Author: Shenzhou
Reviewers: DClean and Weiming

  The novel coronavirus outbreak (hereafter 2019-nCoV; claims circulating online that the virus had been named “SARI” were false) has drawn widespread attention across China. For ordinary members of the public, whether or not we live in an affected area or have spent time in one, we must stay alert, take proper precautions, and not assume that we will simply be lucky. We should wear a mask whenever we go out, avoid crowded places wherever possible, and refrain from indoor activities in enclosed or poorly ventilated spaces.

Transmission and Protection

  Some reports suggest that 2019-nCoV originated in bats or other wild animals, but no official source has confirmed this.

  Because 2019-nCoV is a new virus, anyone who has not previously been infected with the same virus is susceptible, regardless of age. It can spread from person to person, most likely through respiratory droplets and contact, with aerosol transmission also a possibility.

  Droplet transmission occurs when a source of infection releases pathogen-bearing secretions and droplets by coughing, sneezing, or speaking, and a susceptible person inhales them. Such transmission generally requires close contact with the source; beyond two meters, infectiousness largely disappears. It can readily occur in crowded places such as stations, schools, and large gatherings. Contact transmission occurs when a pathogen reaches a susceptible person through direct or indirect contact with a vehicle of transmission. In direct contact transmission, the pathogen passes straight from the source to a suitable portal of entry in the susceptible person; indirect contact transmission results from touching contaminated objects. Masks offer effective protection against droplet transmission, while rubber gloves can provide some protection against contact transmission.

Symptoms and Treatment

  At present, no effective treatment for pneumonia caused by 2019-nCoV has been validated in clinical trials; clinical care consists mainly of symptomatic and supportive treatment. Recent high-throughput drug-screening efforts have identified several drugs that may be effective against 2019-nCoV. Do not blindly trust online rumors or folk remedies. Any unofficial treatment circulated online should be assessed through scientific reasoning and careful research. Follow official information as it is released to avoid unnecessary problems.

  The main symptoms of pneumonia caused by 2019-nCoV infection are fever, cough, and fatigue, and more than half of patients experience difficulty breathing. Some people may not develop a fever. It should also be noted that patients infected with 2019-nCoV rarely show upper-respiratory symptoms, such as a runny nose, sneezing, or a sore throat, or intestinal symptoms.

  Sneezing is a response to irritation of the nasal mucosa, and much of the expelled air leaves through the nose. Coughing, by contrast, is a response to irritation of the trachea, bronchial mucosa, or pleura, and the expelled air leaves mainly through the mouth. The two should be distinguished. If upper-respiratory symptoms appear, an upper-respiratory infection rather than the novel pneumonia should be considered.

  Patients with similar symptoms that are not severe—a temperature below 38°C and no difficulty breathing—should first call a nearby community doctor. The doctor can visit the home wearing full protective equipment and then determine whether a trip to a designated hospital is necessary, reducing the risk of cross-infection while seeking care. Patients with severe symptoms should immediately call the local designated hospital and center for disease control and prevention, then put on the recommended protection and go to the hospital as instructed.