[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

  • goingDHfast on 21/03/2020 - 18:10

    Thanks for the AMA doc :-)

    1) does microwaving facemasks kill COVID-19?

    2) what are your thoughts on shared ventilators? Should the army be brought in to help significantly increase ventilator production (I believe there is a plant in Sydney)

    3) in what % of cases does the surviving patient experience reduced lung capacity/organ damage?

  • Souljarh on 21/03/2020 - 18:16

    what state are you in? How long is your turn around time for COVID PCR?
    In VIC we are waiting for up to 72 hours - even for our patients in ICU.

    • maximum on 22/03/2020 - 01:11

      In NSW at the covid 19 clinic in wollongong results for the test take 3-5 days. I am self isolating after returning from overseas (not mandatory as I came in 14 hours before it came in) and my work would like me to be tested (so I can return to work). I asked the health line last Monday and they said I didn't meet criteria.
      I now have a slight cough but I was advised on Friday that I would be putting myself in more danger going in to get tested and should just stay at home self isolating. I am getting a bit worse but my son had a dreadful cold when I got home so I reckon I have just picked that up.

  • bargdebarg on 21/03/2020 - 18:23
    +5

    Hello Dr from our non-mandatory (mandatory in our view) self isolation. I just wanted to thank you. You and all your colleges are brave people and we owe you a lot. All the best.

  • Magicbee on 21/03/2020 - 18:30

    The government keep assuring us that we are well prepared for this COVID19. However they acknowledge that we do not have enough testing kits. Based on your experience, do you agree more testing should be done?

    • inamotoichiban on 21/03/2020 - 20:12
      +2

      I definitely agree that more testing should be done, however there is a shortage of testing kits.

      That is why we are only testing those with a higher suspicion of COVID-19 (Please refer to the criteria I mentioned in another comment)

      Singapore and South Korea as of late have done really well, because they have been able to test widely and contact trace rigorously.

  • Nutrino on 21/03/2020 - 18:40
    +1

    What is this testing kit?. As far as ive seen, it is a swob from the mouth and get analysised on a machine. If this is the case, are we running out of mouth swob kits?.

  • justwii on 21/03/2020 - 20:11
    +3
    1. Are all the nations using the same method (or test kit) to test for the virus?
    2. For the method being used in Australia, how accurate is the result? (e.g. false positive, false negative rates)
    3. Why does it require meeting the few points you listed in order to get tested? Is it because of cost (e.g. test kit) or time (e.g. piling up tests)?
    4. If it is cost, how much is it per kit?
    5. If it is time, would there be any faster turn around test in development?
    6. What about requesting a chest ray in the ED? Understandable it may not show anything at early stage, but is 100% positive at later stage and super quick to get result
    7. Any quick and easy test one can do at home (e.g. some rumor said try holding a deep breath or monitor with oximeter)?
    8. If testing is not done cheaply and quickly, how can we find out those invisible carrier?
      Thanks for the AMA doc!
    • inamotoichiban on 22/03/2020 - 11:49

      Hi justwii.
      In terms of testing, I believe we use a real-time reverse transcriptase-polymerase chain reaction (RT-PCR) test, which is currently the common test being used.
      In terms of sensitivity, there have been various studies showing rates from 60-70% up to rates of 97%.

      A chest x-ray has not been recommended as a screening tool, as I'm guessing that you would be causing more harm irradiating thousands of people, when you may only pick up a few in every thousand people you x-ray. Plus a CXR would not be specific enough to diagnose COVID-19. Findings may be due to a normal pneumonia rather than COVID related.

      The rumour regarding holding your breath is definitely wrong and very dangerous.

  • wittyusername on 21/03/2020 - 20:27
    +1

    Are children not able to be carriers / spread the disease?

    I understand that they are not at high risk from it, but leaving the schools open and publicly stating it's the safest place for them to be seems to ignore the fact that if they have it they can pass it on, or do they not have that ability?

    • MrFrugalSpend on 21/03/2020 - 23:23
      +1

      As I'm sure OP can confirm, they do definitely have the ability to catch and pass on COVID-19. The official information was they'd rather them stay in schools with new protocols for the schools than be a burden on parents/wandering the streets/various other uncontrolled activities etc. It's one of the most controversial decisions so far and the jury is out of whether its a good idea or not

    • inamotoichiban on 22/03/2020 - 11:54
      +3

      It has been shown that children can have the same infection rates as adults, however their illness tends to generally be more mild than others.
      This can be a worry as they may not appear as sick, and therefore there is a false sense of security to let these children go out, and potentially spread it further.

  • AFOS on 21/03/2020 - 21:06
    +1

    Question: Should I have regular flu vaccination this year?
    Can it be aggravating/mitigating factor now? Is it better to skip/postone it this year?

    • drrrr on 21/03/2020 - 21:55
      +2

      The answer is yes you should get fluvax, it does not interact with covid. Imagine coming down with the flu in the middle of this crisis…

    • inamotoichiban on 22/03/2020 - 11:56
      +2

      Definitely get the flu vaccine if you can. There isn't any concern with it interacting with COVID-19
      As health care workers we have all been strongly encouraged to get our flu vaccines

      • ChurchMouth on 25/03/2020 - 02:06

        Do you know where it is confirmed there is no concern for flu vaccine interfering with corona virus?

        https://www.sciencedirect.com/science/article/pii/S0264410X1…

        From the article "Vaccine derived virus interference was significantly associated with coronavirus and human metapneumovirus; however, significant protection with vaccination was associated not only with most influenza viruses, but also parainfluenza, RSV, and non-influenza virus coinfections."

        It is hard to make sense of Odds Ratio but it is indicating 1.36 odds ratio for corona virus interference. If that were a risk ratio it would be a serious concern I would have thought.

        Understand flu vaccinations will keep hospital beds free in theory though, assuming the above doesnt mean anything.

  • Captain Howdy on 21/03/2020 - 21:30
    +1

    I keep reading different things on whether there is any permenant damage if the virus is contracted? Lung efficiency is what I’ve seen mentioned. If there is permanent damage, is this only a factor with older and unhealthier people, or do younger people face the same fallout after contracting?

  • Cherry12 on 21/03/2020 - 21:30
    +1

    Is it safe to eat takeaway? Would people get infected if the person cooking/preparing the food had Covid-19?

    Thanks

    • Jumpup on 22/03/2020 - 15:08
      +1

      The virus can live on the surface for hours/days so yes you are risking it. If the person coughed on your food or didn’t wash their hands properly.

  • 2190sarah on 21/03/2020 - 21:36

    Hi, I’ve got two questions

    1. Does donating blood temporarily reduce my own immune system, or increase the likelihood of becoming severely ill if I got infected soon after donation? (I was going to donate blood but then got nervous).

    2. Whooping cough is also going around my child’s school at the moment. My kids are immunised, but I’m worried about my kids somehow getting both at once? How easy is it for young kids to get whooping cough even though they are immunised?

    Thanks!

    • drrrr on 21/03/2020 - 21:59
      +1

      Donating blood does not reduce the immune system. Thanks for been a donor! =)
      I'm not a pediatrician but as far as I know whooping cough vaccine is pretty effective. Just make sure they are up to date.

  • trapper on 21/03/2020 - 21:37
    +1

    Current projections have us at 25k cases by around April 4th. Even if we start a full lock-down today there is no way to avoid this.

    If we have critical cases at say 10% of that we will be out of ICU beds. What is the plan then?

    • cheaplee on 21/03/2020 - 21:51

      Probably ventilating people in unused theatre space

      • shap08 on 21/03/2020 - 22:14

        bingo

    • Stone Monkey on 21/03/2020 - 23:28

      Makeshift medical facilities and diverting the less seriously ill patients away from hospitals.

    • inamotoichiban on 22/03/2020 - 12:07
      +5

      This is what we are afraid of.

      Hospitals have been planning for this in the last few weeks.
      Elective surgery has been cancelled in order to make way for extra space in theatres and recovery.
      Plans have been made to transform parts of the ED department and ICU into a COVID area.
      However we anticipate there will still be a shortage.

      Sadly, it may come to a situation where we are full, and we will be forced into picking and choosing who we can treat, and who to send home to die. This is a reality in Italy at the moment.

      That is why there is such a strong push from us to slow the spread down! If we lockdown now, then less will be infected and less will require hospitalisations, and less people will be turned away and left to die.

      • luffyex2010 on 22/03/2020 - 16:28
        +2

        Do not pick any from the bondi beach incident that is if you are at a picking situation. Let them be the last to be treated.

        • trapper on 22/03/2020 - 19:56
          +5

          Triage doesn't work like that unfortunately, the old and sick will be the ones who pay for that stupidity. :(

  • [Deactivated] on 21/03/2020 - 22:09
    -1

    When does your license expire, and are you scared of Google, and lastly do you have any toilet papper.

  • [Deactivated] on 21/03/2020 - 22:15

    Out of all the statistics you have read and knowledge. What is your personal opinion on when we will peak? Also do you think we will follow the uk as in shutting schools down at what seemed to be 2500 cases and pubs restaurants at 4000 cases?

  • mreddie on 21/03/2020 - 22:48
    +1

    My wife is a nurse and has been treating COVID patients (although is not her usual ward or role). I'm pretty sure she'll pass it on to me and potentially our children.. Should we be putting in extra measures at home considering the work she is doing???

    • OldBugger on 21/03/2020 - 22:59

      In the same position, I wonder if I am to self isolate if she is in contact with a confirmed covid19 patient.

      • [Deactivated] on 21/03/2020 - 23:27

        I honestly feel for your predicament. There seems to be so many positives with how Australia is, then after this has happened, seems to be every person/family for themselves. I really appreciate your wife still working through these challenging times.

        • OldBugger on 21/03/2020 - 23:35

          Cheers. I address her as a soldier preparing for battle when she departs to ED. The worst part is the bit of disorganisation that's happened as the hospital grasps with new processes. But, she is in her element really.

    • inamotoichiban on 22/03/2020 - 12:40
      +3

      Mreddie I feel for your situation as unfortunately my family is in the same boat

      I would definitely recommend taking extra measures at home

      From your wife's point of view, what I have been doing at work is
      1. Change into theatre scrubs when I get to work
      2. Showering at work after my shift
      3. Changing into my normal clothes before I leave
      I know this may not be possible at her workplace, but if she can I would recommend it

      At home some things you can do include
      - Avoid sharing utensils, cups and plates
      - Use separate bathrooms if you are able to
      - Wash your hands with soap for at least 20 seconds before eating, as well as straight after you get home

      • stalker878 on 22/03/2020 - 13:20

        i would agree with the showering and hand washing.

        those in front line contact with COVID 19 patients have strict PPE gowning practices.

  • triviums on 21/03/2020 - 22:56

    When treating COVID-19 patients what's some of the more important medical equipment you require?

    I recently returned from a developing country where I was doing volunteer work repairing medical equipment at a major hospital in the country. There was so much broken equipment I had to prioritise what I thought was more important. I really want to know I got my priorities right when it comes to COVID-19 since the country is definitely not ready for a massive COVID-19 outbreak and there will be a high number of deaths when the COVID-19 outbreak starts.

    • inamotoichiban on 22/03/2020 - 20:45

      At the moment we need more PPE as there is an anticipated shortage, and also more ventilators for the most sick

  • FareEvader on 21/03/2020 - 23:08

    Which university did you graduate from? What do you specialize in? Did anyone see this coming?

    • wittyusername on 21/03/2020 - 23:42
      +1

      I'm under the impression that Obama saw it coming.

      He publicly stated that his biggest fear wasn't war or terrorism, but a pandemic. So much so that his administration created a mock pandemic 'walk-through' for Trump's incoming administration. Additionally, when in power, Obama created a section of the National Security Council dedicated to health in developing countries, one of which was based in China.

      https://thehill.com/policy/healthcare/488069-obama-officials…

      https://apnews.com/ce014d94b64e98b7203b873e56f80e9a

      • luffyex2010 on 22/03/2020 - 02:06

        …it was Bill Gates in 2015 ( Ted & Vox)

        • luffyex2010 on 22/03/2020 - 08:40

          TED
          VOX

        • wittyusername on 22/03/2020 - 12:34

          …Bill Gates ran the pandemic walk through for the incoming Trump administration?

          • luffyex2010 on 22/03/2020 - 14:32
            +1

            @wittyusername: No, more on..Bill Gates fears of pandemic instead of terrorism (similar) was in 2015

            as he sort of predicted this current pandemic.

            Sorry nothing bout Trump, anyway he wouldnt understand even they go thru with him a million times 🤣

    • diazepam on 22/03/2020 - 20:44

      University doesn't matter.
      He stated he's ED doctor (although not sure level of his training)
      Yes people saw it coming, no one knew when or where. Enough population theories out there to be honest…

  • striker5950 on 21/03/2020 - 23:14

    do you consider a dentist a doctor?

    • luffyex2010 on 22/03/2020 - 08:44

      I would say yes just in case he doesn't reply lol

      Oral Health Doctor

    • diazepam on 22/03/2020 - 20:47

      Optometrists, Dentists, etc. all graduate with a Dr title.
      Like how I don't call my colleagues "Dr xyz", neither do I call my dentist or optom "doc". That's not to say they aren't doctors… of their own field.
      It's a complicated issue because you also have Drs by PhD which makes the entire situation complicated.

      Au law states that you can't use the Dr title to mislead others e.g. if you're signing off a medical cert, you need to be the correct Dr to do so.

  • striker5950 on 21/03/2020 - 23:16

    some idiots say masks dont do sh!t, is that true?

    • luffyex2010 on 22/03/2020 - 08:45
      -1

      "some idiots" you have already answered your question.

      • striker5950 on 22/03/2020 - 21:35

        how would i know, only in my mind they are idiots, the title of the post is called "ask a doctor"

    • diazepam on 22/03/2020 - 20:53
      +1

      Yes and no.
      Depends on a few things as per my ID colleague. Not giving advice here - just answering your question and you can make your own judgement.
      What type of mask?

      Surgical masks (don't care about the level) only at most, modestly reduce transmission. Also because they're usually an awful fit (my ears are funny), I use the ones that tie around my head to prevent me needing to ask the scout nurse to readjust my face mask. These masks are for those that are sick - they capture the droplets and minimise further transmission. They do very little for anything that's already aerosolised because there's leakage from the sides. You might say "modest transmission is better than none". True. But the problem is that people touch their face to readjust it and therefore that dramatically increases likelihood of transmission.

      N95 masks are the gold standard (with eye protection), but they're not easy to put on perfectly, awful to be in for long periods of time, and are exceedingly hard to get at the moment. And you'll likely touch your face during the course of the day, especially when you take it off (and no longer have protection).

  • fozzie on 21/03/2020 - 23:39
    +1

    A friend of mine sent me an audio from someone supposedly in Spain. Anyway she was saying:

    If you go out when you come back have a shower including hair;
    Wash hands every 20’minutes
    Drink hot drinks every 20 minutes
    Gargle water with lemon or salt once a day.

    It seems excessive to me. There is no way I can drink something warm every 20 minutes or wash my hands every 20 minutes.

    Another friend said that the virus on a person then only attacks 3 people.

    All of the above seems bs. Please confirm

    • inamotoichiban on 22/03/2020 - 12:58
      +3

      Hi Fozzie. In regards to the recommendations given by your friend, I don't think any of them are evidence based.
      Definitely washing your hands will help, but not necessarily every 20 minutes.

      In regards to your friend saying that the virus only attacks 3 people. That is wrong.
      I think they have been told a bit of a twisted fact there.
      They are probably referring to the transmissibility rate of COVID-19 there which is estimated to be about 2.6-2.8 last time I recall. This means that on average 1 person with COVID-19 will pass it on to 3 other people. However this is only on average, and there have been super-spreaders who have ignored self-isolation and gone out and given it to 20-30 other people.
      That is why self-isolation is so important.

      Also if 1 person gives it to 3 people, then those 3 people will give it to 9, then 27, then 81, 243, 729 etc.
      You can see how quickly this escalates.
      The flu transmissibility rate is much lower than COVID-19 and hence why COVID-19 is so contagious

      The only way to prevent yourself from getting it is to stay at home!

      • fozzie on 22/03/2020 - 23:55
        +1

        Thanks very much! What do you think of the decision of leaving schools open? I am a teacher and often I have 30 kids in 20 square meters. I don't see how I can protect myself. Scomo only mentions kids are safe.

        What about us?

        • fozzie on 23/03/2020 - 23:56

          I saw already you answered that. Thanks

  • Thaal Sinestro on 22/03/2020 - 06:58

    What do you think about the use of chloroquine to fight Coronavirus? What are the side effects of short term use? Does the world have a large enough supply of this old generic drug to treat large numbers of people?

    • inamotoichiban on 22/03/2020 - 13:02

      It will be interesting to see what the research shows

      They are starting a trial in Australia soon to compare chloroquine vs and old HIV drug vs both to see the effect

      I'm not an expert in this area, but from what I have heard, chloroquine is generally a well tolerated drug. I'm not sure regarding the supply of this drug

    • Ok computer on 22/03/2020 - 23:14
      +1

      I have taken chloroquine before. After about three weeks I suffered depression and hallucinogenic dreams, very dark!! I stopped taking it.

      But if it was gonna save my life I may reconsider.

  • luffyex2010 on 22/03/2020 - 08:21

    Lets watch if the stupidity of people continues, if they were to turn up today (massive groups or …>500) we can guarantee Australians wants to achieve higher numbers in the Coronavirus Olympics :)

    Bondi Beach
    Bondi Beach 2 offline at the moment

  • PaperplaneXXX on 22/03/2020 - 09:02

    If you have an autoimmune disease or chronic or something like Lyme what are the risks?? 35 years old

    • diazepam on 22/03/2020 - 20:55

      No one can answer that absolutely.
      But risks are substantially higher because an infective and chronic disease act synergistically to screw your body around.

  • blergmonkeys on 22/03/2020 - 09:57
    +9

    GP here.

    I am seeing lots of misinformation right now so I think I need to provide some clarifications surrounding this virus.

    What: covid19 is a novel version of the Coronavirus, a family of viruses known to cause flu like symptoms. This particular virus causes cough, fever, lethargy, body/joint aches. It can cause significant damage to those with underlying predispositions: cardiovascular disease, respiratory disease and diabetes being the top 3. It also causes significant harm as age increases with a near 16% mortality (death) in those >80 years of age. People with serious complications require respiratory support to help them fight the virus.

    Where: currently, we have one confirmed case in Cairns. We likely have a few if not many unconfirmed cases.

    Why: it is incredibly infectious. The problem with this virus is that it infects people and can be shed for 7-10 days without symptoms. This means people without symptoms will spread it to those around them and they will carry it without symptoms and spread it further. This is called exponential growth. 1 person gets it and infects another, these 2 spread it to 2 more, 4 goes to 8, 8 to 16, 16 to 32… leading to thousands. Add in the relatively high mortality in elderly and predisposing illnesses and you have disaster. In Italy, they saw this dramatic rise and it completely broke the back of their healthcare system. There weren’t enough staff or equipment. Doctors are having to choose who to let live or die. It is dire. Please watch this video on a better explanation in video form: https://www.youtube.com/watch?v=fgBla7RepXU

    So, that’s the picture. It is here. We cannot get rid of it, but we can slow it’s spread and if we do that, we can hopefully give our medical system room to deal with the likely scores of seriously ill people that will flood into our hospitals and clinics.

    What can we do?

    3 simple but difficult things
    - hand hygiene: wash your hands thoroughly and often
    - don’t touch your face: hard to do but if you have the virus on your hands, this is how it will get into your body
    - social isolation: this means you have to isolate yourself from others. Do not go out of your home unless you have to. If you must go shopping, get what you need and go home. That cheeky beer? Pass it up. Tell your friends it’s not worth it.

    If you follow the above, we will hopefully not be left like Italy. But we need drastic measures. Thousands will die otherwise.

    You yourself may be fine, you may just have the flu for a week, but you could pass it on to someone who may die. You don’t want that on your conscience. We are all in on this together folks. So let’s unite and beat this thing. Aussies Aussie Aussie!

  • netsurfer on 22/03/2020 - 10:00
    +5

    So far, this AMA from OP is rather disappointing. We've had AMA from other people working in medical industry. This one so far only mentioned common sense without providing any additional information. Previously, OZB AMAs from people working medical industry were helpful and provided more insights.

    For example, just wash your hands often is so superficial. Why and how? TV programs from overseas, the doctors tell you why you need to do a lot of rubbing when washing and why we tell children to use the happy birthday song as a rough indication on how long to wash their hands.

    OZB is not the place to get medical advice or info, but if an AMA is being done for this, provide some useful, in-depth information.

    A doctor working in emergency department doesn't work from home. Some people work on jobs which simply cannot be working from home. Give those people some pointers and bear in mind they don't have access to masks like medical staff.

    Are we able to ask you whether we are trialing Remdesivir and Chloroquine on patients? If yes, why Chloroquine? Remdesivir is understandable, but Chloroquine? Any progress on the COVID-19 vaccine the Australian team of researchers are working on?

    Also, other than those 3, are there other things we can do? Doctors overseas are also recommending general health tips for boosting immune system (or essentially don't do things which would hamper the immune system). Are they useful? Or, just those 3 things (wash hands, avoid touching face, self isolation)?

    • cheaplee on 22/03/2020 - 12:11
      +3

      If you want specific answers with more insight then you need to ask the right questions.

      For example, just wash your hands. You have added the why and how bit. Do you really need a doctor to tell you why to wash your hands? You have already described how to judge the length of washing. Do you want a doctor to tell you to sing happy birthday to yourself?

      The pointers for people who have to go to work and cannot work from home? Wash your hands a lot. Every 30min to 1 hour is a good start. How long for? Sing yourself happy birthday and when the song is finished you have washed long enough. Why? Because that and social distancing is the ONLY thing you can do to protect yourself, others you interact with and slow the spread. You already know this. Most people already know this. There is no magical inside doctor knowledge of how to continue normal daily life.

      Chloroquine is being used for certain cases. Remdesivir - unsure if it is being used in this country. I think supply in Australia would be very, very limited. It was developed for Ebola and that was never an issue here so we wouldn't have a lot of it floating around. Why chloroquine? Because in vitro studies have shown with reasonable dosing we can achieve concentrations that have anti-viral activity in cells. In theory you kill the virus, the patient gets better. In vivo using primate models and other viruses, like chikungunya, chloroquine does not result in improved clinical outcomes. So why would we use it? Because we don't have anything else and if used (and measured ie RCT) in the right way we may know in the next few weeks whether it helps humans with COVID.

      Don't know about the vaccine. Don't know why you would think an ED doc might know about the inner workings of CSL, Roche and such. A vaccine, whilst being a handy get out of jail card if effective, is a massive cash-cow. Even if the company only made $1 profit per vaccine, that will be $6-7 billion profit next financial year. The companies developing vaccines are not going to go around telling everyone how they are doing it.

      Boosting the immune system may be beneficial, may actually be harmful. If you put the general comment in a box (how do you measure the activity of the immune system? How do you know if what you are saying does indeed 'boost' it) the same unknowns apply to drug therapy like above. My interpretation is that people are not dying from the amount of COVID in their system, which by the way is probably unmeasurable. They are dying in the second week of illness when the immune system realises shit has hit the fan and overreacts, resulting in ARDS. So if you 'boost' your immune system it may just bite you in the arse. That's probably why kids aren't really getting sick. They have a much more immature immune system and it sees COVID, acknowledges it is something to be avoided and makes a determination not to allow it in again. In contrary to the adult immune system it accepts it as a temporary visitor for now, but changes the lock when it's gone. The adult system gets the shotgun out and starts trying to blast the shit out of COVID all through the house (lungs) effectively doing more damage than just quietly ushering it out the door.

      When it comes back to what we do know, the 3 things you listed are key. Don't get it (wash hands, don't touch face) and don't give it to anyone else (social isolation) and everyone will be ok. Yes it's common sense, everyone already knows this. But how many people are actually doing it?

  • leiiv on 22/03/2020 - 11:04

    How are the patients suspected/confirmed with covid-19 treated here? Please explain in great details the treatment for each of different severities.

    • paraneoplastic on 22/03/2020 - 13:03
      +3

      80% will only ever have mild symptoms - these patients can self isolate for 14 days and they will recover with out a problem, dpending on the centre who confirms the diagnosis some may require a follow up swab to ensure you're no longer shedding the virus.

      20% will require hospitalization, these are patients with chronic medical conditions (particularly those affecting the heart and lungs, as well as the kidneys to a lesser extent). The varies from IV fluids + monitoring to full blown intubation and ventilation (mechanical breathing)

  • neonlight on 22/03/2020 - 11:09
    +9

    Self isolation does not work in this country.

    It should be enforced. Kept track of you with GPS like what Singapore and China has been doing. It needs to be policed and we are two months late

    Doing it here in Aus people will sue for human rights how great

    • lachhelix on 22/03/2020 - 12:59
      +1

      I agree. A lot of people don't seem to take it seriously - 'just popping out for lunch with the boys'

      • stalker878 on 22/03/2020 - 13:25
        +1

        i think its because australia did not have much fallout from SARS in the first instance - thus no fear..

  • ilikecheap on 22/03/2020 - 11:10
    +1

    Should a cashier wear a mask and gloves? E.g employees at Coles or Woolworth.

    • nfr on 22/03/2020 - 11:29
      +1

      There are no masks available anyway. This is expected to last at least 6 months, so that's at least 180 masks per person.

    • cheaplee on 22/03/2020 - 11:49
      +2

      The issues with general public use of PPE is two-fold.

      Firstly supply issues. For the past x years Australia has on average used y amount of masks, gloves, etc. All the supply chain is geared towards keeping inventory low and stock turnover high. Now we need y times 10 amount of PPE, but the last shipment from China was delayed and the local inventory has been kept low for so many years…you get the point.

      Second issue is improper use. It is so easy to make a mistake with PPE that renders it useless. Especially when said cashier is likely to be standing in the one spot for 3-4hrs at a time and will probably want a sip of their accompanying water bottle during that time…

      Ultimately it is a use of precious resources to protect 1 cashier when the same qty of resources could have been used by 1 nurse to provide clinical care to 10+ patients who are sick with COVID. I know the cashier wants to protect themselves, not spread it, etc. But bang for buck the nurse needs the masks and gloves.

    • hypie on 22/03/2020 - 12:58
      +2

      Healthy individuals should not wear masks. We already have limited stock for health care professionals. I don't see a problem or clear benefit with wearing gloves though.

      • ilikecheap on 22/03/2020 - 14:33
        +1

        What if they have their own masks its what I meant.

        • cheaplee on 22/03/2020 - 14:49
          +2

          If you already have a box of masks at home then chances are they will never make it to those who really need it, frontline healthcare workers.

          Best use in that case would be to give them out to people you know who are most vulnerable. Tell them to put a new one on every time they leave the house. Don't touch it, take it off or touch your face while you are out. Do what you need to quickly (food shopping) then go back home. Wash your hands well, take mask off taking care not to touch outside of mask, dispose of carefully, wash hands again before touching anything else.

          Better yet call your local GP practice and ask if they could make better use of them then you.

      • TEER3X on 22/03/2020 - 14:35
        +4

        Everyone should wear a mask, but there's just not enough to go around, hence healthcare workers should be the number 1 priority

  • random101 on 22/03/2020 - 11:16
    +1

    Stop public transport!

  • rehan770 on 22/03/2020 - 11:29

    I have bit of runny nose, I think I had too much white wine past 2 days. Now I'm worried about the cold, will it affect or transfer it to covid. Plz help

    • paraneoplastic on 22/03/2020 - 13:00

      i think you forgot the

      /s

      if you're being serious, a cold is a colloquial term for a bunch of respiratory viruses which are not influenza. In theory, if you do have a 'cold' it would make you more susceptible to getting another infection, whether it be covid19 or otherwise. However you still need to come into contact with the virus…

  • Gersman on 22/03/2020 - 11:42

    Has anyone got knowledge of any autopsy findings that have been done on the Covid-19 deaths.
    What does it do and is there any thing other than what has been discussed already on here that people can do.

  • sintro on 22/03/2020 - 13:47

    Have you looked into the high does vitamin C protocol for prevention and treatment for COVID-19?

    Expert consensus on comprehensive treatment of coronavirus disease in Shanghai 2019 https://translate.googleusercontent.com/translate_c?depth=2&… See point 6 on Vitamin C

    Hospital treatment of COVID-19 with high-dose Vit C (in Shanghai)
    https://www.youtube.com/watch?v=54D62zap67c

    • TEER3X on 22/03/2020 - 14:42

      Interesting, but at that dosage it would send me running to the toilet

  • Captain M on 22/03/2020 - 13:50

    Is it ok to go out on bike rides on the bike path with kids? Its hard staying indoor all the time.

    • cheaplee on 22/03/2020 - 14:16
      +1

      I'm debating the same question myself. Strict social policy would say no.

      You may be do it well, turn around if you see someone, don't touch anything but your own bikes, etc but just like we are seeing with self isolation other people will not follow the rules. Therefore as a public message it would be hard to endorse anything that involves leaving the house/home property.

      In theory though if you guys made sure to avoid all interaction with other people and objects it should be ok. The problem then becomes if everyone around you with kids has the same idea how feasible is it to avoid everyone else? The only place this is done now in normal life is at home where we effectively avoid everyone who doesn't live in that house.

      Also bear in mind that you technically should not come within 1m of anything that could harbour and transmit a fomite just in case one of you is infectious. You produce droplet by breathing and talking, not just coughing and sneezing. That includes not riding close to car door handles, bus stops/public benches, letterboxes, etc.

      The more you think about it the more you realise why the advice will always be don't leave your house

      • trapper on 22/03/2020 - 14:31
        +1

        The thing is at an individual level you are very-very unlikely to contract the virus doing these kind of things.

        But millions of people doing similar things and it will continue to spread with no end.

    • randombrick on 22/03/2020 - 23:28

      Its hard staying indoor

      This is very true especially when it involves younger kids. There are only so many games that you can invent.

      My house backs out on to a trail so in theory I could get to the playground and back without a lot of interaction. However, the kids or I could leave behind (or pick up) the virus on the play equipment. Wonder if the rules will be this granular - leaving up to common sense may not be effective.

      We are going to see a lot of mental health implications on the other side of this. Not to mention the strain a lockdown will put on relationships.

  • picket23 on 22/03/2020 - 14:31
    +1

    Do you agree with the current criteria for receiving a COVID19 swab test?

    • paraneoplastic on 22/03/2020 - 14:33
      +1

      It's ever evolving, it literally changes every single day.

      However, it seems the constant is:
      - Travel withini last 14 days internationally and you have respiraotry symtoms +/- fever
      - Came into contact with a known COVID19 case and you have respiratory symptoms +/- fever

      • For healthcare workers, the line is very blurred and i think the criteria will change soon.
      • picket23 on 22/03/2020 - 15:45
        +1

        It doesn't seem to have changed at all for weeks.

        "Travel within last 14 days internationally and you have respiraotry symtoms +/- fever
        - Came into contact with a known COVID19 case and you have respiratory symptoms +/- fever"

        Same as it's been for ages…

        Seems to me like the criteria is way behind where we're at with community transmission. Agree or disagree?

        I'm currently sick with a cough. I work with 100s of international travellers entering the country everyday. I can't get tested. Is there a shortage of test kits? Manpower?

        • paraneoplastic on 22/03/2020 - 18:02
          +2

          scarcity of test kits, and if you're a fit and healthy person, 14 days isolation would be the treatment anyway :/

          My guess is the criteria will change soon (at least in QLD - where i am getting my info from)

          It's going to get really tuff when this years flu kicks in as well, as the symptoms are pretty similar.

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