Table of Contents

Introduction

Chapter 1               What Is Coronavirus?

Chapter 2               Properties of Corona Viruses

Chapter 3               Your Risk & the Symptoms

People at Risk

The Symptoms

Fatality Rate

The Transmission Rate

The Incubation Period

Chapter 4               What to Do During an Epidemic or a Pandemic

Disaster Preparedness

Stocking Up on Supplies

Keep Your Distance

Limit Your Time Out in Public

Make Sure You’re Immunized

Chapter 5               Preventive Measures by Countries

Chapter 6               Global Spread And Reponse

Chapter 7               Protecting Yourself

Chapter 8               How It’s Affecting China

Chapter 9               Prevention And Immune Strengthening

Chapter 1 0               The Virus & Your Body

The Second Study

The Third Study

Chapter 1 1               What to do During a Quarantine

What Supplies to Keep at Home

Don’t Travel

Wear Masks When Accepting Deliveries

Don’t Break Your Quarantine, Even if You Feel Better

No Visitors

Don’t Share Germs, No Matter What

Disinfect Surfaces Regularly

Call for Medical Assistance When Needed

Chapter 1 2               How to Handle Quarantine with One Sick Family Member

Wear a Mask when Helping the Patient

Quarantine the Patient in Their Room

Disinfect All Surfaces in the House

Keep Conflicts to a Minimum and Resolve them Quickly

Play Games to Keep Everyone Occupied

Plan Activities to Entertain the Family

Conclusion

Introduction

What people are currently scared of is the Wuhan coronavirus? Coronaviruses are a large group of viruses, which include a core of genetic material that has protein spikes around the envelope. These spikes give the virus a crown-like look which is why it's called the corona, which means crown in Latin. There are subgroupings for these viruses. They are alpha, beta, gamma, and delta. Some can cause gastrointestinal symptoms while others cause respiratory. The symptoms for the respiratory disease can be mild I most people, appearing like the common cold or to pneumonia.

According to the CDC (Centers for Disease Control and Prevention), seven types of coronaviruses can affect people, and this has been identified since the mid-1960s. These are as follows.

•      NL65: Alpha Coronavirus

•      229E: Alpha Coronavirus

•      OC43: Beta Coronavirus

•      HKU1: Beta Coronavirus

These are the ones that just circulate from person to person. However, some animals can pass sickness onto people, and these are as followed.

•      SARS-CoV (Severe Acute Respiratory Syndrome Beta Coronavirus) This was identified in 2002. It also originated in China.

•      MERS-CoV (Middle East Respiratory Syndrome Beta Coronavirus). This was identified in Saudi Arabia in 2012.

•      nCoV (The Wuhan Coronavirus.

Several types are circulating in different animals including camels, pigs, cats, and bats. These are zoonotic coronaviruses, which means they can jump from an animal to a person, which is called a spillover event. This can happen due to an increase in contact between people and animals or it can be caused by a virus evolving. Viruses can mutate and combine with other viruses that allow for what was once an animal virus to infect humans.

This is also called the Novel coronavirus, which was discovered late in 2019. This is new because it was not previously detected in humans, and the first outbreak was in December of 2019 located in Wuhan, China. There were 41 people with pneumonia that were also identified as having this virus, and two-thirds were associated with the Huanan Seafood Market. This market is important because it's the largest wholesale market of seafood and live animal in the Jiangshan Discrtic, Wuhan, Hubei province, China.

Chapter 1.       What Is Coronavirus?

World Health Organization (WHO) has defined Coronavirus as a family of viruses that brings about ailments that ranges from common cold to very severe diseases like Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS).

Coronavirus was first described in detail in the 1960s and is named after a distinctive corona or "crown" of sugary proteins placed on the envelope surrounding the particle. The viral mapping encoding is the most extended sequence of an RNA-based virus–a single nucleic acid strand that is between 26,000 to 32,000 basis long.

Coronaviruses are a wide range of viruses known to infect humans and animals and cause respiratory diseases in humans, which vary from common colds to more severe infections. Severe Acute Respiratory Syndrome (Sars) was the most famous case of a coronavirus disease and was identified in Southern China in 2002 and infected 26 countries and resulting in over 8,000 cases. The number of persons diagnosed with coronavirus has now reached that impacted by Sars.

Although the cause of the epidemic was initially unclear, Chinese health authorities determined it is linked to an outbreak of coronavirus not previously seen in humans on January 7. Five days later, the Chinese government shared the virus ' genetic sequence to allow other nations to develop their diagnostic kits.

Coronaviruses are a class of viruses known to contain mutations that can cause life-threatening diseases in mammals and birds. In humans, the fluid created by infected individuals usually spreads by airborne droplets.

Coronaviruses (COV) are a big family of viruses that cause diseases ranging from the common cold to more severe diseases like CRTD (MERS-CoV) and SARS-CoV. A new coronavirus (nCoV) is a new strain not found in humans previously.

Other uncommon but notable strains, such as Wuhan coronaviral (2019-nCoV) and severe acute respiratory syndrome (SARS) and the Middle East respiratory syndrome (MERS), can cause human death.

Four families are recognized, called Alphacoronavirus, Betacoronavirus, GammaCoronavirus, and Deltacoronavirus. The first two strike only birds, pigs, cats, and humans. Gammacoronavirus primarily infects poultry and can infect birds and mammals by delta coronavirus.

A few fatal cases have had a devastating impact on animal and human welfare worldwide.

Wuhan coronavirus in the Chinese city of Wuhan was first described in 2019. By the time of writing, the number of infected individuals is still on the rise, with several deaths reported.

Snakes are accused of being a potential source of the disease, although this is thought doubtful by other experts.

SARS was first recognized as a distinct coronavirus strain in 2003 as a Severe ARS (SARS-CoV) syndrome. The virus origins were never established, although the first human infections were reported in 2002 in the Chinese province of Guangdong.

The outbreak became a pandemic that caused more than 8,000 influenza-like illness outbreaks in 26 countries, killing nearly 800 people.

MERS was first stated in 2012 in Saudi Arabia with signs of fever, cough, shortness of breath, and sometimes gastrointestinal problems such as diarrhea. An animal vector for the virus has never been officially confirmed, but evidence shows the possibility of infection in dromedary camels.

Since its original outbreaks, the World Health Organization has reported about 2,500 cases of diseases in 27 countries, resulting in almost 860 deaths.

Scientists believe that this new virus was first able to jump to humans in early December 2019. It initially appeared as though the virus first infected people on the Wuhan seafood market and spread there. Nonetheless, an initial study of the disease released on 24 January 2020 showed that the first patient to get sick had no business touch. Experts still try to keep track of the outbreak.

The type of animal from which the virus arrived is unknown. A team of Chinese scientists published a report which claims that snakes originated from the virus ' genetic code. But scientists are very doubtful about that. Another analysis revealed that the new virus's genetic sequence is 96 percent similar to one coronavirus found in bats. SARS and MERS both came from bats.

Is it the same as SARS?

The new virus isn't SARS, but it started in China as well. Since it comes from the same viral family as SARS, it is identical, but it is an entirely new virus. The commonalities indicate, though, that experts and policymakers of public health will use the lessons learned from the previous epidemic to try to stop it.

We need information both about how dangerous illness is and how quickly it can spread to decide how "bad" it can be. Epidemiologists often use this tool to evaluate, for example, new flus and to guide decisions: Image: Disease Control Centers When the illness is not very serious, but only a small percentage of the population is transmissible, it can still have devastating effects— the small percentage it kills will continue to have high numbers of fatalities if something affects millions.

Scientists also try to understand the effects of coronavirus, from mild to severe, like those in the cold. According to the WHO, about 20 percent of confirmed cases are sharp. That's around 20 percent of the cases we know about — there are still many mild cases of illness not flagged, which would decrease the percentage of severe cases.

To date, the new coronavirus fatality rate is around 2 to 3%, though this could still change as the outbreak progresses. The death rate for SARS was between 14 and 15 percent. The majority of deaths in this epidemic were in older people with underlying health conditions, like cardiovascular disease, high blood pressure and diabetes. (That is the same population which is at highest risk of dying from diseases such as flu.)

How quickly does the virus spread?

They still don't know how quickly or efficiently the virus can spread. Throughout China, people with the illness have been infecting others by personal-to-person contact since the beginning of January, and the WHO has confirmed the presence of continuous chains of individuals that have been spreading the virus for at least four decades.

Early evidence shows that the virus occurs between people in close contact with each other, as with other coronaviruses, and is likely to spread when an affected person sneezes or coughs.

Yet Chinese officials said they saw reports of contamination by people with the virus before they became symptomatic.

If this happens regularly, it will become more difficult to stop the spread of the virus. There is only limited evidence, though, that the infection can be transmitted among asymptomatic individuals. And although this would happen, it would probably not significantly impact the outbreak, scientists believe that every sick person will on average kill 1,4 to 2,5 more individuals, but this is only a tentative estimation. Other teams of experts have released their predictions, most of them suggesting that a sick person would kill about two to three people on average.

These numbers are referred to as the R0 virus (pronounced "R-naught"). The R0 reflects mathematically how well a virus will spread. The bigger the number, the more likely it is to spread. The R0 for SARS ranged between two and five for reference. That does not mean, however, that every sick person is infecting that many people; quarantines and other measures are taken to contain influenza outbreaks will reduce the number of people affected by a disease.

ORIGIN AND HISTORY OF CORONAVIRUS

Since the 1960s, Coronaviruses (CoV) have been known as human pathogens. Infecting humans and many other vertebrates are coronavirus. Human sickness is primarily respiratory or gastrointestinal, but symptoms vary from the common cold to more serious lower respiratory infections such as pneumonia. Bats have a variety of coronaviruses, which can play a vital role in the development of alpha and beta-coronavirus lines. Certain animal species will, however, also serve as a host and food reservoir.

Zoonotic coronaviruses in recent years have evolved to cause human outbreaks, such as 2003 SSR and Middle East Respiratory Syndrome (MERS) since 2012. Zoonotic coronaviruses have been found to cause human outbreaks.

The pathogens Coronaviruses are in the class of Nidovirals with positive-stranded RNA viruses. The viruses have a normal appearance that appears like a crown under the electron microscope; hence, the viruses are termed after the Latin word corona, which means' crown' or' halo.' The Orthocoronavirinae subfamily of the Coronaviridae family is further divided into four types of coronavirus (CoV). Five subgenera (Embecovirus, Hibecovirus, Merbecovirus, Sarbecovirus, and Nobecovirus) distinguish the beta-coronavirus genus also.

In the mid-1960s, coronaviruses were discovered to infect human beings and several animals (including birds and mammals). The primary target cells are epithelial cells in the respiratory and gastrointestinal tract. According to these characteristics, viral dumping takes place via these mechanisms and can take place by various routes, including fomites, airborne or fecal-oral.

To date, it has been shown that seven coronaviruses infect humans. HCoV-Oc-43 and HCoV-HKU1, as well as HCoV-229E common human coronaviruses, cause common colds, but also severe lower respiratory tract infections among the earliest and the old; while HCoV-NL63 is known as a significant (pseudo) source of croupe and bronchiolitis in children.

SARS-CoV (2002, Betacoronavirus, Sarbecovirus subgenus), and MERS-CoV (2012, Betacoronavirus, Merbecovirus subgenus) have been developed and caused by other human outbreaks. In late 2019, a new coronavirus associated with a group of pneumonia cases was reported in Wuhan, China (2019-nCoV). The 2019-nCoV has closely linked to SARS-CoV and genetically modified clusters of Sarbecovirus betacoronavirus.

Frequent Coronavirus infections are moderate and asymptomatic, but severe and fatal infections have been observed. In people with pneumonia, the viruses are occasionally capable of causing lower respiratory tract infections, which are more likely in immuno-affected persons, cardiopulmonary illnesses, older adults, and young children.

In 2002–2003, SARS-CoV was reported and contributed to significant outbreaks; 8,096 people worldwide were infected, causing several pulmonary infections, MERS-CoV was found in 2012 in Saudi Arabia. Following MERS-CoV infection, clinical presentations can range from asymptomatic to symptomatic. The signs of pneumonia can include fever, toxins and shortness of breath. Symptoms can lead to acute respiratory distress syndrome, septic shock, and death in severe cases. The urinary tract may also be impaired by gastrointestinal symptoms such as diarrhea.   The clinical course in immunocompromised patients is more severe.

As for the 2019-nCoV, there is still no epidemiological or serological evidence that limits our ability to describe the full spectrum of disease caused by the virus. 20–25% of lab-confirmed cases currently have severe clinical presentations. To date, the symptoms of patients diagnosed with 2019-nCoV primarily include fever and breathing problems, with radiological pneumonia findings. However, severe patients with ARDS and even critically ill have also been reported.

Epidemiology

The virus infected 8,096 people with severe acute respiratory syndrome-associated coronavirus (SARS-CoV) in 2002-2003 and 774 deaths (case-fatality ratio: 10 percent).

For MERS-CoV, dromedary camels are essential animal reservoirs of the virus and the primary, intermediate vector of animal host for human MERS-CoV infection. Most human cases in Saudi Arabia, the United Arab Emirates and South Korea have been reported in the Arab Peninsula, although small numbers of imported cases were reported in several nations. Patients with a room or a hospital, health workers and family members were spread during health-related outbreaks. With MERS, there have been no ongoing human-to-human infection or population incidents except for close contacts. The study of transmission patterns is supported by molecular epidemiological studies, which, in spite of no distinct risk factors for transmission, may classify relativity of viruses. The MERS-CoV case-fatality ratio is estimated to be 35%.

On 31 December 2019, Wuhan, China, announced the first cluster of hospitalized patients with pneumonia. Case reports have consequently increased sharply, primarily in China, and travel-related cases also increased exposure to Wuhan. Human-to-human transmission is also shown to occur in persons without exposure to wet markets but who are exposed to respiratory symptoms and health workers infection.

Chapter 2.       Properties of Corona Viruses

What viruses are and how they work

Viruses are fascinating minimalists. They consist of very few components and can still achieve a lot. They consist of just some genetic material, depending on the virus type, as DNA or RNA, and the whole thing is usually packaged in a shell with a membrane and proteins. Finished, the virus is done. The genetic material contains very few genes: information for the own multiplication, spread and information, how the metabolism of another living being as host can be redirected for the own purposes. The virus cannot produce its own metabolism, gain energy or produce proteins. It is not a cell, because it also has no plasmatic space with organic structures in which cellular processes can take place. That is why viruses are considered not to be part of life. You could also call them clumps of organic molecules that, when they encounter other organic structures, perform a pre made sequence of reactions.

There are a number of theories about the development process of viruses, none of which has yet been clearly proven. Many scientists believe that viruses are genes that have been lost from creatures and become independent through unknown processes. For almost every living being there are one or more viruses that can infect them. So far, only a small part of the viruses have been identified. Even 15,000 year old viruses can be recovered from the ice cores of the Arctic or high mountain glaciers. The existence of living things with viruses goes back to their genesis. Even in dinosaur bones deformations can be found as evidence of paramyxovirus infection.

Virus morphology

Viruses are tiny. They have sizes between 20 and 300 nm and therefore go through normal microbial filters (e.g. bacterial filters). Even a normal mouthguard in standard design (FFP1) cannot hold a virus back. At approximately 120-160 nm, corona viruses are among the larger viruses. Viruses are not recognizable with the normal light microscope, but with the electron microscope. They have various forms and often differ clearly in the protein surface structures, which are responsible for adhering to the host cells. Corona viruses are spherical viruses and have club-shaped protein outgrowths, so called spikes, on their surface. They give them a crown-like appearance and this property was used for their naming.

Hosts of viruses

There are viruses that infect animal, plant or human cells. Most of the time, the viruses specialize in a specific host. They can only multiply through their host cells. Because of their protective covering, they can persist outside the host‘s cells for a while, but sooner or later they will decay depending on the virus type and environmental conditions.

Many viruses are harmless and we collect a lot of virus infections over the course of our lives, but these are usually not noticeable. From herpes, with which a large part of the population can live without decisive disadvantages, to deadly HIV, all levels of virulence and infestation are possible. Novel variants are usually problematic if they change to a new host and there is a first encounter. The host and the virus are then often not yet well coordinated and serious damage or illnesses can occur in the host. Viruses make us sick so that they can spread: e.g. cough, which spreads the virus particles through the air and leads to droplet infection in others, or as diarrhea so that the excretions can be absorbed by others if hygiene is poor. In order to trigger this reaction, the virus must destroy the host cell after it has successfully propagated. In this way it can get back into the environment and infect other suitable cells or hosts. Destroyed cells lead to inflammatory processes through the body‘s reaction. With the new coronavirus, if enough cells in the lower airways have been destroyed, it can lead to pneumonia and shortness of breath. If the course is severe, you can die from it. However, it is not a good strategy for the virus to kill its host so quickly, because then it can no longer be used for reproduction. From an evolutionary point of view, viruses adapt to the host over time so that they find a balance between damage and protection that both parties can live with. We can just hope the new coronavirus will develop in such a way.

Infection and multiplication

The first step of the infection is to dock the protein surface structures of the virus envelope onto suitable structures of the host cells. The novel coronavirus finds suitable structures for binding especially in the lower respiratory tract on the ACE2 protein (angiotensin converting enzyme). SARS-CoV also uses the ACE2 protein for docking. Only a very firm bond enables the virus to penetrate the cells. 2019-nCoV binds weaker to ACE2 than SARS-CoV. During the infection process, the virus envelope fuses with the cell membrane of the host cell. It is pressed into the interior of the cell until the virus can infiltrate its genetic material. There, virus components can be duplicated with the host‘s own production facilities. The new virus particles are made up by self assembly oft he produced components. This uncontrolled production of virus components creates stress in the cell, which is recognized by the cell and leads to counter reactions.

The host is not entirely helpless. He has developed an immune system to defend himself against viruses, among other things. It is partly innate, partly acquired. Defense creates antibodies and cytotoxic T cells that can recognize, bind and eliminate components of the virus. The defense system releases phagocytes, which can recognize, dissolve and digest cells infected by viruses. Once the immune system has recognized the intruder sufficiently and produced defense cells, it can be contained. After successful control we become immune. The immune system is then prepared so that the virus does not have a second chance. We take advantage of this principle with vaccination by injecting a harmless, killed or weakened virus into the body. The immune system gets to know the virus. If there is an infection, the body is already prepared and the virus has no time to multiply or do severe damage, as the immune system will react very quickly.

Mutations, adaptation and change of host

The immune system is a strong protection. However, viruses have developed at least a similar strong strategy: they can easily mutate and change their properties. With their ability to mutate, they have a mechanism for adapting and creating variability in order to get unknown to the immune system and be able to infiltrate again and again. Sometimes the changes go so far that they can even open up new hosts, jump from one species to another. More than two thirds of all human viruses originate from animals and have changed hosts on humans. So it is not an unusual process that led to the newly modified corona virus in Wuhan.

Sequence analyzes of the virus genes made it possible to identify bats as the original hosts. It seems possible that there was a change to another animal as an intermediate host before it was transferred to humans. If humans and animals come together in a confined space, such as in the animal markets in China or in animal husbandry, there is an increased chance that such newly created viruses will have the opportunity to jump on humans. If viruses are widespread in large numbers, they have many possibilities for mutation. We can see that in our flu viruses (influenza), for example. They are divided into numerous different strains and a new vaccine has to be developed every year because many strains of the virus have already changed too much.

Cold viruses

There are approximately 200 cold viruses, which also include normal corona viruses. They are usually not a problem for a healthy immune system and the infections are often so mild that the symptoms of the disease are barely noticeable. On average, adults get 2-4 colds a year, in children there may be a few more because the immune system is not yet fully developed, especially at a young age. For most colds, the incubation period is 1-4 days, i.e. so many days after the infection, the first recognizable symptoms of the disease, such as runny nose and sneezing, appear, which can then also cause the infection of other people. The disease usually lasts for a week and in most cases one is only an infection carrier in the first days of the disease. As a rule, only the upper respiratory tract is affected and there is no or only a low fever. With an infection with influenza viruses (the so called flu), the infection is much more severe. Symptoms include marked fever, headache and body aches, fatigue and tiredness. The novel Wuhan coronavirus can also cause similar symptoms. It is difficult to differentiate between influenza and the new corona virus based on the symptoms of the disease. In case of doubt, only a laboratory test can provide clarity.

Corona viruses

In comparison to influenza viruses (flu), normal corona viruses are more likely to be harmless cold viruses and are less contagious. Four types of corona viruses, named 229E, OC43, NL63 and HKU1, are found worldwide and can infect people with relatively mild symptoms. It is estimated that they are responsible for 10-30% of upper respiratory infections. Many corona viruses specialize in animals as hosts. The greatest variety of virus strains were found in bats, from where they can transmit to domestic and farm animals. The viruses can continue to multiply in these intermediate hosts. With each multiplication their genetic material, and thus the properties of the virus, can change. This can go so far that the virus even acquires the ability to open up a new host, for example a change to humans. Coronaviruses that infect humans are given the abbreviation HCoV (H for human-pathogenic coronaviruses).

Corona viruses were actually rated as harmless cold viruses. However, this has changed in the meantime, since three severe pathogenic variants have so far emerged: In 2002/2003 the SARS-HCoV, which originated in China and led to 8,000 illnesses worldwide with 774 deaths, in 2012 the MERS-HCoV, which continues to this day and still leads to infections mainly in the countries of the Arabian Peninsula and led to 2500 illnesses and 858 deaths by January 2020, and now the new virus strain 2019-nCoV from Wuhan in China. The spike protein of 2019-nCoV and SARS-CoV binds to the protein ACE2 (angiotensin converting enzyme) of surface cells of the lower respiratory tract. Some areas of the 2019-nCoV spike protein are not yet optimal for firm attachment, so there are still opportunities for a stronger bond and more aggressive infection rate. The design of the spike protein determines which host cells it can bind to. Structural analyzes have shown that individual mutations in the right place are sufficient to significantly increase the binding strength and attachment of the virus particle.

Novel Corona Virus 2019-nCoV

The new type of coronavirus from Wuhan has been given the preliminary designation 2019-nCoV, „n“ as an abbreviation for new (novel) and CoV is the abbreviation for coronaviruses. The virus is a single stranded RNA virus that belongs to the group of beta corona viruses. As an RNA virus, it can mutate much faster than DNA viruses. The genome is very large: it is the largest known RNA virus. Of the four main structural proteins, the “spike” protein is critical for attachment and infection. It is very similar to SARS spike protein. The gene sequences are 79% similar to the SARS pathogen and approx. 50% similar to the MERS-CoV. There is a high correspondence of approx. 90% with already isolated and sequenced viruses from bats. For all three new types of corona viruses (2019-nCoV, SARS-CoV, MERS-CoV), it is possible to determine the origin of viruses from bats using gene sequence comparisons.

Disease development of insensitive persons

The virus seems to lead to a milder disease in many cases, much frequently compared to SARS and MERS. Especially in younger healthy people with a strong immune system, an infection can remain without clear symptoms or only cause a slight fever. In such cases, the infection usually heals within a week. One case was reported by a child who was infected but showed no symptoms. In the first 425 cases of illness in Wuhan, there was no child under 15 years of age. Even in the first cases in Germany, the origin of the chain of infection was initially assumed to be asymptomatic. It later turned out, however, that the person of origin had non-specific illness symptoms such as body aches, which, however, were not particularly noticeable and were interpreted as jet lag. During talks at a seminar, the infections did take place. Overall, the disease development of the infected was mild, presumably because they were younger and healthy people (no people in the risk group). Based on the people who were infected during the seminar, it was possible to estimate that a more intensive discussion from about 15 minutes in close distance was necessary for the infection. In the case of seriously ill people with a significantly higher viral load, a shorter contact could already lead to the infection.

Disease development of susceptible

The risk group includes, in particular, older people (older than 60 years) with already weakened immune systems, risk behavior (smokers) or pre-existing conditions (diabetes, heart diseases etc.) which have weakened resistance. However, some younger people died, who at first could not be clearly identified as belonging to this risk group.

An analysis of the first 425 cases of illness in Wuhan showed: The average age was 59 years and 56% were men. No children under the age of 15 were affected. In the first evaluation of 41 cases, significantly more men were affected. But that can also be in connection with the employment and activity on the “seafood market” and the first wave of infection in Wuhan.

The following symptoms of disease were observed in susceptible individuals in the initial phase: fever, dry cough, muscle and body aches, chills, general exhaustion. The lower respiratory tract is mainly affected. If the disease progresses, shortness of breath and pneumonia occur. If a severe illness develops, pneumonia leads to death.

As a rule, no improvement could be achieved with antibiotics, since they fight secondary bacterial infections but cannot influence the cause, viral pneumonia. Many patients have a decrease in the number of white blood cells (lymphocytes), which are presumably almost completely used up in the immune system reactions, and severe inflammation of the lungs due to an excessive immune response. High levels of inflammatory cytokines are found in the blood serum, which correlated with the destruction of the lung tissue. Some scientists who examined SARS and MERS more closely assume that the cause of serious illnesses was because of the immune response was poorly adapted: there was no change from the reactions of the innate to the reactions of the acquired immune system. It was observed that even the viral load decreased in the severe course, but the disease and inflammation promoting cytokines continued to increase. Corticosteroids were used to slow down the excessive inflammation. With SARS and MERS, no clearly recognizable effect on the course of the disease could be achieved. In CT (computed tomography) you can often see glass-like shadows in the lungs of presumably collapsed tissue.

The upper airways were affected less often, i.e. there was rarely a runny nose or sneezing (would make it easier to spread via droplet infection). However, new studies have shown that even without striking symptoms of the upper respiratory tract, a high virus load can sometimes be detected there, even days after the patient appears to be cured.

Since the beginning of February, diarrhea and viral findings in the rectal smear or excretions have been reported in rare cases, so that extreme caution is also required in the toilet area. A toilet flush without a closed toilet lid can distribute a number of fine droplets (possibly loaded with virus particles) in the room. With MERS and SARS, diarrheal diseases occurred in about 20-25% of the patients.

Overall, there are few specific symptoms due to 2019-nCoV. The symptoms that occur can also be triggered by other colds.

Analysis of deaths and statistics

A Chinese release on the first 490 deaths found:

80% of the deceased were over 60 years old, 75% of the deceased had previous illnesses. The youngest deceased was 36 years old and died of heart failure.

Not all of the deceased had a fever before they were hospitalized. For example, there was a 66-year-old man who had irritable cough on December 22. On December 29th he had severe shortness of breath and from mid-January he needed artificial respiration. In this case too, the course of the disease extended over many days.

Due to the often long course of the disease until death, one must also be very careful with the interpretation of the previously reported death rate (case fatality), which is given as 2 - 3% of those infected. However, the infections increase by leaps and bounds every day, while the deaths only become apparent weeks later. It makes more sense to me to put the number of deceased in relation to the number of people who have been healed, although even here a distortion is likely, since the healing process is probably faster than the severe course of the disease until death.

For a correct calculation, one would have to take the new diseases one day and follow their further development and divide them into cured and deceased. And this procedure for each day separately in order to gain a statistical mean.

Looking at the data from February 6th in China:

30,827 cases, including 3863 (13%) in critical condition;

635 patients died and recovered in 1615.

This means that off the dismissed until this day 635 (28%) of the patients registered in the hospital have died and 1615 (72%) have been cured. As a patient admitted to the hospital, the mortality rate is rather unsettling. And if this relationship from death / healing continues, this would result in 30827 patients (the total infected minus those who have already died and those who have been cured) on February 6 to a proportion of around 8000 dead who could die in the next few weeks.

A mortality rate still cannot be calculated because one does not know the probably large number of mild infections that have not been recognized. The exact rate will only be able to determine later with antibody tests, in which the population is tested with random samples to determine how many actually had contact with the virus.

Late diagnosis: The case Dr. Li Wenliang

The Chinese medical doctor was the first to warn of the novel corona virus. He suspected SARS had broken out again. On December 30, he warned colleagues in a chat group that they should protect themselves from possible infections with protective clothing. Four days later, he was visited by officials from the security bureau and had to sign a document accusing him of making incorrect comments and rumors of disturbing the social order. For the first weeks of January in Wuhan, the official assessment was that there is only infection in contact with animals. There was no recommendation for protective clothing. 16 medical staff were infected in the following days, including Dr. Wenliang.

He did carefully document the development of his disease. On January 10 a cough startet, fever showed up on January 11, and he got hospitalized on January 12. He was tested for the virus several times, but the test only showed the infection on January 30th. The 34 year old doctor died on February 7. The disease lasted for 28 days. The virus cold only be tested positive after 21 days.

In the case of the sick family in Germany, all five people initially showed symptoms of the disease, but the test only showed the virus in two. Many days later, two more could be tested positive to virus infection. Since the virus spreads mainly in the lower respiratory tract, it may be difficult to get samples in which it is already present in detectable threshold.

Epidemiology and distribution

The average incubation time, i.e. the time span from infection to the first recognizable symptoms of illness, was on average about 5 days with a large fluctuation from a minimum of 2 days to a maximum of 14 days. There are already some hints, that incubation time could be up to 20 days and more in rare cases. Basically, these are orientation values with a certain error, since it was probably difficult in many cases to correctly determine the day of the infection retrospectively. There is also an individual, different body perception of when someone defines himself as sick. Observations have shown in some cases, that someone can spread infections even a few days before the first symptoms of the disease appear.

Infection occurs through droplet infection (e.g. sneezing, talking to someone in close distance), smear infection over surfaces, presumably also by excretions and bowel movements. The droplet infection always depends on the number and intensity of the person‘s contacts. It is now expected that, in some cases, further transmissions are possible from the third day after the infection. However, the transmissions require relatively intensive and close contact, especially in this early phase, since the viral infection mainly settles in the lower respiratory tract and there are usually no symptoms of the upper respiratory tract, e.g. runny nose, there. Runny nose and sneezing cause a wide spread via droplet infection. Based on observations, it is assumed that, a successful transmission of the virus occurs during a conversation at a distance of about 1 m from the interlocutor and a duration of around 15 min. Direct coughing in direction to the other person can of course lead to transmission immediately.

How long the novel virus can survive in the environment has not yet been precisely investigated. But in best conditions for virus it may survive up to one week and longer. I try to derive some orientation values for environmental survival of the virus from experiments with normal corona viruses or SARS-CoV. In China, many people use sprayer to disperse disinfectant in public places. Even vehicles spray tons of disinfectant.

The evaluation of the first cases of illness in China show: About 20% to 30% of the patients develop serious diseases of the lower respiratory tract and pneumonia, about 2-3% of the patients die, despite of the medical care, from the consequences of the serious illness, mostly pneumonia. Bacterial infections can also cause pneumonia. This usually happens through a secondary infection with bacteria such as pneumococci, which can easy attack the lung due to the weakened condition oft he patient and the previously damaged airways. Medical treatment with antibiotics can cope with these secondary infections. But this is not the case with pneumonia caused by the coronavirus. It is caused virally and cannot be stopped with antibiotics. In some deceased, secondary infections with bacteria and fungi were also found. When breathing threatens to fail, artificial respirators and other high-tech medical devices can help, but ultimately the patient‘s own defenses have to win or the patient dies.

However, the relative percentages of the diseases should be assessed with caution, since the exact number of infected people is not known as a reference point. Due to the often mild course of the disease, many patients remain undetected and do not appear in the statistics.

In Wuhan, approx. 90% of the sick came to the hospital at the earliest 4 - 5 days after a recognizable illness. So there was a long contagion phase, since they were not immediately isolated.

In a pregnant woman who was infected, the virus was detected in the baby 30 hours after birth. However, it is not clear whether the virus was transmitted through close contact or already in the womb. There were also some other pregnant people infected, where the child was born without the virus.

How long the illness lasts is variable. If the course is mild, those affected can be well after just a few days to a week. If the course is severe, the disease can drag on to about 3 weeks until death, depending on how long the patient can be supported with intensive medical care measures. Observations have shown that those affected can still be contagious for a few days after the end of the symptoms. The virus was still found in the nasopharynx and sputum. To declare a patient cured a labor test has to confirm free of virus.

The fatal course of the disease of 2019-nCoV is significantly less than that of the other coronavirus variants SARS-CoV (9% of patients died) and MERS-CoV (30% of patients died). The severe course of the disease mainly affects older people from the age of 60, people with a weakened immune system or chronic previous illnesses. However, 2019-nCoV has a much greater spread than SARS-CoV or MERS-CoV, presumably due to many mild illnesses and the risk of infection transfer without clearly recognizable symptoms of disease.

Origin of the virus

Where the virus originated is not yet fully understood. First, a Chinese scientist from the University of Beijing did analyze gene sequence of the virus and assumed that the novel coronavirus could have arisen from the recombination of two coronavirus strains that occur in two Chinese snake species. The snake virus theory is meanwhile considered rather unlikely.

At present, a precise phylogenetic family tree has been created, which shows the origin of already known isolated and sequenced viruses of bats (Rhinolophus sinicus - Chinese Rufous horseshoe bat). Since bats were already in hibernation at the time the infections appeared, an intermediate host is still suspected. Several animals are suitable for this, since the ACE2 protein of lung cells, where the virus is binding first to infection, occurs in a similar form in many other animals. That could be pigs, cats, monkeys, ferrets or others. Mice or rats are out of the question their ACE2 shows some differences. There is a high probability that the virus could come from viruses from the endangered armadillo pangolin, where Chinese researchers have found viruses with a 99% similarity with 2019-nCoV. The pangolin is used in traditional Chinese medicine (dandruff) and also eaten, although it has long been protected.

At SARS-HCoV, the virus was transmitted to humans via sneak cats, which are considered a delicacy in China. A similar case would also be conceivable at the seafood market in Wuhan, since many wild animals are also sold there. The virus could be transmitted to humans through unsanitary contact with infected animals. This theory was supported because many of the first patients with severe disease were dealers or sellers in this market. However, people who are unrelated to the seafood market were also found in the first cases of illness, which were dated back to early December 2019. The virus could also have come from somewhere else and only got its first human-to-human transmissions at the seafood market. There could already be a reservoir of animal hosts from which a jump to humans is possible again and again under suitable conditions, directly or via various intermediate hosts. Of course, the virus can change even further in this animal reservoir, to a more harmless but also more dangerous strain.

The intermediate host at MERS-CoV was camels and dromedaries, and the transmission was probably via the excretions in the barn. Virus particles could be detected in the air in the stable of infected people.

Where 2019-nCoV comes from can only be clarified by checking animals in regions around. But at the moment there should be no time for that as China is in emergency. Unfortunately, the inspection team checking the seafood market in Wuhan failed to examine the animals for sale.

Many properties of the new Coronavirus 2019-nCoV have not been researched in the short period of time since the first identification. However, we can learn a lot from the related coronaviruses SARS and MERS, which have also developed in a similar way from a virus reservoir in bats. From the observed and documented infection chains, we can learn a lot how to deal with the Wuhan corona virus and what characteristics can be expected.

Chapter 3.       Your Risk & the Symptoms

In this chapter, we’ll go over who is at the most risk as well as the symptoms that you need to look out for. As with any virus, some people are more at risk than others, and knowing the symptoms means you know what to look out for.

People at Risk

The Wuhan coronavirus can affect people of any age if they are in the area that the virus is circulating in. if you have pre-existing medical conditions, such as diabetes, heart disease or so forth, you're at a higher risk. You're also at a higher risk if you're elderly, which can also make it easier to become severely ill with the virus. However, there is a study that was published in January 2020 from the New England Journal of medicine that speculates that children are less likely to become infected, and those that are infected will likely show milder symptoms. Extremely young children, however, are also at high risk because their immune system has not completely developed.

Chinese health officials have announced as of January 2020 that the death ratio was skewered towards elderly men who already had preexisting medical conditions. Younger patients and women, including a young man with no health issues previously, have also died from the virus. So while it isn’t likely for this virus to cause death, it is also possible for it to do so. Dr. Guan, who is from the University of Hong Kong, worries that we have a chance of a pandemic outbreak. He has traveled to Wuhan in hopes of helping out but reported quickly feeling very angry and powerless. He left early on. Dr. W. Ian Lipkin, from Columbia University, advised the WHO as well as the Chinese government that there is no way to contain the spread of this disease.

The Symptoms

There is a range of symptoms to look for, and these symptoms can range from mild to severe as well. this is another reason it can be hard to diagnose the Wuhan Coronavirus. These include fever as well as respiratory symptoms. These respiratory symptoms can take the form of coughing or even shortness of breath. There has also been kidney failure, pneumonia, and death in some cases. One of the main issues with diagnosing and therefore treating this virus is that it acts very much like other illnesses at first. There are also not known as medications or vaccines that can help patients. So, those that are being hospitalized are primarily being treated with oxygen, rest and fluids.

As reported in January 2020, the wait time for medical assistance in China is currently 36 hours. The government has required that three hospitals with one thousand beds to be built within a week. This is to help manage the flow of patients. They also hope to bring in more medical professionals to ease the burden that has been placed on both nurses and doctors who are currently working around the clock to try to keep up with the number of patients coming in. One doctor has died from a heart attack simply due to the brutal demands of the sheer number of patients coming in. anyone with symptoms of this virus is being asked to immediately go to their local hospital. Those in the US are also being instructed to call their hospital to avoid infecting others. The list of symptoms is as follows.

- Fever

- Cough

- Runny Nose

- Muscle Pain

- Shortness of Breath

- Headache

- Breathing Difficulties

- Diarrhea

- Fatigue

These were the initial symptoms, but as the illness progresses the symptoms do as well. those who are hit by a severe form may have the following.

- Severe Acute Respiratory Syndrome

- Pneumonia

- High Fever (Above 100.4 F)

- Seizures

- Sepsis

- Kidney failure

- Passing Out

- Abdominal Pain (One of the earlier symptoms)

- Nausea (Can Be Seen Early On)

- Vomiting

Those who do not get emergency treatment quickly enough ave a higher chance of dying from this illness. There have been reports that people experience flu-like symptoms. They can start to recover, and then still pass out from the sheer viral overload. If you have any combination of these symptoms and have recently been to China or in contact with someone who had, you need to seek immediate medical attention. It’s also important to note that not every patient will start with a fever.

All signs currently indicate that this virus is airborne, and it has traveled to twenty-eight countries. Luckily, while it has gotten to a large number of countries, the cases per country are still very small. Many people still remember the Ebola virus, since its outbreak wasn’t long ago. It’s important to note that these are different. The Wuhan coronavirus has more virulence and potency, and therefore should be taken more seriously. It's important to be taken seriously, and the primary objective is to slow the spread. As of February 2020, a team of researchers published a study review in the Journal of Hospital Infection, which states the Wuhan coronavirus is likely to survive on surfaces for a period of four to nine days.

Of course, this is given it stays at 'room temperature'. Cooler temperatures and high air humidity can make it easier for the virus to stay on these surfaces longer. Some surfaces are more suitable living environments for this virus than others. This includes paper, plastic, wood, aluminum, and glass. Studies have shown that stainless tell is suitable when the temperatures are low. Those working at hospitals have to keep any object within the vicinity of their patients and have to be as clean as possible including bed frames, bedside tables, door handles, call buttons, and anything that's made of plastic or metal.

Fatality Rate

So, let’s talk about the death rate next. This virus has traveled to twenty-eight countries, and it has killed over six hundred and thirty people. This virus had infected more than thirty-one thousand people. It seems to be less deadly than SARS-CoV and MERS-CoV. According to WHO, it only seems to have a fatality rate of two percent thus far. Most of these cases are concentrated in Hubei Province, China. The fatality rate in that area is at 3.1%, which is higher than the global figure. In Wuhan, the rate is 4.9%, which is the highest so far. So far, two-thirds of these death cases are male, leaving only one-third of them being female. Death is more common for people over sixty, since these deaths account for more than eight percent, and more than seventy-five percent of these deaths are with people who already had underlying diseases.

The Transmission Rate

The transmissibility rate means how rapidly this virus spreads. This can also be called the attack rate of the virus, which is indicated by its reproductive number. This will show you the average number of people a single person can infect with the disease. So far, this is between 1.5 and 4.5 according to preliminary studies. On average, this means each case can make three to four new cases.

The Incubation Period

Incubation is the time between when someone contracts the infections and the time it takes them to show symptoms of the virus. Since very few studies have been done since the virus is new, the incubation period that’s been found varies widely. It’s said to be between two to fourteen days, and the average is a little over five days. Of course, keep in mind this varies greatly between patients. The incubation period may also be affected by age. It’s shorter for people who are seventy years old or older.

Chapter 4.      What to Do During an Epidemic or a Pandemic

Disaster Preparedness

The CDC, the Red Cross, the Department of Homeland Security and FEMA (The Federal Emergency Management Agency) have all published their own sets of guidelines for the public to follow in the event of national emergency. These guidelines can help you to make sure that you have everything you need, from mindset to supplies, in the event of a national emergency.

These are typically used for situations of natural disaster like hurricanes, tornadoes, tsunamis, earthquakes, and things like that. Many of the tips are helpful for any disaster, but ensure that you refer to your local authorities on the protocol for evacuation in the case of widespread illness. In many cases, they will insist that you remain indoors.

Here are some things you should be aware of when it comes to planning for something hitting the area where you live.

Be aware of the situation you’re actually facing. Without all the sensationalism and group fear or mass hysteria that might be hitting your area, take a look at what the situation really is. Figure out what you’re really in for and what you should expect. With preparedness, it’s always best to hope for the best, prepare for the worst without going too overboard. You don’t have to be a doomsday prepper!

Learn the most effective evacuation routes for your area and find out how best to avoid traffic if an evacuation is called. Evacuations are a fairly common occurrence when you take the entire world and all the natural disasters that can occur. That being said, it doesn’t mean that everyone in the world has or even will experience one. The traffic is unbelievable when an evacuation is called, so the best time to evacuate is before that point. Keep an eye on the websites for your local government, as there is always a great deal of chatter before the evacuations are really called. Figure out where you can go that’s safe, figure out the most direct route to get there, and plan to get on the road before everyone else.

In situations that are causing a huge stir in your area, have a plan to reconnect with your people. Cell towers can go down, internet can get choked up, and communication can be temporarily blocked. In such situations, make sure that you and your loved ones have a rendezvous point and make a plan to try to touch base with one another every so often to see if you’re able to get through. Try this once every few hours, because much more frequently than that will simply jam up the system.

Sign up with your local government to get emergency alerts. This will tell you the state of your area and what messages your local government would like its citizens to have.

Have a plan if things strike while you’re not at home. Have a plan for getting you back to your home to get your supplies, refer to your evacuation plan, refer to your communication plan, and get out of the area as quickly as you can.

Have a kit on standby. Your kit should have some basic supplies like snacks, first aid, water, batteries, and things that you might need if you find yourself between homes or between areas with all the modern conveniences.

Keep anyone’s special prep in mind. If you have children, seniors, or people with special needs in your home, take their needs and supplies into account when you’re preparing. Children will often need entertainment and activities to keep their spirits up and to keep them occupied as well, so don’t discount that!

Have a plan for your pets. Keep a little bit of extra pet food on hand, have a shallow bowl for them to eat and drink out of, have a disposable litter tray handy, get a carrier id you don’t have one, and maybe an extra leash and some treats. Pets can be hard to wrangle in the middle of this kind of tumult, but having a plan makes it all the easier.

Brush up on some handy skills. If you don’t know how to use a fire extinguisher, give CPR, shut off power, or what to do in cases of possible infection, do a little bit of research on how to do these things or take it a step further and get certified. It’s always better to be more prepared than you need to be.

Find out if there is a local community effort to support. If there is a center in your area that is contributing to local efforts to support and improve things in the middle of a situation and you have the time and effort to lend, consider volunteering!

Stocking Up on Supplies

It can be hard to know what kind of supplies you need to stock up on in the middle of a large scale emergency. For many cases of natural disaster, you want to be sure that you’re prepared for the loss of infrastructure. In most cases of widespread illness, this is not a concern.

If you would like to have a stock of supplies that you can use in the event of something happening to your area or community, you can refer to this list of essentials to have in your house just in case things get a little bit dicey.

Water. It is recommended to have three gallons of water on hand for each person in the house, to be used at a rate of one gallon per day.

Food. Having a three-day supply of food on hand for each person in the house is a great way to stay prepared for any eventuality, though if you are quarantined, you may need to procure enough food to last you for two weeks. Consider grocery delivery to your home if you need to stock up as soon as you are quarantined and have the delivery person leave the groceries on the doorstep, only opening the door once they have gone away. This will help to prevent the spread of illness.

A working radio with either batteries or a hand-crank. This will allow you to listen to any emergency broadcasts being put out by local stations.

A flashlight that either has extra batteries of a hand-crank. Hand-crank items are much more inexpensive and much more reliable than battery-operated ones. Batteries, when left for a long period of time, can leak. If you do store your flashlight for later use, leave the batteries stored separately.

A first aid kit with all the bells and whistles. Amazon has some pretty comprehensive first aid kits with just about everything you can think of and several things you can’t. Consider buying one of those and leaving it in your home just in case of any emergency.

More batteries than you need. You never know when the batteries in your flashlight or radio could die, so having some extras on hand can help you to keep the lights on and to stay informed.

Face masks to help you to breathe contaminated air. Make sure that you have the right masks for the situation you find yourself in.

-            For Smoke: particulate respirators, N95, P100, and NIOSH masks can help to protect your lungs from the harsh smoke in a fire.

-            For Pollution: N95 masks are best for air pollution.

-            For Dust: N95 or R95 masks can help to keep dust and oily particulates from getting into your lungs.

-          For Contagion: DFM, N95, and P2 masks are the best to keep your lungs safe from harmful contagions, mists, fumes, and dust. You can also look for something labeled “disposable respirator.”

Basic tools. You never know what you’re going to need when you’re without help or access to a hardware store. Keep a set of basic tools to help you get through just about anything that might come up to or repair something if it breaks while you’re quarantined.

Sanitary products. Moist towelettes, pads, tampons, trash bags, plastic ties, toilet paper, soap, and any other products that one might need for personal sanitation.

A can opener for canned goods without a pop-top. Make sure you can opener is ready to go!

Maps for your escape route. If your GPS goes down, you need to know where you’re going!

Cell phone chargers and a backup battery. If you know you’re going to be leaving the area before an evacuation is called, charge up every device in your home, including any auxiliary batteries you have one hand to make sure you have access to your devices on the go.

Keep Your Distance

It is recommended that you don’t come into close contact with too many people while you’re out and about. You want to make sure that you don’t sit and relax in public areas within about six feet of other people, you don’t want to put yourself in situations where you’re packed in close and tight with other people, and you don’t want to shake too many hands.

If you find yourself about to get into a packed elevator to ride to the thirtieth floor, maybe wait for the next one! If you’re only going up a few flights, consider taking the stairs instead and washing your hands after using the railings. When you’re worried about the contagion of an illness, you will want to make sure that you limit your contact with germs as much as you can. Doing this means admitting that you don’t know who or what has touched public surfaces before you. When in doubt, wash your hands always .

Limit Your Time Out in Public

By limiting your time out in public places, you are limiting your exposure to any contagious illnesses that are out there as well. This isn’t to give you the sense that the outdoors are unclean and that you shouldn’t go there. This is just to say that, in the middle of an epidemic, if you are out in public places, your risk of exposure does increase.

Try to make sure that the time you spend outside is brief and that the time you spend in your personal and workspaces is spent keeping your hands away from your face, washing your hands regularly, and keeping your contact limited to as few people as possible.

Make Sure You’re Immunized

As of right now, there is no vaccination for COVID-19. However, making sure that you are properly immunized and that your immune system is operating at peak levels can minimize your risk for infection, illness, or symptoms.

Speak with your doctor about the immunizations that you’ve had and make sure that you are up to date on all the ones that are typical for someone in your age group, in your area, and with your medical history.

If you have concerns about the immunizations or about their effects on you, speak with your doctor about anything that might cause you to hesitate. Your doctor can provide you with all the right information about your body, about your needs, and about what you require in order to stay as healthy as possible in the face of a growing illness. Doing all you can to keep yourself clear of any illnesses will also help to keep public health on the rise as well.

Chapter 5.       Preventive Measures by Countries

Ever since the outbreak of this virus in Wuhan, various preventive measures have been adopted in China on airports and railway stations to screen travelers traveling from affected areas for higher temperatures. In this chapter, a brief discussion about the preventive measures taken by various countries shall be undertaken to create awareness at the public at governmental levels to adopt measures aimed at preventing such a virus from entering a country.

Starting from the United Kingdom, where the Heathrow Airport, which receives direct flights from Wuhan, China, has tightened surveillance of passengers coming from Wuhan China, who shall be screened by an airport Health team. Furthermore, to facilitate sick passengers, detailed guidance is displayed in multiple languages: English and Mandarin, being the most noteworthy. The British government is also attempting to screen passengers who had traveled from China, especially Wuhan, before the outbreak became known.

In America, the CDC - Center for Disease Control issued a level 1 threat advice for traveling to China. In addition to this, effective screening of people traveling from China is underway at all airports receiving international flights. Going by the estimates, around 60,000 to 65,000 people travel from Wuhan to the United States on a yearly basis. In response to the threats, the John F. Kennedy International Airport in New York City, the San Francisco International Airport and the Los Angeles International Airport began the screening of passengers for symptoms, well ahead of the Chinese New Year season. Later other airports, namely the O'Hare International Airport in Chicago and Hartsfield–Jackson Atlanta International Airport, have also been added to the list.

The United Arab Emirates, being a large market for foreign workers, attracts thousands of workers from China every month. In order to cope with any possible outbreak of this virus in the United Arab Emirates, the busiest Dubai International Airport and the Abu Dhabi International Airport have started screening travelers arriving from China for temperature in the fever range.

In Turkey, the Ministry of Health declared that the country had prepared quarantine rooms, inspection focal points, and thermal cameras to screen at the airports, while adding that such measures have not been considered necessary by the World Health Organization.

In Indonesia, a hefty amount of thermal scanners have been installed at more than 135 airport gates to prevent an infected person from entering the country.

The most effective prevention regime has been implemented by Russia, where the consumer health watchdog ‘Rospotrebnadzo’ advised travelers and tourists to avoid visiting Wuhan and China as a precautionary measure. The watchdog also advised the public not to visit markets selling animals and seafood and Chinese zoos. Moreover, based on WHO's recommendations development of a vaccine against the virus was underway. Also the Russian city of Blagoveshchensk situated near the Chinese border has limited its access to the country while Cultural exchanges and official visits to China have also been canceled.

Bangladesh has also initiated preventive measures by enhancing screening measures at Shahjalal International Airport.

In Armenia, the passengers arriving from China will be screened for fever, but entry restrictions have been imposed. The Armenian Ministry of Health shared the details.

Sri Lankan authorities have been very proactive in dealing with Coronavirus. The most worrisome matter related to the presence of Sri Lankan students in Hubei Province, the number was less than 100, while most of them returned before the lockdown in Wuhan. While Sri Lankan embassy in Beijing estimated that still 30 Sri Lankans were in Hubei province at the end of January. Ministry of Health in Sri Lanka stated that Quarantine Unit at Bandaranaike International Airport is screening passengers for symptoms and infants, children, pregnant mothers, elderly, and people who suffer from chronic diseases have been advised to avoid travel, especially to China.

Brazil’s Health Ministry has issued guidelines for medical staff to isolate people with fever, cough, and pneumonia symptoms in case they have a recent travel history for China. Hospitals have been designated, and the staff is given adequate training to manage and test suspected patients, while no mention of any screening at the airports.

Georgia has canceled all flights from Wuhan and the rest of China, while the Health Ministry has declared that every incoming passenger from China will be selected for C-Virus screening.

Nikola Tesla Airport in Belgrade, Serbia, also adopted precautionary measures by installing thermal cameras.

In Cambodia, according to the Cambodian Ministry of Health, preventive measures in the form of thermal scanners have been installed to screen incoming patients from China at Siem Reap, Phnom Penh and Sihanouk international airports. However, in January, the Ministry of Health had informed that still no case had been detected as yet.

Kazakhstan’s Almaty Airport staff and Almaty medical brigades conducted a medical exercise to gauge their level of preparedness. Minister of Healthcare disproved messages and information citing that infected people had been traced in the country. Also, Kazakh students are in Wuhan, but no reports of their infection were available at the time of writing this book.

The North Korean authorities have decided to ban foreign visitors from touring the country.

While Lithuanian authorities confirmed that medical exercises had been conducted and screening of patients coming from China is underway at all three airports in Lithuania. The authorities further added that National Public Health Center specialists are monitoring the situation on a day to day basis.

In Mongolia, the Ministry of Health quarantined all universities, colleges, schools, and kindergartens until March, while at the Chinggis Khaan International Airport and all border entry points with China have been beefed up with more security, and continuous medical checkups of passengers from china and other infected countries.

Maltese authorities informed the media about preventive measures relating to the public and health and training of workers to maintain sanitary guidelines to prevent the spreading of the virus.

Thailand also joined this global drive to prevent the spread of this virus, although al little too late as cases of infection have been detected. However, Thailand initiated the screening of passengers at four airports: Chiang Mai International Airport, Suvarnabhumi International Airport, Don Mueang International Airport and Phuket International Airport. Mainly people coming from Wuhan are scanned.

Since the detection of the virus in four Chinese nationals in Pakistan, the government of Pakistan has also taken steps to screen passengers at Islamabad, Karachi, Lahore, and Peshawar to prevent this virus and infected people from entering the country. Similarly, the Pakistan International Airlines also decided to pre-screen passengers at the Beijing Airport before they board the plane on its flights.

In Vietnam, authorities ordered measures to prevent and counter the spread of the disease. Measures such as closing the border with China, cancellation of tours and transit to Wuhan and subsequent cancellation of all flights to the affected areas.

From the above discussion relating to the preventive measures adopted by various countries, a reasonable conclusion can be drawn that the most most common method adopted to ensure prevention is the screening with thermal cameras and thermal scanners to check for temperature fluctuations in patients while countries with frequent flights to the affected areas have taken much more drastic measures. Hospital staff has been trained, and the necessary guidelines have been issued to the medical staff. To prevent the outbreak of the novel Coronavirus (2019-nCoV), countries, states, and metropolitan cities must adopt preventive measures while taking a holistic view of the situation and only through effective and efficient screening can they prevent such a virus from spreading.

Guidelines for Prevention

This chapter pertains to the management and prevention of Coronavirus. Prevention remains a tricky affair for any viral and virus-based illness as it requires years and years of research and testing to finally achieve success in creating the most potent vaccine to ensure prevention from the said disease.

In the case of Coronavirus, the best possible prevention is to avoid exposure to the virus. To date, no effective vaccine exists for 2019-nCoV infection. Moreover, since the epicenter of the present outbreak of this 2019-nCoV infection is Wuhan, China, people traveling to Wuhan must ensure that remain agile and ensure necessary precautions to avoid contact with this virus. The usual preventive actions and precautions that aid in curbing the outbreak of illnesses caused by respiratory viruses should be observed. These include the following.

•Keeping the hands clean as the first step in effective and efficient prevention. Washing hands with soap and water for at least 20-30 seconds is necessary.

•If there is no availability of water or soap, then any alcohol-based sanitizer must be used to keep the hands clean, especially after approaching any person suffering from any illness; it is better to sanitize the hands.

•Keeping the contact to the minimum, and that does not imply contact with another person only, but also it is better to avoid touching on one's eye, nose, mouth, or face without washing or sanitizing hands.

•In illnesses, where methods to complete cure are yet not known or the vaccines to prevent the attack of such viruses is still in the development phase, it is better to avoid all sorts and forms of contact with the sick person.

•Quarantining the sick person and the premises is always the best exercise. Also, people from infected area or suspected to having had any contacts with infected people, should be kept in quarantine at least for 14 days, tough the suspect exist, that a 24 days period could last from the infection to the appearing of the first symptoms .

•People suffering from eye redness (conjunctivitis), fever, cough, or flu facing difficulty in breathing must seek medical care sharing complete travel history with the doctor.

•In case you are sick and exhibit symptoms of a disease or the symptoms of 2019-nCoV infection, then it is better to avoid public places and confine one's self to home.

•As in the case of flu or cough, it is advised to cover the nose and mouth to avoid any inadvertent spreading of germs.

•The best practice in the case mentioned above is to either use a tissue and dispose of it after the use. A cloth may also be used, but it must also be discarded to avoid contamination of people who might come in contact with the cloth.

•The use of the face mask is the wisest choice in diseases that are related to the respiratory system, and the virus is carried through the air.

•Cleaning the surroundings is a must as well. Thus to ensure prevention, the surfaces, and objects coming in frequent contact with the patient may also be cleaned and properly disinfected to ensure the protection of other people.

The people traveling to the affected areas in China, in order to prevent this Coronavirus should avoid travel, to begin with. Secondly, while traveling to other parts of China, the travelers should strictly adhere to the preventive regime discussed at length in the preceding pages.

In addition to the preventive regime and avoidance of travel to affected areas, avoiding contact with animals alive or dead is also essential. Thus any visit to animal markets touching uncooked meat or produce from such animals must be avoided at all costs. Also, the consumption of raw or undercooked animal products is not advised and, therefore, should be avoided to ensure prevention. Products such as raw meat, milk or animal organs should be handled with diligence and necessary caution so that uncooked foods are not contaminated.

Two essential explanations are needed, first that the symptom of fever may not be existing in some patients, for example, very young patients or elderly and immunosuppressed patients on fever-lowering medications. Thus clinical judgment is required and advised to guide the testing of patients. Also, the act of caring for, attending to, and remaining in close vicinity of the patient. Lastly, the fact that a person comes in direct contact with infectious secretions of an infected person suffering from the disease.

Now some measures and guidelines for people having a recent travel history that bears the name China. In case you have traveled to China in the last 14 days and feel sick with fever, cough or breathing heavily, medical care and help are advised at the earliest.

•You must inform the person responding to you at the healthcare desk that you have recently traveled to China.

•You must avoid contact with other people and patients.

•You should not travel while sick.

•Covering face with tissue or cloth while sneezing or coughing.

•And wash hands as suggested above.

In the end, some clinician information needs to be discussed, as well. Healthcare providers must obtain a comprehensive travel history for patients with fever and respiratory symptoms. In case patients with these symptoms have visited Wuhan on or after December 2019 and show illness within two weeks of traveling, then risks of infection to the 2019 novel Coronavirus are considerably high. They should notify infection control personnel and your local health department at their earliest. Furthermore, adopt all necessary precautions such as quarantine and isolation and restricting access of staff to the affected areas. Even though routes of communication and infection are yet to be fixed, the CDC endorses a cautious methodology during the interaction. Especially with patients under investigation and showing a high risk of the infection. Such patients should wear a surgical mask as soon as they are identified. It is also advised that their evaluation is done in a private and isolated room: ideally, it should be an airborne infection isolation room. Also, the access should be restricted, and personnel entering the room should be made to use standard precautions, contact precautions, and airborne precautions, and the use of eye protection should be mandatory.

While these guidelines are not exhaustive, yet they create a considerable barrier for the protection of individuals and aids in prevention. The knowledge and information of medical staff and doctors is much more technical, and this book is written for the general public’s consumption.

Chapter 6.       Global Spread and Reponses

The outbreak, which the World health organization has referred to as an international Public Health concern, has triggered research, funding and action from health agencies across the globe, countries and governments, as well as private and personal efforts. The WHO has said that the sum of $675 million for preparedness and response plan would need to be launched. This plan would cover the months of February through April.

Also, In China, the government has put immigration measures in place to ease the entry of non-governmental organizations willing to come in and offer assistance in the fight against the outbreak. Humanitarian relief organizations such as Project HOPE have indicated interest in working through existing health systems and agencies in China.

The USAID delivered protective gears to Laos. Save The Children Fund delivered 36,000 face masks to Indonesian hospitals and to Wuhan. Mèdecin Sans Frontieres has also offered to support health authorities in mainland China and Hong Kong.

Other companies with no direct involvement with the items needed for protection in the care for patients have lent support by other means. For example, the hospitals constructed in Wuhan over 10 days had beds supplied to it. The 1000-bed Huoshenshan Hospital and the 1600-Leishenshan Hospital had such fittings taken care of. The State Grid Corporation of China has also made power supply guaranteed in certain facilities with network cables channelled to the newly built facilities as well as the installation of 5G remote video diagnostic centers which has enabled medical staff to carry out diagnostic procedures on suspected patients remotely.

Another strategy than has been of help is the fight of misinformation. Companies like Baidu and Qihoo 360 have set up platforms on their apps that help users know in real-time the locations of confirmed and suspected cases of the virus . This information helps travelers in avoiding the affected regions and further reducing any potential of spread. Others like Tencent' "Mepedia" and Ping An's "AskBob" are artificial intelligence programs that serve as remote doctors in answering questions and providing verified information on preventive and protective protocols to its users. Because of the economic devastating effect of the thousands of people who have had to miss work because of the quarantine measures in place, other platforms have come up with ideas to help a lot of people work from home. These platforms include Alibaba's DingTalk, Tencent's WeChatWork and Meeting, ByteDance's Feishu and Huawei's WeLink. Such platforms have added features such as video conferences and call time, online check-ins and industry-specific solutions.

On the aspect of education, schools are closed all over China to prevent further and faster spread of the virus. However, it's now easier for people to undertake classes and courses online. Online education platforms like Liulishuo, Onion Academy and Zuoyebang are offering free classes to students online, nationwide. Lecturers and university professors are not left out also as they can now conduct online classes to a wide range of their students who can attend these classes online from the comfort and safety of their homes.

Tech solutions are also being offered to aid speedier diagnosis and treatment. Softwares with AI computing capabilities, RNA predicting algorithms, high tech CT scanners, AI imaging, cloud platforms and remote advanced post-procession softwares are being made available to hospitals in Wuhan.

On the flip side, the global nature and approach to the corona virus outbreak has also brought about fringes in administration, political and diplomatic frictions. In the following weeks after the outbreak, questions and controversies have trailed the travel ban placed on Chinese citizens. This brings to mind the dilemma that surrounded the Ebola outbreak of 2014-2016 in which prohibitions were put in place to stall travelers from west African countries, which was a violation of the IHR (International Health Regulations).

The widespread use of quarantine has also been a topic of controversy. The city of Wuhan was placed on cordon sanitaire, an unprecedented action. The 11 million inhabitants of the city have been totally barred from entering or leaving the city and on a larger scale, 760 million people across the country have been restricted and in some form of residential lockdown. There is a mental side effect to this which many people have argued for and against.  Other countries like the United States of America , Australia have also imposed some form of quarantine or the other and immigration processes have been under close monitoring . The WHO has however, been silent on the above quarantine measures and the outcry they have raised.

The Impact of the COVID-19 outbreak on the cruise industry

Due to the peculiarities of cruise travel, which essentially brings a large number of persons together in close proximity, the risk of spread of infectious diseases are particularly high in such situations. This was seen in the case of the Diamond Princess cruise ship which had embarked on a holiday trip to Yokohama, Japan that was to morph into a deadly nightmare. About 3,711 cruise passengers and crew members were caught in the disease outbreak, and about 621 of them were confirmed to carry the virus. After a prolonged quarantine that drew mixed criticisms from international quarters regarding the handling of cruise ships, over a thousand of the passengers were allowed to leave the ill-fated ship, but not before two of the infected passengers had died.

The criticism was largely as a result of existing cruise travel regulations which view passengers on board ships as being outside of national borders and hence, giving countries the freedom to either accept or reject their docking. Such measures may be seen to rather than control infection spread, actually worsen it. In some other cases, this might seem to be the prudent step to take. An example is seen in the Holland America's Westerdam cruise ship which several countries rejected even with no reports on board of any cases of the virus, and which would later be accepted by Cambodia, a decision they may have regretted as it later was reported that one of the passengers tested positive for the virus. This regret however, may have been fortunately short-lived as the US CDC later confirmed that the passenger did not have the virus and indeed, neither did any of the other passengers.

Ports are refusing to take in cruise ships which have been either to Chinese ports or which have on board, Chinese passengers. According to their restrictive measures, passengers who have travelled to, or visited/ passed through China, Hong Kong and Macau within the proceeding 14 days before embarking would be denied entry into cruise ships. Other control measures include pre-boarding screening procedures such as temperature checks, as well as enhanced screening and medical evaluation for persons who display symptoms of the disease.

Chapter 7.       Protecting Yourself

Most private living quarters are relatively clean spaces relative to viral infection with the exception that other people who enter or even stand at the front door may be infected and bring the virus in with them—other family members, friends, delivery people, repair people, etc. After making any kind of physical contact with anyone who may be infected, it’s important to wash your hands as described above.

Avoid handling any item or object that has recently been touched by someone who may be infected. Wipe down any questionable packages with disinfectant before handling them, including items delivered by the postal service.

Shop online as much as possible to avoid crowds. Remember that anything you order may be touched by the hands of people who could be infected, including the delivery person. Wipe down the package before you open it, and if you believe the contents has been packed less than twenty-four hours before you received the package, wipe down the contents, too. For shopping that cannot be avoided, such as trips to the supermarket, try to shop at low-traffic times, such as immediately after the store opens or before it closes.

But…avoid home delivery of prepared foods or meals. People who cook, prepare, package, and deliver the food may be infected, and since there is often only a short time between preparation and consumption by the customer, the risk of being infected may be significant. To further lower your chance of catching a virus, prepare all your meals from packages or cans that you can be sure have not been exposed to other humans for at least one day.

Check for common air vents. Some apartments, townhouses, and other multi-family dwellings incorporate air vents that run between private living quarters. These vents are typically covered with metal grills and may be located in inconspicuous places in a corner, or near the ceiling or floor. If a neighbor is sick, take care to tape the vent over with plastic all the way around.

When caring for sick family member or friend, minimize close, face-to-face contact. Keep the ill person isolated in a separate room and have them use a separate bathroom, if circumstances allow. When holding sick children, place their chin on your shoulder so they will not sneeze or cough in your face. Use disposable surgical gloves when carrying for a sick person, or be sure to wash your hands after touching them and after handling their tissues or laundry. Periodically wipe down their living space and bathroom with disinfectant. Be sure that you don’t use their dishes or eating utensils without a proper washing, and be mindful keeping items like your toothbrush well-separated from theirs. If you sleep in the same bed, then make sure the sick person has their own pillow and that it stays separate from yours.

PROTECTING YOURSELF AT WORK

Research shows that, for a variety of reasons, most employees go to work when they’re sick or still recovering from an illness. This means that many of them are contagious. Viruses are often spread at work via coughing, sneezing, and touching contaminated objects.

Following these guidelines will lower your risk of being infected.

Avoid touching break room sink faucet handles. Studies have shown that break room sink faucet handles were found to be teeming with bacteria and viruses. Protect your fingers with a napkin or tissue, or clean the handles an antibacterial wipe or spray to clean it first.

Use care when operating the office microwave and coffee pot/water boiler. Use the same precautions as listed above (the same unsanitary research findings apply to buttons and levers on devices like these)

Avoid using the office kitchen sponge. Kitchen sponges harbor germs and sometimes aren’t replaced often as necessary. One study found respiratory and blood-borne pathogens lurking on sponges. Always wash your hands thoroughly after using one, and avoid cleaning anything that with it that you will be using to eat or drink (including spoons, forks and other utensils)

You can rid the office kitchen sponge of flu viruses by either running it through a full dishwasher cycle or microwaving it (while wet) on high for one minute.

Be careful when using vending machines. The buttons on these, too, have be found to have high levels of contamination. Vending machines are particularly unsanitary because not only are people who may be sick touching the buttons, but anyone using the machines is handling coins and/or paper money—surfaces on which viruses can survive for hours’ time.

Don’t eat out of the reception candy bowl or company snack dish. The reasons are obvious. Buy and keep your own personal snacks in your desk drawer.

Avoid sharing your keyboard and mouse, or using your colleagues’ computer. Keyboards are particularly unsanitary, one study claiming that they are thousands of times dirtier than a toilet seat. Keep a pack of disinfecting wipes handy at your desk to regularly wipe down your keyboard and mouse.

Avoid sharing office phones. Few office phones are regularly disinfected, and some studies have found them to be the dirtiest part of the office environment. If someone who may infected used your phone, wipe it down with disinfectant before using it, giving particular care to cleaning the mouthpiece.

Avoid shaking hands. Such casual yet direct contact is one of the easiest ways the flu is spread.

It’s hard to refuse a handshake or a hug without seeming rude, and sometimes, in business, it cannot be avoided. In this case, as always, avoid touching your face and (discreetly) retreat and wash your hands thoroughly.

Avoid taking the elevator. This is one of the most contaminated places in any office building, not only because of all the different people pushing the panel buttons, but because it is a tight, enclosed space, perhaps without much fresh air or circulation. Take the stairs instead—the exercise will help you maintain a strong immune system. If you can’t avoid the elevator, use your elbow for button-pushing. If you have to use your fingers, do not touch your face before thoroughly washing your hands.

Be extra careful using office restrooms. Try not to touch the door handles, sink faucet handles, stall door handles, etc. Many offices are now equipped with touchless faucets—unless you work in such an office, take special care to use tissues or paper towels to protect yourself when touching anything inside the restrooms. If the entry door the pushes to open, use your elbow or shoulder. Do the same when leaving, or use a tissue/towel to turn and pull the handle.

Be careful when using a copy machine. If you need make copies, wipe down the buttons and other parts you have to touch with a disinfecting wipe beforehand.

Avoid drinking fountains. Most new designs are sanitary, but older designs may not be. Some studies have indicated that the splashing of backwashed saliva into the bowl can cause viruses to be dispersed into the air. Drinking fountains also have the problem of having to be activated by hand with a faucet or lever. If drinking water is not available from a cooler with disposable cups, bring your own bottled water to work.

Protecting yourself while commuting/traveling on planes and mass transport

Whenever possible, choose a window seat. Aisle seats on planes, trains and busses experience significantly more traffic and therefore have a greater risk of exposure. People tend to touch seat arms, backs and headrests for balance when going to and from the restroom, and sick people are particularly prone to this. Window seats generally don’t have as much contact with passengers.

Wipe down your seat. When packing your carry-on for your trip, take along some wipes and sanitizer. The armrests (and seatbelts, on planes) are among the least sanitary things on mass transport. Give them a thorough wipe-down before you sit down, and wipe the window area, too, if you plan to take nap.

Avoid using the tray table and seatback pocket. Tray tables and seatback pockets are also quite unsanitary because so many people use them. If you must use them, wipe down all the surfaces before touching them.

Avoid touching support poles, support handles, and any other structures on the interior. The reasons for this are obvious. If you do make contact with them, remember not to touch your face and clean your hands with disinfectant wipes as soon as possible.

Avoid using transport restrooms. As in offices, you have the same potential for contamination on doors, sinks, flush handles and toilet seats, but in this case the problem is compounded due to the compact volume (similar to the problem with elevators). It’s possible that the person who used the tiny restroom just prior to you is contagious and contaminated the air that is still circulating in the small space. Try to use a less used, more spacious restroom just before you embark.

Change your seat as soon as possible if you are next to someone who appears ill (coughing, sneezing, etc.) This isn’t always an option, in cases where seats are assigned and accommodations are tight. On a plane, ask the flight attendant for permission to move to a free seat.

Keep your overhead air vent turned on. Research has shown that keeping overhead air vents open. This air has been cleaned by the onboard filtration system, and when directed straight downward, it create a “cone of protection” which can actually stop airborne viruses from approaching you. This can be particularly useful if you are stuck next to a passenger who is obviously ill—the airflow from the vent can ward off germs.

Stay hydrated.  For busses and trains, low humidity is usually not a problem. Aboard planes, however, humidity is about fifteen percent, as opposed to land, where it’s thirty to sixty percent. The low amount of moisture in cabin air can dry out mucous membranes in your nose and airways. When this happens, you are much more susceptible to viruses. To alleviate this vulnerability, stay hydrated. Take along your own bottle of water and plan to drink eight ounces per every hour you’re in the air to maintain proper hydration. Also, alcohol and caffeine will not only dehydrate you, but will cause your bladder to fill faster, as stated earlier. Therefore, it’s best to forgo the cocktails and coffee until after you’ve reached your destination.

Last but not least: avoid using mass transport altogether, if it’s an option. There’s no question that flying in plains or riding trains or busses, and passing through their associated crowded stations, creates much greater exposure than if you drive your own car, or ride a bicycle or motorcycle to your destination. One study showed that the chances of contracting a virus increased by twenty percent. This elevated risk is particularly true at airports, where you may be exposed to travelers from various parts of the world which may have a much higher concentration of infected people. For daily commutes to work or plane trips less than one hour, consider using some other form of transportation with less exposure. Again, walking and/or riding a bike or other self-propelled vehicle will strengthen you immune system.

Chapter 8.       How It’s Affecting China

Now that you know how to protect yourself and the truth behind the Wuhan coronavirus, you're probably curious about what is happening in China. In this chapter, you'll learn the reality of what it's like. The first thing you need to keep in mind is that this virus is impacting almost everyone in China.

Travel

Traveling in China is nearly impossible for some people and impossible for others. It makes getting to international airports impossible for many and very difficult. Which makes it almost impossible for them to come to the US for depositions. There are entire cities in China that are completely closed off, including Shantou which has completely locked itself down. It’s done this because it was able to get approval from Beijing. Foreign governments have stepped in to arrange evacuation flights from China for their citizens, which include foreign government officials who are being evacuated.

Foreign embassies and consulates are pared down to only essential personal, and they have plans in place to evacuate quickly too. It’s almost impossible for Chinese citizens to get foreign visas promptly. Many people are afraid to leave China because they are afraid that any country they want to go to will not accept them even though this fear is unfounded. For example, US officials are calling for a ban on people entering China. For the same reason, there's a fear that they will not be able to return to China or their place of residence since domestic travel has been locked down and made difficult. This doesn't just impact travel.

Business

It also impacts international litigation, which impacts international businesses. Almost every business has been impacted in China. Since people who appear completely healthy can still be spreading the disease, it is making it difficult for people in China to go about their daily lives. However, the official death toll in Chia right now is only sixty people, but the people infected are 2,000. However, almost no one believes these reports since many people do not believe the Chinese government or their ability to keep a handle on it. laked reports from Wuhan also directly oppose these numbers. However, even if you were to assume that these numbers are true, you have to remember that the numbers will be higher come tomorrow as the virus continues to spread. Some studies predict there are nearly 190,000 people infected in Wuhan by February 4, 2020.

The Hospitals

Chinese hospitals are running out of testing kits as well as many other medical supplies. Some sick people are being turned away and being made to go home. Remember that we’ve previously stated that Chinese hospitals are also working around the clock, while others simply don’t have enough room. without the testing kits, these sicknesses are just being called pneumonia or other illnesses and being mislabeled. There is no way to know the number of people who have this virus.

Schools

There are schools as well as universities that are being closed across Hong Kong and China. This is also the case for public attractions, including Disneyland in Hong Kong. Many cities are prolonging the current holiday by a week, and it's expected the entire country will follow suit. Virtually nobody may be working in China soon other than essential government personnel and essential medical personnel.

The Numbers

As we covered in the myth section, there is reason to believe that the Chinese government isn’t reporting the actual numbers of those affected by the Wuhan coronavirus. There are many epidemiologists from various parts of the world who are speaking out about their worries with China's official numbers reported for both the number of cases as well as the number of deaths. The first reason we've already covered. China doesn't have enough test kits, which make it impossible for them to confirm if everyone dying or sick has this virus or not.

According to Neil Ferguson, who released his opinion in Scientific American on January 27, 2020, he believes the number of cases is at least 30,000, but his estimate says it could be as high as 200,000. Of course, Ferguson isn't alone. there is also an expert in Hong Kong who suspects at least 44,000 people affected as of January 27, 2020. Lancaster University’s disease forecast though it would be about 150,000 people would develop this virus by February 2020.

It doesn’t help that early voices were silenced. The New York Times has confirmed rumors that stage there was a cover-up in an article that was published on January 29, 2020. They say that symptoms started on December 1, 2019. The Chinese government took action against people who were trying to raise awareness of this future epidemic. Nine doctors received discipline from the government as well as local police. One for these doctors signed a statement saying he was wrong to suggest an outbreak. Wuhan's mayor was not allowed to talk about the virus until just before the shutdown that the government forces on the city on January 23, 2020.

Li Wenliang was the first Chinese doctor that spoke out about this new virus, and he died from it on February 6, 2020. There are demands for justice for this doctor, and the Chinese government bowed to pressure and announced they would be investigating this death. This doctor is being seen as a hero because he tried to raise awareness early on and stop the spread until the Chinese government thwarted him.

The Truth About Their Doctors

Even if the numbers that China is reporting on these cases is accurate, these doctors are still facing odds that are against them. Just look at the hospitals located in Wuhan, and you'll see that there are several that have already contracted the virus and therefore are no longer able to work. Those who are still healthy can work shifts that are up to a full twenty-four hours, and after they finish this shift some are just taking naps on the floor.

The South China Morning Post interviewed Wuhan Hospital, showing that one of the doctors hadn't been home in two full weeks. Even with midnight shifts, he could have 150 patients waiting on him. this doctor has asked not to be named, but he did express fear at the frustration his patients are experiencing. With emotions running high, people think and act irrationally. Many cannot find a bed, and all patients are anxious. Some patients are threatening to stab or harm doctors.

On January 29, 2002, there was a doctor at the Wuhan Fourth Hospital who was beaten up with his collective clothing ripped away by a family member of a patient. It happened in the infected zone, so this doctor was forced to face a high probability of contracting the virus. For some doctors working at Tongji Hospital, some shortages prevent them from changing their protective gear as often as they need to. They find it necessary to wear adult diapers and drink less water during their shift so that they don’t go to the restroom because they simply don’t have time. People are lying on benches, extra beds in the hallways, and extra beds at doors of every bathroom. There is sixty to seventy percent of people who are actually on oxygen, and some people in better conditions are in their cars in a parking lot on a drip hanging from branches. Those that don’t have a car are sitting on their steps.

With a lack of city transportation, people can't get to the hospital. When people do get there, there's no way to get admitted. There's very little reason for people to go to the hospital if they're having an issue getting diagnosed. Chen Quishi is a popular journalist that's been making these reports on YouTube, showing the state of Wuhan hospitals. His mother has reported him missing, and it’s been told to the family that he was forcibly taken. Another citizen journalist was reported missing on February 13, 2020. His name was Fang Bin, who was posting videos that encouraged citizens of China to rise against "the bullies" and "tyranny". He was detained by authorities and his equipment was confiscated. He continued to post videos until February 9, 2020.

Using Drones

While the US usually uses drone technology either for military purposes or entertainment purposes, the Chinese government has taken a different approach in light of the outbreak. The usage of drones is serious and practical, as they're used to disinfect areas. Drones which are carrying disinfectants are flying through the sky in cities in Wuhan as well as cities that are in a 300-mile radius. It makes it possible to cover 15,000 square meters (172,000 square miles) with a single drone.

However, there are enough areas that need to be covered that the Chinese government has asked both police departments as well as farmers to use their drones to help cover the whole area. Drones are being used differently in Wuhan. Some drones are capable for facial recognition, and they're being used to scold people who aren't wearing face masks. They're programmed to say things such as "you'd better go back home and wash your hands", "don't walk outside without wearing a mask", and even "staying at home is contributing to society". They're meant to be helpful reminders, but the government is taking the fear of public humiliation to spur people to take the preventive measures they need to keep this virus from spreading.

Chapter 9.       Prevention and Immune Strengthening

In previous cases of infection with the novel coronavirus from Wuhan, it can clearly be seen that some people do not develop any disease or only develop a mild course. The statistics show that serious illnesses and deaths occur especially in people with weakened immune systems, as is the case in advanced age. Since there is currently no specific therapy, but only treatments that alleviate the symptoms, the body itself has to deal with the immune system. There are now many influencing factors that affect the performance of our immune system. Let us try to strengthen it as an important protective factor against the virus and also other pathogens. This becomes especially important with the advanced years of life, because the immune system ages and many immune cells function only poorly. This increases the susceptibility to infections. In addition, the body is often in a latent, low-threshold, inflamed state due to various accumulated damages. Increased levels of inflammatory cytokines circulate in the blood and inflammation can be contained more and more poorly. If coronaviruses then trigger pneumonia, this is a poor starting point for healing. Some important factors influencing the immune system are discussed below.

Stress and recovery

For many, it is obvious from their own experience: If you are under a lot of stress and pressure, the immune system suffers and you become more susceptible to infections. The field of “psychoneuroimmunology” can already describe quite well how the connections between immune systems, nervous system and hormones act as mediators. An increased susceptibility to infection with high stress levels is well documented. Respiratory infections in particular can be associated with stress. The metabolic pathways behind it are extremely complex. Following an overview.

Stress hormones in the corticosteroid group

Our body has developed in such a way that it can temporarily increase its performance in threatening situations in order to counter the danger with maximum physical performance. Situations that are perceived psychologically as stress lead to an increased release of stress hormones such as adrenaline. This triggers a variety of physiological changes: the blood vessels constrict, the heart beats faster, the blood pressure increases, the blood flow to the muscles and brain increases, the airways widen and the lungs can absorb more oxygen. The hormone cortisol controls the metabolism so that more energy can be provided for these processes. However, this reaction comes at a price. The immune defense is suppressed at the same time. The strategy behind is, the body should survive the immediate danger first, and the body can take care of infections later. The performance of the immune system is severely shut down. Among other things, inhibition of cytokine production, reaction of T and B lymphocytes and natural killer cells. Antibodies of the immunoglobulin IgA type, which are present in saliva, nasal mucus and lung secretions, bind foreign pathogens such as bacteria and viruses and activate inflammatory reactions. Experiments have shown that the concentration of IgA is reduced during stress.

When the stress is over, the metabolism normalizes again. However, the body often does not know when the danger has been averted. That is why it makes sense to relieve tension after physical stress with physical exercise. Then the body knows, the fight is over, now it goes back to normal.

Prolonged chronic stress

A single stressful day with subsequent recovery is not a problem as it is a normal program for the body. However, being permanently under pressure is damaging and leaves traces in our physiology. When there is permanent stress, the metabolism gets messed up and the immune system then reacts less efficiently. In a test with a nasal spray containing viruses, it could be shown that the chronically stressed test participants had impaired immune systems and became more susceptible to a viral infection.

Our working world and social environment are often not conducive to our resistance to disease. The health system has to repair it out again. In times when there is an increased risk of infection, preventive measures could be taken to reduce the workload, to pursue less ambitious goals, and to deliberately incorporate more „recovery programs“. During unavoidable stressful work peaks, one could consciously try to create a restful balance afterwards. How relaxation looks like varies individually. Having a sporting component in the recovery program is definitely beneficial, since it reduces stress physiology by the increased metabolism.

Lack of exercise and sport

A trained, efficient body can also cope better with the burden of an illness. Regular and moderate training strengthens the immune system. Natural killer cells have a strengthened defense function (particularly important for the defense against virus-infected cells), the anti-inflammatory system of the immune defense is optimized so that inflammation does not get out of control and overshoot. There is a general increase in immunoglobulins. Surface antigens, which are responsible for the recognition of foreign cells, are increasingly being produced. Athletes have fewer infections than the population average. Above all, moderate regular endurance sports strengthen the immune system. The strain creates a new, increased balance of the defense components. The sport creates a stress stimulus on the immune system due to micro injury in muscle cells and it adapts in response to it and becomes stronger. So with exercise you not only train your physique but also your immune system. The effects even endure periods of less exercise, at least for a while.

The performance of the immune system deteriorates with age. Preventive health sports can slow down the age-related immunological degradation processes. Depending on the state of training, running around 3-4 times a week with a total distance of approx. 15 to 25 km is already beneficial to health. The load should mainly be in the moderate range with a pulse between 110 - 150. Other “gentle”endurance sports such as hiking, cycling, swimming are also suitable. There are many ways to design sport and exercise depending on individual preferences. Our often sedentary work and leisure time weakens our natural defenses, which the human species would be able to achieve with a “species-appropriate lifestyle”.

Intensive training and overtraining

You should watch out for sports immediately after training. Depending on the condition and intensity of the training, the immune system is weakened for some time due to physical exertion (the so-called “open window”). The length of time depends on many factors. As a guideline: The immune system is weakened, especially 1-3 hours after exercise, sometimes the temporary weakening lasts up to 24 hours. During this time, you should be particularly careful not to come into any contagious infection situations. The immune system can be particularly suppressed if intensive training is carried out too often and there is too little regeneration, sleep and an unbalanced diet. With very intensive training, the immune system can still be affected 1-2 days later.

Endurance athletes are known to experience more infections of the respiratory tract after intensive training because the mucosal epithelium of the upper respiratory tract is irritated and its immune function is therefore weakened. If there is insufficient regeneration or overtraining, the immune defense may also be impaired: the level of immunoglobulin A decreases (saliva, blood serum) and the oxidative burst of the phagocytes (decompose pathogens with oxidants) is reduced.

In an experiment with endurance athletes, a mixture of soy proteins, polyphenols from blueberries and green tea was administered as a nutritional supplement. Soy protein stabilizes polyphenols in the digestive tract, increasing the amount that can be bioavailable. After training, during the time of weakened immune system, blood serum was withdrawn and exposed to the vesicular stomatitis virus. Virus replication increased due to the weakened condition, but was significantly reduced by the nutritional supplement. The authors conclude that such supplements can protect athletes from infections after hard training in the immune-compromised phase.

cold

The term cold is quite apt when it comes to talking about respiratory infections. If someone freezes when the outside temperature is cold, the blood vessels contract and the blood flow decreases. This is a survival reflex and reduces further cooling, but our mucous membranes are also affected. In consequence this also reduces the activity of the immune cells and attacking pathogens get their chance to infect and multiply. We often already have infection germs within us, which do not yet have a chance to reach an infestation when the respiratory tract is in good working order. But they become active when the opportunity arises.

If the cold air flows directly into our airways, the bronchi contract. Fog or smog is also irritating to the respiratory tract. Depending on the environmental conditions, the wet, cold and moist air in the small drops of water that we breathe in carries a lot of dissolved dirt particles and pollutants that additionally irritate the respiratory tract and weaken the virus defense. Sensitive or older people in particular should avoid such debilitating circumstances. Outdoor athletes also have to be careful: from around - 10 ° C the weakening of the airways becomes relatively strong and it is better to try to postpone the sport elsewhere (e.g. indoor).

Environmental pollutants

Studies have shown that high levels of particulate matter and nitrogen oxides increase the course of the disease from viral respiratory effects. The pollutants cause oxidative stress on the mucous membranes of the respiratory tract and thereby increase inflammation. This increases the severity of a viral course of the disease.

Chinese studies have shown that air pollution (especially fine dust particles smaller than 2.5 µm, NO2 and ozone) significantly increases the susceptibility and severity of the disease caused by respiratory viruses. The rapid growth in population and industry in China has resulted in very poor air quality in many cities. The fine dust particles, which are often mixed with fine drops (smog), can facilitate the adhesion of the virus particles to the surfaces of the respiratory tract and, due to their small size, penetrate deep into the lower respiratory tract. They also cause damage to the mucous membrane and the barrier protection function. The ability of macrophages to absorb virus particles decreases. This results in a greatly increased susceptibility to viruses for the respiratory tract as a whole.

Another study that investigates the link between SARS corona virus infections in 2002/2003 and air pollution divided the areas of China with diseases into categories based on air pollution. There was an influence of air pollution primarily on the severity of the course of the disease and the deaths. Zone 2 residents with medium levels of air pollution were 86% more likely to die from SARS compared to zone 1 residents with low levels of air pollution. In zone 3 regions with the highest levels of air pollution, the risk of death was even doubled compared to the areas with the lowest levels of air pollution. The authors of the study suspect latent inflammation of the airways from the air pollutants as the cause of a weakening and the severe course of the disease.

Another study conducted investigations directly in Wuhan. The city has seen a large increase in industry and population in recent years. Car traffic and coal heating also increased sharply. Air pollution is high, but is only classified as medium in the Chinese national average. The scientists found a strong link between NO2 and fatal outcomes in the population group older than 65 years. They also found that men were affected more than women. They justify the result by the reason, that men are more likely to have jobs outdoors and protect themselves less.  Women usually lead a healthier lifestyle, with less smoking and drinking of alcohol. Overall, this leads to a higher susceptibility of men.

So air pollution can increase susceptibility to viral infections. The „worst case“ would be: With the bicycle in the cold air (reduces the defenses of the mucous membranes), inhale smog and pollutants (leads to a preload on the respiratory tract due to oxidative stress) and then at work in the office with dry heated air (dries the airways, virus aerosols can circulate in the air for a long time). This results in perfect infection conditions when a sick employee is present. And this can be the real situation in many work sites. The driving ban in Chinese quarantine may counter the virus spread in this regard, if it reduces the effect of pollution and smog on the respiratory tract.

Nutrition

In general, a healthy diet also leads to a healthy and resilient body. If no previous illnesses weaken and the body is well supplied with vitamins and minerals, the immune system can fight off infections with high efficiency. Perhaps plant ingredients have always protected us so well that an infection is usually not so difficult but easily tolerable. In the long term, a balance between host and virus has an advantage for both: the virus grows and does not seriously endanger its host as its basis of propagation. And the host can live with the infection without creating too hard a selection pressure.

Perhaps this fine-tuned balance is disturbed in many infections and illnesses, especially when new pathogens appear. Since humans in their time as hunters and gatherers ingested 2-3 times the amount of plant ingredients via wild plants than the average citizen consumes today, at that time they were able to survive many infections with only a mild disease course with a much more powerful immune system. The genes from the time of hunters and gatherers have hardly changed for today, we only have created a world that in many areas no longer suits us.

Antioxidants

Our body is constantly exposed to oxidative reactions and it has to slow them down with antioxidants to prevent damage. Part of the antioxidants are produced by the body, others are ingested through food. There are many different substances that are found in plants as protective substances and benefit us as antioxidants. Many people think of the word antioxidants only as vitamin C and effervescent tablets as a dietary supplement. However, individual substances often do little to help the body, unless there is a specific deficiency for a certain vitamin. In the body, antioxidant defense works as a widely ramified network with various antioxidative substances that interact with each other and also regenerate each other. If a single substance is supplemented in large amounts at one point, the antioxidative performance can often not be significantly increased as a result of a limiting deficiency in the subsequent or other metabolic steps involved. That is why complex mixtures of plants usually work best to support immune systeme performance.

Food with a high polyphenolic content is particularly interesting. Polyphenols usually have the strongest antioxidative effects and at the same time they also have other special health-promoting effects. There are many experiments that have shown antiviral properties of these substances. Although there are hardly any experiments with corona viruses, there has often been a rather broad non-specific activity against viruses and there is a chance that there will also be an activity against corona viruses.

Unfortunately, most of the experiments have so far only been carried out with cell cultures and there are still many influencing factors in the in vivo system that can reduce or prevent an effect. In any case, the antioxidant effects can keep inflammation at bay so that it does not become too destructive. It may also help to slow down and limit the escalating inflammation caused by the severe course of the coronavirus 2019-nCoV, and thus prevent fatal pneumonia.

Protease / antiprotease balance

There are about 40 different cell types on the surface layer (epithelium) of the respiratory tract, including many cells of the immune system (macrophages, B cells, T cells, etc.). A coordinated approach is important for them to work well together. The immune cells are controlled and activated by signals that are transmitted by receptor proteins. Proteases and antiproteases are an important system for controlling the immune response and are influenced by many factors, including the level of antioxidant supply via our diet. Proteases are key components of defense in the respiratory tract. But increased „net protease“ activity leads to lung destruction. Antiproteases inhibit proteases and thus modify the immune response by limiting inflammation cascades. For example, the antioxidant EGCG (epigallocatechin-3-gallate, a polyphenol) from green tea is known to support the immune system. Or isothiocyanates such as sulphorophanes (e.g. in broccoli) intervene in such a way that the resistance in the respiratory tract is increased by limiting oxidative stress and inflammation and not becoming too destructive. The experiments were carried out with influenza viruses.

In order for the immune system to work well, a good supply of some vitamins and trace nutrients is particularly important. It should be noted that there is an optimal range. Too much is just as harmful as too little. An overdose can only rarely be achieved by eating food. In the case of nutritional supplements, on the other hand, care must be taken and an optimal level is set for safety in consultation with a correspondingly specialized doctor.

Vitamin A

This vitamin is particularly important for a well-functioning outer barrier (skin, mucous membranes). It is also important for the development of immune cells with anti-inflammatory properties, such as M2 macrophages and regulatory T cells. They are necessary in order to limit inflammation again. Vitamin A is usually taken up with food via its precursor ß-carotene and converted to vitamin A in the body.

Food rich in vitamin A: carrots, kale, savoy cabbage, lamb‘s lettuce, red peppers, crape fruit.

Vitamin D

In our low-sun months, exactly during the usual time of annual cold waves, our vitamin D level is mostly sub optimally low. Vitamin D plays an important role in many immune reactions, e.g. differentiation of monocytes into macrophages (they eat up damaged or infected cells). It could be shown that the infections had a better course with vitamin D supplements.

On average, about 80% of vitamin D is produced by the body itself under the influence of the sun, only about 20% is ingested through food. In the low-sun months in winter, vitamin D supplements can therefore be useful, since otherwise it is very difficult to cover the need with food alone due to the greatly reduced proportion of sun.

Food with a lot of vitamin D: fish (especially fatty fish like salmon), avocado, cheese, eggs, milk, oatmeal

Vitamin E

The vitamin has two main tasks: On the one hand, it is central to the defense against free radicals that damage our cells. This is particularly important for polluted air (smog in winter) or for smokers to limit damage to the airways. Pre-damage favors infections. It also activates the immune system‘s killer cells for an efficient response to infections.

Food with a lot of vitamin E: fruits and vegetables, vegetable oils (wheat germ oil, sunflower oil, corn oil)

Zinc

The micronutrient is an important component for the defense metabolism so that the immune system can efficiently produce antibodies. Zinc is very important for the intracellular signaling pathways of the innate and acquired immune system. The right zinc balance (zinc homeostasis) is also very important for a suitable immune and inflammatory reaction, especially as a protective factor against an excessive inflammatory reaction. The zinc-containing transport protein ZIP8 is important for cell protection against inflammation. With a zinc deficiency, chronic inflammatory reactions worsen and the oxidative stress is increased. A zinc deficiency can often be found, especially in older people. Research shows that about 30% are affected by deficiency. Vegetarians can also be affected, since many plant-based foods contain high levels of ingredients that chelate zinc and worsen absorption or bioavailability.

Food with a lot of zinc: wheat bran, beef, cheese, legumes, nuts, pumpkin seeds

Selenium

The trace element is used in many physiological processes, including the immune response. Humans have some selenium proteins with a greater importance in metabolism. With selenium deficiency, the innate and acquired immune system cannot work well. It has been shown that with food supplements the defense against infection could be improved if there was a deficiency. A deficiency primarily affects the innate unspecific defense, which provides the first defense measures against unknown infections. The selenium content of the food is determined by the content in the soil or the intake via the root. In many countries zinc levels are rather low in the soil and the supply of people is not optimal. Selenium-poor soils are common in China, parts of Europe, New Zealand and Russia.

Food with a lot of selenium: fish, legumes (soybeans, beans, lentils etc.), coconut, Brazil nut, oatmeal, brown rice, chicken.

There are many ways to keep the immune system fit or to have a negative impact. The factors discussed above offer a small insight into a complex topic with numerous options. In order to optimize the diet, it makes sense to study the nutritional tables and possibly rely on the specialist knowledge of nutritionists. In everyday life it is not always easy to design everything optimally. With small steps you can change your habits and improve lifestyle. While the young body can still tolerate many sins, it is becoming increasingly important to pay attention to these factors, especially with advanced age. We would naturally be given a body that could be around 120 years old and still remain relatively healthy. But that‘s a lot of hard work and discipline. In our modern civilization it is often not easy to avoid an unhealthy lifestyle. Nevertheless, try it as best as possible and a good quality of life will reward the efforts.

Chapter 10.                         The Virus & Your Body

According to the Lancet Medical Journal, a hundred percent of their patients were suffering from pneumonia. These findings are from Wuhan Jinyintan Hospital. This means that their lungs also became inflamed, so the sacs that are responsible for moving oxygen into your bloodstream had been filled with water instead. All ninety-nine had pneumonia, eight-two of them had a high fever when admitted to the hospital, and eighty-one had a dry cough. There were thirty-one that was experiencing shortness of breath, and eleven had muscle aches. Eight of them had persistent headaches, and only five were battling a sore throat.

Later on, there was a larger variety of symptoms including diarrhea. Eleven of the original ninety-nine patients had died by January 25, 2020. Thirty-one recovered enough to be discharged by this time, but fifty-seven were still hospitalized by this date. The first two men to die had no known health issues besides being long-term smokers. Both of these patients suffered from breathing difficulty due to viruses. Patients one and two were both on ventilators and one used an artificial lung.

They still died due to lung complications. More than half of the ninety-nine had preexisting conditions including damaged blood vessels, a weakened heart or diabetes. It is considered that these conditions were a large part of why their body was not able to fight off the virus. The majority of these patients were middle-aged men and older men. However, since that initial outbreak, the split is more even with about 1.2:1 ratio between men and women getting diagnosed.

The Second Study

There is a second study published in JAMA on February 7, 2020, that is also on Wuhan patients. One hundred and thirty-eight patients were monitored, trying to figure out how this coronavirus spreads. These patients ranged from twenty-two to ninety-two years old. The median age was fifty-six, and each of them was admitted to Wuhan University's Zhongnan Hospital from the first of Juanray to the twenty-eight.

With this study, forty-one percent of those people who were infected caught the virus in the hospital. There were forty healthcare workers and seventeen patients that were admitted for different issues. It’s been documented that a single patient spread this disease to fourteen people at least. This was because he wasn't seen as a carrier at first. After all, the initial reason he came in was due to abdominal pain. Ten percent didn’t have common symptoms. This means they didn't have a fever or cough, but their symptoms were diarrhea and nausea.

Abdominal pain, dizziness, and headaches were other symptoms that were less frequently reported. Those that were admitted with less severe symptoms had a significant increase in symptoms between five to seven days later. From this study, you can see that day one through four most people only experience mild symptoms. Day five and six you'll notice shortness of breath, and on day seven hospitalization is required. Day eight can cause severe difficulty in breathing, which is why hospitalization is severely important on day seven. Out of the initial one hundred and thirty-eight people in the study, twenty-six percent ended up in the ICU (intensive care unit).

The median age of patients who ended up in the IC was sixty-six. Those who didn’t need intensive care had a median age of fifty-one. The gender ratio is fifty-four percent male and forty-six percent of women. With this study, only 4.3% died. This study helped doctors to discover that this virus is accompanied by systematic viral infection as well as pneumonia, which causes a strong inflammatory response. This can affect the heart, liver, kidneys, lungs and blood-clotting systems. Serious viral infections, which include the flu, can cause a larger inflammatory response, which can stick around thirty days after the signs of illness have already gone away. during this period, older people are at more of a risk for heart attack as well as stroke.

The Third Study

There was a third study reported by the National Geographic, which looked at Wuhan coronavirus patients as well as those that contracted MERS and SARS. This study was supposed to show how dire this virus can become in certain patients. The first thing to look at is the lungs, which go through three different stages. This includes viral replication, hyperactivity as well as pulmonary destruction. The second stage begins when the cilia cells are killed by the virus. Since mid-February, eight-two percent of these patients don't reach the pulmonary destruction stage, and those who do reach this stage and do not pass away will develop permanent lung damage. this damage has been said to look like a honeycomb.

The stomach also has issues that include vomiting, nausea, as well as diarrhea. However, not all of these are reported in ever the case, and it's believed that the stomach is only affected because the virus uses it as a shared gateway away from the lungs. It’s important to look at the cytokine storms next. When this happens, your blood vessels bleed out into your circulatory system, which damages multiple organs.

Liver damage can come next, and in severe cases, it can lead to liver failure. Kidney damage is also a worry, especially in those that have a severe form of the illness. In most cases of this virus in humans, kidney and liver damage often become lethal.

You also need to be worried about mother to newborn transmissions, which you may have already heard of. It made the headlines when a baby that was only thirty hours old contracted the virus. However, it is not clear if that is how the child became sick.

Chapter 11.                         What to do During a Quarantine

What Supplies to Keep at Home

If you have been ordered to stay at home to prevent the spread of an illness, you want to make sure that you have all the things you could possibly need to get you through that quarantine. You will want to make sure that you have enough food, entertainment, medical supplies, first aid, and anything else that you could possibly need over that two-week span.

If you are sick, you might need tissues, prescription medicine, soup, lip balm, a thermometer, and other things that help you to feel comforted and well while you’re trying to get better. If you are helping someone in your home who is sick, you might need to make sure that you have books or puzzles to keep yourself busy during the day.

A good basic list of things to keep in the house, but I have modified the list specifically for a quarantine and listed it here:

Water. You need to drink plenty of fluids when you’re sick, so make sure that you have enough for about ¾ of a gallon per person, per day for the duration of your quarantine.

Food. If you are quarantined, you may need to procure enough food to last you for two weeks. Consider grocery delivery to your home if you need to stock up as soon as you are quarantined and have the delivery person leave the groceries on the doorstep, only opening the door once they have gone away. This will help to prevent the spread of illness.

A first aid kit with all the bells and whistles. Many of the first aid kits that are available for purchase online come with things that you can use for symptom suppression as well as things to treat wounds. It’s best to have one of these on hand when you’re quarantined, just in case of anything that might happen.

Face masks to help you to breathe contaminated air. Make sure that you have the right masks for the situation you find yourself in. DFM, N95, and P2 masks are the best to keep your lungs safe from harmful contagions, mists, fumes, and dust. You can also look for something labeled “disposable respirator.”

Sanitary products. If the person or people who are going to be quarantined are menstruating or could be during the time of the quarantine, it’s best to stock up and make sure that you have any menstrual cups, pads, tampons, pantiliners, wipes, or whatever other products might be needed. As a side note to this, if there are any foods that help to cope with cramping or symptoms of the period, you will want to stock up on those as well.

Entertainment. Do not underestimate how easy it is to go completely stir-crazy when staying in the house for two full weeks, especially if you’re in there with other people. You want to make sure that you have games to play, television to watch, books to read, activities to do with one another, as well as on your own, and you want to make sure that there is always something to keep your attention.

Don’t Travel

This one might seem really obvious to you, but it has to be said. If you are diagnosed with the illness, you should not travel anywhere. This does, unfortunately, apply if you are abroad when you are diagnosed. You need to find somewhere local to where you were diagnosed to stay until it’s fully treated.

Traveling through areas that have not yet been exposed to the illness opens them up to new, more wide-spread cases. It is better to have 1,000 infected people all in one city than it is to have 500 infected people all across the globe. Those 500 people could come into contact with hundreds, if not thousands of people within the incubation period and could infect countless other people, making it imperative that you stay right where you are following diagnosis and pending treatment.

Wear Masks When Accepting Deliveries

It’s best to avoid getting deliveries at all if you’re in the middle of treatment for COVID-19, but if you find that you are out of something you desperately need, there may not be an alternative. If it’s possible, the best option would be for the delivery person to drop the products at the door and leave before you open it. If this isn’t something they can do or if they need you to sign a receipt, be sure to very, very thoroughly wash and sanitize your hands, wear a mask when you open the door, and use a spray disinfectant to treat the air around you when you open the door.

This might seem like overkill, but delivery people deal with lots of stop every single day. That could be at least a hundred more people exposed in one week after delivering to your home.

Don’t Break Your Quarantine, Even if You Feel Better

As mentioned previously, it is quite possible to still be carrying COVID-19 after your symptoms have subsided. If your doctor has advised that you keep yourself at home and away from others for a specific period of time, you should keep to that limit in spite of how you feel.

For other illnesses that affect these parts of the body, it’s possible to feel better, branch out and do more in your day, only to find that you overdid it and suddenly your symptoms are back in full swing. What does that tell you? It says that the illness has not yet left your body, but that your immune system was just really working hard that day and starting to win the battle. Go outdoors, exert yourself just a little too much and your symptoms are back. In any case, you’re exposing anyone around you to COVID-19 and it’s just not safe.

When it comes to quarantines, the entire philosophy is based on the notion that it’s better to be safe than it is to be sorry! For people with compromised immune systems and even for some who aren’t compromised, coronavirus can be fatal. There just isn’t anything you can do to apologize enough for spreading that kind of illness by breaking your quarantine, so it’s best to just stay put.

No Visitors

The principle behind this is just the same as it is with breaking the quarantine and with getting deliveries. Having company can be really, really tempting if you’ve been alone in your quarantine for two weeks, but you can get through it. You can voice chat with people, call them on the phone, play video games online, video call, and anything that would allow you to connect with family that are not near you. Doing this is a great way to keep yourself from feeling too isolated while you’re being cut off from the rest of the world.

Do your best to fight the temptation to have visitors in your home during your quarantine. In fact, you should do your best to keep visitors from coming to your home until you’ve had the chance to properly sanitize everything once the illness has passed. Wash all the pillows, pillowcases, sheets, blankets, and clothing. Sanitize all the surfaces, dust, vacuum, and get brand new toothbrushes. You don’t want any possibility of the virus or germs to be lurking around in your home to latch onto anyone who comes to visit you.

Don’t Share Germs, No Matter What

If you and someone else happen to be quarantined together and you are both affected by COVID-19, it is still not a good idea to share cups, dishes, or food. The transference of contaminants from one patient to another is still a concern for the doctors who are working to treat the illness and who are trying to find the best avenues for treating and curing the illness.

Because people are walking incubators, the virus could behave differently once it’s inside you than it might inside the other person. Because that person is working to fight off the illness when a new mutation of it enters their body, they might be unprepared to fight it off, causing more problems for you, that person, their doctor, or anyone else who happens to be involved in the quarantine or treatment.

Disinfect Surfaces Regularly

While you’re stuck in quarantine, it’s a good practice to make sure that you’re routinely disinfecting surfaces and cleaning up any messes that collect in the house. Studies show that a cleaner, more orderly environment is more conducive to faster healing from illnesses and injuries. It can also be helpful to give yourself maintenance tasks around the home in order to keep yourself busy for a portion of each day.

You can also consider taking on a small cleaning or organizing project to take yourself from room to room to clean things up as you’re spending time in the house. Make sure you don’t push yourself too hard and overdo it, but giving yourself something to focus on and something to work toward can help you to feel better faster, and it can help you to occupy a lot of time that might otherwise be filled with boredom and wishing that you weren’t still stuck in that one space.

Call for Medical Assistance When Needed

When you are sent into quarantine by your doctor, it’s typical for them to give you a particular protocol to follow in the event that you need medical assistance. In many cases, it won’t be fine for you to just hop in the car and drive down to the doctor’s office if something is wrong.

You will likely need to call your doctor, explain the nature of the problem that led you to call and arrange for a professional medical transport to your doctor or to a medical facility that is equipped to help you.

When you’re quarantined, you have to plan every move you make with the help of your doctor to make sure that you’re not going to step on any regulations, that you’re not going to cause any problems, and that you’re not going to make yourself any sicker. With the professional medical advice given to you by your doctor, you have the best possible chance to getting through your illness with as little hassle as possible.

Chapter 12.                         How to Handle Quarantine with One Sick Family Member

It is an unfortunate possibility for one member of your family to become sick and to need to be quarantined in the home with the rest of the family. In many cases where there isn’t overcrowding in the hospitals, such cases are kept in the hospital. In many cases as well, the patient can be given a choice depending on the severity of the illness. This may or may not be an option that the doctor will consider or allow, but just in case, it’s best to have all the information about how you can keep yourself and your family safe, happy, and healthy throughout the quarantine.

Wear a Mask when Helping the Patient

If the patient, your family member, is staying in your home, it’s a great idea to try to limit their activity to one part of the house so everyone else can interact without the fear of infection. If you decide this is the best possible option, you should wear a mask while you’re in that room to help them with food, getting dressed, or whatever other help the person may require.

In some cases, as when the patient is a child, they might need more contact and more closeness than someone who is more independent might. It’s imperative that you make sure you are as protected during these interactions as possible. Rubber gloves may be a good idea to help keep your hands from coming into contact with infectious materials. Speak with your doctor about what other measures you can take to ensure that you’re safe while providing support and comfort for your affected family member.

Putting ourselves at risk in order to accommodate or help a family member—particularly our children—is something that appeals to many of us and it might seem like the right idea at the time to stay with your child in spite of the risk. With an illness such as this one, it is best to keep yourself safe and to avoid contracting the illness at all costs. You can provide the best possible care for your child when you are feeling your best.

Quarantine the Patient in Their Room

Keeping the patient—your family member—in their room while they recover is the best possible option you and the rest of your family have for keeping that sickness at bay. Make sure that the person has access to all the things they could need in order to keep themselves occupied and entertained while they’re stuck in there, but it’s best not to spend too much time in the room with them.

With all the avenues for personal entertainment, there is a wealth of options available to keep someone busy while they’re stuck in their room. Video games, books, movies, TV shows, puzzles, mobile games, audiobooks, crafts, crochet, knitting, macramé, building blocks, toys, model building, magazines, music, coloring, drawing, and so much more.

If your family member is having a hard time choosing something they think they would like to do, help them to narrow it down and make a coin flip or dice rolling randomizer to help them choose something. Pick six things you feel like doing, assign each one a unique number from one to six, roll the die and bingo! There’s the first task for you to do.

Being creative is the best possible way to keep yourself from feeling too isolated during a quarantine, so get to thinking! Talk with your family member about the types of things they like to do in order to pass the time when they’re by themselves and help them to get what they need in order to get it done!

Disinfect All Surfaces in the House

I know I sound like a broken record on this particular point, but it’s even more important if you have one sick person in the house and you’re trying to keep everyone else from getting the illness. Using a disinfectant solution of some kind, make sure to wipe down all the surfaces in your house at least once a day. Bathroom counter, kitchen counters, the top of the island in the kitchen if you have one, the coffee table, the end tables, and for good measure, you may as well get all the doorknobs while you’re at it.

If you know of things that are being handled a lot in the house like remotes, video game controllers and cell phones, go ahead and sanitize those as well. Doing so will help to keep everyone’s hands a little bit cleaner. Everyone should also be committed to washing their hands regularly, keeping their hands away from their noses, mouths, ears, and faces, and making sure that they’re keeping things clean if they have touched body fluids like mucus, tears, or saliva.

Keep Conflicts to a Minimum and Resolve them Quickly

With families, there will always be the occasional spat or argument to defuse. When you and your family are kept in close quarters for a long period of time, it can cause those things to come up a little more frequently. When those things do come up, it’s important to be able to help everyone to reach an agreement and settle those arguments quickly. Letting them continue or ramp up in intensity will only serve to sour the mood in the house and to make life a little bit harder for everyone to cope with.

If you are able to resolve conflicts, then you should absolutely do so. If a resolution simply doesn’t seem possible, then the arguing parties should make it a point to separate themselves from one another to give the rest of the family peace. Conflict resolution can be difficult and it’s not ideal for the entire family to get involved over every single dispute.

That being said, there are cases in which a little bit of mediation and intervention can help to calm things down, put things in perspective, and to help all involved parties to feel as though they’ve been heard. Sometimes, a proper acknowledgment is all it takes for two people to admit to one another that the argument was more intense than it needed to be and that they can behave amicably from that point forward.

If you are unclear on how to resolve and calm down conflicts, take a look into some conflict resolution tools online to help you to get an edge on it. Sometimes, it doesn’t even need to be the other person in the argument acknowledging someone and their point of view to cool things down. If you can tell someone, “I see what you’re saying and I get why you feel that way,” it can really help them to come around and to stop seeing the situation as being quite so adversarial.

Play Games to Keep Everyone Occupied

Games are a great way to keep the whole family engaged, occupied, happy, and entertained. It gets people talking, it helps people to work together, it stimulates the mind, and it helps to pass the time much more easily. I would recommend against games that inspire people to get too competitive or upset in the process, but for the most part, you will find that board games are a great way to go.

If you are a family that likes to play video games or do crafts together as well, then you should absolutely make the necessary provisions to be able to do that during the time of your quarantine. If you need crafting supplies, extra games, or more things to do as a family, consider having a friend or family member come to drop some items for you at the door. Once they’ve gone, you can open the door and get those items for you and your family to use for entertainment!

You can also make your own board games using instructions from the internet. If you like to play Yahtzee™ , you can look up the instructions and scoring sheets online, then all you need is five dice! Getting creative as a family can help to bring you closer together and can do wonders to make it feel like your time together is less forced, and more of a little stay-cation.

Plan Activities to Entertain the Family

Little activities in the house can help you to forget why you’re there, can keep you from feeling like things are getting too serious, and can pass the time much more readily. Consider crafting projects, cleaning projects, organization, going through family photos, doing things that you’ve always meant to do around the house but never had the time, or some other activities that you feel would appeal to your family’s needs and hobbies.

If you like to get creative, you can make little clues for your family and send them on a little scavenger hunt from place to place throughout the house. Put a prize of some kind inside the dryer or some other hiding space, then leave little strips of paper with clues on them that lead them to the bathroom, kitchen cabinet, entertainment center, the shoe rack, and then all the way to the dryer. You can make enough clues to keep them busy for quite some time. If you get super creative with your clues, you can put entire puzzles into each one to make it really worth their time as well.

You can also do things together like reading from your children’s favorite books, talking about their goals and dreams, helping them to understand things about life and world, and just talking about what’s going on in everyone’s lives. Once the ideas start flowing when you brainstorm ideas, you’ll find a whole bunch of things that you would like to do as a family. Putting your heads together, you’ll be surprised at all the wonderful things you can think of to make the most out of your time stuck in the house together!

Since the outbreak, the World Health Organization (WHO), as well as other official groups have stated that indoor pets including cats and dogs are not at risk fo catching or even spreading the disease. There are still rampant rumors going around, which is causing people to abandon their pets outside. However, there are statements from some scientists, including Li Lanjuan, that says this virus can be transferred between mammals of different species. He urges that you simply keep a close eye on your pets.

China Daily published that if pets go out and can come into contact with an infected person, they run the risk of becoming infected. This means that you need to isolate your pets, and you need to be careful with other mammals. However, Li Lanjuan has not confirmed that there are cases where pets have contracted this virus. The only proven species that can transmit this virus are bats, and it’s suspected that snakes can too.

WHO has not provided guidelines regarding pets or given anyone reason to fear that they can contract the virus from their pets. However, they did make the statement that you need to avoid contact with animals that were possibly living in the Huanana Wholesale Seafood market, including stray cats, dogs, birds, bats, and rodents. The WHO has also urged people not to eat raw animal products or undercooked animal products. This includes raw milk, meat or organs. Avoid cross-contamination and practice good food safety. It is advised that if you are worried about your cat and would like to keep safe, then you may consider keeping them indoors until the outbreak passes. Dogs are alright outside if they are leashed and kept away from other people and animals.

What About Masks for Pets?

If you’re curious about masks, there are animal respirator masks that can be used for dogs. However, there are none at this time that can be used for cats. Some cats an ewer masks that are made from tiny dogs. However, it’s unknown if these are necessary or even if they’ll help your animals.

Conclusion

It is my hope that you have found the information in this book to be a helpful guide to you in keeping yourself and your family safe from the contagion of a disease that is still being figured out by the medical community at large. Keeping yourself and your family safe and healthy is always the number one priority in life and I commend you for taking steps to be informed and proactive about it.

The information in this book was gathered from valuable resources such as the Red Cross, the Centers for Disease Control and Prevention, the Federal Emergency Management Agency, and the Department of Homeland Security. These reliable sources were used and cited, as their expertise in the control of the spread of disease and the health and wellness of large populations give them great experience to back up those claims.

It is my hope that the information that has been compiled and relayed here for you is helpful to you in keeping yourself and your loved ones safe in the event of a nation or city-wide emergency. It is my hope that the use of this information serves you well and helps you to come through the situation healthier, stronger, and more vital than ever!

No one plans or intends to be the victim of an epidemic disease, but being prepared for any possibility helps to ensure that you’re not caught completely unaware, should the unthinkable happen.  With this book, it is my goal to educate you about the risks that are real in the case of an epidemic or pandemic, and how to keep yourself and your family safe from illness. With the proper precautions and with the right supplies, you can keep your family safe from illness and get the proper treatments you need. Your health is the number one priority.

Please always keep your eye on the health authorities for your region and bear in mind the suggestions that they make for your area. Always listen to your doctors and follow their advice to the letter, and help to slow the spread of illness with the tips in this book!

Bottom line – if you’re sick or think that you just may have are available contact with an infected person, don’t panic. likelihood is it’s the flu or simply the respiratory illness. At the very least, it could help limit any confusion or anxiety that patients could also be feeling, wondering what they need. Taking advantage of a virtual visit with a doctor will be an honest start towards getting and feeling better while limiting the spread of germs.

Get involved magisterially and acquire informed about evolution!

Table of Contents

Introduction

Chapter 1......................................................................................What Is Coronavirus?

Chapter 2........................................................................Properties of Corona Viruses

Chapter 3............................................................................Your Risk & the Symptoms

People at Risk

The Symptoms

Fatality Rate

The Transmission Rate

The Incubation Period

Chapter 4......................................What to Do During an Epidemic or a Pandemic

Disaster Preparedness

Stocking Up on Supplies

Keep Your Distance

Limit Your Time Out in Public

Make Sure You’re Immunized

Chapter 5.............................................................Preventive Measures by Countries

Chapter 6..........................................................................Global Spread And Reponse

Chapter 7..........................................................................................Protecting Yourself

Chapter 8................................................................................How It’s Affecting China

Chapter 9....................................................Prevention And Immune Strengthening

Chapter 10.................................................................................The Virus & Your Body

The Second Study

The Third Study

Chapter 11...............................................................What to do During a Quarantine

What Supplies to Keep at Home

Don’t Travel

Wear Masks When Accepting Deliveries

Don’t Break Your Quarantine, Even if You Feel Better

No Visitors

Don’t Share Germs, No Matter What

Disinfect Surfaces Regularly

Call for Medical Assistance When Needed

Chapter 12..............How to Handle Quarantine with One Sick Family Member

Wear a Mask when Helping the Patient

Quarantine the Patient in Their Room

Disinfect All Surfaces in the House

Keep Conflicts to a Minimum and Resolve them Quickly

Play Games to Keep Everyone Occupied

Plan Activities to Entertain the Family

Conclusion