Traveling is becoming more fraught in the peri-pandemic days of coronavirus. Italy has seen the most impact of COVID-19 (the clinical syndrome caused by the novel coronavirus) in Europe to date, though cases have reached the UK and Republic of Ireland.
More people were at the airport than I had expected, and it was business as usual at first sight. Or so it appeared. Twenty eight people failed to show for our flight. Probably for various reasons, mused the pilot, despite the sizeable elephant in the room. He also cited disruption across the European flight networks. Flights to Italy are being cancelled, with more destinations set to follow. People are afraid, and business is going to feel their fear. And feel the pain.
Still reeling from disastrous floods in November, Venice has seen further cancellations with carnival cut short and tourists giving up holiday plans. The ordinarily overflowing city has become a ghost town. A city almost entirely dependent on tourism cannot survive without it even if it is not always welcomed with open arms.
Over the weekend France announced bans on gatherings of more than 5,000 people in an attempt to contain the spread of SARS-CoV2 (the official name for the new strain of coronavirus). We were waiting with bated breath for an announcement from Disneyland, but none was forthcoming. Disney theme parks in Tokyo, Shanghai and Hong Kong have closed their doors in light of the outbreak.
What do we know about the virus?
A novel strain of coronavirus closely related to the virus which caused the SARS outbreak of 2003, SARS-CoV2 is believed to have originated in a wet market in the Wuhan province of China. The close proximity of live animals and butchered meat and produce is the perfect environment for species to species transmission.
The number of cases has rapidly increased in recent days, and transmission has been reported in individuals who had not travelled to affected areas (in particular China, Italy and Iran at this time).
Why is coronavirus a global concern?
The novel coronavirus can cause anything from minimal symptoms to significant respiratory compromise and death. In that, it is similar to seasonal influenza which is a significant burden on healthcare worldwide, responsible for up to 650,000 deaths annually (statistics from World Health Organisation).
Where it differs is that we are yet to develop a vaccine for SARS-CoV2. Additionally, we are lacking in effective treatments. This is the case for many viral illnesses including the common cold – antibiotics don’t work for these as they’re designed for bacteria. Some antiviral drugs are available for specific infections, though none are known to be effective for COVID-19. Doctors have been trying existing antivirals and antiretrovirals (ordinarily used for HIV treatment) but this is all experimental at present.
What can I do?
Follow the official guidance. If you’re coming back from a high risk area and have symptoms, call the NHS non-emergency number for advice. (111, if you’re in England) It may be that you’re asked to self-isolate for 14 days and home testing will be organised.
If you can manage and your symptoms are mild, steer clear of going to your GP or Emergency department. Get advice first and go from there. You might not have severe symptoms, but could spread the virus to vulnerable individuals whose immune systems cannot fight the virus as effectively.
I cannot emphasise this enough: wash your hands! There’s no excuse for this, and we’ve known the importance of this since Semmelweiss (well, that wasn’t a great example but we have known for a long time). Effective hand washing with soap and warm water is a crucial element to containing this thing. Hand sanitiser is useful if you cannot get to a sink, but it’s not a substitute for the real thing.
Cover your nose and mouth when sneezing/coughing. Again a simple measure that shouldn’t have to be explained, but common sense isn’t necessarily common.
Should I wear a mask?
I can’t answer that question for you personally, but for me the answer is no. That is unless I’m called up to work in the Emergency Department or wards and in that case I would use all personal protective equipment available to me.
My reasoning is as follows. The effectiveness of certain types of masks is not entirely assured. Even if you have the correct level of protection, the filters need to be changed at appropriate intervals and the masks need to be kept clean and disposed of properly. The chances of doing everything correctly are slim and you’d be better off practicing effective hand washing.
I have a secondary motive. Please do not deplete the supply of masks for healthcare workers. These people are on the front lines potentially exposed to coronavirus and worse, and genuinely do need masks. Panic buying of these items pushes prices up and reduces supply.
Should I be worried?
This is the most difficult question. I don’t know. I don’t know if this will blow up or blow over. The number of cases looks to be increasing rapidly, and the disease more aggressive than seasonal flu. This is all based off preliminary information, and we won’t know the true statistics until we’re out the other side.
I do believe the vast majority of us will not come to significant harm through COVID-19. The risk comes to the usual at-risk groups: the very young, the elderly and people with pre-existing medical conditions (particularly respiratory disease and immunosuppression). In order to protect these people it’s our job to ensure the spread of SARS-CoV2 is controlled, which means following official advice, avoiding travel to at-risk/high-risk areas, and self-isolating where required.
This will continue to damage the global economy, but shutting down business and staying in might be necessary to get on top of this.
I’ll update as things develop. My day to day job behind the microscope is set to continue as normal, but I may be called up as part of contingency plans. Good thing my advanced life support training is still valid!