Apart From The World Havoc How Do You Get Infected With Covid-19?

Apart From The World Havoc How Do You Get Infected With Covid-19?

Hundreds of flights have been cancelled.

Tourists are stranded, quarantined in their hotels. World stock markets are in freefall, and there are reports of desperate shoppers stockpiling crates of supplies – from nappies to medicines to toilet roll.

Sales of surgical spirit have surged and Boots announced it has sold out of anti-bacterial hand gel. There’s even talk of cancelling – not just postponing – the Olympics.

It’s hard not to feel a sense of impending doom when reading about the coronavirus infection, known as Covid-19, sweeping the globe. At the time of writing, it has killed more than 2,900 and infected in excess of 85,000 people in 47 countries.

The majority of infections and deaths are in the Hubei province of China, where the virus emerged. But in Italy, nearly 5,000 miles from the source, cases have surged, forcing some northern towns – home to 55,000 people – into lockdown.

Twelve Italians have died so far, and on Friday the first British fatality, a passenger aboard the Diamond Princess cruise liner quarantined in Japan, was reported.

In the UK, of the nearly 8,000 who have been tested for the virus, 20 have been diagnosed, and there have been no deaths.

Plans are in place to close schools, disrupt our public transport system and postpone major sports events should the situation change. But for now, experts are urging the public to prepare and take measures to help prevent the spread of illness.

The world wants to know what to do about it and so – from risks to the elderly or ill and how to self-quarantine, to what ordinary people can do to protect themselves – we asked some of the world’s leading experts for answers to the big coronavirus questions.

How do you catch this virus?

Covid-19 seems to spread much like flu, through coughs and sneezes. Once contracted, it lives and replicates in the tissues that line the airways. Secretions from these tissues – mucus and saliva – therefore also contain the virus. When an infected person coughs, sneezes, or simply talks, tiny droplets of moisture are expelled into the air, carrying the virus out of the body. Unless you are directly in the firing line, you should be safe. Droplets travel only up to 7ft.

But another risk comes when people cover their cough or sneeze with their hand and then touch something other people touch, such as a door knob or tap. Touch a contaminated surface, then touch your own mouth or nose, and the virus can be transmitted.

The World Health Organisation (WHO) says the coronavirus can live on surfaces for several days.

Günter Kampf of the University of Greifswald in Germany says such viruses can be killed by disinfectants such as alcohol or bleach – but many things we touch every day on transport or in public buildings are not frequently disinfected.

If 14 per cent of those infected develop a severe disease and five per cent of them are critically ill, it could be a ‘massive threat’ according to an interview Dr Peter Openshaw, professor of experimental medicine at Imperial College London, gave The Times.

‘It doesn’t present like a common cold and the symptoms can range from completely unapparent to serious disease to going into intensive care.

‘From what we have learnt so far, it seems that virus shedding – the transmission stage from infected persons – is going on relatively early during the course of infection.

‘Tests can quite often become negative but then sometimes go positive again,’ he said.

According to Alistair Miles, head of epidemiological informatics, Wellcome Centre for Human Genetics, we should stop touching our faces.

He told The Times: ‘Stop touching your face. Especially stop touching your eyes, nose or mouth.

‘Wash your hands often, especially before eating or touching food.

‘While a mask seems like a good idea, there isn’t a lot of good evidence that it can reliably prevent infection when worn by the public. But they are useful to put on a sick person to reduce their spreading of the virus.’

He said: ‘It looks unlikely this will be over quickly. It may be with us into next year and might eventually become a seasonal infection, returning each winter.’

Could I die if I get it?

It depends to some extent on how old you are. Covid-19 barely even causes symptoms in children, even babies, and in China is not known to have caused any deaths in under-tens. The main concern with children is that if they catch the virus they may pass it on to older at-risk individuals. This is why some headteachers have chosen to close schools, but this is not yet official policy.

According to the most recent data from the China Centre for Disease Control, death rates are 0.2 to 0.4 per cent between the ages of ten and 50, but then start climbing.

You have a 1.3 per cent chance of dying from it in your 50s, a 3.6 per cent risk in your 60s, an eight per cent risk in your 70s, and a 14.8 per cent risk in your 80s.

Risk climbs with age because older people more often have other diseases, such as cancer or conditions such as high blood pressure, diabetes or pulmonary disease, which worsen Covid-19.

Professor Neil Ferguson, on the faculty of medicine at Imperial College London, told The Times: ‘China seems to be suppressing transmission at the moment. In Italy we think there are many thousands of cases distributed across the country. In Iran there are tens of thousands, if not more.

‘We calculated with an enormous amount of uncertainty that one per cent of those infected might die – with a fourfold margin of error in each direction. So a death rate of 0.25 per cent of cases would be similar to the 1957 and 1968 influenza pandemics while a four per cent rate would compare with the 1918 Spanish flu epidemic (with a death toll estimated at 40 million to 50 million).

I have a horrible cold – could it be coronavirus?

Symptoms of Covid-19 are not like those of a cold: it causes a fever, a cough and trouble breathing, not a runny nose or congestion. Most cases appear to be mild.

If it’s mild, could I have the virus and not know it?

The short answer is yes. Although at present only those who have been in contact with people known to be infected or who have been to a high-risk area (a full list of these locations comes later) should ask about being tested.

It takes from two to 14 days after being infected by the virus to show symptoms – the average is five days. Chinese scientists say 80 per cent of all cases are quite mild. Some victims have barely any symptoms at all, so if you get sick you might not realise it’s Covid-19.

Worryingly, it seems to be possible for people to spread it before they start showing symptoms – or even if they never do. Scientists at the Guangdong Centre for Disease Control and Prevention in China found one Covid-19 patient who showed no symptoms but had as much virus in his nose as people who had symptoms.

In Germany, a woman with very mild symptoms – not enough to make her or anyone else suspicious – passed the virus to two people who shared a meeting room with her, who then passed it to two more people before they got symptoms.

During the 2002 outbreak of severe acute respiratory syndrome, or SARS, it was discovered that people were infectious – with a high enough concentration of the virus in their fluids – only after they developed symptoms.

This meant that isolating patients, to stop it spreading, was more straightforward. This time, ‘if people are infectious and spreading the virus before symptoms, then containment becomes much more difficult,’ warns Caroline Buckee of Harvard Medical School in the US.

There have been these outbreaks before, like SARS, and we got through it. Do we really need to worry now?

Experts have urged the public not to panic – however, people are being advised to stay informed.

SARS infected more than 8,000 people and killed nearly 800 in 29 countries in less than a year.

It went away because it spread poorly among people, and only after symptoms started.

There was also a massive global campaign, led by the WHO, to isolate people who had been exposed.

‘It took a lot of hard work,’ says David Heymann of the London School of Hygiene and Tropical Medicine, who led that campaign at the WHO. ‘And we were lucky.’

SARS never invaded any developing countries which might have had trouble organising the surveillance and isolation required.

This coronavirus spreads more readily, and has already infected more than ten times as many people, on all continents.

But really, don’t more people die each year from falling down stairs than will be killed by coronavirus?

More people do die in a year falling on stairs in the UK – 787 last year – than die of HIV, the virus that causes AIDS, which killed 428. Few would argue that HIV is trivial, or not something to avoid.

At present, it is believed that one per cent of Covid-19 cases die. But this makes it as deadly as the 1918 ‘Spanish’ flu – one of the worst pandemics known, thought to have killed up to 50million worldwide.

Should I wear a mask in public?

No. Studies show they do not really protect you from being infected. Some think it makes you touch your face less, but others report it makes you do it more.

The only reason to wear a mask in public is if you think you are infected – to protect others.

And, regardless, those who suspect they are infected are advised to stay at home and self-isolate (more on this later).

Current advice from Public Health England is to wear one at home if you are caring for a sick person – and if you get sick, to stop you infecting others. The NHS may give you some if they tell you to self-quarantine.

But don’t buy large quantities of masks. There is a global shortage and the close-fitting ‘respirator’ style ones, like N95 or FP2, which are similar to those worn by builders to protect them from toxic fumes, should be saved for the healthcare workers who will really need them.

I think I’ve been exposed, but I feel fine. What should I do?

Do not go to a clinic or the doctor’s without calling first. If you have the virus, you could infect more vulnerable people.

The current official advice is this: if you have visited Hubei province in China in the past 14 days, or Iran, northern Italy and the Daegu and Cheongdo areas of South Korea since February 19, call NHS 111 – even if you do not have symptoms.

You may well be asked to self-isolate for 14 days.

If there is a risk that you may be infected, other family members or close contacts may also need to be contacted and questioned.

You should also contact the NHS on 111 if you have a cough, high temperature or are suffering shortness of breath and have been to other parts of mainland China or South Korea, Hong Kong, Japan, Macau, Malaysia, Singapore, Taiwan or Thailand in the past 14 days, or other parts of northern Italy (anywhere north of Pisa, Florence and Rimini), Cambodia, Laos, Myanmar or Vietnam since February 19.

You should call the helpline if you think you may have been in close contact with someone who is infected. Even if you’ve been to a high-risk area, from what we know so far, if you don’t develop symptoms in 14 days, you don’t have the virus.

This list may change, and the latest advice for England and Wales is on gov.uk.

How do I isolate myself?

Public Health England says stay home for 14 days.

It means not going to work or school – employers and school heads should be informed.

Do not go to public areas such as parks or shops and public transport or use taxis. Avoid having visitors, and ask friends, family or delivery services to get the shopping – and put it down outside, where you can pick it up.

If you share a home with others, and they have not been advised to self-isolate, then stay in a separate, well-ventilated room.

If you share a bathroom, use it after other people, use separate towels – and then clean it.

If you share a kitchen, try not to use it when others do, eat in your room and wear a mask if others are there. Stopping you from infecting others is the one thing a surgical mask is good for. Public Health England advise that if a family returns from somewhere that requires quarantine when they get back, they can stay together and don’t have to be in separate rooms.

Isn’t staying home for two weeks a bit extreme?

Self-isolation for two weeks may be an unpleasant prospect. But it is absolutely vital, aimed at stopping the virus from getting loose and circulating generally, whereupon there will be far more cases, and it will be harder to protect the vulnerable, such as the elderly.

Officials may also try to slow the spread of the virus by cancelling large gatherings and perhaps shutting down schools or transport.

Apparently people with flu symptoms in some areas of the UK are being tested now. Why?

Covid-19 is diagnosed by looking for the virus in samples taken from the nose or mouth. The UK has mostly tested people with risky travel or contact history.

But Public Health England is now working with some hospitals and GP surgeries to test other patients, to see if the virus has already spread more widely.

In eight hospitals, patients in intensive care with severe respiratory infections will be tested.

In 100 GP surgeries, those coming in with milder flu-like symptoms – dry coughs, fever, shortness of breath – will be tested. As of Saturday, two cases had been found.

What can I do to protect myself, and my family, if the virus starts spreading in the UK?

‘Think through how you will look after infected family members while avoiding infection yourself,’ says risk expert Peter Sandman.

‘Maybe get some plastic gloves in the case of caring for someone who is sick – perhaps a few disposable surgical masks to wear, for the same reason. Plan what to do for childcare if you or they are sick,’ he advises.

Possibilities include making arrangements with neighbours or family to care for each other’s children if one or the other is sick – or see whether there are any emergency arrangements being organised in your community.

When you are in public places, wash your hands often with soap, or at least alcohol-based hand cleaner, in case you’ve picked up the virus from some surface.

If you must touch a public surface, don’t touch your face afterwards until you’ve washed.

You can wear gloves, but don’t touch your face with those without taking them off first.

Use a knuckle to push elevator buttons and a tissue to open doors and hold railings. Substitute an elbow bump for a handshake.

Practise not touching your face when you are out in public, says Sandman. It’s hard, he admits, but not a bad skill to acquire.

Sneeze or cough into a tissue (then bin it), or your elbow – as the old saying goes, it’s coughs and sneezes that spread diseases.

I’ve read that there’s no vaccine for this virus. Will a flu jab protect me?

Scientists are racing to come up with a vaccine or an antiviral drug for Covid-19, and some are now being tested, in record time.

But there is currently no specific treatment, as it is an entirely new virus. Realistically, it’s not going to be available until next year.

Coronaviruses are different from flu viruses, so the flu jab won’t offer protection.

However, if you’re in a high-risk group for flu, and are eligible for a jab, it is advisable to have one. You don’t want complications of flu at a time when hospitals may be stretched by Covid-19 patients.

I know people who have recently come back from holiday, and are now ill. Should they be self-quarantining? And if they aren’t, should I call the police or someone else?

It is still flu season – other illnesses can be in circulation. The UK is advising self-quarantine only for people exposed to a known case, or who went to places where they might have encountered the virus. Check online for the current list of such places, and call the NHS, not the police, if you have doubts.

My child’s school has been closed due to children there having come back from a high-risk area. Should we be self-isolating now?

The school closed so you wouldn’t be exposed, and you will not have to self-quarantine.

Is it safe to travel at all right now?

If you’re going somewhere with the same or lower levels of the virus than the UK, there seems little reason not to. In airports, rail terminals or other places where people with the virus may have been, take the precautions mentioned above. Don’t go close to places that have large or suspected outbreaks – this virus can spread fast. Check gov.uk for the latest travel advice.

Dr Carmen Dolea, head of International Health Regulations Secretariat, World Health Organisation, told The Times: ‘Aircraft cabins are absolutely not dangerous and travellers do not need to cancel their plans unless visiting restricted.

‘The International Air Traffic Association (Iata) maintains an up-to-date list on its Travel Centre website.

‘The best thing to do in aircraft cabins is to practise proper hand hygiene with alcohol-based rub or gels, and to use coughing etiquette.

‘Make sure you cough and sneeze into your elbow, use a tissue and throw it in a bin.’

I’ve read that the virus jumps from animal to humans. Could my dog be at risk?

No. The WHO says there is no evidence of any involvement of cats or dogs with this virus.

Last week’s reports about a dog in Hong Kong testing ‘weak positive’ for coronavirus were ‘incredibly irresponsible’, according to Jonathan Ball, Professor of Molecular Virology at the University of Nottingham.

Experts say that the test probably picked up a bit of virus from contamination in the environment, not because the dog was infected.

The coronavirus is thought to have come originally from East Asian fruit bats – so unless you have one of those for a pet, you’re OK.

Even if you do have a bat, it will be fine – the virus doesn’t hurt them.

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