Coronavirus, the Achilles tendon of the world

Abstract

English version

Editorial

Coronavirus, the Achilles heel of the world

COVID-19 is a viral infection, which originated in a wholesale market in Wuhan, capital of Hubei province, China [1]. The first cases reported at the end of December 2019 and given the alarm by Dr. Li Wenliang ophthalmologist when observing them, published that the cases had symptoms similar to SARS such as clinical manifestations of fever, respiratory distress and infiltrated chest X-rays bilateral pulmonary.

On January 5, 2020, the World Health Organization reports on the appearance of these cases of pneumonia with no known etiology, by the end of January 2020, the disease had spread to 9 countries (8 in Asia and the United States) ; On January 12, China made the sequenced genome available to the WHO, which allowed the development of reliable diagnostic tests (polymerase chain reaction) in a rapid manner.

By February 20 in Lombardia [2], the first case was reported in Italy and in the following 24 hours a total of 36 new cases not related to it, which started the epidemic in that country and at the European level.
On March 11, the WHO declares that the Coronavirus outbreak is a pandemic.

Evolution of Covid-19 in Panama

On March 9, the first case of COVID-19 in Panama is confirmed by laboratory. This is a 40-year-old female patient, who entered the country on March 8 in the afternoon, from Barajas Spain [3].

On March 10, the Minister of Health announced a total of 8 confirmed cases of COVID-19 in the country, including one death. The cases, all Panamanians, between 29 and 64 years old, correspond to the Panama Metro and Panama North Regions.

Recreational activities, classes in schools and universities in the areas of Panama Metro, North and the district of San Miguelito [4] are suspended.
The President of the Republic, through cabinet resolution number 11 of March 13, 2020, declares a state of national emergency [5].

It is ordered that as of Monday, March 16, the closure of all establishments dedicated to recreation (beaches, theaters, bars, etc.), entry to commercial premises is limited to 50 people and the entry to Panama of travelers from Europe and Asia, except Panamanians and residents [6].

What do we know about SARS-CoV-2 so far?

It is an RNA virus of the Coronavirus family, initially known as COVID-19 and later as SARS-CoV-2. SARS Cov2 has an origin close to the coronavirus of
bats with an unknown intermediate host. Transmission is by air, fomites that contaminate objects or surfaces, but mainly from person to person.

That there are asymptomatic individuals can transmit the virus and secondary transmission occurs before the onset of the disease, which is highly contagious, with a basic reproduction number R of 2.5 (number of infections that a case can generate throughout its period infectious).

The average incubation period of 5 to 10 days, the virus remains in respiratory secretions, urine for up to 15 days and in feces for up to 5 weeks.

That until now, worldwide, the severity of the infection does not appear to occur in children under 15 years of age, the spectrum of presentation in pediatrics being wide from asymptomatic to mild to moderate cases and with less lethality.

But this has only just begun and we will have to wait for the data that will be generated in the coming months on this disease.

Dra. Elizabeth Castaño
Chief Editor

Referencias/References

[1] Zhu N, Zhang D, Wang W et al. N Engl J Med 2020;382:727-33.DOI: 10.1056/NEJMoa2001017
Grasselli G, Pesenti A, Cecconi M. Critical Care Utilization for the COVID-19 Outbreak in Lombardy, Italy: Early Experience and Forecast During an Emergency Response. JAMA. 2020;323(16):1545–1546. doi:10.1001/jama.2020.4031

[2] Comunicado del MINSA 9 de marzo 2020 http://www.minsa.gob.pa/noticia/panama-confirma-primer-caso-de-covid-19

[3] Comunicado del MINSA 10 de marzo 2020 http://www.minsa.gob.pa/noticia/comunicado-n-2

[4] Resolución de gabinete número 11 del 13 de marzo de 2020, “que declara el estado de emergencia nacional y dicta otras disposiciones”. https://www.gacetaoficial.gob.pa/pdfTemp/28979_B/GacetaNo 28979b 20200313.pdf

[5] Comunicado del MINSA 16 de marzo de 2020 http://www.minsa.gob.pa/noticia/comunicado-ndeg10