Medical Musings, Health Hypotheses & Therapeutic Thoughts
NOTE: a blog on the internet should never be a substitute for professional medical advice. If you have any queries or concerns about the information in this blog, please contact your healthcare professionals.
I imagine there are few people who have not heard about the coronavirus (officially SARS-CoV-2) situation, with cases of COVID-19 in sixty-seven countries and territories around the world, but I thought I would write an update about how it affects us in Coburg, Brunswick, and the inner north of Melbourne.
What Is A Coronavirus?
Coronaviruses (CoV) are a large family of viruses that are common in people and several different species of animals, including cattle, cats, camels, and bats. Some coronaviruses you may have heard of might include Severe Acute Respiratory Syndrome (SARS-CoV) and Middle East Respiratory Syndrome (MERS-CoV). SARS was transmitted to humans from civet cats, and MERS from dromedary camels. There are several known coronaviruses circulating in animal populations that have not yet been spread to humans. So these things happen from time to time. What is important is how we respond to them.
SARS-CoV-2 is a bit of a mouthful, so we’ll just call it ‘the coronavirus’ from here on in.
Anyway, so why the brouhaha about the coronavirus? Like most of its kind, it causes a respiratory (lung) disease.
Symptoms include fever, cough, and shortness of breath, sore throat and fatigue or tiredness. These can be pretty mild, and there have even been some reports of asymptomatic (that is, not having any symptoms at all) infection. There have, on the other hand, of course been deaths.
And this is where things get tricky, because there is so much we don’t know. A lot of what we think we know we are basing on the behaviour of other coronaviruses, such as MERS and SARS.
We don’t really know how long the incubation period is. Symptoms may appear anywhere from 2-14 days after initial exposure (based on the incubation period for MERS), but it may be anywhere up to a month.
We don’t really know who is particularly at risk. Based on the limited data available, and that from related CoV, it is possible that older adults, and persons who have underlying chronic medical conditions, may be at risk for more severe outcomes.
We don’t know when (or for how long) someone is infectious. As the CDC rather sheepishly puts it, “The onset and duration of viral shedding and period of infectiousness for COVID-19 are not yet known”. We also don’t know whether the aforementioned asymptomatic cases are involved in transmission, or whether people who haven’t started developing symptoms yet can spread it.
We don’t know how long the virus can remain viable (still infectious) outside the body, and in which body fluids. MERS, for example, could only be transmitted through ‘respiratory specimens’, that is, stuff that came from the lungs. SARS, on the other hand, could be found in respiratory, blood, urine, and stool samples.
We don’t even know if someone can be reinfected or not. Hopefully not. People who were unlucky enough to get MERS did seem at least to be lucky enough to not get it again [shortly after they recovered].
So a lot depends on the above information, which is why it’s important for us to keep studying these things, and also to listen to the experts’ recommendations about what to do about it.
What Should I Be Doing About The Coronavirus Outbreak?
Most people in Australia will currently have little risk of exposure to the virus.
Let me say that again, louder for the people at the back:
MOST PEOPLE IN AUSTRALIA WILL CURRENTLY HAVE LITTLE RISK OF EXPOSURE TO THE VIRUS!
If you are at risk, which basically means you have been directly exposed to someone who has the virus, or have been travelling in an area with a mass outbreak, you will probably already know about it. If you are at risk AND showing symptoms, I very much hope your healthcare professional has already assessed you, and you are probably sitting there, bored out of your mind at home, having caught up on all the series you’ve been meaning to watch since forever. Good on you for reading up more about the coronavirus!
For those who are at risk but not showing symptoms, stay at home (self-quarantine) and avoid public settings (do not attend work, school, childcare, university etc. Do not go to public places such as restaurants, cinemas and shopping centres, and avoid public transport and taxis.). Do this for at least 14 days after leaving the area of the outbreak, or your last contact with the person who has coronavirus.
The virus is not currently spreading widely in Australia.
However, that said, there are a few things to monitor.
As we get new information, the situation can change quite rapidly.
One of the more concerning things we have seen more of in recent days is community spread, which is when it is unclear how someone has contracted the disease; with no relevant travel history or exposure to another patient with the virus.
The CDC currently advises that is likely that this virus will cause a pandemic, which sounds terrifying but just means it affects multiple countries/regions of the world, which is kind of already does.
Things You Can Do
Wash your hands. Seriously, this is the single biggest thing you can do to prevent the spread of this, or any other outbreak. Wash your hands frequently with soap and water, or, failing that, alcohol gel. A study showed that washing your hands five times a day resulted in a 45% reduction in respiratory illness rates.[i]
Avoid touching your eyes, nose or mouth. You have no idea how many times during the day you touch your face! Touching a contaminated surface and then your face is a great way to spread germs. This obviously ties in with the Golden Rule – wash your hands!
DON’T bother with masks, unless you are caring for a family member who has a suspected or confirmed case, or unless you have the virus yourself. There is already somewhat of a worldwide shortage of suitable masks, and we need our medical professionals to have the equipment they need to combat this issue if infection rates continue to rise.
If you have any respiratory symptoms, that is, a cough/cold, fever, etc., call the dedicated hotline on 1800 675 398, or please call your GP and tell them.
DO NOT go to the clinic or hospital unannounced, as they will need some time to prepare things to keep other patients isolated. Some clinics will simply not have the facilities to effectively quarantine suspected cases.
In a similar vein, we are asking those with respiratory symptoms and/or fever to cancel their osteopathic and psychology appointments, and observe a fourteen day quarantine period after the end of the fever.
With any luck, we will get more information in the coming days and weeks that show all of this to be over-preparation, but until we know more, it is better to be safe than sorry.
Summary / TL;dr
There is much we don't yet know about SARS-CoV-2; and until we do, it is probably best to expect the best (i.e. don't panic!) while preparing for the worst.
To put it in perspective, in Australia, there are more people who have recovered from the coronavirus than currently have it (15 vs. 13), and while there are the aforementioned concerns about community transmission, at the moment we are in a 'Watch And Act' sort of state.
It is however worth noting that we have a very large Italian population in the Inner North, so please be vigilant if you or family members have recently returned from Europe.
Practice good hand hygiene, avoid snogging sick strangers in the street, and call the hotline or your GP if you have any concerns.
Australian Government Department Of Health Coronavirus Information
BetterHealth (Victorian Government) Coronavirus Information
World Health Organisation (WHO) Coronavirus Information
Centre for Disease Control (CDC) Coronavirus Information
Worldometer Coronavirus Statistics - updated
[i] Handwashing and respiratory illness among young adults in military training
Margaret A.K Ryan, Rebecca S Christian, Julie Wohlrabe
American Journal of Preventive Medicine Volume 21, Issue 2, August 2001, Pages 79-83