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Covid-19: What are the symptoms and what protocols are in place to deal with suspected cases?

There remains one confirmed case of Covid-19 in the Republic of Ireland.

A flyer from the Covid-19 public information campaign.
A flyer from the Covid-19 public information campaign.
Image: Sam Boal/RollingNews.ie

WITH A CASE of Covid-19 now confirmed in the Republic of Ireland, following on after the first case in Northern Ireland on Thursday, there is a renewed focus on Ireland’s response to the global crisis. 

As things stand, these are the only two cases on the island of Ireland. More than 100 people here had been tested as of last Thursday. An official update on that figure will be provided by the government on Tuesday.

On Sunday evening, the Department of Health announced that a Dublin school will close for 14 days in response to the first case of Covid-19 in the Republic of Ireland. 

It’s understood the patient is a pupil at the school and that the school is based in Glasnevin, Dublin 9. 

The general approach from the HSE remains unchanged today. 

Worldwide, about 89,000 people have been infected and over 3,000 people killed since the virus was first detected late last year in the central Chinese city of Wuhan.

China yesterday reported a fresh spike in infections, with 573 new cases – the highest figure in a week after a dip. All but three of them were in Hubei province, of which Wuhan is the capital. 

The virus has spread to more than 60 countries around the globe, prompting the World Health Organisation (WHO) to raise its risk assessment to its highest level.

The WHO urged all countries to stock up on critical care ventilators to treat patients with severe symptoms of the virus. 

The EU said on Monday that the risk of a widespread, sustained transmission of Covid-19 in Europe has risen to “moderate to high”

According to the most extensive study done so far, the novel coronavirus was benign in 80.9% of cases, “serious” in 13.8% and “critical” in 4.7%. The remaining 0.6% was not specified.

Part of the reason Covid-19 been declared a public health emergency is due to the speed at which it has spread compared to other coronaviruses (like Sars and Mers) and the fact that there’s a lot about the disease we still don’t know – including how exactly it’s being transmitted.

It is likely that the numbers of suspected cases in Ireland will increase over the next few weeks, but this should not be a cause for panic, Health Minister Simon Harris said earlier this week. 

The latest HSE advice states: “The risk of catching coronavirus in Ireland is still low.”

Dr Tony Holohan, the Chief Medical Officer, said that the case was “not unexpected”. 

“We have been preparing for this eventuality for many weeks now,” he said in a statement. 

What are the symptoms?

Symptoms of Covid-19 include:

  • Fever
  • Dry cough
  • Shortness of breath
  • Breathing difficulties
  • Tiredness

Health experts have said patients who have the virus mainly have symptoms around the top of their chest. 

Some patients may have aches and pains, nasal congestion, runny nose, sore throat or diarrhea. These symptoms are usually mild and begin gradually.

There may be cases where a person becomes infected but does not develop any symptoms.

Most people recover from the disease without needing special treatment. Around one out of every six people who gets Covid-19 becomes seriously ill and develops difficulty breathing.

Older people, and those with underlying medical problems like high blood pressure, heart problems or diabetes, are more likely to develop serious illness.

What happens if people have symptoms?

These are the places where there is a spread of Covid-19:

  • China
  • Hong Kong
  • Iran
  • Japan
  • Singapore
  • South Korea
  • In Italy, the provinces, Lombardy, Piemonte, Veneto and Emilia – Romagna

Department of Foreign Affairs travel advice can be found here

There is no spread of coronavirus in Ireland or Northern Ireland. This means you can continue your normal routine.

“Most people may continue to go to work, school and other public places, as usual,” the HSE advises. 

The same applies to Tenerife, where there has been a case of the virus in a hotel. There is no widespread transmission in Tenerife. If you have travelled from the area and did not stay in the affected hotel, continue your normal routine. 

Regarding the case in Ireland, health minister Simon Harris said he had notified Taoiseach Leo Varadkar of the case and urged people to heed the advice of health officials. 

The HSE is still working to identify people who may have come into close contact with the patient.

Holohan said on Sunday evening that no other schools will be closing.

On Saturday evening, Dr John Cuddihy, Director of the Health Protection Surveillance Centre, said: “The HSE is now working rapidly to identify any contacts the patient may have had, to provide them with information and advice to prevent further spread.”

“It is important to note that the risk of transmission through casual contact is low,” he said.

“We are being very thorough,” he said, “so it will take some time, but the people who need to be notified will be notified”.

You should contact the HSE/your doctor/your local Emergency Department (all by phone) if you have been:

  • in contact with a person who has coronavirus (call 1850 24 1850);
  • in an overseas hospital or healthcare centre where people are being treated for coronavirus  (call 1850 24 1850);
  • or, if you have been to one of the above locations and have symptoms of the virus (call your GP/ED).

If you’ve been to an affected area in the last 14 days and have a cough, fever (high temperature), feel short of breath or have difficulty breathing, you should:

  • phone your GP, emergency department (ED) immediately, or 112/999 if you do not have a GP;
  • stay indoors;
  • avoid contact with other people;

People should follow this advice even if their symptoms are mild.

If you’ve been to one of those areas and are feeling well, this is the advice from the HSE

If you are feeling well, carry on with your normal routine. Follow the advice on how to protect yourself from coronavirus and other infections such as flu. Avoid spending time with people who are ill with a cough, high temperature, or breathing problems.

Do not go to your GP’s surgery, the Emergency Department or a healthcare centre – phone them first.

This is so you do not accidentally put other people at risk. Your GP or doctor will tell you over the phone what to do next.

Who exactly needs to self-isolate?

People who have returned from an affected area within the last 14 days and who develop symptoms need to self-isolate.

Anyone who has had contact with a person who has the virus will also be asked to stay separate from people as much as they can for 14 days, including not going into work. 

To self-isolate:

  • Stay at home or in your hotel room on your own with a phone
  • Do not go to work, school, religious services or public areas
  • Do not use public transport or taxis
  • Avoid having visitors to your home

It’s important to keep away from older people, those with long-term medical conditions or pregnant women.

People who have returned from an affected area, but who haven’t had contact with another person who has the virus and who are not feeling sick themselves, do NOT need to self-isolate.

This advice also applies to school groups who have travelled to affected areas.

In a bid to reduce pressure on hospitals, the government has decided that an individual who has been tested for the virus may be asked to go home to self-isolate until the results are back.

What is the test?

Assistant National Director, Health Protection Dr Kevin Kelleher has said that the HSE wants “to do as many tests as possible nearly, so we don’t miss anything”.

When a person who is concerned they may have the virus contacts the HSE, details will be taken such as country/cities of travel, dates of travel and arrival in Ireland, contact with confirmed or suspect cases and visits to markets.

They’ll also be asked about the date of the onset of symptoms.

Source: TheJournal.ie/YouTube

If a doctor suspects a patient may have the virus, they will tell them where the test will be done. The person will be taken to hospital, sometimes by ambulance, and brought to an isolated area of the hospital. 

The UCD National Virus Reference Laboratory will then be informed before a sample is dispatched for testing.

A respiratory sample will be taken – this is a swab taken from the nose or throat.

At the lab, a molecular diagnostics method is used to detect small amounts of the genetic material of the virus. Estimated turnaround time is 12 to 24 hours.

Patients are not required to remain in the hospital until the test results come back. Once the test is done they will be given guidance on how to self-isolate until they get their results. 

There is a confirmed case. What now?

The male student returned from northern Italy with symptoms of Covid-19, identified themselves to medical professionals and were brought to hospital. 

He travelled through Dublin Airport. The Department of Health is not commenting on which mode of transport was used by the patient after he left the airport. 

Officials had previously said that if there was to be a confirmed case in Ireland, it would be managed in a hospital environment.

A school based in Glasnevin, Dublin 9 is now set to close for 14 days as contacting tracing by health officials continues. 

Today, Holohan told RTÉ Radio One’s Morning Ireland programme that the staff and pupils at the school have been asked to “limit social interactions” as much as possible.

A telephone helpline has been established for those involved and a public meeting will be held tonight in the local area. 

HSE advise states: “If you are a student or staff member at this school, and you develop symptoms (fever, cough, shortness of breath), phone your GP or local emergency department (ED) immediately.”

Holohan said the risk of transmission of the virus “will still be low”. 

Official guidance for the country has not changed and Ireland is still in the containment phase. 

All acute hospitals have identified isolation facilities specific to Covid-19. Management guidance for the care of any patients with the virus has also been developed. 

Health officials do not foresee patients refusing to follow clinical guidance after they are diagnosed with the virus, but there are legal powers to detain a person in quarantine.

Dr Cillian De Gascun, virologist and chair of the HSE’s Coronavirus Expert Advisory Group, said last night:

Nothing really changes for Ireland, we’re still in the containment phase.  

A version of this article initially appeared on Thursday 27 February. It has been updated this afternoon. Additional reporting by Dominic McGrath, Sean Murray and Daragh Brophy. 

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