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Dr Kate Harrison, Lecturer of Immunology and Researcher of Viral Pathology

Dr Gareth Nye, Lecturer of Anatomy and Physiology and Researcher of Maternal and Fetal Health

The last six months has seen the world change. COVID-19 has swept through our communities and turned our day-to-day lives upside down. A few positive changes have come out of this – far more people are washing their hands and hygiene practices are on the up, the move to online teaching in schools, colleges and universities has opened the door to more people than ever before making education far more accessible, and we have rediscovered our families and neighbours. With it, however, are the downsides; isolation, being alone during hospital appointments or maternity care, a rise in abusive behaviour and, tragically, deaths of loved ones.

The last six months has also seen massive change in Government policy and scientific research. In March 2020, we provided a myth busting article which aimed to stop the spread of misinformation. After six months, and a flood of new information and new regulations, it felt like a right time to revisit this.

What is COVID-19?

COVID-19 is caused by a virus called SARS-CoV-2, particularly affecting the respiratory system (lungs and airways) and has caused over a million deaths worldwide. SARS-CoV-2 is a specific virus within the coronavirus family of viruses, within which there are 45 different types. In humans, generally coronaviruses lead to a range of symptoms varying from mild cold-like symptoms to very lethal infections that can prevent us from breathing altogether. COVID-19 appears to cover this whole range.

This is not the first coronavirus outbreak. SARS-CoV caused over 8,000 infections and 750 deaths between 2002-2004, while Middle Eastern Respiratory Syndrome (MERS-CoV), has appeared twice, in 2012 and 2015, causing over 2,000 cases and 860 deaths. The new coronavirus that causes COVID-19 is significantly more infectious than both of these past examples, with current recorded deaths over one million with an estimated number of infected patients rapidly approaching 34 million, and almost every country in the world is now reporting cases. This is why COVID-19 is being taken so seriously.

Cases and deaths are changing almost every minute but the following link gives you an up to date count globally and by country https://ncov2019.live

Thankfully, recovery rates remain high. However, the recovery is based on a countries having a fully operational healthcare system.

What’s changed since March?

We now know the three most common symptoms are a new continuous cough, a fever and a loss of smell or taste. Some people don’t display any symptoms whatsoever and we still don’t actually know why. In fact, it’s estimated that only 20% of people show symptoms, though they are the cause of the majority of new infections. Recent research has also suggested that catching COVID-19 once will not stop you from catching it again.  

To keep everything in context let’s imagine a person infected with COVID-19 is a person with an automatic air freshener device. 

  • The virus spreads in tiny particles very much like the air freshener. It can travel around 1.5 metres away from the source and can settle on surfaces. We did think it could survive up to 72 hours on surfaces but now we know the amount of virus halves every six hours, meaning that something would have to be contaminated with an extremely large amount of virus in order for some to still be present 72 hours later. However, washing your hands regularly is still best practice!
  • As long as you have a clear nose, you can smell the air freshener. This is why all face coverings must cover mouth and nose. As both your nose and mouth connect to your lungs the virus can travel through either and cause the infection. Most importantly though the masks are to stop the spread – like covering over the spray nozzle!
  • The more people in the room, the more people can smell the air freshener – or the more people in close contact with an infected person, the more chance you have of spreading it. The risk of transmission is 20 times higher when in close contact for a long period of time. 
  • If the air freshener goes off outside or in a well-ventilated room, you can’t smell as much – the same with the virus; if the space is well ventilated then your likelihood of catching it decreases.
  • You can still smell the air freshener with a face shield – face shields are useful but new studies have found that they only stop 60-70% of the virus. Coverings should be tight to the face, covering both mouth and nose.

Myth buster:

Don’t believe everything you read on the internet! Lots of fake stories are being spread about COVID-19, and these can be just as dangerous as the virus itself. Make sure you’re getting your information from credible sources, and not just things shared on social media. 

  1.  I won’t catch it if I keep drinking – unfortunately this is false, the virus can enter through different paths such as the nose and eyes, and as soon as it reaches your bodys’ cells, it fuses and cannot be washed away. 
  2. I won’t catch it as I use a face mask over my mouth - Face masks don’t completely stop you catching it and as you will have seen from our healthcare workers, they require face masks, goggles and face shields. You have to be careful not to tamper with the mask once in place as you may introduce the virus via your fingers, for example.
  3. I use hand sanitiser all the time, I’m fine – be careful to read the bottles you use, most hand sanitiser is anti-bacterial not specifically anti-viral. Only hand sanitisers with an alcohol content of at least 70% are effective.  Although it’s useful to use, regular soap and water is just as good, as any soap will break down the outer coat of the virus, just like any washing up liquid breaks down grease on your pans.
  4. It only kills the elderly so younger people are fine – You only need to see the news to know that the virus isn’t picky. Younger people may not be dying at the same rate as older people, but they are just as likely to get very serious symptoms and after-effects, or simply be carrying and spreading it with no knowledge. Many young people who have had even mild cases of COVID-19 report symptoms such as fatigue, headaches and breathing difficulties for weeks or even months after infection. Younger people may also have comorbidities (conditions or diseases that are underlying and may make the symptoms of COVID-19 worse) which can make your chance of dying much higher. 
  5. Very few people have it, it’s not that serious! –Even if one person in 1,000 has the virus it can spread extremely quickly. You only have to look at the spread across the North West of England at the moment to see that. The virus is able to spread quickly in enclosed, busy spaces, such as bars, restaurants and houses.
  6. A vaccine is coming – a range of vaccines are currently being tested in humans right now, however they must go through several rounds of rigorous testing to ensure they are safe and effective. You will have seen a number of high profile trials being temporarily stopped to investigate adverse reactions (unexpected changes to the body based on being given the drug) so 18-24 months is still more of a realistic timeframe for a vaccine, even with the whole world working on it.

So why can I go to the pub but I can’t see Granny?

This comment is spread around quite frequently and although it seems unfair, there is a real reason for doing this. Trips to work, the pub, the cinema etc., are done under the provision that social distancing is maintained or you stay within your household circle. In reality this doesn’t always happen which is why we see spikes in cases.

When visiting a family member in a different household it is extremely difficult to maintain that social distancing. Everyone wants to see family members but particularly vulnerable ones are at such great risk. As we know, only a minority display symptoms and so you can be passing it on without even realising.

These measures are designed to protect our most vulnerable.

Equally, social bubbles are increasing without us even realising. What was a few months ago simply a household to a bubble we now share our bubbles with our children’s classmates and our work colleagues, each with their own bubbles.

Why do we need to isolate if we have symptoms?

Generally a virus can’t survive very long without infecting something. For an outbreak to keep going therefore, it needs a steady stream of new people to live in. The best and simplest way to stop the transmission, and therefore limit an outbreak, is to reduce contact with each other, reducing the potential number of new hosts for the virus. This is easy in theory but in practice limiting contact with people and keeping day to day lives normal is difficult. This is why we are being told to stay at home as much as possible, to reduce the number of new people that the virus can come into contact with.

If we do have to leave the house, we are being asked to stay two metres apart and be mindful of what we touch. This may seem odd if we don’t have symptoms, however it is crucial in helping to prevent the spread for the reasons already given above. 

Often we hear the line – “well I don’t have symptoms why should I stay indoors?” - we now know for certain that people are contagious for several days before you even start to show symptoms and many people have no symptoms whatsoever. This is going to be even harder as we reach the colder months with the increase in colds and flus. The simple answer is, the virus can spread quickly without much effort, or without knowledge if you don’t display symptoms (figure 1). 

figure 1.png

COVID-19 transmission
Figure 1

In addition, you never know who you may inadvertently infect. Some people are far more vulnerable to COVID-19 and its severe complications than others, such as those over 60, and people with existing health issues. As shielding has been stopped, this is even more important.

If so many recover, what’s the point?

Social distancing, self-isolation and staying at home is in place to once again ‘flatten the curve’ particularly with the seasonal cold and flu season approaching, and the annual pressure this puts on the healthcare system as it is.  This term has been used a lot in the media but what does it actually mean? Well, we only have a finite amount of equipment and NHS staff to help the most seriously affected recover from the disease. We have seen some hospitals struggle to treat everyone who is infected and this may well return. By reducing transmissions and spreading the total number new of infections out over a longer period of time, we are aiming to reduce the amount of serious cases at any one time (figure 2). This will ease the pressure on the NHS and allow everyone to get treated and have the best chance of survival. Even if many are surviving COVID-19, an overburdened hospital has knock-on effects for other patients. For example, if your local hospital is already overloaded with COVID-19 patients, where can they find the resources for you if you have a car accident, or your grandparent if they have a stroke?

How are we following the guidelines?

All University staff who can work from home are doing so and working tirelessly on maximising online remote teaching. Those on site are ensuring the campus and satellite sites are COVID proof to the best of our ability and have revolutionised the way we work as a University family. We are still available on email and Microsoft Teams for your questions and to give advice as PATs (Personal Academic Tutors) even more so now. Remember that we are all going through this together, students, admin, lecturers, even the Vice-Chancellor, so don’t feel isolated and alone, reach out as you always would do.

Summary 

In essence, staying at home stops the spread of the virus. Doing this saves overwhelming the NHS particularly as winter approaches. By keeping the NHS working, they can save lives. It only works if everyone pulls together and thinks of others. One infected person will infect at least 2.5 people inadvertently, who can then infect at least another 2.5 people each and so on. Bluntly, one person can lead to thousands of new cases without even realising, so stay indoors where possible, wash your hands, wear your mask and be mindful of others around you. 

Along with other UK lecturers and researchers, Dr Gareth Nye was asked to contribute to the Lords select committee inquiry into ‘Life beyond COVID’. As his contribution, Dr Nye argued the importance of close care to mums and young children following the disruption to maternity care during the pandemic.

The report can be accessed on the POST website

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