COVID-19 Q AND A

The following questions were asked by members of the public through various social-media platforms during a recent virtual town hall organised by the RJRGLEANER Communications Group. The answers were provided as a public service by the highly respected Dr Peter Figueroa. He was last year recognised by the World Health Organization (WHO) for his substantial contribution to public health in Jamaica, the Caribbean, the Americas, and the world over the past four decades.

Note: The name of the coronavirus that causes the disease COVID-19 is SARS-CoV-2. For ease of reading, we have referred to it as the ‘virus’ in the text.

1. Can you catch COVID-19 more than once?

During this epidemic, it is unlikely that someone will contract COVID-19 more than once. However, we do not know whether someone will be protected from COVID-19 in the future or whether they may be susceptible to becoming infected again.

2. Please clarify whether a person can spread the virus while being asymptomatic.

The virus causing COVID-19 is spread primarily by persons who have symptoms of the disease. There are reports of persons who are asymptomatic who may be spreading the virus, but this is less common.

3. Has there been, or is there any form of testing to find out what the long-term effects would be, if any, on persons’ lungs after contracting the virus?

Most persons who become ill with COVID-19 recover fully. The majority of persons (80 per cent) have a mild or moderate illness, 14 per cent have a severe illness, and six per cent have a critical illness that may result in death. Persons with a severe or critical illness will need to be monitored in the future to see if there is any permanent damage to their lungs.

4. How long after contracting the virus can it stay in your system after recovering from it?

Most persons recover from COVID-19 within one to two weeks. Most persons are no longer infective within two weeks after recovering from their illness. Some persons may recover from the illness but continue to shed the virus for a period of time. There is one report of a man who shed the virus for 37 days. Persons who have COVID-19 are not released from medical care until they have two negative tests.

5. Is it true that the virus does not do well in the heat?

The virus spreads from person to person through droplet spread, especially when an infected person coughs or sneezes. Therefore, the disease spreads readily in tropical countries like Jamaica.

6. If there is no cure or vaccine for this disease, then how do you recover? When one has recovered, is it that one no longer has it?

When a person becomes infected with the virus, their immune system responds to control the virus and clear it from their body. During this period, they usually become ill and then recover and no longer have the virus.

7. As Jamaica has one of the highest incidence of diabetes per capita, are we to expect higher percentages of fatalities than what has been seen in countries such as Italy and China?

We cannot predict what the level of deaths will be in Jamaica. This is known as the case fatality rate. Most persons will recover from COVID-19. The elderly are at more risk of severe illness. Persons with serious underlying conditions such as diabetes, heart or lung disease are more at risk of dying if they develop severe disease. This is why elderly persons and those with serious medical conditions are urged to stay at home, wash hands regularly, and practise physical distancing.

8. Can COVID-19 be transmitted by mosquitoes, ticks, or any other vector?

The coronavirus that causes COVID-19 is thought to have originally come from bats. It is not known how it got from bats to humans. The virus is now spreading from person to person primarily by droplet spread from infected persons. It is not being transmitted by mosquitoes or ticks.

9. How does the Ministry of Health and Wellness ensure that persons are self-isolating?

The ministry places persons in need of isolation in hospital or in designated buildings and monitors their health because they are infected or suspected to be infected.

Persons who do not have symptoms but who may have been exposed, e.g. they are returning from a country where there is community spread of the virus, are placed in self-quarantine at home. They are monitored by telephone, and, at times, a visit from a health provider.

Persons with respiratory symptoms due to the common cold are encouraged to self-quarantine at home. If they develop shortness of breath or difficulty breathing or are getting more ill, they should phone their doctor or the Ministry of Health help line number.

10. Why is it that wearing the mask is downplayed or being instructed to be worn by only persons with cough or with the virus? How is it that we see it worn and encouraged to be worn by most persons in other more resourceful first world countries?

Persons with a cough are advised to wear a mask in order to reduce the likelihood of infecting other persons in case they have the virus and do not know it. If it is known that they are infected, they are placed in isolation and monitored closely.

Health providers must use masks when caring for persons who may be infected.

The World Health Organization (WHO) assesses that persons who are well and without any respiratory symptoms do not normally need to wear masks. They should maintain physical distancing, wash hands frequently, and avoid touching their face. If everyone who is well was wearing a mask every day, the supply of masks would rapidly run short, and health providers and those who need them would not be able to get them.

11. Can this COVID-19 be passed on by pregnant or lactating mothers to their unborn or breastfeeding baby?

We are not aware of any reports of a pregnant woman passing on the virus to her unborn baby while the baby is still in the womb. There is a report of a mother who had respiratory symptoms passing on the infection to her young baby. This is thought to have been transmitted by person-to-person droplet spread.

12. How long does the Ministry of Health and Wellness think the virus will be in Jamaica?

We do not know at this time. However, the virus will be here for at least several months or longer. It could become endemic, meaning that after the epidemic passes, it could remain circulating in the population at a low level.

13. As we are in the dry season when there will be a number of bush fires, will that pose a more severe threat for persons who have chronic cases of the coronavirus?

If a person with severe COVID-19 recovers but develops some lung damage while ill, then any form of air pollution such as a bush fire could present a difficulty for that person.

14. What about someone infected with the virus COVID-19 using a swimming pool, would it affect other users?

We would not advise anyone who is ill with COVID-19 to use a swimming pool. All persons who are known to have COVID-19 are placed in isolation until they are no longer shedding the virus.

Persons using a swimming pool or going to the beach at this time should maintain physical distancing.

15. What precautions should persons with an immune system that is immunocompromised - in other words, unable to fight off any form of infection, for example, persons with HIV, diabetes, asthma, or other respiratory illnesses - take?

It is best for persons who are immunocompromised to work from home and to take special care when they must go out. Persons who are living with HIV and are taking their medication daily are not known to be at a greater risk of infection than other persons. If you are immunocompromised and concerned, phone your doctor or call the Ministry of Health and Wellness helpline.

16. How long can the COVID-19 virus stay on surfaces?

The virus may remain on surfaces from two hours to three days. This is why it is important to wash hands frequently, avoid touching your face, and clean or disinfect surfaces regularly.

17.Can a positive COVID-19 patient develop immunity against the virus?

Yes, most persons when infected develop immunity to the virus and recover from illness. We do not know how long this immunity will last. However, it appears unlikely that these persons will become infected again during the current epidemic.

18. Does the COVID-19 virus linger on the surface of fruits, vegetables, and meat? If it does, are there guidelines for safe consumption?

Yes, the virus may linger on the surface of fruits and vegetables if these are handled by persons who are ill and fail to wash their hands.

Careful washing of fruit and vegetables and proper cooking of eggs, poultry, and meat will prevent any exposure to infection.

19. Does Jamaica have the facilities to quarantine persons should the situation escalate?

The Ministry of Health and Wellness is expanding the facilities for both isolation and quarantine. Once community spread becomes widespread, persons will have to self-quarantine at home, and it would become necessary for persons who are infected, but have mild disease, to self-isolate at home. The objective would be to preserve hospital beds for those with severe illness.

20. Some persons use tissues to sneeze/cough and throw it on the street. With all this heavy breeze can we catch the coronavirus in the air?

Persons who cough or sneeze into tissues should dispose of them properly and not throw them on the street. However, it is most unlikely to catch the virus from the air. The tissues could contaminate surfaces or the clothes or shoes of someone who steps on the tissue. Someone may get the virus on their fingers by touching a contaminated surface or when taking off their shoes. If the person touches their face before washing their hands, they may be at risk of infection. This is why we must wash our hands frequently, including when we get home and avoid touching our face.

21. Is our Government going to invest in long-term scientific research to combat these viruses that arise from time to time so that we are not lagging behind, waiting on other countries for help?

Jamaica does conduct research into various diseases and should invest more in scientific research.

22. Could the National Health Fund (NHF) make an adjustment to their policy to allow patients to get at least an additional month supply of their prescription drugs?

NHF has already adjusted their policy for the elderly and is considering a more flexible policy during this epidemic.

23. If COVID-19-infected people don’t exhibit symptoms (coughing, sneezing), how are they able to infect others they come in contact with?

Persons at the early stage of infection may not have obvious symptoms, but they may be shedding virus by clearing their throat or sniffing or getting virus on their hands by rubbing their nose and shaking hands or touching someone or surfaces that someone touches. This is why physical distancing, frequent hand washing, and avoiding touch your face is important.

24. Has the Government considered doing tests for the virus among a cross section of front-line workers in the hotel industry to truly assess the country’s COVID-19 situation?

The Ministry of Health and Wellness is introducing surveillance among some front-line persons who may be at greater risk of exposure. This would include testing where indicated.