29 March 2020
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My answers to your Coronavirus questions

Dr Ross Walker
19 March 2020

Following my recent article on the coronavirus, there were some very insightful questions asked by a number of people. I thought I’d answer them below:

1) What about those of us with heart issues such as dilated cardiomyopathy? I'm reading some worrying comments about some cardiac drugs and their interaction with the virus.

There is no doubt that anyone with significant comorbid conditions, such as a dilated cardiomyopathy, chronic lung disease, diabetes, cancer etc are at a greater risk if they contract the virus. Interestingly, the coronavirus appears to be much more virulent in the older populations in Europe, such as Italy, Spain and France where there is a much higher cigarette smoking and therefore probable underlying lung disease. I can only reassure you by stating that there are still a number of older people or people with comorbid conditions who have recovered fully from this virus.

Regarding the interaction between some of the cardiac drugs and coronavirus; a proper clinical trial has not been published to date and any comments are purely anecdotal based on the individual’s experience. I would certainly not stop any cardiac drugs at this stage as there is no doubt that in most cases these drugs do improve heart function and long-term complications from the condition.

2) You haven't addressed the need to flatten the curve at all. Do you think this is a valid point or just panic talk?

The only way we can flatten the curve from a clearly moderately contagious disease with a relatively low fatality rate would be to shut down society completely for 2 to 4 weeks. Clearly this is not practical nor necessary but as I did state in the article, I do agree with the travel restrictions, quarantine, isolation, social distancing and cancellation of events involving more than 500 people. I'm not sure, in a world of nearly 8 billion people that any stricter measures can be implemented. I hope this has answered your question.

3) If you happen to contract coronavirus, do you just take cold and flu tablets?

Firstly, if you suffer the symptoms of coronavirus which are predominantly high fever, cough and shortness of breath, you need an assessment from a facility that specifically deals with the virus. This article was written on Sunday, March 15th and today there was a heavy advertising campaign from the federal government explaining how you should do this. 

Unfortunately, there are no specific treatments for coronavirus and if you have a mild version of the illness, after this has been specifically diagnosed and confirmed with a throat swab, isolating yourself at home, along with any other contacts you’ve had, should do the same. Symptomatic treatments such as cold and flu tablets may give you some partial relief but thankfully the symptoms should clear up over a week or two. It is, however, recommended that you should have a two week isolation period from the onset of your symptoms.. After that it appears you are no longer contagious.

4) When is the best time to get the flu shot? Is the pneumonia shot good for people in their 40s with mild heart disease?

As I'm sure you are aware, the flu shot only prevents (in the majority of cases), influenza. You can still contract influenza despite having the vaccination and you may have a mild reaction to the flu shot but this does not cause the flu. It does not prevent coronavirus or any other respiratory illness. Antibiotics are useless for any viral illness and in fact in some cases may make them worse.

The pneumonia vaccine (Pneumovax) is only effective in preventing pneumococcal pneumonia and the advice from the medical profession is to have this vaccination around age 65. There is no suggested for people with mild heart disease in their 40s.

5) If you come into contact with coronavirus & experience mild or no symptoms, are you immune? 

If you infect any population with any virus, a significant proportion of the community already have some degree of protection and will not develop the illness. Interestingly, there are some other versions of the coronavirus that are not Covid-19 which have affected many children which may be the explanation for why children do not seem to be particularly affected by this condition. The two more serious coronaviruses before this one, SARS & MERS appeared much more lethal but less contagious. Those people who fully recovered probably have immunity against coronavirus, although this has not been proven in any studies.

If you are an otherwise healthy person and exposed to coronavirus with a full recovery or even no symptoms, it is likely you are therefore immune to further episodes although the virus has not been around long enough for us to be 100% sure of this fact. But, if you are elderly or have an underlying comorbid condition and therefore your immune system is not working as well as a younger person, you may not have the reserves to mount a proper immune response and therefore may be prone to developing a virus on the second occasion or possibly a re-emergence of the same infection.

It is also important for me to make the point that it appears in a number of cases that in the initial stages of infection with coronavirus there appears to be a mild non-specific illness with a fever, sore throat and possibly even a mild runny nose and then a few days later when the immune system kicks in, the body mounts an intense autoimmune response that leads to the pneumonia and possibly even the honeycomb long that I mentioned in the previous article. This is where the coronavirus is a serious illness with potential lethal consequences.

Can I make the point that all of my answers here are purely my opinion based on the evidence around the coronavirus to date and as the virus continues around the world, the scientific community will gather much more information. Hopefully the fear and panic induced by this pandemic will subside over the next month or two but only time will tell. In the meantime, it is vitally important we all practice the well described hygiene and social distancing methods described by the authorities.

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