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Less over-prevention, more positive mentality

Cai, Lei*; Bao, Yiran; He, Lin*

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Journal of Bio-X Research: March 2020 - Volume 3 - Issue 1 - p 1-2
doi: 10.1097/JBR.0000000000000064
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An outbreak of the COVID-19 is currently underway across China. The government has allocated a lot of staff and material resources to control the spread of this epidemic. However, at the meaning time, excessive prevention involving the use of massive disinfectants is happening at places far away from the core outbreak area, and the induced secondary problems must not be ignored.

Based on new epidemic data issued on February 14, 2020 from the National Health Commission,[1] the mortality rate of patients with COVID-19 infection is about 2.29% in Wuhan city, the capital of Hubei Province and core outbreak area holding almost 56% of the infected population in China. This rate is lower than the 9.6% observed for severe acute respiratory syndrome (SARS)[2] and 35% for Middle East respiratory syndrome (MERS).[3] Outside Hubei Province, although there are nearly 1000 patients with new coronary pneumonia in several areas, such as Guangdong, Henan and Zhejiang provinces, the mortality rate for these patients is less than 1%, or even close to zero.[4] Chinese health authorities and researchers have identified the disease pathogen and its main route of transmission,[5] but have not yet finalized the intermediate host of COVID-19.

Evidence shows that the disease spreads quickly, especially in agglomeration. During the outbreak, cases of family clusters were often reported in China. In addition, cases aboard the Diamond Princess, a cruise ship that was quarantined by the Japanese Health, Labor, and Welfare Ministry for 14 days, have drawn great international attention. As of February 17, 2020, a total of 454 passengers and crew onboard had been diagnosed with COVID-19 infection,[6] reflecting the virus's high spread efficiency in this agglomeration situation.

From observations of currently treated cases, the condition is relatively mild, recovery is faster, and the prognosis is better in children compared with adults.[7] Severe cases are rare among confirmed cases in children, possibly because children are less likely to enter crowded areas than adults. Additionally, during the epidemic, parents tend to pay attention to the protection of children and bring them to the hospital during the early stage of symptoms, thus contributing to a low proportion of severe cases among children.[8]

To control the disease and treat patients more effectively, mobile cabin hospitals have been built in Wuhan city. However, public concerns about the risk of cross-infection in these hospitals still remain. The good news is that the virus was clinically observed to be self-limiting, which means the new coronavirus may not require intensive antiviral treatment, and some patients can effectively eliminate the virus through their strong immunity. However, self-healing does not mean treatment is not needed.[9]

In Chongqing city, approximately 800 km from Wuhan city, everyone must wear a mask even when entering no-man's land, everyday disinfectant is sprayed profusely, and individuals are sprayed with a special disinfection device similar to a carwash when returning a housing estate. The main component used in disinfectants is sodium hypochlorite, which is currently at risk of being abused to control the new virus COVID-19.

Sodium hypochlorite is an environmental hazard and corrosive substance. Diverse health effects occur after acute or chronic exposure to sodium hypochlorite. Specifically, dermal/ocular exposure to sodium hypochlorite can cause irritation and damage to skin or eyes, which may become apparent over time; the inhalation of aerosols can cause coughing, sore throat, headache, and nausea.[10] Moreover, sodium hypochlorite is poisonous for aquatic organisms and can persistently pollute the environment by forming organic chlorine compounds, such as absorbable organic halogen.[11] Thus, massive disinfection is not good for the human body or environment, and can even cause long-term damage over time.

At present, an effective vaccine for COVID-19 infection is not available yet. As such, the ultimate epidemic prevention relies on individuals’ immunity. Positive moods are often associated with a decreased risk of inflammation through changes of immune response functions.[12] Therefore, in the face of this current epidemic, it is better for those far away from the core outbreak area to improve body immunity by maintaining optimism and using appropriate preventive measures according to different situation.

Acknowledgments

None.

Author contributions

LC and YB drafted the manuscript. LH revised the manuscript. All authors approved the final version of the manuscript.

Financial support

None.

Conflicts of interest

The authors declare that they have no conflicts of interest.

References

[1]. National Health Committee of the People's Republic of China. Update on new coronavirus pneumonia situation as of 24:00 on February 13. http://www.nhc.gov.cn/xcs/yqtb/202002/50994e4df10c49c199ce6db07e196b61.shtml. [Accessed February 14, 2020].
[2]. World Health Organization. Summary of probable SARS cases with onset of illness from 1 November 2002 to 31 July 2003. https://www.who.int/csr/sars/country/table2004_04_21/en/. [Accessed February 16, 2020].
[3]. World Health Organization. Worldwide reduction in MERS cases and deaths since 2016. https://www.who.int/emergencies/mers-cov/worldwide-reduction-in-mers-cases-and-deaths-since-2016/en/ [Accessed February 16, 2020].
[4]. Real-time big data report on COVID-19. https://voice.baidu.com/act/newpneumonia/newpneumonia/?from=osari_pc_3. [Accessed February 14, 2020].
[5]. National Health Committee of the People's Republic of China. Diagnosis and treatment of novel coronavirus pneumonia (trial version 6). http://www.nhc.gov.cn/yzygj/s7653p/202002/8334a8326dd94d329df351d7da8aefc2.shtml. [Accessed February 19, 2020].
[6]. China News. Japanese media: 519 people diagnosed with COVID-19 in Japan. https://www.chinanews.com/gj/2020/02-17/9094907.shtml/. [Accessed February 17, 2020].
[7]. She JT, Liu WJ. Epidemiological characteristics and prevention and control measures of corona virus disease 2019 in children. Luzhou, China: Department of Pediatrics, Southwest Medical University; 2020.
[8]. Yang BB, Zhu YL. Epidemiology and treatment of novel coronavirus pneumonia (COVID-19) in children and adults. Hangzhou, China: The Children's Hospital of Zhejiang University School of Medicine; 2020.
[9]. China Youth Daily. COVID-19 needs to treat in spite of its self-limiting. http://news.cyol.com/app/2020-02/17/content_18378523.htm. [Accessed February 17, 2020].
[10]. Agency for Toxic Substances and Disease Registry (ATSDR). Calcium Hypochlorite (CaCL2O2)/Sodium Hypochlorite (NaOCl), in Medical Management Guidelines (MMG) 2002, US Department of Health and Human Services: Atlanta, USA.
[11]. Emmanuel E, Keck G, Blanchard JM, et al Toxicological effects of disinfections using sodium hypochlorite on aquatic organisms and its contribution to AOX formation in hospital wastewater. Environ Int 2004;30:891–900.
[12]. Graham-Engeland JE, Sin NL, Smyth JM, et al Negative and positive affect as predictors of inflammation: Timing matters. Brain Behav Immun 2018;74:222–230.
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