An infectious doctor's perspective on COVID-19

I usually stick to professional posts, but I'll make an exception for the clearest COVID-19 explanation that I have seen thus far. Original post by Malin Lagerl?f, translated by Google Translate plus a few manual edits (thanks Anneli Albertsson).

My brother's colleague Olle, investigator at the Swedish Medical Products Agency and infectious doctor has written this text about the Corona virus. Think it is so clear and good that I asked to post it. Read though it is long! You get wiser.

Olle Karlstr?m, investigator at Effect and safety at the Swedish Medical Products Agency and infection doctor at Karolinska, gives us a snapshot of the Corona virus and how we should think together to help prevent the spread of infection.

The disease symptoms are mild for the absolute majority

The fact that the spread of SARS-CoV-2 goes so fast means that the majority of those infected should have mild symptoms, and now we know that is the case. The figures on the "number of infected" and the number of deaths reported daily on the news are very misleading. In Wuhan, where it all started, it can be assumed that a very large part of the population (11 million) is infected, not 80,000 as stated in news; only those with more severe symptoms have been tested. Maybe 3-4 million have been infected there, rather. On the other hand, the number of deceased people is quite good.

Wuhan is a densely populated metropolis, and my understanding is that generational living is common in China, ie grandma / grandfather lives with children and grandchildren. An effective way for rapid dissemination to the risk groups, i.e. the elderly.

This is confirmed by what we have seen so far at Karolinska Hospital, where I work at the infection clinic half my working time. Initially, people with respiratory symptoms who came home from risk areas (especially Italy) were invited to get tested. Of the approximately 250 people who tested positive, almost all had common cold symptoms, or symptoms of mild flu. Of these, virtually none have had to be admitted for medical reasons in connection with testing, and of those sent home for quarantine, virtually no one has had to seek care later because of more severe symptoms.

Our Swedish data, which are taken "from the bottom" of the pyramid from which we see pictures in China and Italy, show that the disease symptoms are very mild for the absolute majority. The vast majority of people with severe illness, and deceased, in China and Italy, are old (80+) and usually with some basic morbidity.

It is therefore important to understand that in the coming year a large proportion of the Swedish population will have been infected, most without having labeled it otherwise as a common cold. There is no way to prevent this. A small proportion will have severe illness, and by and large it will be the elderly and the sick. Children have not been affected by severe illness, although they have certainly become highly infected abroad in China and Italy.

Stay home if you're sick

All the calls and measures that are being made now have one purpose: to get the spread (which will happen) to a slower pace so that the small proportion of people who become seriously ill can be taken care of in a good way in health care, and not come in too many at a time.

Many are now afraid to become infected themselves thinking of images from Italy, and stay at home for this reason. It's understandable, but wrongly thought. We should keep going to work, but go home when we feel like we have a cold.

The children should, at least now, go to school, but be home when they have a cold. Then they should also not go other places/ the store and infect people there instead. All in solidarity with the elderly sick, for the aforementioned reasons. Grandma / Grandpa or Grandma and Grandpa should not take care of the children.

In Italy, the spread has certainly been going on for much longer than stated, and spreading occurred early (without being understood) even among healthcare professionals and in hospitals. The measures now being taken in Italy are likely to have little impact on the future. Here, too, people live more densely than in Sweden, spending time at bars, cafes and the proximity to the older generation can probably be different than in Sweden. Our sparse country, where our elderly care for themselves or live in care homes, may be in our favor this time around, as long as the care staff only works if they are healthy.

What do you think is the most effective way to prevent infection right now?

- Do not go to work and school if you have a cold, then you should "do Netflix"- do not play with friends at home, or stop by your local store.

- Wait for two days after you feel well before returning to work or sending children to school.

- Wash your hands when you come to work, before you eat, and when you come home from work.

- Avoid meeting people if you have a cold. Regular common sense.

- You should not avoid going to work, meeting friends and living as usual as long as you do not have such problems. Little grandchildren might say hello to Grandma via Skype rather than meeting indoors.

- Take the chance to start cycling and go to work - that's great for many reasons.

It is important to understand that the advanced protective equipment now used at the infection clinics is designed to prevent infection from reaching via personnel to the ward and other patients, not to protect the staff as such. We will be infected as much as others. At the shops, the bus or some other place where we pick up our colds.

An employee is found infected at LV, do I need to be worried about going to work?

Of course not, and I hope the description above makes it understandable. Please note that the healthcare system is now changing its testing recommendations. We will only test for medical reasons. That is, just as we usually take samples for respiratory tract infection, when deciding how to treat for pneumonia and when admitting to hospital.

Healthcare / nursing staff will already be tested for cold symptoms, in order to as far as possible keep the virus away from nursing homes and hospitals, where the risk groups for severe illness are present.

Would you yourself travel abroad right now?

No, now comes the Swedish spring. Heard the first chaffink today. And it wouldn't be fun to go abroad right now, as everything is affected. But the infection, it will keep spreading at home too. Slowly, if we all help out.

What exactly is Covid-19?

The Coronavirus (CoV) family has long been present in humans. There are a number of different strains and Coronavirus constitutes a proportion of the viruses that give us common cold. More recently, three new Corona strains have transferred to humans from the animal kingdom, a virus to which we have no immunity.

In 2002, there was a minor epidemic with Corona where the disease was named SARS (Severe Acute Respitatory Syndrome) in fr.a. China, but also Canada had a number of cases. This virus, called SARS-CoV, caused severe symptoms in a large proportion of those who became ill, and mortality was high. The virus died out - a virus that causes such severe symptoms is rarely spread effectively in the population (you do not go around and transmit it in the form of common cold).

2012 came the next coronavirus, originating in Saudi Arabia. The source of infection was camels. This virus causes pronounced airway disease, and human-to-human infection has been sparse, and no actual outbreaks have occurred. The disease condition was called MERS (Middle East Respiratory Syndrome) and the virus is called MERS-CoV.

Now we have the third virus here, where the virus is called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and the disease "COVID-19" (COrona Viral Disease). The spread is completely different, and the picture has become very scary, with images of chaos in China and Italy. The disease picture with the previous two viruses has of course increased concern. The clinical picture is quite different for the absolute majority than for the other two, usually with symptoms such as normal upper respiratory tract infection, but where a small proportion, especially the elderly, have pronounced lung effects.