The Background

Many of my patients, justifiably, have questions and concerns about COVID-19 and pregnancy. Some of these relate to their delivery and admission for delivery and others relate to the risks of being pregnant during this time of uncertainty. As a result, it is only appropriate that I answer those questions and hope to bring some clarity on the topic and consequently some reassurance.

This post will focus on some general aspects of COVID-19 and will be followed by one looking at pregnancy specific considerations.

What is COVID-19?

Coronavirus Disease 2019 (COVID-19) is a respiratory tract infection caused by a coronavirus called Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-COV-2) which  was first recognized in Wuhan China in December 2019. South Africa has experienced multiple ‘waves’ of COVID-19 infections that has justifiably created anxiety and sometimes misinformed rumours.  We are all inundated with information from news platforms and social media and it can be overwhelming to try and keep abreast of all the latest developments concerning something that is so new and unknown.

What is important to know about COVID-19?

It is a very infectious virus that spreads rapidly by human to human transmission. The spread is predominantly via respiratory droplets that come into contact with another individuals’ mucous membranes (mouth, nose, eyes etc). This virus does seem to remain infectious for some time after it has been on a surface and so is also transmitted by fomites (or objects that carry the virus).

An individual usually experiences symptoms 3-7 days after exposure. This coronavirus causes a flu-like syndrome which may result in fever, headaches, body pains, diarrhoea and even loss of smell or taste. The vast majority of those infected will only develop mild symptoms or may even be asymptomatic. However, some individuals may go on to get chest pain, shortness of breath and other more serious complications of the virus.

A person is considered not be infectious 10 days after resolution of symptoms (although one can still test positive for the virus at this stage). Unlike the MERS and SARS viruses however, COVID does not have a very high mortality rate (in the region of 1-2%) and as a result the prognosis is better than those previous epidemics.

Why is all of this important?

Protecting ourselves and others (and not worrying about social graces) – some helpful strategies

  • Since is predominantly droplet spread, you should understand the emphasis on mask wearing. Insist that others wear their masks if you are needing to engage with them in conversation. You will not be permitted to remove your mask during the consultation.
  • Do not allow people in shopping queues to stand closer than 1,5 meters from you since the droplets generally do not travel further. Where possible, engage online shopping.
  • You cannot wash your hands often enough at the moment! If you have touched something someone else has touched, make sure you sanitise your hands. Adopt this practice for your whole family.
  • Stay away from social gatherings and crowded places, as anyone in those spaces may be carrying and spreading the virus.
  • Unfortunately, this virus does demand a high degree of vigilance. If we are all responsible for ourselves, we can beat this virus.

Stay home if you feel unwell in any way, or if you have someone at home who currently has COVID-19.

  • There is a national hotline which you can contact to ask for advice: 0800029999. If you have an appointment, please call us to reschedule. If you really do not feel well and think you may need admission, please go to casualty or contact me telephonically so this can be appropriately arranged.

I’ve tested positive – now what?

  • If you do get COVID-19 then it is most likely that you will not get very sick and will recover with some simple vitamin C, Zinc,Vitamin D and Paracetamol.
  • Once you start to much feel much better, you need to isolate yourself for 10 days until you can get back to your routine.
  • The same quarantine period applies to those who have tested positive but haven’t developed symptoms.
  • If you have been in contact, unknowingly at the time, with someone who tested positive for COVID-19 you need to be in quarantine for 8 days, and if you do not develop symptoms you should be out of the danger zone.
  • It is possible to get COVID-19 more than once, so do not assume that you are immune if you have already had the disease. Follow the same strict prevention strategies that have been advise previously.

What about treatment?

For the large part, treatment is supportive and if the need arises, high flow oxygen may be required. As you may know, drugs like dexamethasone can help in increasing recovery but whether other drugs work, is still to be determined. Like most viral infections, your body’s immune system is its own best form of defence, so keep eating healthy foods and ensure you are getting enough sleep and exercise. Then it cannot be stated enough – wash your hands, keep your distance and wear your mask!