Peter Openshaw

So in terms of treatments, I think it's very important to emphasise the difference between somebody with mild illness

which we hope is going to be the majority and those who may actually need more advanced treatment in hospital or in intensive care.

The initial disease tends to be quite mild and there self-isolation, paracetamol, ibuprofen, sleeping it off, the usual sort of things that people do when they feel a bit under the weather is all you need and there's no evidence that anything on top of that is going to be beneficial.

So at the moment there's no proven antiviral

Antibiotics are of no help at all, and so that's about it.

In those that need hospitalization, the treatment is supportive care and avoiding things that do harm, I think most importantly.

There were studies in the SARS outbreak where patients were given very high dose steroids in some hospitals, not given steroids at all in others, sometimes given a bit of steroids in a third.

There was a complete spectrum of opinion about whether steroids helped.

I would say generally the experience from that outbreak was that steroids were not helpful and indeed were causing harm, particularly in the very, very high doses that were being used by some.

So I would say avoid steroids unless there's a specific indication for steroids.

Almost all the patients that have been reported have been put on antibiotics.

That probably is not a good thing, but it's irresistible as a clinician when you're faced with somebody with pneumonic changes on the chest x-ray, a fever, a cough.

Who is going to withhold the antibiotics?

However, it's perfectly possible that the antibiotics are counterproductive.

So I would suggest that the decision to use antibiotics should be taken carefully.

Obviously, the symptomatic treatments with paracetamol or acetaminophen to bring down the fever seems very reasonable.

But in some common colds, there's a bit of evidence that using a lot of those sort of antipyretic drugs can actually mean that the virus load stays higher for longer.

So even that, maybe there isn't such a strong evidence base.