What is Covid-19?
- Coronavirus is a group of viruses that range from the common cold to recent severe outbreaks such as SARS (Severe Acute Respiratory Syndrome, 8098 cases in 2003, 17 countries, 774 deaths, 10% death rate) and MERS (Middle East Respiratory Syndrome, 2,000 cases during 2012-2017, 21 countries, 600 deaths, 30% death rate)
- These viruses typically cause respiratory and flu-like symptoms. In a study from China’s initial outbreak, 80% of cases had fever, 69% had coughing, 38% had fatigue, 34% had mucous or phlegm, 30% had loss of smell, 19% had shortness of breath, 15% had body aches, 14% had headache, 14% had sore throat and 5% had gastro-intestinal symptoms
- Covid-19 originated in China during late 2019 and has been classified as a pandemic, indicating prevalence and a risk of spread globally (as of today, over 786,000 cases and 38,000 deaths globally)
- Other notable pandemics include Swine flu in 2009 (200,000 fatalities), Spanish flu in 1918 (40-50 million fatalities), Smallpox in 1520 (56 million fatalities) and the Bubonic plague in 1347 (200 million fatalities)
How bad is Covid-19?
- There are 3 ways to assess severity of an outbreak. The first is the Ro or R naught (reproductive number), which is how infectious a virus is, the second is death rate (case fatality), which is how deadly a virus is across a population, and the third is how stealthy it can spread undetected
- Covid-19’s R0 is 2.2 (more infectious than Salmonella or Syphillus, but less than measles or chicken pox), and its death rate is currently 3.4% (less fatal than SARS, MERS and Ebola, but more than influenza). These data points may be conservative if many cases were initially unreported in China or if countries run out of test kits
- A key challenge is 44% of transmissions occur before the onset of symptoms (you’re infectious 2.5 days before symptoms, and most infectious 14 hours before symptoms)
- Once infected with Covid-19, 14% of cases become severe (shortness of breath, pneumonia) and 7% of cases become critical (respiratory failure, septic shock, multi-organ failure). Importantly, the risk of severe complications and death is higher in the elderly and those with chronic health conditions (e.g. 10% death rate in people with cardiovascular disease)
- Children appear to develop less severe symptoms but can be vectors for transmission (CT scans of asymptomatic kids with Covid-19 infection show lung inflammation)
How does Covid-19 spread?
- The virus can spread by symptomatic and asymptomatic patients through respiratory droplets when sneezing or coughing, or on contaminated surfaces (it can be airborne for up to 3 hours). Covid-19 lasts up to 3 days on hard surfaces (e.g. counter tops or utensils), up to 24 hours on porous surfaces (e.g. paper or cardboard). There is also evidence it may be transmissible via food and stool contamination
- Incubation (time between exposure and symptoms) is typically 5 days, but can be up to 3-4 weeks. If symptoms arise, mild cases recover within a few days whilst severe or critical cases may last weeks before recovery or deterioration
- Anyone with respiratory infections needs to wear a mask and adhere to strict lock-down rules; the best way to prevent spread is to consider and treat everyone as if they have Covid-19 (universal precautions)
- As virus, it has 30,000 base pairs in its genome (humans have 3 billion in comparison) – 11 pairs have mutated since the initial Wuhan outbreak and most mutations in the pandemic can be traced back to China; the mutation rate is 8 times slower than normal influenza (a good thing, which allows the potential for a medium term vaccine, rather than an annual vaccination like the flu)
What should I do to minimise my risk of getting infected?
- Wash hands thoroughly – use an antiseptic soap or cleanser for 30 seconds, covering wrists, palms, fingers and webbing between fingers, tips of fingers and back of the hand; use alcohol disinfectant or sanitiser often, especially if contact common surfaces e.g. door handles, mobile devices, shared keyboards, stair rails, light switches etc.
- Minimise unnecessary crowd contact – epidemics spread in concentrated areas with high pedestrian traffic or close living quarters. Avoid anyone with cold or flu symptoms; avoid overseas travel and cruises at all costs
- Practise social distancing – Stay 2 metres away from others in public. Avoid physical touch including shaking hands, hugging and kissing. Avoid all unnecessary social gatherings in enclosed areas, including restaurants, cafes and events. Aim not to interact physically with elderly or immune compromised people
- Cover nose and mouth when sneezing or coughing, and wear an appropriate surgical mask if you have one (shave facial hair where possible when wearing masks). Don’t touch your face during the day
- Be diligent with food and general hygiene – cook all your meat thoroughly, avoid contact with wild animals, sanitise rooms and bedding as often as you can
Should I be worried about Covid-19?
- Given Covid-19 is now a national health emergency, we need to adopt draconian measures. This is especially important for anyone with hypertension, diabetes, heart disease, lung disease, kidney disease, and for seniors generally
- Overall, there is a moderate risk many Australians will be infected this winter, and currently there are over 400 confirmed cases in Australia and increasing community human-to-human spread; some experts believe up to 60% of the population must be infected before there is adequate herd immunity to reduce spread (unless there is a vaccine which may be possible before the end of the year)
- Osana recommends that everyone is aware of the preventative measures, and understand what to look out for and where to get help if they are at risk or develop symptoms. Most importantly, if you have a chronic health condition, make sure you talk urgently to your GP via telehealth (phone call or video) to ensure it is absolutely well managed and stable. Everyone must get a flu vaccination in April to avoid the double whammy of influenza and Covid-19
How do I know if I am high risk?
- High risk is defined as any overseas travel, or known close contact with a confirmed Covid-19 patient. Hotel isolation for 2 weeks is now compulsory for all travellers that arrive in Australia from overseas. Community spread is a smaller portion of total cases, compared to overseas travellers, but is growing the fastest
- Call your GP rather than attend in person. Anyone who is high risk and develops fever or respiratory symptoms must get tested with a naso-pharyngeal (back of nose) swab
- Most critical is preserving respiratory (breathing) and cardiac (heart) function, because that is how Covid-19 causes severe disease and fatalities. There are specific medications to avoid (ACE-inhibitors for blood pressure and ibuprofen more generally) as well as potential vitamins that may reduce the likelihood of respiratory infections (such as Vitamin C and Vitamin D). It is critical to control blood pressure and sugar levels, and make sure medications for breathing and your heart are optimal (e.g. using puffers or inhalers correctly, taking the correct dose of medication for you)
- At a population level, there is evidence men may be more susceptible to infection than women (similar infection rates, but men exhibit higher death rates). Conversely, infection rates are lower (than population averages) in children and pregnant women
- Once infected, the individual gains immunity (antibodies to the virus) for 5 to 10 years
Should I get tested for Covid-19?
- Get a respiratory swab at a designated testing site if you have any respiratory symptoms or are at risk of exposure; if unsure call your GP for advice – Osana is providing telehealth consultations for all respiratory symptoms and for all patients
- Follow the diagrams below for prevention steps and actions to take based on your symptoms
- Testing sites are listed here: https://www.health.nsw.gov.au/infectious/diseases/Pages/coronavirus-testing.aspx
- Make sure you book in your flu-vaccination now – it is currently available.
For the latest updates on Covid-19 recommendations, join our Facebook groups in your local area here>
Also, read our news articles on how to stay healthy, boost your immune system and maximise your chances against Covid-19 if you do get it.