What do people with ME need to know about Covid-19 and self-isolating? updated 10 April 2020
The Health Minister for Wales has confirmed that people over 70 and people with a range of health conditions, including neurological conditions, should self-isolate. People with a cough and/or high temperature are asked to self isolate for 7 days. Those who have had contact with someone with confirmed Covid-19 should self-isolate for 14 days. Everybody should stay at home except for essential shopping, short daily exercise a day, essential medical needs, travelling to and from essential work, but only where this cannot be done from home. Social distancing is required by all people when outside the home.
Many people with ME have been self-isolating to some extent for years, because they have been too ill to mix with others. They will be practised in ensuring they have enough food, cleaning products, personal care items, ‘distractions’ and medications, but the coronavirus Covid-19 poses some extra problems and questions.
Much is still not known about this new virus, but some clues are emerging from US research and from the badly affected countries of China and Italy.
People don’t have to have symptoms to be infectious
- symptoms appear 2-14 days after infection
- infection can last weeks, up to 37 days (China)
- people can be infectious before & after symptoms are apparent, or without symptoms
- it is uncertain how many have no obvious symptoms and are spreading the virus
- no symptoms doesn’t necessarily mean less able to spread the virus
What are the symptoms?
Regular flu has similar symptoms to COVID-19. However, COVID-19 is more likely to cause shortness of breath and other respiratory symptoms. Some people have only mild symptoms while others are very ill and struggle to breathe.
How does the virus spread?
- it might be airborne to a small extent
- it definitely remains on surfaces
- it probably doesn’t survive in water
- it survives to some extent in faeces
- they are unsure if it survives in sewerage systems
- it enters the body via the eyes, nose, mouth, not through the skin
- cats can catch it but it is uncertain if they can infect humans
Who is most at risk?
Early indications in China and Italy was that the majority of people who died were over 60 with certain underlying health conditions, (but anyone can catch and pass on the virus):
- heart disease
- hypertension – high blood pressure
- chronic lung disease
- some cancers
It has now become clear that younger people with no known health conditions can also be at risk.
It is unknown to what extent people with ME are at greater risk but Dr Nancy Klimas believes we could be, as ‘one of the underlying problems is that the cells protecting you against viruses are less functional because overworked.’ Dr Charles Shepherd says: ‘an infection such as this will almost certainly cause a relapse, or significant exacerbation of symptoms’.
Public health England’s updated list of those at risk & requiring social distancing, which includes Neurological Conditions, the obese and pregnant women.
What distance is safe when social distancing?
It may not be possible to avoid close contact with people giving you care, or for whom you care, but all sources say where possible stay 2 metres or 6 feet away from other people. If people are moving (cyclists or runners) it may be wise to stay up to 10m away. Face masks won’t stop you catching the virus, but they may reduce the likelihood of passing it on to others.
Prof Hugh Pennington adds: “This virus needs 15 minutes of close contact with someone carrying it for you to have a reasonable chance of contracting it…But if someone who is infected coughs or sneezes on you directly then the droplets can infect you — that will be a much higher risk.”
How long does it last on surfaces?
When self isolating we will need to receive post, groceries etc. Are they safe? US researchers measured how long the virus stays active on various surfaces:
- up to 24 hours on cardboard
- up to 2 or 3 days on plastic and stainless steel.
- it remained viable in aerosols—attached to particles that stay aloft in the air—for up to 3 hours.
Accept goods from outside, then put away perishables without contaminating other items. Either thoroughly wash the outside of the items or leave them until they are safe to touch. Wash your hands and don’t touch your face!!
Can you become re-infected?
- it is uncertain if or how long immunity lasts
- it appears to be possible to relapse, though numbers are small
- there are 2 variations of the virus and potentially it could mutate, though probably unlikely
- in some countries testing for the presence of the virus may not be reliable so people only think they have recovered
- most people recover but some experience reduced lung function following recovery, which will require some rehab
- some concerns have been expressed that the virus may trigger an ME-like reaction as happened with SARS.
What kills the virus?
- soap & water – dried by single use paper or warm air
- alcohol based sprays on surfaces – leave 5 mins before wiping
- hand sanitisers
- cooking removes any danger from food
- bleach – disinfects, but pollutes- 5 tbsp (1/3 cup) of bleach per gallon of water
When to get tested?
The UK is stepping up testing of frontline workers but still only wants to test those whose symptoms become serious due to shortage of tests – if experiencing severe symptoms ring 111 anywhere in Wales. (Don’t press any numbers, just hold to be connected to NHS Wales, rather than NHS England)
How should it be treated?
- paracetamol for fever, uncertainty in NHS if ibuprofen or other anti-inflammatories will slow recovery
- drink fluids to reduce risk of dehydration
- in hospital oxygen might be given to aid breathing
- there are a number of drugs that might help but they haven’t been tested yet.
How can I self-isolate?
Information on what it means to self-isolate in your home, or in a room within your home can be found on the UK Government website. Increasingly local support schemes are being set up by concerned citizens to make it possible for people to self-isolate, even when they don’t have friends or family nearby, or access to online deliveries.
For info about how to get or give support, find your COVID-19 Facebook support group here Some Council & AVO websites list local sources of help and delivery services. Age Cymru and RVS provide support.