Covid-19 is the illness caused by Sars-CoV-2 coronavirus (Severe Acute Respiratory Syndrome Coronavirus 2). Coronaviruses make up a whole set of viruses. They cause various types of respiratory disorders, ranging from common colds (note that seasonal viruses are coronaviruses too) to things more serious like Mers-CoV (Middle East Respiratory Syndrome-related coronavirus), Sars or Covid-19 acute respiratory sorts of distress.
The virus was first identified in China, in December 2019. It is a new strain of virus. The World Health Organization (WHO) named Covid-19 the new disease triggered by the virus. On March 11th 2020, the WHO declared the outbreak a pandemic, meaning that the outbreak had spread the world over.
During active virus circulation, anyone infected with it will pass it on to a minimum of three other people if no collective protection measures have been implemented. In addition, the carrier will pass on the virus before he/she has presented with any symptom. This means that someone contaminated but asymptomatic can pass on the virus to the people around him.
What are the symptoms?
Common symptoms include fever or feeling feverish, and dry cough. Symptoms associated with the viral infection can include headaches, fatigue, muscle and joint pain.
Patients with more serious forms can even present with a sudden loss or change in sense of taste or smell (with no nasal blockage, however) associated with diarrhoea.
In severe case, breathing difficulties are so important that it can be necessary to hospitalize the patient for respiratory resuscitation: reanimation so as to ward off death.
Diagnosis.
Diagnosis is based on clinical signs and symptoms and detecting the virus through RT-PCR (reverse transcription polymerase chain reaction) testing of infected respiratory secretions using a nasopharyngeal swab collection method.
If necessary, RT-PCR testing can be supplemented with a serological test that will bring a clear answer to: “Am I or was I ill with Covid-19?”
However, it should be noted that no serological test can answer the question: “Am I contagious or not?” And last, that kind of test is still inappropriate to answer the question: “Am I safe against Covid-19?”
What treatments are available?
Up to now, no drug treatment, specific or otherwise, against Covid-19, has proved efficient enough to be recommended as appropriate to ambulatory care (except for the clinical trials under way). We do not advise delivering systematic prophylactic antibiotic treatment.
If necessary, home rehab’ can be implemented, after the acute phase of the disease. This is to gradually, and under control, take up again low-intensity physical activity. That is to say taking up again usual ambulatory and functional activities with an eye to adequate dyspnea, fatigue management, and how well the recovering patient bears up with his/her resumption phase. A back-to-normal training plan focusing on physical endurance may be appropriate to get back to employment, and to resume physical and social activity.
Following barrier measures (physical distancing, wearing a face mask, hand-washing, and associated hygiene measures) is a must when attending to a Covid patient. Contagiousness begins one or two days before the symptoms show up and will spread over a usual 8-days period.
How to manage the symptoms?
If patient has developed symptoms, even light, the right things to do are as follows:
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must stay away from other people;
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at home, or indoors, must keep a minimum 2 m. distance between him/herself and the other people;
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must wear a mask when going out;
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must contact usual his/her usual GP (in case usual GP cannot be contacted, must contact another GP in town);
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must call up Health Insurance people to be given another GP’s phone number;
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must not go straight off to GP or care facility (hospital or emergency department); call up 09 72 72 99 09 first (free service + call charges);
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must have the test GP has prescribed, as soon as possible in the nearest biomedical or specialized lab’ (the cost of the test is 100% refunded by the French Health Insurance).
If patient has difficulty breathing (shortness of breath when speaking or while doing little), phone 15.
What’s bringing you along?
A 69-year-old male retiree has come to the local pharmacy because he complains of cough and fever he’s had for a couple of days.
Pharm: What can I do for you?
Ret: For 2 days now, I’ve had fever and I cough a lot.
Pharm: Do you think some people around you have Covid?
Ret: I couldn’t tell you really. The thing is my wife had some coughing some ten days back. But she’s getting on the mend now.
Pharm: Have you got difficulty breathing?
Ret: Fact is I cough a lot but that’s not much trouble when I’m breathing.
Pharm: Do you think you have other signs? Loss of sense of smell, loss of taste, diarrhoea?
Ret: That’s right. I believe I’ve got all that kind of things.
Pharm: From what you’re telling me, it’s likely you have been contaminated with coronavirus. The best thing for you is to see a doctor.
Ret: I must go to my GP or to hospital?
Pharm: We’re having an epidemic. I suggest you have a tele-consultation session with a healthcare professional. It’s easy to do and it’s strongly advised.
Ret: OK, then. I’ll call them up. Is my wife to see a doctor too?
Pharm: Contact people must be tested for Covid, even if they have no symptoms. The test is carried out with no doctor’s prescription. Cost is entirely paid by the French Health Insurance.
Ret: Is it possible I have passed that on in turn to someone else?
Pharm: It all depends on what contacts you’ve had so far, knowing that the contagious phase of Covid starts some 24 to 48 hours before the first symptoms show up. I suggest you wear a face mask so that you can help stop contamination. Don’t forget to wash your hands very often.
Ret: Do I have to take something against my fever?
Pharm: You may have some paracetamol, on the basis of one gram per taking, with a maximum of 3 takings a day.
Ret: Fine. Thanks a lot.
Keywords and reading aid.
Ambulatory care: soins en ambulatoire.
Back-to-normal training plan: programme de réentraînement.
Bears up with: supporte.
Call charges: prix de l’appel.
Care facility: établissement de soins.
Common colds: simple refroidissement.
Cost is entirely paid for: le coût est entièrement pris en charge.
Difficulty breathing: difficultés respiratoires.
Dry cough: toux sèche.
Fatigue management: fatigabilité.
Getting on the mend: commence à aller mieux.
Go staight off to: aller directement chez.
Gradually take up again: reprendre progressivement.
Health insurance people: services de l’Assurance maladie.
Home rehab’: rééducation/réadaptation à domicile.
It’s likely you: il est probable que vous.
Make up a whole set: forment un ensemble.
Male retiree: retraité.
Muscle and joint pain: courbatures.
Nasal blockage: obstruction nasale.
Nasopharingeal swab collection method: prélèvement par écouvillonnage naso-pharyngé.
Not much trouble when I’m breathing: ne me gène pas trop pour respirer.
Outbreak: la vague.
Passed that on in turn: transmis à mon tour.
Physical distancing: distanciation physique.
Prophylactic antibiotic treatment: antibioprophylaxie.
Refunded: remboursé.
Respiratory resuscitation: réanimation.
Resumption phase: période de reprise.
Spread over: s’étendre sur.
Stay away from other people: s’isoler.
Strain of virus: souche de virus.
Symptoms show up: apparition des symptomes.
Taking: prise.
Test is carried out: le test se fait.
To get back to employment: retour à l’emploi.To spot: repérer.
Under way: en cours.
Ward off death: prévenir un décès.
While doing little: au moindre effort.
With an eye to: en veillant à.
Disclosure of interest
The authors declare that they have no competing interest.