Corona Virus – Fact Vs Fiction (March 2020)

Our Thoughts

There is quite a lot of misinformation out there currently on the Coronavirus including keeping your mouth constantly moist, holding your breath for 10 seconds in the morning and a variety of other myths and false truths.

If you feel this article is too long for your needs, please feel free to skip to the highlighted sections below, which I think are the most salient.

The Current Facts

• The virus, first identified in January 2020, is a new “Coronavirus” – officially named SARS-CoV2, and the illness it causes is called COVID-19.
• Probably emerged from bats, infected an animal species, and then mutated to infect people in contact with them.
• Now spreading efficiently from one person to another through respiratory droplets.
• People who are mildly sick (may just have a sore throat and are physically capable of continuing their regular activities) can spread the illness.
• When an infected person talks, cough, sneezes, they spray droplets that are carrying the virus about 1.5 metres. These droplets infect us if they gain access to our “mucous membranes” (eyes/nose/mouth) either:
  • Directly – landing in our eyes/nose/mouth, AND
  • Indirectly – when they land on objects/surfaces, we touch these surfaces and get the virus on our hands and then can infect ourselves when we touch our eyes/nose/mouth.

• The virus can possibly live for 3 days on surfaces if they aren’t cleaned.
• Anyone can be infected.
• There is a lot that we still do not know for sure about this virus and the illness it causes however the data so far indicates:
  • Most people will have a mild infection and make a full recovery, some people will have severe pneumonia and some will die.
  • People who are at the highest risk of severe illness, and most likely to die if infected are the elderly and people who have underlying health issues such as heart disease, lung problems and many other chronic health issues including hypertension.
• We don’t have an effective antiviral medication or a vaccine yet. Tamiflu doesn’t work – it does work for influenza though.
• This has been declared a ‘pandemic’ (world-wide outbreak). It is likely that every area will have cases at some stage.
• Some areas such as Wuhan in China and Lombardy in northern Italy have experienced very rapid outbreaks with the healthcare systems being overwhelmed. It is not only COVID-19 patients that were unable to receive the medical help they needed, but people with other health conditions such as heart attacks and strokes may also have missed out on hospital treatment.
• Health authorities are now implementing measures to try and ‘flatten the curve’ – have fewer people infected at the same time so that we do not exceed our hospital capacity.
• These measures are increased hygiene and ‘social distancing’ – keeping people away from each other as much as practically possible.
• We must especially protect the most at risk of dying – the elderly and those with chronic health conditions.

So what do I recommend?

• Be prepared – monitor developments and the latest recommendations and guidelines.
• Follow any restrictions on movement – if you have travelled overseas you must isolate yourself at home for 14 days after arrival.
• If you are sick from any infection, stay at home and seek medical advice even if your symptoms are mild. Especially do not risk spreading your illness to people who are at higher risk of severe disease. Even if you have a cold etc, you should stay at home, in any case, to prevent the spread of any infectious disease to others in your community. If not high risk for Coronavirus, stay at home until well or even for a further 24 hours.
• Following the current guidance on testing, note that we do have a temporary shortage of tests.
• The recommendations on who is tested may change. At the moment we are advising testing only for the general public who have a respiratory illness with or without fever and have:
  • Returned from overseas in the past 14 days, OR
  • Been in close contact with a confirmed COVID-19 case in the past 14 days.
• Keep in the best possible health – get the recommended amount of sleep each day, eat a healthy diet, and keep up regular physical activity. Speak to your doctor now about any chronic medical conditions you may have, and get them under optimal control, including asthma.
• Ensure you have adequate supplies of any necessary equipment and medication.
• Monitoring your health – I’d be buying a thermometer to keep it home, now.
• I’d be getting a flu shot when available (it may be available privately now but not through the government for a couple of weeks). Let me know if you’d like to get it privately and we will send you a script. There may be a small fee.
• I am hand washing a lot more.
• I’m not wearing a mask. The masks tend to be more effective if you have an infection and don’t want it to spread to others but there’s much less evidence for effectiveness in not getting it from someone else – likely because the masks don’t seal very well.
• I probably won’t visit my 89-year-old mother for quite some time.
• I am advising my mother who is at high risk to not go to her group events and be much more isolated at home as she is at much higher risk of death.
• I am shaking hands with my clients because of the reality that I will be examining them with my bare hands, as a doctor would anyway – as noted above, I’m being much more diligent with hand washing. However, I’m less inclined to shake others hands if I’m not going to be examining them anyway.
• I am being asked, “should I take my children out of childcare?”. The answer is more difficult – clearly, children don’t seem to be at high risk, however, on the other hand, they may spread it to each other more frequently who will then spread into an adult and then to an older person – so I don’t think we have a definitive answer there yet. If your child has an underlying health problem, I’d be erring on the side of caution.
• I am more diligent with treating my asthma at the moment. It’s best to have your lungs in tiptop shape as this is where the virus is going to hit you, hard in your lungs, and if you happen to get bronchitis or something unrelated to Coronavirus e.g. laryngitis (I’ve had both recently), I would be getting into antibiotics sooner rather later, again to try and get your lungs into pretty good shape.
• I’ve stopped doing martial arts training where by definition you are hands-on with a lot of people who are breathing out vigorously with lots of body fluid exposure.
• I have not stopped going to my gym yet, where I can still maintain a measurable distance around most people. Make sure to practice good hygiene in this environment.

Recommended Resources

Good resources I recommend to get your info from:

https://www.cdc.gov/coronavirus/2019-ncov/index.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2Findex.html

I’d like to give a huge thank you to Dr Irene Lai, our excellent Executive Medicine practitioner and also outside of here a very senior medical officer with International SOS, who helped co-write this post using her extensive expertise in this field.

Dr John Cummins (Consultant Physician and Practice Principle – Executive Medicine)