Dr. Jason Carmichael, MPH, answers your Coronavirus questions | Tibu

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It is extremely important to not panic and to stay calm, this can prevent you from making your situation worse.

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Dr. Jason Carmichael, MPH, is trained in Public Health and Epidemiology from the Faculty of Medicine at the University of British Columbia with a lot of passion for public health and massive experience responding to outbreaks such as Ebola, Cholera and Polio with the World Health Organization. Here are your top questions on Coronavirus answered by Dr. Jason.

If you have medical questions related to Coronavirus and want to get them answered by local doctors, please submit them as a comment below! We are in this together and always here to support you!

Is Covid-19 airborne? Is it advisable that we wear masks while stepping outside?

Airborne spread has not been reported for COVID-19 and it is not believed to be a major driver of transmission based on available evidence.

Normally children and the older generation are more susceptible to infections, how come with this strain only the older generation seem to be dying more?

The virus is so new that we don’t really know. The fact that very few children have severe Covid-19 infection so far suggests that there is something fundamentally different about the way they are handling the virus.

The first suggestion is that there are many ways in which the immune system of a child differs from that of an adult, not least because the immune system of children is still very much a work in progress: children, especially those in nursery or school, are exposed to a large number of novel respiratory infections and this might result in them having higher baseline levels of antibodies against viruses than adults. The second suggestion related to that difference between children and adults could be put down to the ageing of the immune system.

Other reasons are suggested but are more technical. One of these suggestions is that the virus needs a protein on the surface of a cell called a receptor, to get into the inside of a cell and start causing problems. It may be that children have less of these receptors in their lower airways (lungs) than in their upper airways (nose, mouths and throats), which is why they are most often showing mild symptoms as it is their upper airways that are predominantly affected.

Additionally, other studies suggest that because children have fewer chronic cardiovascular and respiratory conditions, they are more resilient to severe coronavirus infection than elderly adults.

However, it is important to remember that we know very little about this virus. Scientists are still speculating in terms of trying to understand why we are seeing the epidemiology that we are seeing, and many studies and researches are still ongoing.

If one requires hospitalization due to inability to breathe well, what's the typical treatment protocol (prior to intubation)?

Practically, non-invasive techniques can be used in non-severe forms of respiratory failure: Patients should receive in that case oxygen therapy using oxygen masks or nasal prongs and require to be monitored very closely.
Note: If the scenario does not improve or even worsen within a short period of time (1–2 hours) the mechanical ventilation must be preferred

What precautions can I take if I have breathing problems due to Covid-19 in the house as I wait for the medical support to arrive?

First of all, it is extremely important to not panic and to stay calm, this can prevent you from making your situation worse. Also do the following:

  • Settle down comfortably (a half-sitting position)

  • Release your clothing

  • Avoid any effort 

  • If necessary, lean forward slightly

  • Call an emergency number

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    Prince | April 04, 2020 20:34

    Hello doctor I'm from Malawi. At what rate can covid-19 be able to kill people if not careful? And which group of people is prone to this pandemic?

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    Faith | April 13, 2020 13:25

    Hello Prince. We have a different Ask me Anything article for the Medical Questions for Coronavirus, and other articles on the website that have tips on how to stay safe and risk factors for COVID-19. Kindly have a read through them and look out for more articles that we will be publishing to provide you with the right information at this time. Please look out for an article within the course of this week that will contain your response

    GERALD | April 02, 2020 09:38

    Yes doctor, am from Uganda and Diabetic, what is the correlation between COVID-19 and Diabetes

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    Faith | April 02, 2020 10:14

    Hello Gerald. Here is the response from one of the clinicians h=that was also featured in one of our other articles. It is assumed everyone is susceptible, though patterns have been varied for different populations. Evidence is rapidly increasing on COVID-19. Risk factors for developing severe disease and increased risk of death are older age, hypertension, diabetes, cancer, chronic respiratory disease and cardiovascular disease. The numbers for severe disease appear to be higher in males. For instance, Italy has the oldest population in Europe; 28.6% of the population are at least 60 years old (second in the world after Japan, 33%), according to the 2015 “World Population Ageing Report.) In Italy, 75% of the cases are individuals over 50 years old and most of the deaths (90%) are in those over 60 years old. Severe disease was reported in more men than women which could be partly due to their higher rates of smoking and subsequent comorbidities. A similar picture has been seen in China where the majority of the deaths were in older men who were smokers. Contrast this with South Korea, where the outbreak has mostly affected much younger people, with the largest group affected being in their 20s. Only 20% of cases have occured in those at least 60 years old. Development of severe disease is not a death sentence. It has been showed that recovery is possible in the elderly with reports of a Chinese grandmother, 103 years old, recovering and being discharged from care. She goes on record as the oldest person to beat coronavirus and return home. There is also a report of a 9-month old baby on record as the youngest case. Also read through the other articles that we have made available on the platform and also look out for more as we ensure that you have access to the right information at this time.

    Peter | April 02, 2020 09:16

    Dr. Where my temperature remains normal (34.6 to 36.4) for over two weeks yet I experience pain in my lymph nodes under the armpits and mild chest pain, with no. cough but inflamed throat glands can this be alarming and a urgent for me to visit a medical facility? Yet I have no traveling history.

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    Faith | April 03, 2020 10:11

    Hello Peter. Here is the response from one of the clinicians. Lymph nodes, a part of the lymphatic system, play a role in immune function. Any foreign agent in the body has the potential to trigger a defensive response by the white blood cells of the body and other inflammatory proteins. These then isolate/trap and neutralise the foreign agent within nodes. Unilateral (one-sided) inflammation may be a sign of an infection or disease on that side of the body, while bilateral (affecting both sides) and potentially involving other node locations may point to a more systemic (generally widespread) disease. It is essential to have a conversation with your doctor, or visit your nearest health facility, so that the history of your symptoms may be evaluated better. This will also aid in providing guidance on investigations that may help identify or confirm the underlying process. You may also access mDakatri telemedicine services online by creating an account and requesting a consultation. This will provide you access to medical professionals over the phone, keeping you out of crowded waiting rooms. The service is available 12 hours a day, 7 days a week. Also read through the other articles the website and also look out for more that we will be publishing.

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