Science

40 important questions and answers about the virus epidemic

The number of coronavirus cases in Germany is growing, in Europe it is even increasing. We have compiled the answers to the most important questions about the spread of the virus and provide an overview of what you need to know and how you can protect yourself – in the event of a possible corona outbreak, but also against influenza, which is currently being avoided.

This ranges from the question of what a mouthguard brings, what symptoms can occur, what you can do in the event of illness, to the question of whether your pet is also at risk. The most important tips on how everyone can effectively protect themselves in advance: Regular, thorough hand washing with soap, preferably more than 1, 50 Keep distance from infected or possibly infected, avoid touching mouth, nose and eyes with your hands. And: don't panic! On the other hand, it is never helpful to be well informed and prepared.

1. What are corona viruses?

Corona viruses are comparatively large, round viruses that have an envelope. The viruses appear crown-like under the electron microscope (Latin: Corona). Researchers have described hundreds of types of corona viruses. They can cause very different diseases in mammals, birds and fish. If they reproduce, their genetic makeup can also change. This can mean that they can change from one species to another – and thus become dangerous for people even though they have only infected animals so far.

. 2 What are the symptoms of the disease?

The symptoms are similar to those of a cold, i.e. scratching of the throat and increased temperature, general malaise. Diarrhea sometimes occurs. Runny nose is comparatively rarely observed. With severe courses with massive virus multiplication in the lower respiratory tract shortness of breath occurs.

3. How is the virus transmitted?

As with other pathogens of diseases of the mouth, nose, throat and lungs, usually also, are both smear infections as well Droplet infections possible. Which way plays the bigger role is unclear.

4. What is a smear infection?

Smear infection occurs when contaminated people or surfaces are touched, for example, by hand and then touch this hand to the nose, mouth or eyes this way viruses are deposited there on mucous membranes.

. 5 What is a droplet infection?

Droplet infection is caused by mini-droplets, which are mainly expelled when sneezing and coughing. However, transmissions are also conceivable when speaking.

6. Can one become infected with imported goods or packaging?

This possibility cannot be excluded, but the risk is classified as very low. This is justified as follows: The viruses can, as far as is known, persist for some time on surfaces, but they are not particularly well equipped for this. In addition, the goods should have been contaminated with large quantities of pathogens, which would be anything but the rule even in epidemic areas.

. 7 What is the use of disinfecting packaging?

In the course of the general increase in hygiene, there is nothing to be said against wiping goods packaging with a damp cloth and with cleaning liquid. It is also advisable to dispose of the packaging immediately and then wash your hands thoroughly.

8. What is the best way to protect yourself personally against infection?

Regular, thorough hand washing with soap, preferably more than 1, 50 Keeping yourself away from infected or possibly infected people, avoiding touching the mouth, nose and eyes with your hands are the most important and most effective precautions. There are also numerous other options, which we have summarized here.

9. Can I do something around the house to protect myself?

For example, towels should not be used together, even at home. When sharing meals, the dishes and cutlery should not be used together (special attention must be paid to children). Since it can hardly be avoided to split the soup ladle, hands should also be washed after eating.

10. What should I watch out for in public transport?

In public transport and buildings, wearing gloves that should be washed and changed every day reduces the risk.

11. What should I watch out for in the office?

Handles used by numerous people, such as doors, windows and kitchen drawers, but also taps or knobs in elevators, are potential sources of germs. This reduces the risk if you open and close them with gloves, or if possible with your elbows, shoulders, etc. If contact with the hand is unavoidable, you can wash your hands immediately afterwards.

12. What should employers consider?

You must not only allow employees, but instruct them to stay at home if there is suspicion of infection and, if possible, to work from there.

13. Do mouth masks always protect against transmission?

Surgical masks (mouth-nose masks) significantly reduce the risk of transmission for the person wearing them due to their filter properties in the presence of infected people, if they are worn correctly – i.e. close-fitting – significantly but not nearly complete.

But: Due to their filter properties, the masks massively reduce the risk of transmission for others if they are worn by infected people. They were originally designed for this. They should protect patients from germs of nursing staff and doctors in the hospital, and especially in the operating room.

14. What else should I know about mouth mask protection?

The protection from the masks diminishes if they are worn for too long. He can even reverse the risk of infection. This also applies if they are not disposed of safely, i.e. people could come into contact with contaminated masks. Details on this below.

15. Is it advisable to wear a mouthguard?

Beyond the filter properties, the masks are indirectly considered to be extremely effective protection because they prevent the wearer from touching the nose and mouth with possibly contaminated hands. According to expert opinion, if you also avoid looking into your eyes, the risk of a smear infection drops to almost zero. Critics, on the other hand, warn that the masks may psychologically suggest an excessive level of protection and lead the wearer to neglect other important hygiene rules or to keep away.

16. How long can I wear a protective mask, can I wash it if necessary?

Normal protective masks should be worn for a maximum of one day, and if possible only if you really need them, i.e. in the immediate vicinity different and not when bringing garbage or jogging or the like. Washing affects the effectiveness of the masks, but does not set them to zero. The same applies to spraying with disinfectant spray. FFP respirators (see below) can be used longer and more frequently.

17. How exactly do I dispose of protective masks?

The masks can be contaminated with pathogens, both outside and inside. You should be careful with them. Protective masks should be disposed of in normal household waste, either in a tied garbage bag or wrapped in kitchen paper, for example. Then wash your hands thoroughly.

18. What is behind the terms FFP2 and FFP3 for mouthguards?

These are so-called respirators with the specification FFP2 or FFP3. They are respirators with filters and valves that offer somewhat better protection than conventional respirators. However, they must also be specially adapted to the face by hand to keep them as tight as possible.

19. How can I best protect others?

The so-called cough and sneeze etiquette should be followed as best as possible: If you have to cough or sneeze, make it clear Move away from others, if possible use a handkerchief or the textile-covered elbow to catch droplets. Anyone who suffers from a respiratory infection should avoid crowds of people – and thus also public transport, the cinema, etc. Avoid coughing on the supermarket displays as well as dragging yourself paracetamol to a party or a meeting. One should refrain from shaking hands to greet one another, as well as from other greeting and farewell rituals connected with close contact.

20. How long is the incubation period?

According to current assumptions, the time between transmission of the pathogen and onset of the disease can be up to 14 days. However, two other aspects have to be mentioned here: On the one hand, there are at least a few indications that it can take longer in exceptional cases. In addition, the incubation period says nothing about how long people who are not at all noticeably ill or recognizable but are infected remain infectious. Experience with other pathogens suggests that such people can pass the virus on for long periods of time.

21. What is behind the term Sars-CoV-2?

The pathogen currently known as “the corona virus” is officially called Sars- CoV-2. It has most likely passed from animals to humans. As far as is known, this happened at a market in Wuhan, China, where live animals were sold. It is currently assumed that bats are the natural host and that the pathogen came into humans through another animal intermediate host.

22. What is behind the term Covid – 19?

The disease that is caused by the Sars-CoV-2 virus is officially called Covid – 19 (Coronavirus Disease 2019).

23. How threatening is the disease Covid – 19?

It is almost proven – for example, to two people who were flown from Wuhan to Germany – that people can be infected and cope with the virus without or showing no symptoms at all. Even people who show symptoms usually don't get seriously ill. A small percentage, which still cannot be reliably determined, leads to serious progress.

These require intensive medical treatment, such as ventilation and hydration by “drip”. Antibiotics may also be necessary due to bacterial infections, which then occur more frequently due to the weakened immune system and the attacked lung tissue.

24. What is the difference between corona and a flu?

The symptoms are sometimes the same or similar, with severe flaking for Covid – 19 – diseases but is atypical. The differences lie, among other things, in the molecular mechanism by which the viruses gain access to their host's cells – and where they do so in the respiratory tract.

The new coronavirus apparently affects only lung cells deep in the bronchial tubes in a manner that causes symptoms of the disease, while flu tends to occur in the upper respiratory tract and only affects these areas seriously in relatively few cases. Sars-CoV-2 actually behaves atypically compared to many other viruses in its family. Because such corona viruses usually trigger the frequent, mild colds, which only affect the throat and nose.

25. Are there special risk groups?

The majority of coronavirus deaths are caused by older people with previous illnesses. In addition, the disease appears to be more dangerous for men than for women. However, the data situation is still not sufficient here.

26. How does a coronavirus test work?

Since the disease primarily affects the deeper lung tissue, from an infectious medical point of view, expectoration from these areas is actually necessary. In fact – since infected people cough in this way only in exceptional cases – throat swabs are used.

Here it is important to really rub the cotton swab over the mucous membrane for a few seconds with noticeable pressure. Frankfurt's virologist Sandra Ciesek recently told Tagesspiegel, many infectious medicine doctors, whether this is carried out by the staff in all cases.

27. What happens to the smear?

Once the swab has been taken, specialized laboratories are able to prove the presence of the virus based on its genetic material. However, there is no way of distinguishing whether these are actually infectious viruses or maybe just leftover genetic material after surviving infection. However, it is likely that the viruses are active.

For the actual detection it would actually be necessary to try to cultivate the viruses in cell cultures. This can only be done in exceptional cases. If the test is negative for an existing flu-like illness, it is highly likely that the symptoms are not caused by Sars-CoV – 19 to be triggered.

28. Suspected infection – what should I do?

First of all, you should take precautions to protect others from possible transmission (see our detailed list of such possible precautions and behaviors). This also includes not visiting the family doctor's office if possible and staying in the middle of other waiting people. You can call the family doctor's office and discuss the situation with a doctor or staff and get advice on how to proceed.

Some doctors make home visits and can also take a smear. You can also call the emergency room at the nearest hospital, especially if you have more severe symptoms. There is a central hotline in Berlin (030 9028 2828), currently between 8 and 20 clock is occupied every day. The Robert Koch Institute also offers an online tool in which local and regional contact points are played out across the postal code in Germany.

29. Are there doctors or hospitals that are particularly well prepared for corona patients?

Patients with severe corona symptoms must be isolated because of their infectivity and need intensive care because of their severe symptoms. This is basically possible in intensive care units in almost every general care hospital. It is also conceivable to provide additional insulating beds or to separate entire stations for this purpose.

30. What do I have to consider with pets?

So far there are no indications that pets such as dogs or cats are at Covid – 19 get sick or transfer it. Like so much in the context of this epidemic, this cannot be ruled out, but the normal hygiene, which should apply in any case when dealing with animals, is considered sufficient by experts.

31. Can the coronavirus be transmitted via faeces?

There is as yet little data on this. What is certain is that virus material is excreted via the intestine. It is unclear whether these are reproductive pathogens or only due to digestive enzymes and the like already dismantled molecular scrap. However, a single recent study suggests that stool may be infectious.

At least one working group from the China-CDC health authority was able to detect under the electron microscope a virus isolated from a stool sample of a sick person that looked as if it was capable of reproduction. However, the actual evidence, which is only possible by growing viruses in cells under laboratory conditions, has not been provided. Nevertheless, hygiene is recommended, especially on the toilet.

32. Is Germany prepared for a major outbreak?

“Best possible” is the answer that Health Minister Jens Spahn has given several times. The best possible does not necessarily mean “very good”.

A Berlin medical officer recently spoke up, who in such a situation considers the authorities to be overwhelmed, above all because many of the official medical positions in Berlin are not filled. Some experts also question whether the current practice, which is regarded as criteria for a possible infection and a test, is sufficient.

The federal system also complicates the coordination and merging of data. In a research by the Tagessspiegel, for example, it was not possible, despite numerous inquiries, to get specific and comprehensive information on the number of isolation beds available in Germany in an emergency and the availability of additional medical staff required. Demography could also be a factor, as there are comparatively many older people with existing illnesses in Germany who are considered the main risk group for life-threatening courses.

33. Is China a role model for Germany when dealing with the virus?

Draconian, and apparently effective measures like in China are hardly imaginable in Germany. Basically, however, Germany is well positioned in terms of medical care and capacity in hospitals. Civil protection organizations would also be able to create additional accommodation capacities for the sick in an emergency. There have also been large-scale, cross-border exercises to simulate a pandemic.

34. How does Covid – 19 differ from Sars?

Although the pathogens of Sars and Covid – 19 are similar, they obviously differ in some relevant properties. Not everything is scientifically understood here. Sars-CoV-2 may be more infectious – more virulent – than Sars. And a crucial role could be played by the fact that, unlike Sars, the virus can apparently also be transmitted by people who show no or only very mild symptoms.

35. Why is Covid – 19 not yet contained?

The above properties of Covid – 19 make it almost impossible to contain the disease in the way Sars has succeeded, namely by isolating the sick. Still, this strategy plays an important role in containing outbreaks. In Wuhan, for example, the apparently declining number of new infections is also attributed to this.

36. Can you cordon off a city like Berlin? And what does that bring?

The discussion about this is complex. The logistics of such an action alone would be extremely complicated, the personnel and material costs immense, and the legality would then be the subject of the judicial decisions required in a quick procedure. The legal basis is primarily the Infection Protection Act.

Studies show that closures, border closings and the like are only partially effective and can prove to be counterproductive. It is problematic, for example, that this also creates a climate that can cause individuals to deal with symptoms in a secret manner, which cannot be wanted at all. In addition, it can be assumed that if a cordon is standing in the room or is about to be closed, many will still try to get out of the city

For this reason, Wuhan apparently left thousands of people shortly before the cordon was closed. All of this can lead to general chaos, but also to the fact that symptoms that are actually necessary are not clarified and the virus spreads in this way and patients are denied the necessary treatment. In a free country, a lot will depend on the most responsible and responsible behavior of individual citizens, institutions and companies to avoid new infections.

37. What do lethality, mortality and virulence mean?

Lethality is the rate of deaths in relation to the total number of sufferers or in relation to the total number of infected. The term “case fatality rate” (CFR) is also used here. How high this is with this virus is still unclear. At a WHO press conference, Bruce Aylward, chairman of a joint mission to investigate the situation in China, reported a CFR of between two and four percent for Hubei province and 0.7 percent for regions outside of Hubei. However, if many infections remain undetected due to missing or only mild symptoms, it could also be significantly lower.

Unlike mortality or CFR, mortality is simply the general death rate within the population or group of people, regardless of specific factors such as illnesses and infections. This means that, for example, a virus with high lethality also increases mortality, while a vaccine that suddenly becomes available could then reduce mortality again.

Virulence is the extent of the pathogenicity, i.e. the pathogenic potential of a pathogen. The higher the virulence of a pathogen, the higher the mortality in humans is usually, but not necessarily. In other definitions, virulence is also used as the extent of infectivity regardless of the severity of the resulting disease.

38. Can we predict when the epidemic will be over?

No. Even in China, where the number of new cases is declining, it is not certain that an end will soon be expected. If, for example, the restrictive governmental measures are relaxed, which will be necessary at some point, new infections and even deaths could increase again. Forecasts are currently impossible for Europe and Germany.

Experts assume, however, that the number of cases will initially increase. Whether the epidemic can at least be contained to some extent will depend on many factors. This includes whether large sections of the population adhere to infection prevention advice or not, whether the authorities make the right decision depending on the situation, such as closing community facilities or travel restrictions, and how early it is possible on average to isolate infectious people.

Mutations of the pathogen can also play a role – also in a desirable way. There are always examples that the end of an epidemic is clearly linked to a reduced virulence of the pathogen. Factors such as weather and season also play a role in many pathogens, such as seasonal flu. To what extent this will be important for this corona virus is still unknown. However, there is reason to believe that there could be at least some relief in this direction. On the one hand, the tendency for people to stay close together in rooms that are not or poorly ventilated decreases in the warmer seasons. This can contribute to less frequent transmission. In addition, coughed or sneezed mini droplets sink faster to the ground in warmer, wetter summer air for purely physical reasons – and thus from the area in which they can be inhaled – than at low temperatures and lower humidity.

39. What are viruses anyway?

Viruses are tiny structures that contain genetic material (DNA or RNA), but are not considered to be independent organisms. They can only multiply in other cells and use their metabolism for this. Host organisms can be bacteria, but also archaebacteria, fungi and other nucleated unicellular and multicellular organisms – from slipper animals and plants to humans. Viruses were discovered at the end of 19. Century. The first was one that affected tobacco plants: the tobacco mosaic virus, which is still very important in research today.

40. Why do viruses cause diseases?

Infection with a virus can be unproblematic for the infected organism, but it can also be threatening. This is how people catch a lot of different viruses in the course of their lives. Even if the immune system does not immediately neutralize them, many have little or no effect. Others, the rabies virus, for example, are fatal in almost 100 percent of the cases. One hypothesis why some viruses make you very sick is that this is in the interest of the virus because it makes it easier for it to spread – for example, by coughing. However, this is contradicted by the fact that very similar viruses behave very differently here.

In order for a virus to spread, it must destroy its host cell, and many destroyed cells mean inflammation and usually also increased “poison” – Concentrations, triggered among other things by the dying tissue, which leads to symptoms of illness.

In fact, a so-called evolutionary strategy of viruses seems to find a balance between damage to the organism and protection of the organism. Because an immediately dying host is not a good vehicle for retransmission. Too little cell destruction and thus the release of viruses is an equally limiting factor.

This could also be a reason why new viruses that have jumped from animals to humans can be very dangerous. Because such a balance only has to develop over long evolutionary periods.

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