So COVID-19 disease is caused by this SARS-CoV-2 coronavirus. Coronavirus has also caused common
cold, but this is far from a common cold and it's far from just influenza. This seems to
be a more multisystem disease, which isn't really an inflammation of the blood vessels.
Some people think it's a lung disease. Well, it's because the lungs are first in line
as the virus gets into you. But once it's inside you, it affects a lot of blood vessels causing
them to perhaps be inflamed and then clot; setting of heart attacks, strokes, and other problems.
But of course, because the lungs are so important to delivering oxygen around the body,
if they start being destroyed by the virus, you can't breathe. Hence those common symptoms of
cough, breathlessness and actually strangely a lack of sense of smell. If you have a fever
along with those symptoms, then you need to be concerned that especially in this pandemic,
that we're in, in 2020, it's not just a cold, it might be coronavirus disease. It might be
COVID-19 disease. If that is the case, then these days we should be seeking out a test
to reassure ourselves that we don't have it. Or to say, we do have it, and we must self-isolate.
If you can't get a hold of a test, you should self-isolate in any case to protect others from
you. Now you have to look after yourself if you think you have COVID-19 disease,
partly as soon as it develops and ideally for the older generation, even before, have the flu jab,
keep the hydration up, keep the food intake good, exercise regularly and practice lung exercises.
So deep breathing exercises, blowing up a balloon and also lying on your front and
practicing breathing while you're lying on your front, recruit those back waters of your lungs
that perhaps you don't use all the time. You may need those if you develop COVID-19 disease. If you
do have it, and you're getting more breathless, then a drop in oxygen saturation of three or
4% from your baseline is something you need to pay attention to. And many people now have home
pulse oximeters that can tell you what auction level you're at. Now, someone who's young and fit
normally would have about 99%. But if you're older and you've had COPD or asthma or other
lung problems, then you may not start off at 99% and I wouldn't be worried about 95 or 94.
It's whatever your baseline is. It's that change from the baseline that's important. If you're
getting breathless going up the stairs, okay, you can live with that. If you're getting breathless
standing up, then I think you're about to be in trouble and you could seek some medical attention.
And of course, you don't want to walk into your GP surgery or straight into an A&E department,
unless you're really sick where you have to call 999, because of course you may be infectious
and that if you walk into the wrong place without thinking about it,
might close off a whole section of that unit if they feel there's now contamination.
It may take the staff offline; it may take other patients offline. So think carefully,
but please protect yourself, ring 111, get some advice and make sure you've told someone
else in your family that you're feeling unwell so they can be there to support you.
We're increasingly recognizing that just as with many infections that we've known about before,
the acute phase disappears, but some people are left completely washed out. And although there's
a vote to say, this might be psychological, they haven't got enough meat in their basket, they've
perhaps got low moral fibre, that's actually just not true. There are some people's whose physiology
is really devastated by the infection and a long COVID disease it's probably not one disease.
There's one branch of it, which is mainly centred on the heart where your control of heart rate and
blood pressure is affected. So the change in blood pressure, you might want to go and run down the
street, it's just not possible. There's long COVID that would be resting on the lungs where
the oxygen transfer is not happening properly and perhaps it is that the lungs are scarred
and there is, I think, another long COVID, that's more neurological; where perhaps the
way your brain drives your nerves so then drives your muscles is affected. Now, each of those has
recognizable serious diseases in the acute phase, which had nothing to do with COVID, but any viral
infection can cause these to then occur. And as we find out more about people surviving after COVID,
I think there genuinely is going to be a group of people that is going to be long suffering
and it may take them a year or more. However, with the right support, both psychological,
because it is of course depressing to be sick and also physical to get them over and cope with these
symptoms, then I would hope for a good recovery as happens with a lot of other conditions we've known
about from before. So is this a version of ME? well, possibly, but we haven't found again, real
physical reasons for ME that are easy to discover, but we know some people are very fatigued. The
cause being not clear. And these are not people who've always been "lazy". They've often been very
high achievers that have suddenly been knocked out by the illness. So long COVID I do believe
is a real disease and it's actually probably not one disease, but several, each facet of which
would require slightly different treatment. It does raise the question about whether
COVID-19 disease also really exists. It's amazing that I live in London and I catch a number of cabs
around the place and some of my drivers have truly asked the question in all reality, as a doctor,
do I believe COVID 19 disease exists and I point out that our intensive care units are full of
people who've been very seriously affected. For no reason apart from having the SARS-CoV-2 virus,
and that it's slightly shocking to understand that some people still don't believe it exists.