CORONAVIRUS-19 AND OPHTHALMOLOGY (UPDATE)
[COVID-19 SERIES #2]
LINKS TO ARTICLES RELATED TO CORONAVIRUS INFECTION AND OPHTHALMOLOGY GIVEN AT THE END OF THE POST
As I
write this update, there is news that the novel coronavirus disease-19 (COVID-19)
has spread all over the globe. More than 195 countries and territories have
reported this pandemic. Although there is some flattening of the curve in some
countries such as China and Italy, others including Spain and some African
countries are still seeing an uptrend. As of today, world-wide 38,1761 persons
have been infected and 16,558 have died.
My previous post on COVID-19 is available on touchOPHTHALMOLOGY Insights (Publishers of US Ophthalmic Review and European Ophthalmic Review).
https://www.touchophthalmology.com/insight/coronavirus-and-ophthalmology/
My previous post on COVID-19 is available on touchOPHTHALMOLOGY Insights (Publishers of US Ophthalmic Review and European Ophthalmic Review).
https://www.touchophthalmology.com/insight/coronavirus-and-ophthalmology/
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| Countries affected (23rd March 2020) |
Lockdowns
and curfews are being implemented in a large number of countries. After months
of dithering and a lackadaisical attitude by governments, more stringent
measures are in force now.
In China,
the epicenter of the outbreak, Wuhan city, was completely in lockdown for the
last few months. This has apparently helped in reducing community spread of the
infection.
Flights,
trains, buses and other modes of transportation have been curtailed. Most
countries have stopped international flights. Passengers coming from hot-spot
countries such as Italy, South Korea and Iran are being sent for COVID-19
screening or in self-quarantine.
Countries such as the Kingdom of Saudi Arabia have taken exemplary measures to stop the spread of the virus. The kingdom stopped Umrah (a holy trip by Muslims to Mecca) and visit visas, suspended all International flights and implemented a travel ban to a large number of countries including it's Arab neighbors. Hospital OPDs have curtailed seeing regular (cold case) patients and Health-care
workers(HCWs)provided with personal protection. Public information is being disseminated on a large scale.
A number
of famous personalities such as the Queen of Spain; Begoña Gómez, wife of the Spanish
Premier; Sophie Trudeau, wife of the Canadian Premier; Karl von Habsburg, the
archduke of Austria; footballers Callum Hudson-Odoi and Mikel Arteta; actors
Tom Hanks and his wife Rita, Idris Elba and Olga Kurylenko have been reported
to be affected by the virus.
HCWs are on the frontline to combat this disease. Naturally, they are
the ones taking the brunt of the infection. In the SARS pandemic nearly 1/3rd
of the cases were HCWs. More than 23 doctors have died in Italy, reportedly 8
have died in China, 5 have died in France, at least 1 doctor each died in Malaysia and Pakistan.
The story
of Dr. Li Wenliang is tragic in many ways. Working in Wuhan, in December 2019 he alerted
authorities for an infection which resembled SARS (Severe Acute Respiratory
Syndrome). The Chinese authorities asked him to "stop making false
comments" and he was investigated for "spreading rumors". The
doctor contracted the COVID-19 infection and died in early February 2020.
Recently, the Chinese authorities apologized to the family of the doctor and
opened an investigation into the incident.
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| Dr Li Wenliang |
In some
places entire teams of doctors have gone into self-quarantine. Out-patient
departments have closed in most hospitals world-wide to break the chain of
transmission. Elective surgeries are banned by authorities and personal protective
equipment being made available slowly to HCWs. In many health facilities
services are badly crippled due to the lack of proper facilities.
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| Situation in a Madrid hospital |
In UK,
the Animal Health Trust has offered to provide ventilators used for animals to
the National Health Service (NHS) to help combat shortage of such equipment in
NHS hospitals.
Reports
of companies and individuals profiting from this disease are coming from all
over the world. Shortage of masks and sanitizers have spiraled the cost of such
items. Panic buying is leading to supermarkets and shops being emptied of
essential items.
Toilet paper is especially being sought after. So much so,
that an Australian newspaper had an extra 8 blank pages to be used as toilet
paper.
In a UK school, a student was apparently expelled for providing hand
sanitizer at 50p a shot.
 |
| Symptoms of COVID infection |
CONJUNCTIVAL CONGESTION AND PERIORBITAL HYPEREMIA COULD BE SIGN OF INFECTION:
A nurse working with COVID positive patients has claimed that one of the most consistent and reliable signs of infection is congestion and hyperemia around the eyes.
https://nypost.com/2020/03/24/red-eyes-may-be-telltale-symptom-of-coronavirus-nurse/
The elderly are most at risk of deaths from COVID-19. A large number of deaths are being reported in individuals above 60 years of age. More than 20% deaths have occurred in those above 80 years of age.
A nurse working with COVID positive patients has claimed that one of the most consistent and reliable signs of infection is congestion and hyperemia around the eyes.
https://nypost.com/2020/03/24/red-eyes-may-be-telltale-symptom-of-coronavirus-nurse/
The elderly are most at risk of deaths from COVID-19. A large number of deaths are being reported in individuals above 60 years of age. More than 20% deaths have occurred in those above 80 years of age.
Death
rates have been more in males, compared to females. In a report the number of
males dying of suspected infection was 2.8% compared to 1.7% of women. In
confirmed cases, the infection was fatal for 4.7% men and 2.8% for women. This
is being attributed to better immunity in females and increased prevalence of
chronic diseases such as cardiovascular disease (found in 13.2% of confirmed
case fatalities), diabetes (in 9.2%) hypertension (in 8.4%), chronic respiratory
disease (in 8.0%) as well as social factors such as alcoholism and smoking in
males.
PROTECTION FROM COVID INFECTION:
PROTECTION FROM COVID INFECTION:
The World
Health Organization (WHO) has updated its advisory for public to protect itself from
COVID-19 infection. WHO has developed the "risk communication and community engagement (RCCE)" readiness and response strategies to protect public's health.
- Wash your hands frequently:
Regularly
and thoroughly clean your hands with an alcohol-based hand rub or wash them
with soap and water.
- Maintain social distancing:
Maintain
at least 1 metre (3 feet) distance between yourself and anyone who is coughing
or sneezing.
- Avoid touching mouth, eyes and nose (M, E, N).
- Practice respiratory etiquette:
Make sure
you, and the people around you, follow good respiratory hygiene. This means
covering your mouth and nose with your bent elbow or tissue when you cough or
sneeze. Then dispose of the used tissue immediately.
- If you have fever, cough and difficulty breathing, seek medical care early:
Stay home if you feel unwell. If you have a fever, cough and difficulty breathing, seek medical attention and call in advance. Follow the directions of your local health authority.
- Stay informed and follow advice given by your healthcare provider:
Avoid
rumors, false-information and unproven or wrong advice regarding COVID-19
infection.
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| 5 Moments of Hand Hygeine |
Presently,
there is no prophylaxis, vaccine or treatment for this infection. A couple of institutes
such as Kaiser Permanente Washington Health Research Institute in Seattle, and Emory
Children’s Center in Decaturin, US have started vaccine trials.
PUBLICATIONS RELATED TO COVID-19 AND OPHTHALMOLOGY:
The ocular features of Coronavirus infection are being presented in some publications. Apparently COVID-19 can cause conjunctivitis, anterior uveitis, retinitis and optic neuritis in animal and murine models. Such manifestations are possible in humans also.
