Helen MacDonald

But I think in the way that some guidance has come out, it's been a bit unclear which of those situations it's been meant for.

And a sense that some of these factors that have been linked to more severe COVID outcomes, such as

particular age groups or hypertension or heart failure, concerned that those might be used in a crude way to say, well, if you have this condition, then you wouldn't be suitable for this particular type of escalation or treatment.

And communicate it well, Carl.

That's also key.

I'm sorry about the conflict of interest.

If people don't understand that, that's what's happened to them.

Well, we've seen some of the guidelines

due to the need for speed, I think compromising on certain elements.

And I think unfortunately one element which sometimes has been lacking has been public and patient partnership with particularly with some of the groups most vulnerable.

And I think that would be a nice thing for us to pick up on in another podcast to hear both how partnership in research and guidance has been coming on through the crisis.

Yes, I've got one research paper which went up online on the 21st of April on BMJ.

And this was looking at viral load and disease severity in patients infected with SARS-CoV-2 in China.

It doesn't have clinical implications as yet, but it's quite interesting.

They evaluated viral loads at different stages of the disease.

So they looked at around 100 people, most of them, about 74 of them had severe disease and 22 had mild disease.

And they looked at the RNA viral load measures in different samples of body fluids.

They looked at respiratory secretions, stool, serum and urine samples.

They had about three and a half thousands of those samples and they found evidence of RNA in about 60% of patients stool, about 40% of people's serum, but very, very rarely in the urine, only one person had it in their urine.

And they found that the median duration of the virus in the stool was about three weeks, 22 days.