COVID-19 is the name of the illness caused by a new (novel) coronavirus first discovered in Wuhan, Hubei province, China, around the end of 2019. The virus – SARSr-CoV-2 (previously 2019-nCoV) – is closely related to that which caused SARS (Severe Acute Respiratory Syndrome) and MERS (Middle East Respiratory Syndrome). As of late May 2020, this virus, via a global pandemic, has caused 5.49million infections and 345 000 deaths, across 188 countries.
By comparison, SARS, the disease caused by the SARSr-CoV virus, caused infections which peaked in 2002-2003, totalling 8422 cases, with no cases reported since 2004. SRASr-CoV is now thought to have originated in bats in Yunnan province, China, and then crossed to humans via civets. The SARS case fatality rate is reported at 11%.
MERS is believed to have also originated in bats and is often transmitted by camels in the middle east. It seems MERS is much harder to catch than SARS or COVID, requiring direct close contact with an infected person or camel, which has limited the number of cases significantly. Cases peaked in 2015 at 492 that year.
COVID-19 results in symptoms such as cough, fever, fatigue, shortness of breath and, interestingly, loss of smell and taste sense. Loss of smell often precedes the more classical symptoms of cough and fever. Incubation periods are typically 5 days but can range from 2 to 14 days. The majority of cases are relatively mild and flu-like, but some progress to a severe illness with acute respiratory distress, often deteriorating around day 10.
The virus is primarily spread by close contact and “droplet” spread – droplets formed by coughing, sneezing or talking. It does not appear that the virus can transmit by aerosol, although viral RNA ( genetic material) has been found in sampled aerosolised secretions. This is important from a pandemic control point of view as droplets remain in the air for a very short time period (several seconds) whereas aerosols can remain airborne for hours.
This leads to methods to prevent spread – social isolation, careful hand and cough hygiene, and all the other restrictions that have been imposed upon us. Further restrictions were put in place in the Health sector in Australia to prepare for an expected onslaught of cases of COVID19. The aim was to maximise resources available to treat these patients and protect frontline health workers from falling victim. Predictions were in parallel to the experience in Italy, the UK and America – if we failed to prepare. Fortunately, to date, these restrictions have worked, and we have successfully “flattened the curve” leading to very few active cases in Australia as of late May 2020.
Some restrictions are now lifting, but we must be careful not to rush into “normality”. The virus has not been eradicated, and a second wave can happen. We must all do whatever is necessary to prevent this second wave of infections overwhelming our health system and causing widespread disruptions to our community. These measures have to date including restrictions of elective surgery, with obvious implications for patients at BHAPS. Thankfully, we can still treat patients requiring timely interventions for urgent conditions, and we are beginning to re-book some patients requiring more elective treatments. There are still some restrictions imposed by Queensland Health, resulting in fewer operating spots with Dr Rowe each month. We are managing the wait times as best we can to ensure no-one waits longer than they should for their surgery.
At BHAPS we continue to limit the numbers of patients in the waiting room at one time, to ensure appropriate distancing and to protect both patients and staff. Consultations will be done by telehealth or video call if possible. If you are to have a telehealth consultation, it is very useful to have photographs of the subject of your consultation – usually a skin lesion. These can be emailed (link to contact page) to Dr Rowe’s staff to be placed in your chart, or possibly texted directly to Dr Rowe. We will try to arrange this prior to your consultation date, so if you need help obtaining a photograph please do this prior to the date.
If you need to be admitted to the hospital after your surgery, be aware that there will be ongoing restrictions on the number of visitors allowed per patient per day. Access to the main hospital buildings is controlled and all visitors’ details recorded in case of any COVID tracing issues. Details will be on the Ramsay website.
You can see all the current COVID19 data from the Australian Government here.
If we all work together, we can get through these challenging times.