Five questions to our respiratory specialist about COVID-19

A/Prof Janet Rimmer, one of the Clinic’s respiratory specialists, gives us an overview of how Coronavirus can affect our lungs and what she recommends to deal with this crisis.

Can you start by describing how COVID-19 affects our respiratory system?

The most common symptoms of COVID-19 are upper respiratory tract infections: typically, cough, sore throat or a runny nose. In some cases, the infection can progress in the second week to pneumonia. This is where serious complications start. 
Pneumonia causes an inflammation of tiny air sacs inside our lungs, called alveoli. When we breathe, oxygen is processed through these sacs and delivered to our blood vessels; with pneumonia, the alveoli are clogged with pus and fluid, which prevents oxygen from getting through.  If patients experience considerable difficulty in breathing, they may be provided oxygen delivered via a mask or tubes in the nose. Those who are more severely ill can develop respiratory failure and acute respiratory distress syndrome (ARDS), in which case they will need a ventilator to help them breathe. When the disease reaches that stage, death rates are unfortunately high. According to the Therapeutic Goods Administration (TGA), 17% of confirmed cases develop severe COVID-19 with ARDS, 4% requiring mechanical ventilation.

Who is more likely to get complications?

Complications are more likely to occur in patients with risk factors. The first risk factor is age, with people over 60 considered more vulnerable, and the second is existing medical conditions – amongst others, respiratory issues. Because COVID-19 targets the lungs, people with asthma, COPD (Chronic Obstructive Pulmonary Disease), and other lung diseases are more likely to develop severe symptoms, since their lungs are already inflamed or damaged. This is also the reason why smokers are more at risk.

What do you recommend to people with an underlying lung disease and family member or carer?

It boils down to one key objective: taking extra care to reduce the risk of Coronavirus infection. It is equally important for the family member or carer, because it is their responsibility to protect the vulnerable person under their care. 
In practical terms, here are my top seven recommendations for limiting risks of infection and dealing with this extraordinary crisis:

7 tips for people with lung disease during COVID19


All those precautions are tough. It is even harder for the elderly who are not always tech-savvy, or don’t have the internet. Some elderly may have hearing problems, which means the phone may not even be an option to connect with the outside world. But, as I remind my patients, right now everyone needs to focus on their health above all else.

Why can’t we treat COVID-19 pneumonia like a common pneumonia?

While bacterial pneumonia can usually be treated with antibiotics, COVID-19 pneumonia is viral, and unfortunately, anti-viral drugs have not been effective. Although several treatment options are being trialled, for now, treatment is supportive care.

The other major difference is that pneumonia traditionally affects one section of one lung, while COVID-19 pneumonia affects both lungs.

How have you adjusted your life to the public health measures?

In my professional life, I have adopted telehealth. In my personal life, I have set up Zoom for my book club!