious illness, morbidity and mortality.

It is crucial for pregnant women to intensify measures to prevent infection, such as frequent hand washing, maintaining social distance (1 metre) and staying away from infected people.


If I have COVID-19 during pregnancy, is there a greater risk of an adverse gestational outcome?

There is not sufficient information concerning adverse gestational outcomes in pregnant women with COVID-19. In other infections with other types of coronaviruses during pregnancy, there have been cases of miscarriage and stillbirth. High fever during the first trimester of pregnancy may increase the risk to the foetus.


If I am pregnant and infected with COVID-19, can I spread the virus to the foetus or new-born?

There is limited scientific information available on the vertical transmission (mother-to-child) of other coronaviruses, but vertical transmission was not verified in those infections.


If I am infected with COVID-19 during pregnancy, will my child be at greater risk of complications?

The risk of complications for children born from mothers infected with COVID-19 is currently unknown. Some women infected with other coronaviruses during pregnancy had babies that were premature and/or small for their gestational age.


If I am infected with COVID-19 during the breastfeeding period, will my child be at greater risk due to nursing?

Until now, there is no evidence of the COVID-19 in breastmilk.

The risk for the baby results from the proximity to the mother’s fluids and droplets that may contaminate the child during breastfeeding and hygiene care.

Since breastmilk is the best source of nourishment for infants, the presence of a severe respiratory infection or confirmed COVID-19 calls for extreme precautionary measures to avoid contaminating the child. Thorough hand washing and wearing a facemask, or drawing milk with a breast pump to administer it away from the mother, are important measures to prevent contagion.


25 March 2020.


Adapted by Fernando Vilhena de Mendonça, MD & Maria Teresa Egídio Mendonça, MD

DGS-Direção Geral da Saúdehttps://covid19.min-saude.pt/perguntas-frequentes/

CDC-Centers for Disease Control and Prevention https://www.cdc.gov/coronavirus/2019-ncov/faq.html#basics

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