From disinfecting shopping to taking ibuprofen — 50 key questions on coronavirus answered by docs

OUR GPs are closing their doors, 111 helplines are stretched and the internet is hit-and-miss for accurate advice on Covid-19.

So today, The Sun on Sunday has assembled a team of medical experts and frontline doctors to answer YOUR 50 most important questions on coronavirus.

Those questions range from how to tackle loneliness during long periods of self-isolation to whether you should take ibuprofen.

For this definitive guide, we bring together Dr Toni Hazell, a GP in Tottenham, North London; Dr Matthew Boulter, a GP from Penzance, Cornwall; and Dr Noorwalla Kassam, a GP in Salford, Greater Manchester; plus The Sun on Sunday’s Dr Carol Cooper.

Our team of top docs — who are at the forefront of the coronavirus fight in this country — cut through the misinformation to give you the FACTS and sound advice.

Dr Cooper said: “In this time of uncertainty, millions of us have so many questions about Covid-19.

“We try to answer your queries based on the information that is currently available and giving the facts.

“These are unprecedented times but there are steps you can take to protect yourself and your loved ones, as well as the wider community.

“These include social distancing, self-quarantine and washing hands.

“Everyone needs to do their bit to beat this. We are all in this together.

“If you are concerned about your symptoms, you should contact 111 online in the first instance or approach your GP surgery by phone or online.”

We asked you to submit your most urgent questions to our experts. Here is what you wanted to know . . .

Q1  - How can I beat loneliness for three   months in quarantine?

Dr Cooper says: Make the most of   technology to keep in contact with family and friends. This is a good time for virtual meet-ups via the phone, FaceTime, WhatsApp, Skype and so on.

Many local areas have started online forums to keep neighbours connected. You could also ‘meet’ others for chatting about specific interests, whether it is motorbikes, knitting or books.

If you do not know of such a group, search for one.

And why not enjoy the vanishing art of letter-writing, albeit online? And write more leisurely emails than the usual businesslike communications.

Use social media, too. There are some great Facebook groups which are helpful for getting through isolation. But stay away from misinformation on Covid-19.

Blogs and podcasts can also be ways of keeping you in touch with the world. Then there is always TV, radio or a good book to help you feel you are not all alone. Keeping mentally active is as important as keeping physically active.

Q2 -  Should I exercise and can you   suggest any ideas?

Dr Cooper says: Keeping fit over a   period of social distancing or isolation is vital. If you have any outdoor space, use it to get fresh air and maybe do some gardening.

Housework may help a bit, and it helps keep surfaces clean — but from a fitness point of view, doing specific exercises is even better.

The Body Coach Joe Wicks has put more than 250 free home workouts on YouTube, with something for all fitness levels. There are other offerings too, so see what takes your fancy.

If you have the space, use a skipping rope or hula hoop in your garden.

As ever, do not overdo it. If you are not used to exercise, start gently, build up gradually and take heed of any pain, shortness of breath or other symptoms.

 Q3 - Is coronavirus more contagious than ordinary flu?

This is still   being studied. It varies by country so more research is needed.

Q4 -  Can you have Covid-19 without showing signs?

Yes, some people may have the disease without displaying any symptoms.

Q5  - Can I walk my dog?

Dr Cooper says: If you have not   tested positive for Covid-19 or been advised to self-isolate, you can carry on, but take extra hygiene precautions when you return from the walk.

You should be social distancing regardless, so be sure you keep two metres away from people.

If you self-isolate, you should restrict yourself and your dog to the house and garden, if you have one.

Perhaps enlist a neighbour or friend for walkies, or try local resources set up to put people in contact during this pandemic.

You are likely to find someone who would be delighted to walk your pooch. You can keep up to date with advice from the RSPCA on rspca.org.uk.

Q6 - Can I do anything to boost my   immune system?

Dr Cooper says: There is a lot   you can do. Top of the list is not smoking and not drinking to excess. Eat a healthy menu rich in fruit, vegetables and wholegrains.

If you are concerned about whether your diet is adequate, take a daily multivitamin.

Exercise regularly, get enough sleep and try to address your stress.

Of course, follow all the advice on washing hands often and well, and avoid touching your face with your hands, especially when they are dirty.

Q7 - Will antibiotics help cure   coronavirus?

Dr Cooper says: No, because   antibiotics are not effective against viruses. They can only work against bacteria.

It is true that some viral infections can sometimes lead on to a bacterial one — for example, a chest infection can complicate flu.

But the research suggests that taking antibiotics ahead of bacterial complications does not actually prevent complications from developing.

Q8 - How long does the virus   stay on surfaces?

 Dr Cooper says: Coronavirus   seems to live for up to 72 hours on smooth surfaces such as plastic and steel, so it makes good sense to clean these areas thoroughly and often.

It is not yet certain to what extent heat, cold or sunlight will affect this virus’s survival, but our knowledge is increasing all the time.

Q9 - Why and how does it attack   the lungs?

Dr Cooper says: Because Covid-19 is   breathed in, it is no surprise that it affects the upper airways and sometimes the lungs.

The lung complications are either pneumonia or acute respiratory distress syndrome (ARDS). If it is going to happen, ARDS sets in during the second week.

With ARDS, the lungs can inflate and deflate, but they no longer do their job of transferring oxygen within the air to the bloodstream.

That is why being on a ventilator is not always the answer. Instead, a treatment called ECMO (extra-corporeal membrane oxygenation), which requires specialist equipment, needs to take over while the lungs recover.

Q10 - Will taking vitamin C or   other   vitamins help?

Dr Cooper says: Unfortunately,   there is no evidence that vitamin C supplements help beat coronavirus. But they are highly unlikely to do any harm.

Having said that, very high doses of vitamin C have occasionally been known to damage the stomach and the kidneys, so do not take more than the recommended dose.

However, people in the UK are best advised to take a routine supplement of vitamin D.

Vitamin D contributes to good immunity and it mainly comes from the action of sunlight on the skin.

That is why so many of us in this often cloudy country have low levels.

Q11 - Are there surfaces on which   the virus lasts longer, such as fabric or my post?

Dr Cooper says: This may not   be what most people expect, but coronavirus seems to last longest on smooth surfaces. It only persists for 24 hours on cardboard, and even less on fabrics.

All the same, it is worth keeping fabrics clean and washing your clothes regularly. A hot machine wash should be enough.

Q12 - How long is the incubation   period?

Dr Hazell says: The incubation   period for any infectious disease is the time between when you catch it and when you start to show symptoms.

The incubation period for coronavirus is thought to be between one and 14 days, probably around five days on average.

Q13 - What is the fatality rate?

Dr Cooper says: It is impossible   to be sure without testing the whole population for Covid-19, but for now the estimate is around three to four per cent.

The death rate is lower for children and higher for older people or those with pre-existing health problems.

Bear in mind that people with ongoing illnesses may die during the coronavirus pandemic without catching the infection at all.

That is because if the NHS is swamped, they may be unable to get the right care for their pre-existing problem.

That is why the Government is doing all it can to slow the spread of the disease — and we all need to do our bit by following the latest medical and scientific advice.

Q14 - Is using soap and water better than   hand sanitiser?

Dr Hazell says: Probably. Soap   and water removes more of certain types of germs than hand sanitiser. And hand sanitiser is not always used correctly — people might not use enough or might wipe it off before it has dried.

But of course the best thing to use is the thing that you have at the time. Suggesting that people wash their hands regularly when out and about is completely impractical, and a hand sanitiser with at least 60 per cent alcohol, used properly, is certainly worth using.

Q15 - How does the virus spread?

Dr Hazell says: Like most viral   infections, the spread is airborne so if someone near you coughs or sneezes, they will spread droplets of the virus which you can ingest. This is why there is such strong advice about social distancing.

Unlike some other viruses, the coronavirus’s long survival period on surfaces — as has been said, it’s maybe up to 72 hours — is another way that it can spread without you being in direct contact with an ill person.

Q16 - What are the at-risk pre-existing   conditions?

Dr Hazell says: The Government   has said that anyone with a condition that would normally mean you get a flu jab on the NHS should follow social distancing carefully.

This includes a wide range of conditions, including asthma, diabetes and chronic diseases of the heart, kidneys or liver.

It also includes those whose immune systems are weakened as a result of disease, such as with HIV, or medications, such as some that treat arthritis and people after transplants.

Q17 - What are the symptoms I need   to be aware of, and why do some people get different ones?

Dr Hazell says: The most   common symptoms are fever (your chest or back will feel hot to the touch) and a dry cough.

You might also feel very tired and achey all over your body. Some people have a sore throat and their nose may be blocked or runny.

I am not sure anyone fully knows the answer to why some people get different symptoms to others. The elderly and those with a long-term condition, particularly one to do with the heart or lungs, are more at risk of getting severe symptoms.

Our understanding of coronavirus, and why some otherwise fit and well people have become very ill, is still evolving each day.

Q18 - What is the single most   important thing I can do to protect myself and loved ones?

Dr Hazell says: The most   important thing is good hand hygiene. Wash your hands when you can and use hand sanitiser the rest of the time.

Do not touch your face — if you have the virus on your hands, that will bring it up to the membranes in your nose and mouth.

Follow advice given about social distancing, especially if you are over 70, and keep an eye on the news for updates. Many people still are not doing that. They need to take heed.

Q19 - My wife is pregnant – should we   be worried?

Dr Hazell says: The Government   has included pregnant women in the list of people who might want to consider social distancing, but it is unclear whether or not this is based on sound science or just on past experiences — like when many pregnant women became very ill with swine flu in 2009.

The Royal College of Obstetricians and Gynaecologists has issued a statement saying that pregnant women do not appear to become more ill than the general population when they get coronavirus.

It adds that there is no evidence it causes an increased risk of miscarriage or can be passed to the unborn child via the placenta.

Q20 - What should I do if I think I   have got it?

Dr Hazell says: Government   advice is that anyone with a new cough or a fever should self-isolate for seven days. Treat it as you would a cold — use paracetamol and keep yourself well hydrated.

Avoid contact with relatives as much as possible, though this can be difficult in a shared house. Unless you are becoming more unwell or think you need the hospital, there is no need to seek medical help.

Q21 - Will warm weather stop the   outbreak?

Dr Hazell says: The simple   answer is we do not know, but probably not. Respiratory infections are generally less common in summer months, but this is a new infection and may behave differently.

We also need to take into account that fewer people are immune to coronavirus because it is so new, so that reduces the likelihood it will disappear in summer.

Q22 - Are the current tests 100 per cent   accurate?

Dr Hazell says: Any test has a   sensitivity (how good it is at ruling out if the person has the condition) and a specificity (how good it is at diagnosing the condition). No test can be 100 per cent sensitive and 100 per cent specific — and the coronavirus tests are no different.

At the start of the outbreak there were many anecdotes about false negative tests, where patients had several negative tests before getting a positive one.

But this could be because they developed the illness after passing the earlier tests.

Studies of some tests have shown that they are around 85-90 per cent sensitive, which means that for 100 people with a negative test, ten to 15 of them may actually have the virus.

Public Health England and NHS England say that the current test they are using is highly sensitive.

Q23 - Can I take ibuprofen?

Dr Hazell says: Best not to for   now. There have been some concerns that the use of ibuprofen and other anti-inflammatory drugs could make some patients with infectious diseases very ill — chickenpox is a good example.

The NHS currently advises patients with symptoms of coronavirus to use paracetamol instead.

Q24 - Can the virus travel in water?

Dr Hazell says: The Centers For   Disease Control And Prevention in the US has said that coronavirus has not been detected in drinking water and that the processes used to make water clean and safe would remove or inactivate the virus.

Q25 - Will I definitely get it if I have   been in contact with people who have it?

 Dr Hazell says: This is almost   impossible to answer because it depends on how close you get to the person and where they are in their disease development.

It is unlikely that coronavirus could be proven to have a 100 per cent transmission rate.

Q26 - Is packaged   food a risk?

Dr Hazell says: You cannot   catch coronavirus from eating food. In theory, you could catch it from a packet if someone with the virus had recently touched the surface of the packet.

Q27 - Can my pets get it?

Dr Hazell says: A dog in   Hong Kong was found to have coronavirus, but there is no evidence to suggest our pets can transmit it.

Q28 - How do I know if I have got   it and not a cold/flu?

Dr Kassam says: The most   recent government advice is that any person with a high temperature (you feel hot to the touch on your chest or back) or a new, continuous cough should self-isolate for seven days.

If they live with other people, all household members should stay at home for 14 days from the day the first person showed symptoms.

Q29 - Should I wear a face mask?

Dr Kassam says: The   World   Health Organisation recommends that if you are healthy you only need to wear a mask if you are taking care of someone with a suspected infection. I would advise my patients to check official government advice on this.

The most important thing people can do at present is self-isolate if showing the signs of Covid-19 and practise regular and safe hand-washing.

Q30 - Can changing my diet protect me?

Nothing suggests that any specific diet or dietary supplements cut infection risk or the length or severity.

Q31  - How is it treated?

Dr Kassam says: As   yet, there is no vaccine, although vaccines are being developed and trials have recently started.

Researchers are also working on anti-viral treatments but again, these are currently only in the trial stage.

Q32 -  How different is it to normal flu?

Dr Kassam says: Seasonal   flu   viruses and Covid-19 are both contagious viruses that cause respiratory illness. The symptoms are very similar in a number of ways and doctors are still learning about Covid-19.

Q33  - Will contagious people show symptoms?

Dr Kassam says: One of the   main difficulties we are facing is that people can be contagious when they have no apparent symptoms. So do not ignore appeals to socially distance.

Q34  - When might a vaccine be made?

Dr Kassam says: Last week,   the first human trial of a potential vaccine was started in the US. There are many different companies developing vaccines but it is likely that a widely available vaccine will not be ready until later this year.

Q35  - If I think I have coronavirus, what should I do?

Dr Kassam says: You stay at   home for seven days if you have either a high temperature or a new, continuous cough. If you live with other people, they should stay at home for 14 days from the day the first person got symptoms.

Q36 - Can I catch it more than once?

Dr Kassam says: There is not   enough data at present to answer this question.

Q37  - Why is it called coronavirus?

Dr Kassam says: The name   comes from the Latin corona, meaning “crown” or “halo”, which is how the virus looks.

Q38 - How do I look after someone who has it?

Dr Kassam says: If you are   looking after someone who is self-isolating, you should also self-isolate for a period of 14 days.

Patients should follow guidance from the NHS if they are struggling to manage.

Q39  - Does hand-washing really prevent the spread?

Dr Kassam says: Yes, most   definitely. Regular hand-washing is one of the most important things you can do.

You should wash your hands for at least 20 seconds and ensure they are thoroughly dry.

Q40 - Does it travel through air, so do I need to be concerned about air conditioning?

Dr Hazell says: There is a   theoretical risk that the virus could be circulated in an air conditioning system, but droplets circulating in the air will probably only survive for a few hours in the air, compared to possibly days on surfaces.

You could consider turning air conditioning off, but if this isn’t within your control (e.g. at work) then the key message of hand sanitising applies.

Q41  - What if I eat some-thing with the virus on?

Dr Boulter says: This is an   unlikely event but eating food that has been contaminated (for example, coughed over) may be a route of transmission.

Q42 - What is social distancing and why should we?

Dr Boulter says: Social   distancing reduces interaction between people and therefore limits the spread of the virus.

Key measures include: Avoiding contact with those who have symptoms; avoiding non-essential use of public transport; working from home if possible; avoiding large gatherings and gatherings in small public spaces (hence the ordered closure of pubs, theatres and gyms); avoiding gatherings with friends and family; and only contacting essential services such as GPs by phone or online.

Q43  - I’m in self-isolation. Should I disinfect my home-delivery shopping?

Dr Boulter says: There is   no   recommended advice regarding this. However, regular hand-washing with soap for at least 20 seconds is vital and always washing before preparing food is advised.

Q44  - What should I do if someone in the house has a cough?

Dr Boulter says: If someone   develops either a high temperature (they feel hot to the touch on their chest or back) or a new, continuous cough, they should stay at home.

They should not go to a GP surgery, pharmacy or hospital. They do not need to contact 111 to tell them they are self-isolating.

Testing for corona- virus is not needed if they are staying at home. They should stay at home for 14 days.

Other people who live in the home should stay indoors for 14 days from the day the first person got symptoms.

If there is someone living in the home who is 70 or over, has a long-term condition, is pregnant or has a weakened immune system, try to find somewhere else for them to stay for 14 days.

While staying at home together, try to keep away from each other.

The NHS 111 online coronavirus service should be used if they feel they cannot cope with their symptoms at home, their condition is getting worse or their symptoms do not get better after seven days.

Q45 - Can I share a bath-room with someone with the virus?

Dr Boulter says: It is better   to   use separate bathrooms if possible. This is particularly important if there is a medically vulnerable person in the home.

If this is not possible, a shared bathroom should be cleaned each time it is used, for example by wiping all surfaces that have been touched. Do not share towels.

Q46  - Can I share cooking utensils with someone who is unwell?

 Dr Boulter says: A dishwasher    should be used if possible. If not, washing-up liquid, warm water and thorough drying of utensils should suffice.

If there is a vulnerable person in the home, shared spaces such as kitchens or bathrooms should not be used at the same time.

Windows should be opened in shared spaces if possible.

Q47  - I’m self-isolating, should I leave the house at all?

  Dr Hazell says: No. The   key   distinction between self-isolation and social distancing is that if you are self-isolating you don’t leave the house at any point to go out. You can use the garden.

Q48  - When are people infectious?

Dr Boulter says: People may   be infectious from an early stage in the disease and before symptoms show. This is why social distancing is so important.

Q49  - When are carriers at their most infectious?

Dr Boulter says: To date this   has not been determined, hence why we should all be using social distancing, disposable tissues and hand-washing to limit the spread.

Q50 - Why are older people more at risk?

 Because, as with all diseases, they are more likely to have underlying health conditions.