From Medical Director:
Dr Zac Turner
As of 14/04/2020
COVID-19 (or coronavirus disease) is a disease caused by a novel (new) type of coronavirus. Coronaviruses are not new, in fact all of us have most likely had previous exposure to coronaviruses as a common cold or upper respiratory tract infection. As with any virus, our body learns via our innate adaptive immune response how to fight back against these infections so that quite often we get a period and sometimes a lifetime of immunity from identical strains of the same virus. The difference and problem with this coronavirus is that when it attacks the alveoli in the lungs there is a stronger response by your immune system so there is more lung inflammation. This can lead, in vulnerable people to acute respiratory syndrome where the body is unable to oxygenate adequately. The person then becomes unwell, requiring oxygen, hospital respiratory support and possibly ICU admission for ventilation.
What Makes COVID-19 So Different
COVID-19 is passed on easily, and can cause devastating damage in a short period of time, notably to certain demographics (older people and those with comorbidities). Its high capacity to be transmitted is due to the fact it goes undetected for a long period of time in a majority of carriers, who are still able to shed the virus despite having little to no symptoms of the illness. Typically, it seems like children and young adults can still have the disease but because they are not acutely unwell and they can continue with normal day to day activities. That increases the likelihood of the disease spreading.
This high capacity to circulate within populations has resulted in some countries in a far larger than normal percentage of the population having the infection at the same time. In those worst affected countries, waves of hospital admissions have reached unprecedented levels, overwhelming intensive care hospital wards, without which there are limited options to treat severe cases.
Why it’s Worse For Older Individuals
The disease is worse in older people, with a disproportionate amount of severe cases happening in those 65 and over. This might be because they have reduced immune function. Also, they generally have underlying medical conditions making it hard to compensate for the respiratory strain. Additionally, they might have had more previous exposure to illnesses and pollutants that affect the health of the alveoli.
Whilst over 65 and those with comorbidities seem more affected, a significant number of people under 65 with no existing conditions have also been admitted in hospital. COVID-19 affects everybody and no matter your age requires you to act with the utmost caution.
Other Countries Reactions
In countries where there has been a swift and comprehensive response to the disease, the rates of disease have been reduced, meaning that if people require hospitalization they can access it. This is certainly the case in Singapore and Taiwan, and likely Australia too.
In other countries where there has been a delayed response to containment, like some European countries or the United States, the rates of illness and death have been much higher. The Italian, Spanish, French, English and American medical systems have all been or will soon be on the brink of serious overrun
The symptoms, if any, are usually similar to that of other viral illnesses. The main symptoms include a fever and a dry cough. Other symptoms have been reported but with less regularity. Loss of smell is being investigated as a potential early symptom as well. Remember however, that a significant portion of those affected might display limited to no symptoms.
Flattening the Curve
Stay at home as much as possible. The Australian government has successfully imposed strong social distancing measures, including lockdown of most non-essential activities, and strict limitations on social gatherings. Australians are urged to remain at home unless for essential activities (work -if working from home is not possible-, grocery and medicine shopping, exercise). The point of these measures is to “flatten the curve” in that whilst COVID-19 will still affect a large proportion of the population, by slowing down the spread you are not overburdening the health system and ensuring that there is a bed for you if you need it in hospital.
Whilst flattening of the curve has clearly happened in Australia over the past week with the number of new cases dramatically slowing down, there is no room for complacency. Just remember that in Italy they were not able to offer ICU to people over 65 years of age, even if they had a good chance of survival because of the shortage. And the number of cases shot up in Singapore following relaxation of social distancing measures. It is estimated that if 90% of Australians observe strict social distancing measures, Australia could expect to get the COVID-19 epidemic under control within its borders by July.
If you are as keen as myself to get back to less restrictive social distancing measures as fast as possible, now is the time to practice the strictest social distancing. Stay at home as much as possible, avoid any non-essential travels. And yes, that means postponing Easter weekend and school holiday plans.
What Else Should you Do
Should you need to leave your home (for essential grocery shopping for example), make sure to reduce risk of transmission with simple yet essential steps. Firstly, wash your hands at every opportunity, preferably with soap and water, or use alcohol-based hand sanitizer. Wash long enough that you can 2 rounds of Happy Birthday. The capsule surrounding COVID-19 is fragile and breaks down with soap. Especially wash hands before eating. Avoid touching surfaces and then touching your face. Surfaces outside your home include desks, escalators, soft furnishings, lift buttons, anything on public transport (including cabs and Ubers), as in some cases the virus can stay alive for up to 24-48 hours on some surfaces.
Wear a Non-surgical Grade Face Mask
Whilst surgical-grade masks should be reserved for medical professionals, you should consider wearing any form of non-surgical face mask in case you absolutely need to leave your home. This is a “better-than-nothing” approach, as masks do not offer any guarantee you will not pass on or become infected with COVID-19, however they might offer some level of protection. If you cannot get your hands on any type of face mask, you can easily make your own DIY mask.
Visiting a Doctor
These are testing times, and you might have some questions or concerns about your situation. For all non-urgent medical questions, it’s time to switch to remote / online doctor consults where possible. Please do NOT show up to a GP without calling ahead. It is potentially unsafe for all the other people in the waiting room, your doctor or nurse and anyone else you may encounter. GPs have very limited resources and are under significant strain. Help them to help you!
If you would like more information on our services and what we do, you can reach me and my team of Australian doctors and psychologists for consults via Concierge Doctors, our online medical consult platform.
A Personal Note
Personally, I have to continue to work and I along with many of my medical colleagues will begin to work and/or volunteer at the nearby hospitals when needed. As a doctor, I have no choice but to see people and attend hospital, but in every other way, I am choosing ways to flatten the curve. I am having all usual meetings online, not attending conferences or other medical meetings in person and limiting all social activity. It is a scary time for us healthcare professionals but you can help us by following the above precautions.