A roadside vendor offers face masks for sale along Kuala Lumpur’s Bukit Bintang shopping district, February 2, 2020. Photo: Nile Bowie

Dr Tariq Mahmood, head of the Department of Pulmonary Medicine at Moti Lal Nehru Medical College in India and a leading medical expert, recently spoke to Asia Times about the Covid-19 outbreak, and excerpts of that interview appear below.

Mahmood has more than 25 years of medical and clinical experience and is author or co-author of 18 original clinical research papers published in national and international journals. He is chairman of the Institutional Ethics Committee of the Regional Research Center of AYUSH in Allahabad, Uttar Pradesh, under the Indian Ministry of Ayurveda, Yoga & Naturopathy. He holds a Bachelor of Medicine and Bachelor of Surgery degree and an MD from the Institute of Medical Sciences, Banaras Hindu University.

Sachi Satapathy: How is the coronavirus outbreak making people sick?

Dr Tariq Mahmood: The early evidence suggests that the virus spreads between people who are in very close contact with each other. It spreads rapidly when an infected person sneezes or coughs.

Coughs and sneezes produce little droplets of mucus and saliva. If these droplets make it into another person’s eyes, mouth or nose, they can get sick. The viruses in those little droplets can also fall on to surfaces like tables or doorknobs – if someone touches that surface and touches their eyes, mouth or nose, they can also get sick.

Initial research finds that the virus can linger on surfaces such as plastic and stainless steel for a few days, which is why it’s important to clean countertops, doorknobs, and other places people touch regularly. The virus doesn’t appear to stay infectious on cardboard for longer than a day, so packages would be safe. The new coronavirus doesn’t spread through the air.

According to the World Health Organization, one sick person can infect on average [between] 1.4 and 2.5 additional people. A recent study found that the Covid-19 coronavirus can survive up to four hours on copper, up to 24 hours on cardboard, and up to two to three days on plastic and stainless steel.

The researchers also found that this virus can hang out as droplets in the air for up to three hours before they fall. But most often they will fall more quickly. There’s a lot we still don’t know, such as how different conditions, such as exposure to sunlight, heat or cold, can affect these survival times.

SS: One of the symptoms of Covid-19 is shortness of breath. What does that mean?

TM: Shortness of breath refers to unexpectedly feeling out of breath, or winded. But when should you worry about shortness of breath? There are many examples of temporary shortness of breath that are not worrisome. For example, if you feel very anxious, it’s common to get short of breath, and then it goes away when you calm down.

However, if you find that you are breathing harder or having trouble getting air each time you exert yourself, you always need to call your doctor. That was true before we had the recent outbreak of Covid-19, and it will still be true after it is over. Meanwhile, it’s important to remember that if shortness of breath is your only symptom, without a cough or fever, something other than Covid-19 is the likely problem.

SS: Many people have a chronic medical condition that puts them at increased risk for severe illness from Covid-19. What can people do to reduce the risk?

TM: You can take different steps to lower your risk of getting infected in the first place: As much as possible, limit contact with people outside your family; maintain enough distance [1.8 meters or more] between yourself and anyone outside your family; wash your hands often with soap and warm water for 20 to 30 seconds; as best you can, avoid touching your eyes, nose or mouth; stay away from people who are sick; during a Covid-19 outbreak in your community, stay home as much as possible to further reduce your risk of being exposed; clean and disinfect high-touch surfaces in your home, such as counters, tabletops, doorknobs, bathroom fixtures, toilets, phones, keyboards, tablets and bedside tables every day.

In addition, do your best to keep your condition well controlled. That means following your doctor’s recommendations, including taking medications as directed. If possible, get a 90-day supply of your prescription medications and request that they be mailed to you so you don’t have to go to the pharmacy to pick them up.

SS: Who is at highest risk for getting very sick from Covid-19?

TM: Older people, especially those with underlying medical problems like chronic bronchitis, emphysema, heart failure or diabetes, are more likely to develop serious illness. In addition, several underlying medical conditions may increase the risk of serious [effects from] Covid-19 for individuals of any age.

These include blood disorders, such as sickle cell disease, or taking blood thinners, chronic kidney disease, chronic liver disease, including cirrhosis and chronic hepatitis, any condition or treatment that weakens the immune response (cancer, cancer treatment, organ or bone marrow transplant, immuno-suppressant medications, HIV/AIDS), current or recent pregnancy in the last two weeks, diabetes, inherited metabolic disorders and mitochondrial disorders, heart disease, including coronary artery disease, congenital heart disease, and heart failure, lung disease, including asthma, COPD (chronic bronchitis or emphysema), neurological and neurologic and neuro-development conditions such as cerebral palsy, epilepsy (seizure disorders), stroke, intellectual disability, moderate to severe developmental delay, muscular dystrophy, or spinal-cord injury.

SS: Many are now wearing masks for air travel. How effective is that prevention method, and are there more effective methods people could be employing?

TM: The World Health Organization does not recommend that people wear a medical mask in community settings if they do not have respiratory symptoms, as there is no evidence available on its usefulness to protect people who are not ill. However, masks may be worn in some countries according to local cultural habits.

Individuals with fever and/or respiratory symptoms are advised to wear a mask, particularly in endemic areas. Only wear a mask if you are ill with Covid-19 symptoms (especially coughing) or looking after someone who may have Covid-19.

Disposable face masks can only be used once. If you are not ill or looking after someone who is ill then you are wasting a mask. There is a world-wide shortage of masks, so WHO urges people to use masks wisely. WHO advises rational use of medical masks to avoid unnecessary wastage of precious resources and misuse of masks.

The most effective ways to protect yourself and others against Covid-19 are to frequently clean your hands, cover your cough with the bend of elbow or tissue and maintain a distance of at least 1 meter from people who are coughing or sneezing.

SS: If someone has asthma and he or she gets Covid-19, is he or she more likely to become seriously ill?

TM: Yes, asthma may increase the risk of getting very sick from Covid-19. However, one can take steps to lower the risk of getting infected in the first place. These include social distancing, washing hands often with soap and warm water for 20 to 30 seconds, not touching eyes, nose or mouth, [and] staying away from people who are sick. In addition, one should continue to take medicines as prescribed to keep asthma under control.

Sachi Satapathy

Sachi Satapathy is an international development practitioner who has worked on large-scale projects. His interests are in public policy, poverty alleviation and public-private partnerships for development in middle-income and developing countries. The author can be reached at sachisatpathy@yahoo.com