COVID-19 is a disease caused by infection with the severe cute respiratory syndrome coronavirus 2 ( SARS-CoV- 2 ) . COVID-19 can cause respiratory system disorders, ranging from mild symptoms such as the flu, to lung infections, such as pneumonia.

COVID-19 ( coronavirus disease 2019) is a new disease caused by a virus from the Coronavirus group , namely SARS-CoV-2 which is also often called the Corona virus .

The first case of this disease occurred in the city of Wuhan, China, at the end of December 2019. After that, COVID-19 spread between humans very quickly and spread to a number of countries, including Indonesia, in just a few months.

To prevent the spread of COVID-19 from becoming more widespread, several countries have imposed lockdown policies . In Indonesia, the government implemented a policy of Imposing Restrictions on Community Activities (PPKM) to suppress the spread of this virus.

Currently the PPKM policy has been relaxed to become PPKM level 1 in a number of areas, for example DKI Jakarta, Banten and West Java.

Death Rate Due to COVID-19

According to data released by the Task Force for the Acceleration of Handling COVID-19, the number of positive confirmed cases as of June 21, 2022 was 6,069,255 people, with 156,695 deaths.

From these two figures it can be concluded that the case fatality rate or death rate caused by COVID-19 in Indonesia is around 2.6%. The case fatality rate (CFR) is the percentage of deaths from all confirmed and reported positive cases of COVID-19.

Meanwhile, the number of survivors or people who have been infected with COVID-19 and then recovered continues to grow, namely 5,903,461 people.

Causes of COVID-19

COVID-19 is caused by SARS-CoV-2, which is a new type of coronavirus (a group of viruses that infect the respiratory system). Corona virus infection can cause mild to moderate respiratory infections, such as the flu, or infections of the respiratory system and lungs, such as pneumonia.

COVID-19 was originally thought to be transmitted from animals to humans. After that, it was discovered that this infection can also be transmitted from human to human. Transmission can be through the following ways:

  • Accidentally inhaling droplets that come out when a COVID-19 sufferer sneezes or coughs
  • Holding mouth, nose or eyes without washing hands first, after touching objects affected by droplets of COVID-19 sufferers, such as money or doorknobs
  • Close contact (less than 2 meters) with a COVID-19 sufferer without wearing a mask

The CDC and WHO state that COVID-19 can also be transmitted via aerosols (particles of substances in the air ). However, this mode of transmission usually occurs in certain medical procedures, such as bronchoscopy , endotracheal intubation, suctioning of mucus, and administering inhaled drugs via a nebulizer .

Transmission through the air can also occur more easily in a crowd of people, especially in closed spaces.

From the data released by WHO, so far several variants of SARS-CoV-2 have been found that cause COVID-19. The following details the type of the new variant:

  • Variant Alfa (B.1.1.7), which was first spotted in the UK in September 2020.
  • Variant Beta (B.1.351/B.1.351.2/B.1.351.3), which was first discovered in South Africa in May 2020.
  • The Gamma variant (P.1/P.1.1/P.1.2), which was first discovered in Brazil in November 2020.
  • Delta variant (B.1.617.2/AY.1/AY.2/AY.3), which was first discovered in India in October 2020.
  • The Omicron variant (B.1.1.529) was first discovered in South Africa in November 2021.

The Omicron variant is the main variant of the virus that causes COVID-19 which is currently spreading widely. The Omicron variant consists of several subvariants, namely BA.1, BA. 1.1, BA.2, and BA.3.

The Omicron variants BA.4 and BA.5 are the latest subvariants that were only detected in Indonesia in June 2022. These subvariants are likely to spread more quickly than the BA.1 and BA.2 subvariants.

Risk Factors for COVID-19

COVID-19 can infect anyone, but the effect  will be more dangerous or even fatal if it attacks the elderly, pregnant women , smokers , people with certain diseases , and people with weak immune systems, such as cancer sufferers .

Because it is easily transmitted, this disease also carries a high risk of infecting medical personnel treating COVID-19 patients. Therefore, medical personnel and people who come into contact with COVID-19 patients need to use personal protective equipment (PPE) .

Symptoms of COVID-19

Early symptoms  of COVID-19 infection can resemble those of the flu, namely fever, runny nose, dry cough,  sore throat and headache. After that, the symptoms can disappear and heal or even get worse.

Patients with severe symptoms can experience high fever, cough with phlegm or blood, shortness of breath, and chest pain. The symptoms mentioned above appear when  the body reacts against the COVID-19 virus .

In general, there are three general symptoms that can indicate someone is infected with COVID-19, namely:

  • Fever (body temperature above 38°C)
  • Dry cough
  • Hard to breathe

Apart from the symptoms above, there are several other symptoms that rarely occur but can also appear in COVID-19 infection, namely:

  • Easily tired
  • Muscle ache
  • Chest pain
  • Sore throat
  • Headache
  • Nausea or vomiting
  • Diarrhea
  • Cold or stuffy nose
  • shivers
  • Sneezes
  • Loss of ability to taste
  • Loss of the ability to smell ( anosmia )

Symptoms of COVID-19 can appear 2 days to 2 weeks after a person is infected with the virus that causes it. Some sufferers also experience happy hypoxia , which is a decrease in oxygen without any other symptoms. In addition, several case reports also state that some COVID-19 patients may experience skin rashes .

To ascertain whether these symptoms are symptoms of the Corona virus, a rapid test or PCR is needed . To find a place to do a rapid test or PCR around your home, click here .

In some sufferers, COVID-19 may not cause any symptoms at all. People who have been confirmed positive for COVID-19 through RT-PCR examination but do not experience symptoms are referred to as asymptomatic confirmed cases. These sufferers can still transmit COVID-19 to other people.

In July 2020, the Ministry of Health of the Republic of Indonesia replaced the old operational terms for COVID-19, such as ODP, PDP, OTG with new terms, namely suspect, probable and confirmation.

When to see a doctor

Immediately carry  out independent isolation  if you experience symptoms of COVID-19 infection as mentioned above, especially if in the last 2 weeks you have been in an area that has cases of COVID-19 or contact with sufferers of COVID-19. After that, call  the COVID-19 hotline  at 119 Ext. 9 for further instructions.

If you suspect yourself of being exposed to COVID-19 but have no symptoms or have mild symptoms, you don't need to  go to the hospital . You only need to self-isolate at home for 10 days from the appearance of symptoms, plus 3 days without symptoms of fever and respiratory problems.

If new symptoms appear, ask the doctor by phone or online health application , for example ALODOKTER, about what actions need to be taken and what medicines need to be taken.

If your symptoms are severe or you need a direct examination by a doctor, you can make an appointment to consult  a doctor through the ALODOKTER application so that you can be directed to the nearest doctor.

ALODOKTER also has a feature to help you check your risk of contracting COVID-19 more easily. To use this feature, please click on the image below.

Diagnosis of COVID-19

To determine whether the patient is infected with COVID-19, the doctor will ask about the patient's symptoms, the patient's travel history, and whether the patient previously had close contact with someone suspected of being infected with COVID-19.

After that, the doctor will carry out the following examinations:

  • Rapid antigen test , to detect antigens, namely proteins that are on the outside of the virus
  • PCR  ( polymerase chain reaction ) test or swab test , to detect the Corona virus in the lining of the nose
  • CT scan  or chest X-ray , to detect infiltrates or fluid in the lungs
  • Complete blood test , to check the levels of white blood cells and C-reactive protein
  • Blood gas analysis , to check the levels of oxygen and carbon dioxide in the blood

Please note, the rapid test  for COVID-19 is only used as a screening test or initial examination, not to confirm a diagnosis of COVID-19. A positive rapid test result does not necessarily mean you have COVID-19. You can only get a positive result if you have been infected with another virus or another type of Coronavirus .

Conversely, a  negative COVID-19 rapid test result  also does not necessarily mean that you are free from COVID-19. Therefore, regardless of your rapid test results , consult your doctor so that further instructions can be given, including whether or not it is necessary to confirm the test results with a PCR test. Usually the PCR test will attach a positive or negative result to the CT value .

Treatment of COVID-19

Until now, there is no drug that can definitely treat COVID-19. If you are diagnosed with COVID-19 but have no symptoms or only experience mild symptoms, all you have to do is self-care or isolate at home.

It is important to remember, the isolation room must have good ventilation and light as well as sufficient air exchange. In addition, the isolation room must also be cleaned every day with soapy water or disinfectant.

During self-isolation, pay attention to the following:

  • Do independent isolation for 2 weeks by not leaving the house and keeping your distance from people in the same house.
  • Always wear a mask when leaving the house or when interacting with family members.
  • Practice cough etiquette.
  • Measure body temperature twice a day, morning and evening.
  • Wash hands with soap, running water or hand sanitizer .
  • Drink plenty of water to maintain body fluid levels.
  • Get enough rest to speed up the healing process.
  • Take cough, fever and pain relievers, after consulting a doctor.
  • Pay attention to the symptoms you are experiencing and contact your doctor immediately if they worsen.

Research shows that COVID-19 patients with mild symptoms can recover within 2 weeks. However, before you end your independent isolation and return to your activities, still consult with your doctor to find out if you meet the criteria for recovering from COVID-19.

If you are diagnosed with COVID-19 and experience severe symptoms, the doctor will refer you for treatment and quarantine at a referral hospital. Methods that doctors can do include:

  • Give medication to reduce complaints and symptoms
  • Install a ventilator or breathing apparatus to meet oxygen needs
  • Give fluids infusion to stay hydrated
  • Give blood thinners and prevent blood clots
  • Giving anti-inflammatory drugs or antiinterleukin-6 (IL-6)

In addition to the methods above, research on several types of drugs and effective methods for dealing with COVID-19 is still being carried out. These drugs include several types of antivirals, namely favipiravir , molnupiravir , and remdesivir to fight the corona virus.

However, until now, studies have shown that antiviral drugs have not been proven effective in treating COVID-19.

COVID-19 complications

In severe cases, COVID-19 infection can cause serious complications in the form of:

  • Acute respiratory failure
  • Pneumonia
  • Acute heart failure
  • Acute liver failure
  • Secondary infection in other organs, such as black fungus disease
  • Kidney failure
  • Blood clotting disorders
  • Rhabdomyolysis
  • ARDS ( acute respiratory distress syndrome )
  • Septic shock
  • Dead

In addition, the term long haul COVID-19 has now appeared . This term refers to someone who has been declared cured through a negative PCR test result, but still feels complaints, such as:

  • Weak
  • Cough
  • Joint pain
  • Chest pain
  • Difficulty concentrating
  • Heart beat
  • Fever that comes and goes

Covid-19 prevention

Currently, Indonesia is implementing a COVID-19 vaccination program in stages. As of June 2022, data shows that 96.6% of the population has received the first dose of vaccine and around 80.91% have received the second dose of vaccine. In addition, as much as 23.59% of the population has received booster vaccines .

Vaccination against COVID-19 aims to build immunity against the Corona virus, while at the same time forming group immunity or herd immunity . The more people who are vaccinated, the faster the transmission of COVID-19 will stop. In addition, the economic conditions affected by the pandemic will also recover.

In order to achieve the above goals, the COVID-19 vaccine is now being given to children aged 6–18 years, pregnant women and nursing mothers. Whereas for people with a history of certain diseases or health conditions, vaccine administration must be accompanied by permission from a doctor.

Please note, even if you have received your second dose of the COVID-19 vaccine, you should still avoid factors that can increase your risk of being infected with this virus. The trick is to do the things below:

  • Apply  physical distancing , namely maintaining a minimum distance of 2 meters from other people, and don't leave the house unless there is an urgent need.
  • Use  a mask  when doing activities in public or crowded places, including when going  grocery shopping .
  • Wash your hands regularly  with water and soap or  a hand sanitizer  that contains at least 60% alcohol, especially after doing activities outside the home or in public places.
  • Do not touch your eyes, mouth and nose before washing your hands.
  • Increase endurance  by living a healthy lifestyle, for example regular exercise and consumption of nutritious foods and supplements.
  • Avoid contact with sufferers of COVID-19, people suspected of being positively infected with COVID-19, or people who have a fever, cough or runny nose.
  • Cover your mouth and nose with a tissue when you cough or sneeze, then throw the tissue in the trash.
  • Keep things that are often touched clean and the environment clean, including  the cleanliness of the house .
  • Keep the circulation and cleanliness of the air in the room. If necessary, you can use an air purifier .

For people suspected of being affected by  COVID-19  (including the suspect and probable categories ) who were previously referred to as ODP (people under monitoring) and PDP (patients under surveillance), there are several steps that can be taken so as not to transmit the Corona virus to others, namely:

  • Do  self-isolation  by living in a separate room from other people for a while. If not possible, use a bedroom and bathroom that are different from those used by other people.
  • Consumption of drugs recommended by a doctor.
  • Take temperature measurements twice a day, morning and evening.
  • Do not leave the house, except to get treatment.
  • Call the hospital to pick you up if your symptoms get worse.
  • Forbid and prevent others from visiting or seeing you until you are completely healed.
  • As much as possible do not have meetings with people who are sick.
  • Avoid sharing eating and drinking utensils, toiletries, and sleeping equipment with other people.
  • Wear a mask and gloves if you have to be in a public place, such as a hospital or with other people.
  • Use a tissue to cover your mouth and nose when you cough or sneeze, then immediately throw the tissue in the trash.

Conditions that require direct treatment by a doctor at the hospital, such as  giving birth  surgery , dialysis, or  child vaccination , will be handled differently with some adjustments during the COVID-19 pandemic. The goal is to prevent transmission of COVID-19 while you are in the hospital.

Therefore, consult with your doctor about the best course of action to take if you experience the conditions above.

If you want to get more information about symptoms, prevention and facts about the Corona virus, please  download  the ALODOKTER application on  Google Play or the App Store . Through the ALODOKTER application, you can also chat directly with doctors and make consultation appointments with doctors at the hospital.

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