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Covid-19: a puzzle with many missing pieces

BMJ 2020; 368 doi: https://doi.org/10.1136/bmj.m627 (Published 19 February 2020) Cite this as: BMJ 2020;368:m627

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Clinical findings in a group of patients infected with the 2019 novel coronavirus (SARS-Cov-2)

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Re: Covid-19: a puzzle with many missing pieces

Dear Editor

May I please add a couple of points to my Response of 1 March?

Let us look back at smallpox and at polio. Only half a century ago, though I appreciate that neither the general public, nor any of our public health experts active today have personal knowledge of those days.
“We“ in England were used to the news of smallpox in the wide world. And when, in 1962, smallpox appeared in Bradford and was carried (innocently) to Wales, we in the rest of the country went about public health containment measures without hysteria.

Working as an SHO in a Midlands hospital, I and my colleagues went about vaccinating one another without hesitation. Fortunately the disease did not come our way.

And “acute anterior poliomyelitis”. It had long been believed that the virus was present in the nasal secretions. So, when a case occurred and the public were advised to avoid congregating - they listened.
They also listened when advised to avoid swimming pools. Anybody who has ever swum knows that the swimmers will inevitably be gulping, accidentally, some water and will be blowing it out. And of course if you have the virus in your mouth or nasal cavities, you WILL be blowing the virus out. It will be inhaled by fellow swimmers.

Now this Corona Virus: it is present in the respiratory passages and you may not feel ill enough to avoid swimming. But logic dictates that the clinical epidemiologists, the public health experts, the Chief Medical,Officer, should advise the public to avoid swimming pools. For the present.

Perhaps someone will care to advise to the contrary?

Competing interests: No competing interests

11 March 2020
JK Anand
Retired doctor
Free spirit
Peterborough