Coronavirus: Your questions answered

In a guest post, Dr Cliodhna, a microbiology and public health doctor has answered some of your burning questions. Thank you so much to Dr Cliona and hopefully we will have an updated post each week. As you are away things are changing every day but this information is considered correct as of 22 March 2020.

COVID-19 is a rapidly evolving situation. What we know about it is changing every day. There is a lot we still don’t know but we are learning more all the time about the virus (SARS-CoV-2) and the infection (COVID-19) that it causes.

Because we don’t have an effective vaccine or a specific antiviral treatment yet we must rely on other measures (Non Pharmacological Interventions) to help limit the spread of infection, these include:

  1. Washing your hands regularly

  2. Covering your mouth if you cough or sneeze

  3. Avoiding touching your face

  4. Keeping surfaces clean

  5. Avoiding handshakes and hugs

  6. Social (physical) distancing of 2 metres

  7. Self-isolation if you have suspected or confirmed COVID-19 infection

  8. Self-quarantine (restricted movements), for example after travel or if you are a ‘close contact’ of someone with COVID-19 infection

It can be hard to implement these measures but at the moment it’s really critical that we all play our part in order to try and limit the spread of infection and break the chain of transmission.

A lot of studies are underway globally looking at different aspects of the virus and the infection it causes. And while a recent study (New England Journal of Medicine) reports that this virus can survive for varying lengths of time on different surfaces (including up to 72 hours on plastic and stainless steel) it’s important to remember that different things can impact upon that like the type of surface, amount of virus, etc. And it is especially important to remember that this virus likes respiratory mucosa in particular.

The main sources of transmission that have been seen so far include direct spread from person to person via droplets from someone with an infection, or indirect spread from a surface that has been contaminated with droplets from someone with an infection.

So social distancing and keeping your hands clean and away from your face will really help you avoid infection.

If you are out and about and using high touch surfaces that alot of other people are touching too, door handles for example, then more frequent hand hygiene is a sensible approach there. If you are using hand sanitiser/alcohol gel then expert groups like the Centers for Disease Control and Prevention (CDC) recommend that it should contain at least 60% alcohol (ethanol).

If you do develop symptoms and are worried about COVID-19 infection it is important to follow the advice given to you by healthcare professionals. If you are suspected to have this infection or if you are diagnosed with this infection it’s really important that you look after yourself and that you self –isolate as advised. This will give you time to recover and will also help to limit the spread of infection to those around you. If COVID-19 infection is confirmed by a lab test then your contacts (the people you have spent time with recently) will also be followed up for up to 14 days. This is called Contact Tracing and this is another measure that should help limit the spread of infection as any new cases of infection would be identified early and asked to self-isolate.

Even though the capacity for a) getting a sample taken and b) getting that sample tested in the lab has increased significantly over the last few weeks here in Ireland, there are delays in the system at the moment. But while you’re waiting for your sample to be taken and tested in the lab it’s really important to continue to self – isolate until you’re advised otherwise by the healthcare professional involved.

This is a very worrying time for everyone and sometimes having access to accurate reliable information can help with that. It is worth using reputable sources for this such as HSE, HPSC or the Department of Health.

Currently in Ireland we are in the delay phase where measures have been put in place to try to slow the spread of the SARS-CoV-2 virus. Some sources refer to this as trying to ‘flatten the (epidemic) curve’. We are seeing increasing numbers of new cases of COVID-19 infection every day and this is likely to be the case for some time. Everyone across the Irish healthcare system, including the hospitals, has been preparing for this and continues to do so. We may need even more stringent societal measures than we have in place now if the desired effect of measures taken so far isn’t seen in the next short while. What we all do right now will shape the Irish outcome including the demand for ICU beds. It really is a challenging time for everyone but in order to protect our family and friends and vulnerable groups around us we must “come together by staying apart”.

Stay safe everyone.

Dr Cliodhna Ni Bhuachalla MB BCh BAO, BMedSc, MRCPI, FRCPath, FFPathRCPI

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