Coronavirus (COVID-19) has caused significant panic in the Australian public as reports of its impact overseas grow. This post is intended to provide a brief summary of what we know about the virus and advice to our families/friends and staff.

For updated information please visit https://www.dhhs.vic.gov.au/coronavirus, make use of the links below or contact your health service.

What we know (as of 9-3-2020)

• COVID-19 is a virus from the coronavirus family (responsible for causing various conditions ranging from the common cold to SARS/MERS). In fact, coronaviruses cause roughly 10-15% of colds.
• It is spread in two main ways:
  • Inhalation of droplets (such as from sneezing or coughing)
  • To a lesser extent the virus may survive on certain surfaces or possibly in faeces for short periods of time (still to be determined), and be transmitted by touching these infected areas and then touching your face/mouth/nose.
• Incubation period:
  • This is the time between contracting the virus to showing symptoms.
  • This is currently estimated at 1-14 days but mostly around 5-7 days.
• How contagious is it?
  • More contagious than Seasonal Flu (slightly) and MERS.
  • A lot less contagious than Measles, Smallpox and Whooping Cough.
  • R0 (reproduction number) estimated at 2-2.5 people for each case.
• Presentations range from:
  • No symptoms whatsoever.
  • Mild cold symptoms such as runny nose and sore throat.
  • Moderate symptoms of pneumonia such as fever, cough, shortness of breath and lethargy.
  • Severe symptoms (which usually occur after the 1st week of symptoms) of worsening respiratory failure and multi-organ failure requiring Intensive Care.
• Who it affects most:
  • MOST people will have no symptoms or mild symptoms.
  • Older people (over the age of 65) or those with other medical problems such as chronic lung disease or immunosuppression. Over the age of 80, mortality rate is very high. 
• Who it affects least:
  • Young people, particularly babies and children (no deaths in 0-9 year olds).
  • These people may still transmit the virus to others but may not become as ill.
• Mortality:
  • Reported by the World Health Organisation as 3.4% on March 3, 2020.
  • The true mortality rate may be lower than this as some cases have not been tested/diagnosed and therefore reported.
  • The mortality rate will likely be lower in developed countries.
  • As a comparison, Seasonal flu (Influenza) has a mortality rate of 0.1% or lower.

Advice (as of 9-3-2020)

• Reduce transmission:
  • Wash hands with soap (dry properly) OR use an alcohol based (> 60%) sanitiser (this is sufficient to break the virus envelope).
  • Avoid touching face.
  • Cover your nose/mouth if you cough/sneeze.
  • Wear a mask ONLY if you exhibit symptoms – remember, the virus does not stay suspended in the air.
  • Keep a distance of more than 1-1.5 metres from people showing symptoms (if you absolutely cannot, then wear a mask).
  • Please do not visit the ICU if you are unwell! Our patients are at high risk.
• Stay well by:
  • Getting the Flu vaccination (available in April).
  • Not smoking.
  • Good sleep, diet and exercise.
• When to call for advice (1800 675 398):
  • If you have been overseas in the last 14 days and develop cold/flu symptoms.
  • If you have been in contact with a person who has confirmed COVID-19 (coronavirus).
  • If you are otherwise concerned.
• For health care workers:
  • Self quarantine for 14 days post return from one of the affected regions or if you develop cold/flu symptoms – notify appropriate health service.  
  • High and moderate risk regions are listed here: https://www.health.gov.au/news/health-alerts/novel-coronavirus-2019-ncov-health-alert#travellers-and-visitors.
  • Use Personal Protective Equipment (PPE) when caring for anyone with a suspected or confirmed. respiratory virus. Practice ‘donning and doffing’ as per local guidelines.
  • Please refer to and follow your health service’s specific and updated advice.
  • To notify of a patient who is suspected of having COVID-19, call 1300 651 160.
• Testing:
  • Occurs via a nasopharyngeal or throat swab sent to a lab conducting the testing (not all labs yet).
  • Can occur at GPs, EDs and likely will be available at new clinics dedicated to testing patients presenting with symptoms.
• Travel advice:
  • See updated travel advice on the Smart Traveller website here: https://www.smartraveller.gov.au/news-and-updates/coronavirus-covid-19.

Treatment

• There is no cure for the virus. 
• Prevention is the best treatment. Apart from the above measures, there is a vaccine in the pipeline but please note this will take many months before it is available for human use.
• The treatment is supportive which includes:
  • Home – rest and symptomatic treatment you would use for any cold or flu.
  • Hospital basic supports – fluids, nutrition, oxygen and treatment of any co-infections such as bacterial pneumonia.
  • Hospital advanced supports – treatment in the Intensive Care Unit using high amounts of oxygen, intubation and ventilation, blood pressure supports, dialysis and extra-corporeal membrane oxygenation.
  • All patients hospitalised with suspected COVID-19 will be isolated.
• There is research being conducted on different medications for critically unwell patients with COVID-19.

Hospital preparation

• St Vincent’s Hospital Melbourne has a detailed plan for different levels of our population being affected by the virus. This includes how to reduce the chance of other hospital patients being infected whilst still providing optimal treatment for all.
• Our Intensive Care Unit also has specific plans to cater for increased need for critical care treatments.