By dentist Dr. Richard Mitchell
You may be worried about Coronavirus symptoms, and the worldwide covid-19 epidemic. But what exactly ARE the symptoms of Coronavirus infection, and is it safe to visit the dentist at the moment? What extra precautions might your dentist be taking in his office to avoid infecting you, and ALSO to avoid being infected BY you?
I am working in Spain, and as of March 16 2020, the government has declared a state of emergency and the country is in lockdown. I have received several emails from the health department about how to proceed during this period, and the information here is based on advice issued by the Ministry of Health in Spain, and the World Health Organization.
But first of all, what are the main Coronavirus symptoms to be aware of and watch out for? There are 4 main symptoms that may indicate you have been infected;
Let's take a look at these one by one, and explain exactly what is meant.
A dry cough.
This is when you get a dry, tickly sensation in your throat, as if you've got a bit of dust or fine sand in there, and you have to cough. But the cough doesn't bring anything up. There's no phlegm, nothing. It's a "dry" cough. You might think that this cough would go away in a few minutes. But if it's caused by a coronavirus infection, the cough persists. You just have to keep coughing.
The best way to check this is with a modern digital thermometer.
The normal body temperature should be between 97-99 degrees F, or 36.5 to 37.5 degrees C. (Celcius or Centigrade). If you record a temperature above 100.4 degrees F, then you have a fever.
Shortness of breath.
You may feel some difficulty breathing, as if you can't take a full breath properly. You feel a bit breathless, and try to take a deep breath to get some more air, but it doesn't work. You end up feeling that you are having to "work" at breathing, where it is normally something we don't think about doing, it just happens.
You just feel tired and weak. Some people have reported getting the dry cough, then the next day feeling short of breath, then feeling better after another day or 2, only to wake up with a feeling of total fatigue.
There are 3 main reasons why this new virus is much worse than normal seasonal 'flu.
1. The seasonal influenza (or "flu") virus that crops up each year changes slightly from year to year. However many people have some degree of protection from previous exposures. While this may not prevent them from getting 'flu at some time, it means that the symptoms are not so severe.
With the covid-19 (coronavirus) infection, humans have NO previous exposure and therefore no resistance to the virus. This is NOT a virus that has infected humans before, and so we have no degree of immunity at all. If you are exposed to the virus, you are highly likely to get infected.
2. During a normal 'flu outbreak, each person with 'flu can be expected to infect about 1.5 other people - on average. With the Coronavirus, current figures suggest that each person with the covid-19 virus will infect at least 4 other people. That's almost 3x as many people.
3. This virus is infecting people at an exponential rate. Just click on this link to see the latest figures at worldometer.info, and be sure to scroll down the page, past the figures, to see the graphs of cases. That is an exponential curve. The numbers are doubling every few days.
The death rate from covid-19 seems to be around 1% or slightly lower. That means that of every 100 people who get the infection, 1 will die. This is lower than for normal"seasonal" 'flu, but the problem is that many, many more people are likely to become infected with covid-19 compared with normal 'flu. This is because of the rate of spread of the new virus.
So the total number of people who will eventually die from this new virus is likely to be hundreds of thousands worldwide.
Approximately 80% of people who became infected in China had mild to moderate symptoms. But around 14% had more serious symptoms, especially men. This may be due to the fact that a high proportion of men in China smoke, compared to women in China. On the other hand, it may be that men are simply affected more severely. We don't know yet.
You are more at risk of developing serious Coronavirus symptoms if you fall into one of these groups;
It seems that the older you are (over 60), the higher the risk. Rather oddly, children do not seem to develop symptoms anything like as severe as adults.
HOWEVER, being younger (say 30 years old) and fit (being a marathon runner or training for an Iron Man triathlon) is no guarantee that you will have only a mild infection. There are documented cases of people like this needing to spend 2 weeks in an intensive care unit, on a ventilator. This disease is unpredictable, and CAN kill even young people.
To dispel one myth immediately - face masks offer only very minimal protection. And that is only for a short time, until they become a little damp. Then they are useless in terms of protecting you from getting the virus.
There are many other myths about eating garlic, saline solutions for your nose, and taking antibiotics. All are useless against the covid-19 virus.
SO, what actually works?
First, avoiding direct contact with anyone else, such as shaking hands, hugging and kissing. The virus is transmitted very easily by direct contact. Try to keep a minimum 6 feet distance from anyone else - admittedly not easy on public transport!
Second, wash your hands with hot water and soap for at least 20 seconds. And do it every 30 minutes. Normal soap contains fats which dissolve the virus shell, so is very effective. Alcohol-based hand sanitizers also work, but not as well as soap and water!
Third, do NOT touch your face, especially mouth, nose and eyes with your hands. This is something we all do without noticing or thinking about it. But touching your face with a finger that has virus on it will allow easy entry into your body.
Fourth, avoid touching any surfaces in public that others have touched, like ATM buttons or touchscreens, elevator buttons, door handles, railings, tables, and even bank notes. If you cannot avoid this sort of contact, use a hand sanitizer frequently, and wash your hands with soap and water as soon as possible. And don't touch your face.
Fifth, avoid crowded situations as far as possible, such as supermarkets, public transport such as buses, trains and aircraft, and places with many visitors like museums, cinemas and restaurants/bars. Do your shopping online.
To protect yourself, assume that every other person is infected - even if they seem well.
To protect others, assume that YOU are infected.
This will break the chain.
Below is a graphic from the National Institute of Allergy and Infectious Diseases to help you tell the difference between a cold, normal 'flu, and a coronavirus infection.
A dental office is normally a place you would think would be on top of infection control procedures - and that is true. But Coronavirus (covid-19) is different.
For example, if a person infected with covid-19 coughs or sneezes into their hand, and then uses the door handle into the dental office, touches the reception desk, uses the restrooms, and touches a magazine in the waiting room, these surfaces are sources of infection with the virus.
Inside the dentist's room, disinfection procedures will already cover virus contamination. BUT now there is a need to minimize the spread of the virus in the first place. How is that done?
What about the Ibuprofen problem?
Otherwise known as Nurofen or Advil, this has been the subject of fake news and scaremongering. According to the BBC, there have been several What'sApp messages circulating that purport they "have a doctor in the family who has been sent information by a lab in Vienna that says Ibuprofen is dangerous."
THIS IS UNTRUE.
The fact is that Ibuprofen belongs to a class of drugs called 'non-steroidal anti-inflammatory drugs'. The important point here is that they are anti-inflammatory.
This means that Ibuprofen exerts it's effects by suppressing inflammation in your body - that is your body's natural immune response. And if your immune response is suppressed, there is a possibility that an infection could last a little longer. BUT this is pure speculation at the moment, and medical opinion is divided.
The World Health Organization recommends sticking to painkillers containing Paracetamol. It's just a precaution, but it's such a simple choice to make.
If you're feeling under the weather, or just want to avoid going out shopping for any reason, you can order just about any food direct from Amazon, delivered to your door!
To find out what you can get, just click on this link to the grocery department at Amazon, and check the list. You can even do your entire weekly shop!
I hope my guide to Coronavirus symptoms and protection has been helpful. I am updating it every day as the worldwide situation evolves, so check back regularly to find out the current recommendations.
HERE is a link to the World Health Organization website with more information.
UPDATED MARCH 24 2020
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