Signs & Symptoms- The facts about the virus

3 April 2020

















I have decided to write about the Coronavius more specifically COVID-19 without sensationalising or undermining it. I hope to be open and honest about the virus from my experience clinically as a trainee nurse and as a normal civilian. I would like to state before I start that I am not a qualified anything...so I am not a nurse (yet) nor am I a doctor or microbiologist but I feel my training up to now makes me sufficient enough to condense all this into layman's terms because that's how I understand things and I guess that's how you understand things.


Let's start with the term Coronavirus. The coronavirus is a group of viruses that cause diseases in mammals or birds, which cause respiratory tract infections, remember this because this will be very important later. So it is possible for someone to be positive for the Coronavirus, but not actually positive for COVID 19 which is something that some members of the public don't seem to understand, although the alternative may not be much better as it could actually be it's notorious older brother SARS and it's lesser-known and more shy younger sister MERS, the latter has a lovely added symptom of diarrhoea so let's all appreciate the fact that we haven't got that one flying about (We would deffo need the toilet paper for that one). So let's recap Coronavirus should not be used synonymously with COVID-19, kinda like how the group of animals oh so scientifically named big Cats could mean anything to a Lion or Jaguar. Doesn't tell us enough,  but leaves us scared of the unknown,



1)  Getting Tested


In the UK you get tested ONLY if you're getting admitted, although I feel like that will change from now and the moment I publish the post so there's that.  Which means the actual number of cases could be huge, particularly as we have found out that some of us are asymptomatic (showing no symptoms).  

So let's bust some myths,  a couple of weeks back someone came unto twitter dot com and suggested that a blood test is a way of getting tested. If the virus enters your bloodstream so much that it can be detected in your blood you,  my friend have a bigger problem greater than both of me and you (just kidding but the Doctors will want to have a serious conversation with you. The possibility is very very VERY unlikely though).

How you're actually tested:

If you present to A&E, they will ask a series of questions

"Any travels in the last 2-3 weeks to any red zone countries or any countries at all"

"Have you had any coughing in the last 2 weeks"

"If Yes, dry or wet?"

"Have you come in contact with a positive person or someone who has recently self-isolated"

"Have you noticed any change in your breathing"


You only have to answer yes to one of these questions before the doctors or nurses will suspect you of having the virus, whether they test you will be dependant on if the doctor wants you to be admitted. So, ta-da!  The doctor wants you to stay in the hospital for monitoring, here is what happens, in your arrival someone will take your observations.

This includes a temperature. Your temperature should be 37 degrees Celcius, but that's in the textbooks, most normal everyday people are 35.8 degrees Celcius to 37.1 degrees Celcius, with the common temperature I have noticed being 36.6 degrees Celcius, this all dependant on age and the environment around you. We would start being concerned if you were hitting 37.5 degrees Celcius which is meh fever and 37.8 degrees Celcius which is a fever fever. The nurses would describe you as pyrexic which means are having a full-blown fever. 
Then we would take your blood pressure, your blood pressure should be 120/80 but that's not the case because this isn't building your human  and none of us are perfect or the same. Most people will have a systolic ranging (the top number ) of  90 to 130 and your diastolic (bottom number) would range from  60-80 there is space for variations depending on the environment, age or other existing health conditions. I don't know if high or low blood pressure would be indictive of COVID-19 but from my understanding, if you were struggling with work of breathing, and your body was struggling with getting oxygen to the correct places I won't be surprised if you would experience some hypertension  (high blood pressure) but that is me using the knowledge I learned in class. The literature is quite thin on this topic.

Then we count Your Respiratory Rate, that is how many breaths a minute, many nurses count that stealthily because often times when we stare at your chest, it causes people's anxiety skyrocket and thus your breathing speeds up. Anyways... so most peoples respiratory rate will be from 15-20 breaths per minute. Someone who has COVID-19 will typically have a much higher rate I have once counted 38 breaths per minute. This happens because the virus reduces the effectiveness of the lungs to give enough oxygen to the blood, so your brain is like "Bet"  and tells you to breathe heavier because your body needs it.
We also count the percentage of oxygen molecules in your blood, this is done by a peg-like thing we place on your finger it is called a pulse oximeter and it spits out a percentage of oxygen in your blood and your pulse. The normal percentage ranges from 94% to 100% but if you're young and healthy the parameters are much tighter at 97%-100%, if you have COVID-19 that plummets drastically, in that case, we offer you oxygen, I say offer but we would heavily advise you to keep the oxygen in your nose so, you know you get better.

Remember I said pulse? Aha yeah, I did we check how many heartbeats per minute. Once again there isn't much to say about your Heart rate and the virus. I am going to go from my teaching and practical applications and say you would be slightly Tachycardic (high heart rate) due to your heart doing it's best to make sure everywhere gets oxygenated blood. A resting heart rate for an adult should be around 60-100 beats per minute, but again it depends on age, environment and past medical history,

So we've done that and your numbers are looking wild, what next?  Your observations won't tell doctors and nurses that you definitely have the virus but it WILL make them investigate further. The doctor would request an X-ray of your chest and in the meantime, your nurse will either swab your THROAT and NOSE or she will only swab your NOSE they will send it off to be tested. It can take hours for the results to come back in the hospital, usually, it takes 5-6 hours, but since they are getting more and more overwhelmed it may take longer. This means you can not go home until the test results are back, I had someone ask me this and I was like sis no, you had a chance to stay at home and you're here and staying here.

The chest X-ray is also a way to see if you have COVID-19, although it won't be used to diagnose you, that is what the swabs are for. Lemme show you an x-ray quick though.







1st one is no COVID-19 and the second one is infected with COVID-19

from https://healthcare-in-europe.com/en/news/imaging-the-coronavirus-disease-covid-19.html
Okay let's talk, so the kind of pair shape in the first x-ray is the heart and all the little branches are the alveoli, they appear in both X-rays as they should. The first X-ray isn't the most healthiest of chests, but can you see the clear space in the middle of the lungs and how clear the sides are?  Well if you compare that to the second lung with all the cloudiness, particularly near the edges, you can secretions your lungs make to fight the infection, not a good sign. It is worth noting that COVID-19 often causes pneumonia secondary to the virus and that is why the x-ray looks like that. In simple terms, COVID-19 causes hench ass pneumonia.


2) PPE (Personal Protective Equipment)


So let me take a deep breath before I start this because the Great  British public has really shown up and shown out, albeit incorrectly. Like, very incorrectly.

So firstly, scarfs. Those are not effective face masks, I have seen some try and make-shift masks, with their scarves, no baby, no. Why? If someone coughs on you and then droplets carrying COVID-19 and the droplets touches you it's a wrap, no pun intended. The scarf touches your neck and the top of your clothing, furthermore, I have seen people just fiddle with them anyway, also I am not quite sure how many people immediately go home and stick that scarf in the wash. A scarf is not sterile the same way perhaps a face mask is so the scarf is, in fact, a lovely breeding ground and with how tiny viruses are they can easily be missed when being washed in the washing machine, particularly if it's being washed in under 60 degrees Celcius.

Now Masks, some of you are wearing surgical masks. Okay so if you wearing the little ones that hook behind the ears, I am not sure they will provide the protection that you're looking for, as surgeons wear them to protect the PATIENTS from THEMSELVES as when you're operating, the patient wound site has to be as sterile as possible to not introduce outside microorganisms and that includes saliva coming from a surgeon's mouth. Not only that some of you be wearing them around your neck and putting them back on, and some of you also take them off to talk and it's like why though? Even saw some girl wear it as a hat and I was like oh my goodness.

Okay here's why that's a problem if you were previously wearing a mask and maybe someone you were talking allowed a  little droplet carrying COVID 19  to land on your mask, and then you take it off and wear it around your bare neck or over maybe the collar of your top. You have now transferred the virus somewhere else, the same way if you were on your head the same you would wear of sunglasses, now you have to wash your hair, chest and maybe your clothes.

On the same thread, wearing a mask particularly in a non-acute setting such as the shop or on a walk will not lessen the chance of you getting it, particularly as you are supposed to be standing at least 2 meters apart from anyone. Or even better you aren't allowed to be out in the first, unless you are an essential worker or can not afford to not work, in that case, your employer should train you to use these PPE correctly. I have also seen masks with the little holes, we call them ventilator mask, well actually I call them that because they have ventilator holes. I had a patient wear that when they thought they had a virus, they were right to some extent. I  think if you have the virus it is more efficient and effective if you wear the mask than the other way round, as they are the one spreading infectious spit bombs, they're also more likely to spread it on surfaces. Think of it this way, if your kitchen tap lost it' mind and started drenching everyone, you wouldn't wear a raincoat and an umbrella and call it a day you would try and plug the tap. That's kind of the same principle. Anyway back to why a ventilator mask is bad, it has holes and so the infected patient could still cough the droplets out of those holes, particularly because we had to be in close proximity to the patient. I wouldn't recommend the mask to anyone in the public because you don't know if you yourself have it, because a large number of people have been asymptomatic and also because you won't know straight away you've got it.  Medical staff will wear them at the hospitals to allow them to breathe easier as long as their patient is wearing the mask and can be worn even if they decided to take the mask off (still risky though). Why? You ask? Well, it's not exactly airborne in the way you think it is but we will get back to that.


Also, reusable masks are not the move, so no point buying the fancy ones unless you're only trying to be fashionable, masks are only effective for an hour MAX  you're even pushing it then. They start losing effectiveness after 15 minutes. Those are approximate time frames, the wetter the masks gets on the inside due to condensation, from your own breathing and talking, the less effective it becomes. So, yeah throw your masks away regularly. If you've moved the mask off your face it has to be binned because it has been contaminated and that includes removing it to talk. If you want to talk it's preferred you just talk with your mask on.

Okay so now gloves. You have to change them after each contact or again it loses effectiveness, so wearing your gloves during your whole Tesco shop is useless, if you picked up bread that had the virus on it and you don't change them regularly you're just passing the virus from surface to surface, you may even carry it home with your unchanged gloves, you are better off just avoiding touching much in general and consistently washing your hands. Also, wash your hands even after you've had gloves on, some people don't do that, I have had people talk about that with me. When you take your gloves off you will still touch bare skin with the dirty glove so wash your hands please and thank you.




3) Hand -Sanitizer  

I am going to hurt some feelings because I already did on Twitter. Hand Sanitizers are antibacterial, they will only kill the large bacteria on your hands compared to the teeny tiny viruses, I am sure the virus on your hand is excited and the prospect of getting alcoholic shot every few minutes. So I would recommend just washing your hand, even hospital we wash our hands AND use Hand Sanitizer you're probably even better of just washing your hands. Some have reasonably approached me and asked if the hand sanitizer is okay if it claims to kill viruses and the answer it's still no because realistically hand sanitizer only works against things like the norovirus (the tummy bug) and the Flu virus, it will not specifically work on another virus because viruses are quite unique and unlike bacteria s not one size fits all.

100% Hand sanitizer will still not kill COVID-19 so no stop using it as way of doing so you'll only get super super dry hands. Just use soap and water dammit! Another thing DO NOT make homemade hand sanitizer oh my goodness, you think the microbiologists and the companies are playing around up there in HQ homemade isn't always best okay?

4) Is it Airborne?



Well,the Virus is transmitted mostly by contact and then touching somewhere with cell membranes (the eyes, the nose, the mouth, etc..). They also can be transmitted via air droplets and that's why it is advised to stand at least 2 meters away from everyone, but it doesn't linger in the air like some sort of chemical poison,  the droplet would have to land on you from someone coughing in your face so not airborne in the way people originally thought.

Click here for more information

5) How do I care for myself if I have got it?


Okay if you have the symptoms here's what you need to do.

-You need to isolate for seven days, this means not going out to get medicine or doctors, you're required to stay in your home. Check your temperature and see if you have a fever. If you don't have one after seven days you no longer have to, but if you do continue for another seven days.
  You don't have the isolate if you still have the cough but the fever has gone away. The takes a while to completely disappear.

- Call 111 and ask for advice they will ask you some questions and might even call an ambulance for you if they feel that you need professional help

-If you live with someone who has symptoms and is self-isolating, you need self-isolate for 14 days, because it takes 7 days for symptoms to appear and another 7 days for the fever to go away.

If you have symptoms it is advised to take paracetamol for the fever, to rest and sleep and also consider drinking a lot more water and also some hot herbal tea to help with the infection in the throat. You also need to keep eating as it will give the body the nutrients to fight it off. Easier said than done but you're going have to push through and try.

Click here for more information

6) The Terms 

Self Isolation
Only to be done when you're sick with the virus, you're not allowed to go anywhere not even out for your government-mandated walk

Social Distancing
To avoid going out as much as possible, no gatherings of 2  or more people. No, you can not hang with your pals and bois if you don't live with them.

Lockdown- The country has closed non-essential things (Including Maccies and cheeky Nandos sorry guys). Only essential workers are well err working...


All in all, everyone has a right to be scared and worried I understand, but let's not turn that fear into hysteria that solves nothing. (I am not talking to those who have anxiety or vulnerable family members). If we are all calm we can focus our energy on the people who really need our help or support.

Yeah, is like the flu, the flu is actually just as awful, but unlike the flu, we don't know how to control it. It's like comparing a Bunsen burner to a house fire, but also remembering, that the bunsen burner is capable of burning the house down.
That's all for now! If you have any questions let me know and message me!

Emmy xx


Trivia!

The Corona derives from the Latin for crown or wreath. The reason it's called coronavirus is because the protein spikes resemble a crown!


Post a comment

It's All Kira Kira © . Design by Berenica Designs.