Since it emerged in China in late 2019, the new coronavirus has infected more than 1.5 million people and claimed 94,000 lives. To stop a pandemic that spreads from person to person in close quarters, the world has largely shut down, with borders closed, streets empty and whole cities going into quarantine.
Australia has its own strict measures to avoid the terrible scenes playing out in places such as Italy and the United States, where hospital systems are now being overwhelmed. We are told to live our lives further apart – literally – by avoiding gatherings, staying home and keeping 1.5 metres clear of each other.
As we learn more about this virus, questions from you, our readers, are flooding in. Our explainer team, as well as our health, science and data reporters, will answer as many of them as we can. And when new information comes to light, we’ll bring you updates too – with the latest featured up top in this story. Here’s what we know so far.
Can you catch COVID-19 from pets?
It appears that, as with the first dangerous coronavirus to emerge in humans, SARS, it’s possible for our pets to catch the virus from us in very rare cases. But despite hysteria about an asymptomatic Pomeranian in Hong Kong returning a “weak positive” test for COVID-19 (and a tiger also catching a mild dose, from a keeper, at the Bronx Zoo in New York), the World Health Organisation stresses there’s no evidence the virus can jump the other way, from pets to people, and no one should abandon their animals.
Hong Kong authorities tested 17 dogs and eight cats from households with confirmed COVID-19 cases or people in close contact with confirmed patients and found two dogs that tested positive – the Pomeranian and a German Shepherd – but they did not appear to show symptoms. They concluded that pet dogs and cats couldn’t pass the virus to human beings, although they could test positive if exposed by their owners.
If it were possible to catch coronavirus from your pet, two veterinary experts looking into the US tiger case told The New York Times, it would have already become a clear factor in this pandemic, given the huge numbers of cases, and other scientists have since echoed the sentiment: there hasn’t been a single case. While the virus is thought to have jumped from wild animals into humans and mutated, that was one “spillover” event, likely at a wet market where wildlife were caged and killed in close contact with people, and there is no evidence of another species jump.
One small study that did cause a stir online found that cats and ferrets could be infected and pass on the virus to one another (dogs and farm animals were less susceptible) but it’s important to note the context for the research – animals in the study were deliberately infected with very high doses of the virus to see if a possible vaccine could be tested on them. And researchers did not find they could then give the virus to humans.
“We’re not overly concerned about people contracting covid-19 through contact with dogs and cats,” the American Veterinary Medical Association’s chief veterinary officer Gail Golab has told the Washington Post, adding “the virus survives best on smooth surfaces, such as countertops and doorknobs. Porous materials, such as pet fur, tend to absorb and trap pathogens, making it harder to contract them through touch.”
“The current spread of coronavirus in humans is the result of human-to-human transmission,” said Australian Veterinary Association President Dr Julia Crawford on March 11. “To date, there is no evidence that pets can spread the disease, or that they can become sick.”
The WHO is now investigating the case of the tiger – which showed mild symptoms but is said to be recovering well – as well as a possible infection in a cat in Belgium and the two dogs in Hong Kong to understand how pets may get the virus. It’s “important we remain respectful and kind” to any animals co-infected with humans, says Dr Mike Ryan, executive director of the WHO’s health emergencies program. “They’re victims like the rest of us.”
In Australia, the federal government says there have been no cases detected in any domestic animals here (pets or livestock) or wildlife, and the current virus is spreading between people not animals. Testing for the virus in animals requires different testing kits and, while Australia “does have capabilities” to do it, it’s not a priority given “the latest scientific information”. The US Centers for Disease Control and Prevention also does not consider there to be evidence of a threat from animals. It instead advises you to “protect pets” if you yourself are sick, limiting contact, but otherwise you should exercise the usual precautions around animals.
With pets now revelling in their owners being home with them (and still allowed to walk them and take them to the vet) under strict new social distancing measures, follow commonsense hygiene. “What owners can do is what we always recommend,” says Dr Crawford. “Please practise good hygiene, including washing your hands before and after handling your pets, as well as their food.” And don’t attempt to disinfect your cat, it could hurt them.
Can you catch the virus from the air?
While scientists agree the virus is not airborne in the same way as other infectious diseases such as measles, they are split on the question of how big a risk it poses in the air. The World Health Organisation says there’s not enough evidence to say the virus can jump from person to person in small or aerosolised particles. It’s mostly shed by larger water droplets from the nose and mouth, tiny balls of mucus, salt and virus that can shoot out up to about a metre when an infected person coughs or sneezes. Sometimes they land on and contaminate surfaces, but they’re too heavy to survive long in the air.
A growing number of scientists, including infectious disease expert Professor Raina MacIntyre and aerosol scientist and WHO advisor Professor Lidia Morawska, now say the risk from aerosols may have been underestimated. Warning signs are piling up, Professor Morawska says – the virus rips through a cruise ship even after passengers are isolated in their cabins, a choir meets in Washington and 45 out of the 60 singers leave the two hour rehearsal infected even though none have symptoms.
As an Australian Department of Health spokeswoman also noted, viruses do not always fall neatly into either aerosol or droplet (which are classed as anything more than five microns in size). They can leave the body as both.
It’s old medical dogma from the 1930s, they only travel a metre. But we know more now.
“It’s old medical dogma from the 1930s that they only travel a metre,” Professor Morawska said. “But we know more now. We’ve already shown other viruses like the flu [that mostly] shed in droplets can also spread from breathing. [In a] pandemic, we need to assume the worst.”
That still doesn’t mean you’ll catch the virus from passing someone on the street “unless they coughed right in your face”, Professor Morawska says. Like cigarette smoke, the virus will disperse in open spaces. And, just like smoke, it can build up in enclosed areas without ventilation.
“We don’t know how much you would have to inhale to get infected, the smaller particles at least carry less virus, but it’s possible,” she said.
Professor Morawska, who heads up the International Laboratory for Air Quality and Health at Queensland University of Technology, is now working with scientists from around the world to write enhanced guidelines for potential aerosol transmission.
On April 9, the Department of Health said COVID-19 was “not as efficient” at spreading in the air as other diseases considered to be airborne – a greater risk was posed by the “underestimated” spread of COVID-19 through touching contaminated surfaces.
Other experts such as infectious disease physician Associate Professor Sanjaya Senanayake say the virus is unlikely to be spreading far or frequently in the air. If it were, the shape of the pandemic would be likely look different – moving faster and striking down more people without close contact to known cases.
On paper, early studies into the new virus show mixed results – some found it in the air of hospitals treating patients, some didn’t. Even if the virus stays airborne, that doesn’t necessarily mean it stays infectious, Professor Morawska notes, as all viruses start to die once they leave the body. The warmer the conditions, the faster they tend to break up. One laboratory study by scientists from the US Centers for Disease Control and Prevention detected the virus in the air for up to three hours but the WHO has since pointed out that it did not reflect real-world conditions.
Still, America’s National Academies of Sciences, Engineering and Medicine wrote to the White House earlier in April saying the current research supports the possibility that COVID-19 can be spread by aerosols from breathing, as was observed to a small degree during the first dangerous coronavirus outbreak, SARS. But back then in 2003, Associate Professor Senanayake notes the virus generally aerosolised in hospitals where treatments such as intubation and ventilation increase the risk.
The WHO itself has issued warnings to healthcare workers that this may happen again and many wards treating COVID-19 operate as if the infection is airborne, including in Australia. “We’re all following that really closely and it seems to be holding up well,” Associate Professor Senanyake said.
Should I wear a face mask?
Face masks can protect against the droplets that spread the virus and are now a common sight on the streets of many cities around the world such as Hong Kong. Both the WHO and the Australian government say masks are still only necessary for people with symptoms and those treating them, and must not be wasted by the general public as shortages of the product could put healthcare workers at risk. All the same, calls are growing in many Western countries for a wider take-up of face masks to slow outbreaks.
In the US, the CDC has already reversed its own advice, given research showing even people without symptoms can spread the virus. It now urges people to wear cloth masks whenever they are somewhere poorly ventilated or can’t keep their distance from others, such as a supermarket aisle. Its guidance to healthcare workers also states that, while the extent of aerosol transmission is still unclear, the virus can spread when someone “coughs, sneezes or talks”. Aerosol scientist Professor Lidia Morawska agrees with the move, saying masks aren’t needed outdoors but are a good idea where ventilation is poor. But infectious disease experts Professor Raina MacIntyre and Associate Professor Sanjaya Senanayake say they are not as necessary in Australia as in places such as New York, where community transmission is now rampant.
It’s also unclear how much home-made masks or bandannas and scarves will block virus-laden droplets. Some experts warn widespread use of DIY masks could leave people with a false sense of security – and an urge to touch (and so possibly contaminate) their face more often as they adjust them. Australian health authorities have indicated they are reviewing their own advice on masks, as they do all their guidelines, but stress it still stands. Chief Medical Officer Brendan Murphy has urged people not to “waste” masks and notes they should be handled carefully and changed regularly (Nobel prizewinner and medical researcher Peter Doherty recommends sterilising used masks rather than throwing them away, given the shortage).
What about air-conditioning and heating?
Right now, health authorities say anyone who spends more than two hours in an enclosed room with an infected person has been exposed to the virus. But Professor Morawska warns there needs to be more focus on the need to opt for natural ventilation by throwing windows open wherever possible rather than using air circulation systems.
Associate Professor Senanayake says air-conditioning and heating could still be considered safe in most settings as droplets will not travel that far. And the Department of Health agreed that, while there was not enough data on the question, the risk from ventilation was low outside healthcare settings.
NSW Health said it considered air-conditioners and heating safe to use even when people in the home had COVID-19. “What is important for suspected and confirmed cases is to try and stay in a room separate to the rest of their family and, if possible, use a different bathroom … to avoid the spread of COVID-19 through droplets … and surface contamination,” a spokeswoman said. “It is only in the very sickest patients, who are in our specialist ICUs, or patients who require hospital treatments like intubation, where we are likely to see the virus be airborne.”
Can someone test negative but be a carrier?
Yes. Some people will be infected without symptoms or very mild symptoms. To test for COVID-19 right now, clinicians need to either take a direct sample of the virus, from a throat or nose swab or in lung phlegm, and examine its genetic code. Those tests are considered very accurate but in some cases if they miss the virus – say, because it is further down in the lungs and someone doesn’t cough up any phlegm (or sputum) – they can return a false negative. That’s why tests are often repeated, especially for patients recovering and returning to the community.
Blood tests, which look for the body’s immune response to the infection, can also be used but are not yet widely available outside China, and bring their own false negative risks – antibodies deployed by the body to fight off the virus can take more than a week to form so may not show up if the test is performed too early into the illness. This is also true of the rapid finger-prick tests being checked in Australia right now by the Therapeutic Goods Administration, after problems overseas. A government spokesman said these are therefore not considered a good substitute for the standard DNA sample or PCR test and “faulty devices” can also lead to false negatives.
Am I immune after catching COVID-19?
Scientists aren’t sure yet but they think it most likely. Recovering from a virus leaves us armed with those aforementioned antibodies in our system to fight it off, and usually confers at least a period of immunity (though not always a life-long shield). Many experts say reports of people appearing to catch this new virus twice are probably best explained by false negative tests clearing them of the infection too early (when the virus had actually remained in their system) rather than catching it a second time. Associate Professor Senanayake says the virus collected by the later tests may even be dead. Common coronaviruses such as the ones that give you a cold tend to go away for at least a year or so before we become susceptible again. Studies of MERS-CoV has found antibodies still present in survivors more than 18 months after recovery, and some survivors of SARS retained antibodies for many years thereafter.
Why isn’t Australia testing more?
Countries that have “flattened their curve” and dramatically slowed outbreaks have carried out exhaustive testing and contact tracing. In many cases, people without symptoms are tested and health officials actively hunt for others, checking temperatures on entry to buildings. Australia’s testing rates are proportionately high compared to many other countries (more than 300,000 have been done so far) but the criteria for being tested is still fairly strict due to a global shortage of testing kits, the government says.
Amid increasing calls from the WHO to “test all suspected cases”, Australia has since ramped up the operation to 10,000 tests a day and expanded that criteria, meaning frontline staff with symptoms can now qualify too. Sample testing of people with symptoms who have not been overseas or exposed to a known case has also started in areas identified as at risk of community transmission, such as Sydney.
Some states are taking matters into their own hands. On April 6, the ACT began random sample testing of those with symptoms but no other risk factors as did Queensland in Brisbane, Cairns and the Gold Coast. That followed news that Victoria would expand testing to people aged over 65, Indigenous Australians, cruise-ship passengers, people in high-risk settings such as prisons, schools, childcare and homelessness and disability support as well as police and firefighters.
Chief Medical Officer Brendan Murphy says he supports more widespread testing but stresses there is still a “temporary” shortage of testing kits. Faster finger prick tests that tell if someone has antibodies against the virus (and so has it or has fought it off) in their blood are also being checked by the Therapeutic Goods Administration. But a government spokesman said these are not considered a good substitute for the standard DNA test because such antibodies can take between five and seven days of infection to develop and “faulty devices” can also lead to false negatives.
The spokesman did not give a timeline of Australia’s work to fix the testing-kit shortage but said it was “working with public and private laboratories and with pathology suppliers to understand both international and domestic supply capacity and capability and are exploring the possibility of building further domestic capability to produce tests and reagents for COVID-19”. They also did not answer questions on how kits are being distributed to the states, as some push ahead with their own expanded testing.
Australia has one of the lowest positive rates for testing in the world, Professor Murphy says, meaning authorities feel “reasonably confident that we are detecting a significant majority of cases in Australia and that means we can get on top of cases” through contact tracing. That’s in contrast to countries such as Iran, Italy and even the US, where Australian authorities say they likely only tested the more severe cases or, as Murphy puts it, “when they detected significant outbreaks they probably had much, much larger outbreaks in community that were undetected”.
Still, at times Australian authorities have also faced criticism for letting contacts of cases slip through the net, most notably allowing 2700 passengers to disembark in Sydney from the Ruby Princess cruise ship, hundreds of whom later tested positive. But the states have also threatened hefty fines and even jail time for those at risk of spreading the virus who break home quarantine orders.
Why do virus death rates vary so much worldwide?
Anyone following the international news on the pandemic will have noticed a marked variation in death rates from Covid-19 among different countries. In hard-hit Italy, for instance, the death rate among confirmed cases is around 12 per cent in the first week of April, compared with 1.75 per cent in Germany and – thus far – less than 1 per cent here. East Asian countries have generally done better, the UK, Spain and the US worse.
A number of factors help account for this variation. The most significant is that the death rate will largely reflect how widely you are testing, and the age groups you test in. If, as in Germany, you test a very large number of people, many of whom are young with mild symptoms, you get a lower rate of death overall. If, as in the UK and US, you only test those who are very ill and in hospital, the converse applies: your death rate looks much higher. Per head of population, Australia’s testing regime has been ahead of many other countries.
Other factors that contribute to varying death rates include: demographics such as the age profile of a country’s population overall; density of living conditions; patterns of interaction between different generations; cultural factors (such as the absence of social kissing and handshaking in Japan); and, importantly, the capacity of health systems to cope with the very ill. Germany has more than double Italy’s number of acute care beds per 100,000 people, and more than triple the UK’s acute bed capacity.
In Italy, with one of the oldest populations in Europe, researchers believe that deeply ingrained habits of adult children living with, or remaining housed close to, their parents has contributed to the high fatality rate there. Younger adults, commuting into larger employment centres where the virus had been silently spreading, bring the virus back to the smaller communities where their parents live. Smoking rates may be a factor in some places. The jury is out on whether seasonality (whether a country is going into warmer or cooler weather) plays a role. – Deborah Snow
What are the basic social rules? When can I leave home?
No matter where you live, Prime Minister Scott Morrison has advised that there are now really only four acceptable reasons to go out:
- Shopping for what you need (such as food or supplies to help keep you at home) – this can include going to the post office or ATM
- Getting medical care or for compassionate or emergency reasons such as caring for someone, dropping off supplies, visiting a sick relative in hospital, taking an animal to the vet or if you are fleeing danger
- Exercising outside, including dog walking
- Attending work or school if you cannot attend either remotely as well as childcare
Here’s the boiled-down version texted to thousands of Australians: “Only leave for what you need + exercise, work, medical and care.”
Whenever you go out you must stick with just those in your household or up to one other external person, and you should keep your distance from others (about two steps or 1.5 metres). Wash or sanitise your hands regularly and ditch the handshake and the kiss hello.
In enforcing these rules, authorities are emphasising a “common sense” approach. As NSW Police Commissioner Mick Fuller says: “If you’re questioning whether you should be doing something, best to give it a miss.” We put a list of your questions to governments and are including the answers below, as we get them, and in more detail in this dedicated explainer here.
Can I go to the beach?
On April 3, Prime Minister Scott Morrison said: “Doesn’t matter what temperature it is, if it’s a warm day, don’t go in masses down to the beach.” The key word here is masses. No state has outlawed a trip to the beach (or the park) but they are urging people to reconsider whether the visit is necessary and warn new rules against gatherings may be enforced. Queensland police have closed some beaches, discouraged people from travelling long distances to them. Victoria also advises people to “keep visits short and maintain physical distancing at all times”. A walk or a quick swim is ok, sunbaking probably not.
Can I drive my car there?
You can still hop in the car on your way to exercise but all states advise limiting travel. In Victoria, a government spokeswoman said on April 1, you should only drive in cars with people you live with, but advice since released says you can still use taxis and other ride-share services for “permitted purposes”. WA advises sitting in the back if getting a taxi or an Uber and Tasmania also encourages people to extend physical distancing to car travel. “Travelling in cars is not restricted … non-essential travel is,” a Tasmanian government spokeswoman said. NSW Police Commissioner Mick Fuller told ABC Radio people should not be going anywhere just for a drive, even if they had no intentions of getting out of the car. “It is not a reasonable excuse,” he said. “If you don’t really need to do it, then stay home and stay safe.”
What about L-platers?
Not all states answered questions on whether learner drivers could still go out for driving practice but in Victoria, learner driving lessons should only be part of essential travel, such as to the supermarket.But NSW Police have ruled that learner driver lessons can continue – for an instructor it could be considered work that cannot be done from home and for the learner it is “akin to the listed reasonable excuse of travelling to attend an educational institution where you cannot learn from home”. Family members can also take learners out for a lesson or for other essential travel. See more here.
Can I visit my partner, friend or relative if I don’t live with them?
It depends on the circumstances – and again on what state you live in. The question of romantic partners who don’t cohabit initially caused particular consternation when NSW and Victoria both ruled out social visits under their new emergency powers.
You can still visit someone’s house to care for them, drop off supplies or in an emergency – say, if you are fleeing danger, but in Victoria Police Minister Lisa Neville said on March 31 “you cannot visit your partner for social reasons”. On the morning of April 1, a Victorian health department spokeswoman added: “You shouldn’t be physically intimate with people you’re not living with, even if they are your partner.” But, later in the day, Victoria’s Chief Health Officer Brett Sutton announced the rules around romantic partners – which by then had become known as the “bonk ban” – would be relaxed with a new exemption for couples.
In NSW, Police Commissioner Mick Fuller came to the same conclusion by a different route, clariyfing that you can still visit your partner as it falls under the category of “care”. “Mental health, we get it … we need to look after each other – but don’t take the whole family with you”.
Meanwhile, jurisdictions such as Tasmania and the ACT still let you have up to two visitors over to your home at one time as long as you are following social distancing measures – no hugging or kissing, and allowing space for one person per four square metres. (So if you live in a tiny apartment you might still have to reconsider guests). In Queensland,you can have two visitors to each household – but no strangers are allowed over.
In all states, child custody arrangements are unaffected and tradesman, cleaners, even removalists are allowed if you really need them (they may fall under essential work or caring) but physical distancing must be maintained. – with Lydia Lynch
Can I have babysitters over? What about grandparents?
Unlike child custody, the rules around babysitting are less clear, although it again appears to fall under either care or work in most states. Victoria has since clarified its own rules to allow you to have someone over to care for children if you need to leave the house for one of the four essential reasons above, or if you are working or studying from home.
But older or Indigenous Australians and those with chronic conditions have been advised by medical experts, including Australia’s chief health officers, to stay home where they can and limit contact with relatives, even grandchildren. “Sadly, I don’t think grandparents can be drafted in for very much at all,” Victorian Premier Daniel Andrews said when asked about babysitting. “It is simply not smart, not right for us to be putting those people at risk.” He acknowledged this was often painful for people, speaking of a new grandparent who had been unable to meet their grandson since the pandemic hit. – with Noel Towell
Can I go on holiday?
Sorry. Prime Minister Scott Morrison has told Australians to stay at home this Easter weekend, saying failure to do so “would completely undo everything we have achieved so far together” as new data shows tough new social distancing measures are slowing down the virus’ spread in Australia.
All states have issued similiar advice, warning a migration to the coast could spread the virus further and put dangerous strain on regional health resources. But not all are fining people for ducking down to the holiday house. Victoria’s Premier Daniel Andrews has said police don’t have the resources to enforce the advice over the upcoming Easter weekend but stressed “this is not a holiday weekend, we can’t have a normal Easter” and state Health Minister Jenny Mikakos says if you’ve booked a holiday you should cancel it.
Police Deputy Commissioner Shane Patton had earlier said that if people have more than one “ordinary place of residence” then they can move between them as a household. “You got a holiday house? You can go to that,” he told 3AW radio. But go straight there and stay there, only going out for one of the four valid reasons – shopping; medical care or caregiving; work or education; and exercise – or you can be fined. Camping or setting up a caravan somewhere is out in Victoria – and an ordinary place of residence is not a short-term holiday rental either.
Airbnb now have cancellation policies in place to get a full refund if you booked before March 14. NSW says people shouldn’t go on holidays or use Airbnb unless it’s for an essential reason such as work and police have revealed they will be using number plate recognition technology to patrol highways and caravan parks over the Easter weekend. See more here.
In Queensland, which has also closed its borders, Premier Annastacia Palaszczuk has gone so far as to say, “Easter holidays are cancelled this year”. Queensland police have flagged they will issue an on-the-spot fines of $1334 to people travelling to a second house for no good reason, such as a holiday house or apartment near a beach. In WA, the state has not only closed its borders but has broken up the state into nine regions – drivers cannot pass beyond those checkpoints without a valid reason. Meanwhile, South Australia and the ACT have warned people not to pitch tents in national parks or travel to coastal or regional communities. – with Stuart Layt, Tammy Mills, Michael Evans, Hannah Barry, Michael Fowler
Can I move house?
If you have to. You can even have removalists provided you adhere to physical distancing rules.
Why do we have to live like this?
The virus needs us to move; it jumps person to person after close contact so the idea is to slow its infection rate by temporarily changing our behaviour through physical distancing As the world waits for a vaccine, this will save lives by helping stop a surge of cases overwhelming emergency departments all at once. Along with measures such as lockdowns and tracing and isolating cases, social distancing has worked against outbreaks in the past, including the Spanish Flu of 1918. The recent surge in Australian cases has started to slow a little in recent days as new rules come into force. But if people do not follow them, Chief Medical Officer Brendan Murphy warns that Australia could lose its window to contain the outbreak – and cases could rapidly explode. .
When can I leave COVID-19 isolation once I get better?
The federal government has stopped tracking recovery numbers in Australia, drawing criticism from some experts who say it is an important measure of any outbreak. Amid a shortage of testing kits, an Australian government spokesman confirmed only healthcare and aged care workers returning to the frontline must be “cleared” with testing (two negative tests) under the national guidelines. Local health authorities keep a close eye on all confirmed cases on the virus and others may still be retested. But most, such as those recovering in home isolation, only have to meet the following conditions:
- 10 days have passed since falling ill
- AND symptoms have been gone for 72 hours
The US Centre for Disease Control and Prevention advises the same 72-hour window of time after symptoms disappear but some studies overseas have shown the virus can live in the body for weeks after.
The Australian government spokesman said “a small proportion of people may have an illness that has completely resolved but their [tests] remain persistently positive”. There a decision on release from isolation will be made on a case-by-case basis after consulting their doctor, the testing lab and the public health unit.
The 72-hour rule was decided by the Communicable Diseases Network Australia, which advises Health Minister Greg Hunt, as “a precautionary period to manage uncertainty around how long a confirmed case remains infectious post-symptom resolution”, the spokesman said.
“Even in these patients there is uncertainty around whether there is a direct correlation of persistent [positive tests] and infectivity, but what we know from other virus infection, it is not a neat correlation,” he said. “There have been case reports of patients testing positive for a couple of weeks post-symptom resolution, but are viral culture negative meaning they are unlikely infectious for very long after symptoms resolve.”
How should I handle takeaway coffee?
Wash your hands after holding your cup. “It’s all about interrupting the chance of self-inoculation,” says Associate Professor Ian Mackay, an expert on coronaviruses, at the University of Queensland. The virus has been found to last for shorter periods on card and paper than some other surfaces but it can persist, according to lab studies. “Whether there is ever likely to be enough virus on that surface to infect another person remains an unanswered question,” says Professor Mackay.
“The overarching rule here is simple: wash your hands before you touch your face if you have come into contact with something that is likely to have been contaminated with virus.”
What’s the death rate?
Calculating the mortality rate of a pandemic that is still spreading is an imprecise science – people may be diagnosed or succumb to the illness further down the line. Based on the first 55,000-odd cases recorded in China, the WHO estimates the fatality rate so far as 3.4 per cent. But, given so many milder cases will go under the radar, most experts, including the WHO, agree the true number is likely closer to 1 per cent.
That makes it deadlier than the flu but less dangerous than the other two rare coronaviruses to emerge in humans: SARS-CoV, which also caused global panic when it exploded onto the scene in late 2002, and MERS-CoV, which causes a condition more deadly again known as MERS (Middle East Respiratory Syndrome). On the raw figures so far, more than 1.5 million people have been infected worldwide and at least 94,000 have died. About 353,000 have already “officially” recovered. The case of the Diamond Princess outbreak has offered one of the most stable data sets yet from which to make calculations- analysis of deaths and infections there put the overall fatality rate at just below 1 per cent.
Am I going to die?
Data out of China found most people (about 80 per cent) recovered from the new virus on their own, even if they developed pneumonia. But about one in five needed more serious medical intervention (such as ventilation to help them breathe) and, of those, 6 per cent were pushed into critical care – as multiple organs began to fail along with the lungs, or septic shock (whole-body infection) set in.
Anyone can catch the virus – but people most at risk of complications are older or have other conditions such as diabetes or heart disease, making their bodies may be less able to cope with the extra strain. Smokers are also more likely to develop a nasty infection, as the virus breeds via cell receptors in the lungs known to increase with cigarette smoke. Experts say the higher the dose of virus you are hit with, the faster you will show symptoms and the more dangerous it can be for your immune system to fight off. For example, catching the virus from a doorknob is likely to give you a smaller dose than caring for an infected person without protective clothing such as a mask. For more on how the new virus affects the body and what it feels like to get it, you can read this explainer here.
What treatment is given in intensive care?
Difficulty breathing is the main reason that people with COVID-19 present to a hospital, says the head of the Alfred Hospital’s intensive care unit, Associate Professor Steve Mcgloughin. The virus, which attacks the lungs, can progress quite quickly, worsening beyond shortness of breath. Once admitted to a ward and receiving oxygen via a mask, a person’s condition may improve – but other people will need increasing amounts of support to keep their lungs sending oxygen throughout their body.
“That’s where intensive care would step in,” says Dr Mcgloughin. “If it’s bad enough that you need to be put on a breathing machine then you would definitely be in intensive care. If there was a sense that a patient was deteriorating towards needing a ventilator or a life-support machine, we’d also put them in intensive care. What intensive care is able to offer is the medical specialists and more monitoring … It’s very intense – not surprisingly, given the name.”
Without a drug that is definitively proven to halt or even slow COVID-19 at this stage, the aim is to support patients until they recover. “We wait for the virus to clear up and then the lungs will often repair themselves if we can wait and just support them while they do that. So you might have a period of, say, a week on a life-support machine where the virus starts to clear itself and the lungs start to improve and then we take the breathing machine away.”
Keeping people in a sort of induced sleep, the energy demands of their body go right down.
But, as experience has shown worldwide, the outcome is not always positive. “Keeping people in a sort of induced sleep, the energy demands of their body go right down,” says Dr Mcgloughin. “They’re not using as much oxygen as they would normally. The problem with that is it works quite well and it’s a really effective therapy but, obviously, being in that state puts the body in quite a vulnerable position.”
There are two problems that can arise, he says. One is that the infection itself can affect the other organs. And there is “just the stress of being so sick”. “We’re supposed to be up and walking around but when you’re in intensive care your body is a little bit vulnerable to either getting another infection from bacteria, or the virus itself affecting your other organs. That’s why there is a difference, unfortunately, that people who are a little bit older or those a bit more vulnerable beforehand don’t do as well as people that are younger.”
Dr Mcgloughin, who chaired the group that wrote the COVID-19 guidelines for The Australian and New Zealand Intensive Care Society, says Australian hospitals are benefiting from the advice of colleagues overseas, including in Italy and Singapore, both about treatments and how to protect themselves. “Within weeks of what happened in Italy, they had already published very detailed summaries of what happened. I’m amazed the guys were able to do that.”
So what would he say to younger people, including those aged 20-29 who have been diagnosed with COVID-19 in NSW and Victoria more than any other age group?
“Stay home. Do what the government’s asking us to do. Let’s do that for a week or a few months. You’re doing it potentially to protect yourself – it’s not impossible that young people get sick – but you’re really doing it to protect the older people in our community. To me, it’s a real social responsibility. It’s sort of a good test of Australians’ ability to look after each other, really. You know, we all like to think we do that – but this is probably the chance to prove it.”
How are ventilators used to treat COVID-19?
Anyone who’s had a general anaesthetic will have relied on a ventilator, whether they know it or not. It happens between the bit where you start to feel drowsy – ”you stop breathing and then I put in a breathing tube and put you on to a breathing machine,” says Dr Suzi Nou, president of the Australian Society of Anaesthetists – and the bit where you wake up in the recovery room. That breathing machine is a ventilator, pushing oxygen into your body. “For healthy patients undergoing routine surgery, [when] I stop giving them anaesthetic, they start breathing for themselves,” says Dr Nou.
Treating patients with COVID-19, whose lungs are compromised by the disease, is another story. “They’re too unwell to do the job of breathing for themselves. We’d induce the state of sleepiness, put a breathing tube in and put them on the ventilator.” While a patient having routine surgery will rely on a ventilator for minutes or hours – and it’s not uncommon for a patient in intensive care to rely on one for four or five days – a patient with COVID-19 might need one for as long as 10 days.
This is why ventilators have become such a precious commodity worldwide since the pandemic took hold, prompting a doctor in the hard-hit Italian region of Lombardy to say they had become as precious as gold. There are plans for the number of ventilators (and intensive care beds to go with them) in Australia to be doubled to 4000 while more have been freed up by the suspension of non-urgent elective surgery and still more are now being manufactured in Australia.
But behind every ventilator is a team of experts too, such as Dr Nou and highly trained nurses. In Australia, every patient on a ventilator has a dedicated nurse. It’s these professionals who need to be supported to keep coming to work in the coming weeks and months, says the head of the Alfred Hospital’s intensive care unit, Associate Professor Steve Mcgloughin. “Everyone is very focused on the machines,” he says, “but the most valuable resource we have in healthcare is the people.”
How long does it take to recover?
Symptoms tend to clear up in just a week or two in mild cases or three to six for more serious, according to WHO data. But early evidence suggests the virus can stick around in the body even longer in some cases. Australian researchers have now mapped the body’s immune response, identifying the antibodies it recruits to defeat the new virus, in some people starting the fight within just three days of the initial infection. Experts say it’s too early to say if this illness will result in permanent damage, such as the lung tissue scarring seen in more severe SARS and MERS patients.
I’m over 70. Should I self-isolate?
The federal government is urging those aged 70 or over (as well as those with a chronic condition over the age of 60 or Indigenous people over 50) to stay home “where practicable”, avoiding contact with others as much as they can, including family such as grandchildren. If you fall into these categories, this measure is designed to protect you, not keep you a prisoner at home. You can still go outside or shop if absolutely necessary but it is best to opt for delivery or seek help from family, friends or even the local council to get supplies. Visits to aged-care homes have also been restricted to protect vulnerable elderly residents.
Deputy Chief Medical Officer Paul Kelly says Australians weighing up whether to bring elderly relatives home to care for them now face a difficult “trade-off”. On the one hand, Professor Kelly says “the most frail, elderly people requiring, for example, a lot of home care … may be best to shelter with relatives”. But if other family members are going “out into the world … and interacting with others”, they risk bringing the virus into the home. The answer isn’t always clear-cut and will come down to personal circumstances.
But I’m young and not at high risk. Why can’t I socialise?
While the elderly and those with underlying conditions are more likely to die from COVID-19, young people can too. Figures from China, Europe and the US show concerningly high hospitalisation rates among the under 60s and in Australia there are people under 50 already in need of intensive care. And note this: there have now been more coronavirus cases in both NSW and Victoria among 25- to 29 year-olds than any other age group. In any case, even if you’re young and get a milder case you can still spread the virus to someone who might not be so lucky.
Can I still have parties?
Aren’t you the optimist? The new rules spell the end of the backyard barbecue or the extended family dinner – at least for now. House parties might even become an offence in some states. But experts say these tough temporary measures reflect just how easily the virus can spread. Victorian Premier Daniel Andrews has warned of a dinner party where one person was infected with COVID-19 – at the start of the night. “By the end of the dinner party, almost everybody [there] had the coronavirus – this spreads rapidly,” he said. Children on school holidays should not have friends over nor hang around shopping centres together, Mr Andrews has said, and it’s not a case of moving beers at the pub to the living room. “We cannot have people queuing for intensive care beds. That will mean they will die. We’ve got to buy time.”
Where are the cases?
The first NSW COVID-19 cases were reported in Burwood, Parramatta, Randwick and Ku-Ring-Gai in late January. Clusters of cases began appearing in Ryde, Parramatta, Hornsby and central Sydney in mid-March. The virus began to spread outside Sydney on March 5, with early cases in Goulburn, the Mid-Coast and Orange. It has since spread up and down the state’s east coast and in regional areas inland. By the end of March, the biggest clusters – in Waverley, the Northern Beaches and Sydney – had more than 100 cases each. More than 100 cases were linked to three cruise ships, including the Ruby Princess, which docked at Circular Quay in late March. On April 1, a pop-up testing clinic opened in Bondi, in the local government area of Waverley, which has the highest number of confirmed cases and the highest number of those with an unknown source of infection.
In Victoria, about four in five confirmed cases of coronavirus have been recorded in the Greater Melbourne area, but COVID-19 has spread to almost every corner of the state. At the start of April, at least one resident had been diagnosed in 68 of the state’s 79 municipalities. So far, the areas with the highest numbers of cases have been among the most affluent parts of Melbourne. A woman infected with COVID-19 on a ski holiday in the US attended a 21st birthday party in wealthy inner-east Malvern, and at least six guests contracted the virus. On April 1, the Stonnington local government area, which encompasses Malvern, had the highest number of confirmed cases with 77. In recent days there have been cases among retail workers, such as a Coles and K-Mart outlet in Melbourne’s east. Hospitals have also been the site of smaller clusters and, as it stands at the moment, about 10 per cent of Victoria’s confirmed coronavirus diagnoses have been in healthcare workers.
How long does the virus live on surfaces?
Viruses need hosts to survive – they can’t make it on their own. So far, the best evidence we have on how long the virus lasts on surfaces comes from a letter to the editor by a team of American scientists published in The New England Journal of Medicine, one of the world’s top medical journals. The data is still early stage and needs to be interpreted with caution. They placed samples of SARS-CoV-2 on plastic, stainless steel, cardboard and copper and tracked what happened to the virus. The virus was the most stable on plastic and stainless steel and could be detected up to 72 hours later. On absorbent surfaces such as cardboard, fabric or paper it degrades much faster. However, the amount of the virus fell quickly over time. On plastic, for example, it halved in about seven hours. That indicates these surfaces do not remain infectious forever.
The overarching rule here is simple: wash your hands before you touch your face if you have come into contact with something that is likely to have been contaminated with virus.
Professor Ian Mackay, coronavirus expert
It is possible, although unlikely, exchanging cash could transmit the virus. Using a card is “probably lower risk”, write Professor Ian Mackay and Dr Katherine Arden on The Conversation, because you keep the card and don’t have to touch other people. In fact, using “tap and pay” is a social distancing practice recommended by the federal government. – with Liam Mannix
What about takeaway food?
You can still order in food but authorities say you shouldn’t let the courier into your home and, if in an apartment, you should pick up the order outside rather than inviting them through a security door into a communal area.
Professor Doherty says that while food delivery is unlikely to be a major source of infection, it’s something to keep in mind when you’re “taking hold of the pizza box”.
“Before you take the food out, wash your hands and then put the pizza box somewhere out of the way,” Professor Doherty suggests in a webinar for the Australian Academy of Science. “It can certainly survive longer on plastics and steel … in the SARS epidemic, of course, we saw people wiping down elevator buttons. […] Just open everything, wash your hands before you take the food out of the plastic and maybe transfer it to another plastic bag before you put it in the fridge.”
Should I disinfect my fruit and vegetables?
No. The Centre for Food Safety’s guidelines say there is no evidence the virus that causes COVID-19 can be passed on via food. The US Centres for Disease Control and Prevention agrees. Food should be washed with water before you eat it. Soap or dishwashing liquid should not be used, as they can stay on food and cause sickness. There is no need to wash food you are going to cook, as the heat will kill the virus, says Arden. You also don’t need to scrub food that you are going to later peel, such as oranges.
Touching produce and then touching your face is more relevant. “Think of your hands as the enemy,” write Professor Ian Mackay and virologist Katherine Arden. If the virus comes into contact with your hands, and then you touch your nose, mouth or eyes, it can gain entry to your body. You must wash your hands with soap and water thoroughly before eating. – Liam Mannix
What temperature should I do my laundry?
We don’t need to be worried about the temperature of a wash because we use strong detergents in our washing powders, even when they are cold wash formulations, says virologist Katherine Ardern and coronavirus expert Associate Professor Ian Mackay, both at the University of Queensland. They cite a recent study, which, although not having yet been through a peer review process so not conclusive, provides an early picture of how the virus reacts in certain conditions. In a laboratory, a 30-minute incubation of the virus at 56C or a five-minute incubation at 70C rendered SARS-CoV-2 inactive. In its recommendations for households where someone is ill, or suspected of being ill with COVID-19, the US Centers for Disease Control and Prevention recommends laundering items “using the warmest appropriate water setting for the items”, and drying the items completely.
Will my dishwasher kill the virus?
A similar answer applies as with washing machines. Professor Mackay notes that if you are caring for an ill person, you need to be extra vigilant in cleaning their crockery and cutlery to ensure that you limit the risk of family spread. The US Centers for Disease Control and Prevention says this if someone has COVID-19 in your household: “The ill person should eat/be fed in their room if possible. Non-disposable food service items used should be handled with gloves and washed with hot water or in a dishwasher. Clean hands after handling used food service items.”
What disinfectant should I use on surfaces?
The NSW Health Department advises using common household disinfectant sprays for surfaces. SARS-CoV-2 is what is known as an “enveloped virus”, which means it is made of a little ball of fat and protein. That makes it relatively easily to kill with standard disinfectants.
In Australia, disinfectants are regulated by the Therapeutic Goods Administration, so if you pick the right one – look for a specific disinfectant, not a cleaner – you can be confident it works. Not all disinfectants are regulated by the same standards. Look for a specific label on the disinfectant that means it kills viruses, such as virucidal or antiviral activity. Importantly, this is different to antibacterial – antibacterial ingredients kill bacteria, not viruses.
Make sure you follow the instructions on the label, which may include cleaning a surface before disinfecting it. Cleaning and disinfecting are different things. As the CDC notes, cleaning does not kill germs in itself but, by removing them, it lowers their numbers and the risk of spreading infection. The Australian Department of Health advises you to target frequently touched surfaces: door handles, bed rails, table tops and light switches.
As with all things COVID-19, there is still much we don’t know. The advice above is based on guidelines from the US Centers for Disease Control and Prevention, guidance from the Australian Department of Health, from the Australian Research Council Training Centre for Food Safety, and expert commentary from Associate Professor Ian Mackay (an expert on coronaviruses) and Katherine Ardern (a virologist), both at the University of Queensland. – Liam Mannix
Can the virus be transmitted by people without symptoms?
One of the big mysteries of the virus is how infectious asymptomatic people really are. Some experts say people shed the most virus when they are unwell, especially while coughing, and the WHO calculates a danger window of infectivity about 48 hours before symptoms first appear. But other studies have tracked infections in parts of China and Singapore to “stealth” transmitters with mild or no symptoms. This also played out in the case of the cruise ship turned floating quarantine site the Diamond Princess in early February. A study found that 18 per cent of those infected on board never showed symptoms. Because this virus can spread before symptoms appear, it is especially hard to contain.
How does COVID-19 compare to the flu?
“Let’s stop saying it’s a bad flu,” pleaded doctor Daniele Macchini, from the northern Italian city of Bergamo, where the virus had gained a deadly foothold. Patients inundating intensive care wards had “far from the complications of a flu”, the doctor wrote on Facebook in March.
While flu has many of the same symptoms and results in tens of thousands of deaths worldwide every year, COVID-19 is more than 10 times deadlier. In Australia, government figures for the most recent flu season ending October 2019 show 812 people died of influenza out of 298,120 reported cases – a fatality rate of about 0.27 per cent.
Emerging coronaviruses such as this strain and SARS can also do more damage to the body, particularly the lungs. And the new virus is more infectious than the flu, or SARS or MERS, with one COVID-19 patient likely to infect between two and three others.
Can you get COVID-19 and the flu at the same time?
Yes, it’s possible. As it breeds in the lungs, the virus can impair your body’s ability to filter out germs falling down from the upper airways and so leave some people susceptible to another bug – whether the common cold, influenza or a case of bacterial pneumonia. So this year there is a particular urgency behind calls for people to have their flu shots, as hospitals brace for a surge of COVID-19 and flu cases hitting all at once. On April 1, Deputy Chief Medical Officer Paul Kelly urged Australians, especially those aged over 65, to get their flu vaccines as soon as possible. “As of now there are millions of vaccines out there ready,” Professor Kelly said.
How long will the pandemic last?
That’s the big question. This virus’s closest relative, SARS, while deadly, spread more slowly and to far fewer countries and so early containment efforts worked to wipe it out, largely within a year. For COVID-19, many experts are instead drawing parallels with the 1918 Spanish Flu pandemic, which killed millions around the world because it spread so far. The good news is medicine has taken a quantum leap forward since then. Still, modelling by the Imperial College London suggests countries will need to use control measures such as social distancing, aggressive case detection, even shutdowns right through until a vaccine becomes available – between 12 and 18 months.
How fast is it spreading?
The virus has now reached most of the world – more than 170 countries, and the World Health Organisation warns it is “accelerating”. It took the virus 67 days to infect the first 100,000 people, just 11 to reach 200,000 and four to top 300,000. By mid-March in Australia, the number of cases was doubling every three to four days. In recent days, since stricter social distancing rules came into force and more people start to stay home, that growth has slowed but authorities say now is “not the time to take the foot off the brake”. Outside China, major clusters of the virus have broken out in Italy, where hospitals have been pushed to the brink as well as the US, Spain, Germany, Iran, France and South Korea.
What are other countries doing to ‘flatten the curve’?
Some nations, including many in Europe, have turned to the “China model” of forced home quarantines and transport shutdowns to stop the virus. But experts note that China, as well as countries such as Singapore, Taiwan and South Korea, have also started to “flatten their curve” of infection growth through exhaustive testing, contact tracing of known cases and community take-up of “social distancing” measures such as working from home or taking schools online.
China’s success so far means it is already starting to relax many of its lockdowns, even as it braces for a potential second wave. In Italy and now other countries such as Spain, France and the UK, people are only allowed to leave their homes to run essential errands such as grabbing groceries (and they must queue 1.5 metres apart). Anyone caught breaking Singapore’s rules can land themselves in prison after the city-state made it an offence for a person to intentionally stand close to another.
Is it a cold or COVID-19?
The main symptoms of the new coronavirus are:
- Shortness of breath
A patient might also complain of chills, headaches or a sore throat. Nausea or diarrhea have also been reported, though not in the numbers seen during SARS, and a blocked nose is less common again.
What’s shutting down?
The federal government has ruled people shouldn’t gather together except for “essential” activities such as school, public transport and work – but working from home is strongly encouraged and schools will move to mostly online lessons after Easter, except for students who have to attend in person.
Shopping centres will stay open but food courts will be for takeaway only. People are urged to just buy what they need and not collect together or take time browsing. Those indoor gatherings still running should allow space for one person per four square metres.
While the government is yet to move towards a full-scale shutdown of all but non-essential services, the following have already closed or suspended:
- Indoor venues such as pubs, clubs, casinos, cinemas, and places of worship
- Auction houses
- Real-estate auctions and open-house inspections
- Personal services such as beauty therapists, waxing and tanning salons, nail bars, spas, massage and tattoo parlours (excluding related health services such as physiotherapy)
- Amusement parks, playgrounds, skateparks and arcades, indoor and outdoor play centres
- Gyms, health clubs, fitness or yoga centres, and public swimming pools
- Galleries, museums, national institutions, historic sites, libraries and community centres and facilities such as halls or RSLs
- Strip clubs and brothels
- Outdoor boot camps – but personal training (with just two people) can continue
- Retail outlets at international airports
The good news is the other thing shutting down is evictions – with a moratorium on evictions from commercial and residential rental properties as a “result of financial distress” for the next six months.
Services so far considered “essential” under a wider shutdown include pharmacies, fuel stations, health care, food shops and public transport and airports. Hairdressers and barbers are not on that list but can remain open for now – though they must strictly manage social distancing and the four-square-metre rule. The federal government says hotels, hostels, campsites, caravan parks and boarding houses will be a decision for each state and territory. All non-urgent elective surgeries are postponed until further notice.
Federal Communications Minister Paul Fletcher has written to states and territories urging them to exempt telcos, postal services and media organisations from any future restrictions on movement as “essential services”.
What about weddings and funerals?
Weddings are limited to five people – the couple, the celebrant and the witnesses – and funerals must be capped at 10 people, in what the government has called “very difficult” but necessary measures.
What’s the difference between JobSeeker and JobKeeper?
JobSeeker is a payment of $550 a fortnight (now increased to $1100 a fortnight as part of a coronavirus stimulus boost) for those who have lost their employment. JobSeeker replaced the NewStart allowance in March. However, the new JobKeeper scheme is a $1500 payment (before tax) per staff member provided to employers by the government over the next six months to help businesses hold onto workers so that after the pandemic is over they can more easily start over. Employers can only receive the subsidy if they have turnover of less than $1 billion and this figure has fallen by 30 per cent or more, or they have a turnover higher than $1 billion and this has fallen by 50 per cent or more. Employers receiving the subsidy must report to the Australian Tax Office every month. See here for details. – Jennifer Duke
I have asthma. Am I more at risk?
At least one in 10 Australians have asthma but the condition doesn’t mean you’re more likely to catch COVID-19. The problem is that because your lungs are already inflamed, it can leave you open to a more severe case or trigger an asthma attack. “It’s a double-whammy, really,” says National Asthma Council Australia chief Siobhan Brophy.
Respiratory physician Peter Wark says there’s not enough data yet to know exactly how COVID-19 affects asthmatics but, from previous experience with other respiratory illnesses, they’ll likely be at higher risk of complications – as was observed during the SARS outbreak and still occurs with common illnesses such as cold and flu. The WHO and other health authorities are urging extra precautions for asthmatics. Brophy says now is the time to be on your “best behaviour”: following your asthma plan and doctor’s advice to the letter and re-filling prescriptions so your lungs are in their best shape possible should an infection come. While people without the condition have been hoarding ventolin, she notes there’s little point as the medication is designed to treat an asthma attack and not COVID-19.
There has been some concern about continuing asthma medication such as steroid tablets or injections, which could suppress the body’s overall immune system, Brophy says, but steroid inhalers are still fine – they only travel to the lungs and remain vital for asthmatics. “Talk to your doctor before you stop taking anything but if you’re still using an old nebuliser to take your medication, use a puffer and a spacer instead. A nebuliser will spray out particles [and possibly germs] from your lungs.” Tell your doctor about your asthma and your medication if you develop symptoms.
Don’t coronaviruses only cause colds?
Coronaviruses are a family of viruses causing respiratory illness mostly found in animals. Only seven have been identified in humans, including the four that commonly give us coughs and colds. But when a new strain jumps across from wildlife, such as SARS and now this new strain, it can be dangerous as there is no natural immunity to fight it off.
Why are there so many names for the virus?
Because it’s new, at first the virus was known simply as the “novel” coronavirus. Then the WHO named it SARS-CoV-2, given it shares so much of its DNA – about 75 per cent – with the SARS-CoV strain behind the SARS outbreak. The illness caused by this current strain is now called COVID-19.
Where did the virus come from?
The illness was first identified after people started falling ill at wet market reported to sell wild animals in the Chinese city of Wuhan. Unfounded theories that the virus is man-made quickly began to circulate online but scientists studying its genome already agree it came from animals – as more than 70 per cent of all new diseases emerging in humans do. Wild animals packed together and then butchered in live markets throughout Asia can be incubators for viruses to evolve and jump species barriers – SARS was traced back to a colony of bats but was believed to have passed into humans again in a wet market via the Himalayan palm civet, an ancient species of mammal eaten as a delicacy in China. And MERS also has bat origins but mostly spreads from infected camels, often in slaughterhouses. Bats are essential to many ecosystems we rely on but, through a lucky quirk in their immune system, they also carry a whole host of diseases that do not harm them. Early work suggests this new virus is 96 per cent similar to a SARS-like strain already discovered in bats a few years back, but experts think it likely first jumped into another animal, possibly the highly endangered and heavily trafficked pangolin, where it gained potency before passing into humans.
How does self-isolation work?
The question of who should practice this social distancing (everyone) versus who should seal themselves off completely has sparked some confusion. To stem the spread of COVID-19, millions of people infected or exposed around the world are also being urged to go into voluntary exile at home or in isolation wards. While some people have chosen to start home isolation themselves, thousands of others in Australia been already been issued formal notices to comply as states call in police to help enforce them.
We dive into the rules in this explainer here but in brief: if you have been in close contact with a confirmed case of COVID-19 or have returned from overseas, then you must self-isolate for a full fortnight (the estimated period of virus incubation before symptoms appear). If you are self-isolating at home, your household can still go out but you should try to keep to yourself, wearing a mask around others, ordering in food rather than going out, disinfecting common areas and keeping a close eye on how you are feeling (symptoms to watch out for are a high fever and shortness of breath). If you are infected yourself or awaiting tests, then everyone should stay home.
You can still wander into your garden or balcony but, while some officials have said you can walk the dog or stretch your legs, Deputy Chief Medical Officer Paul Kelly says you must stay home if you’ve been told to self-isolate: “Sorry.”
Despite these rules, Chief Medical Officer Brendan Murphy said, on March 27, that Australia was still seeing large numbers of returned travellers with the virus and, in many cases, passing it on to their families. “More than two-thirds are returned travellers, and a significant proportion of the other cases have been transmitted from returned travellers,” he said. From March 29, all overseas arrivals are being escorted from airports into hotels and other accommodation for the 14-day window, at the government’s expense. The army has been called in alongside police to enforce these quarantines after a number of people were caught out of their homes breaking isolation orders.
Can I still travel?
Only if you really have to. Our borders have closed and overseas travel is now banned under biosecurity powers, except in exceptional circumstances. Citizens still travelling abroad are urged to come home as countries impose similar shutdowns of their own.
Starting with Tasmania, most states have also started to close their domestic borders – police patrols will now ask people crossing over to go into quarantine for the recommended 14-day window.
How does the virus affect pregnant women – and babies?
At this early stage, we are still not absolutely sure how the virus affects women and babies. Different governments have offered different advice.
For now, let’s stick to what Australia’s peak body, the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZOG), has to say. Note these guidelines are changing regularly and you should check back on their website for the most up-to-date advice. According to guidelines, at this stage it does not appear that pregnant women are at greater risk from COVID-19 than the rest of the population – like they were during the world’s last pandemic Swine Flu in 2009.
However, they tend to be more susceptible to respiratory illnesses in general, such as the flu. There is no evidence of an increased risk of miscarriage or birth abnormalities, nor is there evidence the virus can pass from woman to unborn child or via breastmilk. “The safest place to birth your baby is in a hospital, where you have access to highly trained staff and emergency facilities,” the guidelines state. If the mother is infected at the time of birth, she should not be separated from her newborn, but should wear a mask and take precautions. The health advice is the same for pregnant women as it is for everyone else: work from home, avoid public places, and nail your hand hygiene.
Are pregnant women allowed to have a support person in the labour ward with them?
The RANZCOG guidelines suggest visitors in hospital are limited only to the immediate partner. But this is just a suggestion – different hospitals will have different rules.
Is public transport stopping?
No. Public transport is still running as it is considered one of the essential activities exempt from the government’s ban on gatherings but cleaning has been ramped up. While calls are growing from some experts to shut down public transport already, many people rely on it. Still, as social distancing rules come into force, travellers are deserting normally packed routes in droves. When on public transport, health officials say you should allow room for others as much as possible, rather than crowding in. It’s also important to keep an eye on what you’ve been touching. If you then touch your face, a virus surviving on, say, a metal handrail could jump across – so carry a disinfectant or even wear one (stylish) glove for holding on and touching things.
How far away is a vaccine?
The most hopeful estimates fall within the range of 12 to 18 months. A report for the British government put it at “potentially 18 months or more”. Why? Because making a vaccine is really, really hard. To make a vaccine, you first need to design a way of giving a human immunity against a virus. Then you need to make sure the vaccine is not toxic. Then you need to test it in animals. Then you need to test it in humans – and the tests need to be large so we can make sure it works and is safe. And then you need to make the billions of doses needed. And there is every chance a vaccine that looks promising in the lab, or in animal tests, won’t work in humans. Experts are hoping to roll out a safe vaccine within 18 months. But even that would be unprecedented. No vaccine has ever been developed that quickly. – Liam Mannix, science reporter
What treatment is being developed?
The Peter Doherty Institute in Australia is working on both a vaccine and a potential therapeutic treatment for the virus, and director Sharon Lewin says the latter might offer a faster fix. A drug that could block the virus from replicating in the body (or calm down the body’s intense immune response to it) could keep patients with severe infections alive and, in the case of an antiviral, reduce transmission. Several existing drugs are now being trialled against the new virus worldwide, including those used to treat HIV, malaria, and arthritis. The results look promising but it’s not time to rush out to the pharmacy just yet.
How does this outbreak compare to others such as SARS?
It took this new coronavirus 48 days to infect the first thousand people. By contrast, SARS took 130 days and the less infectious MERS more than two years to infect a thousand people after it emerged in 2012. When SARS finished its spread after nine months in 2003, only 8098 cases had been confirmed across 26 countries but close to 10 per cent of those were fatal. (Most clusters happened in hospitals or households.) MERS has been circulating for eight years across 27 countries so far, and kills about a third of those who fall ill – out of about 2500 confirmed cases. Ebola is even more deadly, killing more than 40 per cent of those diagnosed over a number of outbreaks since the 1970s but it has been reported in just a handful of countries.
In the pandemic records, the infamous 1918 Spanish flu killed about 2.5 per cent of its victims over two years – but because it infected so many people (close to 27 per cent of the world’s population) at a time of much cruder medical care, about 50 million died. Today, doctors are much better able to stave off secondary bacterial infections, which proved particularly deadly during that outbreak. And, unlike the Spanish flu, young people are not dying at the same high rates.
The last pandemic was swine flu in 2009, the second coming of a H1N1 influenza that infected between 11 and 21 per cent of the world’s population. Governments mounted costly responses until it was ruled to be over in October 2010. But the virus killed about 285,000 people (fewer than seasonal flu normally does) with a relatively low fatality rate of .02 per cent, and the WHO copped criticism for labelling it a pandemic at all.
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What happens if I lose income?
Billions of dollars are being poured into the Australian economy to offset the damage being done to businesses and employment by the coronavirus pandemic. For details of who gets what from stimulus packages, look here.
Centrelink payments have been lifted and expanded. And, in a bid to stop companies cutting jobs, employees of eligible businesses can claim a new $1500 fortnightly ‘Jobkeeper’ payment, even some who have already been let go so long as they were with the company on March 1. Businesses and not-for-profits that have experienced more than a 30 per cent downturn in revenue are eligible and payments will be delivered in May but backdated to March.
The federal government estimates about half of the workforce – or six million people – will get this payment over the next six months.
If you’ve lost your job because of the crisis, this explainer outlines what support is available.
Our team will answer more questions and update information in this story regularly.
If you suspect you or a family member has coronavirus you should call (not visit) your GP or ring the national Coronavirus Health Information Hotline on 1800 020 080.