[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

    • inamotoichiban on 24/03/2020 - 09:21
      +3

      All great points, but also remember that the most important thing is to stay at home, even if you are well.

      stayhome

  • HenryF001 on 24/03/2020 - 01:30

    My colleague’s husband just shake hands with someone returned from Vietnam and doing self isolating today. My boss still told her to come to work tomorrow. What should I do?

    • cheaplee on 24/03/2020 - 08:06

      You or your colleague's husband?

    • inamotoichiban on 24/03/2020 - 10:13

      While it may seem unlikely that your colleague has caught COVID-19, there is no guarantee that it isn't possible.

      There are so many factors that contribute to this
      First of all, do you know if your colleague's husband washed his hands thoroughly straight after shaking hands? Or did he go on to eat something, touch his face or physically touch your colleague.
      Second of all, how long did your colleague's husband spend with this person? Were they in close proximity?

      I would hazard a guess to say that you would not know the answers to these questions, and that perhaps your colleague would not even know.
      That is why it is so important to practice good hand hygiene and social distancing.

      The safest thing to do would be for her to stay at home. Is there a capacity in your workplace where you can work from home?

  • JavaTheDog on 24/03/2020 - 07:58

    Hey. How do you think about wearing face masks? In China, South Korea or Japan, face masks are recommended to wear. They are doing pretty well controlling COVID-19. Do you reckon we should also wear masks when going to the public?

    • cheaplee on 24/03/2020 - 08:09
      +4

      In theory if used properly by everyone simple surgical masks would reduce the community spread. In reality they will not be used properly, only have a minimal impact on community spread and then when we run out of masks in Australia the transmission to frontline healthcare workers will skyrocket and more people will die.

      If supply was not an issue then yes it would make sense for everyone to use properly when out.

  • Hangryuman on 24/03/2020 - 09:54

    OK - thanks doc for offering your help here ! my questions if I may -

    first - criteria for testing ? since yesterday I have had the beginnings of a sore throat, and shortness of breath, but no general weakness, fever or joint pains yet. What key symptoms would they be looking for before testing (so as to not run out of limited test kits, etc.) ?

    second - I'm over 65 and on low dose 4mg/day candesartan to reduce my blood pressure to reduce the risk of AAA due to born-with enlarged aorta - I've read this drug might be associated with higher morbidity - should I stop taking it ?

    third - living as a couple and sharing everything with my partner it's most likely we'd both get this (she had a sore throat before me) - so what's our best action if we suspect we have it coming - garlic and chicken soup ?

    • luffyex2010 on 24/03/2020 - 10:23

      …sir you might want to have a check for your own life and family.

    • Chridim on 24/03/2020 - 11:47

      Op states that does not offer direct medical advice, you should call the help line.

    • paraneoplastic on 24/03/2020 - 14:35
      +1

      Go to your GP mate

      Don't stop taking your meds without getting a consultation first (the school of thought is that there is a covid19 strain which can cause kidney problems - not going to elaborate further)

      The last study i saw out of china 86% had a dry cough, ~50% had a fever, ~15% sore throat.

      Remember, this could just be the start of a common cold (viruses other than influenza) or the flu itself - don't panic.

  • northern nsw on 24/03/2020 - 11:49
    +1

    Hi doc, is it true that NSW public hospitals are continuing to undertake elective surgeries, and using up valuable PPEs uneccessarily, that will be needed by theatre staff in the next few weeks? If so, what on earth, surely knee and hip replacements can wait, FMD!!!
    I've heard that most doctors in Italy that contacted COVID-19 have died?

  • [Deactivated] on 24/03/2020 - 11:51
    -1

    check PMs for personal questions

  • J6 on 24/03/2020 - 16:55

    It seems there are several doctors on this thread now as they have answers to everyone's questions.

  • gomelbcityfc on 24/03/2020 - 19:00

    I cant believe people saying China etc “fudging” figures, and ignoring the fact that aust is only testing a fraction of Suspected cases. It seems we are fudging figures too. If we tested every sick person the number of cases in australia may be double or even triple.

    Just heard WHO D-G Dr Tedros say “we must test for every suspected case”.

    • paraneoplastic on 24/03/2020 - 20:39

      Then we'd run out of swabs in a day or 2.

      The testing criteria is specifically set out to test the most probable cases (though even i must admit, the previous criteria of testing anyone who had travelled overseas in 14 days with resp symptoms was waaaaay to generalized)

    • fusion17 on 25/03/2020 - 00:01

      ..what kind of logic is that. There is a major difference.

      We aren't fudging figures, and most certainly not deaths. You can find the stats on how many people we've tested very easily.
      No one is saying it's adequate, but right now it's the best we can do. You know tests aren't readily available or easily manufactured right? There is a world shortage, just like with masks and anything else used in the fight against the virus.

      And using WHO as an example is hilarious.

      Let's not forget they along with the CCP were totally against us banning the Chinese students and tourists when we belatedly did. They also continued to underplay this pandemic for as long as it suited them. Now they along with the CCP continually praise how well china managed it and helped the world. (profanity) congrats.

      If scomo is a Muppet then I don't even know what to call "dr Theodros" and the rest of the WHO clowns.

  • User5755 on 25/03/2020 - 00:13

    Is there a cardiac icu?
    Will I get to be in icu if I’m 38 and have existing cardiac issues or would I not make the cut?
    Can dr friends make a difference to my chances of icu?

    • trapper on 25/03/2020 - 11:13

      If you are high risk you should not be taking any chances in the first place. Do not leave your house.

      • User5755 on 25/03/2020 - 23:43
        +2

        I am home with kids and only taking food deliveries not even going to the supermarket.

        • trapper on 26/03/2020 - 11:05

          Good to hear, stay safe.

    • cheaplee on 26/03/2020 - 07:16

      There is kind of a cardiac ICU depending on your hospital.

      Depends how full the ICU is when you get sick. If it is full of 30-35 year olds without medical conditions, I'm afraid you will be out of luck.

      Unless your Dr friend actually runs the ICU and is willing to sacrifice their career to get you in, no it won't make a difference.

  • voteoften on 25/03/2020 - 02:46

    What do you think the feasibility of establishing a program. Whereby healthy adult volunteers deliberately get infected under clinical conditions with a low innoculum load to create a group of people who can make antibodies then return to work or helping others. I'd assume recovery would be done at isolated locations, such as resorts or cruise ships. This would hopefully ensure the economy is not completely destroyed abd could possibly save millions of lives worldwide. Thanks

    • TEER3X on 26/03/2020 - 17:05

      I'm not answering this as I'm not a doctor but someone posted on Reddit about grabbing serum (or plasma) from those that recovered and injecting into those that need treatment

      see: https://www.nature.com/articles/d41586-020-00895-8

      Would love to hear what the good doctor thinks about that.

  • hongco1990 on 25/03/2020 - 04:28

    Hi Doc,
    Thanks for starting this AMA. A few questions

    1. Is there a false negative with Covid test? I was told by my NUM early this month that there is no false reading. However, just came to know that a patient needs a repeated Covid 19 swab as their first result was negative. So does this mean a false negative might exist? Or to exclude human error when collecting the swab?

    2. Say if someone is positive and having mild symptoms, they undergo the 14-day self isolation. After this 14-day period, do they need to get tested again? I know in countries such as Vietnam they do get tested until the result is negative then they will get released from the isolation centre. If we don't do another swab post 14 days, how do we know they are cleared?

    3. When reading results from my patients, which were all "not detected", the comment section said "This test is not validated to current NPAAC requirements due to the immediate threat to public health. Results should be interpreted accordingly". What does this mean?

    Thanks

    • inamotoichiban on 26/03/2020 - 07:38
      +1

      For most tests we do have false negatives, and the same applies to the covid swab as well.

      I believe that people who are positive do get swabbed later on, and are only cleared to go outside once they return 2 negative swabs spaces more than 24 hours apart.

      I don’t know the answer to your last question, but I’m guessing it’s something to do with the fact that the test has been rushed in, and has not been formally validated through the processes that other tests normally go through.

    • cheaplee on 26/03/2020 - 23:23

      I can't give you the technical answer for 3, but my basic understanding is it means some smart f***er built a test really quickly and they haven't had time to put it through the proper application process that shows it's reliable, accurate, repeatable, etc.

      It's a get out of jail free card for the government is something doesn't quite go right. Like if they run for 2 mins too long on the machine and all come back negative. We might not know that is an issue because we haven't done the required quality control.

      Your result is saying 'It's probably negative, but if it's actually a false-negative and bad things happen, we told you not to believe the results, it's on you…'

      They have similar clauses on all the assays that are developed in house before they undergo the right process (application + fee I'm sure) to become accredited.

  • luffyex2010 on 25/03/2020 - 17:28

    The Science behind Corona Virus

    This doctor/guy is worth $6.4b

    • ozhunter on 25/03/2020 - 18:26

      This doctor/guy is worth $6.4b

      Should that make me believe him more?

      • luffyex2010 on 25/03/2020 - 18:47

        Pretty good presentation, compared to what we have from our health experts.

  • jdawgz on 26/03/2020 - 00:04

    Will there be enough flu vaccines for everyone? Have chemists and pharmacies started to sell out of these? I have elderly grandparents (in their 90's) and not sure if I want to risk taking them out to get this done. What would your advice be?

    • Pineapples on 26/03/2020 - 16:58
      +1

      GP here. I'm torn about this. On the one hand, people don't want to come out to get the flu shot. On the other hand, mass hysteria! We haven't received our Government supply yet - expecting in about 3 weeks (rural centre). As from whether you take your grandparents out, there isn't a correct answer. Depending on where you live, you might be able to find a quiet pharmacy that's doing them. Otherwise, from your GP/ GP nurse. The main goal with the shot is that the Flu kills people, but also getting corona and the flu, esp if you're 90, is more likely to be deadly.

      • jdawgz on 26/03/2020 - 19:01

        Thank you for your reply. Now that GP practices are live for telehealth consultations, would you say that the a GP medical practice would "technically" be a safer place given that you won't be coming in face to face contact with as many patients and less traffic?

        • Pineapples on 27/03/2020 - 17:31
          +1

          Our practice has been quite assertive in our approach to keeping sick people out for a few weeks. Anyone with respiratory symptoms automatically gets isolated before getting to the main foyer, and seen by a designated doctor who is no longer working at our more vulnerable sites (local rural hospital, nursing homes) to avoid the spread. We've done unpaid phone consults since before there was funding for it because we knew it was important and HealthDirect unfortunately can't seem to deal with the influx (Ive heard of people waiting over three hours on hold). We've limited our waiting room seating so people aren't so close to each other, and cleaning it all ever hour as a minimum.

          Most of our patients are quite considerate - that being said - people still just turn up (even though we have never done walk in appointments, and the community still generally know that) and walk straight past the warnings to reception.

          It's really difficult to do an accurate assessment on the phone, particularly for kids, the elderly and people with other health problems (heart failure is difficult to distinguish from COPD without physically reviewing a patient). We don't have webcams plus plenty of my patients can hardly make a call from a mobile, let alone a telehealth consultation. It works well for the 20 year old with a cold and for people who just need scripts etc.

          I think we've struck a decent balance for in terms of keeping our patients and staff safe. I've heard of other GP surgeries flat out refusing to see anyone with a respiratory illness and sending them to hospital. And other surgeries who just aren't doing enough.

          So to answer your question in a round about way - "it depends."

          I'd say we have better control of the flow of our patients compared to an ED and less crowding. Of course an ED has better facilities than us (particularly rapid access to imaging and pathology). It's not just about the number of patients coming through, but also the systems in place. We will never be able to safely see everyone on the phone, or even webcam.

          If in doubt, call your GP. If you don't have one, get one (and a decent one, not a sh*t one that makes the rest of us look bad, even if you have to pay for it). That includes young, healthy people

          Alot of spread is going to happen between asymptomatic people, and the current government isolation guidelines won't be cutting it soon (or now), so you're arguably safer in a practice with good hygeine and social distancing, than you are being in a crowded Coles (even if they now refuse to pack your bags for you…)

  • jjj123 on 26/03/2020 - 18:38
    +1

    Hi Doctor, i have a 3 months old baby, my wife insist to walk the baby in the community/suburb street to get the son and to see bird, she said it is OK and baby loves it,I am just worried about this at work, am i incorrect?

    • cheaplee on 26/03/2020 - 23:24
      +1

      I can't understand what you want to do, when, with whom or how work is involved. It's probably best just to stay inside with a 3 month old baby

    • John Kimble on 31/03/2020 - 22:59

      Staying home is probably the best/safest option, but if she must go out, then she just needs to ensure she stays away from other people I suppose?

    • trapper on 01/04/2020 - 11:32

      If she is careful to not go anywhere near other people or touch anything then there is very little risk if any.

      If she is blase about though, it I would be more cautious.

    • Will Mcdonald on 02/04/2020 - 01:04

      call the GP hotline for a proper response, billed to medicare anyway.

  • mathew42 on 28/03/2020 - 11:27
    +1

    Coronavirus: As a young doctor in ICU, this is what scares me the most is worth a read.

    We are being trained in the best way of providing care to patients with COVID-19, and we are also being taught how to protect ourselves. If the protective equipment we use (masks, gowns, gloves etc) runs out, we've been told to protect our most valuable resource - healthcare staff.

    That means we don't provide medical care unless we are protected. We don't do CPR unless we are protected. We would essentially watch people die until we get proper protective equipment. It's a chilling reality that I hope we never reach.

    Interesting. My local clinic was given 10 masks for 15 GPs and cannot obtain more masks yet are still expected to treat patients. Currently they are re-using masks when treating those with respiratory illness symptoms, exposing them to risk from asymptomatic patients.

    • [Deactivated] on 01/04/2020 - 11:48
      -1

      A faraday cage to absolutely contain energy is an impossibility. As the Corona virus is simply another form of energy at the chemical level, wearing any sort of personal protective gear to either stop this energy entering or exiting a persons body is an impossibility.

      The correct way to treat anyone suffering from exposure this kind of energy is to place them outside in the fresh air. Only fresh air can cleanse the lungs of toxic parasites. Only fresh air has the capability to disperse toxic respiratory parasites so other people will also not fall ill…

  • 123456K on 01/04/2020 - 22:40

    Hi, I understand the importance of staying home but what do you think about partners who live apart but visiting each other's place say on the weekends? Only staying inside the house, not going anywhere else.

  • Will Mcdonald on 02/04/2020 - 01:02

    Just had a quick skim through the comments, there has been in the past a 'AMA Doctor' who claimed they were a doctor, ending up admitting they were not a doctor. But a student studying some form of health and medical related field. I agree with the self isolation, that is a key point above everything. Once all the Corona cases are isolated and treated. We can return to a normal way of life within Australia, except with strict closed borders. A case study people should look at is Singapore, a very small crowded country. As the AMA said, isolation is the key. Also stop hoarding, we produce 4 times the amount of produce we consume. Once this recession is over there will be a ton of excess supplies we can't sell and less demand for manufacturing and business to restart.

  • freespirit on 04/04/2020 - 10:48

    Firstly, thanks for making yourself available to answer our questions. In regards to blood groups, can you please confirm or dismiss whether people with A type blood group are at greater risk of contracting Corona Virus. Thank you.

  • [Deactivated] on 05/04/2020 - 14:50
    -3

    Whole thing is a con, 99% old people dying who would of died with a flu anyway, average age 80 in Italy, 10 million world wide a year die from cancer, 18m from heart disease. Let's ruin the economy and everyone's lives over a flu.

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