It is not possible to distinguish clearly between symptoms of the common cold, influenza and the COVID-19.
In an article in the Lancet, it was reported that there were three major patterns of the clinical course of infection:
Mild gradual illness with upper respiratory tract presenting symptoms;
Severe pneumonia with acute respiratory distress syndrome (ARDS) that begins with mild symptoms for 7–8 days and then progresses to rapid deterioration and ARDS requiring advanced life support.
According to the WHO, the majority of the novel coronavirus cases in China were considered “mild”. A breakdown of cases provided by Chinese authorities found that 80 per cent of the cases were mild, 15 per cent severe and 5 per cent critical. There were relatively few cases amongst children and more research as needed to understand why. Severe disease more likely among older people or those with coexisting diseases, such as diabetes, pulmonary disease, and other chronic conditions.
Transmission and Infectiousness Update
Preliminary studies suggest that incubation period for the COVID-19 can range from two to 14 days. Mean incubation period observed in a study: 5.2 days. The role of pre-symptomatic transmission (infection detection during the incubation period prior to illness onset) is unknown.
Scientists have estimated that each infected person could spread it to somewhere between 1.5 and 3.5 people without effective containment measures. The extent of transmission in pre-symptomatic individuals is currently still being investigated.
Like other human coronaviruses, transmission of the COVID-19 occurs through droplets and can happen through:
Coughing and sneezing
Close personal contact, such as touching or shaking hands
Touching an object or surface with the virus on it, then touching your mouth, nose, or eyes before washing your hands
The role of faecal–oral transmission is yet to be determined in COVID-19.
Medical care of viral pneumonia is largely supportive using medication and to help relieve symptoms and address seven complications such as bacterial infections. There are no licensed vaccines or coronavirus antivirals.
MOH reported that a combination drug, comprising lopinavir and ritonavir, is being used on a small number of patients with positive outcomes so far.
Meanwhile, scientists from the United States to Australia, led by the Coalition for Epidemic Preparedness Innovations (CEPI) established in 2017, are using new technology in an ambitious, multi-million-dollar drive to develop a vaccine in record time.
Updates on Definition of Suspected Case of COVID-19
In view of the rise in imported cases in Singapore, the MOH definition of a suspect case of the COVID-19 infection revised on 10 March to be:
a. A person with clinical signs and symptoms suggestive of pneumonia or severe respiratory infection with breathlessness AND who within 14 days before onset of illness had travelled to affected areas as listed above.
b. A person with an acute respiratory illness of any degree of severity who, within 14 days before onset of illness had:
i. Been to Hubei Province (including Wuhan city), China, Daegu city or Cheongdo County, Republic of Korea; OR
ii. Been to a hospital in affected areas listed above; OR
iii. Had *close contact with a case of COVID-19 infection.
Affected areas include:
- Mainland China
- South Korea
*Close contact is defined as:
Anyone who provided care for the patient, including a health care worker or family member, or who had other similarly close physical contact;
Anyone who stayed (e.g. household members) at the same place as a case.