COVID-19 – FAQs

COVID-19 – FAQs

Frequently Asked Questions

*Page update 20th May 2020
Public Health Gibraltar are no longer screening for countries of concern, as the coronavirus is already within the community; if symptomatic however, it may be useful to report any recent travel.

Understanding COVID

Vulnerability

Protection

Home and Self-Isolation

Travel

Miscellaneous

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How does the new Coronavirus spread?

Because it’s a new illness, we are still learning about how the novel coronavirus spreads from person to person, but similar viruses are spread through droplets carried in the air, particularly through coughs and sneezes. The coronavirus appears more contagious than seasonal influenza, and may be spread by people who show mild or unrecognised symptoms.

COVID-19 is mainly passed on by person-to-person spread between people who are in close contact with one another and by droplets produced when an infected person coughs or sneezes. However, a new study published in the New England Journal of Medicine found that the virus that causes COVID-19 remains on surfaces and in aerosols for several hours to days. This study suggests that this virus is transmissible through relatively casual contact, making it very hard to contain. Furthermore, scientists have discovered that the virus is detectable for up to three hours in aerosols, up to four hours on copper, up to 24 hours on cardboard and up to two to three days on plastic and stainless steel.

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 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 disinfect 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 of three metres between yourself and others when in a public space
  • 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 is likely to be a large spike in infections in 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?

We are still learning about the symptoms that appear most prominent in our local community. Typical symptoms of coronavirus include a fever, flu-type body aches, a sore throat, runny nose (but not straight away), and/or a cough. Other reported symptoms include headaches, 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?

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 remember: There is no medication to treat COVID-19 at present, nor are any vaccines currently available. We rely on time and our immune systems to combat the virus. However, some more vulnerable people will require extra support for their symptoms; please call 111 if you are concerned about worsening symptoms. 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).

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 as you may need to cough, retch or sneeze afterwards.

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 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. Ensure you wash your hands regularly, maintain social distancing when appropriate, and avoid any contact should you begin to feel any cold or flu symptoms. Remember any masks only work for 15 minutes, and then their only function is to stop your spittle from coughs and sneezes landing on someone else.

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

If you work as a front-line healthcare worker and someone you live with has tested positive, you will be NOT be expected to home isolate. As long as you are not displaying symptoms you can continue as normal. It is necessary to remember, we are not trying to stop the infection as we cannot, we are trying to slow the spread to a rate at which our healthcare system can manage. We are a small densely settled population and we are unable to carry out any other method.

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

From a public health perspective, there is no need for you to avoid work unless you identify as being part of the vulnerable population (over 70, unstable condition, or immunosuppression). It is however, up to each individual employer to take decisions that best safeguard their employees; please take your directive from them. The Government of Gibraltar recommends working from home wherever possible [Read CM’s speech 22nd March].

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, but what is evident is that people who have lowered immunity or have unstable underlying medical conditions, as above, 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.

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. 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), or an ambulance in an emergency (call 190). BUT it is important if you are currently under-going self-isolation you call ahead to inform them of your current situation, so they know you have symptoms suggestive of COVID-19.

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 only be attended by car as this provides a contained unit. Swabbing is usually carried out on the third day of symptom onset as this provides the most reliable results. Without a referral to drive through swabbing, 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 provide details including your:

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

You will also need to confirm whether you have access to a car or not. Please note that if you are self-isolating and require swabbing you may leave the house to attend the drive through swabbing by car.

What can I do to protect myself?

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

  • 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. Use a sanitiser gel if soap and water are not available. 60% alcohol is best for killing viruses
  • Avoid touching your eyes, nose and mouth with unwashed hands.
  • Avoid close contact with people who are unwell.
  • Avoid smoking and secondhand smoke. As mentioned in the severity of symptoms question, 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? Getting this infection on top of another will not go well, so if you have a chronic condition you can pop down to the PCC between 2pm-4pm and get it free Monday-Friday.

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?

Alongside the decision to begin relaxing lock-down measures, the advice regarding home isolation is being made stricter (to isolate infections and reduce spread in a more aggressive strategy). 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 (frontline workers need to be swabbed with priority), and the duration of the symptoms you report. Frontline workers may be given special advice based on their circumstances. *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.

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; irrespective of symptoms. 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).

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

In a word, 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?

The protection a mask provides is very limited in terms of duration (around 15minutes) and suitability (the correct size and facial-seal per person). A mask will more likely provide a false sense of security.  Current government guidance advice now recommends the use of a mask in an enclosed area where physical distancing cannot be maintained. Good hand and respiratory hygiene are still the best protection against the spread of infection.

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. 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 moisturize 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 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.

Are my children safe?

People of any age can be infected by the new coronavirus (COVID-19) however children are usually fit and healthy so are 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.

Will I die?

As of March 3rd, the World Health Organisation (WHO) estimate the mortality rate of COVID-19 at around 3.4%. This varies by country for several reasons including accurate surveillance (knowing how many people are infected or die from the virus) and intensity of transmission (considering for example, how quickly the virus spreads from one person to another or the resources available to combat it). 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:

  • Maintain good hand and respiratory hygiene. Catch it, Bin it, Kill it.
  • Maintain our 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.
  • Stay up-to-date with our vaccine schedules, taking advantage of the annual flu vaccine when offered.
  • Support their access to a healthy lifestyle; which includes a healthy diet, regular physical activity, and avoiding second-hand smoke.

Can I run away and hide?

Remaining at home is the best way to safeguard our most vulnerable. Going out for shopping and essentials can continue as normal unless you are aged over 70 (see HM GoG press release). It is important to remember we are no longer trying to prevent the virus in Gibraltar, it is already here, the aim is to slow the spread. Also, 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.

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, and 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 Monday-Friday 8:30am – 7pm and Weekends 8:30am-12:30pm & 5pm – 7pm Tel: 200 07910.

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 may persist for a few weeks after testing negative for COVID-19, this is not a sign of active infection.

If I get COVID-19 will it come back?

Much of the information surrounding the new coronavirus is still emerging. Often, when someone has been exposed to an infectious disease the body can develop an immunity to that specific strain which will prevent or significantly lessen their body’s response when they are in contact with the illness again. This is not however the case with all viruses and in all people, and studies have yet to determine whether or not people can develop full immunity once they contract the COVID-19.

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

As COVID-19 is new it is difficult to state what potential long-term consequences may be. 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- STOP. Take up vaping/e-cigarettes as it will not damage your lungs in the same way, or, seek support from the free smoke cessation service to quit the habit entirely. Most experts believe that COVID-19 patients will develop some immunity after contracting the virus, but it is not known for sure. Scientists continue working to develop a vaccine to duplicate the body’s immune response and provide a long-term solution to preventing COVID-19 associated illness.

Do I have to keep my children at home?

With the change to our approach to slowing the spread of COVID-19, children should now be kept in home isolation with parents as much as able. Schools have been officially closed as of week ending 20th March; parents may utilise an online platform to maintain the learning routine (though this will not cover the curriculum) or those who have to physically attend work are able to leave their children in school (see: Dept of Education for more). There are also updates for students regarding GCSE/ A level grades; click here for more.

It is advisable that all parents make their children aware of the correct way to wash hands, get them to do so regularly, and that they know the Catch it, Bin it, Kill it method for their coughs and sneezes. [See best prevention advice here].

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

Home deliveries are now advisable; however, many services are now over stretched and thus priority will be shown to those who are more vulnerable. If you can shop in person, try to do so independently (without taking friends and family) and maintain physical distancing and hand hygiene throughout your shop.

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 your home isolation period, in its entirety, 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.

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.