COVID-19: Everything thing you need to know

Now deemed a Global Pandemic we are learning more day by day about COVID-19. With all the hysteria across the media, it has become difficult to determine what is hype and what is true. From people panic shopping and fighting over toilet paper, the world is going a little bit crazy.

In this post, we will aim to provide you with an overview of accurate up to date information. Following this post, we will discuss strategies on how to combat this issue.

Hysteria:

First of all, I need to address the panic, we all need to calm down……… There is no need to prepare for the end of the world and stock up on supplies like toilet paper and food. Well not in New Zealand at least as we produce all essential supplies (food, toilet paper etc) in New Zealand, we are not reliant on global markets. Even the supermarkets are requesting for everyone to calm down and to shop as normal, there is plenty to go around. 

From a hysteria standpoint, the timing couldn’t be worse for NZ/ southern hemisphere with the changing of seasons and drop in temperature and as we head into flu season. As a result of lack of education and understanding of COVID-19, people that are suffering from common flu are unnecessarily concerned for the worst and stressing our health system which is going to need every spare bed atm. What is the difference between common flu and COVID-19? Stay tuned as we will highlight this below so you can stay informed and rest easy.

Important: COVID-19 is treatable.

 

Stop stressing! 

Don’t forget stress is one of the leading causes of disease (something I have written extensively around) so you are not doing yourself any favours worrying about things you cannot control. Our hope in this article is by sharing the facts we can help in easing any anxiety or stress you may have. Our next post will begin to address what you can do to mitigate this and the anxiety around it.

What is it COVID-19?

Similar to SARS, research points out that the virus also originates from bats. COVID-19 causes respiratory and intestinal infections in animals and humans. 

What happens in the respiratory system and immune system in response to the virus?

  1. Your body will produce mucus in an attempt to contain or trap the virus. 
  2. The infection involves overstimulation of the body’s defences against viral infections. Cytokines, proteins secreted by certain immune cells, signal for more immune cells to enter the picture and try to engulf the virus, resulting in cell death and increased inflammation.
  3. Due to the high replication rate of the coronavirus, it often overwhelms the immune responses leading to local tissue destruction and depletion of infection-fighting cells. Cytokines also can travel via the circulatory system to other organs such as the kidneys, liver, and small intestine. Dramatic increases in cytokines are referred to as a cytokine storm and this appears to be a distinguishing feature of severe respiratory viruses vs lesser viruses like the common cold.

Not all people with the virus will experience all three stages and also in some cases, you may be a carrier of a virus but have no symptoms (meaning you can unsuspectingly pass it on).

How COVID-19  spreads

As a new disease, we are still learning how it spreads but below as of 19th of March the CDC believe these are major methods: 

 

  • Human interaction

 

    • Between people who are in close contact with one another (within about 6 feet).
    • Passed through respiratory droplets produced when an infected person coughs or sneezes. These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs.

 

  • Can someone spread the virus without being sick?

 

    • People are thought to be most contagious when they are most symptomatic (have symptoms)
    • Potentially it is possible before people show symptoms. However, it is not thought to be the main method in which the virus spreads.

 

  • Contaminated surfaces or objects

 

The virus could potentially spread through cross-contamination of surfaces or objects that have the virus on it and a person touching it and then touching the mouth, nose or possibly eyes. However, this is not thought to be the main method for the virus spreading.

 

What happens if you feel sick?

Remember that symptoms of the common cold or seasonal flu can be similar to symptoms of coronavirus, which can make it difficult to determine what might be going on. Especially with New Zealand heading towards flu season. Here is a great chart to review symptoms and determine next steps.

Determine what you are dealing with

We encourage anyone with signs of a respiratory infection or COVID-19 (fever, dry cough, and shortness of breath) to contact their primary care physician for guidance. Ideally where possible connect with your doctor online or by phone to reduce the risk of transmission. 

If you develop severe symptoms or are in the high-risk groups outlined below and develop shortness of breath, call 111 or go to the nearest emergency room after calling ahead for safe arrival instructions. 0800 358 5453

 COVID-19 risk factors:

If you are high- or medium-risk and fall within any of these risk factors below, it is recommended that you self-isolate and practice social distancing for a minimum of 14 days, even if you have no symptoms. 

 

  • Age: 

 

While the overall global mortality rate of COVID-19 is currently estimated to be around 3.4% by the WHO (as of March 3), early reports out of China and a similar pattern identified in Italy (the highest number of coronavirus deaths outside of China) show that the mortality rate increases with age. The mortality rate is highest (14.8%) for those over the age of 80. This most likely due to older individuals often suffer from at least one chronic health condition that stresses their immune system, increasing their risk. 

Children are rarely affected by the disease. 

 

  • Pre-existing conditions

Adults with preexisting conditions like heart disease and diabetes or chronic lung conditions such as asthma, emphysema, COPD have a greater risk of being affected by any virus, including COVID-19 because of decreased ability to fight off infections due to a less robust immune response. In China, coronavirus patients with heart disease had a 10 per cent mortality rate, while those with diabetes had around a 7 per cent mortality rate, far greater than the global average — which WHO estimated at 3.4% on March 3rd.

 

  • Immunocompromised adults 

Immunocompromised means the inability to normally respond to environmental exposures including viruses or bacteria due to a weakened immune system. People who are immunocompromised include those with diabetes, heart disease, hepatitis B, chronic kidney disease, autoimmune conditions, malnutrition, and cancer because those conditions do lessen one’s ability to mount an adequate immune response. 

 

  • Smoking

 

Adults who smoke on a regular basis (cigarettes, cigars, marijuana) are at an increased risk for more severe upper respiratory infections overall. Some Experts believe that this is one of the reasons that men in China died more often than women from coronavirus was because of their smoking habits. 

Social distancing: bell curve

Why should we consider social distancing? 

This is a manageable/treatable disease but if we don’t control the spread we will surpass the health systems capacity and will result in a higher mortality rate as health professionals won’t be able to keep up with demand. The primary goal is to slow the spread of disease, a concept which is being referred to as  “flattening the curve” which you will see depicted down below. Essentially it will provide us the time to manage the disease but more importantly and often forgotten it will also allow the health system the capacity to deal with other business as usual cases eg. trauma, surgeries, chronic diseases etc. If capacity is maxed out COVID-19 patients won’t be the only ones who will suffer the consequences! 

The new research also showed that 97.5% of people who are infected develop symptoms within 11.5 days. About 1% of patients, however, show symptoms after 14 days – outside the window of the CDC’s quarantine guidelines.

Cure

Once again no need to fear. The University of Queensland Centre for Clinical Research director Professor David Paterson told news.com.au they have seen two drugs used to treat other conditions (Malaria and HIV) wipe out the virus in test tubes.

Prof Paterson said the medications given to some of the first positive cases of COVID-19 in Australia, had already resulted in “disappearance of the virus” and complete recovery from the infection. 

Another reason for us to flatten the curve and provide scientists like Prof Paterson the time they need to design a cure which could be distributed worldwide.

Keeping safe in the meantime

It is simple, practice good hygiene and social distancing where possible. 

  • Most importantly due to the nature of how it spreads through bodily fluid, if coughing or sneezing do so into your left elbow as many people are now greeting using right elbow touch instead of a handshake (weird I know, but best to be safe than sorry).
  • Wash hands frequently (at minimum 20 sec, see image below) and carry a hand-sanitiser with you and use frequently (if you can find one…).
  •  
  • If you use tissues, do not reuse them, throw out after use.
  • Avoid highly populated areas, where possible.
  • Aim to keep a 1.5m distance between other individuals to prevent spread.
  • Clean and disinfect everything after use.
  • Avoid travel were possible. 

Sick or medium-high risk

  • Self-isolate a minimum of 14days.
  • Wear a mask around other people. You do not need to wear a facemask unless you are caring for someone who is sick (and they are not able to wear a facemask). 

Future

The news is not all bad. I am one to always look on the bright side and there are plenty of learnings to take away from this outbreak. For example, it will greatly impact our lives in so many ways, some of which we probably haven’t thought about yet. I will touch on some of these in future posts, I will discuss things like the future of the workplace etc.

Next post

Stay tuned for our next post where we will discuss the science and nutrition around prevention and management of COVID-19.