A coronavirus tipping point, antibiotics in pregnancy, broken legs and heart health risks

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What is the current status of the coronavirus outbreak and its potential to become a pandemic?

Unknown 0:02

This is an ABC podcast.

Norman Swan 0:05

Hello and welcome to the Health Report with me, Norman Swan. Today, a warning about certain antibiotics during pregnancy, where you have your rehab for a traumatic injury, counts and home may be best. Does knowing your genes help predict your cardiac future? And after a weekend where pundits have been arguing that the coronavirus epidemic may have reached a turning point and is close to becoming a pandemic if it already hasn't, in other words, Gone truly global. I thought it was time for a catch-up. And just to complicate things, the new name for the virus is SARS-CoV-2 or QCOV2, leaving COVID-19 as the name for the disease it causes. Late last week, a study in the New England Journal of Medicine found that the viral load, the amount of virus, in an asymptomatic person was the same as in people who were sick, with which which, if generalizable, is a real

Norman Swan 0:55

Worry. There's an unknown number of cases in Iran, it must be in the many hundreds. There's an outbreak in northern Italy, one in South Korea, and locking down nations or borders is becoming progressively harder. And the January influenza report from the New South Wales Health Department shows a significant spike of people in January turning up to emergency departments with respiratory symptoms, yet testing negatively. For influenza. Professor Reina McIntyre has been watching SARS-CoV too closely. Reina heads the Kirby Institute's Biosecurity Research Program at the University of New South Wales. Welcome back to the Health Support, Rainer.

Raina McIntyre 1:33

Good evening, Norman.

Norman Swan 1:34

So first let's talk about this report in the New England Journal of Medicine last Thursday, Australian time. What can you just give us a bit more detail on that?

How does asymptomatic transmission affect the spread of COVID‑19 and what evidence supports this?

Raina McIntyre 1:42

Yeah, so we've been getting more and more information suggesting that asymptomatic transmission is possible, particularly from the Japanese. testing everyone on board the Diamond Princess and also testing all their evacuees from Wuhan. They found a number of people who were asymptomatic but positive. The paper in the New England Journal sh um had two important findings. One is that they found that the level of virus shedding from the respiratory tract was the same in people who were asymptomatic and symptomatic, which means that Асимтomatic people could be just as infectious as symptomatic people. And the second thing they found was at the highest level of viral shedding was very early in the infection.

Raina McIntyre 2:28

So we know that with people who do have symptomatic disease. That it usually starts with several days, you know, five to nine days of very mild illness. where people may be wandering around and thinking that they're They haven't got it. Um, and but that's when it's most infectious, right at the beginning. So that's a concern as well.

Norman Swan 2:48

And that makes it more like influenza than SARS.

Raina McIntyre 2:53

That's right. SARS was generally only contagious when it when people were symptomatic. So um th diseases like that are easier to control than diseases where there is asymptomatic or pre symptomatic transmission.

Norman Swan 3:07

Now this report this influenza report from New South Wales Health, um, is there anything to it? This spike in people turning up in casualty in the emergency department in January with respiratory symptoms, but it wasn't flu?

Raina McIntyre 3:21

Um, I've had a look at it and I don't think it's li I don't think it's likely to be cr it's possible, but I don't think it's likely to be coronavirus because At that time and you have to look at the incubation period, right? So two weeks before if people had left China two weeks before. The number of cases in China wasn't as high as it became after about January the twentieth. Um And secondly, we have seen a lot of summer flu last year particularly and now again this year. So we have s and that's often from people travelling in in our long summer holidays to the northern hemisphere, to Europe or the US. They pick up flu, they come back. So we certainly saw that la a year ago. So um a lot more flu than we'd normally expect.

Raina McIntyre 4:07

Um And it could be just the flu. I I did read in the report that