Dr Sarah Buckley

Covid-19 virus: Q&A for expectant families (Part 1)

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(Published April 2 2020, most recently updated 10 June

These are certainly intense times for all of us worldwide, with the Covid-19 pandemic.

I send my love and prayers to each and every one of you, wherever you are globally: mothers, babies, fathers, partners, children, families and all who care for them. May you, your loved ones and communities stay safe.

This new virus brings many implications and new situations for us all. Here is some basic information and some responses to your questions, as well as useful links. 

Please note that much is still unknown, as the spread has been so fast that there has not yet been time to perform studies. Healthcare systems are making the best decisions and policies they can, in the absence of good evidence, to protect birthing women, families and their front-line staff, who are very much as risk.

A special thank you to all who are working with birthing families in clinics, hospitals and homes right now.

Also, this situation is evolving rapidly, and information and policies are also likely to change. I will keep these updated with new information as far as possible. 

Note that I am trained as a GP (family physician) and not an obstetrician or public health physician, although I have some public health training. I am providing general information for you to take into account in your decision-making. At this time, there may not be certainty or simple answers, or one right thing to do, even in the most simple areas. (A bit like parenting!) 

Update- see my webinar for expectant families! Covid-19 Virus: Your hormones are your helpers

Q: Should I be worried about this virus? 

The SARS-COV-2 virus is a type of coronavirus that can cause COVID-19 illness. This is a new infection that humans have not encountered before, therefore none of us have immunity. In addition, it seems to be able to spread more widely than other cold or influenza viruses.

For example, just one infected person could pass the virus to more than 400 people within a month, unless they take precautions. (More info) These factors mean that many people will eventually be exposed to this virus. 

It is important that we all take this seriously. Each of us must take precautions to reduce the spread, including washing hands, avoiding close physical contact and staying home. See World Health Organisation (WHO) recommendations, and also your own local recommendations. This will help to keep you and your family safe as well.  

Sign up to my newsletter to get notified for Part 2: Covid-19 Q&A for labour and birth

Q: Am I at risk of catching Covid-19?

This depends on your situation. You are more likely to catch Covid-19 if you have had contact with someone infected with the virus, or with someone who has had contact with an infected person. 

Generally, this means close contact e.g. having a face-to-face conversation for 15 minutes or more, or being in the same space for more than 2 hours Those who have been travelled internationally recently, including on planes and cruise ships, and their close contacts are also at greater risk. 

You are also at greater risk if there is more community infection and spread in your area- more good reasons to stay home, as far as possible! 

Spread within the community also means that people working with the public are at higher risk. Health care workers on the front lines treating infected people are at high risk and require effective personal protective equipment (PPE- gowns, gloves and masks) to work safely.

Q: What are the symptoms?

The main symptoms of Covid-19 are 

  • fever (88% of infected people have fever)
  • dry cough (68%)
  • fatigue (38%) 
  • short of breath (19%) 

New research suggests that loss of smell and taste are also very common. More info Many people will have only mild flu-like symptoms, but others may not have symptoms at all, especially if young and healthy. More info 

See this comparison of Covid-19 symptoms vs common cold or flu. If you are in doubt, phone your local or national hotline for advice (see below) and whether to have a test. 

If there is any possibility that you are infected, please avoid contact with others and take stringent protection measures (quarantine) for 14 days or until you have a negative test.  See CDC recommendations

Q: How will Covid-19 affect me and my family? 

According to the best information so far, based on experiences in China and other countries, around 80% of people who contract Covid-19 will have a mild flu-like illness, with a sore throat, fever and dry cough.

Around 20% will have a more severe illness, where the virus goes on to infect the lungs and causes pneumonia. This usually happens 5-7 days after first symptoms and likely requires hospital treatment and support, although there are no specific drugs to treat or cure this virus right now. 

Around 6% (based on worldwide figures) will become severely ill, requiring intensive care and even a machine (ventilator) to help them breathe. Between 1- 4% of infected people may die from the disease, according to current figures. Older people (over 65-70) and those with pre-existing illnesses are more vulnerable.

It seems that children under 18 are much more likely to have a mild illness, or even have no symptoms. Many younger healthy adults may also have no symptoms. However these populations may also transit the virus to more vulnerable people. There is much that remains poorly understood in relation to asymptomatic infections.

Q: How can I protect myself and my family?

Covid-19 is spread by the secretions from the respiratory tract of infected people- nose, throat, breathing passages and lungs. When people cough or sneeze, these secretions go into the air as droplets, which can travel 1-2 m (3-6 feet). For this reason, ‘social distancing’ rules are designed to keep people 1.5-2m (5-6 feet) apart.

If an infected person touches their mouth or nose, or coughs into their hands, and then touches another person, especially if that contact then touches their face, the virus could get into their respiratory tract and spread the infection

In addition, the virus can stay alive on some surfaces for hours to days, at least in theory. (More info) If an uninfected person touches a surface that has been contaminated by someone with the virus, and then touches their face, the virus could cause infection. Because of this risk, it is recommended that we all wash our hands frequently and especially avoid touching our faces when out in public.  

It is safest to presume that anyone you meet could be infected, especially because people can be contagious before they develop symptoms, and because some people will have very mild or no symptoms. 

In summary 

  • Keep a safe distance from others 
  • Avoid touching surfaces when out in public as far as possible
  • Wash hands frequently : see this video for effective technique 
  • Stay home as far as possible 

Q: Help! I’m pregnant! 

Update- see my webinar for expectant families! Covid-19 Virus: Your hormones are your helpers

Covid-19 does not seem to cause more severe illness in pregnant women compared to the general population and does not seem (from what we know so far) to cross from mother to baby during pregnancy, also called ‘vertical transmission.’ The virus has not been found in breastmilk. 

It is still possible that an infected mother could pass the virus to her breastfeeding baby, but the evidence so far has found that babies and young children are much more likely to have a mild illness, compared to adults, or even have no symptoms.

However, there are many implications for your care in pregnancy. Because of the increasing spread, it is sensible to keep healthy pregnant women away from risky places such as hospitals and clinics. Therefore, many care-providers are moving to tele-health appointments, where you talk by phone or computer and have simple tests done by yourself (eg taking your own blood pressure or having your own urine dip-sticks ) or your pharmacist.

There are many more questions, and uncertain information, in relation to labour and birth, whether or not you are personally at risk or infected with Covid-19. Also see below for some resources

Sign up to my newsletter to get notified for Part 2: Covid-19 Q&A for labour and birth

Q: What about breastfeeding?

Breastfeeding is very beneficial to our babies’ immune systems. In general, a breastfeeding mother passes immune factors (antibodies) through breastmilk that protect her baby from diseases that mother or baby encounter. More info 

Continuing breastfeeding is recommended, even if mother or baby develop Covid-19 illness. The World Health Organisation recommends that infected breastfeeding mothers take some precautions;

  • Practice respiratory hygiene during feeding, wearing a mask where available; 
  • Wash hands before and after touching the baby;
  • Routinely clean and disinfect surfaces they have touched

More links and resources for breastfeeding below

Q: How do I take care of myself and my children, while they are off school?

In many places, schools are closing, and parents may also choose to keep children home to reduce their chance of catching and spreading this virus, including to grandparents and other vulnerable loved ones.

At the same time, offices are closing and many parents are now working from home. How can we educate our children- or at least, keep them out of trouble!- and fulfil out own responsibilities?

Educating your children can seem like a huge task. A reassuring personal note here: I have had a variety of educational experiences, including home-schooling, with my 4 children who are now happy healthy well educated adults! I personally chose a relaxed, unstructured approach (structure can be great in some families!) and allowed my children to follow their interests, including time for play, friends (perhaps on Skype right now!) and some computer/TV times too. 

In relation to activities, there are learning opportunities everywhere, from what you eat for breakfast to why the sky is blue. As one wise Mama advised “provide a rich environment, involve children in everyday living, and help find answers to their questions.” I learned a lot from our home-schooling years too! 

Here are some resources and info to start you off

Update- see my webinar for expectant families! Covid-19 Virus: Your hormones are your helpers

Sign up to my newsletter to get notified for Part 2: Covid-19 Q&A for labour and birth

Resources:

Official COVID-19 sites -updated regularly

General COVID-19 information

COVID-19 for pregnancy, labour, birth and breastfeeding

World Health Organisation on pregnancy labour and birth

Evidence-based birth —summaries and great resources

Great guidelines from Queensland Health (Australia)

CDC –Coronavirus and pregnancy (includes breastfeeding and infant care)

Canadian recommendations for pregnancy birth and infant care

Info hub for pregnancy and Covid-19 here

Professional statements-

Breastfeeding organisations- see also above

La Leche League multi-language updated statements resources and links

Australian Breastfeeding Association (ABA) statement

Free online breastfeeding resources from Lactation Ireland

Covid-19 research and interesting studies