SARS-Cov-2 Pandemic; the Features and the Measures We Should Take


SARS-Cov-2 Pandemic; the Features and the Measures We Should Take

SARS-Cov-2 means ”Severe acute respiratory syndrome Corona virus 2”, meaning the Corona 2 virus (or the ”new virus”, so a mutant form, unknown until recently) of severe acute respiratory syndrome; in other words, the virus that causes this disease.

Earlier variants of this virus were responsible for previous outbreaks
-          „SARS epidemic”:  originating in Hong Kong (2002-2004)
-       „MERS epidemic” (Middle East Corona virus syndrome) originating in the Middle East (Saudi Arabia): the epidemic started in 2012 and new cases are still being registered these days

The new variant (SARS-Cov-2) produces a disease called COVID 19 (Corona Virus Disease 19, that is the disease produced by the Corona virus and identified for the first time in 2019).

The virus is of animal origin and most probably comes from bats, having as an intermediate host an animal on the brink of extinction called pangolin; it was also called ”Wuhan Virus” after the name of the Chinese city where it was firstly identified and where the first epidemic outbreak was registered.

The transmission of the virus is currently done from man to man through the drops resulting from coughing or sneezing, either directly (when between the carrier and the person it infects is a distance of less than 2 meters) or indirectly, by contamination of the hands from the surfaces infected with virus (it has been proven that the virus can remain alive on plastic or metal surfaces for up to 3 days).

The virus has an extremely high contagiousness which explains the very rapid spread of the whole earth.

As the name implies, it is a disease that primarily affects the airways and lungs.

In mild forms it manifests itself as a common flu, with dry cough, fever, headache and general distressed state.

At some patients, diarrhoea may occur, which also involves a digestive transmission of the virus, with the possibility of affecting other organs (primarily the liver).

The disease is almost unknown among the children, and young adults get mild forms and most of these heal spontaneously.

The patients over 70 years old represent the major problem and, in particular, those with comorbidities: diabetes, obesity, high blood pressure, chronic kidney or liver disease, pulmonary emphysema or chronic obstructive bronchopneumopathy.

Since there is currently no vaccine, the only way to avoid the disease is to avoid contact with any other person.


It is the motto of this period. The appeal is addressed especially to those who have over 70 years, but not only. At the same time, according to Naftali Bennett, the Minister of Defence of Israel, the most useful measure at the present is the separation of the elderly from the young, given the high lethality among senior citizens. No matter how painful could be, but during the  epidemic grandparents are not allowed to kiss their grandchildren!

The severity of the forms at the elderly and sick people (with associated diseases) consists in the extension of the viral infection from the level of the oral and nasal cavity, including the paranasal sinuses (which are a true virus reservoir) to the trachea and lungs.

That is why maintaining the best hygiene at this level is highly recommended. Inhalation of hot steam for cleaning the sinuses and gargle with hot water for sterilization of the pharynx are highly recommended measures.

It is considered that the virus initially stations in the nose, mouth, pharynx and paranasal sinuses and only after 3-4 days it descends into the airways and lungs.

Therefore, it is recommended that, at the onset of the first symptoms, mentioned above, the respective person should contact a profile institution (in Bucharest these are the Matei Bals Institute and the Victor Babes Hospital), in order to avoid further complications.

Beginning the treatment during this period has the highest chances of success.

There are a number of drugs with proven efficacy:
-     Lopinavir (trade name Kaletra): is an antiretroviral class of protease inhibitors used successfully in the treatment of HIV infection
-    Hydroxychloroquine (trade name Plaquenil): is a well-known antimalarial drug that has also proven effective against coronavirus
-    Azithromycin: is an antibiotic from the macrolide group that prevents bacterial superinfection, primarily in the lung.

Paracetamol is the most recommended anti-inflammatory drug (which is usually taken in seasonal viruses), and Ibuprofen (which can aggravate the disease) should be avoided in particular.

Lung damage is the leading cause of mortality so far. First of all because lung damage is very severe and difficult to treat. According to necroptic data from China it results that at the level of respiratory treeit forms  mucus “plugs”, which can completely obstruct the airways and lungs.

Secondly, as the mechanical ventilation (which can often be required in such cases) can predispose to bacterial superinfection (especially when it is for a prolonged period of time).

Finally, thirdly, because when the number of cases exceeds a certain limit, not even the best performing health system in the world can provide a sufficient number of ventilators for all who are in need. This is the case of Italy where doctors were put in the dramatic situation of determining whom should mechanically ventilate and whom should not, in other words who lives and who dies!

Normally, the epidemics reach a maximum in terms of the number of cases, after which they begin to decrease. The point of inflection from which the decline begins is quite difficult to predict. At the same time it is not excluded that the virus will return (there are forecasts that the current epidemic will decrease in intensity with the arrival of the hot season, but will resume during the autumn, when the cold season will arrive again). Finally, according to the MERS model mentioned above, humanity may face an infection that once appeared will become permanent and that the population of the planet must become accustomed to.

Researches for the discovery of a vaccine are in advanced stages but, in all likelihood, it will not be available before the end of the year.

In the long term, however, the possibility of vaccination could prove salutary in the fight against this disease.

Let us hope that, as every time until now, humanity will win in the fight with the disease!

Prof. Irinel Popescu is a prominent surgeon and a member of the Romanian Academy of Sciences. He is a leader in surgical oncology and liver-related medical procedures. For the last three decades, Prof Popescu has been the pioneer and motivator of liver transplants in Romania and the founder of a Romanian school for liver transplantation.
Prof. Popescu is a social contributor in raising the public awareness for organ donation, which Romania is still showing a very sluggish progress in.
He is a member of many local and international medical associations and a respectable writer and speaker in the most important medical and surgical conferences.
Prof. Popescu serves as the President of the Romanian Academy of Medical Sciences and as a Corresponding Member of the Romanian Academy.