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Coronaviruses (CoV) are a large family of viruses that are common in both humans and animals. There are currently seven strains of human coronaviruses that have been identified. Four of these strains are common and found in Wisconsin and elsewhere around the world. These common human coronaviruses cause illness ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV).

In December 2019, an outbreak of a novel coronavirus occurred in Wuhan, Hubei Province, China. The virus, now officially named SARS-CoV-2, is thought to have originated in a seafood market and is likely to have come from bats before being transmitted to humans from an intermediate animal. In January 2020, Chinese authorities confirmed apparent humantohuman transmission of the virus.

The virus quickly spread throughout Hubei Province and to other provinces in mainland China, before spreading internationally. Quarantine measures implemented in mainland China and border control measures including travel restrictions implemented internationally, contained the virus and delayed significant spread. However, by the end of February 2020, cases had been reported in 57 countries with rapid increases in Iran, South Korea and Italy. WHO declared a global pandemic in March 2020.

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Epidemiological FAQs

What is the incubation period?

The incubation period is the duration between exposure to the virus and the onset of symptoms. The World Health Organization (WHO) currently estimates that the incubation period ranges from 1 to 14 days, with a median incubation period of 5 to 6 days. These estimates will be refined as more data becomes available.

The Department is aware of reports that suggest there have been cases with longer incubation periods, such as 24 days. The incubation period of infections often has a skewed distribution, where most patients have an incubation period that clusters around the average, but a few patients have a longer incubation period. Medical experts believe reports of cases with longer incubation periods are statistical outliers – while longer incubation periods are possible, they may have been reported in error, or had exposure to an unidentified case at a later date that has not been identified in a transmission chain.

Is there asymptomatic or presymptomatic transmission?

To date, the exact nature of transmission of SARS-CoV-2 is not well understood. Epidemiological data suggests that the majority of transmission occurs from symptomatic cases. However, there have been documented cases of asymptomatic and presymptomatic transmission in a small number of cases.

Can reinfection occur?

There have been reports of apparent re-infection in a small number of cases. However, most of these describe patients having tested positive within 7-14 days after apparent recovery. Immunological studies indicate that patients recovering from COVID-19 mount a strong antibody response. It is likely that positive tests soon after recovery represent persisting excretion of viral RNA, and it should be noted that PCR tests cannot distinguish between “live” virus and non-infective RNA. Australian guidelines currently require patients who have had COVID-19 to test negative on two tests 24 hours apart before being released from isolation.

What is the case fatality rate and overall severity of the disease?

A large study conducted in China on 44,672 confirmed cases has informed much of what we currently know with regards to case fatality and overall severity of the disease. However, at the moment there is not enough data on cases outside mainland China to make a meaningful comparison.

In China, the case fatality rate (CFR) is reported to be 2.3%, however this is much higher in Hubei Province (2.9%) than in all other provinces (0.4%). The CFR is likely to be much lower than reported, due to a proportion of mild cases going underreported in the community. CFR estimates for regions outside mainland China are generally low; however, the clinical outcomes for the majority of these cases is still unknown. Based on current estimates, it is estimated that approximately 1% of COVID-19 patients will die. We will be able to better estimate this proportion once serological studies are performed.

Likewise, we continue to gather information on the overall severity of the disease. Based on current data, it is estimated that approximately 80% of cases will have a mild illness, approximately 20% will require hospitalisation, and approximately 3-5% will require ICU admission. Cases classified as critical (respiratory failure, septic shock, and/or multi-organ failure) have a CFR of approximately 50%. Patients in this circumstance have tended to be elderly with comorbidities.

How infectious is this pathogen?

There are a number of ways that this can be measured. The reproductive rate of the virus, or R0, measures the average number of secondary infections caused by a single case. The R0 is a context specific measurement. While the R0 in mainland China is estimated to be 2.58, it is likely that public health measures imposed by China have led to a relatively low R0. The R0 may be higher in countries which do not implement strong public health measures, such as the case isolation and contact quarantine measures used in Australia. There has been a large variation in R0 calculated by different studies. The WHO initially estimated the R0 to be 1.4-2.5 (average 1.95), however a recent review of 12 studies estimated the basic R0 to be 3.28 and the median R0 to be 2.79.

Another measure of infectiousness is household secondary attack rate, or the proportion of household members who are likely to get infected from a case. Estimates of this rate have varied significantly between studies, ranging from as low as 3-10% to as high as 100%. This suggests that there may be factors that vary considerably between different groups, such as types of activities, duration of event, ventilation of the household and viral shedding of the case. The Department has released guidance on home isolation which outlines steps household members should take if there is a suspected or confirmed case in the house.

Clinical Care FAQs

How does COVID-19 spread?

The virus is thought to spread mainly from person-to-person.

These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs.

Can someone spread the virus without being sick?

Spread from contact with contaminated surfaces or objects

It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes, but this is not thought to be the main way the virus spreads.


Reported illnesses have ranged from mild symptoms to severe illness and death for confirmed coronavirus disease 2019 (COVID-19) cases.
These symptoms may appear 2-14 days after exposure (based on the incubation period of MERS-CoV viruses).

If you develop emergency warning signs for COVID-19 get medical attention immediately. Emergency warning signs include*:

*This list is not all inclusive. Please consult your medical provider for any other symptoms that are severe or concerning.

Preventions and Treatment

There is currently no vaccine to prevent COVID-19 infection, and there is currently no specific treatment. The best way to prevent infection is to avoid being exposed to the virus.

Take these steps to help prevent the spread of respiratory viruses:

Clean your hands often

Avoid close contact

Take steps to protect others:

Stay home if you’re sick

Cover coughs and sneezes

Wear a facemask if you are sick

Clean and disinfect

To disinfect:
Most common EPA-registered household disinfectants will work.
Options include:

Follow manufacturer’s instructions for application and proper ventilation. Check to ensure the product is not past its expiration date. Never mix household bleach with ammonia or any other cleanser. Unexpired household bleach will be effective against coronaviruses when properly diluted.

COVID-19 testing

Testing for the respiratory illness coronavirus disease 2019 (COVID-19) is possible with two main methods: molecular recognition and serology testing.

Molecular methods leverage polymerase chain reaction (PCR) along with nucleic acid tests, and other advanced analytical techniques, to detect the genetic material of the virus using real-time reverse transcription polymerase chain reaction for diagnostic purposes. Serology testing, leverages ELISA antibody test kits to detect the presence of antibodies produced by the host immune system against the virus. Typically, two ELISA tests against two different proteins produced by the virus on between 2 and 4 samples taken from sputum and swabs taken nasally and from the mouth. If either test is positive, a microneutralization assay test is performed to confirm the positive result. Since antibodies continue to circulate even after the infection is cleared, serology tests continue to be positive for individuals who have been previously exposed and developed an immune response, which means a positive test may not indicate an active infection.

CT scan

Chest CT scans can sometimes help identify and characterize lung pathology, and have yielded non-specific findings with COVID-19 infection. A systematic review of chest CT scan findings in 919 patients described the typical early manifestation of COVID-19 as "bilateral multilobar ground-glass opacification (GGO) with a peripheral or posterior distribution"

Typical CT imaging findings

No study yet has validated the accuracy and discriminatory value of CT scans to distinguish COVID from other viral pneumonia. Therefore, the CDC does not recommend CT for initial screening, People with suspected COVID should be tested with RT-PCR, which is the most specific test.

CT imaging of rapid progression stage.



Wearing and Removing on Personal Protective Equipment (PPE)

Perform hand hygiene before wearing on PPE. The order to wear on PPE is Apron or Gown, Surgical Mask, Eye Protection (where required) and Gloves.

The order for removing PPE is Gloves, Apron or Gown, Eye Protection, Surgical Mask.


In late 2019, a new strain of coronavirus was detected in humans. Within weeks, this novel virus spread from it's original location, Wuhan, China. But can COVID-19 be stopped? And if so, how? There are many issues when it comes to stopping a new virus, but detection, containment, medications, and vaccinations will all play a huge role in making sure this doesn't become a global pandemic.

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Zoonótico (de animales a humanos)
Come down with (something) to
Get over
Fight (something) off
Break out in (hives, a rash, etc.)
Vencer, derrotar
Brotar, estallar

The Passive Voice

Serology antibody testing is being used both for surveillance and investigational purposes.
Based on current estimates, it is estimated that approximately 1% of COVID-19 patients will die. Passive voice is used when the focus is on the action. It is not important or not known, however, who or what is performing the action. In previous examples, the important fact is serology antibody testing is testing and 1% of COVID-19 patients will die.

How do we make the passive?

Subject + finite form of to be + Past Participle (3rd column of irregular verbs)
Example: Serology antiboody testin is being used…
When rewriting active sentences in passive voice, note the following:

  • the object of the active sentence becomes the subject of the passive sentence
  • the finite form of the verb is changed (to be + past participle)
  • the subject of the active sentence becomes the object of the passive sentence (or is dropped)

Passive Sentences with Two Objects 
Rewriting an active sentence with two objects in passive voice means that one of the two objects becomes the subject, the other one remains an object. Which object to transform into a subject depends on what you want to put the focus on.
A letter was written to me (by Rita)
I was written a letter (by Rita)
Adding by Rita does not sound very formal, that´s why it is usually dropped.

Personal and Impersonal Passive
Personal Passive simply means that the object of the active sentence becomes the subject of the passive sentence. So every verb that needs an object (transitive verb) can form a personal passive.
They build houses. – Houses are built.

Verbs without an object (intransitive verb) normally cannot form a personal passive sentence (as there is no object thatcan become the subject of the passive sentence). If you want to use an intransitive verb in passive voice, you need an impersonal construction – therefore this passive is called Impersonal Passive.
It is estimated that approximately 1% of COVID-19 patients will die.
Impersonal Passive is not as common in English as in some other. In English, Impersonal Passive is only possible with verbs of perception (e.g. say, think, know).

Differences between Isolation and Quarantine

  • Isolation is used to separate ill persons who have a communicable disease from those who are healthy. Isolation restricts the movement of ill persons to help stop the spread of certain diseases. For example: Hospitals use isolation for patients with COVID-19.
  • Quarantine is used to separate and restrict the movement of well persons who may have been exposed to a communicable disease to see if they become ill. These people may have been exposed to a disease and do not know it, or they may have the disease but do not show symptoms. Quarantine can also help limit the spread of communicable disease. For example: The country is in quarantine.
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