Practical Considerations About COVID-19.
Updated 16th September 2020.
Covid-19 is going to be with us for a while longer. The best way to deal with it is by taking into account practical considerations by which we can safely live and overcome the coronavirus.
Practical Considerations About Covid-19
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What do We Know about Covid-19?
It’s a new respiratory illness that affects humans.
Covid-19 came to global attention in December 2019, after a rapidly growing outbreak from a mainland Chinese city, Wuhan in Hubei province.
Caused by a novel (new) virus, it has since been named: SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2).
We know it belongs to the family of coronaviruses, just like the common cold.
In terms of structure, it is enveloped and ~120nm (0.12 μm) in diameter.
We also know that similar illness outbreaks in the past have been caused by other viruses belonging to the same family as the SARS-CoV-2.
These are also coronaviruses that have caused serious respiratory illness in the last decade:
- MERS-CoV (the Middle East Respiratory Syndrome coronavirus, 2012) and
- SARS-CoV (Severe Acute Respiratory Syndrome coronavirus, 2013) outbreaks.
There is a lot that scientists do not yet know about the virus, but this is changing every day.
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How does Sars-CoV-2 spread?
Currently, we are not sure of all the ways or methods of transmission of the new virus.
We know one method is by direct surface contact; that is, the virus gets on the hands from touching infected surfaces.
The hands then carry the virus to the face and into the body.
Another method is through respiratory droplets from coughs and sneezes from infected individuals travelling in the air for short distances.
What does a COVID-19 infection look like?
Scientists believe that a lot of the cases of Covid-19 are asymptomatic.
‘Asymptomatic’ means a person who has the SARS-CoV-2 virus living in their system but does not show signs of illness.
It seems that a large proportion of people could very well be asymptomatic.
The next group of individuals who develop the disease may have mild symptoms from which the majority will recover.
A smaller group may have a more serious illness including respiratory problems and need hospitalisation.
A minor (but significant) proportion can develop more severe disease.
So far, this has mainly affected 2 main groups of people:
- Older people over the age of ~50-60 years
- People who have a serious underlying illness such as heart, lung or kidney disease as well as conditions like Diabetes mellitus.
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The Practical Considerations about Covid-19
In this post, we will try to draw your attention to practical considerations when dealing with the question of Covid-19 infection.
Depending on which part of the world you are in, you may need to consider one of these questions sooner or later.
Information on the SARS-CoV-2 virus is continually evolving. Below are links to a number of monitoring organisations for up to date news.
- Useful health information sites:
Is there really a Climate effect?
Why has the virus outbreak been minimal (so far) in some parts of the world?
The disease at this stage has recorded very little impact in certain parts of the world compared to others.
It’s important to know that this may change with time, but it does raise a curious question:
Could this minimal impact in those countries have something to do with the effect of warmer climates on the growth or transmission of the virus?
Some studies are looking at this matter with the limited information available.
As yet, though, there is no information to say with certainty that the virus does better in cold or temperate areas than warmer climes.
Wear Face Masks or Not?
Can face masks prevent healthy people from contracting Covid-19 if they are in the presence of an infected individual?
Yes. Even more, face masks and coverings worn by everyone reduces the risk of droplets spread and lowers the spread of the coronavirus.
In health care, we find different types of face masks in use.
Face masks generally protect people from respiratory hazards, including chemical, biological, and radioactive materials.
Masks commonly used in health care include:
- Surgical masks
- N95 masks
- FFP3 masks
Surgical Masks (SM)
Surgical masks (SMs) block large particles (such as droplets, splashes, sprays, or splatter) that may contain germs (e.g., viruses and bacteria) from reaching the nose and mouth.
In routine medical care, such as during surgical procedures, surgical masks primarily protect patients from healthcare workers.
They do so by minimizing exposure of saliva and respiratory secretions to the patients.
However, they generally do not form a tight seal against the face skin and so are not most effective in protecting people from airborne infectious diseases.
Therefore, SMs find a use generally for protection against infection through fluid repellence only.
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N95
N95 are a US classification for a special type of face masks.
They are a type of “particulate filtering facepiece respirators (FFRs)”.
This means they are devices able to filter particulate or very small matter such as bacteria or viruses.
N means “not resistant to oil”; meaning this category of respirators are not for use in an ‘oil-droplet’ environment.
Numerical designation 95 shows the mask’s minimum filtration efficiency of 95%, among masks of similar category.
FFP2 and FFP3 masks
The same “particulate filtering facepiece respirators (FFRs)” are classified by European Standards into FFP1, FFP2 and FFP3.
Thus, these masks have corresponding ability to filter particles efficiently of 80% (FFP1), 94% (FFP2), and 99% (FFP3).
Therefore, an FFP2 device has roughly similar filtering effectiveness as the N95 mask.
The FFP3 mask is more effective than FFP2.
The protection provided by SMs against particles (0.04–1.3 μm) is 8–12 times less than N95 FFRs.
However, both of these types of masks offer similar protection “against influenza infection when the concentrations of infectious viruses are low”.
You can read a lot more about the different respiratory devices and how they work here.
So, N95/FFP2 and above masks are air-purifying respirators that have been recommended for healthcare workers against airborne infectious diseases such as Ebola.
However, because N95/FFP2 respirators or above may be in short supply during a pandemic—or not available in many countries—it is important to know the protection efficiency of surgical masks.
Having established their effectiveness, why are they not included for use by the general public with hand washing and other clean practices?
Very simply, purchasing the masks limits their availability for use by health workers who work closely with affected individuals.
By depleting the available resources, health care workers are more likely to succumb to ill health.
When a hospital’s staff strength is affected, it cannot cater to people who fall severely ill from the disease.
Face Covering/Cover
Clothing fabric from cotton material sewn together can make effective face coverings and help reduce spread of droplets and thus the virus.
There are studies which show droplets travelling for quite a good distance with talking, coughing, sneezing, singing and shouting.
You can either make your fabric face coverings or purchase them.
Avoid material that is too thick, so you are able to breathe freely.
If you choose to wear the mask, do not let it lull you to a false sense of security.
Maintain safe distances from possibly infected people and wash/clean hands frequently.
Avoid touching your face; trying to wear and remove some face masks may make you touch your face more than you should.
You should remove them by the ear or tie loops rather than by touching the mask fabric.
You can learn more about face masks from this video.
Personal Hygiene
From what we know so far, close personal contact with someone who is infected increases your risk of getting infected.
Cleaning your hands with soap and water and hand sanitiser several times a day is important – in addition to doing so:
- Before and after meals
- Before and after using the toilet
- After using public facilities
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Visiting Public Spaces.
Earlier we talked about how the disease could spread.
This mode of spread suggests that busy public areas could make it easy for viral transmission.
It makes sense, then, for you to consider carefully where to go and how to keep yourself safe while outside your home.
Consider public places to include markets and supermarkets, places of religious gathering and schools.
They can also include offices, gyms, sports stadia and such.
When visiting any of these places, consider your safety, social distancing and using face coverings.
Pregnancy
What is the effect of the Covid-19 disease on a pregnant woman, or her baby?
From limited data so far, we believe that the Covid-19 infection in pregnant women appears to be less severe than the SARS-CoV-1 infection in pregnant women.
This gives us a reason for some optimism.
So far as we know, being pregnant does not appear to increase the risk of developing Covid-19.
Of course, this may change with time and development of more cases.
Pregnant women should take great care and practice the same hand hygiene advice as the rest of the population.
Maintaining a safe distance from people with respiratory symptoms and reporting any signs of ill-health promptly will provide the greatest protection to mum and baby.
A study was reported in the Lancet of 9 pregnant women who were seen at a Wuhan University Hospital in late January 2020.
So far, there is limited evidence the virus can be transmitted from mother to baby.
Of all the women in the study, none of their babies died in the womb or after birth. They did not have any complications that could be attributed to the SARS-CoV-2.
You can read more about pregnancy and breastfeeding and Covid-19 here.
Learn more guidance for pregnant women from the Royal College of Obstetricians and Gynaecologists in our Pregnancy and Covid-19 video series.
Safety Awareness
Be aware of your own personal safety.
Being in close contact with people who have the virus means you could get infected.
Keep a good distance between yourself and any person who appears to be coughing and sneezing persistently. The recommendation is at least a 2 metre or 6 feet distance between you and the next person in public or outside your home.
Self-isolation.
This is the recommendation for someone who has either minor symptoms of illness (see above) or is well and may have been exposed to the infection.
It is recommended that rather than attending your health facility, you should make contact by phone for advice on how you can be tested.
But what are the challenges that come with self-isolation?
The worse possible scenario is that your area may start having outbreaks after some time.
Many people may then need to self-isolate.
Technically, it means remaining in your own home and avoiding contact with other people for the period of isolation.
For the majority of people, their families or those with whom they share the home will also be affected.
To survive during self-isolation requires essentials – food, toiletries, regular medicines etc.
Avoiding public places and gatherings will be key to reducing the risk of infection.
Thus preparing for a period of restricted movements may seem reasonable.
You should make your own judgements based on the local factors – which evolve every day.
If you do need to prepare for such an outcome, then consider the following:
Food items – tinned, dry, non-perishable items, water and other drinks
Household cleaners or disinfectants
Soaps, Toothpaste, personal hygiene materials.
Travel
Should you travel or not?
Even if your country is not in lockdown and without restrictions on travel, you should still consider possible implications for travel.
It’s tempting to travel when your destination seems to be a low-risk area.
But what if that changes while you are away?
What if you fall ill while you are away?
Or you require to be in quarantine on your return?
No one enjoys being placed in quarantine – but prepare yourself that this (or self-isolation) may be the result following travel.
Being in quarantine can be quite challenging and the environment may be less than pleasant.
If you have young children it may be even more challenging.
This is why you should consider plans to travel especially while there is still quite a lot of uncertainty.
What are the current government recommendations in your home and destination?
What kind of travel insurance arrangements do you have?
Vaccines
By September 2020, we have several vaccine trials going on around the world.
We need to have vaccines as soon as possible, but they must be safe.
We emphasise the need not to skip Phase 3 vaccine trial stages while developing the vaccines for Covid-19.
At this time, there is no vaccine readily available that has undergone standard testing protocols to satisfy human use.
However, a lot of work is going on and the best estimates are that we may have suitable vaccines within the next 12-24 months at best.
Young Children
So far, there have been limited deaths in people under the age of 16years from Covid-19.
In this age group, the risk of infection is also the lowest possible based on the current data available.
However, some cases have been reported of children developing infection with the virus with a very small number developing severe illness – a Kawasaki like Syndrome.
Encourage children old enough to observe hand hygiene practices and avoid touching their face.
If you live in an area where cases have been reported it makes sense to limit strictly other people from carrying your young babies or children.
Most of all, what we need at this time is to avoid panic, and be careful what reports we listen to; and believe.
Watch this video about Scaremongering in Covid-19.
Final Thoughts
Most scientists agree that we are in for a long haul with Covid-19.
This means that we must be conscious of the risks, arm ourselves properly and follow well-supported evidence for the best way to overcome the virus.
If you have any questions about keeping safe during the pandemic – ask here.
More Reading:
References
- Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records.
- Novel Coronavirus infection and pregnancy
- Particle Size-Selective Assessment of Protection of European Standard FFP Respirators and Surgical Masks against Particles-Tested with Human Subjects
Editing by AskAwayHealth Team
Disclaimer
All AskAwayHealth articles are written by practising Medical Practitioners on a wide range of health care conditions to provide evidence-based guidance and to help promote quality health care. The advice in our material is not meant to replace the management of your specific condition by a qualified health care practitioner.
To discuss your condition, please contact a health practitioner or reach us directly through info@askawayhealth.org