Articles

Handy Guide to: Eldercare Grants and subsidies in Singapore

 July 4, 2020

According to the Ministry of Health, Singapore is facing a rapidly ageing population. The number of elderly in Singapore has increased to 13% in 2015 and is forecasted to reach 24% in 2030. In riding the silver tsunami, there is an increased importance placed on eldercare in Singapore. The government is hence actively pumping more funds and creating more Eldercare grants and subsidies such as Eldershield and Seniors mobility and enabling fund (SMF) to help make healthcare more accessible and affordable for the growing elderly population.

Elder care services doesn’t need to be a cause for financial burden for your family.  Education is definitely important to make healthcare affordable and accessible for everyone!

COVID 19: Caregiving for the Elderly

 June 26, 2020

When it comes to COVID-19, the disease caused by the new coronavirus, older people are especially vulnerable to severe illness. Research is showing that adults 60 and older, especially those with preexisting medical conditions, especially heart disease, lung disease, diabetes or cancer are more likely to have severe — even deadly — coronavirus infection than other age groups.

If you’re caring for an older loved one, you might be worried. Alicia Arbaje, M.D., M.P.H., Ph.D. specializes in internal medicine and geriatrics at Johns Hopkins. She shares what you need to know to keep elderly people safer, and what to do if they do become infected with COVID-19.

Keep yourself well

First and most important, as a caretaker you should take all the precautions you can to avoid becoming infected yourself. Here are the basics:

  • Wash your hands frequently with soap and water for at least 20 seconds before and after providing care, preparing food, using the bathroom, or touching surfaces in public places.
  • Avoid crowds, and if you cough or sneeze, do so into the bend of your elbow or into a disposable tissue.
  • Keep your hands away from your face.
  • Clean frequently touched surfaces in your home often, including mobility and medical equipment used by your loved one, such as walkers, canes and handrails.

Practice physical distancing but not social isolation

One important way to lower the risk of your older family members catching COVID-19 is to limit in-person visits. But this may be tough for older adults who cherish time spent with friends and family members.

Arbaje says, “Physical distancing doesn’t have to mean isolation or loneliness. We need to keep older adults safe, but also keep in mind that social isolation can have a negative impact on older people’s  immunity and mental health.”

She notes that in terms of social contacts, seniors should be encouraged to think beyond their usual circle of friends and family. “Saying hello to the mail carrier or checking in on neighbors close by can add to a sense of connectedness,” Arbaje says.

With many houses of worship closing their doors until the pandemic eases, congregants, especially older ones, may feel cut off. “Faith communities are often a big part of older adults’ social lives,” Arbaje says. Caregivers might help their loved one access online services and outreach for spiritual solace and support.”

Technology for Staying Connected

To help older adults feel involved, purposeful and less lonely during the pandemic:

  • Show them how to video chat with others using smartphones, laptops or tablets.
  • Use apps on these devices to provide captions for adults with hearing challenges.
  • Encourage friends and family outside of your household to telephone, write notes or send cards to lift your loved one’s spirits.

Keep elders involved

Arbaje recommends giving homebound older adults a project they can work on. “Think about going through and organizing old photos and memorabilia together, and enjoy the stories and happy memories they inspire. It can be a good time for an elder to demonstrate cooking a favorite family recipe or share favorite songs or movies with other people in the household.”

Minimize the risk of COVID-19 infection

Postpone unnecessary doctor visits. If an older adult in your care is feeling well, consider helping them postpone elective procedures, annual checkups and other non-essential doctor visits.

Keep in mind that many older people, especially those living with chronic illness, have important relationships with their caregivers. To help them stay in touch, ask their doctors’ offices if they offer telemedicine, which enables doctors and patients to communicate over video, email or other means rather than face-to-face.

Avoid travel. Older adults should put off non-essential travel, particularly cruises or trips with itineraries that would expose them to crowds.

Decide on a plan

If you can, involve your older family member in discussions of how you’ll manage interruptions of routines and what will happen if they (or someone else in your family) becomes sick. Talking things through ahead of time as a family can reduce stress and help everyone feel more involved and prepared.

Pick an emergency contact. If you’re the main caregiver, designate someone nearby whom you could rely on to care for your elderly family member if you yourself become ill.

Stock up. Gather one to three months of medications, and at least two weeks’ worth of food, over-the-counter remedies, pet supplies, and other essentials. Find out which delivery services are available in your area.

Symptoms or exposure? Call ahead

If you or your loved one learn that you might have been exposed to someone diagnosed with COVID-19 or if anyone in your household develops symptoms such as cough, fever or shortness of breath, call your family doctor, nurse helpline or urgent care facility.

Extracted from: https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/coronavirus-caregiving-for-the-elderly

 

Staying Safe in Phase 1

 June 12, 2020

 

As Singaporeans return to workplaces or social activities with the gradual re-opening after circuit breaker, the risk of transmission will increase. Everyone needs to play their part to keep Singapore COVID-safe.

How do I minimise the risk of transmission?

Here are some steps to remember:

For individuals and families

  • Maintain overall cleanliness and hygiene
  • Wear a mask outside
  • Avoid sharing food and crockery. Clear used trays and crockery after meals if dining out
  • Stay home if you fall ill
  • Practise safe-distancing, avoid crowded areas and minimise time spent outside
  • Pay special attention to seniors and other vulnerable groups
  • Facilitate contact tracing efforts by downloading TraceTogether, and using SafeEntry wherever it is used

At work

  • Employers to implement a safe-management system:
    • Work-from-home arrangements, staggered working hours, split team arrangements
    • Regular disinfection of common touch points
  • Avoid physical meetings
  • Employers to monitor employee’s health and have evacuation plans in the event of a confirmed case
  • Avoid gathering in groups during meals and break times
  • Avoid planning events that could draw large numbers of employees

At school

  • Students to remain in their respective classes and avoid mingling with students from other classes, including during recess and break times
  • Students should head home after school and school-related activities

For seniors

 

Extracted from gov.sg

Five surprising things to keep in mind about your muscles in your 40’s, 50’s , 60’s and beyond!

 May 28, 2020

Having muscle is more than just strength and how you look on the outside. Muscles play a role in your body’s movement, balance and posture, as well as your metabolism and even facial structure. While maintaining your muscles can be more challenging as you get older, science has shown that we can all be strong no matter what age.

Here are five surprising things to keep in mind about your muscles in your 40’s, 50’s, 60’s and beyond.

 

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Why some Covid-19 patients continue to test positive despite a strong recovery and no symptoms

 May 12, 2020

SINGAPORE — Some Covid-19 patients continue to test positive for the infection even though they are recovering and are clinically well and this may be because tests are picking up fragments of the coronavirus that are no longer viable, Health Minister Gan Kim Yong said on Monday (May 4).

He said this in Parliament in response to a question by Member of Parliament for Fengshan Single Member Constituency Cheryl Chan who raised the issue of Covid-19 patients who are recovering well but continue to test positive for the coronavirus despite being housed in community care facilities.

In some cases, patients are in these facilities for over a month.

Mr Gan explained that in some cases the fragments may return a positive result on the test but these patients are no longer infectious.

The Government, he said, is in talks with infectious disease experts on what more can be done for such patients.

TODAY spoke to infectious diseases experts to understand the peculiarity of these test results.

WHAT ARE THESE FRAGMENTS?

The coronavirus requires many components to be fully infectious, said Associate Professor Richard Sugrue, who is a virologist from Nanyang Technological University’s School of Biological Sciences.

First, the particle is surrounded by a membrane and on this, there is a spike protein, which forms the knob-like structures that appear on many visual representations of the virus.

These structures are used by the virus to gain entry into cells.

The virus genome is buried inside the particle and is associated with a protein that stabilises and protects it from other cell enzymes that could degrade it.

When the virus particle is disrupted into its separate parts by the patient’s immune system, the virus becomes non-infectious.

Currently many diagnostic tests seem to be detecting these residual fragments, said Assoc Prof Sugrue.

Elaborating, Associate Professor Hsu Li Yang, co-director of National University Singapore’s Saw Swee Hock School of Public Health’s global health department, said the coronavirus PCR (polymerase chain reaction) tests, which is what Singapore is using, do not distinguish between “live” virus fragments or fragments of virus genetic material — the “dead” virus.

“The PCR tests identify small segments of genetic codes unique to the virus and amplify them. These amplified portions of the genetic code can then be detected by various means depending on the testing systems used.”

WHY DO PATIENTS WHO FEEL WELL SHED THE VIRUS?

There are many reasons why some patients continue to shed the virus — both “live or “dead” — after they have recovered, said Assoc Prof Hsu.

But a key reason is that recovering from an infection does not always go in tandem with how and when viruses multiply and spread.

This means an individual’s virus load is not necessarily representative of the severity of their symptoms or how poorly they are feeling.

For instance, there is evidence that other viruses, such as those that cause influenza or chickenpox, can shed and spread to others before the patient develops symptoms.

The virus for these infections can also be detected in a patient days after he or she has recovered.

“But the virus is ‘dead’ most of the time or shed in very low quantity and will usually not infect anyone,” said Assoc Prof Hsu.

Dr Leong Hoe Nam, an infectious diseases specialist from Mount Elizabeth Hospital, noted that the same has been uncovered for the coronavirus.

Studies have now shown that the virus that causes the Covid-19 disease can be found in a patient one to two days before the onset of fever, said Dr Leong. He added that coronaviruses are known to shed for up to six weeks.

So far, the longest known period that these fragments can stay in the body is over 70 days from the start of the infection, said Assoc Prof Hsu.

WHY DO SOME PEOPLE TAKE LONGER THAN OTHERS TO RID THEMSELVES OF THE VIRUS?

Not much is known as to how and why this differs from person to person.

Said Assoc Prof Hsu: “We do not yet understand the mechanism, but people who have been more ill, or who have had their immune systems suppressed, tend to shed virus for a longer period of time.”

Professor Wang Linfa of Duke-NUS Medical School said there is still no conclusive evidence to show the exact mechanism of why this is happening in some patients.

“More research is needed on the topic before (infectious diseases experts) can make any conclusive remarks.”

IS IT SAFE TO HAVE CLINICALLY WELL BUT POSITIVE PATIENTS DISCHARGED?

While the risk of this group passing the infection on to others is slim, Dr Leong said it would still be “a big leap of faith” to let them back into the community while they still test positive for Covid-19.

“All we need is to make one mistake and we could undo our (progress fighting the virus),” he said.

However, one scenario where he sees the authorities considering discharging these patients back to the community is if the healthcare system no longer has the capacity to take in new patients.

These individuals would likely still have to be kept away from the greater community and be put under more stringent rules than those under current stay-home notices and instead follow quarantine order rules even while at home.

“The person would have to stay in his own room, have food placed outside his room and someone would have to help launder his clothes, for example, without him having to come out,” said Dr Leong.

But he added that at the moment, the Government has “no stress” to make such a move as it is still planning to open more community care facilities for Covid-19 patients.

Extracted from Today Online

89m shoddy face masks swiped in China crackdown

 April 30, 2020

China has confiscated over 89 million poor-quality face masks, a government official said yesterday, as Beijing faces a slew of complaiabout faulty protective gear exported worldwide.

Demand for protective equipment has soared as nations across the globe battle the deadly coronavirus, which has infected around 2.9 million people.

But a number of countries have complained about faulty masks and other products exported by China, mostly for use by medical workers and vulnerable groups.

As of Friday, China’s market regulators had inspected nearly 16 million businesses and seized over 89 million masks and 418,000 pieces of protective gear, said Gan Lin, deputy director of the State Administration of Market Regulation.

Regulators had also seized ineffective disinfectants worth over 7.6 million yuan (HK$8.31 million), she said.

It is unclear how much of the confiscated goods were destined for markets abroad.

China released new rules Saturday saying even non-medical masks must meet both national and international quality standards. Exporters must also file a written declaration that their medical products meet the safety requirements of the destination country, the ministry of commerce said.

The tighter rules come after several countries including Spain, the Netherlands and Turkey were forced to recall hundreds of thousands of masks and pieces of protective gear imported from China. The Canadian government last week said that about one million face masks purchased from China failed to meet proper standards for healthcare professionals.

Extracted from The Standard HK

6 science-backed activities to help you relax while you’re home

 

If you’ve been inside for days on end amid the COVID-19 pandemic, you might be getting a little stir-crazy — or at the very least, feeling bored.

“Human beings are not real great about endless time at home, not really knowing what to do with yourself,” Lauren Murray, a clinical psychologist and associate scientist at Johns Hopkins University, School of Public Health in the Department of Mental Health and International Health, tells CNBC Make It. In other words, we’re not great at having free time.

You don’t have to use this time to write the next great American novel; indeed, there’s a lot to worry about and do. But if you are looking for some structure in your day, here are some relaxing activities you can do at home during the COVID-19 quarantine.

Color or doodle

Studies have shown that “structured coloring of a reasonably complex geometric pattern,” such as a symmetrical mandala pattern or coloring book, can lead to a meditative state that helps reduce anxiety. Consider breaking out your adult coloring books, or drawing your own pattern.

Go for a walk

Walking not only counts as physical activity, but also provides some mental health benefits. If you can get outside to walk, studies have shown that a brisk walk can make you feel more creative. A 2016 study found that walking can make you happier and reduce feelings of boredom and dread, even if you’re just walking indoors. (Walking outside and staying at least six feet from other people is safe during the COVID-19 pandemic, FYI.)

Sleep

Aim to get seven to eight hours of sleep, because when you’re sleep-deprived your body has a harder time fighting infectious diseases, according to the Mayo ClinicStudies have shown that people are more likely to get infected with other types of viruses (like influenza and rhinovirus) if they’re sleep-deprived.

If you’re going to take a nap, stick to 10 to 20 minutes to avoid feeling groggy or messing with your sleep-wake cycle, according to the Mayo Clinic.

Just keep in mind that sleeping too little or too much can be a symptom of depression.

Do yoga

Feeling stiff from sitting at your WFH station? Consider doing some yoga. Not only does it count as physical activity, but studies have shown that yoga can boost your mood, lower stress and anxiety and boost your self-esteem.

There are several online yoga classes to explore from the comfort of your own home, such as YouTube’s Yoga With Adriene or CorePower Yoga On Demand.

Chat with a friend

Call, text, email or video chat with your friends and family. Just because you’re socially distancing doesn’t mean that you can’t connect. Research has shown that social support can make you more resilient to stress.

Listen to (or play) music

You’ve seen the viral videos of people singing while quarantined, and it turns out they may be onto something: Singing has been shown to improve people’s mental health and sense of belonging.

Not much of a musician? Listening to music can help people in the face of a scary and stressful experience; a study on cancer patients found that music reduced anxiety and pain, while bolstering people’s moods.

Extracted from CNBC

Coronavirus: what happens to people’s lungs if they get Covid-19?

 March 24, 2020

What became known as Covid-19, or the coronavirus, started in late 2019 as a cluster of pneumonia cases with an unknown cause. The cause of the pneumonia was found to be a new virus – severe acute respiratory syndrome coronavirus 2, or Sars-CoV-2. The illness caused by the virus is Covid-19.

Now declared as a pandemic by the World Health Organisation (WHO), the majority of people who contract Covid-19 suffer only mild, cold-like symptoms.

WHO says about 80% of people with Covid-19 recover without needing any specialist treatment. Only about one person in six becomes seriously ill “and develops difficulty breathing”.

So how can Covid-19 develop into a more serious illness featuring pneumonia, and what does that do to our lungs and the rest of our body?

How is the virus affecting people?

Guardian Australia spoke with Prof John Wilson, president-elect of the Royal Australasian College of Physicians and a respiratory physician.

He says almost all serious consequences of Covid-19 feature pneumonia.

Wilson says people who catch Covid-19 can be placed into four broad categories.

The least serious are those people who are “sub-clinical” and who have the virus but have no symptoms.

Next are those who get an infection in the upper respiratory tract, which, Wilson says, “means a person has a fever and a cough and maybe milder symptoms like headache or conjunctivitis”.

He says: “Those people with minor symptoms are still able to transmit the virus but may not be aware of it.”

The largest group of those who would be positive for Covid-19, and the people most likely to present to hospitals and surgeries, are those who develop the same flu-like symptoms that would usually keep them off work.

A fourth group, Wilson says, will develop severe illness that features pneumonia.

He says: “In Wuhan, it worked out that from those who had tested positive and had sought medical help, roughly 6% had a severe illness.”

The WHO says the elderly and people with underlying problems like high blood pressure, heart and lung problems or diabetes, are more likely to develop serious illness.

How does the pneumonia develop?

When people with Covid-19 develop a cough and fever, Wilson says this is a result of the infection reaching the respiratory tree – the air passages that conduct air between the lungs and the outside.

He says: “The lining of the respiratory tree becomes injured, causing inflammation. This in turn irritates the nerves in the lining of the airway. Just a speck of dust can stimulate a cough.

“But if this gets worse, it goes past just the lining of the airway and goes to the gas exchange units, which are at the end of the air passages.

“If they become infected they respond by pouring out inflammatory material into the air sacs that are at the bottom of our lungs.”

If the air sacs then become inflamed, Wilson says this causes an “outpouring of inflammatory material [fluid and inflammatory cells] into the lungs and we end up with pneumonia.”

He says lungs that become filled with inflammatory material are unable to get enough oxygen to the bloodstream, reducing the body’s ability to take on oxygen and get rid of carbon dioxide.

“That’s the usual cause of death with severe pneumonia,” he says.

How can the pneumonia be treated?

Prof Christine Jenkins, chair of Lung Foundation Australia and a leading respiratory physician, told Guardian Australia: “Unfortunately, so far we don’t have anything that can stop people getting Covid-19 pneumonia.

“People are already trialling all sorts of medications and we’re hopeful that we might discover that there are various combinations of viral and anti-viral medications that could be effective. At the moment there isn’t any established treatment apart from supportive treatment, which is what we give people in intensive care.

“We ventilate them and maintain high oxygen levels until their lungs are able to function in a normal way again as they recover.”

Wilson says patients with viral pneumonia are also at risk of developing secondary infections, so they would also be treated with anti-viral medication and antibiotics.

“In some situations that isn’t enough,” he says of the current outbreak. “The pneumonia went unabated and the patients did not survive.”

Is Covid-19 pneumonia different?

Jenkins says Covid-19 pneumonia is different from the most common cases that people are admitted to hospitals for.

“Most types of pneumonia that we know of and that we admit people to hospital for are bacterial and they respond to an antibiotic.

Wilson says there is evidence that pneumonia caused by Covid-19 may be particularly severe. Wilson says cases of coronavirus pneumonia tend to affect all of the lungs, instead of just small parts.

He says: “Once we have an infection in the lung and, if it involves the air sacs, then the body’s response is first to try and destroy [the virus] and limit its replication.”

But Wilson says this “first responder mechanism” can be impaired in some groups, including people with underlying heart and lung conditions, diabetes and the elderly.

Jenkins says that, generally, people aged 65 and over are at risk of getting pneumonia, as well as people with medical conditions such as diabetes, cancer or a chronic disease affecting the lungs, heart, kidney or liver, smokers, Indigenous Australians, and infants aged 12 months and under.

“Age is the major predictor of risk of death from pneumonia. Pneumonia is always serious for an older person and in fact it used to be one of the main causes of death in the elderly. Now we have very good treatments for pneumonia.

“It’s important to remember that no matter how healthy and active you are, your risk for getting pneumonia increases with age. This is because our immune system naturally weakens with age, making it harder for our bodies to fight off infections and diseases.”

 

Extracted from The Guardian

We’re Reading the Coronavirus Numbers Wrong

 February 25, 2020

 

Numbers have a certain mystique: They seem precise, exact, sometimes even beyond doubt. But outside the field of pure mathematics, this reputation rarely is deserved. And when it comes to the coronavirus epidemic, buying into that can be downright dangerous.

Naturally, everyone wants to know how deadly COVID-19, the disease caused by the new coronavirus, is. The technical term for that is the case fatality rate — which is, put simply, the number of people who have died from the disease (D) divided by the total number of people who were infected with it (I), or D/I. As of Tuesday morning, at least 1,873 people were thought to have died from the disease worldwide and 72,869 people to have been infected.

But those figures may not mean what you think.

The number of deaths (D) seems like it should be easy enough to determine: After all, dead is dead. And yet ascribing a cause of death can be tricky.

The coronavirus might be blamed for the deaths of vulnerable people, especially seniors, already suffering from other illnesses, such as diabetes and other chronic conditions. On the other hand, some deaths will be attributed to other illnesses that might more accurately be ascribed to COVID-19.

Even more problematic is figuring out the total number of infected people (I) — call that the mystery of the denominator. Patients who have tested positive and are hospitalized are included in that tally, of course. But what about those who are being treated without formally having been tested? Or those who might be infected and yet display no symptoms?

Another complicating factor is the remaining number of unresolved or indeterminate cases: Medical experts still aren’t sure, for example, how long the infection’s incubation period may be.

And then, in addition to the uncertainty inherent in the basic numbers, there are the distortions unintentionally created by the way those numbers are reported by medical officials and presented by the media.

Last week, the authorities of Hubei, the province in China at the center of the epidemic, revised their definition of what it means to be infected by the new coronavirus: On Thursday, they started including people who displayed symptoms associated with COVID-19 — coughing, a fever, difficulty breathing — even if those people hadn’t been tested or had tested negative for the virus. As a result, the number of new daily cases increased by a factor of nine overnight.

But what did that spike reveal, in fact?

If the daily tally of newly infected people increases, does that mean the disease actually is spreading at that moment? That it is more contagious than we had known?

And if the number of deaths — or the ratio of deaths to infections — jumps from one day to the next, does that mean the disease has just gotten more lethal? Or that it actually is more lethal than we thought it was the day before?

Not necessarily, though it may seem or feel that way. The shifts might be short-term adjustments or simply the effects, or artifacts, of delayed disclosures — a kind of numerical optical illusion.

Yet when news outlets reported last week, after the revision in what counts as an infection, the largest jump in reported cases “in a single day and more than twice the previous record high,” readers could be forgiven for assuming that the situation had just taken a turn for the worse. Even articles that stated the broader circumstances of the increase could be misleading: Some, by announcing in their headlines a “dramatic spike” or a “surge” in the number of cases; others, by discussing the swell while stating that local officials had been sacked for it.

The fact that China suddenly broadened its criteria also raised fears that its earlier numbers might have been incorrect: too low, and perhaps deliberately so. National pride and the fear of economic costs or a popular backlash might have motivated underreporting, the suspicion went.

But the reasons for the shift could also be more mundane. Maybe the medical authorities in China didn’t report more infections previously because they couldn’t — because, say, they were short of reliable test kits (which they were). It’s possible that the numbers were fudged. But maybe they weren’t, or not as much as some people seem to fear. The change in criteria for what counts as an infection may indicate, not so much nefarious evidence of a cover-up now exposed, but the struggles of a local health care system overwhelmed by a sudden and colossal medical crisis.

Last Thursday, the Hubei authorities also reported a leap in the new daily tally of deaths: 242, compared with 94 for Wednesday. That’s a big jump, but not nearly as big as the increase in the number of newly infected people over the same period. Which could be a cause for some measure of relief: The disease’s lethality would seem to have decreased or be lower than was previously thought. Yet that’s not the takeaway likely to have prevailed.

Some of the reporting has amounted to a set of contradictory pronouncements, confusing at best. Journalists could display more critical distance and a modicum of skepticism toward the data they relay, instead of turning the media coverage into a hall of mirrors.

One major problem is the doing of no one in particular. The story about the coronavirus’s spread is evolving quickly, with medical authorities in China and elsewhere disclosing figures daily (or more often), and the media reporting the information immediately to satisfy the fast-paced, staccato rhythms of publishing cycles. But up-to-the-minute, blow-by-blow accounts of hard data can create mistaken impressions about the underlying facts, even if both the data and the accounts are accurate.

Last Thursday, a surge in the number of infections was reported, because of that change in official criteria. On Monday, China announced a drop in the number of new cases for the third consecutive day. Now what should we make of that?

Constant on-the-nose reporting, however much it seems to serve transparency, has limitations, too.

It’s a short-term, and shortsighted, approach that’s difficult to resist, especially when people are afraid and the authorities are taking draconian actions. It’s only natural to compare and contrast whatever hard facts are available. And yet it’s especially dangerous to do that precisely because people are so anxious, and fear can trick the mind.

A view from a loftier perch — a month’s, or even just a week’s, perspective — would, and will, produce far more reliable information.

As of Tuesday, the case fatality rate of COVID-19 appeared to be about 2.5 percent. That’s in keeping with what it was, for example, from the beginning of the outbreak up to Jan. 28. By comparison, the case fatality rate for the seasonal flu in the United States ranges between 0.10 percent and 0.18 percent. For SARS, it’s about 10 percent and for MERS, about 35 percent. For Ebola, it has varied between 25 percent and 90 percent, depending on outbreaks, averaging approximately 50 percent.

And so based on what we know so far, COVID-19 seems to be much less fatal than other coronavirus infections and diseases that turned into major epidemics in recent decades. The operative words here are “based on what we know so far — meaning, both no more and no less than that, and also that our take on the situation might need to change as more data come in.

Remember, too, that even if only a small percentage of the people infected with COVID-19 die in the end, the death toll in absolute numbers could still be dreadful if the total population of infected turns out to be very large.

However much we would like to know all the relevant facts about the coronavirus, we don’t know them right now, and we should accept the discomfort of that uncertainty. Which is all the more reason to abide by one of the things we do know at this point: You should wash your hands regularly.

John Allen Paulos is a professor of mathematics at Temple University and the author of “A Mathematician Reads the Newspaper” and, most recently, “A Numerate Life.”

What is coronavirus and how worried should we be?

 February 10, 2020

What is the virus causing the illness in Wuhan?

It is a member of the coronavirus family that has never been encountered before. Like other coronaviruses, it has come from animals. Many of those initially infected either worked or frequently shopped in the Huanan seafood wholesale market in the centre of the Chinese city, which also sold live and newly slaughtered animals.

Have there been other coronaviruses?

New and troubling viruses usually originate in animal hosts. Ebola and flu are other examples, and severe acute respiratory syndrome (Sars) and Middle Eastern respiratory syndrome (Mers) are both caused by coronaviruses that came from animals. In 2002, Sars spread virtually unchecked to 37 countries, causing global panic, infecting more than 8,000 people and killing more than 750. Mers appears to be less easily passed from human to human, but has greater lethality, killing 35% of about 2,500 people who have been infected.

What are the symptoms caused by the Wuhan coronavirus?

The virus causes pneumonia. Those who have fallen ill are reported to suffer coughs, fever and breathing difficulties. In severe cases there can be organ failure. As this is viral pneumonia, antibiotics are of no use. The antiviral drugs we have against flu will not work. If people are admitted to hospital, they may get support for their lungs and other organs as well as fluids. Recovery will depend on the strength of their immune system. Many of those who have died were already in poor health.

Is the virus being transmitted from one person to another?

China’s national health commission has confirmed human-to-human transmission, and there have been such transmissions elsewhere. As of 9 February, there have been at least 800 deaths from the virus worldwide. Infections inside China stand at almost 37,200 and global infections have passed 280 in 28 countries. The mortality rate is 2%.

Two members of one family have been confirmed to have the virus in the UK, a third person was diagnosed with it in Brighton, and a fourth is being treated in London, after more than 400 were tested and found negative. The Foreign Office has urged UK citizens to leave China if they can. Five new cases in France are British nationals, and British nationals are also among the 64 cases on a cruise liner off Japan.

The number of people to have contracted the virus could be far higher, as people with mild symptoms may not have been detected. Modelling by World Health Organization (WHO) experts at Imperial College London suggests there could be as many as 100,000 cases, with uncertainty putting the margins between 30,000 and 200,000.

Why is this worse than normal influenza, and how worried are the experts?

We don’t yet know how dangerous the new coronavirus is, and we won’t know until more data comes in. The mortality rate is around 2%. However, this is likely to be an overestimate since many more people are likely to have been infected by the virus but not suffered severe enough symptoms to attend hospital, and so have not been counted. For comparison, seasonal flu typically has a mortality rate below 1% and is thought to cause about 400,000 deaths each year globally. Sars had a death rate of more than 10%.

Another key unknown, of which scientists should get a clearer idea in the coming weeks, is how contagious the coronavirus is. A crucial difference is that unlike flu, there is no vaccine for the new coronavirus, which means it is more difficult for vulnerable members of the population – elderly people or those with existing respiratory or immune problems – to protect themselves. Hand-washing and avoiding other people if you feel unwell are important. One sensible step is to get the flu vaccine, which will reduce the burden on health services if the outbreak turns into a wider epidemic.

Should I go to the doctor if I have a cough?

Anyone who has travelled to the UK from mainland China, Thailand, Japan, Republic of Korea, Hong Kong, Taiwan, Singapore, Malaysia or Macau in the last two weeks and is experiencing cough or fever or shortness of breath should stay indoors and call NHS 111, even if symptoms are mild, the NHS advises.

Is the outbreak a pandemic?

Health experts are starting to say it could become a pandemic, but right now it falls short of what the WHO would consider to be one. A pandemic, in WHO terms, is “the worldwide spread of a disease”. Coronavirus cases have been confirmed in about 25 countries outside China, but by no means in all 195 on the WHO’s list. It is also not spreading within those countries at the moment, except in a very few cases. By far the majority are travellers who picked up the virus in China.

Should we panic?

No. The spread of the virus outside China is worrying but not an unexpected development. The WHO has declared the outbreak to be a public health emergency of international concern, and says there is a “window of opportunity” to halt the spread of the disease. The key issues are how transmissible this new coronavirus is between people and what proportion become severely ill and end up in hospital. Often viruses that spread easily tend to have a milder impact.

Healthcare workers could be at risk if they unexpectedly came across someone with respiratory symptoms who had travelled to an affected region. Generally, the coronavirus appears to be hitting older people hardest, with few cases in children.

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