Covid Q and A

It is a respiratory infection caused by a coronavirus called SARS-CoV-2.

In Portugal, the current mandatory isolation period is 7 days. After which you do not need to be tested again and can return to the community. All positive cases should be reported to SNS 24 by calling 808 242424. This not only helps the local community and the country to see where cases are occurring, track the spread and make the necessary provisions to manage cases for effectively if required, but also helps scientists around the world understand the virus, how it affects countries and look out for new variants.

Coronaviruses belong to the family Coronaviridae, which includes viruses that can cause infection in humans, other mammals (for example, bats, camels, civets) and birds. To date, we have identified eight coronaviruses that infect and can cause disease in humans. Typically, these infections affect the respiratory system and may be similar to common cold or progress to a more serious illness, such as pneumonia. Of the coronaviruses that infect humans, SARS-CoV, MERS-CoV and SARS-CoV-2 have crossed the species barrier, meaning, these viruses have been transmitted to humans from a reservoir or host animal of these viruses. SARS-CoV originated as an epidemic in 2002-2003 and MERS-CoV emerged in 2012 and caused sporadic cases of human infection or small clusters of cases of respiratory disease. The new coronavirus, SARS-CoV-2, which causes the disease called COVID-19, was first identified in December 2019 in China.

Most common symptoms:

• fever
• cough
• tiredness
• loss of taste or smell

Less common symptoms:

• sore throat
• headache
• aches and pains
• diarrhoea
• a rash on skin, or discolouration of fingers or toes
• red or irritated eyes

Serious symptoms:

• difficulty breathing or shortness of breath
• loss of speech or mobility, or confusion
• chest pain

Seek immediate medical attention if you have serious symptoms.

The signs and symptoms of COVID-19 vary in severity, from the absence of symptoms called asymptomatic, to fever -temperature ≥ 38.0ºC, cough, sore throat, tiredness and muscle pain and in the more severe cases, severe pneumonia, severe acute respiratory syndrome, septicaemia, septic shock and eventual death. The data shows that the worsening of the clinical situation can occur quickly, usually during the second week of the disease.

COVID-19 is transmitted person-to-person by close contact with people infected with SARS-CoV-2 . This is called direct transmission. COVID-19 transmits when people breathe in air contaminated by droplets and small airborne particles containing the virus. The risk of breathing these in is highest when people are in close proximity, but they can be inhaled over longer distances, particularly indoors. Transmission by close contact occurs mainly through droplets that contain viral particles that are released by the nose or mouth of infected people, when they cough or sneeze, and that can directly reach the mouth, nose and eyes of those close to them. Droplets can settle on objects or surfaces that surround the infected person and thus infect other people when they touch these objects or surfaces with their hands, then touch their eyes, nose or mouth. There is also evidence to suggest that transmission can occur from an infected person about two days before symptoms develop.

• Crowded places
• Close-contact settings, especially where people have conversations very near each other
• Confined and enclosed spaces with poor ventilation.

The precise incubation period of coronavirus is not yet known. Experience so far suggests the average time it takes for symptoms to develop is 4 to 6 days after exposure, but it may be as short as 1 day or much longer.

The time between getting infected with a disease and starting symptoms is known as the incubation period. The incubation period for COVID-19 is between 2-14 days. But the average time before showing symptoms is thought to be 5 days. This is based on a study done in Wuhan, China, where the pandemic started. The study found that the median incubation period was 5.1 days and that 97.5% of people with symptoms will develop these within 11.5 days. The day you develop symptoms is classed as ‘day 0’ of your infection.

The simple answer is yes. Some people, even infected, never present any symptoms, but can nevertheless be contagious. At present the
percentage of asymptomatic people is not known.

Before the vaccination programme was introduced, 80% of COVID-19 cases had mild illness and symptoms, namely fever, runny nose, headache and body pain. Only 15% of cases became severe, with pneumonia and difficulty breathing, requiring hospitalization, and 5% eventually needed intensive care and assisted ventilation. Most deaths occurred in older people and those with chronic diseases or underlying health issues. These statistics changed greatly with the roll out of the vaccines and currently there is much less hospitalisation and death.

Two of the most effective measures are hand hygiene and respiratory hygiene. Hand hygiene should be done several times throughout the day. Before and after eating, going to the bathroom, arriving home or at work, or whenever justified. You should wash your hands with soap and water for at least 20 seconds, starting by rubbing the palms, backs of each hand, each finger, then thumbs and then the wrists, drying them well at the end. If you do not have access to soap and water, disinfect your hands with an alcohol-based solution at 70% concentration. Do not forget to remove rings, bracelets, watches, or other objects before washing your hands. These must also be cleaned.

Respiratory hygiene should be applied to avoid transmitting droplets from the nose or mouth. When coughing or sneezing, protect your nose and mouth with a disposable handkerchief or with your forearm. After using throw the tissue away, and then wash your hands immediately.

The use of masks is an additional protection measure, which must be complementary to the measures of distance, hand hygiene and respiratory hygiene. Its use is still mandatory in public health situations, (clinics, hospitals, care homes etc). To use a mask effectively, you must ensure that you put it on and remove it safely. You must cover your nose and mouth. Try not to fiddle or touch you mask once placed on your face.

Thankfully we are much more knowledgeable about treating Covid-19.There are now drugs that target the virus or our body in different ways:

• anti-inflammatory drugs that stop our immune system overreacting with deadly consequences
• anti-viral drugs that make it harder for the coronavirus to replicate inside the body
• antibody therapies that mimic our own immune system to attack the virus are used in hospitals for severe cases

Yes!! Thankfully there are now vaccines available to everyone who wishes one. Currently 91% of the population in Portugal is fully vaccinated (two doses) and 60% have had the booster. You can book your vaccine using the SNS 24 portal https://www.sns.gov.pt/vacinacaocovid19/ You can choose to read in Portuguese or English.

Or go to your nearest Casa Aberta/Open House during the times stipulated on the SNS website without an appointment.
The vaccine is available for anyone over the age of 12.

Our clinic recommends everyone to get vaccinated and boosted where possible.

Diagnostic test

The SARS-CoV-2 RT-PCR test is a real-time test and involves taking samples of the upper respiratory tract (nasal and/or throat swabs)
collected from individuals suspected to have COVID-19, belonging to a risk cohort, or having been in contact with a confirmed COVID-19
patient.
There is also a Covid-19 Antigen quick test available that you can buy yourself and test at home.
You should be tested:

• If you are experiencing any one of the symptoms suggestive of a Covid-19 infection
• If you been in contact with a person infected with Covid-19. You should have a swab test at day 1 and repeat at day 5
• Currently most countries have stopped the need for mandatory testing; however you should always check before travelling. In some countries a negative test swab is mandatory before departure, depending on where you are travelling to and from. Please also
  remember to check the requirements when re-entering your home country

The blood test is looking for antibodies against Covid-19 in your blood. If you have had an infection of coronavirus, after an average of 6 weeks your body produces antibodies. So to know if you have had a Covid-19 infection, we can do this blood test. For now we do not know how long these antibodies remain elevated after infection or if having these antibodies will protect you from re-infection.

Vaccines against pneumonia, such as pneumococcal vaccine and flu vaccine, do not provide protection against the new coronavirus. The virus is so new and different that it needs its own vaccine. Although these vaccines are not effective against COVID-19, vaccination against respiratory illnesses is highly recommended to protect your health. We recommend the pneumonia vaccine for over 65´s and anyone with a chronic respiratory condition

Anyone can be infected by the COVID-19 virus. Older people, and people with pre-existing medical conditions such as asthma, diabetes, cancer and heart disease are more vulnerable to becoming severely ill with the virus. WHO advises people of all ages to take steps to protect themselves from the virus, for example by following good hand hygiene and good respiratory hygiene.

Antibiotics work only against bacteria, not viruses. COVID-19 is caused by a virus, and therefore antibiotics should not be used for prevention or treatment. However, if you are hospitalized for COVID-19, you may receive antibiotics because bacterial co-infection is possible.

It is highly unlikely that people can contract COVID-19 from food or food packaging. COVID-19 is a respiratory illness and the primary transmission route is through person-to- person contact and through direct contact with respiratory droplets generated when an infected person coughs or sneezes. There is no evidence to date of viruses that cause respiratory illnesses being transmitted via food or food packaging. Coronaviruses cannot multiply in food; they need an animal or human host to multiply.

From onset to clinical recovery for mild cases is approximately 1-2 weeks and is 3-6 weeks for patients with severe or critical disease. However a longer convalescence period has been reported in numerous cases after prolonged or severe illness.

The virus that causes COVID-19 infects people of all ages. However, evidence to date suggests that two groups of people are at a higher risk of getting severe COVID-19 disease. These are older people (that is people over 60 years old); and those with underlying medical conditions (such as cardiovascular disease, diabetes, chronic respiratory disease, and cancer). The risk of severe disease gradually increases with age starting from around 40 years. It is important that adults in this age range protect themselves and in turn protect others that may be more vulnerable.

COVID-19 causes more severe disease than seasonal influenza. While many people globally have built up immunity to seasonal flu strains, COVID-19 is a new virus and the issue of immunity is still being evaluated. That means more people are susceptible to infection, and some will suffer severe disease. By comparison, seasonal flu generally kills far fewer than 1% of those infected.