ENGLISH PAPERS

“CORONA VIRUS (COVID-19)”

SUPPORTING LECTURER : MELISA YULIANI RIDUAN, M.Pd

Arranged by:

DELIANA MONIZ (113063C117004)

NURSING SCIENCE STUDY PROGRAM AND PROFESSIONAL NURSING

HIGH SCHOOL OF HEALTH SCIENCE INSAN

BANJARMASIN

2020
 CHAPTER I

PRELIMINARY

On December 31, 2019, China reported a mysterious case of pneumonia with no known
cause. In 3 days, there were 44 patients with such cases and it continues to grow until now there
are thousands of cases. Initially epidemiological data showed 66% of patients were related or
exposed to a seafood market or live market in Wuhan, Hubei Province, China. This is
reminiscent of the incident 17 years ago, where the outbreak of Severe Acute Respiratory
Syndrome (SARS) first appeared in China. When viewed from the level of death from the virus
(Case Fatality Rate of CFR), CFR Covid-19 is lower than the CFR SARS, which is 2% while
SARS reaches 10%. Although the CFR is lower but the Covid-19 case is developing rapidly and
has spread in 27 other countries. At first the transmission of this virus could not be determined
whether it could be passed between humans. The number of cases continues to increase over
time. In addition, there were cases of 15 medics infected by one patient. One of the patients was
suspected of being a “super spreader” case. Finally it was confirmed that this transmission of
pneumonia could be transmitted from human to human.

On February 11, 2020, the World Health Organization was named the new Severa acute
respiratory syndrome coronavirus-2 (SARS-CoV-2) and the name of the disease as Coronavirus
disease 2019 (COVID-19). As of 11 February 2020, there were 44,885 confirmed cases, with
details of 44,409 cases in China and 496 cases in 27 other countries.

For this incident, WHO as the World Health Organization assesses the risk due to the
virus, including the high category at the global level and establishes the status of the Public
Health Emergency of International Concern (PHEIC) since 30 January 2020.

Indonesia is one country that has been affected by the Corona virus (Covid-19), and
patients who have tested positive for Covid-19 from day to day are increasing in number.
Indonesia is required to always remain calm and maintain cleanliness, especially hand hygiene,
because this virus is very fast transmission.

Based on the description above, this paper aims to determine the course of the corona
virus, how to prevent it from being exposed to Coronavirus, and how to use the correct mask.
 CHAPTER II

DISCUSSION

A. DEFINITION
Coronavirus is a single positive, encapsulated, non-segmented RNA virus.
Coronavirus belongs to the order Nidovirales, Coronaviridae family. Coronaviridae is
divided into two sub-families based on serotype and genome characteristics. There
are four genera, namely alpha coronavirus, betacoronavirus, deltacoronavirus, and
coronavirus [ CITATION Erl202 \l 1033 ].
Coronavirus 2019 (COVID-19) is a respiratory infection caused by an emerging
coronavirus that was first identified in Wuhan, China, in December 2019. The genetic
sequencing of this virus has occurred that this virus is a type of betacoronavirus that
is closely related to the SARS virus.
Covid-19 is a virus that attacks the respiratory system with symptoms of fever,
cough, runny nose, afternoon throat, shortness of breath, fatigue, and lethargy. In
severe cases can cause pneumonia, acute respiratory syndrome, until death [ CITATION
Kom20 \l 1033 ].
B. CHARACTERISTICS
Coronaviruses have capsules, round or elliptical particles, often pleomorphic with
a diameter of about 50-200 m. All orders of the Nidovirales virus have capsules, are
not segmented, and are RNA positive viruses and have very long RNA genomes. The
structure of the coronavirus forms a cube-like structure with the S protein or the spike
protein is one of the main antigenic proteins of the virus and is the main structure for
writing genes. This S protein plays a role in the attachment and entry of the virus into
the host cell (the interaction of the S protein with its receptors in the host cell).

C. CLINICAL MANIFESTATIONS
 Based on current epidemiological investigations, the incubation period for
COVID-19 lasts between 1 to 14 days, and generally within 3 to 7 days.
Fever, fatigue, and dry cough are considered the main clinical manifestations,
while symptoms such as nasal congestion, runny nose, pharyngalgia, myalgia, and
diarrhea are realtively less frequent. In severe cases, shortness of breath and/or
hypoxemia generally occur after one week’s onset. In the worst cases, it can rapidly
develop into acute respiratory distress syndrome, septic shock, metabolic acidosis that
is difficult to correct, coagulation and bleeding disorders, multiple organ failure, and
so on. It is important to note that patients with severe or critical illness show only
moderate fever, or even no fever at all.
In mild cases it only shows mild fever, mild fatigue, and so on without
manifesting pneumonia.
Based on the cases handled recently , most patients have a good prognosis. As for
the elderly and people with chronic diseases, generally have a poor prognosis. While
cases in children generally have relatively mild symptoms [ CITATION Kom20 \l 1033 ].

D. PATHOPHYSIOLOGY
Most Coronaviruses infect animals and circulate in animals. Coronavirus causes a
large number of diseases in animals and its ability to cause severe diseases in animals
such as pigs, cows, horses, cats and chickens. Coronavirus is called a zoonotic virus,
a virus that is transmitted from animals to humans.
Bats, bamboo rats, camels and weasels are hosts commonly found for
Coronavirus. Coronavirus in bats is the main source for events. In general,
Coronavirus pathways from animals to humans and from humans to humans through
contact transmission, droplet transmission, fecal and oral routes.
Coronavirus mainly infects adults or older children, with mild clinical symptoms
such as common cold and pharyngitis to severe conditions such as SARS or MERS
and several strains that cause diarrhea in adults. All people are generally vulnerable
infected.
New types of coronavirus pneumonia can occur in immunocompromised patients
and normal populations, depending on exposure to the amount of virus. If exposed to
large amounts of the virus at one time, it can cause disease even if the body's immune
system is functioning normally. Coronavirus can only reproduce itself through its
hostcell. Viruses cannot live without host cells. Following the cycle of Coronavirus
after finding host cells according to its tropism. First, the attachment and entry of
viruses into host cells is mediated by Protein S which is on the surface of the virus.
The S protein is the main determinant in infecting its host species and its tropical
determinants. In the study of SARS-CoV protein S binds to the receptor in the host cell
, the enzyme ACE-2 (angiotensin-converting enzyme 2). ACE-2 can be found in oral
and nasal mucosa, nasopharynx, lung, stomach, small intestine, large intestine, skin,
thymus, bone marrow, spleen, liver, kidney, brain, pulmonary alveolar epithelial
cells, small intestinal enterocyte cells, endothelial cells cells venous arteries, and
smooth muscle cells. After successfully entering the next translation of the gene
replication of the RNA viral genome. Furthermore replication and transcription where
the synthesis of RNA viruses through translation and assembly of the virus replication
complex. The next stage is the assembly and release of the virus.

Figure 2. Coronavirus life cycle

 After transmission, the virus enters the upper airway and then replicates in the
upper airway epithelial cells (carrying out its life cycle). After that spread to lower
airway. In acute infections the virus decays from the airways and the virus can
continue to decay for some time in the gastrointestinal cells after healing. The
incubation period of the virus until the disease appears around 3-7 days [ CITATION
Erl202 \l 1033 ].

E. LABORATORY EXAMINATION
In the initial phase of patients with COVID-19, normal or decreased total white
blood cell counts and decreased lymphocyte counts can be found. In some patients
there can be an increase in the value of liver enzymes, LDH, muscle enzymes and
myoglobin and in some critical patients an increase in troponin levels can be found.
Most laboratory tests show an increase in the value of C-Reactive Protein and blood
sedimentation rate, whereas the value of procalcitonin is normal. In severe patients,
the D-dimer value increases and peripheral blood lymphocytes continue to decrease.
In addition, an increase in the value of inflammatory factors also occurs in severe and
critical patients.

Chest X-ray (Chest Imaging)

In the initial phase of COVID-19, chest x-rays show multiple small patches of
shadows and interstitial changes, especially in the peripheral lung. As the disease
progresses, the image that appears in a patient develops into multiple ground glass
and infiltration in both lungs. In severe cases, lung consolidation can occur. Pleural
effusion is rare in COVID-19 patients [ CITATION Kom20 \l 1033 ].

F. PREVENTION
Prevention principles and control strategies in general.
Take precautionary measures in the practice of daily life . Some prevention efforts
that can be done for the community:
1. Wash your hands with soap and water for at least 20 seconds. Use alcohol-based
hand sanitizers that contain at least 60% alcohol, if water and soap are not
available.
2. Avoid touching eyes, nose and mouth with hands that have not been washed.
3. As much as possible avoid contact with people who are sick.
4. When you are sick, use a medical mask. Stay at home when you are sick or
immediately go to a suitable health facility, don't move much outside.
5. Cover your mouth and nose when coughing or sneezing with tissue. Discard the
tissue in the designated place.
6. Using a medical mask is one way to prevent transmission of airway diseases,
including COVID-19 infection . However, the use of a mask alone is still
insufficient to protect a person from this infection, so it must be accompanied by
other prevention efforts. The use of masks must be combined with hand hygiene
and other prevention efforts .
Prevention according to conditions and places
The following precautions in various conditions and places:
1. Prevention of transmission in animal markets
a. Avoid contact with farm animals or wild animals without protection
b. Use a mask
c. Wash your hands after returning home
2. Prevention of transmission at home
a. Healthy lifestyles
b. Good personal hygiene
c. Cough and sneezing ethics
d. Wash hands, don't touch eyes, nose or mouth with dirty hands
e. Good room ventilation, keep it clean
f. Avoid close contact with people with respiratory system symptoms
g. Food that is safe, and cooked thoroughly
3. Prevention and control of infections in health facilities
The following PPI strategies to prevent or limit transmission of infections in
health facilities include:
a. Triage, early detection and control of sources
b. Application of preventive standards for all patients
c. Application of empirical measures ( droplets and contact and prevention of
other airbones ) for cases suspected of COVID-19 infection
d. Implementation of administrative controls
[ CITATION Erl202 \l 1033 ]
 PROCEDURES FOR USE OF TRUE MASK

1. Before using a mask, do hand hygiene / wash hands using soap or handrub

2. Use a surgical mask / surgical mask with a colored side on the outside. Make sure the
side of the mask with the wire is on the top.
3. Make sure the mask covers the entire nose, pull it up to cover the chin. Bend the wire at
the top of the mask so that it follows the curve of the nose bone. Make sure there is no
gap between the mask and the face.

4. Avoid touching the mask, especially the outside, during use. If you accidentally touch the
mask, wash your hands using soap or handrub.
5. Remove by pulling on the mask strap. Avoid touching the outside of the mask. Change
the mask every time it is contaminated or feels moist.

6. Dispose of the mask immediately in a closed bin after removing the mask. Don't use the
mask repeatedly.
7. Back to do hand hygiene / washing hands using soap or handrub after removing the mask
 CHAPTER III
CLOSING
A. CONCLUSION
Covid-19 is a virus that attacks the respiratory system with symptoms of fever,
cough, runny nose, afternoon throat, shortness of breath, fatigue, and lethargy. In severe
cases can cause pneumonia, acute respiratory syndrome, until death.
Coronavirus spreads very quickly, especially spread between humans to humans,
and after being exposed by Coronavirus not everyone shows symptoms, but it is more
dangerous if Coronavirus Affects the elderly or elderly, because the immune system in
the elderly or elderly has gone to decline and rapidly leads to death. The incubation
period after being exposed to Coronavirus is 14 days. And if you feel the body starts to
feel uncomfortable and sick, immediately contact a health facility or directly come to the
hospital, and always keep your hands clean and don't touch your eyes, nose and mouth
before washing your hands.

B. SUGGESTIONS
After knowing the definition of the corona virus to how to prevent it, we are
expected to always take care of each other's health , avoid crowds and stay indoors and
always maintain a healthy diet and adequate rest.
 QUESTION
1. Regarding the virus that has spread to almost all parts of Indonesia, when should it be
checked immediately to the health service?
Answer:
Immediately do independent isolation if you experience symptoms of Coronavirus
infection (CPVID-19) as mentioned above, especially if symptoms appear 2 weeks after
contact with sufferers of COVID-19 or are in an area that has COVID-19 cases. After
that, contact the COVID-19 hotline at 119 for further guidance. If you might be exposed
to the Coronavirus but don’t experience any symptoms, you don’t need to go to the
hospital, just stay at home for 14 days and limit contact with others.
2. What is the right type of cleaner to eradicate the Coronavirus on the surface of the object?
Answer:
According to WHO’s recommendations, if you feel that there is an unclean surface, you
should clean it with soap or detergent and rinse it with clean water.
3. Can spraying alcohol and chlorine in the human body prevent Coronavirus?
Answer:
According to WHO recommendations, spraying alcohol and chlorine on the human body
cannot prevent the Coronavirus. Spraying lime and chlorine can actually harm the eyes
and mouth. Alcohol and chlorine should only be sprayed on objects suspected of being
unsterile to prevent to spread of the Coronavirus.
 BIBLIOGRAPHY
Erlina Burhan; Fathiyah Isbaniah;Agus Dwi Susanto. (2020). Pneumonia Covid-19
Diagnosis&Penatalaksanaan Di Indonesia. Jakarta: Perhimpunan Dokter Paru Indonesia.

Komisi Kesehatan Nasional RRC; Administrasi Nasional Pengobatan Tradisional RRC. (2020).
Panduan Menghadapi Penyakit Virus Corona 2019 Model RRC: Pencegahan,
Pengendalian, Diagnosis dan Manajemen. Kupang: ISBN.