Year : 2020 | Volume
: 13 | Issue : 2 | Page : 55--56
Staring down the barrel of COVID-19
Milind Prasannakumar Suryawanshi, Rashid Al Saidi
Ophthalmology Centre, Armed Forces Hospital, Oman
Milind Prasannakumar Suryawanshi
Ophthalmology Centre, Armed Forces Hospital
|How to cite this article:|
Suryawanshi MP, Al Saidi R. Staring down the barrel of COVID-19.Oman J Ophthalmol 2020;13:55-56
|How to cite this URL:|
Suryawanshi MP, Al Saidi R. Staring down the barrel of COVID-19. Oman J Ophthalmol [serial online] 2020 [cited 2020 Oct 19 ];13:55-56
Available from: https://www.ojoonline.org/text.asp?2020/13/2/55/285304
Corona (crown) viruses (CoVs) belong to a large family of viruses that have existed in the animal kingdom. The novel virus is the seventh known strain to affect humans. It has 96% genome that is identical to a bat coronavirus and now is labeled as severe acute respiratory syndrome (SARS)-CoV-2.
Three times, CoV has cross-infected species (from animals to humans) to cause severe disease and global transmission concerns. SARS from 2002 to 2004; Middle East respiratory syndrome in 2012, which has remained in the circulation in camels since then; and COVID-19, has now emerged in December 2019 from China and is spreading like a wildfire all over the world in the form of COVID-19 pandemic. It spreads mainly by droplets expelled during coughing, sneezing or breathing. Virus shedding occurs in symptomatic patients as well as in asymptomatic carriers. A feco–oral transmission has also been reported, and transmission by aerosol contact with conjunctiva is possible.
The patient usually presents with fever, dry cough and shortness of breath. Tiredness, bodyache, sore throat, running nose, and loss of smell and taste sensations are few other symptoms. Follicular conjunctivitis is seen in few cases. Eighty percent of healthy individuals with good immunity recover from illness without sequelae, but elderly patients and those with comorbidity may develop life-threatening complications such as pneumonia, acute respiratory distress syndrome, and organ failure.
Because there is no proven medical treatment or vaccine available at present, prevention is the best strategy. Ophthalmologists aged above 60 years and those with comorbidity should maintain social distancing and may even abstain from practice in their own interest. Rest of the fraternity must work with proper personal protection equipment (PPE); liberal use of alcohol-based sanitizers; hand washing between two patients; slit-lamp breath shield; appropriate sterilization of instruments; and abstaining from touching one's face, mouth, nose, and eyes with unclean hands. Competent health-care workforce comes into existence with many years of meticulousness and rigorous training, and loss of lives of health-care personnel (HCP) due to unavailability of medical supply will be catastrophic.
Almost all the statutory bodies at the moment are recommending against continuing routine consultations and elective eye surgeries because HCP are not immune from getting exposed to COVID-19 patients. Large corporate hospitals and government hospitals are at the advantage of having access to multidisciplinary management and organizational and financial support from their administration when they are treating these patients. Unfortunately, small setups are in unfavorable position because of lack of support and loss of revenue.
Every day, the world is waking up to the new normal and so also is ophthalmology practice. The use of telephonic consultation for minor ailments and telemedicine for advocating tests and reviewing results and for treatment recommendations will be explored more widely. Wearing PPE for HCP will have to continue for days to come. In spite of the evolving scenarios, emergency services, procedures, and surgeries will have to be carried out without any doubt. The patients with a sudden loss of vision such as retinal detachment, vascular occlusions, acute uveitis, ocular injuries, uncontrolled glaucoma, bilateral mature cataract, lens-induced glaucoma, intravitreal injections for endophthalmitis, sight-threatening macular lesions etc. need urgent treatment. Preoperative investigations for major procedures may need to include tests for CoV. The protocols to guide how such emergency procedures are to be carried out are available and vary from center to center.
We may suggest our colleagues that to make the most of their time, organize and finish administrative paper work and research work; maintain, calibrate, understand, and upgrade your paraphernalia; and refresh your and your colleague's knowledge and skills by arranging and attending online workshops and didactic lectures so that we will be ready for better services.
The health of a nation and economy are two sides of the same coin. This pandemic will knock down the global economy and the ripples will be felt for many years to come. Investment in health-care infrastructure, building up of workforce, and allocation of funds will be revisited by each and every country.
Preparedness for the long haul is the key. After the restoration, instead of a grand opening, let us be mindful of the lessons we learned during the lockdown that they may guide us in self-protection, providing sanctuary to humankind and preventing the future carnage of the planet.
The bottom line is, while continuing our work, remain vigilant because CoV is lurking around us.
|1||Mackenzie JS, Smith DW. COVID-19: A novel zoonotic disease caused by a coronavirus from China: What we know and what we don't. Microbiol Aust 2020;4:45-50.|
|2||Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395:497-506.|
|3||CDC COVID-19 Response Team. Severe outcomes among patients with coronavirus disease 2019 (COVID-19)-United States, February 12-March 16, 2020. MMWR Morb Mortal Wkly Rep 2020;69:343-6.|
|4||The Lancet. COVID-19: Protecting health-care workers. Lancet 2020;395:922.|
|5||Olivia Li JP, Shantha J, Wong TY, Wong EY, Mehta J, Lin H, et al. Preparedness among ophthalmologists: During and beyond the COVID-19 pandemic. Ophthalmology 2020;127:569–72.|