FAMILY doctor Jane Wilcock from Harwood explains why physical distancing is important, how access to GP surgeries has changed ­— and the less common symptoms of Covid-19 as she helps to keep people informed in a series of occasional articles for The Bolton News during the coronavirus pandemic.

WE are almost in "lockdown" but have liberty to walk, cycle, jog to keep fit once a day.

The Government has asked us ­— with a few exceptions like essential workers to seeing vulnerable people for care ­— to only go out to exercise, once a day and to shop less frequently.

We ramped up hygiene, washing hands on entry to house, car, public spaces, wiping down door handles etc visiting others less, we undertook some physical distancing but not enough

We should be social but physically distant, keep mentally in touch with each other and optimise our health.

On March 13, the UK had 10 coronavirus deaths, now there are more than 1,000.

These are not people who would have died anyway, these are excess coronavirus- related deaths.

Coughs and sneezes travel at 10 -100mph and travel up to six foot, so spreading infection, and coronavirus also lives on surfaces for up to three days.

The explanation for physical distancing is that people are infectious before symptoms occur and afterwards for seven days. Some people never get symptoms but still spread it about, most people get mild to moderate symptoms and 15 per cent need hospital admission, usually Covid-19 affecting their lungs.

An epidemiologist, Adam Kucharski states:"Early in the outbreak, each Covid-19 case infects 2.5 other people on average. There is about five days between one infection and the next, so we expect one case to lead to 244 more cases in 30 days. If we can halve transmission, so each case infects 1.25 others instead, we'd expect four more cases."

That’s a massive reduction from one infected person, and as none of us is certain who is incubating the illness, we must all cut down physical contact.

Don’t be despondent if little happens initially, those in hospital are already ill and those who caught the virus today may not be admitted for three weeks, if they become ill, because they are incubating for up to two weeks. We hope to see a reduction in acceleration of new cases in 2-3 weeks.

There are also people diagnosed with Covid-19 who are isolating indoors and not going to the shops at all for seven days so that they do not touch, sneeze or cough over other people and their items. Their household members have to self- isolate for 14 days, as this is the time Covid-19 might incubate.

If they too get symptoms, they are isolating for a further seven days, even if that means they are isolating over the 14 days as new cases are infectious for seven days after symptoms start.

Information can be found on NHS coronavirus self isolating at

Symptoms of Covid-19

How do you know if you have Covid-19 when not being tested?

Be thoughtful as some people have a chronic cough, it is normal for them, and they have not got Covid-19.

There are four definitions of Covid-19 in my view, but only two are official.

The first official definition is: those needing admission due to pneumonia or due to respiratory distress syndrome or due to severe influenza like illness ­— fever of 37.8°C or higher and at least one of acute onset: persistent cough, hoarseness, nasal discharge or congestion, shortness of breath, sore throat, wheezing, sneezing.

The second official group is: cases who can stay at home with new continuous cough and/or a high temperature. They should self -isolate, also the household. The NHS coronavirus site online discusses these symptoms.

In typical Covid-19 symptoms are: fever occurred in 88 per cent, dry cough in 68 per cent, cough with sputum ­— mucus ­— in 34 per cent, breathlessness in 19 per cent, aching in 15 per cent, chills in 11 per cent.

The third group are people with no symptoms and we never know they had Covid -19.

The fourth is a group of symptoms seen uncommonly but reported in the medical literature in people with Covid-19.

This is not well publicised and my own advice is if anyone has these in this pandemic, that they self- isolate and don’t go shopping, their household too (as above), to reduce possible Covid-19 transmission. Symptoms are: lack or absence of sense of smell.

In South Korea 30 per cent of cases testing Covid-19 positive said lack of smell was their major presenting symptom in otherwise mild cases, and some people had no other symptoms.

Chest tightness or discomfort. Nausea and/or diarrhoea ­— also some reports of diarrhoea before cough and fever.

Covid-19 may cause eye symptoms, including dislike of the light, irritation, conjunctival redness and watery discharge.

Incidence of conjunctivitis is one to three per cent. Other symptoms are nasal congestion, headache, sore throat, fatigue, coughing blood, and rarely tonsil swelling, enlarged lymph nodes and rash. It seems upper airways irritation may be a feature for some people.

From these symptoms it is clear a lot of viral symptoms might be Covid-19, my view is to really get levels down in Bolton we should take all viral symptoms seriously and assume they are Covid-19 to prevent spread.

General Practice access

To get help with new onset temperature and cough go online to NHS coronavirus at and you may be directed to phone NHS111 for advice.

If diagnosed as Covid-19 and managing at home yourself, be aware that mild symptoms can deteriorate and you should phone NHS111 again.

Most people can manage with rest at home.

If at any time your symptoms are worrying and you cant get help, general practice is still there so phone in. Do not attend the practice, we are trying to cut down spread of coronavirus by using phones and video first if at all possible.

We will still see and examine patients if necessary, we are reorganising our clinics to ‘clean’ areas to protect the public but we are still open for business if needed.

For minor health problems or information go to NHS home: then to A-Z of conditions and see if you can self- manage.

If still worried phone in. Check we have your correct phone number, preferably if you have one, your mobile number. You may have to wait for the doctor or nurse to phone back, but your home is the waiting room, not our general practice now.

We are also moving prescribing to electronic means so you don’t have to visit the practice. You can attend the pharmacist or have the pharmacy deliver your medications, so select a pharmacist and let the general practice know. This cuts down delay and contact in crowded places for you.

Keep your bugs to yourself, keep other’s bugs to them. Look out for each other, without physically contacting, outside of your household. It can be a worrying time but remember we are all being careful so that cases are the lowest possible whilst we await a treatment and vaccine.