Is smoking in public allowed since mask-wearing is now mandatory everywhere? - Andrew Tonna

Smoking leads to disease and disability and harms nearly every organ of the body. Hence, it is a health hazard and people are advised not to smoke. Smoking any kind of tobacco reduces lung capacity and increases the risk of many respiratory infections including severity. Smoking impairs lung function, making it more difficulty to overcome coronaviruses and other respiratory diseases. Available research suggests that smokers are at higher risk of developing severe COVID-19 outcomes and death.

In addition, second-hand smoke causes stroke, lung cancer and coronary heart disease in adults. Children who are exposed to second-hand smoke are at increased risk for sudden infant death syndrome, acute respiratory infections, middle ear disease, more severe asthma, respiratory symptoms and slowed lung growth. So smoking near each other will affect the health of those around you.

If people still decide to smoke in locations where smoking legislation allows, one can temporarily remove the mask until a cigarette is lighted although, as health authorities, we always advice people to stop smoking and also provide support services for people to quit.  

What happens if someone gets the flu and COVID-19 at the same time? Can the health authorities tell the difference with just the swab test? - Michael Mizzi

COVID-19, influenza and other common respiratory infections can cause similar symptoms. They are present as a wide range of illnesses from asymptomatic or mild through to severe disease and death. The symptoms include fever, chills, cough, difficulty breathing, fatigue, body aches, headache, sore throat, runny nose, nausea, vomiting and diarrhoea. Testing is the only way to correctly identify the pathogens causing these symptoms.

These viruses are transmitted by contact, droplets and fomites. As a result, the same public health measures, such as hand hygiene and good respiratory etiquette (coughing into your elbow or into a tissue and immediately disposing of it), using a mask and physical distancing, are important actions all can take to prevent infection. 

Can medical professionals (physios, dentists etc.) refuse to treat patients who have been positive in the past but have now recovered? - Rochelle Borg

Evidence shows that it is safe to release positive patients from isolation based on clinical criteria that require a minimum time in isolation of 14 days. Hence, the risk of transmission after recovery is such that people can go out in the community and attend to their usual needs.

Can employers ask their workers to present a negative swab test if they call in sick to work for a few days because of illnesses unrelated to COVID-19? - Amanda Cini

One needs to remember that a negative result does not rule out COVID-19 and should not be used as the sole basis for treatment or patient management decisions. The requirement for testing should come from the caring physician.

All employees should stay home if they are sick until at least 24 hours after their fever and other symptoms are gone. If employees have symptoms upon arrival to work or become ill during the day, they should promptly separate themselves from other workers and go home.

How many people have now contracted the virus twice? How are they the second time around? - Charlene Grech

A few cases have retested positive after having  recovered. However, the actual cases with suspected or possible reinfection with SARS-CoV-2 recently reported in different countries have been few. In many of these cases, it is uncertain whether the individual’s polymerase chain reaction (PCR) test remained positive for a long period of time following the first episode of infection or whether it represents a true reinfection.

In order to differentiate cases that are SARS-CoV-2 RNA positive over longer periods of time, possibly with prolonged viral shedding, from cases with a true reinfection, epidemiological and virological information from each infection episode need to be assessed thoroughly.

Have any questions to ask the superintendent? Send an e-mail to askcharmaine@timesofmalta.com.