Bali Journal of Anesthesiology

: 2020  |  Volume : 4  |  Issue : 1  |  Page : 1--2

Covid-19: What we know so far

Christopher Ryalino 
 Department of Anesthesia and Intensive Care, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia

Correspondence Address:
Dr. Christopher Ryalino
Department of Anesthesia and Intensive Care, Faculty of Medicine, Udayana University, Jl. PB Sudirman, Denpasar 80232, Bali

How to cite this article:
Ryalino C. Covid-19: What we know so far.Bali J Anaesthesiol 2020;4:1-2

How to cite this URL:
Ryalino C. Covid-19: What we know so far. Bali J Anaesthesiol [serial online] 2020 [cited 2023 Jan 31 ];4:1-2
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Full Text

Dear Editor,

It has been almost three months since the world shook due to this recent outbreak, the Coronavirus Disease 2019 (Covid-19). The event started on December 31, 2019, when the WHO China Office received a report about 44 cases of unknown-origin pneumonia in Wuhan, Hubei Province. Pneumonia of unknown aetiology is defined as an illness without a causative pathogen identified that fulfils the following criteria: fever (≥38°C), radiographic evidence of pneumonia, low or normal white-cell count or low lymphocyte count, and no symptomatic improvement after antimicrobial treatment for 3 to 5 days following standard clinical guidelines. Authorities report that the reported patients were isolated and receiving treatment in Wuhan medical institutions. The clinical signs and symptoms include fever, with some patients had difficulty in breathing, and chest x-ray showed invasive lesions of both lungs.[1] Most cases (55%) with clinical onset before January 1, 2020, were associated with the Huanan Seafood Wholesale Market.[2]

Li et al.[2] reported valuable data on the first 425 confirmed cases. They found that the median age was 59 years, and 56% of the confirmed cases were male. They also reported that the mean incubation time was 5.2 days. In the early stage, the epidemic doubled in size every 7.4 days. Within less than three months, the outbreak has gone worldwide. In its latest sitrep, WHO announced that 88,948 cases were confirmed worldwide, with 8,774 cases occurring in 64 countries outside China.[3] According to the same sitrep, Armenia, Czechia, Dominican Republic, Luxembourg, Iceland, and Indonesia are the latest countries that reported cases of Covid-19. The death toll has now reached over 3,000 cases. Many experts suggest that we could be in the early stages of a pandemic.[4]

Symptoms of Covid-19 include fever, cough, tired feeling, aches, nasal congestion, sore throat, and runny nose. One in six people who gets Covid-19 will develops difficulty of breathing. Older people and those with underlying medical problems like high heart problems or diabetes are more likely to develop serious illness.[5] WHO recommended that people with fever, cough and difficulty breathing should seek medical attention.

WHO issued six recommendation on the basic protective measures against Covid-19: wash your hands frequently with an alcohol-based hand rub or soap and water; maintain social distance at least one meter between yourself and anyone who is coughing or sneezing; avoid touching your eyes, mouth, and nose; covering your mouth and nose with your bent elbow or tissue when you cough or sneeze then dispose of the used tissue immediately; and seek medical care early if you develop fever, cough and difficulty breathing.[6]

For protective measures, those who recently visited (past 14 days) areas where Covid-19 is confirmed, WHO recommended that they follow the basic protective measures above, and to stay at home when one begins to feel unwell, even with mild symptoms such as headache and slight runny nose, until they recover. Research is underway to develop a vaccine against Covid-19.[7] Current therapy consists of supportive therapy and isolation to stop the transmission. Antiviral medications like lopinavir–ritonavir, interferon-1β, remdesivir, and chloroquine, are currently being explored.[8]

In the last two decades, we saw the world had to face two flu-like illnesses outbreak, the Severe Acute Respiratory Syndrome (SARS) and the Middle East Respiratory Syndrome Coronavirus (MERS-CoV). On February 15, 2020, the WHO Director-General Dr Tedros Adhanom Ghebreyesus mentioned, “We're not just fighting an epidemic; we're fighting an infodemic.”[4] It is undeniable that misleading information regarding the transmission and prevention of Covid-19 has been rapidly evolving nowadays.

It is our duty as a medical professional to provide one with truthful and scientific information about what we do know, and what we do not know yet, about this virus. We may not be able to prevent this pandemic, but we certainly can educate the society, especially those who are living around us, to stop these chains of inaccurate information from spreading more.


1World Health Organization. Pneumonia of Unknown Cause – China: Disease Outbreak News. Geneva: World Health Organization; 2020. Available from: [Last accessed on 2020 Feb 26].
2Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y, et al. Early transmission dynamics in Wuhan, China, of novel coronavirus–infected pneumonia. N Engl J Med. 2020. DOI: 10.1056/NEJMoa2001316. Available at: [Last Accessed on 2020 Mar 03].
3World Health Organization. Coronavirus Disease 2019 (COVID 19) Situation Report 42. Geneva: World Health Organization; 2020. Available from: [Last accessed on 2020 Mar 03].
4The Lancet. COVID-19: Fighting panic with information. Lancet 2020;395:537.
5World Health Organization. Q&A on Coronaviruses (COVID-19). Geneva: World Health Organization; 2020. Available from: [Last accessed on 2020 Mar 03].
6World Health Organization. Coronavirus Disease (COVID-19) Advice for the Public. Geneva: World Health Organization. Available from: [Last accessed on 2020 Mar 03].
7World Health Organization. DRAFT Landscape of COVID-19 Candidate Vaccines. Geneva: World Health Organization; 2020. Available from: [Last accessed on 2020 Mar 03].
8World Health Organization. R&D Blueprint: Informal Consultation on Prioritization of Candidate Therapeutic Agents for Use in Novel Coronavirus 2019 Infection. Geneva: World Health Organization; 2020. Available from: [Last accessed on 2020 Mar 03].