Corona virus (COVID-19) - Frequently asked questions

Source: NSW Health Pandemic What is a pandemic? A pandemic is an epidemic (infectious disease outbreak) that spreads on a global scale. Pandemics usually occur when a new infectious disease emerges that can spread rapidly around the world. The World Health Organization (WHO) declared the outbreak of COVID-19 a pandemic on 11 March 2020. This COVID-19 pandemic is the first caused by a coronavirus. (WHO) What causes pandemics? A pandemic can occur when a new virus emerges and there is worldwide spread of the disease. Most people do not have immunity to a new virus. Viruses that have caused past pandemics usually come from animal viruses that have mutated to affect humans. For a new virus to have pandemic potential it must meet three criteria: humans have little or no pre-existing immunity against the virus the virus causes disease in humans the virus can spread efficiently from person to person. Previous pandemics include Spanish Influenza in 1918 or H1N1 Swine Flu in 2009. Only Type A influenza viruses have been known to cause influenza pandemics. This COVID-19 pandemic is the first caused by a coronavirus. What does it mean that the WHO has declared a pandemic? On 11 March WHO declared COVID-19 a pandemic. The WHO used this declaration to call for urgent and aggressive action. They noted that this is a pandemic that can be controlled. Both China and the Republic of Korea have significantly declining outbreaks. On 30 January, the WHO declared that COVID-19 was a Public Health Emergency of International Concern. In the last two weeks, the number of cases of COVID-19 has increased substantially and the number of affected countries has tripled (WHO). Why do pandemics occur? How serious will the impact be? The health impact of a pandemic on the community depends on how easily the virus can be spread between people (i.e. transmissibility) and the seriousness of the illness it causes (i.e. clinical severity). Healthcare systems can limit the impact on a community by slowing the spread of the infection between people and increasing the ability of the healthcare system to look after people who do get sick. NSW Health is putting a lot of effort into doing both of these things. About COVID-19 What are coronaviruses? Coronaviruses are a large family of viruses. Some coronaviruses cause illness in humans and others cause illness in animals, such as bats, camels, and civets. Human coronaviruses generally cause mild illness, such as the common cold. Rarely, animal coronaviruses can evolve to infect and spread among humans, causing severe diseases such as Severe Acute Respiratory Syndrome (SARS) which emerged in 2002, and Middle East Respiratory Syndrome (MERS) which emerged in 2012. What is the COVID-19 virus? COVID-19 is a new strain of coronavirus that has not been previously identified in humans. It was first identified in Wuhan, Hubei Province, China, where it has caused a large and ongoing outbreak. It has since spread more widely in China. Cases have since been identified in several other countries. The COVID-19 virus is closely related to a bat coronavirus. There is much more to learn about how COVID-19 is spread, its severity, and other features associated with the virus; epidemiological and clinical investigations are ongoing. Outbreaks of new coronavirus infections among people are always a public health concern. The situation is evolving rapidly. How is the virus spread? Human coronaviruses are spread from someone infected with COVID-19 virus to other close contacts with that person through contaminated droplets spread by coughing or sneezing, or by contact with contaminated hands, surfaces or objects. The time between when a person is exposed to the virus and when symptoms first appear is typically 5 to 6 days, although may range from 2 to 14 days. For this reason, people who might have been in contact with a confirmed case are being asked to self-isolate for 14 days. Most COVID-19 cases appear to be spread from people who have symptoms. A small number of people may have been infectious before their symptoms developed. How long does COVID-19 last on surfaces? According to the World Health Organization, it is not certain how long the virus that causes COVID-19 survives on surfaces, but it seems to behave like other coronaviruses. Studies suggest that coronaviruses (including preliminary information on the COVID-19 virus) may persist on surfaces for a few hours or up to several days. This may vary under different conditions (e.g. type of surface, temperature or humidity of the environment). If you think a surface may be infected, clean it with a common household disinfectant to kill the virus and protect yourself and others. Clean your hands with an alcohol-based hand rub or wash them with soap and water. Avoid touching your eyes, mouth, or nose. What are the symptoms? Patients may have fever, cough, runny nose, shortness of breath and other symptoms. In more severe cases, infection can cause pneumonia with severe acute respiratory distress. What is the difference between COVID-19 and the flu? The first symptoms of COVID-19 and influenza (flu) infections are often very similar. They both cause fever and similar respiratory symptoms, which can then range from mild through to severe disease, and sometimes can be fatal. Both viruses are also transmitted in the same way, by coughing or sneezing, or by contact with hands, surfaces or objects contaminated with the virus. As a result, the same public health measures, such as hand hygiene (hand washing), good respiratory etiquette (coughing into your elbow or into a tissue and immediately disposing of the tissue) and good household cleaning are important actions to prevent both infections. The speed of transmission is an important difference between the two viruses. Influenza typically has a shorter incubation period (the time from infection to appearance of symptoms) than COVID-19. This means that influenza can spread faster than COVID-19. While the range of symptoms for the two viruses is similar, the fraction with severe disease appears to be higher for COVID-19. While most people have mild symptoms, approximately 15% of people have severe infections and 5% require intensive care in a hospital ICU. The proportions of severe and critical COVID-19 infections are higher than for influenza infections. I have travelled to another country. What should I do? If you have been overseas in the last 14 days, you should: self isolate yourself from others for 14 days from the day you returned or arrived from overseas and monitor yourself for symptoms If you develop a fever or respiratory symptoms, please: call your doctor and tell them where you have travelled or if you have been in contact with a confirmed case. or (if your symptoms are severe) visit your local Emergency Department. When you arrive, immediately tell staff where you have travelled or if you have been in contact with a confirmed case. If you have symptoms it is important that don’t go to work, school/university/childcare, the gym, or public areas, and you should not use public transport, taxis, or ride-sharing services. If you need to seek medical care wear a surgical mask if available when attending. You should not use public transport, taxis, or ride-sharing services to get to your doctor or emergency department. Should I avoid attending public events, for example, religious celebrations, music festivals or sporting matches? On 15 March 2020, NSW Health Minister Brad Hazzard made an Order under Section 7 of the Public Health Act 2010 to force the immediate cancellation of major events with more than 500 people. This includes events such as concerts, sporting fixtures with large crowds, exhibitions and religious celebrations. Individuals who fail to comply could face up to six months in prison or a fine of up to $11,000 or both, plus additional penalties for each day the offence continues. Corporations face even harsher fines. Critical workforce, such as healthcare professionals and emergency services workers, are also recommended to limit their attendance at non-essential meetings or conferences. The advice on mass gatherings does not apply to attendance at schools, universities or child care centres. While all Australians are encouraged to exercise personal responsibility for social distancing, there are no current restrictions recommended on attending other settings, such as shopping centres, or using public transport. For non-essential organised gatherings with fewer than 500 attendees, NSW Health recommends that organisers: remind attendees and staff not to attend if they are feeling unwell remind attendees and staff they must not attend if they have travelled overseas in the past 14 days ensure emergency management plans are up to date brief staff on how to practice good hygiene and making it easy for staff and attendees to practice good hygiene have adequate hand washing facilities available NSW Health also encourages people considering attending these gatherings to: stay home and not attend if you are feeling unwell stay home and not attend if you have travelled overseas in the past 14 days practice good personal hygiene including: cleaning your hands thoroughly for at least 20 seconds with soap and water, or use an alcohol-based hand rub covering your nose and mouth when coughing and sneezing with tissue or a flexed elbow. How long does the COVID-19 infection last? The infection period for the virus will vary from person to person. Mild symptoms in an otherwise healthy individual may resolve over just a few days. Similar to influenza, for an individual with other ongoing health issues, such as a respiratory condition, recovery may take weeks and in severe cases could be potentially fatal. What if I don’t have Medicare? Most people that are not eligible for Medicare will have health or travel insurance. For those that do not have adequate insurance coverage, NSW Health will waive these costs. This includes the waiving of payment and debt recovery procedures for ambulance transfers of people suspected to have COVID-19 infection, who are taken to NSW Health facilities for assessment. These arrangements have been put in place to ensure payment issues are not a barrier for people from overseas with respiratory symptoms seeking early medical advice. How is COVID-19 diagnosed? Infection with COVID-19 is diagnosed by finding evidence of the virus in respiratory samples such as swabs from the back of the nose and throat or fluid from the lungs. Samples for testing can be taken directly by GPs or at a range of private pathology sites across the state that are suitable for collection of COVID-19, or at public hospitals across NSW. What should I do if I come into contact with a person with COVID-19? If you have been identified as a contact of a person with confirmed COVID-19 infection in Australia, the local public health unit will contact you with advice. You need to isolate yourself at home for 14 days after contact with the infected person, and to monitor your health and report any symptoms. Person to person spread of coronaviruses generally occurs between people who are close contacts with one another. A close contact is typically someone who has been face to face for at least 15 minutes, or been in the same closed space for at least 2 hours, with a person that was infectious. The public health unit will keep in touch with people who are close contacts of patients with COVID-19 infection. If any symptoms develop contacts must call the public health unit to report those symptoms. If your contact with the person was less than this, there is a much smaller risk of you being infected. However, as a precaution you must still monitor your health until 14 days after you were last exposed to the infectious person. If you develop symptoms including a fever and/or respiratory signs, please call ahead to talk to a doctor or call healthdirect on 1800 022 222. Tell your doctor that you have been in contact with someone with COVID-19. The doctor may tell you to attend your nearest emergency department – if so when you arrive, immediately tell staff you have had contact with someone with COVID-19. More information about home isolation is available for: people suspected or confirmed to have COVID-19 infection close contacts and recently returned travellers. Practice simple hygiene by: making sure to clean your hands thoroughly for at least 20 seconds with soap and water, or use an alcohol-based hand rub cover your nose and mouth when coughing and sneezing with tissue or a flexed elbow. What should I do if I come into contact with a person who has been identified as a contact? If you have been in contact with a person identified as a close contact of another person with confirmed COVID-19 infection, you do not need to self-isolate (although the close contact does) and don’t need take any other special precautions. If a close contact develops symptoms and is confirmed as a COVID-19 case, public health authorities will determine who, if anyone, has been in close contact with them while they were infectious, and these people will be directed to self-isolate. Who is at risk? People who have: been in contact with a person with COVID-19 been overseas in the previous 14 days As there is increasing community transmission in a number of countries around the world, anyone who has travelled overseas in the past 14 days is at increased risk. People with underlying illnesses that make them more vulnerable to respiratory disease, including those with diabetes, chronic lung disease, kidney failure, people with suppressed immune systems and older people are at a higher risk of serious disease. How is it prevented? Clean your hands with soap and water for 20 seconds, or an alcohol-based hand rub. Cover your nose and mouth when coughing and sneezing with tissue or a flexed elbow Avoid close contact with anyone with cold or flu-like symptoms. Practice cough etiquette (keep away from other people, cover coughs and sneezes with disposable tissues or clothing, and clean your hands. Travellers to Asia should not visit live bird and animal markets, including ‘wet’ markets. Is there a cure or vaccine? There are no vaccines that protect against COVID-19. There is no specific treatment for COVID-19. Early diagnosis and general supportive care are important. Most of the time, symptoms will resolve on their own. People who have serious disease with complications can be cared for in hospital. Has my doctor been informed? Health workers in NSW public hospital emergency departments as well as community-based general practitioners are aware of the symptoms and actions to take to prevent the spread of COVID-19 through careful infection control measures. What if I am unable to speak to my doctor? If you are after medical advice and your general practitioner is not able to speak with you, you can call healthdirect on 1800 022 222. They will be able to discuss your symptoms and travel history with you, to help decide if COVID-19 testing is recommended. How do I get tested for COVID-19? NSW Health is recommending people with acute, cold, flu-like symptoms who are returned travellers, or a contact of a confirmed case, be tested for COVID-19. Samples for testing can be taken directly by GPs or at a range of private pathology sites across the state that are suitable for collection of COVID-19, or at public hospitals across NSW. COVID-19/Flu clinics are being established within all Local Health Districts across NSW to assess and diagnose patients with possible COVID-19 infections and other respiratory illness such as influenza as we approach the winter season. NSW Health is also expanding the laboratory capacity across public hospitals and private laboratories to scale up the analytical testing to determine the results of those tests. Currently, NSW Health laboratories have capacity to perform more than 1,000 tests a day at three public hospitals at Randwick, Westmead, and Liverpool, and they will soon be joined by four more hospitals: Royal North Shore, Royal Prince Alfred, John Hunter, and Nepean. NSW Health has already engaged private pathology laboratories to assist in the collection of samples from people who require COVID-19 testing. Testing is recommended for all returning overseas travellers who develop symptoms within 14 days of return, contacts of cases who develop symptoms, people admitted to hospital with severe respiratory infection irrespective of travel history, other special circumstances such as where there is an outbreak of respiratory infections without an identified cause such as flu. This testing can take up to two days to complete and report back. How are other coronaviruses tested? COVID-19 is one kind of coronavirus, but there are other kinds of coronaviruses that have infected people for many years around the world, including in Australia. If you are sick with a respiratory infection (for example you have a cough, runny nose, sore throat or fever), the doctor may order a swab from the back of your nose or throat for testing. Many laboratories will test the swab for several different viruses. This test is called a multiplex viral respiratory panel, which often include tests for these other coronaviruses. These tests currently do not test for COVID-19 and do not indicate whether it is present or absent. Source: NSW Health