As Health Carer Workers (HCWs) we are anxious about spreading the infection to our families and the people we live with. On top of that, our friends & families are worried about us because we face an increased risk.

It is an important time to have conversations that explore the risks and share decision making.

Here are some tips to get you started.

Start the conversation.

• Be honest, and for kids be age-appropriate (they don’t need all the information adults need)
• Share factual information – not the exaggerated news and social media feeds
• Balance the risks with the good information – our hospitals are well prepared, the actual COVID illness is mostly mild for kids, and even for most adults.
• Ask for opinions, and try to achieve shared decision making

Factual information- Risk for HCWs

• The risk for COVID-19 is increased for health care workers, but we actively reduce those risks:
  • Everyone is screened on entry
  • Strict protocols to reduce transmission & use protective equipment
  • Increased hospital cleaning protocols
  • Rigorous contact tracing for HCWs
  • Extra isolation measures – including potential alternative accommodation in hotels if the risk gets too high
  • Extra testing availability
• The risk is also increased for people who live with HCWs but it is small and unlikely to be a significant driver of spread

There are things we can do to reduce risks at home

• Maximise isolation within the home if you can
  • Separate rooms, separate spaces, regular cleaning of surfaces, video calls etc
  • Minimise touch – fewer hugs, fewer kisses (save them up for after COVID)
• There is also this advice from the Australian Nursing and Midwifery Foundation for entering your home and minimising the risk of infection. Please note, this is not the Department of Health & Human Services' advice, and most hospitals do not have enough scrubs for all staff.
  • Keep a box by the door to place your shoes
  • Leave your bag, wallet, mobile, keys, etc in a box near the entry
  • Change out of your clothes immediately and wash them. Use the hottest possible machine wash setting and dryer if you can.
  • Have a shower
  • Clean items you’ve bought in and surfaces you’ve touched
  • Remember to wash your hands regularly
  • Wash your personal things like phone cases, glasses, keys, lanyard, etc (hot soapy water or disinfectant spray)
  • Consider changing in and out of your uniform/scrubs at work

And remember:  The main goal of social isolation is to slow the speed of spread (to flatten the curve) so we don’t overwhelm our hospitals. That way, when we get sick we get first-rate care. It is inevitable that some of us, whether HCWs or not, will get infected.

Apart from avoiding infection, the next best thing we can do to ensure we all recover is to ensure our health care system works and for that to work, we need to stand together – HCWs, our families, our communities

The risks are less if we stand together.

This is a quick guide to the essential health info you need for preventing, preparing for, and having COVID-19. There are many resources online, especially at the Australian Health Department Coronavirus info page. Below is a quick & basic summary. Prepare yourself

• Stay fit – eat, sleep, exercise
• Give up or cut back on smoking now (get nicotine replacement from the pharmacy)
• Prepare mentally – find ways to relax like meditation apps & slow breathing
• GET the flu shot (available April).

Prepare your house

• Have enough food and drink for about a week
• Buy basic medical supplies – paracetamol (about 100 tablets per person will be plenty), a thermometer, and some face masks if available
• Have enough cleaning supplies – soap and water, detergents, household disinfectant
• BUY an alcohol-based hand sanitiser with over 60 percent alcohol.

Prevent infection – reduce your risk

• WASH hands often with soap and running water, for at least 20 seconds. DRY with paper towels or hand dryer
• TRY not to touch your eyes, nose or mouth
• COVER your nose and mouth with a tissue when you cough or sneeze. If you don’t have a tissue cough or sneeze into your upper sleeve or elbow
• You DON’T wear a face mask if you are well.

What to do if you get sick

• Isolate yourself, and if you need to be in the company of other people then wear a face mask.
• Cover your face when you cough, use tissues, dispose of the tissues.
• Clean your hands often to avoid infecting others from touching shared surfaces.
• Call a doctor – don’t go directly. They will instruct you on how to get tested and what you can do to relieve symptoms.
• Common symptoms:  fever, cough, sore throat, runny nose.
  • Less common: shortness of breath, fatigue, aches & pains, headache.
  • Rare symptom: Diarrhoea
• Supportive care at home – just like the flu or a cold, use paracetamol for pain and fever and keep drinking enough fluids. Otherwise, rest.
• The usual course of illness: time from getting infected to showing symptoms (called incubation time) is about 5 days (range 2 to 14 days), duration of illness is about 2 weeks for mild cases and about 3 to 6 weeks for more severe cases.
• Likely severity: Mild symptoms (no or mild pneumonia) 80 – 90% people; severe disease requiring hospital 10 - 20% of people (rough estimates)

Manage your anxiety The news has been frightening, and you may feel anxious and panicky. Here are some things to remember:

• The news has not been completely reliable. Whilst government sources are stressing the importance of trying to reduce the spread of the virus, they have also been trying to stress that in most people the illness is NOT severe and NOT life-threatening. Many people have it without symptoms. Of those who get sick at least 80% do NOT need hospital care.
• Cut back on news & social media; get your information from reliable government websites like https://www.dhhs.vic.gov.au/coronavirus
• Anxiety passes. It is temporary.
• Try things to relax: download a meditation app like Smiling Mind or google slow breathing techniques and watch them on YouTube. Here is an example of slow breathing on YouTube
• Remember the usual supports:
  • Lifeline – 13 11 14
  • Beyondblue – 1300 22 4636
  • Kids Help Line – 1800 55 1800
  • SANE Australia - 1800 187 263

When should you go to a hospital?

• If you are uncertain call your doctor and ask, and if you do go to hospital wear a facemask if you have one.
• The National Coronavirus Helpline is 1800 020 080 or Victorian Department of Health & Human Services (DHHS) hotline 1800 675 398
• If you think your symptoms are serious call 000 for urgent medical help
• The key warning signs that the hospital might be necessary are:

• Difficulty breathing or shortness of breath
• Persistent pain or pressure in the chest
• New confusion or inability to wake up
• Bluish lips or face

Things to take to the hospital Super useful:

• Medicare card &/or private insurance, DVA card
• Your GPs details
• Medications – bring a list or just bring the packets
• Any health aids - hearing aids, dentures etc
• Pyjamas, warm clothes, underwear, non-slip footwear
• Toiletries - including toothbrush, toothpaste, soap, shampoo, deodorant, etc
• Phone & charger

Useful:

• Sleeping mask and ear plugs
• Headphones, computer, charger
• Money – not too much, for snacks and newspapers

When can you break isolation? Follow medical advice, as the DHHS guidelines are updated frequently but as a rough guide this is from the latest version (sourced 25/3/2020):

• The patient has been afebrile for the previous 72 hours, and
  • At least ten days have elapsed after the onset of the acute illness, and
  • There has been a noted improvement in symptoms, and
  • A risk assessment has been conducted by the department and deemed no further criteria are needed.
  • Testing is no longer required to meet clearance criteria

Are you immune to COVID-19 after you've been infected once? There is not enough information about the immune response to SARS-CoV-2 virus yet to know for sure, but experts think that you probably are immune, but that the immunity might not last forever. Here is a good summary of the information so far in New Scientist. What should you do if you live with other people who are unwell or isolated?

• Maintain good isolation (social distancing) and wear a mask when that is not possible
• Clean all surfaces in your isolation area daily
• Get a caregiver to clean all surfaces in other areas daily
• Use soap and water or another detergent if the area is dirty. Then a household disinfectant afterward.
• Do not share household items

What to do if your kids have symptoms

• Kids appear less likely to get sick
• Kids appear less likely to transmit the virus
• Seek medical advice for testing and symptoms relief
• Treat them as you would if they had a cold or the flu
• Pay close attention to your cleaning, hand washing, and mask use to avoid becoming infected yourself.
• Reassure them and communicate clearly that you expect them to get better quickly (they will have been hearing the exaggerated doom and gloom on the news too)
  • This info from the Royal Children’s Hospital is more detailed - Royal Children's Hospital Kids info

Frequently Asked Questions What's the difference between COVID-19 and SARS-CoV-2? COVID-19 is short for Coronavirus Disease 2019 meaning it is the illness (disease) caused by the virus. SARS-CoV-2 is the name of the virus that causes the disease, and it is short for Severe Acute Respiratory Syndrome Coronavirus 2. The first, SARS-CoV caused an epidemic in 2002 & 2003 in China, Canada, Hong Kong, Chinese Taipei, Singapore, and Hanoi in Viet Nam. It didn't spread enough to be considered a pandemic.