What is coronavirus and COVID-19?
Coronavirus is a new or ‘novel’ viral infection which is very easily transmitted from person to person when in close proximity, particularly indoors. Up to a third of people get coronavirus but don’t have any symptoms (asymptomatic infection). This has been a big challenge to control the spread of the virus within the population. Since the start of the pandemic coronavirus has evolved to become more transmissible resulting in rapid increases in case numbers as each wave of new infection develops.
Thankfully the current vaccines are providing a high level of protection against severe COVID-19 illness, hospitalisations, and death. There is a much better understanding of how to treat severe illness caused by coronavirus.
Early symptoms of coronavirus illness include loss of, or change in taste or smell, development of a new continuous cough and fever. Some people also experience shortness of breath, sore throat, nasal congestion, loss of appetite, headache, diarrhoea, nausea, and vomiting. If you think you have coronavirus it’s important to get a test (lateral flow or PCR) and self-isolate until the test result is confirmed by a PCR test.
Despite being a mild to moderate illness for the majority of people, it can take some time to fully recover from coronavirus. The average time to a return to health can take up to 28 days. Long COVID has been identified as a complication and can result in debilitating symptoms which last for up to 3 months or longer in some cases. Some NHS organisations have developed Long COVID assessment clinics which offer a range of specialists working together to people experiencing brain fog, anxiety, depression, breathlessness, fatigue, and other debilitating symptoms.
COVID-19 can be life threatening for some people. Older age and people from black and brown ethnic minorities are at greater risk of developing severe illness. People who have other health conditions particularly diabetes, obesity, high blood pressure or other long-term health conditions that affect the lungs, heart and kidneys are also at greater risk of becoming very unwell.
Severe COVID-19 symptoms are characterised by breathing difficulties with the development of other complications which affect the heart, cardiovascular system, and kidneys, which require hospital treatment and care. If you experience breathing difficulties, you should seek medical help as soon as possible by calling the 111 or 999 service is there is a clear risk to life. The treatment for COVID-19 has improved since the early days of the pandemic and there are 2 medicines available to help those with who experience severe breathing difficulties and illness. Specialist Doctors and nurses have a much better understanding of the care required to help people recover.
HIV & coronavirus
The majority of people living with HIV, who are on treatment, have undetectable viral load and generally well, are unlikely to experience serious illness when compared to their HIV negative peer group. Several studies have identified HIV an independent risk factor amongst those with a CD4 cell count below 200 and those with detectable viral load. As with the general population, the risk of severe illness increases amongst older age groups. There is a signal that a greater proportion of people living with HIV may experience severe illness after the age of 60 than their HIV negative peer groups. Further research is required to better understand the impact HIV has on coronavirus transmission, vaccination, and COVID-19 illness.
If you are admitted to hospital, we strongly advise you tell the medical team looking after you that you're living with HIV. This information will enable them to look after you in the best way possible and undertake the correct tests, investigations and provide you with the most suitable treatment. You should continue to take your HIV medication as usual unless otherwise directed by the medical team who should contact your clinic team or specialist HIV doctor to get further advice.
Protecting yourself and others from coronavirus
The most effective way to protect yourself and others from serious illness is to have the full course of vaccinations. There is clear evidence that the risk of developing severe life threatening COVID-19 illness is significantly reduced amongst those who have been fully vaccinated.
The Joint Committee on Vaccination and Immunisation (JCVI) have issued advice that people living with HIV who have a CD4 cell count below 200 should be offered a third dose as part of their initial coronavirus vaccination course. This additional dose is intended to improve response rates in people who are less likely to respond to the standard double dose coronavirus vaccination.
There is room for an individual approach as to who should receive a third dose. This may include people who have had (in the last year) or recovering from, advanced HIV related illness or those who continue to have detectable viral load where CD4 cell count is below 350, have a CD4:CD8 ratio less than 0.5 or where the lowest CD4 result (nadir) was below 200 prior to starting treatment.
The third dose is different to having a booster. A booster is given to enhance the immunity provided by the initial standard double vaccination course. Those who require a third dose as part of their initial vaccination course will still be eligible for a booster which will be provided in line with yet undetermined national guidance on routine boosters for the general population.
Aside from getting vaccinated the regular use of lateral flow tests is encouraged together with observing good hygiene practices and the use of face coverings where local arrangements require this (public transport as an example).
As we move into the Autumn and Winter months it’s important to be mindful of updates on the advice provided by local authorities and government departments across England, Wales, Scotland and Northern Ireland as different advice and arrangements are often in place.