Coronavirus (635) Loss of taste and smell as early symptom and correct physical distance

20 May, 2020

I'm helping Bangladeshi colleagues provide guidance for primary care private practice about reopening. I've advised them to consider the UK not WHO guidance in two respects - what do others think?

This week the UK government added loss of taste and smell as one of the three main symptoms based on the evidence that loss of taste and smell may be one of the earlier symptoms (rather than fever). https://www.gov.uk/government/news/statement-from-the-uk-chief-medical-o... On the WHO list it is "less common" https://www.who.int/health-topics/coronavirus#tab=tab_3 I've suggested to my colleagues they specifically list it as an early symptom.

I've been trying to find the reasons behind the differences in guidance on the distance for physical distancing indoors between people (for when there needs to be a face to face consultation as the only option). UK is 2m, Australia and US 1.5m, Taiwan is 1m outdoors and 1.5m indoors and 1m if wearing a mask https://www.cdc.gov.tw/En/Bulletin/Detail/kM0jm-IqLwNBeT6chKk_wg?typeid=158, the WHO is 1m and therefore many countries is 1m. This was about the best I could find https://medicalxpress.com/news/2020-03-coronavirus-meters.html. So, I'm suggesting "A minimum of 1m" and more if possible, and agreeing with their views that they supply masks to patients and consider a plastic sheet between the patient and clinician (and handwashing etc). Length of consultation matters too.

Implementation will depend on what the practices can achieve of course, but does anyone have different guidance?

Thanks

Siân

HIFA profile: Sian Williams is Executive Officer at the International Primary Care Respiratory Group in the UK. Professional interests: Implementation science, NCDs, primary care, respiratory health, education, evaluation, value, breaking down silos. sian.health AT gmail.com