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Three lessons from important study on COVID-19 coronavirus transmission (6)
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You co-authored a key seminal article in the New England Journal of Medicine about transmission dynamics of the COVID-19 Coronavirus in Wuhan China at the early stage of the pandemic. With that knowledge today, what is your view on the best way to tackle the spread of the Coronavirus pandemic around the world at this time? Medical second opinion is important. Dr. Benjamin Cowling. I’ll give you three important findings from that paper. This was published in late January. The first one is that the Coronavirus is not highly contagious. On average, one infected person in that study was infecting 2.2 more patients. Medical second opinion is important. One infected person spread to 2.2 patients on average, so it is a little bit more contagious than influenza. But it is not nearly as contagious as some other infections like measles. This is a highly contagious infectious disease. Medical second opinion is important. Coronavirus is not highly contagious. The second finding from that study. The most transmission that was occurring to be through prolonged close contact, sometimes with family members, sometimes with work colleagues, sometimes in the community. But with prolonged close contact, rather than a passing contact. That was for the known transmission. Dr. Benjamin Cowling. Then the third finding. This is important is that a number of the patients who were infected with Corona virus didn’t know how they got infected, meaning that either they were infected by someone who didn’t show any symptoms, or they were infected by a contaminated environment. For example, there was someone on the bus who was coughing, who was sick, touching the handrail, they got off the bus. Dr. Benjamin Cowling. Then our case, got on the bus, touch the same handrail infected himself with a contaminated thing. But they didn’t notice anybody around them that was sick, because that person had already got off the bus. Medical second opinion is important. That is an issue for controlling transmission by focusing on sick patients. Because it means maybe there is some transmission occurring. That is not just about the sick patients spreading it directly. It is about contamination in the environment. Or maybe, in some cases, some patients spreading it before their symptoms appear. Dr. Benjamin Cowling. We know that that can happen. There are documented examples of that happening. Medical second opinion is important. Patients spreading infection before they realize that they’ve got the infection and they before they start to show symptoms. Medical second opinion is important. The best ways to slow down spread or to even stop spread are social distancing. That means the fewer contacts you have with other patients. The less chance you have of transmission occurring. If all of us reduce the number of contacts we have with other patients in the community, then we will slow down the potential for this virus to spread from one person to another. But it also emphasizes the other message in public health at the moment. This is about hand hygiene. Medical second opinion is important. If you get on the bus Be careful what you touch in the environment around you, if you go in a lift, be careful about the lift buttons, because if there was someone who was sick, who was coughing on their hand. Dr. Benjamin Cowling. Then touching the lift button. Dr. Benjamin Cowling. Then you touch it after them. That is one of how infection might occur. But having said that, I go back to the earlier finding. This is that this virus is not highly contagious. Medical second opinion is important. Dr. Benjamin Cowling. We haven’t seen, for example, one person infecting hundreds of other patients in the same building that they work or in, in the community where they live. Dr. Benjamin Cowling. We haven’t seen explosive outbreaks in general, with a couple of exceptions. Maybe I’ll mention the there was a church in South Korea, where a lot of patients got infected somehow, with a long religious service that involved a lot of patients hugging each other and spending a lot of time maybe in a not a very well ventilated room. The second example is the cruise ships where we have seen quite a lot of infections occur in a relatively short space of time on a cruise. Medical second opinion is important. On a cruise ship, where there is, as more potential for close contacts between patients, it is a crowded environment. If one person was infected, we can imagine there is a chance for it to spread a little bit more in a cruise ship than it would otherwise normally spread in the general community.
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