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    Lisa Bywaters
    25/Jun/2020
    Health InformationMSK articles

    COVID-19 outbreaks

    The last week has seen a large number of new cases of COVID-19, particularly in Victoria. With this large increase in the number of active cases, should we be worried?

    Well – yes and no. Let’s explore some of the issues.

    We’re dropping our guard

    SARS-CoV-2 (the virus that causes COVID-19) is like a mythical beast. It’s caused so much damage and devastation – both here and globally – but most of us haven’t faced it. It’s hard to stay vigilant against something that seems so elusive.

    So we drop our guards and our standards along with them.

    It’s absolutely understandable – it’s been a long road so far, we’re sick of being isolated, we want life to go back to normal.

    “I wish it need not have happened in my time,” said Frodo.
    “So do I,” said Gandalf, “and so do all who live to see such times. But that is not for them to decide. All we have to decide is that to do with the time that is given us.”
    J.R.R Tolkien – The Fellowship of the Ring

    But because most of us haven’t been exposed to the virus, we’re still susceptible. And some people are more at risk than others of becoming very ill if they develop COVID-19, including people with immune issues and certain other health conditions.

    So we need to maintain our vigilance.

    Community transmission

    Most of the new cases can be linked to people returning from overseas and specific clusters where the origin of the virus transmission is known.

    However there are some cases where we have absolutely no idea how/when/where a person became infected. This is known as ‘community transmission’ – a person becomes infected with the virus but they’ve had no contact with a known case.

    They may have been in contact with someone who’s asymptomatic (infected but don’t feel unwell or show any symptoms) or someone who’s pre-symptomatic (infected but not yet showing symptoms). Or they may have come into contact with someone who thinks they have a bit of a cold, or even someone who suspects they have the virus but isn’t self-isolating.

    The issue of community transmission is why we need to remain on guard against this virus. Just because restrictions have been easing doesn’t mean we can ease up on our physical (social) distancing, washing our hands as often as possible, using hand sanitiser if there’s no access to soap and water, sneezing and coughing into the elbow, staying home when we’re sick and getting tested if/when we develop symptoms, however mild.

    Remember, symptoms of COVID-19 are:

    • fever
    • chills or sweats
    • cough
    • sore throat
    • shortness of breath
    • runny nose
    • loss of sense of smell.

    For more information about symptoms and to see if you or someone you care for may have the virus, use the healthdirect Coronavirus (COVID-19) Symptom Checker. Answer a few simple questions to find out if you need to seek medical help or be tested. Or call the National Coronavirus Helpline on 1800 020 080, 24 hours a day, seven days a week.

    Winter is here

    And for most of Australia there’s is a bit (or a lot) of chill in the air. Which means we’re staying indoors, huddling close together to stay warm, keeping the windows closed to keep the cold out and the warm in. Unfortunately all of these things make it easier for germs to spread. We’re close together and there’s little ventilation. Perfect to help the little buggers move from person to person.

    Along with the cold weather, we’re seeing more people gather together as restrictions ease and as boredom well and truly sets in. This’s a big problem. On a recent trip to the local shopping centre I was shocked by how many people I saw –most weren’t allowing 1.5 metres between themselves and others, people were hugging, coughing into their hands, not using hand sanitiser when entering stores…all of these things allow germs to spread through the community. Needless to say I hightailed it to the closest exit and went home.

    It’s cold and flu season

    This pandemic is overlapping with our flu season. Yay! Currently flu numbers in Australia are low due to our physical distancing measures. However, this may change for the same reasons we’ve seen increases in COVID-19 cases.

    There’s also the potential that people may become infected with the flu and COVID-19 at the same time, which, to put it mildly, isn’t ideal. While we don’t know if this leads to more severe cases of both infections, the immune system will be weakened by fighting two infections. And if a person’s immune system is already weak due to another health issue, this has the potential for very serious outcomes.

    Finally if flu numbers do increase as we continue through our flu season, it will have an impact on our healthcare system, which is already working overtime because of the pandemic. It seems like so long ago, but the 2019 flu season was our worst flu season on record.

    So for all of these reasons we’re being urged to get our flu vaccination this year.

    This is also a time of year when many of us succumb to colds. Coughing, a runny nose or sore throat may be symptoms of cold, allergies, the flu or COVID-19. If you experience these symptoms, don’t just assume it’s a cold or your allergies flaring up. The same goes with muscle soreness and a fever. For some people with musculoskeletal conditions, this may be a symptom of a flare. Or it may be your body displaying signs of COVID-19. The best thing you can do is stay home and contact your doctor – and if recommended – get tested.

    So should we be worried about these COVID outbreaks?

    We should be concerned because most of us are still susceptible to the virus, and some of us are at risk of becoming seriously ill if we become infected with COVID-19.

    So stay at home if you’re unwell, know the symptoms of COVID-19, wash your hands often and thoroughly, cough/sneeze into your elbow, maintain physical distancing measures and continue to follow the advice of our health officers.

    But we shouldn’t become so worried that we don’t get out (safely and responsibly), that we don’t live our lives. We were able to keep the numbers down for months. We can do it again.

    Contact our free national Help Line

    If you have questions about things like COVID-19, your musculoskeletal condition, treatment options, telehealth, managing your pain or accessing services be sure to call our nurses. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

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    Lisa Bywaters
    04/Jun/2020
    Health InformationMSK articles

    When you have COVID but don’t know it

    The silent spread of COVID-19

    By now we’re all aware that some people with COVID-19 may never feel sick or have any symptoms. They’re what’s called asymptomatic – they have no symptoms at all.

    But did you know that people can also spread the virus when they’re pre-symptomatic – contagious before the onset of symptoms; or mildly symptomatic – they have minor symptoms such as a cough or slight fever.

    Understanding how the virus spreads throughout the community gives our health system and researchers more tools to fight it. While there’s still so much we don’t know about this virus, we’re learning more and more every day.

    Asymptomatic

    You can be a carrier of a disease and never show signs of the illness yourself. The most famous case is that of Mary Mallon – or as the press dubbed her – Typhoid Mary. In the early 1900s she worked as a cook in America. She spread typhoid fever to many of the people she cooked for, even though she appeared and felt perfectly well.

    This is what it means to be asymptomatic. You carry the disease but you aren’t sick. In the case of COVID-19, people who are asymptomatic have none of the signs we’re on the lookout for – no cough, fever, breathing issues, fatigue.

    While this is great for them, it means that they could unwittingly share the virus with others – family, friends, the general public. They don’t know they’re carrying the virus, so they don’t isolate themselves to stop the spread.

    We don’t know how common this is. There are estimates that range from 5-80% – obviously a massive difference! This discrepancy in stats is in part due to the fact that they come from different studies around the world, from different, unique settings (e.g. aged care facilities, cruise ships), different demographics of people and the diversity of testing practices around the world.

    Until we’re in a position to test more of the community, not just those who display symptoms, we can’t know how much of the population are asymptomatic.

    We also don’t know to what extent this group is infecting others. Are they highly contagious and infect a lot of people, or do they infect only a small number? We just don’t have enough information to be sure.

    Pre-symptomatic

    This is the group of people who have the virus but aren’t yet showing symptoms. Again they’re out and about living their lives and not realising they’re contagious. They appear to be infectious 1-3 days before they start showing symptoms themselves.

    Mildly symptomatic

    This final group is people who have mild symptoms such as a light cough or low fever or feel a little fatigued, but otherwise don’t feel unwell. At this time of the year many of us may put these symptoms down to things like allergies or a cold or even our musculoskeletal condition. But it may in fact be COVID-19.

    That’s why if you have any symptoms, no matter how mild, you need to stay home and contact your doctor about getting tested. If you’re not sure what the symptoms are, use the healthdirect online symptom checker or call the National Coronavirus Help Line on 1800 020 080.

    Why does this matter?

    We’re learning a lot about COVID-19, but there is still so much we don’t know. And if we’re going to win this fight against the virus, we need to know how many people are unknowingly spreading the virus. This will help make better predictions about how the virus will affect communities going forward, as well as the types of things we can do to combat it.

    But until we have this information we all need to continue to maintain good hygiene, practise physical distancing, self-isolate if we’ve been in contact with someone who’s tested positive to the virus, stay active, eat well and look after our mental health. All of these things will help prevent the spread of COVID-19 and help us stay healthy and well.

    Contact our free national Help Line

    If you have questions about things like COVID-19, your musculoskeletal condition, treatment options, telehealth, managing your pain or accessing services be sure to call our nurses. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

    More to explore

    Photo by mauro mora on Unsplash

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    Lisa Bywaters
    07/May/2020
    Health InformationMSK articles

    Testing for COVID-19

    In the last couple of weeks pop-up and drive through testing centres for COVID-19 have been appearing in places like shopping centre carparks, town halls and community centres.

    Testing in Australia has now been expanded to include anyone with COVID-19 symptoms. At the beginning of the pandemic we were focused on mainly testing people who’d been overseas, on cruise ships or had been in direct contact with someone diagnosed with the virus.

    Now focus has moved to community transmission. This is when someone develops COVID-19 for no obvious reasons. They’ve not been overseas or in contact with someone with the virus…that they know about.

    Symptoms

    As we know some people may have the virus without having obvious or severe symptoms. If they’re out and about they may unwittingly spread this highly infectious virus to others.
    That’s why testing is being broadened to anyone who has symptoms such as:

    • fever, chills or sweats
    • cough
    • sore throat
    • shortness of breath
    • runny nose
    • loss of sense of smell.

    For more information about symptoms and to see if you or someone you care for may have the virus, use the healthdirect Coronavirus (COVID-19) Symptom Checker. Answer a few simple questions to find out if you need to seek medical help or be tested. Or call the National Coronavirus Helpline on 1800 020 080, 24 hours a day, seven days a week.

    It’s important to be aware that there are currently some slight differences in the testing criteria for states and territories.

    For example Victoria has started a two week testing blitz. As well as people with symptoms, some people can be tested even if they don’t have symptoms. This includes people with chronic conditions, Aboriginal and Torres Strait Islanders and people who can’t work from home (including healthcare workers, police, construction workers).

    Visit your state/territory health website for information about testing criteria relevant to where you live or call the National Coronavirus Helpline on 1800 020 080.

    So what are the tests and how do they work?

    First, it’s important to note that all tests for COVID-19 are performed by health professionals. You may have seen information about home tests on social media. In Australia it’s illegal for anyone to sell a home testing kit and claim that you can test yourself for COVID-19. Supply of these kits is also prohibited under the Therapeutic Goods (Excluded Purposes) Specification 2010. Testing for COVID-19 is complicated and requires the specialised knowledge and training of health professionals. As well as the actual testing and interpretation of results, they’re also able to give you expert information and support. So if you see these home tests advertised, ignore them.

    The main test currently used for COVID-19 is a swab test.

    A swab (similar to a long cotton bud) is inserted into your nose or back of your throat to collect fluid and cells. Once the sample has been collected it’s sent to a lab for testing.

    At the lab, technicians will look for genetic material from the virus. They will then send the result to the health professional who took the sample. This usually takes between 1-3 days. You’ll be contacted with the results – whether you have the virus or not.

    The swab test can only tell you if you have an ongoing infection, it can’t tell if you’ve had COVID-19 in the past.

    While this test is considered to be very accurate, especially in a laboratory setting, there can be errors. People may be told they aren’t infected when they are. This is called a false negative. It can happen if a sample hasn’t been taken correctly or if the virus hasn’t replicated in your body to a level that can be detected. There’s also the possibility of a false positive, when a person has been told they have the virus, but they don’t. This can happen if the sample becomes contaminated in the lab. However these are not common occurances.

    Another test that may be used in some situations looks for antibodies in your blood. If you have the virus, your body will create antibodies to fight it. The blood test will look for this. However it takes time for your body to create antibodies, so you may have already recovered from the virus before antibodies appear. So this test can’t tell you if you still have the virus, or when you may have had it – only that you have had it.

    Testing as we go forward

    As well as testing for COVID-19 in people who have symptoms or suspect they may have the virus, testing may begin to be carried out on the community at random.

    Called sentinel testing or sentinel surveillance this mode of testing will look for cases of COVID-19 in people that aren’t displaying symptoms.

    It’s likely that sentinel testing will be happening in the near future as we begin to relax restrictions. We just have to wait to hear from the Federal Government as to how and when it’ll happen.

    For more info, read What is sentinel surveillance and how might it help in the fight against coronavirus? 

    Contact our free national Help Line

    If you have questions about things like COVID-19, your musculoskeletal condition, treatment options, telehealth, managing your pain or accessing services be sure to call our nurses. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

    More to explore

    CONTINUE READING

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