Trains and buses across the country are still heaving – but is public transport safe? Picture: John Grainger
Trains and buses across the country are still heaving – but is public transport safe? Picture: John Grainger

Is it still safe to catch public transport?

Welcome to Dear Doctor, news.com.au's new weekly column answering all the medical questions you've always been too embarrassed to ask.

This week, our resident expert Dr Brad McKay tackles the one thing on every Australian's mind - coronavirus. Is public transport still safe? Do surgical masks work? And what should you expect if you're expecting?

HOW DO I STAY HEALTHY ON PUBLIC TRANSPORT?

QUESTION: My office is not shutting down, which means I'll continue getting the train to and from work every day. How can I stop myself from getting the virus?

ANSWER: We all need to work together to slow down the spread of this novel coronavirus (SARS-CoV-2). If your office hasn't closed down yet, then it's important to speak with your boss and see if there is any way possible for staff members to work from home. Your management team should be making every endeavour to make this possible.

Some businesses are splitting their employees into two teams. This structure is designed to protect your work colleagues from infection and also protect the business. If one member of the team gets diagnosed with COVID-19 and their close contacts need to be quarantined at home, at least the other half of the business can keep things running for the following 14 days. Unfortunately these measures aren't possible in every workplace environment.

A coronavirus vaccine may be more than 12 months away and we don't have any effective medication to treat COVID-19. At this stage our best weapon against the virus is to wash our hands regularly and create a physical distance between people.

When you leave home in the morning, make sure you take a bottle of high concentration (>60%) alcohol-based hand sanitiser with you. Don't touch anything with your fingers, especially your face. Be especially careful when inserting or removing headphones.

Masks work best when worn by someone who is already infected with coronavirus. It creates a physical barrier for droplets and can help prevent transmission of the virus when people are coughing or sneezing.

There is less evidence to show that surgical masks prevent you from getting sick, but if you want to wear a mask, wear a mask. And don't think poorly of anyone else who chooses to wear a mask either. Everyone is doing their best to stay well and keep their family and friends safe.

Plenty of crosswalk buttons don't do anything, so you often don't need to push them. If the lights won't change and you really need to push the button, use your elbow or your keys. This technique works well for elevator buttons too.

Don't get on a crowded train. Wait for the next carriage. People will increasingly be staying at home in the next few weeks, so hopefully you don't need to wait too long for the next train.

 

Dr Brad McKay. Picture: Supplied
Dr Brad McKay. Picture: Supplied

It's all right for families and household groups to sit together, but solo travellers should maintain a comfortable distance of about 2 metres from each other. Passengers should be spaced out over the carriage, with about 50 per cent of the usual capacity being an ideal limit.

Use antiseptic gel after handling money, after touching your credit/debit cards, and after using public transport travel cards.

Contactless payments can really help us out too. Readers are able to identify your card from a small distance, so you're able to make payments (or tap on and off) without any direct contact with the machine.

Hover your card or phone over the reader and you'll be able to make contactless payments, without the risk of picking up the virus. Paying this way also reduces the risk to retail assistants because they don't need to handle your filthy notes and coins.

Wash your hands with soap and water when you get to work. Wash them thoroughly for about 20 seconds (I don't care what song you sing).

Wipe down your desk before you begin work, including your phone (buttons and handset), your computer keyboard and mouse. Use disinfectant that kills more than 99.9 per cent of germs, spray it onto a paper towel, and dispose of it thoughtfully into a bin with a lid.

Please note that these are all handy hints if you really need to travel to the office, but the best solution is to stay at home.

 

DO MASKS STOP THE SPREAD OF THE VIRUS?

Sorry, but masks don’t always stop the spread of coronavirus. Picture: AAP Image/James Gourley
Sorry, but masks don’t always stop the spread of coronavirus. Picture: AAP Image/James Gourley

QUESTION: Do surgical masks work? Will they protect me from the virus and if not, why are so many people still wearing them?

A NSWER: Surgical masks aren't very effective at preventing infection from coronavirus. It's impossible to get a good seal around the sides, people take them off to eat, drink, or smoke, and any fiddling with the mask may allow the virus to touch your face. From there it's easy for the virus to touch your mouth, nose, or eyes, and for you to become infected.

If you choose to wear a mask, make sure you fit it correctly and don't take it off while you're in an area of potential exposure. Wash your hands thoroughly with soap and water before you put it on and after you take it off. If you don't have access to a sink, then use antiseptic gel (>60% alcohol).

Even though surgical masks haven't been shown to provide much protection, you'll soon find everyone around you will be wearing them in the hope of not becoming infected or infecting their loved ones.

Australia is at the precipice of a viral tsunami. It may seem hard to believe, but very soon you will be surrounded by invisible viral particles. Door handles, buttons, handrails, bench tops, desks, cups, plates, toys, playground equipment, everything will be covered. The novel coronavirus (SARS-CoV-2) will be floating in the air around you and will be inside your friend's lungs. When you become infected, it will contaminate your breath.

Health professionals have been warning the community and pleading with our government to act quickly, but we're deeply concerned our leaders have been too slow in attempts to contain the virus.

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Just another day at the office. #covid19

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Aussies tend to have a "she'll be right" attitude, but it won't be. You're about to see events and experience situations that will change your life forever. We have already seen the devastating effect that coronavirus has made in Italy, China, and other countries around the world. Australia will be no different.

If you become sick and start coughing, it's best to wear a mask. This isn't for your own safety, but for the safety of others.

Practice good respiratory etiquette. This means covering your mouth when you cough, sneeze, or yawn. It's better to cover your mouth with the inside of your elbow, but if you accidentally use your hands, wash them or use antiseptic gel immediately. Teach your friends, relatives, and kids to do the same.

If you're not brave enough to confront strangers who are openly coughing in public about their poor respiratory etiquette, then at least reduce your risk. Don't remain within coughing distance. Move away.

When you're infected, masks provide a physical barrier to catch the virus contained within your saliva, sputum, and snot, but there's no guarantee that they'll stop everything.

Your mask won't work well once it becomes damp from your breath. When this happens, carefully dispose of it in a bin with a lid, and replace it with a fresh, new, dry one.

Surgical masks may help a little bit to reduce the spread of infection, but very soon we'll take whatever we can get. In the USA, the Centre for Disease Control and Prevention (CDC) has started recommending bandannas and scarves for health professionals to wear as their supply of masks are running out.

We are living in a time of crisis. We need to respond urgently, but not panic. Be careful, thoughtful, kind, and meticulous, but never complacent.

 

 

I'M PREGNANT - HOW DO I PROTECT MYSELF?

QUESTION: I'm pregnant - do I need to take extra precautions?

ANSWER: Pregnancy places an enormous strain on your body. Your immune system changes to accommodate a foetus, your ankles swell up, and your uterus increases in size until it begins to press on your diaphragm, making it increasingly difficult to breathe. And that's just when things are normal.

When you suddenly introduce a severe viral infection, your physical condition can change dramatically.

Influenza is a classic example and over the years we've seen certain influenza strains causing considerable harm to pregnant women. Otherwise healthy pregnant women have been admitted to intensive care units around the world and required respiratory support.

Keeping people on life support and helping them breathe for days or weeks at a time is difficult enough, but doctors always get a little bit more anxious when we need to treat a foetus too.

In dire situations it's often the best option to perform a cesarean section while a pregnant woman is intubated, ventilated, and sedated. It's disorientating to wake up and be a new mother without remembering the delivery process, but at least they've got a better chance of being alive with a healthy newborn baby.

In among all the bad news we're hearing, I can at least tell you some good news. Unlike influenza, the novel coronavirus (SARS-CoV-2) doesn't seem to cause significant problems for pregnant women.

Now this good news doesn't make pregnant people invincible but at least it can alleviate some of our anxieties.

It's still better to avoid coronavirus if you can help it, and general hygiene measures apply to everyone, including people who are pregnant.

Stay home. Work from home. Wash your hands. When you go outside keep a distance of at least 1.5 metres from others who aren't household contacts. And if you're already a parent and the Australian government has continued to delay closing schools, consider keeping your kids at home.

This is general medical information and should not be regarded as medical advice or relied upon. It does not take into account any person's specific circumstances. Persons requiring medical advice or whose symptoms persist should consult their doctor.

Dr Brad McKay started studying medicine at Monash University at 16 and was a qualified doctor by 21. He hosted Embarrassing Bodies Down Under and works as a GP in Sydney.

Do you have a question for Dr Brad? Email stories@news.com.au

Originally published as Is it still safe to catch public transport?



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