COVID-19 – FAQs

COVID-19 – FAQs

Frequently Asked Questions

*Page update 13th June 2021
Public Health Gibraltar have updated guidance regarding the screening for countries of concern, as indicated by HM GoG; it is important to report any recent travel and contacts of interest if and when approached by the CTB.

Understanding COVID

Testing for COVID

Vulnerability

Protection

Home and Self-Isolation

Travel

Miscellaneous

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Understanding COVID

How does the new Coronavirus spread?

The SARS-CoV-2 virus (severe acute respiratory syndrome coronavirus 2) that causes the coronavirus disease (COVID-19; previous referred to as the novel coronavirus) spreads from person to person through infected droplets. These can be transmitted through the air, particularly through coughs and sneezes, or via contaminated surfaces where a person may touch their face (eyes, nose or mouth) after exposure. The COVID-19 virus can survive for several hours on surfaces, but can be killed with the use of simple disinfectants.

What is the best way I can protect myself, knowing that the virus that causes COVID-19 lives on surfaces?

You are more likely to catch the infection through the air, if you are next to someone infected, than from a surface. Thorough cleaning of surfaces with disinfectant or soap is very effective; but this does rely on proper disinfection and good hand hygiene. Make sure to use a good household cleaning spray or wipe, according to the label instructions, including precautions you should take when applying the product, such as wearing gloves and making sure you have good ventilation during use of the product. In addition to healthcare workers and other front-line staff, cleaners, caretakers and concierges play an important role in keeping people in their buildings protected from COVID-19.

Public Health guidance on protection against the COVID-19 virus includes:

  • Cleaning and disinfecting the ‘high-touch’ surfaces that many people come in contact with. These include phones, tables, bedside tables, door handles, light switches, counter tops, desks, keyboards, tablets, toilets and sinks. In addition, clean any surfaces that may have blood, stool, or body fluids on them.
  • Avoiding touching high-contact surfaces in public.
  • Washing your hands often with soap and water for at least 20 seconds immediately when you return home from a public place.
  • Keeping a distance between yourself and others when in a public space; ideally 2 metres or more, particularly if in an indoor setting.
  • Most importantly, staying home if you are unwell and calling 111 if you have any flu-like symptoms that you cannot manage at home.

What do you mean by “flattening the curve”?

Epidemiologists consider how infectious diseases are by looking at various parameters of risk, namely:

  • The transmission rate of the infection (the number of people who can be infected from a single case)
  • The fatality rate (the number of deaths seen)
  • And factors including whether the transmission of the infection is possible whilst showing no symptoms at all

Without public health interventions to slow the spread of COVID-19, there are likely to be recurring large spikes in infections within a short period of time. This risks overwhelming health systems and increasing the number of deaths as a consequence. In order to slow the spread of disease to a rate at which the healthcare systems can cope requires interventions such as increased hand-washing practice, enforcing social distancing and using the telephone instead of meeting in person.

What symptoms are expected with this virus?

Typical symptoms of COVID-19 that appear to affect the local community include:

  • Tiredness (61.02% cases)
  • Headaches (59.96% cases)
  • Muscle aches (55.22% cases)
  • Dry cough (52.73% cases)
  • Runny nose (44.87% cases)
  • Joint aches (44.70% cases)

Other reported symptoms include fever, sore throat, anosmia (lack of sense of smell), ageusia (lack of sense of taste), nasal congestion, hot/burning eyes, nausea, vomiting and diarrhoea. We all experience illnesses differently, so it is difficult to state uniform symptoms. A particular concern is protecting those most vulnerable from the potentially fatal symptoms, including severe pneumonia which can cause shortness of breath and breathing difficulties.

I’ve got the symptoms, should I be worried?
(how do you treat COVID-19 symptoms?)

If you have symptoms you should stay home, self isolate and call 111 for guidance. The symptoms of COVID-19 are very similar to a cold or the flu; for the majority of us this will mean treating symptoms at home with plenty of rest, over the counter pain relief (such as paracetamol as per recommended dose) and by staying hydrated (warm drinks and soup work well). It is important to note:

  1. There is no one medication to treat COVID-19 at present. We rely on time and our immune systems to combat the virus. There are some over-the-counter remedies advised by the GHA medical team which may help aid recovery in COVID-19 positive patients, namely:
    Vitamin D tablets
    Vitamin B strong tablets
    Thiamine tablets
    Zinc tablets or lozenges
    You should also strive to maintain a clean environment; increase ventilation by opening windows, wipe down frequently touched surfaces, remove used tissues immediately and using mouthwash as part of your dental practice.
    There will however, be some more vulnerable people that require additional support to manage their symptoms; please call 111 if you are concerned about worsening symptoms at any time.
  2. Our resources are limited. Beds in the hospital will have to be kept available for those who really need it. Treatments for symptoms will include respiratory care (for example use of ventilators or oxygen therapy).

If I get COVID-19 will it come back?

Scientists for the British Medical Journal highlight that infections from usual coronaviruses can lead to immunity of differing lengths, on average lasting around a year or two; re-infection is likely, though not every year. The SARS-CoV-2, new type of coronavirus, produces questionable immunity and how well this prevents reinfection remains uncertain. There have been less than 40 confirmed cases of reinfection worldwide, however the figure remains uncertain due to delays in reporting and resource pressures observed in the ongoing pandemic. Researchers believe that immunity to reinfection lasts at least six months after contracting COVID-19 however further studies are required to understand in more detail.

If I’ve had COVID-19 will I have any long-term complications?

It is difficult to state what potential long-term consequences a person may or may not suffer following a COVID-19 infection. It is likely that those with underlying conditions, who suffer severe symptoms as a result of the virus, will be affected differently than those without. If you have chronic bronchitis, and smoke, please STOP. Take up vaping/e-cigarettes which will not damage your lungs in the same way; or seek support from the free smoke cessation service to quit the habit entirely.

If you have had COVID-19 and are concerned about any long-term consequences you can call the Primary Care Centre to have the medical staff assess/ investigate as appropriate (Tel: 200 52441).

Should I be worried about Long Covid?

Most people who experience mild symptoms, such as a high temperature and cough, recover quickly from Covid-19 and are able to resume their normal lives quickly. But some others suffer from long-term effects; the effects of Covid-19 can last for weeks or months. This has now been labelled “Long Covid”. The collection of these symptoms has been categorised into four syndromes:

  1. Post-viral fatigue
  2. Fluctuating multi-system symptoms
  3. Lasting organ damage
  4. Post-intensive care syndrome

The National Institute for Healthcare Research (NIHR) have undertaken a review of published evidence, patient experience and expert consensus around the long-term impact of COVID-19; read more HERE.

How long does it take to recover from Long Covid?

Unfortunately, there is currently no way to predict how long recovery from Long Covid takes. Some other viral illnesses also demonstrate longer lasting effects, and based on these illnesses symptoms likely disappear within three months (though tiredness may still be reported up to six months later). However, these timings may vary from person to person.

For tips on how to best manage symptoms of Covid-19 see more from the National Institute for Health and Care Excellence (NICE) HERE.

Do previously positive Covid-19 cases need to isolate if identified as close contacts?

After recovery from Covid-19 you will be exempt from screening swabs and isolation as a close contact for 180 days; evidence suggests a short term level of immunity remains.

Testing for COVID

How do you test for COVID-19?

Nasopharyngeal swabs are used to detect respiratory viruses such as RSV or influenza viruses. A sample of secretions are gathered using a swab (which looks like an elongated Q tip) from the uppermost part of the throat, and then behind the nose. The procedure can be uncomfortable, and you may need to cough, retch or sneeze afterwards.

PCR or Lateral flow test?

The PCR test is currently best practice, however it takes longer to receive a result; read more HERE.

The lateral flow test provides a faster result than the PCR, however is found to have lower levels of clinical sensitivity; read more HERE.

How does the Drive Thru facility work?

The drive through for swabbing is now open and is based on a referral system. The service can now be attended on foot and by car, however, without a referral to the drive through swabbing unit, you cannot be swabbed; so you should not just show up and request swabbing.  If you have flu-like symptoms please call 111 and you will be triaged, which may lead to a GP referral for swabbing. You will need to wear a face covering/ mask whilst attending the unit and provide the following details:

  • Name
  • Date of birth
  • GHA number (if available)
  • Work information (Employer and their contact details)
  • Symptoms and the date of their onset
  • Phone number

If you are self-isolating and require swabbing please take your directive from the Contact Tracing or Infection Control teams.

Do I need to be swabbed after my isolation period ends?

If you have been identified as a Close Contact of a positive case, you will require a swab at the end of your isolation period to ascertain whether or not you have the virus.

If you have tested positive for Covid-19 and have completed your advised isolation period, you will not require a re-swab. This is because repeat swabbing does not provide a good marker of whether you remain actively infectious (the contact tracing team will use clinical criteria to ascertain necessary indicators).

Do I need to be tested when flying in to Gibraltar?

Anyone flying into Gibraltar who is not fully vaccinated will need a pre departure Covid-19 test to enter Gibraltar. Similarly, those who have been vaccinated but have visited a red list country within the 10 days before entry will require a pre departure test. Read more on travel guidance here. Self isolation as a protective  measure is only required for those unvaccinated, according to the countries visited beforehand (amber list country 5 days, red list country 10 days).

Vulnerability

What is meant by vulnerable?

When we talk about vulnerable people this generally means those who have lowered immunity. With regard to COVID-19 those that are considered high risk:

  •  are aged over 70 years
  • have poorly controlled long-term conditions; such as respiratory, heart, kidney, or liver disease
  • are immunosuppressed; for example, those receiving cancer treatment, taking corticosteroids, are on anti-TNF therapy or have poorly controlled HIV/AIDS
  • are part of the BAME (Black, Asian and Minority Ethnic) cohort; recent studies indicate a doubling of risk.
  • have a combination of the factors above

The main vulnerability is older age, above 70 years of age. You will have a reduced respiratory defence if an active smoker; now is a great time to give up. Pregnant women are monitored if found to have symptoms for COVID-19 as they are known to be at risk for other viral illnesses.However, to date no data has placed them at an increased risk for the virus. The Royal College of Obstetricians and Gynaecologist (RCOG) has made a precautionary recommendation that women healthcare workers who are at greater risk of exposure to infected patients might wish to work in a different setting. Whilst this may be a recommendation, there is no convincing evidence that they are at any greater risk.

Should carers who work with vulnerable groups be concerned?

If you work or live with a vulnerable group you should take every precaution to prevent the spread of infection; this includes availing yourself of the COVID-19 vaccine. Ensure you wash your hands regularly, maintain social distancing when appropriate, and avoid any contact with others should you begin to feel any cold or flu symptoms. Wear a face covering or mask if you are advised to; this helps to reduce the risk of unexpected spread (ensure you clean/ dispose of the items appropriately after use).

If I have been in touch with a positive case should I be worried?

If you are identified as a close contact you will be contacted by the Contact Tracing Bureau and they will inform you of how to proceed. If you think you may have been overlooked as a potential close contact you can contact the 111 line and relay the relevant information.

I have been told I cannot go to work, though I have no symptoms, what should I do?

If you have been contacted by the Contact Tracing Bureau and advised to stay home you must follow their advice, regardless of whether or not you have symptoms. This isolation period will ensure there is no potential viral spread.

If you have not been in contact with a positive case (or contacted by the CTB), there is no need for you to avoid work. As from 1st March Gibraltar steps down from its major incident posture, with catering establishments re-opening and the relaxation of rules including use of masks in low footfall areas [Read CM’s statement to parliament]. It is however, up to each individual employer to take decisions that best safeguard their employees; please take your directive from them.

Why do some people suffer more severe symptoms (having for example Intensive Care admissions)?

COVID-19 remains a new virus and information about risk is continuously being revised. What is evident is that people who have lowered immunity or have unstable underlying medical conditions are more likely to suffer severe symptoms. Of the patients admitted to hospital with this infection around half have pre-existing chronic conditions, and deaths that have occurred are nearly all in older individuals.

Evidence is also beginning to show that people with smaller exposures have a milder illness; highlighting the importance of preventative measures such as mask wearing and physical distancing.

I’m a smoker should I be worried?

Smoking status appears to be another factor for those who become severely ill. COVID-19 appears to affect the lower respiratory passages, and by smoking you weaken the lungs and further restrict the airways, making symptoms worse (read more here). If you are a smoker, it is advisable to quit or consider switching to vaping (which contains fewer poisonous ingredients and is less harmful to your body). Speak with a pharmacist or contact the PCC smoking cessation team.

I have breathing difficulties and have symptoms of a cold what do I do?

If you have monitored your symptoms and they appear to be worsening, it is advisable you seek medical advice from your GP or Nurse practitioner (call 111 for advice). In an emergency call an ambulance  (190).

NOTE: It is important if you are currently under-going self-isolation you inform them of your current situation, so they know you have symptoms suggestive of COVID-19.

I have a weakened immunity/ suffer from a chronic disease (eg bronchitis, diabetes, asthma). Is there anything I can do?

Follow the ‘What can I do to protect myself?’ advice, taking advantage of any free vaccinations you may be offered (e.g. for COVID-19, Influenza or Pneumococcal). Continue to control any underlying conditions as you normally would (taking relevant medication).

For any queries regarding your medication contact your GP. Telephone consultations are available as follows:

  • Monday-Friday 8:30am – 7pm
  • Weekends 8:30am – 12:30pm & 5pm – 7pm.
Tel: 200 52441

Protection

What can I do to protect myself?

There are things you can do to help novel coronavirus spreading:

  • Get vaccinated! The COVID-19 vaccines are key to helping curb infection rates and hospitalisation. The better the uptake in the community the more likely we are to achieve the desired “herd immunity”. Read more on the available vaccines here.
  • Always carry tissues with you and use them to catch your cough or sneeze. Then bin the tissue, and wash your hands, or use a sanitiser gel. Catch it, Bin it, Kill it.
  • Wash your hands often with soap and water, especially after using public transport and shopping. Use a sanitiser gel if soap and water are not available. 70% alcohol is best for killing viruses
  • Avoid touching your eyes, nose and mouth with unwashed hands.
  • Avoid close contact with people who are unwell.
  • Ensure you wear a mask whenever you are in an indoor public setting, or an outdoor setting with those outside your ‘household bubble’ where you are unable to maintain your physical distance. [Follow the correct mask etiquette].
  • Avoid smoking and exposure to secondhand smoke. This will greatly improve your lung health. If you are a current smoker, consider quitting or switching to vaping which contains fewer poisonous ingredients.
  • Have you had the flu jab? Catching the flu on top of another infection will not go well; so if you are a front-line worker or form part of a vulnerable group ensure you get your vaccine.

What is the correct way to don Personal Protective Equipment?

Healthcare workers who are, or may be, in direct contact with COVID-19 patients are trained to correctly don and doff Personal Protective Equipment (PPE). See PHE video for reference and for more information read the infection prevention and control procedure guides on the website here.

I have just seen some people dressed up in white protection equipment; should I be worried?

No. Personal Protective Equipment such as gowns and gloves and masks/hats are the way employers show they look after the health of their workers. That is why painters and decorators wear coveralls and masks. That is why healthcare workers may be doing the same – so their employer shows they care (and also because of their legal responsibilities to their workers). If there was a wider risk, the building or individual tenant would be told, as every situation is risk-assessed. Remember, healthcare workers live and work in the same community we all do.

Should I wear a mask?

Restrictions regarding mask use in open areas throughout town have been removed. Current government guidance recommends the use of a face masks in enclosed public spaces that are likely to visited by those who are not vaccinated, such as retail shops and on public transport.  Read more here.

What about mask exemptions?

Mask exemptions may be granted in limited unavoidable circumstances, noting the potential impact this will have on the person in question and those around them. Those requiring a mask exemption should read more HERE.

Should I wear gloves?

Public use of gloves does not stop the spread of COVID-19. You are more likely to touch your face when wearing gloves, touch dirty surfaces, and inadvertently spread the virus. Use of alcohol rubs on with gloves on may also damage the material’s integrity, reducing the barrier function. Healthcare professionals use gloves after training on their appropriate use and disposal. To help stop the spread of COVID-19 it is more beneficial to wash your hands regularly, for 20 seconds or more with soap and water.

Should I use hand cream?

Frequent washing of hands is a great way to remove germs but it can also remove the skins natural oils. In order to prevent hands from becoming too dry or cracked (which can increase your risk of carrying germs or contracting infections) it is sensible to moisturise your hands after washing them. You can also try alternating hand washing with sanitizer use when appropriate.

Are hand washing and hand sanitizer use the same?

Washing your hands with soap and warm water, following the correct method (click here for guidance), is the simplest and most affordable way to prevent the spread of germs. If you are on the go hand sanitizers or gels (containing a minimum of 70% alcohol) are a fantastic way to provide a quick hand wash solution; it is important to note that the effectiveness of hand sanitizers decreases substantially when hands are visibly dirty, so if you feel too mucky it is best to wash with soap and water. Drying hands thoroughly after washing, or allowing them time to dry after using a sanitizer, will complete the cleaning method.

Are my children safe?

People of any age can be infected by the new coronavirus (COVID-19). Children are usually fit and healthy and therefore less likely to become severely ill. Children are, however, great carriers of viruses, spreading them to more vulnerable adults, particularly grandparents. It is important to employ the same protective measure in children, encouraging good hand and respiratory hygiene practices.

Are antibiotics effective in preventing and treating the new coronavirus?

No, antibiotics do not work against viruses, only bacteria. The new coronavirus (COVID-19) is a virus and, therefore, antibiotics should not be used as a means of prevention or treatment. There are no medicines of vaccines available to treat the virus at present, but the World Health Organisation is working hard to provide these solutions. Treat this virus as you would the flu, stay home, keep hydrated, and get plenty of rest; call 111 if you have any concerns.

 

Home and Self-Isolation

What is the contact tracing procedure?

When a person tests positive for COVID-19 they are asked to identify anyone who has had close contact with them during the time they are considered to be infectious. Close contacts will have been within a metres distance of the infected person for more than 15 minutes OR have come into direct contact with contaminated body fluids. A contact tracing team will make every effort to find these people as soon as possible and provide them with relevant advice, part of this will include relaying the requirement to self isolate for 10 days (note, this may be required to change due to individual circumstance/ test results).

I’ve been identified as being at risk of carrying the coronavirus, what do they mean by self-isolation?

Just like when you have the flu, individuals should remain at home and should not go to work, school or public areas. Where possible, individuals should avoid having visitors to their home but it is OK for friends, family or delivery drivers to drop off food at the door. These recommendations apply to those who do and do not currently display symptoms (as this allows for the virus incubation period). Click here for more.

What is the self-isolation period? Why is the duration different for some people?

The standard recommendation for anyone who may have coronavirus symptoms, or has been in contact with a positive case, is to maintain self-isolation for 10 days. This will vary according to the date of symptom onset, the place in which you work (front-line workers need to be swabbed with priority), and the duration of the symptoms you report.*A persistent cough may last for several weeks after the COVID-19 infection has gone; this is considered the only symptom at present that may be disregarded after the isolation period.

If you have been vaccinated and are identified as a close contact you will not need to isolate; should timings be 2 weeks or more after your first vaccine. You will be asked to wear a mask when outside your home for the 10 days and be aware of any Covid-19 symptoms that may arise (which would mean staying home and calling 111 for advice).

What happens if I’m told to isolate and I live with other people?

If you have tested positive for COVID-19 all members of your household will need isolate too, unless they are vaccinated (as per information above). Following home isolation advice is important, particularly if you share a home with others. You are encouraged to sleep in separate rooms, ensure good hygiene practices (clean home surfaces, no sharing of cutlery etc. as you would if someone had the flu) and do not share face/hand/body towels. Latest guidance states you do not need to laundry separately.

How will my leave from work be managed during my home isolation?

The current leave recommended, for those home with symptoms or those who have tested positive for COVID-19, is sick leave. In order to be presented with a certificate for your employer you will need to contact 111 (or your line manager if you work for the GHA).

 

Travel

I have a holiday planned to an at-risk country, should I go?

The Government of Gibraltar is advising that all non-essential travel at present should be postponed. If you do decide to travel you do so at your own risk; see FCO advice here.

If I cancel my trip, will I get my money back?

Remuneration for cancelled holidays must be discussed with your individual insurance providers; the Public Health department have no influence on their policy.

I’m currently self-isolating, as per the Public Health guidance, but I have a trip abroad planned within this period; can I go?

No. Remaining within your home/ identified accommodation for the entire home isolation period, is essential for preventing the spread of infection. Anyone who leaves the home within this self-isolation period would be in breach of the law and subject to actions taken by Royal Gibraltar Police.

I work in Gibraltar, but live in Spain, am I required to follow the same guidance?

It is advisable to contact your local Spanish Public Health Authority as you would be subject to their regulations. If you have symptoms of infection (see Symptoms above) you are advised to call 112 or 061 for assistance. Note, it is important you keep your local employer aware of any changes to your current health status; call 200 41818 if you require further advice regarding employment.

How do I get a certificate for travel?

People who intend to travel are urged to avoid travel to areas and regions:

  • with a high incidence of COVID-19
  • where you may not be covered by insurance,
  • from which you could bring infection back into your family and community in Gibraltar.

Public Health advises that you familiarise yourself with the rules and regulations in your country of destination and, if applicable, of transit before departing Gibraltar. Some jurisdictions now require certificated proof of a recent negative test showing no virus present. Further information can be obtained from the FCO Travel Advice website. Please note that different countries have different requirements for the test and the time when those tests have to be taken. It is the traveller’s responsibility to ensure they meet those requirements.

Travellers who require certificates after their test should contact the Public Health Department at least 96 hours (excluding weekends) before their date of travel. They should email: covid-travelcertificate@gibraltar.gov.gi with the following information:

  • Full Names (as printed on Passport)
  • Passport Number
  • Date of Birth
  • Scanned Copy of GHA Card
  • Contact Telephone Number

On receipt of the information above, an appointment will be made for testing which will be carried out at the Mid Town Drive Through Facility (Monday to Sunday). The traveller should make sure that the timing and type of their test is valid for their country of travel.

At present there is no cost for the first Private Travel Test for travellers holding a valid GHA card and only a charge of £30 for the cost of the certificate will be incurred. Any further tests required for Private Travel by the same person will be charged. Travellers not holding a GHA Card, will be required to cover the cost of both the Test, which is £150, and the Certificate, which is £30.

Certificates will be issued electronically. Payment details will be provided in the response email to the initial application.

I’ve returned from another country; do I need to do anything?

There are no current restrictions for anyone entering Gibraltar from Spain walking or by car, unless travelling from a ‘relevant area’ or forming part of a high risk group; read more HERE.

Anyone entering Gibraltar by plane will be required to undertake a mandatory a pre-departure COVID-19 test if not fully vaccinated. This requirement also applies to fully vaccinated people who have been to a country or territory on the Red List in the 10 days preceding their arrival into Gibraltar. It will be necessary to upload evidence of a negative pre-departure COVID-19 test or fully vaccinated status, as applicable. Read more HERE.

Miscellaneous

Will I die?

The World Health Organisation (WHO) highlight that case fatality ratios vary widely by country, from less than 0.1% to over 25%. This variation occurs for several reasons including accurate surveillance (knowing how many people are infected or die from the virus), intensity of transmission (considering for example, how quickly the virus spreads from one person to another or the resources available to combat it) and access to healthcare systems (in order to effectively treat complications arising from infection). The main areas of concern for us in Gibraltar are panic and a rapid rise in cases that could overwhelm local services. It is already clear that those who are vulnerable are more likely to suffer the most severe symptoms, and in order to safeguard them it is important to:

  • Stay up-to-date with our vaccine schedules.
    Take advantage of the COVID-19 vaccine if and when you are offered it. There are ample opportunities for you to discuss any concerns you may have with nursing staff and doctors prior to the delivery of the vaccine.
  • Maintain good hand and respiratory hygiene. Catch it, Bin it, Kill it.
  • Maintain social distancing. Calling instead of visiting in person, and helping providing assistance such as helping with their food shopping and leaving it on their doorstep for them to receive.
  • Support their access to a healthy lifestyle; which includes a healthy diet, regular physical activity, and avoiding second-hand smoke.

Can someone die from Covid-19 even if they have recovered?

The swabbing and PCR analysis tests for SARS-CoV-2 identifies the genetic material found in the virus (RNA), not the virus itself. This viral material deteriorates as the body mounts an immune response, such that after 10 days, the only thing being identified by further tests are fragments of RNA, not of viable virus. This means that a person who tests positive for the virus is infectious for a maximum of 10 days from their positive test result. After those 10 days, the person is no longer infectious even though parts of the RNA may be found up to 84 days later.

The Contact Tracing Bureau (CTB) identifies people as being positive for the virus when the person first tests positive, and automatically deems them to have recovered 10 days later. This means only that the person was infectious for that 10 day period, and has then recovered from that state. It does not mean the person who had COVID-19 has now fully recovered. Both the virus and illness can persist. This includes the state now being referred to as long-haul COVID; this may be where the virus persists in the organs, or the damage caused by the presence of the virus in the body reveals itself over time.

A person can therefore die from COVID-19, even though they are no longer infectious with SARS-CoV-2; they may be marked as recovered, but the disease they suffer from (COVID-19) can persist over time. It is also possible to die with COVID-19 in a situation where death was inevitable, but coincidentally the person has contracted COVID-19. The confusion is between the virus and the disease. CTB records the virus, and the death certificate records the disease.

Can I run away and hide?

Having a reduced social bubble size is a good way at present to reduce the risk of viral spread. Going out for shopping and essentials should continue as normal, being cautious to clean hands and maintain distance where possible particularly if you are a vulnerable person. It is important to remember that we must learn to live with this virus; it is already established worldwide, with new strains developing, and our aim is to reduce infection rate and any pressure on healthcare services that could become unsustainable. For most of us, catching the coronavirus will feel a lot like the flu; how many of us run away & hide when it is flu season? What we need to do is ensure we protect our most vulnerable.

Does garlic work?

Eating garlic is not a preventative measure for the COVID-19 virus. Read about this and more common myths here.

How long will the illness last?

The length of time you can expect to be ill for will vary according to multiple factors including for example whether you have a pre-existing medical condition or if you are a current smoker. Generally speaking, you can expect to feel unwell for one to two weeks much as you would with other viral infections. A dry cough, change in taste, or some tiredness may persist for a few weeks after testing negative for COVID-19, though these are not of themselves a sign of active infection.

Do I have to keep my children at home?

As of Monday 22nd February schools in Gibraltar re-opened, in line with Public Health guidance [Read press release here].The Dept of Education will be provide updates as required in the forthcoming months.

It is advisable that all children remain aware of the importance of hand and respiratory hygiene, and that parents continue to reinforce this. [See best prevention advice here].

My child, of school age, has tested positive- what do I do?

If your child has tested positive for COVID-19 you should follow the advice given by the Contact Tracing Bureau (CTB). Your child, along with yourself and any other other household contacts, will be asked to self-isolate for a period of 10 days from when their symptoms started (Read more on managing self-isolation here).

You should contact the school or nursery that your child attends to ensure that they are aware of the diagnosis, although it is likely that they will already have been contacted by the CTB.

Should I use a home delivery service, rather than shop myself?

Home deliveries are available; however, many services remain over stretched and thus priority will continue to be shown to those who are more vulnerable. If you can shop in person you may do so, wearing a face covering, and maintain physical distancing and hand hygiene throughout your shop.

Can I use communal showers (e.g. at my gym)?

To minimise the risk of COVID-19 transmission in changing rooms and showers, there use should be discouraged wherever possible. Clients should be advised to change and shower at home. Spas should keep saunas and steam rooms closed until further notice.

Can I take antivirals to protect myself?

Anti-virals are being trialled as potential therapy in hospitalised patients with early stage of COVID-19. These medical interventions are currently being trialled in clinical settings under medical supervision. So far only one anti-viral has been approved for use in clinical setting for hospitalised patients. It is therefore not recommended to self-diagnose or self-treat COVID-19 without the supervision of your doctor in a hospital setting.

What if I take corticosteriods- am I protected??

Corticosteroids have not been found to be effective in early stages of a COVID-19 infection. The first or early infection stage, appears to respond better to antiviral therapies. In the second or later stage of infection, COVID-19 is driven by an exaggerated immune/ inflammatory response which may mean that immunosuppressive/ anti-inflammatory therapies such as corticosteroids are more likely to be beneficial; however, treatment with corticosteroids should be implemented by clinicians in a hospital setting where the correct and safe dose can be administered.

Does vitamin D reduce the severity of COVID-19 symptoms?

The Lancet, a prominent medical journal, highlights that the issue of vitamin D supplementation has been extensively debated, with arguments in favour and against. Vitamin D levels are not only seen to influence bone health, but also known to influence inflammatory responses within the body; and reduce respiratory tract infections. Groups that traditionally exhibit vitamin D deficiency or insufficiency, such as older adults, nursing home residents, and BAME populations, are the same groups that have also been disproportionately impacted by COVID-19. Additionally, increased time spent indoors due to lockdowns and shielding measures may mean that some people are not able to maintain adequate physiological levels of vitamin D from sunlight.

NICE guidance suggests that vitamin D supplements be taken as part of a general wellbeing plan, as opposed to being used solely to prevent or treat COVID‑19 [Read more here].