CORONAVIRUS (COVID 19)
Allianz EFU Health Insurance
Limited
D-136, Block-4 KDA Scheme-5
Clifton Karachi-75600, Pakistan
Coronavirus (COVID-19) is a respiratory illness caused by a new
virus. Symptoms range from a mild cough to pneumonia. Some
people recover easily, others may get very sick very quickly.
There is evidence that it spreads from person to person. Good
hygiene can prevent infection.
CORONAVIRUS (COVID 19)

Symptoms of Coronavirus Disease 2019 (COVID-19

For confirmed coronavirus disease 2019 (COVID-19) cases, reported illnesses have ranged from mild symptoms to severe
illness and death. Symptoms can include:

• A high temperature - Fever

• A new, continuous cough – coughing for more
than an hour, or 3 or more coughing episodes in 24
hours
• a loss or change to sense of smell or taste
• Shortness of breath

Symptoms of COVID-19 may appear in as few as 2 days or as long as 14 days after exposure.

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

 Difficulty in breathing or shortness of breath

 Persistent pain or pressure in the chest
 New confusion or inability to arouse
 Bluish lips or face
 Fatigue and Lethargy
 Headache
 Sore Throat
 Aching Muscles
 diarrhoea and vomiting

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

COVID-19 symptom progression

Symptoms may begin gradually and are usually mild.

• The majority of people (around 80%) have asymptomatic to moderate disease and recover without needing hospital
treatment
• Around 15% may get severe disease including pneumonia

 Older people and those with underlying medical problems such as high blood pressure, heart and lung
problems, diabetes, or cancer are more likely to develop serious illness
 Around 5% become critically unwell. This may include septic shock and/or multi-organ and respiratory
failure

The infection fatality rate (the proportion of deaths among all infected individuals) is estimated to be 0.9% but it varies
according to age and sex. It is lower in younger people (0.5% for those 45-64 years) and higher in those over 75 years of age
(11.6%)
CORONAVIRUS (COVID 19)

Complications of Covid-19 disease

Complications from COVID-19 can be severe and fatal. The risk of developing complications increases with age and is
greater in those with underlying health conditions. The type of complication that can develop may include:

• venous thromboembolism
• heart, liver and kidney problems
• neurological problems
• coagulation (blood clotting) failure
• respiratory failure
• multiple organ failure
• septic shock

Prevention For Coronaviruses Coronavirus Disease 2019 (COVID-19)

There is currently no vaccine to prevent coronavirus disease 2019 (COVID-19). The best way to prevent illness is to avoid
being exposed to this virus. We urge everyone to be diligent and practice safe hygiene. Everyone should be following
standard recommendations to prevent infection spread including:

 Wash your hands regularly with soap and water

for at least 20 seconds; use hand sanitizers at
home and in the workplace
 If you are sick, stay home, and follow the advice
of your health care provider
 Cough and sneeze into your elbow, not your
hands or into a tissue which should immediately
be discarded; avoid touching your eyes, nose and
mouth
 Avoid close contact with anyone showing
respiratory symptoms (breathing difficulties,
cough, runny nose)
 Avoid touching public surfaces - credit card
machines, gas pumps, hand railings, elevators.
Use a tissue or paper towel when touching
surfaces
 Over-the-counter masks are generally not an
effective deterrent and are not recommended for
the public at this time
 Evaluate your travel plans as conditions warrant;
you should rethink traveling to areas that are
already under a travel advisory or areas that are
experiencing an outbreak of Coronavirus
CORONAVIRUS (COVID 19)

Social Distancing

Social distancing includes ways to stop or slow the spread of infectious diseases. It means less contact between you and other
people.

Social distancing is important because COVID-19 is most likely to spread from person-to-person through:

 Direct close contact with a person while they are infectious or in the 24 hours before their symptoms appeared
 Close contact with a person with a confirmed infection who coughs or sneezes, or
 Touching objects or surfaces (such as door handles or tables) contaminated from a cough or sneeze from a person
with a confirmed infection, and then touching your mouth or face.
So, the more space between you and others, the harder it is for the virus to spread.

Social distancing in the workplace

 Encourage flexible working arrangements including working from home and off-peak travel, and consider whether
staff work stations can be more widely spaced.
 Purchase COVID-19 prevention supplies, for example alcohol hand sanitizers
 Provide and promote hand sanitizers at building entrances.
 Stay at home if you are sick
 Stop handshaking as a greeting
 Hold meetings via video conferencing or phone call
 Defer large meetings
 Hold essential meetings outside in the open air if possible
 Encourage personal hygiene, such as use of hand sanitizer or hand washing with soap by all staff.
 Take lunch at your desk or outside rather than in the lunch room
 Clean and disinfect high touch surfaces regularly
 Consider opening windows and adjusting air conditioning for more ventilation
 Limit food handling and sharing of food in the workplace
 Reconsider non-essential business travel
 Promote strictest hygiene among food preparation (canteen) staff and their close contacts
 Consider if large gatherings can be rescheduled, staggered or cancelled

Things to consider when visiting hospital or organizing public gatherings

 Hospital is place where chance of exposure of different infections is very high especially infection likes COVID 19.
It is suggested do not visit hospitals until unless medically necessary, try to limit visiting sick people, consider
whether you can postpone planned surgery or elective procedure except it requires emergency care.

 Events where a large number of people are in one place can increase the risk of transmission of viruses. If you are
organizing a gathering, consider whether you can postpone or cancel the event. If you decide to go ahead, you should
assess the risks and reconsider any aspect that may increase risk of transmission.
CORONAVIRUS (COVID 19)

Recommendation for using Mask

• It does not recommend that people who are well

wear a facemask to protect themselves from
respiratory diseases, including COVID-19.
• Facemasks should be used by people who show
symptoms of COVID-19 to help prevent the
spread of the disease to others.
• The use of facemasks is also crucial for health
workers and people who are taking care of
someone in close settings (at home or in a health
care facility).
• Wash your hands often with soap and water for at
least 20 seconds, especially after going to the
bathroom; before eating; and after blowing your
nose, coughing, or sneezing. If soap and water are
not readily available, use an alcohol-based hand
sanitizer with at least 60% alcohol. Always wash
hands with soap and water if hands are visibly
dirty.

Who is at Risk
In Pakistan, the people most at risk of getting the virus are those who have:
Recently been in COVID-19 affected area
Been in close contact with someone who is a confirmed case of coronavirus

Based on what we know about coronaviruses, those most at risk of serious infection are:

 people with compromised immune systems (such as people who have cancer)
 elderly people
 people with chronic medical conditions
 people in group residential settings

Who gets tested for the virus?

Currently there are two main reasons someone would be tested for the coronavirus: having symptoms or exposure to an
infected person.
The main symptoms of COVID-19, are fever, dry cough and shortness of breath. These look a lot like the flu and the
common cold, so it takes a physician to determine if testing for the virus is necessary.

You will only be tested if your doctor decides you meet the criteria:

 You have returned from overseas in the past 14 days and you develop respiratory illness with or without fever
 You have been in close contact with a confirmed COVID-19 case in the past 14 days and you develop respiratory
illness with or without fever
 You have severe community-acquired pneumonia and there is no clear cause
 You are a healthcare worker who works directly with patients and you have a respiratory illness and a fever
CORONAVIRUS (COVID 19)

After testing
It may take a few days for the test results to come back. If you have serious symptoms you will be kept in hospital and
isolated from other patients to prevent the virus spreading.

If your doctor says you are well enough to go home while you wait for your test results, you should:

 self-quarantine at home and do not attend work or school

 wash your hands often with soap and water
 cough and sneeze into your elbow
 avoid cooking for or caring for other members of your household
 wear the mask your doctor gives you if you cannot avoid close contact with other people

How to seek medical attention

To seek medical help from a doctor or hospital, call ahead of time to book an appointment. You will be asked to take
precautions when you attend for treatment. Follow the instructions you are given. If you have a mask, wear it to protect
others. Stay at least 1.5 meters away from other people. Cover your coughs or sneezes with your elbow.

Tell the doctor about:

 your symptoms
 any travel history
 any recent contact with someone who has COVID-19

Treatment
There is no specific antiviral treatment recommended for COVID-19. People with COVID-19 should receive supportive care
to help relieve symptoms. For severe cases, treatment should include care to support vital organ functions

• Take pain and fever medications (Caution: do not give aspirin to children)
• Use a room humidifier or take a hot shower to help ease a sore throat and cough
• Drink plenty of liquids
• Stay home and rest

Treatment includes symptomatic treatment for fever, cough, I/V Fluids, Oxygen if needed and other measures to keep patient
comfortable.

Fear of Disease

• Fatality is as much as 3.9% with severe disease

• It’s not the case that everyone who gets the virus will have severe disease
• COVID 19 is not death sentence, there are 96.1% disease recoveries
• The mild and moderate cases have been recovering well
• The risk fatal disease is higher for those with low immunity, increasing age and comorbidity (suffering from other
illnesses
CORONAVIRUS (COVID 19)

Instructions for Sick Persons

 Wear a surgical mask especially when in public. By limiting the volume and travel distance of expiratory
droplets dispersed when talking, sneezing, and coughing, masks can serve a public health benefit in reducing
transmission by those unknowingly infected.
 Those who may already be infected are advised to stay at home.
 Regularly wash hands with soap and water, and avoid sharing personal household items.
 Isolation is important to stop transmission. Do not go to work, school, or public areas. Avoid using public
transportation, ride-sharing, or taxis. Separate infected person from other people. Do not share personal items.
Use a separate bathroom if available. Use a household cleaner to clean all frequently-touched surfaces (counters,
toilets, door knobs, etc.) every day.

COVID-19 Situation in Pakistan

The rise in COVID-19 infections and deaths during the third wave is most likely due to the spread of the UK and South
African virus variants in Pakistan, a new study has revealed. The situation may slip out of control if immediate measures are
not taken to address the looming disaster. The study revealed that around 50% of the new infections are of the UK variants
while 25% are South African variants. Due to large-scale violations of coronavirus SOPs in Pakistan, these variants have the
potential to infect a large proportion of the population within a short period. There is an urgent need to increase genomic
surveillance of the coronavirus to contain rapidly emerging new strains.
Another newly-identified coronavirus variant is also causing a surge of infections in India. The variant, known as B.1.617,
has experts worried because of its “double mutation”. It has two mutations in the virus spike protein that might make it easier
to escape immune responses as well as spread faster. Patients with typical severe COVID-19 symptoms are testing negative
even using the latest RT-PCR-based assays

COVID-19 VACCINE

The Immune System—the Body’s Defense Against Infection

To understand how COVID-19 vaccines work, it helps to first look at how our bodies fight illness. When germs, such as the
virus that causes COVID-19, invade our bodies, they attack and multiply. This invasion, called an infection, is what causes
illness. Our immune system uses several tools to fight infection. Blood contains red cells, which carry oxygen to tissues and
organs, and white or immune cells, which fight infection. Different types of white blood cells fight infection in different
ways:

 Macrophages are white blood cells that swallow up and digest germs and dead or dying cells. The macrophages
leave behind parts of the invading germs, called “antigens”. The body identifies antigens as dangerous and stimulates
antibodies to attack them.
 B-lymphocytes are defensive white blood cells. They produce antibodies that attack the pieces of the virus left
behind by the macrophages.
 T-lymphocytes are another type of defensive white blood cell. They attack cells in the body that have already been
infected.

The first time a person is infected with the virus that causes COVID-19, it can take several days or weeks for their body to
make and use all the germ-fighting tools needed to get over the infection. After the infection, the person’s immune system
remembers what it learned about how to protect the body against that disease.
CORONAVIRUS (COVID 19)

The body keeps a few T-lymphocytes, called “memory cells”, that go into action quickly if the body encounters the same
virus again. When the familiar antigens are detected, B-lymphocytes produce antibodies to attack them. Experts are still
learning how long these memory cells protect a person against the virus that causes COVID-19.

How COVID-19 Vaccines Work

COVID-19 vaccines help our bodies develop immunity to the virus that causes COVID-19 without us having to get the
illness.

Different types of vaccines work in different ways to offer protection. But with all types of vaccines, the body is left with a
supply of “memory” T-lymphocytes as well as B-lymphocytes that will remember how to fight that virus in the future.

It typically takes a few weeks after vaccination for the body to produce T-lymphocytes and B-lymphocytes. Therefore, it is
possible that a person could be infected with the virus that causes COVID-19 just before or just after vaccination and then get
sick because the vaccine did not have enough time to provide protection.

Sometimes after vaccination, the process of building immunity can cause symptoms, such as fever. These symptoms are
normal and are signs that the body is building immunity.

Types of Vaccines

Currently there are four main types of COVID-19 vaccines.

Below is a description of how each type of vaccine prompts our bodies to recognize and protect us from the virus that causes
COVID-19. None of these vaccines can give you COVID-19.

 mRNA vaccines The Pfizer-BioNtech and Moderna vaccines both are mRNA vaccines, which work differently
than many other types of vaccines. mRNA vaccines train your immune system to make antibodies for specific
diseases without injecting the virus into your body.

Typically, vaccines work by injecting a tiny part of a virus called an antigen into your body. This type of vaccine is
called a live attenuated vaccine. The amount injected is not enough to make you sick, but it makes your immune
system create cells called antibodies that can fight that particular antigen. Then, if your body experiences the antigen
again, it will remember it and quickly produce more antibodies to defend itself.

Instead, mRNA vaccines use messenger RNA, a piece of genetic code that tells our cells what to do, like make new
proteins or repair damage. mRNA is naturally found in all of our cells, but in 2005, infectious disease experts at Penn
Medicine discovered how to modify mRNA to safely make our cells create proteins similar to those found in some
viruses. Once those proteins are made, our immune systems can then create antibodies for that virus

 Protein subunit vaccines Protein subunit vaccines work by injecting only small pieces of the COVID-19 virus that
best stimulate your immune system, rather than the whole germ.

These COVID vaccines include spike proteins (S proteins) that your immune system recognizes as not belonging in
your body. It then creates antibodies, so your body remembers the virus and can fight COVID-19 if you become
infected in the future.

Novavax is currently developing a protein subunit vaccine for COVID-19, which entered a large-scale clinical trial
on Dec. 28, 2020.
CORONAVIRUS (COVID 19)

 Vector vaccines contain a modified version of a different virus than the one that causes COVID-19. Inside the shell
of the modified virus, there is material from the virus that causes COVID-19. This is called a “viral vector.” Once the
viral vector is inside our cells, the genetic material gives cells instructions to make a protein that is unique to the
virus that causes COVID-19. Using these instructions, our cells make copies of the protein. This prompts our bodies
to build T-lymphocytes and B-lymphocytes that will remember how to fight that virus if we are infected in the future.

The Johnson & Johnson, AstaZeneca, Sputnic V and CansinoBio vaccines are vector vaccines

 Whole Virus Vaccine The whole virus vaccine uses a weakened or deactivated form of the pathogen that causes
COVID-19 to trigger protective immunity to it.

The two vaccines Sinopharm and Sinovac – both use inactivated pathogens, therefore they cannot infect cells and
replicate, but can trigger an immune response.

COVID-19 Vaccines available in Pakistan

 Sinopharm (China) required 2 doses

 CansinoBio (China) required 1 dose
 Sputnic V (Russian) required 2 doses. It is the only vaccine the government has allowed commercially.

When and how long will I be protected by the COVID-19 Vaccine?

• Most of the vaccines are 2 doses, 3-4 weeks apart

• Protection occurs 1-2 weeks after the second dose
• We will most likely not know how long the vaccine will be protective once we receive it. We will know more as
more time passes in the current research
• May need to have vaccine shots for COVID-19 on a regular basis (like the flu shot)

Vaccine interchangeability

Data is not yet available on the interchangeability of different COVID-19 vaccines. Therefore, every effort should be made to
determine which vaccine the individual received and to complete with the same vaccine.

Why Should I get vaccinated?

• Protect myself and my family

• Keep my resident’s safe
• Help stop spread in the community
• Set the example for others, including residents, families, co-workers, and the community-at-large

Will I Still need to wear a Mask?

Yes! Similar to other vaccines, a large number of people in the community will need to get vaccinated before transmission
drops enough to stop the use of masks.
CORONAVIRUS (COVID 19)

Where to get admitted in Panel Hospital

List of network hospitals offering treatment of COVID-19 cases can be accessed from the following link

https://allianzefu.com/xls/covidfile.xls

Please note that hospitals servicing Covid-19 patients continue to change. Details on hospitals servicing Covid-19 patients in
a region may kindly be sought from Allianz EFU 24/7 Medical Hotlines.

NOTE: OMI Hospital has made a protocol that each and every patient who needs admission in any condition is to be kept in
isolation for 2 days or until his or her COVID-19 test results are known. Those patients who will have a negative result will
be able to shift to a regular room or ward.

A routine admission with general medical condition or for surgical needs, except COVID-19 effected patients seeking
hospital admission, is not recommended for OMI hospital. If patients with a negative COVID-19 (till the result come) are
kept in an isolation/quarantine facility wherein patients with possible COVID-19 results are also being kept, the risk of
contracting virus increases manifold.

The following are some important points to consider before being admitted to the hospital.

● It has been observed that COVID-19 service providers are changing each passing day. Some panel hospitals are
offering services for COVID-19 patients, however, when healthcare workers working in a hospital get infected, the
hospital stops servicing COVID-19 patients.

● The Government has defined a protocol for hospitals whereby the Government or DHO must be reported of any
patient who is admitted for the management of COVID-19. Likewise, as per defined protocols, COVID-19 test will
be repeated after the patient is admitted in hospital's isolation ward for 14 days. Discharge of the patient will be
processed only after the test result is negative. This means a patient, once admitted for treatment of COVID-19, will
remain hospitalized for more than 14 days.

● The average cost of treatment of a COVID-19 patient, under hospitalization, is approximately PKR 100,000 per day
without ventilator support; whereas a patient seeking ventilator support will be booking a daily expense of
approximately PKR 150,000. In such cases, the cost of a 14-day hospitalization can range from PKR 1 million to
PKR 2 million. This is an approximate cost of treatment, which may increase if the patient is admitted for more than
14 days in complicated COVID-19 disease.

● Considering the high cost of treatment, a few hospitals have also developed a protocol for such admissions, which
requires a minimum cash deposit or insurance approval of PKR 1 million. For these hospitals, if this amount is not
deposited before admission, the patient’s admission is not processed by the hospital. In such cases, the insurance
company will approve up to the patient's available Hospitalization Limit whereas, in line with the hospital’s policy,
the remaining over and above amount will have to be paid by the patient before admission.

● Insurance companies have been informed by hospitals that soon after discharge of the patient, the bill will be
dispatched immediately and the hospitals are seeking settlement of their bills within seven days of receiving the bill.
In such cases, any amount over and above the available hospitalization limit of the patient shall have to be borne by
the patient himself.

Dr. Ziauddin Hospital, Karachi is charging insurance companies 30 percent higher cost than the cost charged to private
patients. Considering this an additional burden on the clients, we have decided not to cover admissions in this hospital on
credit.