Coronavirus COVID-19
Join the discussions relating to the Corona Virus and help fight medical misinformation. The 2019–20 coronavirus outbreak is an ongoing outbreak of coronavirus disease 2019 caused by SARS-CoV-2, which started in December 2019. It was first identified in Wuhan, capital of Hubei province China. Join us in discussions relating to the virus, how we can stay safe and how to avoid fake news or misinformation.
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Hi @GTH thank you for the questions here!

With respect to the cough issue, it does sound like reflux is the likely cause. However, given the failure of therapy you should have a review with a GP or consider a specialist to explore further testing. There are some causes of chronic cough that can progress and become debilitating if not addressed at the early stage. You could save some time to decide the best possible course of action throughh a detailed discussion using telemedicine - more on this here: https://www.todayonline.com/brand-spotlight/doctor-will-see-you-next-app

With respect to the left sided pain, this can have many possible causes from muscular strain to diving issues like the “bends” depending on the methods and depth of practice. I would recommend to review with a GP in-person for this (given that should any issue become severe while diving it could rapidly result in an emergency) so they can examine your abdomen/bladder and hip to determine if there are any issues that could impact diving.
Dr. Dinesh G
space doctor
Hi @BusinessJing unrelated clusters is consistent with the level of spread that has been announced. Fortunately for us in Singapore, the authorities have been very proactive about contact tracing, and our peers have readily adopted social distancing and hygiene measures which greatly helps to suppress the spread. Shampoo/soap are antiseptic substances that can be used to kill the virus, and therefore protect you in that situation.

In terms of the latest evidence - there is only proof of spread by respiratory droplets which can get into the body directly/indirectly via mucus membranes such as the mouth/nose/eyes. CDC has confirmed that there is no airborne spread as they are too heavy to remain suspended in the air and drop onto surfaces. This indirect spread occurs through contact of contaminated surfaces/items ("fomites") as you alluded to, or direct through projection when someone coughs or sneezes.

Therefore it is imperative to practice social distancing/hygiene, and for those that have such symptoms to wear masks to protect those around them. More information about this is available on MOH's health advisory and FAQ here: https://www.moh.gov.sg/covid-19/faqs
Dr. Dinesh G
space doctor
Hi @NIG . Thanks for your question!

In this situation if his symptoms are improved I would say it is alright for him to return to school. Given the onset of symptoms from last thursday, he would have been given 5 days MC if he saw a doctor which means it would have lasted until today (tuesday, return to school on wednesday). Though if he still has a slight cough, it may be prudent to bring him to see a doctor to get an MC for the next few days (given the current COVID situation).  Overall, the progression of his symptoms sound quite typical of the general flu at present. Hope this helps! 

Dr. Adnaan S
space doctor
Hi @Suzanna, if your passenger was tested positive for COVID recently after coming into contact with you in your car, in view of the close and enclosed proximity there is a chance you may have caught the virus especially without wearing a mask. I strongly recommend adopting the precautions of social distancing/ hand wash/ wear a mask and to see a doctor immediately if you feel unwell. If the time period between the diagnosis and your contact with the patient was recent enough, you should have been contact traced too for quarantine 
Dr. Bryan K
space doctor
Hi @Two002 . Thank you for your question! I assume you are referring to pneumonia in this case. 

Pneumonia is classified as a lower respiratory tract infection and hence symptoms tend to be slightly different. Also depending on if it is a viral or bacterial cause, symptoms can differ as well. In general, most people would have fever, productive cough, difficulty taking deep breaths or rapid breathing, pain on breathing in or coughing though the severity of which can defer from patient to patient. 

Chest pain can have a variety of diagnosis on its own and it would be wise to see your GP if it is persistent. It might not be directly related to your sore throat or a respiratory illness and the most common cause is more of a muscular problem. 

Pneumonia does not only occur when you are having a fever and vice versa. In the current COVID situation, symptoms can vary and the main concern is that of a pneumonia as it can lead to deterioration. Most patients were noted to be having a fever but there are patients with mild symptoms/low grade fever based on limited available data. 

I would recommend you to see a doctor regarding your throat though. It may not be an infectious cause but may require some medications and evaluation. 

Hope this helps!
Dr. Adnaan S
space doctor
Hello @upon_a_star , it is not uncommon for a cough to last longer than a week. You should reattend to the GP for a reassessment of the situation since your cough has not fully resolved. Upper respiratory tract infections can be viral or bacterial. Generally, an uncomplicated upper respiratory tract viral infection Is treated symptomatically with a period of rest as well while a bacterial upper respiratory tract infection has antibiotics as an add on. Remember the precautions such as social distancing/ hand washing and wearing a mask during this period ! 
Dr. Bryan K
space doctor
Hi @Mandy there is no need to wait, although do be particular about hygiene and not touching your face while cleaning. You can refer to NEA's guidelines on this for more details here: https://www.nea.gov.sg/our-services/public-cleanliness/environmental-cleaning-guidelines/guidelines/interim-guidelines-for-environmental-cleaning-and-disinfection-in-residences

Hope this helps!
Dr. Dinesh G
space doctor
Dear teck337,

Thanks for your question!

In terms of protection from viruses, wearing a surgical or cloth mask may not protect you. There was a Vietnamese study on cloth masks vs surgical masks in healthcare workers. It showed that the group wearing surgical masks had a lower rate of developing influenza-like illness or viral respiratory infection, compared to the cloth masks group. However, even the group wearing surgical masks still had some infections. 

We would advise you to wear a surgical mask if you are unwell. The purpose of this is to protect others when one coughs or sneezes, as the mask would trap those droplets and prevent those droplets from spreading and disseminating. In order to do this, the surgical mask is made with a certain pore size and materials that allow it to do its job. 

At the end of the day, what you can do to protect yourself includes avoiding crowds, keeping a safe distance from others, hand hygiene, refraining from touching your face. As per our MOH guidelines, a medical mask is not required for people who are not sick.

Take care and stay well!
Dr. R T
space doctor
Hi @Wen . Thank you for your question! I do receive a lot of similar requests. 

Yes most doctors will be able to provide a memo regarding the diagnosis after examination and history taking. Based on what you have written down it sounds possible to be related to allergic or vasomotor rhinitis (environmental causes) rather than an infective cause. The aforementioned is even more so if you/your husband or your son has a history of eczema/asthma/allergic rhinitis. 

Though you may want to call ahead as usually such memos are written by the resident doctor (in the event the clinic is being covered by a locum doctor). 

Hope this helps!
Dr. Adnaan S
space doctor
Dear J3llyb3ans,

Even in cities on lockdown, health experts encourage sunshine and exercise for their mental health and immune-boosting benefits. 
However , there are certain safe and responsible practices to adhere to if you want to go outside without raising your risk of contracting or spreading COVID-19. Keep the safe distance while performing your exercise and avoid touching your face and surfaces during your exercise. There may be occasions when weather or other circumstances make it less than ideal to go for a jog outdoors. In that case, it's still possible to get your exercise done at home with plenty of video guides on YouTube.
Dr. Hamid R
space doctor
Hi @Concerned , I assume you are referring to Corona virus on this!

I would say excessive thirst alone has a broad number of possible diagnosis though the most common is just lack of hydration. In isolation I wouldn't say that it is related to COVID especially if it has been happening for a long period of time (2-3 months). A sore or dry throat itself can also cause "thirst" but this would not be classified as "true excessive thirst" or what we term as polydypsia. Would be good to see your GP if it has been happening in isolation for a long period of time. 

Hope this helps! 
Dr. Adnaan S
space doctor
Hi @RAS the average number of days can vary based on the test being used and clinical factors associated with the patient. Therefore the advice for testing is tailored to each individual case by the attending doctor.

Currently, the virus has entered community spread and there are reports of patients with re-infections. Therefore, it is certainly possible to get a negative test and then positive again depending on this and abovementioned factors surrounding performance of the test.

Ultimately, due to the large number of variables involved, the best way to manage risk in this situation are strict social distancing and hygiene measures just in case of any infection (unresolved or recurrent), particularly to protect vulnerable individuals such as the elderly and those with pre-existing conditions like lung diseases.
Dr. Dinesh G
space doctor
Hi @Aicrop thank you for the question! Im delighted to hear that your kids have cultivated such an excellent hobby. Yes, it is absolutely safe to borrow and read books during this time. In fact, it is recommended to do so along with physical activity outdoors, given that everyone is getting on the #stayhomestaysafe bandwagon (studies have shown our kids in Singapore get too much screen time).

To keep them safe, just continue to observe and guide your kids on MOH’s general advice as follows;
1) social distancing (eg when in the library)
2) avoid touching the face
3) wash hands thoroughly after leavig common areas, upon reaching home and before eating meals

Hope this helps😊
Dr. Dinesh G
space doctor
Hi @Ew thank you for the question! As a general rule of thumb, a temperature more than 37.5 is considered a fever. Some variation may be due to calibration settings, although this crisis has also exposed errors and fundamental flaws in some non-contact thermometers sold online that consistently produce inaccurate readings. 

Use the “probe” type thermometers for a measurement of oral or armpit temperature, which you can purchase from established brands such as Guardian.

That being said, fever is a natural response of the immune system to any trigger of inflammation. If you feel unwell, with or without a measured temperature, and especially if you developed other symptoms, don’t hesitate to review with a medical professional to get personalised advice. Hope this helps!
Dr. Dinesh G
space doctor
My short answer is yes however it is because it is able to capture droplets from the wearer and restrict you from touching your face. Cloth mask typically does not fit well and may be less breathable than a surgical mask.

If you want to know more, refer to the link below.
https://smartairfilters.com/en/blog/best-materials-make-diy-face-mask-virus/
@Bock_Keat
Hi @_yt . Thanks for your question! 

Other than medication, for such a condition, the best way to resolve it would be to remove the offending agent. 

We see many patients with persistent symptoms which are usually attributed to dust/cold air. Occasionally, it can be related to certain foods which trigger the condition. It is important to figure out for yourself what is causing triggering your symptoms. Patients often overlook locations/objects that can retain dust. Such examples include air conditioner unit/stuffed animals/carpets. 

In terms of medication, you may want to try nasal sprays such as avamys/nasonex/oxynase which can help relieve symptoms. Though I would suggest trying to remove the offending agent where possible as medications are only temporizing. 

Though, if you develop fever/purulent nasal discharge (appears very thick and foul smelling)/significant facial pain or headaches, these could be signs suggesting you are having an episode of sinusitis. These occasionally require antibiotics and I would advise you to see a GP if it occurs. People with sensitive nose or "allergic rhinitis", are more predisposed to such infections. 

Hope this helps! 
Dr. Adnaan S
space doctor
hi @Sue . Thank you for your question!

I would say that you should visit a doctor again if it has persisted for 2 weeks. There are other causes (other than infection) that can cause throat inflammation such as reflux disease, environmental factors such as irritants and physio-chemical factors such as shouting/smoking/snoring. 

Given the current situation I would advise you to review to see if there is any need for you to be referred for further testing especially if it is not common for your to have such long periods of throat inflammation. It would also be good for you to monitor your diet and intake and see if anything causes it to worsen such as spicy/hot/acidic foods. 

Hope this helps!
Dr. Adnaan S
space doctor
Hi @malfrands unfortunately this indicates that your infection is persisting after the 5 days of rest and MC. 

In the current situation, you will need to have a physical review with the GP that issued the MC, in order to have an assessment including examination of your lungs etc to determine what is happening.

In order to protect those at home and around you, please wear a mask as well as call the clinic to let them know that you are returning for a review so that they can prepare their clinic room accordingly👌🏻
Dr. Dinesh G
space doctor
hi @AM . Thank you for your question!

Neck pain and headaches can be due to a variety of causes and they can be interlinked as well as what we refer to as a "cervicogenic headache" which might be what you are suffering from. 

You may want to have a trial of anti-inflammatories such as brufen or neurofen and muscles relaxants such as anarex. 

I would say that if it is disrupting your life, the pain is worsening and/or you develop any form of neurology such as weakness/numbness/imbalance/blurring vision you should visit your GP for a review. More often than not, the cause is likely due to either some form of physical activity or poor sleeping/sitting posture (in your age group). 

Hope this helps!
Dr. Adnaan S
space doctor
Hi @Na . Thank you for your question!

At present it would be difficult to say as to whether you could have COVID or not. Most of the time, suspicion is still based of contact history and patients travel history (in sg and overseas). If you feel you have been to any high risk areas or noted that there were people around you that were unwell, you should go to see a GP for a review again especially if the symptoms are worsening rather than improving. 

As patients presenting with COVID have a wide variety of symptoms which could be as simple as running nose, it is often difficult to tell based on symptoms alone. Having said that, there are some symptoms that have been present in more COVID patients compared to the seasonal flu which include  high fever with sudden onset of symptoms, loss of smell, difficulty breathing and chest pain. 

If it helps to reassure you, most cases are linked to clear clusters and if you have only been going to work/home and travel by private transport, I would say you risk is lower than the average person. 

Hope this helps! 
Dr. Adnaan S
space doctor