Understanding COVID-19

Bringing information together from various sources to understand more about COVID-19, why we should be concerned, how to avoid it and what to do if you think you have it.

Why Coronavirus COVID-19 is different from flu

Transmission methods

Flu

Transmission period

According to the US Center for Disease Control & Prevention (CDC), the prime time for transmission for flu is in the first 3 to 4 days of illness though it is possible to spread it a day before the illness becomes evident and up to 7 days after it starts.

Transmission methods

It is transmitted by respiratory droplets – from coughs, sneezes or normal speech landing in the mouths or noses of people nearby.
It can also be transmitted by contact with a surface that has such droplets on it. Contact with the skin is not enough and the recipient would then need to touch their mouth, nose or eyes.
Combined this means that Flu is reasonably difficult to catch provided the following sensible precautions are taken:

COVID-19

Representation of Covid-19

Transmission period

Is transmittable for up to two weeks before the person is showing signs of the disease as well as when there are symptoms. Some people are atypical meaning they will never develop symptoms but will be carrying and transmitting COVID-19.

Transmission methods

It is acknowledged that COVID-19 can be transmitted by respiratory droplets. Evidence is also emerging, unusually for the family of viruses known coronaviruses, that it might be possible to transmit through the following methods, as well:

Contagion

The variety of ways that COVID-19 can be spread along with a substantial period when someone can be inadvertently spreading it makes the virus highly contagious. Though we are still learning about the virus, Marc Lipsitch, a Harvard epidemiologist, estimates that within the coming year 40-70% of people will be infected with the virus.

Direct effects of COVID-19

After infection, some people will remain atypical and not show any sign of infection. This is known as some countries have mass screened citizens rather than just those suspected of having the virus.

Early-stage symptoms are fever, cough and shortness of breath. There are many causes of such symptoms and few of us have got through life without experiencing this combination of symptoms, so if they occur follow the latest NHS advice but don’t panic.

With COVID-19 this can persist and develop into pneumonia meaning 20% of those infected will need hospitalisation.

Approximately 25% of those will need intensive care for respiratory support.

Ultimately there are two outcomes from contracting COVID-19, recovery or death.

Mortality rates are very difficult to ascertain as treatment methods improve. It appears that overall mortality is 1-2% but this is hugely skewed towards the older population. Figures released on 29th Feb show no deaths below the age of 9 years, less than 0.5% to the age of 50 and then rising to 14.8% among over 80’s. This is unusually skewed as most viruses have higher mortality rates among both the young and the old.

Flu has 5-7 times the mortality rate in an 85-year-old compared to a 50-year-old whilst COVID-19 is more like 30 times as lethal.
As there are roughly 2.8m people over the age of 80 living in the U, if 40% of them contract COVID-19 that is approx. 1.1m people and could lead to 150,000+ deaths due to the virus, in this age group alone.

To put this in perspective, the report Surveillance of influenza and other respiratory viruses in the UK Winter 2018 to 2019 – Public Health England expects annual deaths due to flu, for all age groups, are generally between 6,000 and 15,000.

Wider effect on Society – side effects

The Government is planning for many possible effects and though they have not yet implemented any changes in behaviour and are encouraging people to carry on as normal, it is highly likely that instructions will have to be issued in the coming days and weeks which mean it will no longer be ‘business as usual’.

Schools may have to close and young children will need to be looked after and parents given time off work to do that so many other areas of life might become short-staffed. The NHS will have a huge burden placed on an already busy service, as potentially thousands of people need intensive care, and may not be able to respond as it normally would to other medical needs.

Bearing in mind the infectiousness of COVID-19 it is not just about treating patients but treating them in isolation to minimise cross-infection. This is a heavy burden and other NHS services that are normally available could suffer as a result.

If interaction with other people is kept to a minimum that will impact the ability of stores to restock and may have knock-on effects into whether interaction that is considered non-essential can continue.

There is a chance that many people will be asked to self-isolate either as they are showing symptoms of COVID-19 or as a quarantine measure as in China. All sorts of services which we expect to be available could be short-staffed and unable to operate as normal.

What can we all do about it

PREVENT

Contact

If you don’t come into contact with the virus you cannot contract the disease. However, as the virus is highly transmittable this is difficult to achieve. You might try to lessen opportunities for infection though.

Full advice is available from the World Health Organisation, here.

Plan as if you were going into quarantine

If you do have to isolate yourself do you have what you need to remain comfortable for up to a fortnight? Think about what would happen if the person who normally looks out for you was also in quarantine and unable to visit.

This includes thinking about:

Hygiene

This is general advice but you might be particularly vigilant whilst COVID-19 is active:

If you think you might have COVID-19

Get the latest advice from the NHS.
This is available by calling 111 on your phone or by visiting https://111.nhs.uk/covid-19

DO NOT visit your GP
GP’s surgeries have many medically vulnerable people visiting them and we all have a responsibility not to behave in a way which is likely to spread COVID-19 or any other virus.

Living in isolation

If you are in quarantine it may be that you have tested for COVID-19 or that you are at risk from it. Either way, the following advice stands.

DO NOT take antibiotics for COVID-19
Many of us have spare antibiotics in our homes, perhaps from old prescriptions. Whilst antibiotics can be very effective against bacterial infection, they have no benefits in treating viruses. Use of antibiotics when you don’t need them may lessen their effectiveness when you do need them.

Eat and drink well
Make sure any food you have is sustaining. Though it is a cliché, chicken soup does seem to have curative properties (see New York Times article). Make sure you remain hydrated.

Exercise and sleep
Don’t be a couch potato. Whilst you don’t have to go as far as one person in China who ran a double marathon in laps of his living room, it is worth making sure you compensate for the lack of outdoors activity. Perhaps look for an exercise programme online (perhaps on youtube) or crack out the Jane Fonda DVDs.

Sleep is also important as this is when your body has a chance to recharge and continue its fight to recover.

Looking after each other

Please look out for others in your community who may be self-isolating. You are probably already aware of your family situation but look out for neighbours. There may be some shopping they need, and leaving shopping by their front door does not break their isolation.

Bear in mind that in ‘normal’ times there are many illnesses/mishaps that can befall a person, so just checking they are OK is valuable. You could do this by knocking on their door, phoning them or – if you have an Assure system – checking on their dashboard.

Informative links

CDC latest information: click here

Johns Hopkins University interactive map showing the latest stats: click here

Informative article with loads of references: click here