Just before Christmas, I started to hear rumblings about an emerging new severe respiratory illness in China. That’s not too unusual as we get regular communication from the Health Protection Surveillance Centre (HPSC). You read them to see if it recommends changes to your daily practice and if not, you move on. Within a month, however, the whole world was talking about coronavirus.
Fast forward to now and about three patients per day will bring up the coronavirus (now with the new name of Covid-19). Some half-joking, some very serious but all are looking for some degree of reassurance.
We’ve been able to reassure the vast majority of these patients very quickly as their potential for exposure was very low, but there have been a few which we have been watching closely to ensure they did not have the illness. So far, I have not seen a patient who I thought may genuinely have Covid-19 and, looking at the latest data from the World Health Organisation (WHO), I think the chances are good that I won’t.
It is useful to look at this infection in its whole context as some reports would have you believe that this illness is coming for you right now.
Coronaviruses are a large family of common viruses which are present all over the world and frequently cause mild to moderate respiratory illnesses (colds). They have in the past been responsible for the SARS outbreak (2003) and the MERS outbreak (2012) so coronavirus making the headlines is not something unheard of in the past.
What’s different now?
A huge number of people have been infected. There have been more than 80,000 confirmed cases worldwide and 2,762 deaths directly attributed to this disease. Coupled with this, we (as of writing) have no effective vaccine for this particular virus and most people will have little or no innate immunity to it.
Digging deeper into those numbers, I can tell you that there have so far been just 2,790 cases outside China, 634 of these were on one cruise liner and 322 in Italy. There have been 51 other cases in Europe, 13 of those in Britain.
This means that the chances of meeting someone who has this particular illness are incredibly slim. That said, the advice on how to minimise your risk of contracting this disease is straight forward and easy to implement.
Covid-19 seems to be more severe in people over the age of 55 and this makes sense for a number of reasons. As we age our immune system becomes slower and a little frailer. The key parts of our immune system that deal with viral infections are our T-cells and B-cells which are involved in the creation and production of antibodies. Unfortunately, both of these systems start to decline in our 50s.
Looking at this we can assume that older people are more at risk of catching the disease and also of having a more severe illness with it. The WHO figures bear this out, with the vast majority of deaths and severe illness in those who are elderly or already have underlying medical conditions.
The virus is spread in droplets, which means that when an infected person coughs, sneezes or wipes their mouth/nose they can spread the virus. It can be in your body for up to 14 days before developing symptoms but most people who catch this will know about it within three to six days of exposure.
The Irish school children who have recently returned from northern Italy should be monitored closely to avoid transmitting illness to vulnerable people.
If reading this is not setting your mind at ease or a colleague just back from an infected region sneezed on you three days ago and you are starting to get fluey then you should give your GP a ring in the morning to discuss it. Don’t turn up at your GP surgery or the nearest emergency department though.
As this virus is transmitted in respiratory droplets, we can all reduce our risk by observing good respiratory hygiene. If you need to cough or sneeze ideally cover your mouth and nose with a disposable tissue, step back from people (2m or so), throw the tissue in the bin immediately after and wash your hands thoroughly with soap.
If you are in crowded spaces with people coughing or sneezing try not to touch your mouth, nose or eyes as it is via this delicate skin that the virus enters the body. These are the most effective methods of reducing your risk and will also reduce your yearly risks of coughs, colds and the flu.
As far as masks go, I haven’t bought one for routine wear and I haven’t recommended my wife or children do so either. There is no evidence that they will help and they may just give you a false sense of security.
None! I read recently that the sales of herbal remedies and immune system boosters have skyrocketed since this outbreak and there is good medical evidence that these will do absolutely nothing at all to improve the immune system’s strength or response time for people with any sort of healthy diet.
That said, there are a number of things you can do to improve your immune system and keep yourself well. A healthy diet, which means limiting our processed foods, high-fat foods and sweets while eating vegetables every day and some fruit intake, has been shown to substantially improve immune system responsiveness.
Exercising three to four days per week has also been shown to improve immune function, with a 2008 review showing regular aerobic exercise can reduce the negative effects of age on the immune system.