The Wuhan Coronavirus outbreak has worried most of us, especially with the Chinese New Year period imminent. The Chinese New Year period is one where there’s a mass movement of individuals, not just in China, but in many countries. In Malaysia, many of us use the opportunity of this holiday period to travel and move around. It is expected that the Wuhan Coronavirus outbreak will grow significantly during this holiday period.
This is a discussion on commonly asked questions, a FAQ, with a hope to help us reduce transmission during this busy travel season.
Has this novel Coronavirus (nCoV) that originated in Wuhan spread to Malaysia?
The best answer to this is the position adopted by the Singapore Health Minister who clearly indicated yesterday that “It is inevitable that we will see an imported case sooner or later“. So it is not an ‘if’ but a ‘when’ the virus will reach Malaysia, if it is not already here. The high volume of travel, between countries in the region, makes such viruses easy to spread; especially with person to person spread confirmed. At present, the Wuhan Coronavirus has spread to various parts of China (571 confirmed cases from 25 provinces and municipalities), as well as cases reported in Thailand (4), Japan (1), Macau (1), South Korea (1), Taiwan (1), and the United States (1). It is estimated that the actual number infected is actually ten times as many as reported.
Will screening visitors from China prevent the entry and spread of the virus in Malaysia?
Temperature screening (fever scanners) at entry points into our country is useful but has limited value. There may be a 5-7 day gap between exposure to the virus and infection symptoms. Infected individuals may be asymptomatic (show no signs of the infection as yet) or only be mildly ill and not show a fever (or fever may be suppressed by medication). Of course, any person with an acute respiratory infection or pneumonia returning from China should be notified to the medical authorities and be isolated.
How severe is the virus infection?
So far, 17 people are known to have died from it, all in China. At present we do not know what percentage of individuals who get infected will have a severe infection. The virus infection may be mild, cause pneumonia, or it could be life-threatening. From available information, 15-20% of those hospitalised require oxygen or ventilation. The virus appears to start with a fever and then a cough develops. The person may then go on to develop shortness of breath due to a lung infection.
How can we protect ourselves (reduce our risk of infection) as well protect others?
How can we help reduce the spread of the Wuhan Coronavirus?
It is important to act responsibly during this time. We cannot act like we live on an island isolated from others. It would be good if we adopt, and continue to practise at all times, good infection control etiquette. The Japanese have a long history of having a good culture of not infecting others and we could adopt some good points from them.
Firstly, limit the spread of infection when you cough or sneeze. There is no way when you cough or sneeze suddenly, that you can reach a tissue or handkerchief in time. So it is important to learn how to cough or sneeze into a flexed elbow or sleeve. You have to learn how to do this by practising it and teaching it to your children and to others. Employers should train employees on this method of limiting the spread of airborne viruses when we cough or sneeze. If you have time to use a tissue that is also ok. Do not cough or sneeze into your hands or openly. That may encourage the virus you are infected with to spread to others.
Secondly, if you are unwell with an acute respiratory infection wear a mask. Although there is doubt if the common masks worn (3 ply surgical masks or cloth masks) can keep out airborne viruses (prevent you from getting infected), but there is some evidence to suggest that masks can help reduce transmissions. Remember that the 3 ply surgical masks or cloth masks are no longer effective once they are wet. They have to be changed frequently (at least hourly) and be worn correctly. Remember to dispose of them safely in a closed trash bin. So it is best that, if you are unwell, to avoid other people, stay in your own room and use a mask when you have to meet others. It would be the responsible thing not to travel if you are unwell, especially not in a closed environment like an aeroplane or bus or train. An additional point is that it is important if one person becomes unwell others should not sleep with them (increases the virus load spread); there may be an exception for young children.
Thirdly, if you have just returned from China and have an acute respiratory infection or pneumonia you should immediately notify the medical authorities.
Fourthly, consider carrying some spare masks and offer them to individuals who cough or sneeze. We need to help others learn to be responsible.
Fifthly, avoid contact with people showing symptoms of respiratory illness such as coughing and sneezing.
Sixthly, wash your hands with soap and water or an alcohol-based rub after coughing or sneezing or if you have come in contact with an ill person. Keep an alcohol-based rub handy with you when you travel. You may want to use it to clean your hands after touching doorknobs, public tables, etc. Remember to try and limit touching your face. Studies have shown that we touch our faces many times each hour and this increases our chances of getting infected.
We do not know at present how worried we should be about this new virus. But remember that there is currently no definitive treatment for the Wuhan Coronavirus and no vaccine developed as yet (work on developing it is in progress). The way we can contain this virus is to identify and isolate infected persons quickly, limit contact with infected individuals, reduce our travelling and have no unnecessary mass gatherings.
Dato’ Dr Amar-Singh HSS
Senior Consultant Paediatrician