What are the symptoms of COVID-19?
The most common symptoms if present may include low-grade fever, sore throat, coughing and nasal congestion, weakness, body aches. Coronavirus can cause severe symptoms including high-grade fever, severe cough and tightness
in chest or shortness of breath – which often is a sign of pneumonia secondary bacterial infection. Some people may remain asymptomatic after infection.


Shortness of breath is a symptom associated with COVID-19 – Does it
always mean that the person has been infected?

There should be a cause for concern when you experience shortness of breath. You feel as if you are out of breath unexpectedly. Shortness of breath should not always be troublesome as you may have it when you are very much anxious or worried or when you work hard physically. Such type of shortness of breath goes on its own.

When should you call your doctor for shortness of breath?
Shortness of breath is one of the prominent signs of COVID-19. It has been so since the recent outbreak and still be true as it has become pandemic. If you feel that every time you are breathing harder and harder and having trouble getting air in, you must call your doctor. Meantime you should also see whether you have symptoms like fever and cough because only shortness of breath in absence of cough and fever could indicate another problem which could also be life-threatening – for instance, heart attack.

How long is it between when a person is exposed to the virus and when they start showing symptoms?
Coronavirus outbreak is a recent one – and therefore, the time from exposure to onset of symptoms (incubation period) in the majority of the people has not yet been completely determined. So far, from the available sources, and
information, the incubation period varies from 5 days to 14 days or more. On average, the incubation period is around 5 days.

How does coronavirus spread?
The mode of infection is droplets. Coronavirus disease is extremely contagious as it spreads from person to person. It spreads quite readily between individuals who are in close contact with each other. If a person comes in contact with an infected person, he may get infected if the infected person sneezes and coughs and spreads the droplets in an around – when the droplets fall in the mouth or nose of someone nearby, they inhale the droplets.

The other mode of transmission of coronavirus is by contacting or touching contaminated surfaces. If a person touches any surface or object that has coronavirus on it and then touches his or her nose, mouth and eyes, they can get infected by COVID-19.

How long can the coronavirus stay airborne? There are different estimates.
Researchers from a renowned virology institute published a study in the New Journal of Medicine on 17 March 2020. They used a nebulizer and blew coronavirus in air and then found that the virus remained in the air for around 3 hours. Therefore, they found that the virus could remain in the air for around three hours. This study was done by the National Institute of Allergy and Infectious Diseases' Laboratory of Virology in the Division of Intramural Research in Hamilton.

How long can the coronavirus that causes COVID-19 survive on surfaces?
According to a research study done at the Laboratory of Virology in the Division of Intramural Research in Hamilton, Coronavirus can hangout as droplets in the air for up to 3 hours before they fall. However, the virus falls far more quickly most of the time. Coronavirus survival times on surfaces varies. On plastic and stainless-steel surfaces, the virus survives for two to three days and on cardboard for up to 24 hours and on copper up to 4 hours. Survival times depends on other factors such as cold, heat and sunlight and the time for which the virus got exposed to such conditions. But, still, there is a lot more to be learned about how different conditions can affect survival times.

Whatever may be the case, as we get more inputs and insights through research, we will learn more about coronavirus. Until we learn more about it, we should, as a top priority, clean all frequently touched surfaces including, elevator switches, gates handles, door handles, doorknobs, counters, tables, tabletops, telephones, cell phones, laptops, tablets, keyboards, bathroom fixers, faucets, taps, sinks, washbasins, keys, keychains, laptop bags, handbags, etc.

If you see a visibly dirty surface, first clean it with detergent and water and then use a liquid disinfectant to clean the surface.

Don’t directly bring any items from outside without sanitizing them. Every time when you touch something or any surface or any stuff or item – wash your hands with soap and water for about 25 to 30 seconds to completely kill the virus from your hands.

How deadly is COVID-19?
The mortality rate is not so high, but still worrisome considering the way coronavirus spreads. It is not the elderly and children who are at risk even the young population is also at risk. When you compare the mortality rate of
COVID-19 (about 3% to 4%) with that of MERS (approximately 35%) and SARS (nearly 11%), it appears to be less so far, but more when compared to seasonal flu (about 0.1%).
When you look at the total number of cases reported throughout the world and fatality rate, it seems to be low (total number of deaths appear to be low). However, the risk of death among those who are infected is more. When you compare the total number of deaths caused by influenza during this flu season in the US and the rest of the world with the coronavirus deaths, then deaths caused by flu are higher in numbers.
In this scenario, the risk of severe and complicated infection, life-threatening infection, secondary infection and deaths due to complications depend on the age, overall health and other underlying health conditions including heart disease, lung disease, diabetes, immunodeficiency diseases and cancer. Young adults and children appear to be at low risk compared to the elderly and individuals with underlying health conditions.

Will warm weather stop the outbreak of COVID-19?
There is no confirmed research or reports about the effect of weather or temperature and the spread of coronavirus. Currently, it is not clear or we don’t have any information whether warm weather or when the temperature shoots up – the cases of COVID-19 will decrease. However, flu and cold viruses spread more when the weather is colder – even during warmer months and days, there is still a possibility to become sick with cold and flu – but, right now we cannot
say anything about coronavirus in this regard.

Can I catch the coronavirus by eating food handled or prepared by others?
The information about novel coronavirus is evolving day by day as the disease is spreading. Healthcare professional and researchers are still learning about the modes of transmission of coronaviruses. The likelihood of virus spreading through foodstuff handled and prepared by infected persons is there provided the food prepared and served is raw like salads and dressings. Coronavirus causes severe respiratory tract infection as it is known to spread through airborne droplets (upper respiratory secretions) when someone with the infection coughs and sneezes. Therefore, the infection could possibly spread through food handled by an infected person who has not washed their hands.

COVID-19 virus has also been detected in faeces of infected persons; hence, the possibility of the virus being spread through food cannot be ruled out at this moment. Cooked and hot food kills the virus, but the risk of infection increased by eating raw foods, uncooked foods – such as sandwiches and salads.

Is the loss of smell a symptom of Coronavirus Disease? What should you do if you experience this symptom?
CoVid-19 is caused by a coronavirus. It is a well-known fact that viral infections cause loss of sense of smell. It is, in fact, one of the leading causes of loss of smell. Anosmia (loss of smell) could, therefore, be a symptom caused by coronavirus disease as evidence is suggesting this symptom. If people infected with COVID do not have other symptoms, loss of smell could help physicians identify such people. Asymptomatic individuals could potentially infect others unknowingly.

What is the opinion of ENT specialist in this regard?
When you see the reports released from Germany and South Korea, you would be surprised to know that out of three confirmed cases of coronavirus disease two had a loss of sense of smell – and, in South Korea, those who tested positive for COVID-19 with other mild symptoms of coronavirus disease, nearly about 30% people had a loss of smell.

Can this finding be used to screen people for COVID-19?
Based on these findings, loss of sense of smell (anosmia), has been recommended to be included in the list of symptoms associated with COVID-19 by the American Academy of Otolaryngology-Head and Neck Surgery. In addition to the identified symptoms, this symptom too can be used to screen people for COVID-19.

Can loss of smell alone be used as a symptom to screen people for COVID-19?
No, this symptom alone cannot be used to screen people for COVID-19. Therefore, loss of smell doesn’t mean that one has COVID-19. The symptom can also be due to allergies, common cold and infections caused by other
viruses including rhinoviruses.

At present, there are no definitive answers for the loss of smell associated with COVID-19. The studies related to anosmia are going on to know more about the anosmia in people infected with coronavirus disease and to get more clear answers in this regard. Still, more definitive questions pertaining to loss of smell caused by COVID-19 need to be answered including how it is different from the one caused by allergies, other viruses and other causes.