Dr Peter Petrie, who is supporting Kingsley Healthcare staff and their families concerning health issues caused by Covid through a private GP service, answers your most frequently asked questions about coronavirus.
Yes, the journey to vaccine has been rapid. Not because corners were cut in the science but because there was finance to throw resources at it and administrators prioritised meetings to move the process along. There were ample trials to ensure there was no hidden frequent serious side effect. Our initial feedback is that there are significant effects in the first 24 hours such as high temperature and headache (probably more pronounced with Astra Zenica). We recommend taking Paracetamol following the injection to minimize this. Interestingly these effects are less pronounced in elderly patients.
Yes absolutely. There is a very tangible significant risk of dying from Covid which is vastly bigger that any potential issue with the vaccine.
The Pfizer vaccine gives 85% protection two weeks after first injection and 95% when second is given after 3 weeks. It only offers significant protection two weeks after the injection so don't get caught in meantime. The Oxford Astra Zenica vaccine is 70% effective three weeks after the first vaccine going to 76% after the second vaccine. We do not know what happens when the second dose is delayed!! I expect that protection slowly diminishes over several months.
We know that some people are more vulnerable when afflicted by Covid. The highest risks are age and ethnicity which we can't change! Next most important is being overweight which can be changed as well as resulting hypertension. Smoking is an important risk factor which is never too late to address. Diabetes is a risk factor but interestingly not for a well-managed diabetic. Asthma has a small increased risk. There are a number of medical conditions and medications which confer unique risks which may well require shielding. The amount of virus exposure is relevant. Therefore keeping distance and mask wearing reduces risk of serious illness.
As Covid is largely an inflammatory reaction, taking things that reduce inflammation are beneficial such as Omega 3 Fish oil 2000mg, Vitamin C 600-1000mg. Zinc is uniquely beneficial for Covid as it affects Zinc within cells which is the reason smell is affected. Therefore take Zinc 30mg daily. Vitamin D was hoped to make a significant impact as it was suspected that low Vitami D in ethnic minorities was a factor in their increased risk. This proved not to be a significant factor. However we should all take Vitamin D during the winter months for other health reasons. The dose should be 1000-2000IU. Interestingly people taking Statins to lower their cholesterol have added protection from their anti-inflammatory properties.
When affected by Covid there are often several days before symptoms appear (if at all), there then follows 5-7 days of symptoms before there is a risk of a Cytokine storm causing a serious rapid deterioration. It is helpful if possible to obtain an Oxygen meter to measure Oxygen levels. This week the NHS has decided to provide these with an instruction of calling help when Oxygen level drops to 93%. There are also several medications available which have shown promise in trials such as Azithromycin which is a potent anti-inflammatory. We also have antibiotics and the steroid prednisolone. For those previously infected they are shown to have 85% protection still after 5 months and the research is ongoing.
Most people have been impacted in their mental health and sadly resources to help are limited currently. Here are a few tips. Do not make the mistake of turning to alcohol to help with sleep or lift mood. It is a depressant and will make things worse. Exercise of any form helps a lot, producing the hormones that lift moods. Sharing and talking about issues is vital. Friends and family would feel privileged to help. Mindfulness, relaxation and Yoga are helpful. There are voluntary organizations available 24 hours a day such as Samaritans. One quarter of doctors have sought professional help or advice with their mental health. Social care has the same stresses and pressures as doctors. Don’t be afraid of short term medication such as SSRIs.
Mutations are normal and usually get milder (probably not the case this time in terms of severity as well as infectivity). There are currently concerns regarding the Brazilian and South African strains. It looks like vaccine protection will be modestly diminished. This means that the vaccine will be adjusted to offer extra protection from these. We then enter into a cycle similar to Flu when we adapt the vaccine each year. Sadly this means that Covid will be part of our lives for years to come. It is highly unlikely we will be able to eradicate this completely. We rarely manage this with Smallpox being our only example of total eradication. This summer there will be a natural reduction in cases. Mask wearing will continue. Travel restrictions will continue all year in some form. There will be localized restrictions cropping up again next winter.
Sadly there is a cohort of people whose symptoms linger over months. Most people have diminishing symptoms over a few weeks. Managing this is the same principle as for post viral fatigue. It is about eating healthy, no alcohol or cigarettes. Listening to the body so as not to over exert with controlled graded exercise.