I would like to give a few bit of advice from a medical point of view to the best of my ability. I would point out that I am not an expert in epidemiology, viruses or respiratory medicine but I will do my best to try and outline what is going on, what you can do to help yourself and others and how to get through this crisis.
David Bouchier-Hayes, Galwegians Medical Doctor
What Is COVID-19?
COVID-19 is a variant of an extremely common virus which has caused respiratory infections for many years. However, the difference on this occasion is that this strain is incredibly contagious and has a significant death rate or mortality which is about 10 times that seen with the common flu. It appears to have been transferred from the animal community, as many of these viruses are, and originated in the Wuhan region of China. Due to strong trade links in the textile industry, it found itself being transferred to Italy and other countries and then has travelled throughout the world.
How Does It Impact Us?
It is important to remember that the vast majority of people who contracted this virus will have minimal symptoms and will recover very well. However, a number of people will be severely affected and this is especially relevant in people who are over the age of 70, with mortality rate increasing as you get older. The good news is that we are starting to see a significant drop off of the cases in China, there are medications that had been trialled which look very promising and there are also vaccines which are being inflated and investigated at present. However, there is no chance of a vaccine being available qualified for probably 12 months, unless some drastic measures are taken, which may compromise safety for those receiving vaccines in the long-term.
How Can We Prevent It?
With this in mind, in the short term the best measures are preventative. You will have heard probably of the phrase ‘flattening the curve’. The idea of this is to reduce the amount of social contact and interaction so that when the inevitable infected cases arise, they do so in numbers and over a period of time that the health care system can handle. The problem in Italy has been that the rise in affected cases has been so rapid that the health care system has been overwhelmed. I have been in touch with friends and colleagues in Italy, Asia, Seattle, Australia and Germany and the situation is very severe in Italy, with the whole health care system of the North of the country being devoted to treating people who have been affected by this virus.
This is why ‘social distancing’ is such an important concept. An infected person will infect between 2 and 5 people. Each of these will go on to infect between 2 and 5 people, and so on and so on, causing exponential growth. This will lead to massive numbers of infections that will also occur here unless we reduce the number of people that we come into contact with. The most effective measures to reduce social interaction are to:
- Stay at home.
- Stay approximately 6 feet away from other people as much as possible.
- Reduce all activities outside of the home to an absolute minimum. That means only travelling to pick up medicines, shopping for food stuffs, or to seek medical care. Activities such as going out to dinner, shopping for clothes, getting a haircut, going to the gym or going to any social gathering including meeting up together in someone’s home, should be avoided as much as possible
- Simple hand washing is the most effective way of reducing transmission. This is much more effective than use of hand sanitiser, it is also much cheaper, and easily available in your home.
- If you have to sneeze, sneeze into a tissue and dispose of this tissue immediately. If you do not have a tissue, sneeze into your elbow.
- Something that I have found helpful is to always have a pen on me. I use this for pushing buttons on lifts, pushing open doors or anything I can use it for so that I avoid touching possibly contaminated surfaces.
What if You Show Symptoms?
If you develop a fever, or a dry cough, significant shortness of breath or begin to feel unwell, at present the advice is to contact your General Practitioner by telephone. They will decide whether you meet the criteria for testing for the virus. In the meantime you should self-isolate.
What is Self-Isolation?
Self-isolation is recommended for anyone who believes that they may have the viral infection, or have recently been in a high risk area. It is quite significant and you have to spend in your time in 1 single room, with meals being delivered to you to the door of the room. You should also try and use a separate bathroom from the rest of the family. It is a pretty daunting prospect, but is extremely effective.
In general, the best rule of thumb advice that I can give in relation to reducing transmission of this virus is to think you have yourself in the situation that you actually have the virus and trying not to give it to anyone else, as opposed to attempting to try and not contract the virus. If you act as if you are contagious, you will be going a huge way forward towards reducing your risks of becoming infected.
Coping Strategies & Mental Health
Another area that is of significance is that of physical and mental well-being. The areas of keeping fit etc will be addressed by other contributors within our club, but I might give a small word in relation to mental health. This is a crisis of unprecedented proportions. It may appear that nature and this virus has defeated us, despite our robust economies, lack of poverty and technological achievements. However, all of these things will work very much in our favour to ensure a resolution of this crisis. Please note that the number of recovered patients is also rising exponentially, and they will help confer immunity in our communities.
Choose Information Sources Wisely
In the meantime, it is worthwhile trying to avoid bombarding yourself on a minute to minute basis with the ever changing details of the crisis. This will only lead to information overload and can be emotionally very difficult to handle. Take a break from social media, and try and concentrate on something else. I would recommend reading a book, binge watching that Netflix series that you wanted to watch, or playing games like Sudoku etc.
Social media will convince you that the end of the world is upon us, if you let it. I would also only put trust in information sources that you respect and can trust. I would listen to the WHO, and in particular, Dr. Michael Ryan, who is a no-nonsense Galwayman, who is at the forefront of defeating viral outbreaks for the last 25 years. He is a straight talking, incisive man of action, and watching him on line will give you confidence that everything that can be done is being done. Also listen to the HSE. They are coordinating the national response, and have many hard-working dedicated people there. There is not a huge conspiracy out there to ‘cull’ part of the population, nor was this a Chinese manufactured biological weapon. It is a tiny, sub microscopic virus, with no innate will power or purpose.
Positive Social Interaction
While the dangers of social media are very apparent, I would also advise keeping in touch with each other. This can be done through telephone communication, WhatsApp groups, Facetime or any number of video communication applications that can be run off your phone or computer. Humans do need some sort of social interaction, and to see other human faces and this is one sensible way of doing this. I would ask people to call their parents, grandparents and other loved ones regularly, and to keep in touch with neighbours, especially those who are older and live on their own and may be very frightened.
A Hopeful Future?
To finish, I would like to point out that there is significant hope out there. We are at the early stages of something that we cannot predict, but with everyone coming together, we can improve the outcome. Those of us involved in Healthcare will be dedicating ourselves over the next few weeks to make sure that this will come to pass. I myself have signed up with the HSE as a volunteer for when the system starts to come under pressure. All of us involved in Healthcare got into this line of work primarily to help our fellow man. It is in a time of crisis like this that I believe that you will see the best response possible from us in the true traditions of medicine and nursing throughout the ages, and I promise you that we will do our very best to get through this crisis with as little damage as possible.
How Can We Help?
Any of you with organisational skills, or simple enthusiasm can sign up as a volunteer via the HSE website. And when you are asked in 15 years time, ‘Dad/Mum, what did you do when the world was going down the tubes in 2020?’, you can say ‘I tried to help’. No one can ask any more of you than that. It is also a good way to fill your time during this lock down period. I would finally say that, in time, this virus will recede, and we will pick up the pieces, and the bar will reopen, and rugby will go on. And when it does, we will all be supporting our club with a new sense of pride and camaraderie that we all got through this together. Stay well, my friends, and feel free to contact me by text or WhatsApp on 0868578222 if you need any help or guidance, and I’ll do what I can.
David Bouchier-Hayes, Galwegians Medical Doctor
