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COVID-19 Questions

COVID-19 INFO

The coronaviruses are a large group of viruses that are common throughout the world. Most of these viruses are found in animals and very few in humans. The name corona refers to the crown-like spikes on their surface when viewed under a microscope. This particular virus is a new one called SARS CoV-2 and was first identified in China in 2019. It enters through the nose or mouth or eyes. The infection travels from your respiratory tract to all parts of your body and can cause anything from no symptoms(asymptomatic) to a severe respiratory illness.

We call the illness that is caused by SARS CoV-2, COVID-19.

The most commonly reported symptoms of COVID-19 are:

    • New cough
    • Fever
    • Fatigue
    • Muscle aches
    • Shortness of breath when moving around
    • Loss of taste/smell

After testing positive, the first and most important thing to do, is to stay calm. We know that at least 95% of those infected will recover completely. The more panicked you feel, the more adrenaline surges through your body and the more your cells think they are in danger. Just slowing your breath down will increase your oxygenation and tell your body that things are ok!


1. Keep calm
2. Notify your line manager and email corona@firstrand.co.za for us to call you and understand your risk assessment.
3. Flag yourself on the FNB Symptom Checker App or email corona@healthwithheart.co.za
4. A Health with Heart doctor will call you to check and see how you are and advise you on next steps
5. Check in with your family doctor so that they are aware of your diagnosis
6. Isolate yourself from loved ones and the public for 14 days from the onset of your symptoms (see below on isolation and quarantine)
7. Make a list of the persons you have been in close contact (1-2m for 15min or more) with in the 3 days prior to you testing or becoming symptomatic – they need to be notified and go into quarantine for 14 days
8. Enlist the help of your community for shopping and getting medication etc.
9. Monitor your symptoms
10. Stay positive and connected to loved ones through virtual platforms

We address treatment and how to be in isolation in later questions. Once positive, you go into isolation and your family or other close contacts go into quarantine. The rules for quarantine and isolation are the same. The terminology differs because we isolate sick people and we quarantine well people.

This depends on what stage of the illness you are in and what your symptoms are. For most people, the symptoms last 7-14 days. There is no proven antiviral that cures the infection, only supportive therapies. Antibiotics do not treat viral infections. In most cases, COVID-19 it is self-limiting, and your body fights the virus, which means the symptoms stop on their own.

The 85% of people that only have a mild flu-like illness usually present with either a fever, chills, body aches, sore throat, red eyes, a cough or mild shortness of breath. Some people have no symptoms at all.

When only mildly ill, the recommendation is:

  • Stay hydrated
  • Take Panado (paracetamol) as needed for the fevers, headaches and body aches.
  • Other supplements that can boost one’s immune system to help fight the virus are vitamin C 500mg three times a day, elemental zinc 25ug daily and vitamin D3 5000iu daily or 50 000iu once off. You can discuss and get all of this through your GP.
  • Rest
  • Move around at regular intervals

Between 10 to 15% of people infected might need oxygen support. Less than 5% might need ICU care. Monitor your symptoms regularly. It is useful to check your pulse and oxygen saturations during the illness if you feel significantly unwell. Talk to your doctor about getting a pulse oximeter through your medical aid or buying one from the pharmacy. A pulse oximeter is a small instrument that you click onto one of your fingers. It tells us how well oxygenated your bloodstream is and it tells us your heart rate.

If you get one of the following:

  • Worsening shortness of breath
  • Chest pain
  • Returning fever
  • Readings of <90% on pulse oximeter

Please flag yourself on the FNB Symptom Checker App for one of our doctors to call you and then please contact your regular doctor or present to your nearest casualty. Please do not wait for a call from us before seeking assistance.

Our body has its own internal clock. Different systems are more active at different times of the day. Night time is a time when the immune system is more active and so your body produces higher levels of the cells involved in pain, inflammation and healing at night. There are also less distractions to keep you from thinking about your discomfort. Sleep deprivation also heightens all physical experiences. It is normal to feel worse at night so do not panic, things should ease by the mid-morning.

It is possible and normal that you may have residual symptoms that linger for weeks after the infection, especially if you were in hospital or had severe COVID-19. These symptoms may include a severe fatigue, ongoing breathlessness, muscle weakness, post viral cough and difficulties with memory and concentration. Whilst these are the physical symptoms, you may also find that you also have anxiety or a low mood – please reach out to loved ones and ICAS on 0800 212 699.

We do not know the definite answer to this question. Based on how other viruses behave in our bodies, we believe that you may have immunity anywhere from three months to three years. We will only know the answer to this with time. As such, we are assuming that employees who have recovered are immune for one month after infection. If they are re-exposed to a positive case after the first month following their infection, we will treat them as non-immune and quarantine them again. This approach will be revisited on a monthly basis.

PREVENTION MEASURES

The truth is that in all likelihood most of us will get COVID-19 at some point in time in the future – it is not going anywhere for a while and vaccine trials, whilst promising will take time to become available. This shouldn’t be a scary thought as we know that more than 80% of people will only have mild to moderate symptoms, much like the flu that circulates every year. If anything it should be a motivator to get healthy and get any chronic conditions you have under control! Knowing the infectiousness of the virus we don’t want to all get COVID-19 at the same time and overload our healthcare system and so preventative measures are important especially where our vulnerable loved ones are concerned – see our advice below.

We know that physical distancing, regular hand washing and wearing a mask helps to prevent the spread of coronavirus droplets. Despite this, the virus is very infectious and spreads.

You can help to support your immune system by:

  • Eating a diet rich in fresh produce,
  • Home cooked meals,
  • Avoiding sugar, salt, fast food and fizzy drinks
  • Stay well hydrated with an average of two litres of water a day for a healthy adult
  • Take a good vitamin D, zinc and vitamin C supplement
  • Do at least 30 minutes of exercise on four or more days of the week
  • Check out free yoga classes online. Also yoga has a brilliant 15 minute or 30-minute
  • Routine that you can do every day before work.
  • Check for additional resources available through Employee Wellbeing on the intranet

We know that physical distancing, regular hand washing and wearing a mask helps to prevent the spread of coronavirus droplets. Despite this, the virus is very infectious and spreads.

There is much debate about grocery shopping and the risks of catching the virus while out shopping. We know that coronavirus can survive for a long time on certain surfaces but only under perfect conditions. Therefore, hand washing frequently is your best defense. Wash your hands before and after preparing food and wash your fruit and veg as you always have.

Other tips:

  • Wear your mask appropriately and not under your chin in respect for your fellow humans.
  • Remember your mask protects me and mine protects you!
  • Be organised with a list to avoid long shops and unnecessary handling of items
  • Buy for the week to avoid multiple trips (but don’t stockpile!)
  • Keep 1-2m from fellow shoppers and when in queues
  • Sanitize the trolley or basket handle
  • Wash your hands before and after going to the shops. Gloves are not necessary as the virus does not penetrate the skin and they are no substitute for good hand washing to avoid transmission to face
  • Avoid handling your phone or keys etc without first sanitizing your hands
  • Try where possible to use no-touch payment methods or swipe your own cards at pay points and then consider sanitizing them

We know that whilst the virus lives on surfaces for prolonged periods of time it needs perfect environmental conditions to be at concentrations that could pose a risk. If you however live in a household with vulnerable persons (elderly, those with severe medical conditions) then you may want to add the following to your regime:

  • Wash counters that groceries are exposed to
  • Wash groceries using soap and water
  • Consider “quarantining” non perishable or dry foods in the garage for a period time before bringing them into your kitchen
  • The virus is not killed by refrigeration or freezing
  • Wash your hands after packing groceries away
  • Consider changing your clothes

It is possible that viral particles can land on your clothing and then get transferred to other surfaces or people. As such, we encourage daily washing of your clothes. We recommend that those of you who may have a COVID-19 positive person living in your household use the following approach when coming to work. We recommend that you come to work in civvies and change into your work uniform when you get there and then change back when you are heading home. Alternatively, you can spray your clothes down with an alcohol spray. We recommend that you do this in order to prevent you bringing viral particles carried on your clothing into the work space.

NB. If you choose to spray your clothes, please always do so in the open air outside and away from anything flammable. Please do not do this near a gas stove or heater or a person who is smoking. Please do this in a well-ventilated place with open windows, preferably outside in the open air.

Please watch the videos provided for this information.

You protect your loved ones by protecting yourself. The more mindful you are of hand washing and social distancing, the less likely you are to contract the virus. If you live with elderly or unwell persons who are more at risk of the complications for COVID-19, then you need to be extra careful. Make sure you physically distance from them at home. Wipe down the surfaces of high touch items that you share with them often i.e. door handles, the kettle handle, fridge door, microwave, light switches etc. If you have any symptoms, consult with a medical practitioner and arrange to get tested. While you are waiting for your test, pretend that you have COVID-19 in order to protect those that you live and work with.

People over the age of sixty and who have underlying chronic conditions are more vulnerable to the complications for COVID_19. They are not more susceptible to contracting COVID-19, but they are vulnerable to its more severe complications.

We do not know ‘the why’ for sure, but it seems that persons with underlying compromise of their blood vessel’s lining are worse affected. There is growing evidence that abnormal clotting during the disease is what causes the complications. Small clots in the bloodstream end up in the lungs and in other organs. When a clot blocks a blood vessel, oxygen and nutrients cannot flow to that part of the organ. When blood supply is cut off, tissue dies and loses its ability to function. Diabetic, hypertensives, obese people and the elderly often have less healthy blood vessels putting them at greater risk. It is important to know your status and undergo annual Personal Health Assessments to determine if you are at risk. For those with these conditions, now is the time to check in with your treating practitioner to understand how to keep yourself safe.

More and more evidence suggests that children do not shed high levels of virus and so are not significant spreaders of COVID-19. We also know that they are rarely affected adversely. This is the saving grace of this virus and we are so grateful. Children should continue to practice hand hygiene and you can make this fun by teaching your children about germs and how to protect themselves against becoming ill.

If you have tested positive, then it is likely that your children are close contacts of yours. As such they should stay home with you through your isolation for 14 days and not go to school. If your child develops symptoms within that time, then they need to be tested and their own isolation starts again with day one being the first day of their symptoms. If your children are old enough to isolate from you in the home, then their date of last contact with you is day one of fourteen of their quarantine.

TESTING

There is a global shortage of test kits. Another important consideration is the timing of the test. We use the PCR test to diagnose COVID-19 (described below) and it is only positive at the stage where the genetic material of the virus is present in one’s airways which may take a few days. As a result, it is not possible or effective to test everyone who has been exposed to a positive case immediately. In line with the guidance from the NICD, we only test symptomatic persons and persons who are being admitted to hospital for a procedure. We do not test people who have NO symptoms. It is unethical to use up tests for well persons. Please be mindful of this and help us to spread this message. We need to keep tests for the unwell and vulnerable.

You get PCR tests and antibody tests – both have limitations. A PCR test detects the genetic material of the virus in the nose or throat – whilst this indicates an infection, it can still be positive for up to 6 weeks after the infection has resolved. An antibody test can tell if you have had a previous infection, but is not used for diagnosis.

A PCR test involves a thin, long ear bud type instrument being inserted into your nose or touched to the back of your throat. This is not painful but can be uncomfortable and result in gagging or tearing of your eyes. There is more and more evidence that just touching the ear bud to the middle part of your nose for ten seconds is enough to get a good sample. We do not have to go in very deep anymore.

The antibody tests have not yet been endorsed by the NICD or WHO and as such are not available for use in South Africa outside of academic research. If it does become available it will involve a finger prick – mush like an HIV test.

CONTACT WITH A POSITIVE CASE

In accordance with the NICD, a close contact is someone who has spent more than 15 minutes within one metre of the positive person while they are unwell and for three days prior to the onset of their first symptoms or positive test.

The first thing you should do is make sure you have the whole story. Make sure the positive case is confirmed and then again, remain calm. Remind your cells that there is no reason to panic. If you are a close contact, as described above, having spent more than 15 minutes within one metre of the ill person during their illness and the three days before their illness started, then you need to go into quarantine. Usually when having been exposed to COVID-19, a person will develop symptoms between days five and seven. Your most infectious time is day four to nine if you become infected. Therefore, it is very important to observe the rules of quarantine to prevent further spread to those around you. We do not yet understand the risk of spread from asymptomatic individuals to others. We are erring on the side of caution now.

ISOLATION AND QUARANTINE

We isolate sick people and we quarantine well people. The rules observed by both are the same.

Take it easy Do not go to work, avoid all non-essential travel, activity and social interaction with other people (even those you live with) Discuss supportive care with your doctor.

Stay Clean Wash your hands with soap frequently or use an alcohol-based sanitiser containing at least 70% alcohol when water is not available. Regularly discard used tissues in a lined bin. Cough/sneeze into the crook of your elbow. High-touch surfaces like table tops, counters, toilets, phones, computers etc. should be frequently cleaned. A bleach and water solution is easy and cheap to use as a disinfectant. Read the instructions and care guidelines of any household items before use.

Mask up Wear a face mask when in the same room or vehicle as other people. Functional face masks reduce the spread of droplets and wearing yours will greatly help to prevent those around you from possible infection.

Be socially conscious You have a social responsibility to stay away from other people during this period. Accept no visitors.


Keep to yourself Limit your contact to those who live within your home and keep a two metre distance from you. If you live in shared accommodation, you should stay in your room with the door closed and use your own bathroom. Keep windows open for good ventilation. Only venture into communal areas when necessary, while wearing a face mask and with clean hands.

No sharing! You should avoid sharing household items like dishes, cups, cutlery and towels. All items should be washed with soap and water after use, this will make them ready for reuse.

Do your laundry When doing laundry at home, wash your items at the highest temperature compatible for the fabric (above 60° C). Wear disposable gloves when handling dirty clothes or wash your hands when you are done. Be sure to clean all surfaces around the washing machine and wash your hands after removing and disposing your gloves.

Keep smiling Isolation can be taxing on one’s mental health, especially when living alone. If well enough, use your time for uplifting entertainment and self-reflection, and remember to practice gratitude! Reach out to loved ones often to keep yourself feeling supported and connected.

Monitor your symptoms Seek immediate medical attention if your illness is worsening, for example, if you have difficulty breathing. If it’s not an emergency, call your doctor or healthcare facility for a virtual consultation. For Gauteng patients, please get in touch with us to borrow a pulse oximeter for use while you are unwell.If it is an emergency and you need to call an ambulance, inform the call handler or operator that you may have/have COVID-19 so that they can arrive prepared.

You can apply to a government or private facility offering accommodation in the context of COVID-19. You can get assistance to do this through the FNB COVID-19 app. When you flag yourself on the app for having symptoms or being exposed to a positive case, you will get called by a nurse or doctor.They will be able to guide and assist you.

If you are unable to access a facility, then you just need to do your best. Spend time outdoors, observe physical distancing, excellent respiratory hygiene, wear your mask and wipe down high touch surfaces with a bleach solution. Another idea if you live with a vulnerable family member or friend, is to send them to stay with friends or relatives who are well for the duration of your illness.

As mentioned above, most people will develop symptoms of COVID-19 within five to seven days after their contact with a positive case. Some people will only develop symptoms on day 11 or 12, we call these people outliers, because they deviate from the norm. The number 14 is a safe amount of time to have passed to ensure that you are not infectious if you have no symptoms. If you do develop symptoms, it will be in this time that you are staying away from others and it will protect them.

Quarantine of healthy people is 14 days from their last contact with a positive case. If they develop symptoms and become COVID-19 positive, then we count day one starting again from the first day of their symptoms and they then go into isolation for 14 days.

If you have a moderate or severe version of COVID-19, then your isolation will be extended. If you end up on oxygen, we count your day one as the first day that you come off oxygen and we de-isolate you after 14 days from then. If you have severe symptoms or are unwell for a prolonged period, your treating doctor will prolong your isolation on a case by case basis.

WORK-RELATED

No, you do not need to repeat your test. Dead viral particles can be detected by the PCR test for up to six weeks after the initial infection and so this will give a person a false positive. Dead viral particles are inactive and CANNOT spread COVID-19.

We do not know for certain how long the virus survives on certain surfaces and we do not know how infectious those viral particles are. We know from some studies that SARS CoV-2 can survive for days on plastic and metals. Lab environments do not mimic the natural world and so are only a guideline. The CDC only recommends a deep clean within seven days of a sick person being in the office. Beyond seven days, there is consensus that all the viral particles are dead and cannot make people ill.

PPE stands for personal protective equipment. It includes masks, visors, goggles, gloves, aprons and protective clothing. Different PPE is required for different scenarios. Outside of medical spaces like hospitals and doctors’ rooms, the general person needs to protect themselves from droplet spread of the virus.

Droplets can be imagined like fine rain that fall and land on surfaces around us. Wearing a face mask will prevent droplets from landing on your face or in your nose or mouth. Therefore, you should wash your mask when you have been in close contact with other people. If you are observing physical distancing, your mask is unlikely to become easily contaminated. Wearing your mask also protects the people around you from your own droplets as these will land in your mask instead of on your neighbour.

Some people are using gloves, we recommend regular hand washing with soap and water instead. Moisturise your hands often with natural moisturisers to prevent skin reactions to washing and sanitising.Visors are worn to protect viral particles from entering your eyes and travelling down your tear ducts into your nose. Goggles or glasses perform the same function. It is thought that protecting your eyes reduces spread by about 10% in health professionals. Most of the spread is via the mouth and nose.