What are coronaviruses, what are the symptoms, and for whom is it particularly dangerous? We answer frequently asked questions about the novel coronavirus.
What are coronaviruses?
Coronaviruses can infect both humans and a variety of animal species, and were first discovered in the mid-1960s. Hundreds of types of coronavirus have been identified to date, which, depending on virus variant, can cause everything from common colds to life-threatening illnesses in humans. Virus variants that in the past have triggered epidemics with especially severe disease courses include the SARS and MERS coronaviruses.
The current respiratory disease COVID-19 is caused by a novel coronavirus, SARS-CoV-2, which is closely genetically related to the SARS virus of the early 2000s. In contrast with the first SARS virus, SARS-CoV, which replicated deep within the lungs, the new SARS-CoV-2 can implant and replicate in the throat. Because of this, it is released much faster into the breath during exhalation and speaking, leading to much faster infectious transmission than the previous SARS virus. As far as its origin is concerned, it is assumed that the first patients became infected with SARS-CoV-2 at a market in Wuhan in early December 2019.
What symptoms are displayed by someone infected with the coronavirus SARS-CoV-2?
The new coronavirus SARS-CoV-2 can cause very different forms of disease. The most common symptoms are coughing, fever and nasal congestion. As such, it was already known that patients mistook the initial stages of COVID-19 for hay fever. In some cases, the disease course can be severe involving pneumonia and breathing difficulty.
Damage to the cardiovascular system as well as neurological symptoms such as loss of smell and taste, lethargy and fatigue have also been described in the meantime. Less common symptoms include sore throat, headache, aching limbs, loss of appetite, weight loss, nausea, stomach ache, vomiting, diarrhoea, conjunctivitis, skin rash and swollen lymph nodes.
Who is at particular risk from the new coronavirus?
According to the Robert Koch Institute, people above 50-60 years of age and those with underlying medical conditions are at increased or at most risk of developing severe disease respectively. High-risk underlying medical conditions include chronic cardiovascular diseases as well as pulmonary and metabolic disorders. Those being treated with medications that weaken the immune system are also at risk. The WHO reports that the disease occurs comparatively rarely in children and when it does, its course is mostly mild. Only a very small fraction of infected children and adolescents become severely or critically ill. The data basis is, however, not yet adequate to conclude whether children are in general less susceptible to the virus. According to the WHO, pregnant women are not at increased risk of a severe course of disease.
How can you become infected with the coronavirus?
The authorities in China initially reported that all of the patients had become infected at an animal market. Coronaviruses are predominantly found in wild mammals and birds. It was not initially assumed, however, that transmission to humans was likely.
It is now considered established that aerosol infection from person to person is the primary route of transmission. For this reason, the same hygiene measures recommended for influenza, i.e. proper flu, should be observed.
Coronaviruses have also been detected in the stool samples of some of those infected. According to the Robert Koch Institute, it has not yet been conclusively determined whether or not SARS-CoV-2 can also be spread via the faecal-oral route.
How can you effectively protect yourself against infection?
Coronaviruses are transmitted via airborne droplets. According to recent studies, the virus cannot survive for long in secretions from the nasopharyngeal cavity that land on objects, such as door handles or light switches. As such, infectious transmission of coronaviruses via objects has not been established to date. Disinfecting all the surfaces in one’s own home is in general unnecessary, but may be a sensible precaution if there are sick people living there. Otherwise, thorough hand washing with soap or disinfecting one's hands with a suitable disinfectant with limited or basic viricidal activity is sufficient.
A sensible hand hygiene routine consists of hand washing or alternatively hand disinfection. It is generally not necessary to do both at the same time.
Wash hands thoroughly with soap for at least 20 seconds, including lathering finger nails, back of hands and between the fingers. If possible, dry hands using a disposable towel. After hand washing, the tap and door handle should only be touched using the disposable towel. If it is necessary to wash hands frequently, as is the case during the current corona pandemic, you should protect your skin. Regular use of hand cream, ideally after each hand washing, prevents your skin from drying out.
If there is no washbasin nearby or your hands are not especially dirty, a hand disinfectant can be useful too. Attention should be paid to ensuring that the disinfectant bottle is closed and put away again before rubbing the solution in, in order to prevent the hands becoming re-contaminated from the bottle. A benefit of using hand disinfectant is that the hands don't become as dried out as they do through washing with soap.
Besides good hand hygiene, it is important not to touch your face with your hands. Contact with the mucous membranes of the mouth, nose and eyes in particular should be avoided. For the same reason, social distancing is a key measure in reducing the risk of transmission of SARS-CoV-2. You should maintain a distance of at least 1.5 metres from other people and forego shaking hands. In addition, you should limit personal contact to an absolute minimum. The Federal Government has issued guidelines regarding how social distancing and limiting contact in public spaces is to be implemented.
In order to protect others, you should ensure that you sneeze and cough into the crook of your arm. Anyone suffering from a cold should already be observing this etiquette anyway. Used tissues should not simply be thrown into a bin, but collected in a sealable plastic bag, for example, and then disposed of. Wearing a face mask can help prevent virus-containing droplets of saliva in exhaled breath from dispersing.
Do health insurance companies cover the cost of a PCR test for the coronavirus?
Doctors can perform the test for infection with the coronavirus and charge it via the insurance card if they consider the test necessary. In deciding this, they should be guided by the latest criteria published by the Robert Koch Institute. The attending physicians must likewise decide if retesting is necessary. If they consider such retests to be medically necessary, they can also be charged via the insurance card.
Who offers the PCR test for the coronavirus?
Determining the presence of coronavirus is generally done using the so-called polymerase chain reaction (PCR) method, whereby sections of the viral RNA are replicated until they can be detected. The technique has been around for some time, and the Charité in Berlin played a leading role in further developing it for SARS-CoV-2. The test is generally performed on a sample collected using a throat swab or sputum coughed up by the patient. Ideally, both secretions, i.e. throat swab and coughed-up sputum, are tested. In the meantime, not only the Charité, but other university hospitals and specialised laboratories are offering the test too. Work is currently ongoing on developing a mass-produced test.
What should you look out for if you were recently in a region affected by coronavirus?
Anyone who was recently in a region with confirmed cases of the respiratory disease caused by the coronavirus should check whether they experience cold symptoms. If this is the case, they should contact a doctor by phone to be on the safe side and point out that they were in a coronavirus region.
You should also bear in mind that the incubation period can be up to 14 days. So, the disease can still develop even after you have already been back home for some time. You should, where possible, avoid being in close proximity to other people for the incubation period, as the virus can be transmitted even when no symptoms are apparent.
What treatment do you receive on becoming infected with the coronavirus?
There is no specific treatment for the virus at present. Depending upon the severity of the course of the disease, a number of supportive measures, such as administering oxygen, maintaining fluid balance and administering antibiotics in case of bacterial co-infections, are implemented instead. The course of disease following infection with SARS-CoV-2 is not severe in all cases. The predominant symptoms of the cases thus far identified in Germany have been those of a common cold.
Will a loss of earnings be compensated if you have to be quarantined?
If an employee has to be quarantined, they have a right to financial compensation under the German Infectious Diseases Protection Act (Infektionsschutzgesetz.) The employer pays the employee's wages for the first six weeks. From the seventh week of quarantine, compensation amounting to sickness benefit is then paid. The affected person must apply to the competent State authority for this him or herself, however.
If, on the other hand, a self-employed person must be quarantined, they must apply for compensation directly to the competent State authority. The level of compensation is calculated differently: in this case, the amount is based on a twelfth of the earned income from the activity eligible for compensation. In case of a threat to livelihood, reasonable additional expenses can be reimbursed on application to the competent public authority. Self-employed workers whose business or practice is suspended during quarantine can additionally claim compensation on application to the competent authority for the continuing operating expenses incurred during this time.
Is wearing a face mask advisable?
In Germany, it is strongly recommended with immediate effect to wear a surgical mask to protect those around you when using public transport and when shopping. In addition, it is advisable to wear appropriate protection in day-to-day situations where it is not possible to maintain the minimum distance of 1.5 metres. This includes when encountering people in narrow corridors, offices or staff kitchens as well as when visiting doctor's surgeries and physiotherapy practices.
A washable mask that can be exchanged when moist, and at least once a day at the latest, is helpful. The mask loses its functionality the moment it becomes moist. Under no circumstances may the mask be used both ways round or the inside touched with the fingers in order to avoid it becoming contaminated and thus the virus being transmitted via the hands. In case of doubt, the mask should be changed several times daily.
It is a good idea to use a face mask (e.g. homemade mask) that is not a medical device so that the professional equipment is available for medical staff and other front-line professions, such as the emergency services and police. An effective mask must meet certain requirements. This includes things like degree of particle porosity, sensitivity to moisture penetration and much more besides. By using a mask that prevents virus-containing droplets of saliva in your breath from dispersing, you protect those around you.
It is not recommended for the general populace to wear higher quality masks that protect the wearer from inhaling virus-containing aerosols. This category of protective mask should be reserved for those people for whom it is imperative that they protect themselves against others infected with the virus, such as medical staff who are in close contact with patients and those belonging to the identified risk groups when contact with persons not cohabiting with them cannot be avoided.