#AskDrH: Dr Hilary answers your coronavirus questions
"Germany have seen their R number increase, is the same likely to happen in the UK?"
Dr Hilary says: "We are not even over this first peak yet, we are in a plateau but that plateau isn't diminishing that quickly and there's no room for complacency. We've seen these outbreaks in China again and Germany - which was heralded as one of the best countries dealing with the virus - Australia has seen a big outbreak and then we are seeing some outbreaks in minor hotspots which puts the R rate up.
"That is what worries a lot of people. I look around and I see people totally ignoring the 2m rule as it exists at the moment. People are forgetting that when they are with the people that they know and love and trust there is no social distancing effectively. I wouldn't be surprised if we see that plateau continue for some time. We are going to be living with this virus for some time until we get a vaccine and that is not on the horizon.
Dr Hilary says: "We desperately need surgeries to open up and GPs need PPE to do this. GPs are doing this and if you get through the telephone triage you will be able to see your GP and that will happen more and more.
"Some people have been using steam inhalations to try to reduce the risk of contracting Covid-19 and as a result burns units have been seeing an increased number of cases of children who've been scolded by boiling water. So a piece of caution there, if you want to use steam inhalation, there's no evidence that it helps, but if you are doing that for any reason then keep your children well away from boiling water."
"Is it safe for children to return to school now?"
Dr Hilary says: "If you look at the age groups, the risk of anyone dying of coronavirus between the age of 5-14 is much less than being struck by lightning, about 1/3.5million, it's a tiny risk. So tiny that professors that study the specialty of risk say we should not be depriving children of their education.
"If you look at the experience of other countries, one of the reasons other countries have been confident about schools reopening is because if you look at the data the risk to teachers is very small. Children are not transmitting the virus significantly to teachers."
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"What is Kawasaki syndrome and what is the apparent possible link with Covid-19?"
Dr. Hilary: "Kawasaki disease has always been around. It's a rare condition affecting about eight in a hundred thousand children. The cause is unknown but it causes an inflammation of blood vessels. What we're seeing now is a different sort of syndrome. It's similar to Kawasaki disease and it's thought to be a delayed immune reaction to Covid-19 so the children who have had this and who have this won't necessarily test positive for Covid-19. Some do. But those that don't often have Covid-19 antibodies so they weren't acutely infected with Covid-19 but subsequently - maybe a month later - and that's why we're seeing this now we think after the peak of Covid-19 here in the UK. We're seeing a number of children with symptoms similar to Kawasaki disease and we think it's a delayed immune reaction to Covid-19."
"What are those symptoms?"
Dr Hilary: "The symptoms are a fever, a rash, sometimes tummy pain and diarrhoea, peeling skin, low blood pressure and swollen glands. These are symptoms that aren't easy to distinguish from normal infectious diseases that can cause those kinds of symptoms in children, but it's good to have a degree of suspicion that your child might have this syndrome which we're calling paediatric multisystem inflammatory syndrome or PMIS."
"Are people leaving it too late to contact 111 if they have symptoms?"
Dr. Hilary: "The answer to the question is when you call for further help is, if you're at home with symptoms of a dry new persistent cough and a high temperature for several days you hope within that seven days, or 14 days, if it takes that long that you start to feel much better and the temperature drops. Now, it didn't happen in the Prime Minister's case, he would've started to feel breathless and struggling to breathe and at that point, that's where we're asking people to contact NHS 111 online or call 111 and if necessary, if you're really finding it difficult to cope at home and breathing is becoming a real problem you call 999, that's when you do it."
"How do you switch off to sleep if you are working on the frontline?"
Dr. Hilary: "This is really tough, they're fighting it on the frontline and they're bringing their work home with them and they need to make sense out of what they have seen and experienced during the day. They are emotionally charged as well as physically drained, it's harder for them. They need to remember, if they can, to have a little bit of exercise at the right time of the day to offset those stress hormones, do some meditation, some deep muscular relaxation where you just give yourself time to lie-down relax your muscles, meditate about positive things, keep things in perspective, they will have chronic fatigue as they go through this but they'll come out the other side."
"I'm a hay fever sufferer, how am I supposed to tell the difference between coronavirus symptoms or the usual hay fever symptoms?"
Dr. Hilary: "The interesting thing about hay fever is that it doesn't give you a fever, whereas coronavirus often can. One of the cardinal symptoms to look for with coronavirus is a fever over 38 degrees and a dry persistent cough which is new, for you. So if you’ve got those two symptoms you need to self-isolate. Hay fever is coming in now people are getting a bunged up nose, that isn’t a symptom of coronavirus. So if you haven’t got the two cardinal symptoms a cough, which is new and a fever, then you carry on as normal."
"What is the evidence suggesting face coverings should be worn in enclosed public areas?"
Dr Hilary: "If you wear a face covering, like a paper mask you can buy cheaply that doesn't deprive a healthcare worker of a mask, and you have symptoms and you cough, sneeze or talk to someone close by this will catch the biggest droplets and stop them being passed on through the air to somebody else. If you are wearing one of these to protect yourself, the evidence is very slight, if any that you are going to stop any tiny droplets coming down the gaps or round the sides of the mask. There are pros and cons but for people who want to avoid coughing and sneezing, it catches the biggest droplets."
"I'm pregnant, what will the experience be like going in for appointments and then giving birth?"
Dr Hilary: "Women will have to make the sacrifice that they go into their antenatal clinic appointments alone most of the time and they will have to socially distant from other patients. Their appointments will be staggered, they will get their scans, they will get their blood tests and the reassurance that they need. Being an expectant is a concern all the time but actually those areas are kept really clear from Covid-19 parts of the hospital.
"I would like to reassure expectant mums that everything goes ahead as normal but the one thing we have to sacrifice is the luxury of having someone there with you to hold your hand through the process."
"Can I still push my neighbour to the local shop in his wheelchair? We live in the same apartment block but not the same household."
Dr. Hilary: "It's close contact of course. We don’t know the reason for the person being in a wheelchair, you have to look at whether he’s in a vulnerable or an at-risk group if he’s not in either of those there is no reason why they can’t go together to the shop. However, if he is one of those groups he should really be getting deliveries brought to him without going to the shop at all."
"I have a pregnant partner who is self-isolating for three months. Am I putting my partner and unborn baby at risk by continuing to go to work?"
Dr. Hilary: "She falls is in a vulnerable group. Not because we know that pregnant women are particularly vulnerable to this virus, in fact, there’s no great evidence to show that they are. However, as an extra precaution, because they have an unborn baby as well as themselves, it is being advised that they regard themselves as in a vulnerable group and socially isolate as much as possible. Now, for partners for people like that they can still go to work. If they haven’t got symptoms, they live in the same household they don’t need to incarcerate themselves for the duration, however long it maybe."
"I'm a royal mail worker how long can the virus stay on parcels and letters, is wearing gloves the best way to protect ourselves?"
Dr. Hilary: "Well, the virus doesn't live very long on those kinds of surfaces, cardboard apparently absorbs the virus. So, if you are handling things you should be wearing gloves and then discarding them when you finish. Washing your hands frequently and if people are having deliveries to your doorstep take the deliveries in, remove the packaging, take the food out and wash it or boil it, heat will kill the virus and then wash your hands again. If you are doing those kinds of things you are minimising your risk."
"Is it safe to have the air conditioning on in the office? Could it spread the virus?"
Dr. Hilary: "There is no evidence that the virus is airborne to the extent that it's circulating through air conditioning units. If they have got filters, hopefully, it can eradicate the virus. It all depends on the air conditioning you have got. However, it is breathing, it is people coughing, sneezing and talking within the near vicinity of you that is the real risk."
"What are the two types of tests for coronavirus?"
Dr. Hilary: "One of them is the antigen test - we are looking for the antigen, the thing in the virus itself which tells us whether you've got it now. It allows us to know who's carrying the virus so we can isolate them and keep them away from the rest of the population who would otherwise be exposed and vulnerable and we can protect doctors from those patients as well."
"The second one is the antibody test, the antibody test measures the antibodies that we make in our bodies in response to acute virus infection and those antibodies take at least ten days to be produced. We can measure those antibodies maybe two weeks after the acute infection when people have already recovered."
"If you contract the virus, are you immune from it after you recover?"
Dr. Hilary: "What we are measuring is two antibodies, one is called IGG and the other is called IGM. One happens quite quickly and the other happens quite slowly but it is detectable for six months or beyond. We want it to be detectable for as long as possible because it tells us you're immune for that period of time. We will continue to see what happens six months or a year down the line to see how long the immunity lasts."
"Does the virus thrive in certain temperatures?"
Dr. Hilary: "It's true with seasonal flu, the normal seasonal flu which tends to get better in the summer and we tend to see winter peaks. However, this virus doesn't behave like ordinary seasonal flu at all and if you look around the world this virus is just a bad in hotter countries as it is here, so we look forward and say it will get better in the summer."
"Is it true we should avoid antihistamine treatment for hay fever because of the way it affects our immune system?"
Dr. Hilary: "First of all when people get hay fever it's true that the immune system is overactive and produces symptoms such as a runny nose and a sore throat. However, it's a different kind of immunity it's the IGE antibody which is affected in hay fever, not IGG and IGM which is the responsible antibodies when you are fighting the virus. So, you can carry on taking your antihistamines without worrying that this is making you susceptible to the virus. What you do need to do with hay fever is to avoid sneezing especially if you carry the virus because it can transmit it through droplets, so sneeze or cough into your elbow and use tissues and wash your hands."
Tune in to Good Morning Britain from Monday to Friday at 6am on ITV for the latest advice from Dr Hilary.
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