The Food Medic - COVID 19 EPISODE

Episode Date: April 24, 2020

Hello and a VERY big welcome back to The Food Medic Podcast. Before we dive into SEASON FOUR of the podcast, I wanted to record a prelude chatting about what has been going on in the world over the last few weeks and my experience working as a COVID19 doctor. Make sure to keep listening through to the end as I answer all the questions you sent in about COVID19 on social media. Tune back in next time when we kick off the season with Dr Jessamy Hibberd who I sit down and chat to about Imposter Syndrome and what we can do about it. Make sure to follow us on social media @thefoodmedic on Instagram/Twitter/Facebook and catch up on our blogs and recipes on www.thefoodmedic.co.uk.#StayHomeSaveLives Hosted on Acast. See acast.com/privacy for more information. Learn more about your ad choices. Visit podcastchoices.com/adchoices

Hey team and welcome back to the Food Medic podcast after a little bit of a hiatus after season three. I wanted to record a separate episode on my own to chat about a few things before we start season four. As you may be able to tell by the sound quality, I am not in the studio today. I'm coming to you from my living room. In case you've been living under a rock the last few weeks, we are currently facing a viral pandemic that is COVID-19, which means here in the UK we are being advised to stay at home and only go outside for food, health reasons or for work if you are a key worker and cannot work from home. When you do go out you must stay two metres away from people at all times and it's absolutely key

that we are vigilant with hand washing as soon as we get home. Now if you've been following me on my social media, mainly on Instagram, you will know that I have been redeployed and I'm now working as a frontline doctor on a COVID-19 ward. So essentially, I just wanted to talk a little bit about what it's actually like working as a doctor at this time and giving you an insight into what things are really like on the frontline. Of course, I'm not going to give you any specifics and I won't be talking about any individual patients in order to maintain their confidentiality and privacy so it'll be just a bit more of a general overview from my own perspective. I think though before we get into that part it's important to just have a recap on what COVID-19 actually is and where it has come from and just as a little

disclaimer we are still learning more about this virus and the situation is evolving rapidly, so the information provided here may change. I'm recording this on the 15th of April 2020 and here's what we know so far. In December 2019, there were a cluster of pneumonia cases in Wuhan City, China. It was found that this outbreak was caused by a previously unknown virus, identified as a novel coronavirus now known to be COVID-19. Most of the patients in the initial outbreak have been linked to a large seafood and live animal market in China, which has since been closed. COVID-19 spreads primarily through droplets of saliva or discharge from the nose when an

infected person coughs or sneezes. It may also be spread through something which has been contaminated with the virus, something like a door handle, but this is not thought to be the main way the virus spreads. However, the best way to prevent the spread still remains vigilant hand hygiene, sneezing or coughing into a tissue and throwing it away. So what are the main symptoms? Now you probably have had this drummed into already but the symptoms range from mild to severe. The majority of people are presenting with mild disease but some people do have severe forms of the illness and have to be hospitalised. The most common symptoms are fever, cough and shortness

of breath. Other symptoms include headache, sore throat, diarrhoea, nausea and vomiting, loss of smell and taste, confusion, the list goes on. In serious forms of the illness some people have to be hospitalised and sadly some people die as a result of the illness. If you do have a temperature or a new continuous cough, this means coughing a lot for more than an hour or three or more coughing episodes in 24 hours, then you should be self-isolating for seven days. And if you live with someone who has these symptoms, you'll need to self-isolate for 14 days from the day of their symptoms starting.

But if you want more information please do visit the NHS website and gov.uk or the World Health Organization website. They've got a ton of resources and information on there so please do take a look of that. Now in terms of treatments and cures at this time there is no specific vaccines or treatments for COVID-19. However, there are many ongoing clinical trials evaluating potential treatments, so watch this space. In terms of treating COVID-19 symptoms, if you are at home, make sure to get plenty of rest and sleep, drink plenty of water to avoid dehydration, and take paracetamol to lower your temperature. If your symptoms worsen during home isolation or are no better after seven days, contact NHS 111 online or 111.nhs.uk. If you have no internet access, you should call NHS 111 or if you have a medical emergency, dial

999. Okay, so now that we've got that out of the way, and hopefully we're all on the same page as to what COVID-19 is and where we are up to with it, I just want to chat a little bit about how my life has changed in the last few weeks and what I'm up to now. Well, before I was redeployed to the COVID ward, some of you may remember that I was working as a doctor on the nutrition team. And I had just come to the end of that six month post and was planning to take some time out to do some research, some writing and some travel. And I was asked on a Wednesday while I was in work would I join the COVID team and by Friday I had joined the team so that will just tell you how quickly things were moving within the NHS and also across the world and essentially the ward that we were working on was completely transformed over a weekend

from a standard ward where we saw gastroenterology patients to a ward where we saw COVID-19 patients and suspected COVID-19 patients. And what was done was we essentially separated the ward into two halves and one side was confirmed COVID and one side is suspected COVID. And when you walk through the ward, you're in a clean area and that is where we put on our PPE and once you walk through the doors of one side of the ward you can't turn back so you're kind of walking through a vacuum essentially and keeping the infection contained. In terms of what my day-to-day looks like in the mornings we have our handover when the night team hand over to the day team any new patients that came in overnight any patients who deteriorated overnight anything we need to know any people who sadly died overnight and then

we separate into our teams and we do our ward rounds we go around and see all of the patients and prescribe anything that may need to be prescribed look out for patients who seem to be deteriorating flag up any patients who are worried about planned discharge for some patients. So it's not too dissimilar to a standard ward round, but our focus is largely on different things. So for example, one of the things that we're checking in all our patients is their oxygen saturation, which tells us how well their blood is oxygenated. If that tends to keep decreasing despite us giving lots of oxygen that's usually a flag for us to get higher ceiling of care so we may need to send them to ITU or to a different ward for ventilation. In terms of the obstacles that

we've been facing on the ward I guess the biggest thing is it's a new disease. It's a level playing field in that no doctor has experienced it before. And we're all learning every day about the disease. You know, doctors of all levels are on the same level now. So consultants to junior doctors, various different specialties, we're all learning from one another and so that makes it really interesting and almost an exciting time in medicine despite how terrifying it is but it does create an obstacle in that you don't really know what's happening next and what's going to come next but we are doing our best and I do feel like we are staying on top of what's facing us. Obviously, PPE, there's lots of difficulties there getting enough PPE, but also having to wear PPE all day is very, very difficult, especially if you're wearing high level PPE, which requires visors, very tight fitting masks, full on gowns, they can be very,

very difficult to work within and also really claustrophobic so there's lots of things and barriers that we're working up against some of the obstacles that have come up for me is not being able to speak with relatives face to face so often having to deliver bad news over the phone and I guess dealing with death isn't easy and No death is ever easy. And we're experiencing that quite a lot, especially on the ward. So having to deal with that on a professional and a personal basis is also really difficult. I don't want to make things all doom and gloom. In the hospital, it's not all doom and gloom, although it's a very difficult job. We're also doing things to keep our spirits high. So the team is incredible. Like I don't feel like I've ever worked in a tighter team before.

And it may be that we're all brought together by the difficult things that are going on. A special thank you to everyone who's donated food, hand moisturizers, drinks, snacks. Everything's been amazing. I mean, I go into work and I come home with a belly full so I don't have to worry about cooking and that's amazing. So thank you to everyone who has been donating. Honestly, it's been really, really well received and we're all so grateful. Everyone in the hospital is grateful. So I just want to pass on my thank yous to anyone who has donated. little things like the other night I went in to do a night shift and the nurses were doing a TikTok dance which obviously everyone is very okay with TikTok at this time I am not I have to admit but

just things like that it's really nice to see in our group of doctors on the ward we've started a book club which is a nice way to have something to look forward to. Also, because no one's socialising at the moment, it's something I'm able to look forward to as well. So I guess what I want to say is that it's a really, really difficult job. And I realise that this whole thing is touching so many families, so I don't want to downplay how serious it is, but I do want to assure you that we are getting through it and we are staying positive as best we can. So what's going to happen next?

When is this going to end? I wish I knew the answer. I think this crisis is far from over. I worry about the long-term effects of the pandemic on my colleagues, myself, my family, my friends, I think this crisis is far from over. I worry about the long-term effects of the pandemic on my colleagues, myself, my family, my friends, the world, you guys. This is nothing many of us have ever experienced before and the situation is evolving every day and I can assure you that we're working our hardest and the NHS to keep you guys healthy. You might

be wondering what can you do to help? I guess I encourage you to all check in on those friends working in the frontline services of which the NHS makes up only one part. Check in with neighbours who may need support getting groceries and medications. Check in with friends, have dinner over Zoom or organise a quiz. quiz and finally and we've heard this one before but please do stay at home and save lives the people i am seeing in hospital are relatable to us all they are of all ages coronavirus does not discriminate and nobody is invincible okay guys i wanted to answer some of the questions that you have kindly sent through on Instagram stories relating to COVID-19 now I have to say as a little disclaimer again some of

the information here may change but I will give you the most up-to-date information that I have available to me and I'm just going to keep this anonymous so no names will be shared. But the first question is, is it true that some symptoms related to COVID-19 are gastrointestinal problems, so gut issues? Yes, that is true. The exact percentage of patients presenting with gut symptoms such as nausea, vomiting and diarrhea varies by case series. But I can say that we are seeing a handful of patients with these symptoms and sometimes this precedes fever and cough. But it's very variable and not everyone with COVID-19 will have these symptoms. OK, the next question is how does COVID impact the lungs beyond the

initial one to two weeks of being ill? So first of all, it's still very early days to know for sure the long-term impact of COVID-19 on the lungs and other organs of the body. However, the vast majority of people who are infected have a very mild form of the disease and should recover without any long-term effect on their lungs. In very severe infections or those that require ventilation in ITU, they can have potential effects on the lungs due to the coronavirus, but also due to the effects of being in intensive care and having all the various procedures done to them. So at the moment we are only starting to collect data on this so I can't say for sure how many people will be affected in terms of the long

term prognosis. The next question is can you catch COVID-19 from just talking to someone who may or may not be infected? Okay that's a very good question. So the chances of catching COVID-19 from a person walking by outdoors, for example, is very small. The virus is spread via droplets, so things like coughing and sneezing can aerosolise the virus into droplets, which means it's easy for that to be spread. I guess if someone was shouting to you or panting, if they were running past that could also create airborne particles but of course we don't have any evidence on this type of transmission. Regardless of what you're doing the best thing is to ensure you're keeping two meters or six feet distance

when you are just talking to someone and ensure good hand hygiene before and after any meetings. These are all the things that we should be doing anyway. Okay, are all COVID patients in hospital in ICU? What proportion need ventilators? No, not at all. Majority are on lower dependency wards and are requiring mostly oxygen therapy. Only a small proportion of patients overall are going to go to ITU. If ward-based care is not sufficient, i.e. if we cannot provide for the patient everything that they need on a ward, then we will step them up to ICU and that's usually for ventilation or for a very tight-fitting mask known as CPAP. So not all patients will go to ICU to answer your question. How long can the virus live on surfaces? Okay, so this is a question I get asked a lot and the New England Journal of Medicine published a study that tested how long the virus can remain stable on

different kinds of surfaces and this was done within a controlled laboratory setting. They found that it was still detectable on copper for up to four hours, cardboard for up to 24 hours and plastic and steel for up to 72 hours. But it's important to note that the amount of the virus decreased rapidly over time on each of those surfaces and so the risk of infection from touching them would probably decrease over time as well and again this was done in a laboratory setting so it's not going to be the exact same to real life scenarios. What I would say is whenever you do touch a surface it's just ensuring that you are using hand sanitizer or washing your hands with soap and water afterwards. Can you get the virus again? Okay

another question which keeps cropping up. We need to remember this is a very new disease and we are learning new information day by day. The evidence so far shows that catching the disease twice is very rare. I will say there have been a few isolated examples but the majority of infected people recover and should develop immunity against it however we do not know for sure yet so we are waiting for tests that will show us whether people have developed antibodies which therefore shows us if someone has immunity or not. However it is not clear also how long this immunity will last. And the data we do have on other coronaviruses, such as the common cold, show that antibodies only give us temporary immunity. So those two questions we need to find out, that is, will we have immunity?

And if so, how long will it last? So watch this space. And once I know more information, I will let you guys know of course. The next question, how is it really on a Covid ward? Hopefully after this podcast you will have a general feel as to what it's like working on the front line and of course I can give you a general answer but I'm not going to give you specifics or the inside scoop. We do have to remember these are very challenging times for the staff, the healthcare system. We do have to remember these are very challenging times for the staff, the healthcare system and we also have to respect that many people in hospital are very

poorly at this time. I guess the main challenges I will say are working in PPE as I mentioned before dealing with patients who are unwell and who can deteriorate pretty quickly and also updating families and trying to keep them involved as much as possible because of course they can't visit so there's lots of challenges but again make sure to listen to the full podcast to find out a bit more as to what my day-to-day is like now that I'm working on a Covid ward. Any positive stories to share from your work week? I can't share any specific stories I guess. I guess I want people to know that not everyone who goes into hospital does really unwell and actually we have lots of people who we are discharging and who are going home safe and sound to their families so hopefully that is some I guess light in all of this dark

news that we're surrounded by at the moment. Is there an indication of when the peak will be reached? Thank you for your hard work, thank you for your message. It's very difficult to say, different experts are saying different things and I don't think I am the most clever person in the room to answer that question just yet. But if I was a betting woman, I would say that we are definitely reaching it. Looking at the graphs every day on the daily briefing that the government do, we can see that the UK cases are definitely plateauing, which is a good sign. Whether or not we've reached the peak or not I cannot say what we are doing does appear to be flattening the curve and slowing down the rate of infection

which means we are better able to manage all those who need hospital care through the NHS so from me and everyone else working in the NHS thank you so much for staying at home because you really are saving lives. Thoughts on lack of sense of smell and taste. I'm on seven day isolation with anosmia and cough. Okay, there is evidence that patients with mild illness may develop anosmia, which means lack of smell, or they may have lack of taste as an early symptom in the absence of other symptoms. King's College London has reported that loss of smell or taste has been flagged as a key symptom for COVID-19 in the UK through its symptom tracker app. But at the moment, we are not

using it as a symptom to, I guess, flag to people to self-isolate. So yes it can be a symptom but it's not one of the key symptoms that we're using as of yet that may change. I think if you do have that symptom and you are able to self-isolate then that is a wise thing to do. It's better to be safe than sorry in these instances. Okay a few more questions. Are antibiotics effective in preventing or treating COVID-19? So antibiotics do not work against viruses, they only work against bacteria and COVID-19 is a coronavirus, so it's a virus. Therefore, antibiotics should not be used to prevent or treat it and they will not work. However if you do come into hospital with COVID-19 you may receive antibiotics or your GP may decide to prescribe them to you because a bacterial co-infection is possible so some people get

a bacterial pneumonia on top of COVID-19. It's unfortunate but in some cases it can happen. Are there any specific medicines to prevent or treat the new coronavirus? As of yet there are no specific medicines recommended to prevent or treat the new coronavirus or COVID-19. However there are some specific treatments which are under investigation, and they're going through vigorous clinical trials. So we need to just watch this space. And I know that there's governments across the world who are trying to accelerate research and development efforts to get things like vaccinations and medications into the system as soon as possible. At the moment, we are just treating symptoms. So as

mentioned before, many people require oxygen, some people require ventilation, and other things like fluids and analgesia like paracetamol. So it's very, very dependent on the patient and the state that they're at in their disease. Okay, the next question is, is it safe to receive parcels? Yes, the likelihood of someone contracting the virus from a package is very low. However, I will say that when you do receive parcels or anything from anyone else, just make sure to follow good hand hygiene measures and that's the best thing you can do. Do we need to wash fruit and veg bought from the supermarket? Okay so it's really important that we are continuing to eat fruits and vegetables as part of a healthy diet but wash them in the

same way that you would in any other circumstances you do not need to do anything extra before handling them wash your hands with soap and water and then you can just wash your fruits and vegetables with some clean water, especially if you're eating them raw. Dr Hazel, what do you do if you think you have it but aren't sick enough for hospital? Okay, well first of all you need to self-isolate for seven days and other members of your household should isolate for 14. In terms of looking after yourself please just rest up. You can take paracetamol for symptoms such as fever and drink plenty of fluids but there's no specific things that you need to be doing. Are there foods to improve my resistance? Are there any special supplements I should be taking?

Okay, no specific food or supplement will prevent or treat you from COVID-19. However, a healthy balanced diet can support the immune system. The only exception to the rule in terms of supplementation is it's worth considering taking a vitamin D supplement which would be 10 micrograms per day as we are now spending most of our time indoors and we get most of our vitamin D from the sunshine we get very little from diet regardless of what diet you follow and so that is the one supplement we could be taking and obviously vitamin D is really important for our bones, but it also may be important for our mental health and potentially can support our immune system as well. So I would definitely recommend that one. How to deal with anxiety during this time?

This is very difficult to answer because I think we all deal with anxiety in different ways. And I myself am feeling very anxious and I really empathise with people who are going through a hard time at home. I want to flag or signpost you guys to the NHS website Every Mind Matters, which has lots of resources there. I also want to remind you that it's okay to be anxious and worried at this time. Some things that can exacerbate anxiety is reading news articles online, watching the news maybe too frequently. So what I'd say is stick to the facts and trusted resources. So the NHS website, gov.uk, the World Health Organization, the CDC. Connect with people who make you feel good, your friends, your family. Talk about your worries, talk about what's concerning you.

It may help for you to support other people who are going through a hard time or volunteering. Maybe there's some people who live in your neighborhood who need some support getting medications or food and by giving back it might help you feel slightly less anxious. What I found helps is making a plan and finding a routine every day so that I'm not feeling at a loose end and just stressing or stress eating. Exercise has been really important for me and it's really important for other people to help bring down anxiety levels and to help take their mind off kind of what we're going through. I'd also say to make sure to prioritize sleep at this time. It's easy to get into a rut, especially when we don't have to get up for work and we may want to stay up at night and watch Netflix. So try to have a regular sleep routine because that will help you feel good about yourself as well.

Final tips, don't panic, be patient. While it seems the power is out of our hands, it isn't and everyone has a role to play. We can choose to cooperate and help one another or we can choose to ignore the government advice. But the faster everyone cooperates the faster we can beat this so please do continue what you're doing stay home and save lives