[AMA] I'm a Doctor. Ask Me Anything COVID-19 Related

Linamotoichiban on 21/03/2020 - 12:13
Last edited 26/03/2020 - 17:14 by 1 other user

As a doctor working in the emergency department, one thing I've noticed is that there has been a lot of misinformation out there. Patients are coming hoping to get tested for COVID-19, but end up wasting their time because they won't meet criteria to be eligible to get a swab. Others are receiving group texts stating that drinking hot water will kill the virus…

Please ask me anything related to COVID-19, even if it is the simplest question (as long as it is not direct medical advice). My aim is to provide some helpful information, because information is key.

I would also like to encourage everyone to self-isolate and stay at home if you can. Even if you are not sick! It is the only way that we are going to slow the spread of this virus. Countries such as Hong Kong and Singapore have implemented strict regimes early on for people to self-isolate, which has drastically slowed the spread of the virus in their countries, as opposed to our Western Neighbours, where there has been a rampant spread.

My colleagues and I have been trying to spread the word to everyone to take this simple step to protect ourselves and our community before it is too late. We are potentially 2 weeks away from where countries like the UK and Italy are at the moment, where our colleagues there have run out of beds and having to pick who to treat and who to leave to die..
They have also seen young healthy people being affected badly and dying from this disease, so do not think you are immune just because you are young! Please get the word out there and tell all your family and friends to STAY AT HOME!

We stay at work for you. Please stay at home for us

Interesting article regarding how self-isolation helps:
https://www.washingtonpost.com/graphics/2020/world/corona-si…

Looking forward to answering your questions!

Additional simple tips to reduce the spread!
1. Wash your hands often, especially before and after eating
2. Avoid touching your face
3. Cough and sneeze into your elbow

Mod: Please note that this is an unverified AMA and take any comments on this thread and anywhere else non-official with a grain of salt. Please see official advice from the Australian Government. While this is a worrying time, please be kind to each other including staff of OzBargain.

Introduce Yourself

closed Comments

  • Melb69 on 21/03/2020 - 12:14

    Should I go to work on Monday Or self isolate. For the given state of the pandemic. Also should my son stay at home rather then go to School. My wife doesn't work so its not preventing someone working.

    • inamotoichiban on 21/03/2020 - 12:24
      +52

      Definitely self isolate if you have the choice. You are going to be more likely to catch it travelling to work and being around other people, than if you just stay at home.
      Same goes for your son as well. He is more likely to catch it being at school, than if he just stays at home and does not go outside.

        • inamotoichiban on 21/03/2020 - 12:36
          +133

          I am saying that purely from a health perspective, that your son is obviously going to be less likely to get COVID-19 if he stays at home and does not go outside as opposed to going to school.
          The government has other things to worry about such as workers being affected if kids have to stay at home. But in your situation this won't be the case.

        • nfr on 21/03/2020 - 13:18
          +8

          Just look at the WHO. The "medical heads" did not get to their positions by espousing unadulterated medical opinions. That would make them unfit as political rubber stamps.

        • diazepam on 21/03/2020 - 13:26
          +25

          Pretty obvious that the government isn't shutting down schools because of economic considerations and they're already trying desperately to prevent an economic recession.
          (ScumMo doesn't want to be the remembered as the first PM that caused a recession since 1991 or whenever it was. And I say this because I've seen the impact on hospitals)

          • stumo on 21/03/2020 - 16:57
            +9

            @diazepam: Scomo seems to be keeping his own kids home from school.
            https://twitter.com/EddyJokovich/status/1240902166321086465?…

            • JH100 on 22/03/2020 - 00:51

              @stumo: "Scomo seems to be keeping his own kids home from school."

              It appears that way, given the words he chose to answer that question.

          • goraygo on 21/03/2020 - 17:15
            -3

            @diazepam: yeah. ScumMo doesn't want to be remembered as the PM that caused a recession with a reason of pandemic.

            BUT… he wants to be remembered as the PM that might lose millions to this COVID-19.

          • R4 on 23/03/2020 - 09:30

            @diazepam: If we get a recession, Morrison (ScuMo? Really?) didn't 'cause' it!

        • YZLY on 21/03/2020 - 16:54
          +6

          Why ask a question if you think you already have the answer?

          • Daabido on 21/03/2020 - 17:06

            @YZLY: Because Dedbny.

          • [Deactivated] on 23/03/2020 - 15:32

            @YZLY: in politics correlation = causation

        • ripesashimi on 22/03/2020 - 01:20

          I really want to see your comeback.

            • fortune500 on 22/03/2020 - 07:23
              +8

              @Melb69: the government is too slow to respond. Italy quarantined Italy before several days later we had the brains to stop Italians coming to Australia. Yet we stopped Iran when the count was much lower right? A large proportion of the cases here are because we failed to stop inbound passengers or quarantine them. The government just let in 3800 cruise ship passengers some of which tested positive to corona. It seems to me the government doesn't know what they are doing. Just look at the UK. One day they have no plans to close schools and then a few days later they do a backflip. Surely, surely we were lucky to have been given the insight from what other countries were going through. We have had the abillity to watch events unfold yet we failed on step 1 of basic pandemic guidelines which is to Stop Inbound Infections. There are enough specialist (including Infectious disease) and medical professionals indicating the government is way too slow and we are heading for an Italy. The USA by the way is also on a path into the abyss. Thankyou OP, many agree with you and to be honest there will always be a diminishing percentage of doubters.

              If anyone has ever watched Jaws think of the economy as the shark and the government is the Mayor saying all is fine you can keep swimming.

            • Parentheses on 22/03/2020 - 21:11
              +3

              @Melb69: Why ask if you aren't actually interested in the answer? Go watch the press release instead you absolute muppet.

        • Keplaffintech on 24/03/2020 - 21:17

          Shame that we have a government that blatantly lies like this.

  • random12 on 21/03/2020 - 12:18
    +35

    how do we know you are an actual doctor, and not someone just spreading more bullshit?

    • Arthur Dunger on 21/03/2020 - 12:29
      +13

      How do we know that any member who starts an AMA is who they say they are?

        • Arthur Dunger on 21/03/2020 - 12:40
          +18

          I can't see anything the OP has written that's dangerous so far.

            • stinkydog on 22/03/2020 - 15:51

              @2pro4sho: So this is really dangerous to your idea of the general population becoming ill and you being fortunate enough to survive. Or maybe you plan on telling lies to the meds you're discrediting right now, all for preferential treatment. Perhaps you'll lie about your situation such as how many children you have, just so that somebody who took this all seriously misses out on critical life support.

              Let's say you're not going to lie, and will be fine, but you'll infect a bunch of other people along the way. Your attitude is what will make or break our country, and I feel sorry for those of us who want what is best for the country.

              It would be great if the health system was able to prioritise help for those who did all they could to stem the tide over those who failed. My hopes are that the tide doesn't rise far enough to make choosing who to help a necessity.

        • cheaplee on 21/03/2020 - 12:55
          +30

          I don't get your angle.

          Common sense would say if everybody in the entire world didn't see another human for about 4-6 weeks this virus would die out with no more live hosts to infect. Along with every other human only, short lived, immune generating virus. You don't need to be a doctor to figure that out.

          He is trying to say if you can limit your interactions with other people it may slow things down and less people will die.

          How exactly is that advice going to
          1. Spread the virus and
          2. Result in more people dying?

          • wallet72 on 21/03/2020 - 16:57
            +2

            @cheaplee: Isolation slows the spread, and that gives time for a vaccine and/or treatment to be developed.
            In theory, if everyone isolated for 2 - 3 weeks, and we had a major disinfecting push for public spaces etc then the virus would burn itself out.
            In reality, there was always be a reservoir of virus somewhere and its impractical to demand everyone stay isolated for weeks.

            All that can really be done is get as many people as possible to isolate so the pandemic is slowed enough so humanity can catch up.

            • cheaplee on 21/03/2020 - 18:25
              +1

              @wallet72: Ok. I think you just said the same thing I did.

              • wallet72 on 21/03/2020 - 18:45
                +1

                @cheaplee: yeah sorry, I replied to you instead of someone else.

                I'll put my training wheels back on.

    • cheaplee on 21/03/2020 - 12:30
      +6

      Well you don't know he is actually a doctor, but nothing they said is bullshit.

      You could ask a question then make a judgement based on his answer.

      If it's any consolation the language used would make me believe he/she is indeed a doctor - criteria, swab, patients, beds, etc. Oh and they specifically said they won't give direct medical advice. That's generally something only a doctor would say given the complexities of diagnosis and management via an internet forum.

    • Baysew on 21/03/2020 - 12:35
      +1

      Are you a Doctor?

    • nepalesesquirrel on 21/03/2020 - 23:50

      Because he wrote this…

      Additional simple tips to reduce the spread!
      1. Wash your hands often, especially before and after eating
      2. Avoid touching your face
      3. Cough and sneeze into your elbow

      • Jackson on 22/03/2020 - 13:36

        Hle could have just seen the ABC ad,

        On a serious note, I have no complaints with this AMA.

  • 2pro4sho on 21/03/2020 - 12:19
    +5

    "Please get the word out there and tell all your family and friends to STAY AT HOME!"

    I'm sorry but that advice is not helpful for workers. We are guided by our employers and their response to this. I can't just refuse to work and expect to be paid if I am required to go into my place of work. Unless their is gov support and protection for this you cannot expect workers to stay at home indefinitely without income. Our work practices are changing day-to-day based on current recommendations.

    • inamotoichiban on 21/03/2020 - 12:31
      +42

      I understand that this is not an easy decision to make for some people, as their livelihoods depend on it, which is why I said self-isolate if you are able to.
      Purely from a health perspective, less people will die if we all self-isolate

        • cheaplee on 21/03/2020 - 12:36
          +35

          He already said he was an ED doc. What have you contributed to this global issue except potentially spreading it to other people?

          And yes everyone knows this already, but it would appear people aren't doing it…

            • arkie0 on 21/03/2020 - 12:42
              +2

              @2pro4sho: What a coincidence, I'm also a primary health care worker, but now I've been reassigned to giving advice on OzB.

              • 2pro4sho on 21/03/2020 - 12:43
                -3

                @arkie0: Where am I giving advice? I have no qualifications in ID.

                • arkie0 on 21/03/2020 - 12:46

                  @2pro4sho: What? I'm so confused. I said I've been reassigned to giving advice on OzB. You said you are at a screening clinic?

            • cheaplee on 21/03/2020 - 12:45
              +1

              @2pro4sho: Yeah I'm a hospital medical registrar who is looking after people admitted with COVID. I won't have access to all the fancy ICU equipment so most of my really sick patients will die.

              • serpserpserp on 21/03/2020 - 14:15
                -4

                @cheaplee:

                I won't have access to all the fancy ICU equipment so most of my really sick patients will die.

                You will admit them ICU if they are serious.

                • cheaplee on 21/03/2020 - 14:18
                  +4

                  @serpserpserp: I was commenting under the assumption that ICU would be full, as would the unused theatre space and then we would actually run out of ventilators.

                  If it was as simple as sending them all to ICU then Italy wouldn't be in the state it is right now

                  • serpserpserp on 21/03/2020 - 14:31
                    +2

                    @cheaplee:

                    If it was as simple as sending them all to ICU then Italy wouldn't be in the state it is right now

                    Italy has this problem because: They got affected at the start of the pandemic before the world got their act together and closed borders etc. They also have the second oldest population in the world (I think that is still correct), they have high level density in terms of living spaces where a number of people of all ages live in very close proximity, culturally they are very hands on with greetings (hug, kiss, shake hands multiple times, big family gatherings, etc etc.) they also have a pretty underwhelming health system by European standards, they also have poor governmental control over all their regions (sometimes the word takes a long time to get out to all people).

                    TLDR - Italy didn't close borders early enough and has a very old population that is like a tinderbox for COVID19.

                    • sakurashu on 22/03/2020 - 00:53
                      +4

                      @serpserpserp: Everything you've said about Italy's issues is correct - but that still doesn't mean our medical system will cope well if a large percentage of the population get sick

                      • serpserpserp on 22/03/2020 - 06:56
                        +1

                        @sakurashu:

                        but that still doesn't mean our medical system will cope well if a large percentage of the population get sick

                        The most prepared medical system in the world wouldn't cope if that happened. Not sure of the point.

                      • trapper on 22/03/2020 - 10:09
                        +3

                        @sakurashu: It won't take a large percentage of the population to overwhelm our medical system.

                        0.1% will put us very close to the limit, 0.2% and we are in very serious trouble, any more than that is going to be catastrophic.

                    • cameldownunder on 24/03/2020 - 13:09

                      @serpserpserp: You are real Brutal with Italy ! But I agree. I also would add that they are disorganised, and less strict in following rules. BTW in Switzerland police are patrolling the group restriction. I expect Germany doing the same.

                      • serpserpserp on 24/03/2020 - 22:20

                        @cameldownunder: I might have been brutal on calling out the healthcare system. They have a wonderful universal healthcare system there that is free to all its citizens, it is also fairly well resourced. It just isn't good enough to deal with what is happening there. But I shouldn't be so harsh as the rest of the world isn't ready either with their medical infrastructure.

                  • Ok computer on 22/03/2020 - 22:58

                    @cheaplee: What is the unused theatre space? Theatres typically have positive laminar air pressure differentials. Not suitable for infections such as Covid19./

                    Great way to spread infections around the whole of theatre though.

                    • cheaplee on 23/03/2020 - 07:46

                      @Ok computer: Lots of elective and semi-elective surgeries are being cancelled. There is a good amount of operating theatre space that is no longer being used, obviously depending on the hospital design.

                      I don't know much about the airflow design in theatre. As long as the droplets are not aerosolised it wouldn't be different to any other shared room in the hospital though. You would have 8-10 patients per theatre all COVID positive and staff would use PPE when entering room and not be changing it between patients.

                      It's not ideal and I get your point about spreading the infection, but compromises have to be made. You would work by cohorting patients so everyone in that theatre would be positive already, only risk then is transmission to staff. Also if the patients are ventilated in there it will be a closed circuit with very minimal droplet production anyway.

                      • 811b11e8 on 23/03/2020 - 11:43
                        +1

                        @cheaplee: A positive airflow theatre room is literally the worst place that you could put them. You would be better of with tents in car parks.

                        Look at how SARS spread throughout hospitals in Asia. Covid 19 spreads very similar to SARS just more contagious.

                        • cheaplee on 23/03/2020 - 19:18

                          @811b11e8: I know (?think) you were being facetious, but unless you actually want these people in tents in car parks there might not be any other sufficiently sized, clean, climate controlled space. The car park could get really cold at night and really hot during the day just to name the first issue that comes to mind.

                          Although I'm not an infection control expert I would have to wonder if droplet vs airborne transmission plays a role here.

                    • Krankite on 24/03/2020 - 09:44
                      +1

                      @Ok computer: Unused theatres are stupid but the recovery/rehab wards are easy enough to convert.

                      • Ok computer on 24/03/2020 - 11:26

                        @Krankite: Convert to what?
                        Check out the Australian Health Facility Guidelines for Isolation, Negative and Quarantine rooms.
                        One then has to look at engineering to see what is achievable.
                        And then see what Infection Control needs to be considered.

        • hypie on 22/03/2020 - 04:32

          @hazmat athena

          If you don't believe OP, you probably won't believe this. But he claims to be working in the ICU in the UK.

          https://youtu.be/tQD4B_hmdvo

    • cheaplee on 21/03/2020 - 12:35
      +13

      Yes it is. When you're not at work stay at home. Rather then going to Bondi beach this weekend stay at home.

      It would be difficult for an emergency doc to work from home so I'm certain there is an understanding that not everyone can self-isolate, work from home, etc

      • Imightnotbearobot on 21/03/2020 - 23:54
        +6

        Agree. The issue is there are so many people contributing to this just because of the simple stupid excuse of … Oh I am healthy and young and it is so boring at home.

  • c64 on 21/03/2020 - 12:20
    +2

    does cooking kill coronavirus?

    • cheaplee on 21/03/2020 - 12:59

      One would presume so. It kills a lot of thing more environmentally hardy than a virus

    • diazepam on 21/03/2020 - 13:33
      +1

      Yes. This isn't for SARS-CoV-2 but
      1. this article states for the nuclear capsid of HCoV-NL63 The denaturation temperature was estimated at 45.7°C.
      2. Heat at 56°C kills the SARS coronavirus at around 10000 units per 15 min (quick reduction).

      Not exactly the same strains but probably won't be significantly different.

      • ozhunter on 21/03/2020 - 13:48
        +1

        So, a 30 minute sauna session at 70 degrees should help?

        • diazepam on 21/03/2020 - 13:52

          Dunno had a quick look on google and it seems apparently so (but nothing published in any research journal as of yet).
          But I wouldn't put my bets on it: (my thoughts only - I'm not qualified in terms of ID/virology/etc.)
          1. Sauna have places that are cold enough
          2. You may be in close proximity of someone who is infected (perhaps asymptomatically) and close enough for transmission
          3. It doesn't kill anything inside you - only on your skin

        • c64 on 21/03/2020 - 13:53
          +8

          i'm guessing yes if the virus on your skin (assuming the above information is correct), but your body's core temperature is not going that high

          • serpserpserp on 21/03/2020 - 14:16
            +7

            @c64:

            but your body's core temperature is not going that high

            Hold my beer…

          • Barganious on 21/03/2020 - 16:16
            +2

            @c64: This is correct.b Saunas do not kill the irus in your body. It was spoken about on the Joe rogan podcast with Prof. Michael Osterholm https://youtu.be/E3URhJx0NSw

            • bringbring on 23/03/2020 - 20:35

              @Barganious: Your skin temperature doesn't even rise that much as it is cooled down with sweat. But yea, a proper dry sauna left for a while between users should be clean in theory, but I wouldn't rely on that.

        • LikeMike on 24/03/2020 - 22:39

          Government said tonight that saunas have to close now.

    • Keplaffintech on 24/03/2020 - 21:20

      Probably a better question to ask is can you get infected by eating contaminated food:

      The answer is most likely no

  • [Deactivated] on 21/03/2020 - 12:23
    +1

    Does exposure accumulate? Quite a few young healthy doctors are dying.

    What is known about the Chinese reports of glass dust opacity in the lungs? Has that been found outside China?

    • cheaplee on 21/03/2020 - 12:39
      +4

      Ground glass opacity is a way to describe CT findings of the chest.

      Every human who gets this virus, gets reasonably sick and gets a CT scan will have ground glass opacification.

      Exposure accumulates only in the sender that the risk of contracting the virus increases. People will not get more unwell just because they have been exposed to someone for 16hrs vs 2hrs.

    • inamotoichiban on 21/03/2020 - 12:44
      +14

      It has been shown that health care workers are more likely to have a more serious course of the illness if they get it, compared to the general population. This has been thought to be due to an increased viral load exposure from seeing multiple patients.
      In regards to glass dust opacity, do you mean ground glass changes? These are findings found on a chest CT in severe COVID cases. People with mild cases would not generally have these changes

  • popsiee on 21/03/2020 - 12:25
    +15

    The PM should of had this guy but still with his economics interests would not have listened . Most cases originated from the US here in Australia and of course he had no ball to shut the US off . Just a way delayed border shutdown when really it was too late .

  • cloudy on 21/03/2020 - 12:26
    +4

    How long can the virus linger on surfaces? Should I be worried about opening all public door handles and stuff like that?

    • cheaplee on 21/03/2020 - 12:40
      +1

      Probably days.

      Should you be aware you might get infected because you touched something in public, yes.

      Should you be worried? That's a stressful way to live

    • mapax on 21/03/2020 - 13:16
      +2

      On the right surface at the right temperature it can survive for up to 9 days.

    • diazepam on 21/03/2020 - 13:38
      +2

      Depends on the surface. Have some light reading from NEJM

      SARS-CoV-2 was detectable after 72 hours after application to plastic and after 48 hours on stainless steel, although titers dropped. Survival was shorter on cardboard (no viable SARS-CoV-2 after 24 hours) and copper surfaces (no viable SARS-CoV-2 after 4 hours)

      Yes if you touch public door handles, everyone should hand sanitise before touching your own things e.g. inside of your house, etc. Where possible use your foot to open doors (assuming push doors of course), elbows to press exit buttons. But really, wash your hands and don't touch anything unless absolutely necessary.

    • diazepam on 21/03/2020 - 13:45
      +11

      If you are indeed a HMO / reg or whatever level of training you claim to be at (as per your posts above), you'd know absolutely no doctor will be willing to put out thier public name and credentials on a forum like this. Similarly since you're on facebook, you'd know that the AMA suggests changing your names on facebook.

      I would argue that anyone medical already knows more than the public on this issue, and I've read through every comment on this post. OP hasn't said anything that requires qualification to speak on critical resp care / ID control. OP has just stating what's already been said but reinforcing it (obviously with the medical credentials).

      • cheaplee on 21/03/2020 - 13:54

        It was me who said I was a HMO, in reply to 2pro4sho.

        They only said they were a 'primary healthcare worker'.

        Complaining the OP hasn't given any credentials but won't even say what their profession is…

        Edit: well you can't see what 2pro4sho claims to be anymore because they've requested it to be unpublished… But naughty OP hasn't given everyone their AHPRA registration number.

        • diazepam on 21/03/2020 - 14:03

          Sorry my bad, just skimmed the above comments.

          I agree 2pro4sho could literally be in any profession… e.g. a resp therapist or a perfusionist lol… (with no disrespect for them of course)
          And if s/he indeed was working for ICU they'd know that we're 100% bound to be bed-locked in ICU (I mean for god's sake look at Italy) and anything to even slightly lift this load helps. Nothing wrong with OP giving advice that's been said before.

  • ChillBro on 21/03/2020 - 12:27
    +1

    What does it take to get sick from someone? Some say all it takes is one cough in your direction but I've also heard you need to at least be in the same space as someone for at least an hour or so.

    Does testing just involve a throat swab? I've also read that you need to pay for it if your scenario doesn't fall under suspicion (i.e. symptoms + overseas in certain countries). How much is this cost?

    Have doctors been getting paid or unpaid overtime during this crisis?

    • inamotoichiban on 21/03/2020 - 13:20
      +8

      I cannot comment on your first question as I'm not an expert in that area.

      But regarding testing, it is a swab of the back of your throat as well as your nose.
      At our COVID clinic, the current criteria for non health care workers to be eligible to be swabbed is if you have developed flu like symptoms and/or fever, and you've either had close contact with a confirmed COVID-19 case (more than 15 minutes in a close proximity), or if you've been overseas in the last 14 days. Please note this is the current criteria, and this criteria may change as community transmission becomes more rampant.
      I am not sure if you can pay to have a swab done if you don't meet the current criteria.

      Doctors have been getting paid overtime to fill in and do extra shifts for staff who are sick. We anticipate there will be an increasing shortage as the weeks go by as more health care workers will get sick from this, and unfortunately some will even die.

        • [Deactivated] on 23/03/2020 - 18:11

          He clearly said ask him anything COVID-19 related…

          • moo on 23/03/2020 - 18:27
            -4

            @[Deactivated]: It is COVID related. Will be interesting to get a sense of the commercial and economic impact due to the overtime. At the same time, the utilisation could also translate to mental health and psychological impacts. So yes, it is COVID related.

            Thanks for chipping in though, appreciate it.

      • saintpotter on 23/03/2020 - 08:52
        +1

        If you had close contact with a confirmed case for less than 15 minutes, and have symptoms after a couple of days of fatigue and earache (no cough or fever), do you recommend getting tested?

    • inamotoichiban on 21/03/2020 - 12:48
      +51

      Yes I usually do not post, but given the extreme situation, I have felt the need to speak up and get the message out there in order to help our community and also my colleagues on the front line

      • brrb on 22/03/2020 - 12:45
        +8

        Long time lurker, first time poster. Just created an account to say thanks to the OP and all the other front line health workers out there.
        Let's do our best following the guidelines, which will hopefully ease their workload in the upcoming weeks/ months.

    • goraygo on 21/03/2020 - 17:20
      +5

      well, at least it is not a new account :)

  • skid on 21/03/2020 - 12:38

    Any ideas why the mortality rate is higher in Italy, US, UK and Switzerland compared to Australia and China? Is it really because of an aged population?

    • Melb69 on 21/03/2020 - 12:43
      +4

      For Italy its more likely the elderly and concentrated areas. We should be locking down hot spots in NSW.

      • trapper on 21/03/2020 - 21:46
        +1

        The health system in Italy is overwhelmed, people are literally being left without any treatment.

        • casho on 22/03/2020 - 17:23

          So sad

    • dmacw on 21/03/2020 - 12:49
      +4

      I'd look at South Korea and Norway data, if you're going to look at mortality rates. The absolute percentage is always going to be dependant on the number of cases identified, and we know that in most healthy people, the symptoms can be quite mild, or even non-existant, but they still facilitate spread.
      Our swabbing criteria is a little restrictive, but I can undestand why, as there is a physcial limit on the availability of swabs and reagent needed for the testing, and at some point in those situations, you start having to consider only swabbing where it'll alter management - ie mild symptoms, assume its Covid19 and stay at home, self-isolating. If you're very unwell, go to hospital and they can test you, to determine if you're admitted to the Covid19 ward or the Influenza ward (to reduce cross contamination). But our current testing policy will miss 10-20% cases at present, with some estiamtes suggesting that for every positive swab we find, there are another 10 people out there infected with mild illness.

      So yes, mortality rate will be influenced by age of population, population co-mobidities, country wealth and spend on healthcare, the spare capacity within the health system, effectiveness of public health policy to limit spread, and also how much time and effort is spent on identifying all the cases out there.

      I'm a doctor and my professional postnomials are MBChB MRCGP FRACGP DRCOG DCH

        • dmacw on 22/03/2020 - 21:45
          +8

          I'm not trying to big myself up. I don't know the OP, but I saw they came under criticism for not declaring their qualifications. So I'm merely stating them.

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