Will there be shortages of medications like HRT, the contraceptive pill and antidepressants? Should I order a bigger supply than normal?
“The NHS has been dealing with various medication shortages for about 18 months,” says Dr James Gill, a GP and clinical lecturer at Warwick Medical School. “When that happens we find the most appropriate alternative and swap a patient to that. In the current situation, I wouldn’t worry about not being able to get your normal medications.”
How should I contact my doctor for a repeat prescription? Can I get my prescription delivered?
“Practice phone lines are busier than normal in GP practices,” says Dr Gill. “Most GP surgeries have a prescription ordering service phone line, so continue to use those. Pharmacists are being requested to assist with access to repeat medications and expand prescription delivery services.”
I’m in the middle of having chemo once every three weeks for ovarian cancer - will it be delayed?
NHS leaders are drawing up new guidelines and sending letters to those most at risk to tell them they must self-isolate with immediate effect. For cancer patients, oncologists will be balancing the risk from cancer not being treated optimally versus the risk of becoming seriously ill if they contract Covid-19 because of immunosuppresison.
Should I still go and see my therapist?
“At the moment, this is a decision that you and your counsellor need to make together,” says Fiona Ballantine Dykes, deputy chief executive of the British Association for Counselling and Psychotherapy.
“For some people, counselling is an essential contact, and you could consider whether telephone or online therapy may be possible, while other people may be able to manage or choose to take a break in therapy. Some counsellors are putting in place precautions so that clients can still visit them for face to face sessions.”
I have a broken foot and need a check-up at my local hospital in a few weeks – should I miss it?
“There are a lot of medical conditions which still need face-to-face assessment in order to ensure things are going well. As time goes on, each case will be viewed on what is best for that person and what is the very latest government advice. I’d suggest that one week before your appointment date, call the department secretary (the number will be on your last clinic letter),” says Dr Gill.
I’m in recovery and go to a weekly AA meeting, what can I do if this is cancelled?
“Addiction is a very challenging battle, and if someone is already engaging with a recovery meeting or programme then they are already doing so well,” says Dr Gill. “We will do everything possible to assist those patients to remain abstinent.
“Each service will be putting their own approaches in place. Don’t worry, you will not be abandoned. Contact your support service and ask how things are changing.” Many are launching online services which you will be able to easily access.
Should I have invasive procedures - eg: a smear test or coil?
“If you are fit and well then having routine health procedures performed at your GP surgery is important for your ongoing health,” says Dr Gill. “ If in doubt, check with your GP, and if services are being temporarily postponed, ensure that you do follow up in a few weeks time, so as to ensure you still get your procedure.”
Should I go to antenatal classes?
"We understand this must be an unsettling time for pregnant women,” says Gill Walton, CEO of the Royal College of Midwives. “Advice is changing all the time. But for now, we would like to emphasise that attending antenatal and postnatal care when you are pregnant and have a new baby is essential to ensure the wellbeing of women and their babies, and we would urge all pregnant women who are well to attend their care as normal.
“However, if you are pregnant and have symptoms of possible coronavirus infection, you should call to defer routine visits until after the isolation period is over."
Are private tests worth it?
Public Health England (PHE) says that you will only receive a free test for Covid-19 if your symptoms are severe enough to warrant hospital treatment or you live in a care home, leaving a large number of people with mild symptoms - including a fever and a cough - in the dark. Private firms have tried to fill the gap, delivering home testing kits for up to £295 that people carry out themselves, using a throat swab. Last week, actor Idris Elba received results for a Covid test despite displaying no symptoms.
The private kits are not officially endorsed by PHE, but neither PHE nor the NHS has expressed any doubt about their accuracy. So the choice is yours: if you are desperate to know your Covid status and don’t mind shelling out hundreds of pounds, then a private test might be a good idea.
If you get it once, can you get it again? If so, would the second dose be milder or more severe?
The answer to this isn’t yet completely clear.
On Monday, the chief scientific adviser Sir Patrick Vallance said it is unlikely you could catch it twice: “In any infectious disease there are cases where people can catch something again [but] they're rare”, he said.
Professor Chris Whitty, the chief medical officer, added: "Even in diseases which do not have long-lasting immunity there's usually a short period of immunity and that's enough for a season.”
At Thursdays press conference the Prime Minister announced that the government was in negotiations to buy hundreds of thousands of antibody tests which can tell whether you have had Coronavirus. “This has the potential to be a game changer,” said Boris Johnson, as “you are therefore likely to be vulnerable and less likely to pass it on.”
What is the truth about ibuprofen and coronavirus?
Experts suggest ibuprofen could dampen the immune system’s response to Covid-19, aggravating pneumonia symptoms and leading to a lengthier recovery.
The NHS and Sir Patrick Vallance have both advised people to err on the side of caution and take paracetamol to take their temperature down. The NHS adds if you are already taking an anti-inflammatory on the advice of a doctor, consult them before changing your medication.
What’s more important, age or health? If you are a healthy fit 70-year-old, would you still be at more risk than an overweight, smoking, drinking 55-year old?
Older people tend to have more severe infections of coronavirus than their younger counterparts, but that does not mean that age is the only relevant factor. Older people can have mild cases, and some younger people are severely affected.
Death rates in those with cardiovascular disease, diabetes and high blood pressure are higher than those with no other serious conditions. These three conditions are largely influenced by lifestyle factors such as weight management, smoking and eating a healthy diet, so it could be that looking after your health generally would help to reduce the severity of the condition.
Is it OK to walk or cycle outdoors?
Yes unless you have been identified as being in a high risk group. Even under last week’s draconian new guidelines, in which the government advised people not to see friends or family or to gather in crowds, you are still allowed to leave your house for exercise - just make you stay at least two metres from others.
You are even allowed to kick a football about with friends, as long as you don’t get too close to each other, according to Prof Chris Whitty, England’s chief medical officer, who said on Thursday: “Being outside in the park is a very good thing to do, and taking exercise is always good. The thing we are trying to avoid is people meeting up unnecessarily or having unnecessary social contact.”
Can I still go swimming?
The good news is that swimming is just fine. “Chlorine is a powerful viricide and swimming pools are either open air or in large spaces. I think swimming is a good way of exercising during the pandemic,’ says Professor Oxford. Now many gyms are closed this will not be possible, so online fitness classes could be a good alternative.
How long does coronavirus last?
The first symptoms of Covid-19 - a dry throat, cough, fever and fatigue - tend to start five days after exposure to the virus, but it can also take as little as two days or up to 14. From the onset of symptoms (which can also include the loss of taste and smell and sore eyes), the average duration of the illness is 22 days, according to analysis on 191 patients at the Jinyintan and Wuhan Pulmonary hospitals.
In this time, the novel coronavirus seems to work to a timetable. Day five is when patients who have pre-existing health conditions or are older start to have difficulty breathing. Problems can escalate rapidly, with patients who have severe symptoms often being admitted to hospital by day seven. Day eight is the median time of when the Wuhan patients developed signs of acute respiratory distress syndrome (ARDS). Day 10 is when these patients tended to be transferred to intensive care.
The average duration of fever is 12 days, according to the researchers. The cough can last longer, with 45 per cent of patients still having one when they were discharged after 12 days.
Some patients will, of course, experience far milder symptoms, with a fever and cough that lasts a few days.
If one of my relatives is admitted to hospital, can I visit them?
One of the biggest fears for people is that loved ones will die - and that they could now do so alone on a coronavirus ward. Given the infectiousness of the virus, visitations to Covid-19 wards, while different at each NHS Trust, are limited and, in some cases, banned. Families will have to check with their individual hospital what the rules are.
Should you still go to beauty appointments?
by Leah Hardy
Except for doctors and dentists, no one comes as physically close to their clients as hairdressers, facialists, manicurists, masseurs and makeup artists and many salons, spas, and hairdressers are now closed or closing.
Millie Kendall MBE, the CEO of British Beauty Council, says the outlook is grim: “Hair, beauty and nail salons directly contribute around £8 billion a year to GDP. Over 600,000 people work in beauty. I have emailed ministers to recognise our industry as one that needs support and acknowledgement.”
So has it been safe until now? Dr Jenna Macciochi, an immunologist at the University of Sussex, told me: “There has been a case in Australia where a nail technician could potentially have exposed up to 40 people to the virus.”
Professor John Oxford, an expert in the transmission of viruses and emeritus Professor of Virology,Queen Mary College, University of London, is even more cautious. “If you can feel or smell someone’s breath, then you are swapping breath with them and that way you can swap a virus too.” Spending time in a small, busy, perhaps stuffy hair salon therefore should be considered a risk.
In a large airy salon, where you are three feet from the next client, the risk is diminished, but the problem is, he says, that coronavirus can be transmitted, “not just via coughs and sneezes but by someone breathing over you.” Namely, your stylist. And it f you touch a contaminated object and then your face, the virus may be able to enter your body via your mouth, nose or eyes.
Viruses can’t be transmitted through skin, so any risk from hands-on therapies such as massages or facials come from particles in breath, not from touch. Again, a large room with efficient air filtration or open windows, plus rigorous cleaning between clients can mitigate against some risks, but not all. “Having one client directly after another is a problem,” says Oxford. ‘Think of it like a taxi. In our studies into flu epidemics, we found the biggest risk of a journey came from getting a taxi to the airport because you were sharing the breath of the person in the cab before you.”
It is vital you don’t go anywhere if you feel unwell and that you wash your hands thoroughly when you arrive and leave. When it comes to future bookings, Professor Oxford says, “Could you postpone it for a couple of months? Everyone needs to do their bit to break the chain of infection right now.”