HEALTH ALERT

Another COVID-19 (Coronavirus) update collated from reliable sources (medical professionals - both clinical and public health) and from official public health advice (13/03/2020):

Disclaimer: I am a clinical General Practitioner (FRACGP) with a Masters of International Public Health. I am not a public health physician nor employed by the public health department, however I am disseminating information consistent with public health guidelines. I am based in Tasmania, and currently there appears to be no community transmission in Tasmania (although this is difficult to ascertain anywhere).

COVID-19 is now a global pandemic, as defined by WHO. Frustratingly, there seems to be some public confusion due to mixed messages from federal and state governments. From the medical reports and live data we’re reading from other countries, it seems to be causing more destruction the later the country waits to shut everything down and enforce social isolation - the countries who have managed successfully are the ones who have ordered home isolation and social distancing early on, and the citizens have obeyed (such as Singapore, Taiwan, Hong Kong and Japan).

It’s good to stay informed and up-to-date, as well as vigilant in hygiene and other precautionary measures, for the sake of our vulnerable population. However panic and hysteria don't help anyone. I've written this based on Australian public health advice I've heard and researched, in response to many questions I've been asked.

Once a case has been identified and confirmed by public health, they are put into isolation for a period that they will advise, and checked up on every day. If they are very unwell, they are isolated in hospital. Any close contacts of a confirmed case are also contacted and given advice.

What we know:
1. It is more contagious than usual influenza (twice as contagious, doubling time of >2 days), so it will spread fast.


2. It can present with mild symptoms and even be asymptomatic in some (particularly young) people, but they can still spread it.



3. The virus seems to be able to survive on surfaces, particularly metal and plastic for 3 to 9 days (link in comments).



4. Symptoms are: fever, dry cough, shortness of breath, fatigue (mild in the 1st week, worse in the 2nd week); also general malaise, loss of appetite, and occasionally diarrhea.



5. Only minimally associated with runny nose or sneezing (but sneezing can spread contagious droplets).



6. We need to slow the spread in order to slow the patient load on overwhelmed hospitals and healthcare systems (even if that means COVID-19 hangs around longer within the wider community).



7. From early data emerging, approximately 80% have a mild course of this disease and will not need to attend hospital, 14% are sick enough to require hospitalisation, and 5% are critically ill requiring ICU --> this will place enormous pressure on our already-struggling hospital system.



8. Limited data on children – it seems they do catch it, but are only mildly/not symptomatic. No mortality data for children <10yo.



9. Pregnant women appear to be at same risk as non-pregnant women.



10. People can be infectious from about 3 days after exposure and about 1-2 days prior to symptoms, and up to 10 days after diagnosis.



11. Unfortunately, if hospitals are overwhelmed, those who would ordinarily need care or ICU for non-COVID-related disease will not get necessary care.



12. Those who will likely be more critically ill will probably be older, immunosuppressed and/or have comorbidities (respiratory disease, cardiovascular disease, diabetes, hypertension and cancer).



13. We are heading into influenza season here in Australia, which will add to the healthcare burden.

What can we do now?

1. The aim now is not to stop it, but rather slow the rate to minimise the rate at which vulnerable populations will be exposed and become unwell. This is to reduce the burden on hospitals and healthcare systems, and to allow those who need medical attention to survive access to necessary resources.


2. Apply common sense such as virus-minimising measures: regular hand-washing, avoiding public gatherings (gatherings >500ppl have been advised against by our Australian Prime Minister this afternoon), cleaning surfaces & food, not sharing food & drinks, not going to work when unwell, coughing into tissues or sleeves. Call 000 and seek urgent medical attention if severe symptoms (chest pain, breathing difficulties, etc)



3. It’s not entirely clear whether children are a risk to grandparents, so best to make an individual choice about isolation within families.



4. If you have mild symptoms, stay home and rest, and try to avoid other people as much as you can.



5. If you have fever and/or cough and have travelled overseas recently, or have had close contact with a COVID-confirmed case (and have been contacted by public health), then CALL your GP, the COVID hotline (1800 020 080) or the state public health hotline to find out what to do next (including getting swabbed). If you're positive, you need to isolate at home for a period that will be advised by public health; if high-risk (close contact of confirmed case or recent travel to a high-risk country), you might be told to quarantine yourself for 14 days (there can also be false negative swab results).



6. If you have been swabbed to determine whether you are positive, PLEASE QUARANTINE YOURSELF AT HOME UNTIL YOUR RESULT IS BACK.



7. Social distancing is the key – from now. This is what has been shown to be the key determinant for better management in certain countries (as I’ve listed above). Please avoid large public events if you can, especially if you are in a high-risk group. For advice regarding school closures, please refer to local public health guidelines. Cancelling school excursions (particularly interstate) should be seriously considered given things are escalating by the day. Work places that can should be starting to transition temporarily to working from home, even for just a few days/week; change face-to-face meetings to teleconferences, postpone workshops. Stay off public transport if possible, minimise any interstate travel, and as of this afternoon, our Australian PM has advised non-essential international travel should be cancelled.



8. Those in high-risk groups should probably start practicing social distancing from now.



9. Get your fluvax when it becomes available.



10. The decisions about how to change your social activities will be personal, but we all have a social responsibility to try and reduce spread and exposure of vulnerable populations.




Politicians, Community Leaders and Business Leaders: What Should You Do and When? ... CLICK HERE


Aus Government Department of Health: https://www.health.gov.au/healt…/novel-coronavirus-2019-ncov

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