Coronavirus COVID-19 updated 22 March 2020

Coronaviruses (CoV) are a large family of viruses, they are transmitted between animals and people. A novel coronavirus (nCoV) is a new strain that has not been previously identified in humans. Because it is novel, people do not have immunity against it, and there are no vaccine available yet.

We have yet to determine the source of the outbreak, and we haven not identified an animal source, investigations are ongoing. Preliminary investigations identified environment samples positive for COVID-19 in Huanan Seafood Wholesale Market in Wuhan City, although some early patients did not report visiting this market.

We have now confirmed this virus can be transmitted human-to-human, therefore precautions are now being taken by public health around the world in order to prevent further spread of COVID-19.

Common symptoms of COVID-19 infection include fever, cough, fatigue, and shortness of breath. Less common symptoms include sore throat, vomiting and diarrhoea.

In more severe cases, infection can cause pneumonia, severe acute respiratory syndrome, kidney failure and even death.

Most people who catch the virus don’t die but rather they make a full recovery though some are very sick for a while. Those with pre-existing medical conditions such as heart disease, diabetes, asthma/respiratory conditions, hypertension, cancer, are at increased risk.

Death rate (the risk of dying if infected with covid-19) is affected by age. Luckily children appears to not be affected as much as other respiratory viruses. Elderly are much worse off. Simple advice like if you are sick, do not visit your grandparents.

We do not yet know exactly how COVID-19 spreads. It is thought to be transmitted most readily by respiratory droplets (droplet spread) produced when an infected person coughs or sneezes. Droplet spread can happen when droplets of an infected person are propelled a short distance (generally up to 3 feet) through the air and deposited on the mucous membranes of the mouth, nose, or eyes of persons who are nearby.

The virus also can spread when a person touches a surface or object contaminated with infectious droplets and then touches his or her mouth, nose, or eye(s).

We do not yet know if it might be spread more broadly through the air (airborne spread) or by other ways that are not now known.

A case is considered as potentially infectious 48 hours prior to developing symptoms, while symptomatic and until symptom-free for 48 hours.

It is thought that the incubation period, the time after exposure to the time symptoms appear, maybe as few as 1 day, or as long as 14 days. (Commonly 3-7 days)

Avoid handshakes, hungs, and hongis!

Follow these general principles to help prevent the spread of viruses. For more details visit Healthnavigator “How to avoid catching and spreading COVID-19 (novel coronavirus)”.

• Wash your hands often with soap & water for at least 20 seconds. Use an alcohol-based hand sanitiser that contains at least 60% alcohol if soap and water are not available. This is particularly important after taking public transport.
• Cover coughs or sneezes with a tissue, then throw the tissue in a bin.
• Masks are not recommended for most people, however for those who are sick wearing a face mask will reduce the spread of infection to other people.
• Wipe down surfaces regularly. Covid-19 is killed by bleach, alcohol and hydrogen peroxide. Diluted household bleach is the most commonly available and affordable option. Common antiseptic wipes may not kill Covid-19.
• Staying home if you are unwell.
• Avoid close contact with people who are sick, this is particularly important for those who are immunocompromised, babies and the elderly.
• If we have serious outbreak in NZ, we would suggest avoiding large crowds but that is a difficult thing to ask.

See WHO advice on protecting yourself and others from getting sick.

A close contact are those:

• living in the same household.
• Face-to-face within one meter for more than 15 minutes.
• A person who spent 2 hours or longer in the same room such as a general practice or Emergency waiting room.
• Seated within 2 rows either side on a flight, bus or train for 2 hours or longer.
• Direct contact with body fluids or lab specimens, or in the same room when an aerosol generating procedure in undertaken without appropriate personal protective equipment (PPE).

A case is considered as potentially infectious 48 hours prior to developing symptoms, while symptomatic and until symptom-free for 24 hours.

Self-isolation means staying home and avoiding situations where you could infect other people. This means all situations where you may come in contact with others, such as social gatherings, work, school, child care/pre-school centres, university, faith-based gatherings, aged care and healthcare facilities, prisons, sports gatherings, supermarkets, restaurants, shopping malls, using public transport, and all public gatherings.

All travellers who leave from, or via mainland China, Iran, Italy or Republic of Korea, or if you have been in close contact to a case, are required to self-isolate for 14 days. See Ministry of Health for more info. If you are unsure if you should be self-isolating, please contact Healthline’s dedicated coronavirus line for free on 0800 358 5453.

PLEASE DO NOT COME INTO OUR CLINIC DIRECTLY. 

There is currently no specific antiviral treatment available. Most people infected will develop viral symptoms and self care recommended include plenty of rest and fluids, with simple analgesia such as paracetamol as required.

Antibiotics do not work against viruses, only bacteria. COVID-19 is a virus and, therefore, antibiotics should not be used as a means of prevention or treatment. However, if you are hospitalized for COVID-19, you may receive antibiotics because bacterial co-infection is possible.

• Does the new coronavirus affect older people only? No, people of all ages can be infected. Older people and those with pre-existing medical conditions such as asthma, diabetes, heart disease appear to be more vulnerable to becoming severely ill.  
• Are antibiotics effective in preventing and treating the new coronavirus? No, antibiotics do not work against viruses, only bacteria.
• What medicine or supplements should I take? To date there is no specific medicine or supplement recommended to prevent or treat the new coronavirus.

For more visit WHO myth busters

Coronovirus, like colds & flus, is believed to be spread mostly by respiratory droplets produced by coughing & sneezing, and talking. Masks are not recommended for those who are well. If you are unwell, wearing a simple surgical mask will act as a barrier to reduce these droplets from reaching those around you. Our receptionist will ask you to wear a mask if you are unwell, and we ask that you keep this on during your entire visit to our clinic.

Respirators maybe worn by health professionals. Respirators differs from masks in that they seal tight to the face of the wearer. If worn correctly respirators filter particles from the air and protects healthcare workers from exposure to biological aerosols including viruses and bacteria. N95 is a common type used by doctors. In the US, the National Institute for Occupational Safety and Health (NIOSH) testing standards means N95 filters at least 95% of airborne particles. The European Norms (EN) are not directly comparable as they use different test protocols. The EN requires 94% efficiencies for class P2 (FFP2), and 99% for class P3 (FFP3) respirators.

Medical workers are required to wear PPE gear to protect themselves, this includes a mask/respirator, googles, gloves and gown. We need to stay well to continue to look after others. Thank you for your understanding and cooperation at this difficult time.

• NO. COVID-19 is a coronavirus that is new to humans, meaning no one has any immunity and everyone is susceptible to catching it.
• There is a vaccine for influenza (commonly known as flu), there is no vaccine for COVID-19.
• The death rate for influenza is 0.1%, the latest estimates by WHO World Health Organisation is around 3.4% death rate for COVID-19.
• Fatality rate increases with age, for those age 80 or above, fatality rate is around 15%. i.e. around 1 in 7 will die.
• Around 80% infected with COVID-19 will be asymptomatic or have mild symptoms only, 15% will have severe symptoms requiring hospitalisation and oxygen therapy, 5% will be critical requiring ventilation.
• This means that even if just 10% of the NZ population catches COVID-19, that is 450 000 sick people. Say 10% need admission to hospital for oxygen we will need an extra 45 000 hospital beds. 22 500 people will need to be ventilated. Even if just 1% need ICU we will need an extra 4500 ICU bed.
• Situation gets worse if medical workers become exposed, require self-isolation and become unwell. Not only are there less medical staff, they become patients themselves requiring care, thereby creating a double whammy to the health system.

So please if you are unwell with fever, cough, fatigue/malaise, sore throat, shortness of breath, or other flu-like symptoms. Please stay home, take time off work and avoid public places and gatherings. DO NOT come into the clinic directly as you will pass your illness to other vulnerable patients in the clinic. Please ring us first on 09-579 6147 or call Healthline coronavirus line on 0800 358 5453.

Social distancing measures are a way to stop or slow down the spread of highly contagious disease. We recommends the general public start implementing social distancing measures in their daily lives now to slow the spread of the virus and protect themselves and their families and co-workers. Everyone need to keep at least 1 meter distance between yourself and anyone who is unwell, coughing or sneezing. Avoid handshakes. We know our hands carry a lot of germs on them. Changing to another method of greeting is encouraged and recommended

If someone is sick, even if it is just a mild viral cold, it is critically important they stay home. The general rule is one should stay home for at least one week, AND at least 48 hours after symptoms have resolved. For example if you have a cough for 3 days, you should stay home for one week, if you are sick for 7 days you can go back to work 48 hours after 

Social distancing measures that will be deployed by public health may include:

• Closing schools, universities and child care centers
• Avoiding malls; theaters; grocery stores; or anywhere with large crowds, such as concerts or festivals
• Suspending services at houses of worship
• Encouraging people to work from home
• Avoiding the use of public transportation

We are receiving a lot of calls about medications. 

Extra supplies of medication: we can not write prescriptions for supplies for longer than the normal 3 month maximum (of 6 months for the oral contraceptive pill). If everyone got more medication then normal then the country would quickly run out.

Experimental medications: We are not writing prescriptions for experimental medications like hydroxychloroquine. These medications have significant risks and are currently experimental. If you are COVID-19 positive and very unwell in hospital then you may be offered this by the hospital specialist, but not by us. The medical council have instructed all doctors to refuse requests from patients for this drug.

ACE inhibitors (e.g. cilazapril, lisinopril, quinapril, etc): The position statements from all medical bodies all are saying to NOT STOP your ace inhibitor. If you are unwell then we may advise you stop. However please continue if you are well. Click here for more information. If you want more reassurance, here is a study showing no difference in morbidity (unwellness) or mortality.

NSAIDs / anti-inflammatories (e.g. ibuprofen): The New Zealand Director-General of health has dispelled the theoretical concerns about using these medications. As always please avoid or heavily limit use if you are over 65, if you have heart disease, if you have kidney disease, if you are allergic, or if have had previous stomach upset from it. Normally we advise you try paracetamol first, and this recommendation hasn’t changed.

Masks: We are not a mask distributor and have very limited supplies. Please do not ask us for masks.