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Coronavirus Guide

The news and advice surrounding the coronavirus pandemic changes rapidly as the outbreak develops. We recommend visiting the NHS and government websites for all the latest developments on COVID-19 and what it means for you.

Reviewed by Dr Sam Rodgers

18th March 2020

Contents

What is coronavirus?

Chapter 1

What is coronavirus?

Can you lower your risk factors in time?

Chapter 2

Can you lower your risk factors in time?

Preparing for coronavirus

Chapter 3

Preparing for coronavirus

What is coronavirus?

Chapter 1

What is coronavirus?

For some, a coronavirus infection can be mild, but for vulnerable groups it can be more serious. Learn about coronavirus and what you should do if you experience symptoms.

Learn about coronavirus and what you can do to get in the best shape possible to beat the virus.

What is coronavirus?

Coronaviruses were first identified by scientists in the 1960s, and infections occur in both humans and animals. A coronavirus infection is an unpleasant but short-lived illness for the majority of people. Typical symptoms can include a sore throat, cough, fever, blocked or runny nose, sneezing, and muscle aches. Many cases of the common cold in the UK are due to coronaviruses. In most cases, the body will fight off the infection within about seven days.

A very small number of those infected can develop complications such as viral pneumonia (chest infection). Complications are most likely in people with weakened immune systems, older people, and those with long term conditions like diabetes, heart disease and chronic lung disease.

Since 2002, two new coronaviruses infecting animals have evolved and caused outbreaks in humans: SARS-CoV and MERS-CoV. These were more unusual as they caused more severe illness for some people. For example, SARS-CoV infected over 8,000 people, and 10% of those infected died.

In December 2019, a new seventh strain of coronavirus emerged in Wuhan, China. It is known as the 2019 novel coronavirus, and the illness it causes is called COVID-19. Experts think that this virus originated in an animal and has evolved to infect humans. The death rate is difficult to estimate because many countries have not had the facilities for testing everyone who reports symptoms. In addition, many people who have coronavirus are not experiencing any symptoms at all. However, the death rate has been estimated to be anywhere between 0.7% to 3.5% with the elderly and people with pre-existing conditions like diabetes and heart disease at a considerably higher risk of complications and death. The majority of cases, however, have experienced a milder illness.

How do you catch this new strain of coronavirus?

As a new virus, there is a lot still to learn about how coronavirus spreads. The two main ways are likely to be:

  1. Person to person
  2. The virus is thought to spread through close contact between people. This is why maintaining a distance of 6 feet away from others is recommended for self-protection. Other established strains of coronavirus spread through respiratory droplets. This means they can spread from an infected person to another person through coughs or sneezes, or items contaminated with the virus (such as hands or handkerchiefs). The eyes are a potential point of entry for the virus, which is touching the face should be avoided. The spread of infection tends to happen to those in closest contact with the infected – typically people living in the same household.

    People are likely to be most contagious when they have symptoms. However, there may have been cases where people have passed on coronavirus even before they have been symptomatic themselves [1].

  3. Spread from contaminated objects
  4. Although the primary way the virus spreads is thought to be person to person, there is also a risk that the virus can live for up to 72 hours on hard surfaces. This is why it is important to disinfect doorknobs, packages (including food packaging), and other hard surfaces before you use them.

How can I avoid catching coronavirus?

There is currently no vaccination against COVID-19. Antibiotics are not effective because the infection is due to a virus.

The most effective way to prevent infection is to avoid exposure to the virus. This can be achieved by following government and Public Health England's advice about self-isolation and practising social distancing. As cases of the virus increase and more parts of the country are affected, these measures are becoming more stringent, with schools closing for the remainder of the academic year, public transport closures, and large gatherings being cancelled. As this is likely to change on a day-by-day or even hour-by-hour basis, we advise you to stay up to date with all the recommendations here [2].

It is also important to continue practising good hand hygiene and respiratory hygiene. These simple steps have been shown to be effective at preventing people from catching all types of respiratory infections such as influenza and the common cold.

These are:

  • Frequent hand washing throughout the day. As a minimum, after using the toilet, after coughing or sneezing, before preparing food, before eating food, when hands are visibly dirty; and after contact with someone who is sick.
  • When coughing or sneezing, do this into a tissue, then immediately dispose of it in a bin, then wash your hands.
  • Avoid close contact with someone who has a cough, fever or flu-like symptoms.

What should I do if I think I have the new coronavirus?

If you develop a high temperature, or if you have a new continuous dry cough, then it is possible that you have the new coronavirus infection. You should follow current government advice, which is to self isolate for 7 days from onset of symptoms, or until the fever ends if it continues beyond this period. The rest of the household need to self-isolate for 14 days from when the first person in the household catches the symptoms for as long as they remain asymptomatic – once anyone gets symptoms within this self-isolation period the 7 day self-isolation starts from that point. The NHS 111 service provides an online tool that will help you to decide whether you may have coronavirus and the actions that you need to take, which can be found here.

It is very important not to turn up at your GP surgery, or to attend an Emergency Department without contacting them first as this could lead to other people in the waiting area becoming infected.

Self Isolation Infographic

Can I get tested for Coronavirus?

Anyone who has symptoms of coronavirus (COVID-19) can get a free test to check if they have the virus through the NHS. Some people without symptoms can have the test too. Find out how to apply for a free test here here.

Do we test for coronavirus antibodies at Medichecks?

Yes, to buy a coronavirus antibody test you will be directed to our sister site here.

We’ve created this site to enable you to buy multiple test kits at the same time.

Simply select the number of tests you want, distribute to your family, friends or workforce, and make sure each person activates their own test kit before using it.

Coronavirus antibody tests can only be bought and used by people over the age of 18.

Can you lower your risk factors in time?

Chapter 2

Can you lower your risk factors in time?

People who have pre-existing conditions can be affected more severely than others. Find out how you can quickly lower your risks through lifestyle changes. 

This novel coronavirus hasn't been around for long, and there is still a lot to learn. However, what we do know is that some people are more severely affected than others. The World Health Organisation (WHO) reports that about 80% of people infected with COVID-19 recover without needing any hospital treatment, but about one person in six becomes seriously ill. Death rates are highest for people with pre-existing conditions. So, what are the conditions that pose the greatest threat, and is it too late to reverse them before coronavirus cases peak?

People at higher risk of becoming very unwell include older adults, those with suppressed immune systems and those with medical conditions such as:

  • Diabetes
  • Cardiovascular disease – i.e., heart disease and high blood pressure
  • Lung disease

The good news is that many of these conditions can be improved or even reversed by lifestyle changes – and in many cases, it doesn't take long to see results. Let's take a look at what studies reveal about how quickly you can get in shape.

Diabetes

Type 2 diabetes is the most common form of diabetes in the UK. It is a condition where you become resistant to the action of insulin, meaning that sugar from the food you eat can't get into your cells for energy. As a result, sugar levels in the blood remain high. Persistently high blood sugar levels reduce the immune response to invading germs, which means that people with diabetes are more prone to infections. Not only that, viruses and bacteria are also known to thrive and multiply more in this environment [3].

Studies showing rapid reversal of diabetes

There are plenty of studies that show that through diet, exercise, and calorie restriction, diabetes can be turned around quickly. Even if you can't reverse it completely, you can lower your blood sugar levels, which can reduce your risk of infection and complications.

3-week Pritikin lifestyle program

The Pritikin program is a residential program that aims to prevent and reverse heart disease. Not only does it improve cardiovascular risk factors, but it also has a profound effect on diabetes risk. There is no reason why you cannot follow a similar program from home. It involves 45-60 minutes of aerobic exercise daily as well as a high fibre, low-fat diet with an emphasis on whole grains, fruit, and vegetables. The results after only three weeks were impressive. 71% of participants who were taking medication to control their blood sugar were able to stop taking their medication as a result of the program - and 76% of the people who weren't taking medication saw their blood glucose levels fall to non-diabetic levels [4].

Very Low-Calorie Diets

Although no one recommends very-low-calorie diets for long-term weight control (they're just too hard to stick to), they can have a dramatic effect on diabetes. A study in 2011 showed that after just one week of restricting calories to 600 per day, fasting blood sugar levels returned to normal. After eight weeks, pancreatic cells and insulin sensitivity were also back to normal [5]. No one is saying that sticking to 600 calories a day is easy, but if you want results fast, it works.

If you are taking any form of medication for your diabetes, you must talk to your GP before you start any of the lifestyle changes described above, especially if you are aiming for rapid change. Your blood sugar and medication dose will need to be monitored closely so that you do not develop hypoglycaemia (low blood sugar).

Cardiovascular disease

A study of 150 patients from Wuhan, China—the epicentre of the coronavirus outbreak—found that patients with cardiovascular disease had a much higher risk of death than those without [6].

The heart, blood circulation, and lungs are all interconnected; when the lungs get infected with the virus, you are less able to breathe in oxygen efficiently. Your heart has to pump harder and faster to ensure the blood is circulating the reduced oxygen to the body's tissues. If your heart is already weak, or you have narrow arteries through the build-up of fatty deposits, it will be even more of a struggle.

Studies showing rapid reversal of cardiovascular disease

The same 3-week Pritikin study mentioned above also showed improved risk factors for cardiovascular disease. Cholesterol levels improved by 22% and 34% of participants who were taking medication for high blood pressure, stopped their medication [7].

A 30-day lifestyle modification program delivered by the Complete Health Improvement Project (CHIP) showed similar success in a population of over 5,000 participants [8], with LDL (bad) cholesterol falling by almost 20% in the people whose levels were highest (above 7.2 mmol/L). Like the Pritikin program, CHIP involves eating a whole-food plant-based diet, doing at least 30 minutes of moderate physical exercise daily, and attending educational workshops. Workshops and residential courses can help keep you motivated to stick to lifestyle changes; however, there are lots of online alternatives and apps that may be more accessible, especially if you are working from home.

More evidence that low saturated fat vegan/vegetarian diets can improve cardiovascular risk factors comes from The Portfolio Diet in 2003. This diet included plant sterols, nuts, soy protein, and soluble fibre. Even when followed for just a month, it led to significant reductions in harmful LDL cholesterol (down 28%). Not only that, C-Reactive Protein, an inflammation marker, and another risk factor for heart disease fell by almost the same amount [9].

Dr Liza's guided mediation for heart health

Lung disease

Initially, the COVID-19 virus infects the cells of the nasal passages and throat, then travels down to cause inflammation in the tubes of the lungs, leading to pneumonia [10]. It is, therefore, no surprise that pre-existing lung conditions increase your risk of a more severe response to coronavirus infection.

Smoking and lung disease

Chronic Obstructive Pulmonary Disease (COPD) is the second most common group of chronic lung conditions in the UK (after asthma). COPD, which is usually caused by smoking, leads to more lung infections. The chance of developing this condition increases with the more cigarettes you smoke and the number of years you have smoked. As smoking generally reduces lung function, it makes it more difficult to control symptoms of asthma and other chronic lung conditions.

Smoking directly impacts your risk of getting flu, and for developing pneumonia. People who smoke are five times more likely to get flu and twice as likely to get pneumonia. However, if you stop smoking, you can see significant improvements in your lung function in as little as 2 – 12 weeks [11]. It is worth quitting smoking not just for the health of your lungs, but because smoking raises your risk of the other conditions which will affect the severity of coronavirus. Smokers are at increased risk of cardiovascular disease as well as diabetes and are more likely to suffer complications of those conditions.

If you need support to stop smoking take a look at NHS Smokefree

Dr Liza's guided mediation to stop smoking

Diet and lung disease

Definitive data is lacking, but there is some evidence that a healthy diet is associated with better lung function and reduced risk of COPD. So what is a healthy diet? A healthy diet is characterised by high consumption of fresh fruit, vegetables, whole grains, plant and/or fish oils, and low intake of alcohol. Foods to avoid include processed foods, foods high in saturated fats, refined foods and sugar, cured and red meats, and sugar-containing beverages.

A healthy diet rich in antioxidants is thought to reduce inflammation and improve lung immune function, effectively preventing the progression of chronic lung conditions [11].

How much time do you have to act?

We cannot predict if or when anyone is going to get coronavirus. It is worth noting that Public Health England is expecting the peak to be in May, which is months away rather than weeks. It means that for many of us, especially those of us in higher-risk groups, we do have time to be making changes that could potentially save our lives. Remember, the chronic health conditions that raise your risk of dying from coronavirus are the very same conditions that shorten your life expectancy generally. Dealing with them now not only gives you a better chance of overcoming coronavirus but could also add years to your life. View this as an opportunity to get in shape and make long-lasting changes for good.

Preparing for coronavirus

Chapter 3

Preparing for coronavirus

Strengthening immunity by reducing stress, exercising and improving diet can all help to make us less susceptible to viral respiratory infections like COVID-19.

Although cases in the UK are declining, everybody's primary focus must still be to avoid getting or transmitting the virus, to limit the strain that is placed upon the NHS so that it can care for those who are most affected by the virus. This is why the government and Public Health England have focused so strongly on simple measures (like frequent handwashing) that we can all take to reduce our chances of getting the virus. But is there anything else that we could be doing to improve our chances of coping with the virus if we do succumb? We've taken a look at the research to see whether there are steps we can take to improve our immune function and make us less susceptible to viral respiratory infections such as COVID-19.

How can I strengthen my immunity?

The elderly, and people with long term health problems such as heart disease and diabetes are the most likely to develop the serious form of COVID-19 infection, causing inflammation of the lungs which makes it difficult for them to transfer oxygen into the blood. Keeping these groups safe must be our top priority.

But what can we do to look after ourselves? There may be steps that we can take to strengthen our immunity in the short to medium term, which can help us deal with the virus if we do become infected.

Reduce stress

Have you noticed that in stressful periods of your life, you seem to come down with every bug or virus going? This is because stress has a direct effect on immunity. When you experience a stressful event, your body responds by releasing hormones like cortisol and adrenaline, which affect your production of T-cell lymphocytes [12], a type of immune cell responsible for fighting infections. If a stressful event is short term, then your immune system will recover. But when stress becomes chronic, you can become susceptible to viruses and bacterial infections. There is much you can do to consciously manage stress, like introducing more time to relax, taking regular moderate exercise, and getting more sleep.

Read our guide to stress to find out more. If you want to test your stress levels, then our Stress Cortisol Saliva Test 4 will reveal if you need to be doing more to reduce stress during the day.

Exercise

Research shows that moderate exercise strengthens the immune system and can potentially reduce the severity of an upper respiratory tract infection. However, overdoing it adds to stress levels, raising cortisol, and weakening your immune system [13]. The good news is that you don't need to go to a public gym to exercise; moderate exercise means raising your heartbeat for around 150 minutes per week, and you can do this by taking a brisk walk or a jog. If you're pounding the pavements night after night, you might want to reduce your exercise load until the threat of coronavirus has passed.

Quit Smoking

It will come as no surprise to learn that smoking appears to increase your risk of developing an upper respiratory tract infection [14]. Coronavirus is a disease that attacks the lungs, and if they are already damaged by smoking, then it increases the risk of complications. Stopping smoking is the single most helpful step you can take for your health. It will help you deal with the effects of coronavirus, but will also improve your risk of numerous chronic conditions like cancer and heart disease, which can shorten life expectancy. Incidentally, if you enjoy a glass of wine in the evening, this might offer some protection, but only for non-smokers [14].

Get sufficient sleep

There appears to be a link between insufficient sleep and upper respiratory tract infections. A study of over 22,000 Americans showed that participants who slept for 5 hours or fewer per night, or who reported low quality sleep, had an increased likelihood of reporting a head cold or chest infection in the previous 30 days than people who slept for 6 or 9 hours [15]. For some people, getting some extra shut-eye is easy, but for others, where sleep doesn't come easily, it can be a problem. Establishing a bed-time routine, banning smart-phones and computers from the bedroom and keeping your bedroom dark and cool are just some of the things you can do to improve your sleep.

You can read more about establishing a good sleep routine in our Health and Wellness Guide.

Improve diet

Most people turn to supplements when they want to boost their immunity, but there is good evidence that simply increasing the amount of fruit and vegetables in your diet will have a positive effect on your immune function and inflammation markers. Research shows that eating fruit and vegetables increases the production of T-cells and is associated with lower levels of C-Reactive Protein, a marker for inflammation [16]. In severe cases of coronavirus, the inflammatory response is exaggerated, attacking not just the virus, but also healthy tissue. Keeping inflammation levels low through following a healthy diet may offer some protection against the worst effects of the virus.

Take vitamins and minerals

There is no shortage of supplements that promise a boost to immunity, but are there nutrients that can affect upper respiratory tract infections specifically? We take a look at the evidence:

Vitamin D

A review of existing research in 2012 which looked at 5 clinical trials found that taking vitamin D supplements may help to prevent respiratory infections [17]. Aim to keep your vitamin D in the normal range (between 50 and 175 nmol/L) – vitamin D levels can easily fall, especially in the winter months. You can test your vitamin D with a Vitamin D Blood Test or as part of a general health check such as our Nutrition Blood Test.

Vitamin C

The evidence around vitamin C and the prevention of respiratory tract infections is mixed. However, once you are infected, vitamin C appears to shorten the duration of the infection, although this effect appears to apply only to women and children [18, 19]. It is difficult to measure vitamin C in a blood test as levels of vitamin C change rapidly according to what you've just eaten. However, vitamin C is safe to take as any excess passes out of your body in your urine. It would seem sensible to supplement with vitamin C, especially if you become infected.

Selenium

Selenium is a trace mineral that is a powerful antioxidant and also supports the immune system. Modern agricultural methods mean that levels of selenium in the soil are becoming depleted, which directly affects the amount of selenium in the food we eat. Selenium deficiency appears to place you at a higher risk of viral infections, including SARS, and also means that the virus mutates more quickly [20]. Measuring your blood levels and correcting any deficiency may offer you some protection against coronavirus. If you want to test your selenium levels, you can order a Selenium Blood Test or, for a more comprehensive health check, which includes nutritional markers, our Ultimate Nutrition Blood Test.

Zinc

Zinc may not stop you from getting coronavirus, but it may help you recover more quickly. A meta-analysis conducted in 2012 of over 2000 participants showed that the people taking oral zinc supplements recovered faster from the common cold than people in the placebo group [21]. If you want to test your zinc levels, you can order a Zinc Blood Test or buy it as part of our comprehensive Ultimate Nutrition Blood Test.

Probiotics

The bacteria in your gut is a relatively new area of research, and we are learning more every day about the beneficial effects of fibre and probiotics for a healthy microbiome. Surprisingly, your gut bacteria play an essential role in regulating your immune system. A study in 2015 of almost 4,000 adults and children found evidence of protection against upper respiratory tract infections for those taking a probiotic compared with those taking a placebo [22]. An excellent way to increase the good bacteria in your gut is to increase your fibre intake. Alternatively, you can take a probiotic in the form of cultured foods like sauerkraut or live yoghurt. If this doesn't appeal, there are plenty of commercially available probiotics available.

What next?

As the UK enters the "delay" phase of a coronavirus outbreak, it is time to look after your overall health and wellbeing. Make time to relax, make sure that you are sleeping well and, most importantly, eat a healthy diet rich in colourful fruit and vegetables to give yourself the best chance of overcoming the virus. If you are worried that you are deficient in vitamins and minerals that may offer you protection, then it is easy to get tested. Our range of tests cover individual vitamins and minerals, as well as advanced tests that look at your general health and measure essential nutrients like zinc, vitamin D, and selenium.

References

[1] https://www.cdc.gov/coronavirus/2019-ncov/prepare/transmission.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fabout%2Ftransmission.html

[2] https://www.nhs.uk/conditions/coronavirus-covid-19/

[3] https://www.ncbi.nlm.nih.gov/pubmed/31657690

[4] https://care.diabetesjournals.org/content/17/12/1469.short

[5] https://www.ncbi.nlm.nih.gov/pubmed/21656330

[6] https://link.springer.com/article/10.1007%2Fs00134-020-05991-x

[7] https://care.diabetesjournals.org/content/17/12/1469.short

[8] https://resources.chiphealth.com/downloads/scientific-articles/20-Effectiveness_of_a_Volunteer-Delivered-5p.pdf

[9] https://jamanetwork.com/journals/jama/fullarticle/196970

[10] https://www.who.int/tobacco/quitting/benefits/en/

[11] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6627281/

[12] https://www.apa.org/research/action/immune

[13] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2803113/

[14] Smoking, alcohol consumption, and susceptibility to the common cold. | AJPH | Vol. 83 Issue 9

[15] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4899278/

[16] https://www.ncbi.nlm.nih.gov/pubmed/29931038

[17] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3543548/

[18] https://link.springer.com/article/10.1007/s00228-018-2601-7

[19] https://www.nature.com/articles/ejcn2016261

[20] https://link.springer.com/article/10.1007/s12011-011-8977-1

[21] https://www.cmaj.ca/content/184/10/E551.short

[22] https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD006895.pub3/abstract/es