So as a healthcare worker I finally got my first dose of the Astra Zeneca vaccine on Saturday! I feel like I have won the lottery, and I was so happy to have seen many of you there also…

So how did I feel after?

Well, truth be told on Sunday I had a mild fever and a few aches and pains, but honestly, I think that’s a small price to pay for being able to protect myself and my patients…..and by contributing to herd immunity I am helping to protect the wider population, aka our parents and grandparents. Speaking of parents, as over 60s, mine also got theirs and felt fine!

According to GAVI, the vaccine alliance, there have been about 190 million Astra Zeneca vaccines administered worldwide so far.

I know that there has been a lot of worry about blood clots with this vaccine, but let me put this into perspective for you:

Just being pregnant increases the risk of a clot 4-5 times above the non pregnant state. A woman on the combined oral pill has on average about three times the risk of a clot as a woman not on the pill (but note that this is less than the risk of a clot while pregnant). The risk of getting a clot with the vaccine is far, far lower than either the background risk from being pregnant or the risk from being on the pill. 

So would you not have had your children because of the risk of a clot? …because this risk is lower than that. And I know many of you take the pill, or have taken the pill, and this risk is lower than that too!

The WHO has issued an interim advisory that a causal relationship, while plausible, has not been confirmed.

Now, this isn’t to say that you must not be on the lookout for warning signs of a clot, or that you should not take individual advice if you have had a clot in the past, or are known to have a genetic condition which increases, your chance of clotting…of course you must check with your doctor in these cases!

However the vast majority are far more at risk of death or serious disease from getting COVID 19 itself, than from the small risk of this vaccine.

My advice: if you are eligible, call your local health center and get your shot!

Did you know that we do minor surgery?  

If you have a lump or bump that you want removed, we can do a minor procedure under local anaesthetic, right here in our new treatment room. 

We also remove ingrown toenails, abscesses and do cyst and comedone extractions too! 

Have a pesky wart or verruca or skin tag that won’t go? We can freeze it off with Liquid Nitrogen, in a procedure called Cryosurgery that involves no cutting! If you are interested, you can watch a video of it being done by Dr Ames here:  https://www.youtube.com/watch?v=VOKdjNiKOy8

So, you had a cough and cold and you were worried about COVID….but you went and got a rapid test and its negative so all is good right? Wrong! 

No test is perfect and this is to help you understand some pitfalls of Covid testing.  

Let’s start with the rapid “blood” test. This is looking for antibodies to the virus, and not directly for the virus itself.  

When we get the virus for the first time, it may take a while for our immune system to mount a response and produce antibodies.  

If the test is done too soon, for example before symptoms start, or even in the first 2 weeks after getting it when you may even have symptoms, it may read negative when you are in facet positive, a so called “False negative”! Then you might be falsely reassured and unwittingly go round infecting others.  

So, an antibody test MAY be useful after your symptoms have passed, and if you never managed to get the proper “throat swab” PCR test and you are wondering if in fact it was COVID you had! 

What if you wait, do the antibody test more than two weeks after your symptoms started and you have antibodies?  Does that mean you are now “immune” to COVID? 

Er, we are still not so sure. It seems that antibody levels wane after 3 months or so, so we are not sure how long that immunity may last…. this is also complicated by the fact that there are different strains of COVID and it may be that the virus mutates very so often, just like the Flu, so your immunity may be short lived! 

On top of this, some people can fight of the virus with a different part of the immune system that doesn’t use antibodies. So you might actually have fought off the virus successfully, and may even have immunity that we can’t measure on the test, but then have no antibodies.  

Confusing right?  

What about the “swab” or fancy RT-PCR  test? 

The swab tests for actual virus particles in the nose/throat.  It is not 100% either!  No test is I am afraid.  The swab is most accurate if done days 3-5 of symptoms.  If done in asymptomatic people right after exposure, it may be too early to get a positive result. Similarly, if taken very late in the illness like day 10, the chance of picking up the virus starts to fall.  

It is very specific and moderately sensitive. So, what does that mean? Well, it means that if you get a positive result it is likely to be a true positive, but a negative result is less reliable. So, we tend to believe the positive results, but if a person has a negative test, that doesn’t automatically mean they are truly negative and that they don’t have COVID 19 and are not infectious. 

That’s why in very suspicious cases you will see us asking for 2 negative tests. ..That’s because if it looks like a duck, and quacks like a duck and flies like a duck it is probably a duck…especially if it comes from an area where there is known to be a flock of ducks living. (Like say, you shot it in the middle of a swamp) So, if someone plucks a feather from that duck and analyses it and tells you it is not a duck then would you believe them?   

Similarly, if a person has been exposed to someone with COVID 19, and they then develop the classic fever cough, anosmia etc, OR we know that we are in the middle of a Pandemic or local spike and someone gets a cough and cold, we have a high suspicion of COVID and just one negative test is not going to reassure us.  

To complicate things, we will shortly be going into the “Flu Season” and it’s hard to tell the difference clinically between the Influenza virus and COVID 19! But that’s for a whole other discussion.  

In short, please don’t just take yourself off for a test without consulting a health professional who is up to date with testing and timing and symptoms. The test may not mean what you think it does, and you may even need a completely different test! 

Good News! We can isolate at home if we have COVID -19! No need to go into hospital if we are well enough to stay home. 

I know this is a huge relief to all of you right? Everyone wants to be in their own bed if they are feeling under the weather!

So what do you do if you think you have COVID 19?

First of all don’t panic! The main symptoms are:

• Fever more than 38

• Dry cough

• Runny nose

• Sore throat

Sometimes:

• Body aches

• Diarrhea

Sneezing is not normally a major feature but can be present.

If you have any of these

1.Do not go out

2.Isolate yourself from your family and household (see our Instagram page for a leaflet on how to do this

3.Seek Medical advice via Telehealth, or a hotline rather than coming in, so you do not infected others. If you are extremely unwell with shortness of breath, for example, and you believe you need emergency help then proceed directly to your nearest public health facility. You can call me to find out where to go if you are unsure.

If I think you need testing I can either refer you privately for accredited PCR testing or send you to be tested via the Public health.

I can also arrange a sick note or quarantine note.

If you are well enough to stay home, you can stay home with Pandol, Fluids etc. People with underlying illnesses like Diabetes, Lung, Heart or Kidney disease should have individualized advice

You will need to stay at home from 14 days from the start of your symptoms.

4.Make a list of all those you have had CLOSE contact with. A CLOSE contact is defined as less than 6ft for 10 minutes or more. It is not someone you passed casually in the corridor at work.

What to do if you have been exposed to someone with known or suspected COVID 19:  Remember exposure is defined as less than 6ft for 10 minutes or more, as above…

1. Don’t panic
2. Stay home and quarantine for 14 days unless you are told otherwise by a qualified doctor. Monitor for any of the above symptoms. Seek medical advice if they develop.
3. Seek medical advice as to whether you need to be tested.

Any questions or suggestions for further leaflets let me know!