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As the official U.S. death toll from COVID-19 passed 10,000, Surgeon General Jerome Adams warned that Americans should brace for the hardest and saddest week of their lives. During a press appearance over the weekend, he called the coming days our Pearl Harbor moment, our 9/11 moment. Inside New Yorkarea hospitals, the prospects match his grim tone. In addition to struggling with widely-reported supply shortages, working seemingly endless shifts, and struggling to manage the influx of patients, infectious disease experts say that even as theyre racing to develop an effective vaccine, they are essentially learning on the job.

The infection itself does have some perplexing features, said Dr. Megan Coffee, a clinical assistant professor at the NYU Grossman School of Medicine specializing in infectious diseases and immunology, who coauthored a study about an experimental A.I. tool that predicts which patients with the virus will develop a serious respiratory illness. She listed just a few of the many unanswered questions: We dont yet know what we can do to prevent this immunologic response. We also dont fully understand why some, who are healthy, go on to have severe disease and others, with more risk, do not.

Specific characteristics of the virus likewise remain a mystery. The pandemic of 1918was associated with bacterial as well as viral pneumonia, which does not seem to be the case with the novel coronavirus, said Dr. Joseph M. Vinetz, a professor at Yale School of Medicine who also specializes in infectious diseases. But we still dont know whether coronavirus can lead to secondary or superimposed bacterial pneumonia in addition to [causing] immune damage to the lungs, which is the primary cause of severe illness and death. This coronavirus, he said, is puzzling due to its unique combination of asymptomatic infectiousness, and the delayed onset of severe disease. Very perplexing.

Dr. Sandra Gelbard, a Manhattan-based internist who specializes in preventative medicine and one of the first doctors in New York City to begin COVID-19 testing, described the current epidemic as way, way more concerning than the first two coronavirusesSARS and MERSwhich is surprising because the first two were more lethal. But those viruses were contained. With this novel coronavirus, 25 to 50% walk around without symptoms. It is the right combination of lethality and transmissibility. This makes this virus a real global threat.

Dr. Coffee concurred. This is the disease weve always feared as infectious disease doctorsa respiratory-borne virus that spreads easily person-to-person, but with a high mortality, she said. Those of us who have worked on Ebola and other crises have feared for a while [that] this would be worse than anything we have ever seen.

The results, said Dr. Gelbard, could be more devastating than current predictions suggest. If we did intense social isolation like they did in China and South Korea, the number might have been around [100,000 deaths], but we missed the boat on that, she said. I dont expect it to be 100,000 to 200,000 people dead. It could easily be 1 million.

She added, we really dont know the mortality of this virus. Were assuming at best its somewhere around the 1% mark. We cant know at this point. No one knows.

Meanwhile, as it spreads, the virus is changing. The issue is that [it] is mutating, said a New York Citybased doctor treating COVID-19 patients. We cannot predict what strain it will mutate to, and in some populations strains may be more virulent than others, so all we can do is prepare for the worst. She added, Its scary because it is a disease that is ever-evolving. Just when we think we have figured out the pathophysiology of the disease process and how to manage it effectively, we realize there is a new loophole or nuance that the disease presents us with.

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Worse Than Anything Weve Ever Seen: Frontline Doctors Race to Learn the Mysteries of a Deadly Virus - Vanity Fair

A newly hatched study out of China, so raw that its not yet been peer-reviewed, has some disturbing news for cat lovers.

Our furry feline friends appear to be susceptible to catching COVID-19, the disease caused by the coronavirus called SARS-CoV-2. Even worse, the cats in the study were able to infect each other, although they showed no signs of illness.

Ferrets were also able to catch the virus, although it didnt appear to harm them. Dogs, on the other hand, were not susceptible, according to the study. The virus showed up in the feces of five dogs, but no infectious virus was found. Pigs, chickens and ducks were also not very hospitable places for the virus.

But theres no need for cat or ferret lovers to panic, experts say. Theres no evidence their pets could get very sick or die from the novel coronavirus.

Yes, people should embrace their pets. These researchers squirted the virus down the cats nose in high concentration, which is pretty artificial, said Dr. John Williams, chief of the division of pediatric infectious diseases at the University of Pittsburgh Medical Center Childrens Hospital of Pittsburgh.

The lab experiment used a scenario that is completely unrealistic, experts say. First, researchers forced extremely high doses of virus up the nostrils of five 8-month-old domesticated cats.

Cats in our homes or even in the wild would never be exposed to that level of virus.

Thats a whole lot more than an average human would get, said infectious disease expert Dr. William Schaffner, a professor of preventative medicine and infectious disease at Vanderbilt University School of Medicine in Nashville.

So this is an artificial circumstance and we dont know that it happens in nature at all, Schaffner added.

Two of the five cats were euthanized six days later. Researchers found virus particles in their upper respiratory systems.

The remaining three infected cats were put into a cage adjacent to three non-infected cats. One of those three cats later tested positive for the virus, while the other two did not. Still, the researchers felt that showed the virus could be transmitted via respiratory drops.

Or did it? None of the infected cats exhibited signs of illness. And even if they did pass the virus to each other, that doesnt mean they would be able to pass it on to humans.

Thats what happened nearly two decades ago with a sister coronavirus called SARS-CoV, which causes the deadly pneumonia-like respiratory disease called SARS.

Just like now, science found cats could be infected with SARS-CoV and infect other cats. But the virus didnt transmit widely among house cats during the 2002 to 2004 pandemic, nor were there any known cases of transmission to humans.

The study found ferrets were also efficient replicators of the virus meaning that the virus can easily grow and reproduce in their long, slinky bodies.

SARS-CoV-2 can replicate in the upper respiratory tract of ferrets for up to eight days, without causing severe disease or death, the study said. The study did not look at a longer time frame.

Thats good news for researchers looking for a way to test any future vaccines for SARS-CoV-2, also called the novel coronavirus.

Its necessary to have an animal model to do initial tests of vaccines and understand how viruses cause disease. So, this will be useful to the field, Williams said.

Its actually not surprising that ferrets appear to respond to the novel coronavirus. A ferrets lung and airways are strikingly similar to a humans. In fact, biologically and physiologically ferrets are more similar to humans than they are to a mouse or rat.

Ferrets are classical animals in which to study influenza its been done for decades, Schaffner said. If scientists were looking for an animal model, they would reach for the ferrets first.

Will your cat or ferret come down with coronavirus? Highly unlikely, experts say, pointing to the fact that we would certainly have heard of many cases in pets by now, considering the significant spread of the virus in the us and Europe.

Hong Kong has been quarantining animals belonging to people diagnosed with COVID-19 and have found only two cases of positive results in dogs. The dogs showed no signs of illness during the quarantine.

Rare as it may be, it appears one cat in Belgium may have gotten the virus in March from her owner, who was ill with COVID-19 after returning from a visit to Italy. But even though the cat had respiratory problems and high levels of the virus in vomit and feces, researchers arent yet sure if the cat was sick from COVID-19 or another illness.

While 2 dogs (Hong Kong) and 1 cat (Belgium) have been reported to have been infected with SARS-CoV-2, infectious disease experts and multiple international and domestic human and animal health organizations agree there is no evidence at this point to indicate that pets spread COVID-19 to other animals, including people, the American Veterinary Medical Association says on its website.

The AVMA and the us Centers for Disease Control and Prevention recommend taking normal precautions when cleaning litter boxes and feeding animals.

Out of an abundance of caution, the AVMA suggests anyone ill with COVID-19 symptoms limit contact at this time, until more information is known about the virus.

Have another member of your household take care of walking, feeding, and playing with your pet, the AVMA states. If you have a service animal or you must care for your pet, then wear a facemask; dont share food, kiss, or hug them; and wash your hands before and after any contact with them.

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Cats may get coronavirus, but it's nothing to worry about - The Philadelphia Tribune

A new trial led by the Perelman School of Medicine at the University of Pennsylvania will evaluate whether the drug hydroxychloroquine (HCQ) can benefit people infected with COVID-19, as well as whether taking the drug preventatively may help people avoid infection altogether. The study, called Prevention and Treatment of COVID-19 with HCQ (PATCH), is currently enrolling patients in three separate sub-studies (NCT04329923).

PATCH sub-study 1 will evaluate HCQ compared to placebo in infected patients who are quarantined at home. PATCH sub-study 2 will evaluate high dose compared to low dose HCQ in hospitalized patients. PATCH sub-study 3 will evealuate HCQ compared to placebo prophylactically in health care workers working with COVID-19 patients to evaluate whether it can prevent infection. Sub-studies 1 and 3 are double-blind placebo controlled studies, meaning neither the patient nor the doctor will know whether they are taking HCQ or placebo until the end of the study. Importantly, if the patient or health care worker starts getting worse, they can be unblinded, and the trial allows crossover to HCQ if the patient was assigned placebo.

We know HCQ can be an effective anti-viral in a lab setting, but despite recent public conversation, there is no definitive evidence it can work in humans infected with COVID-19. It is our hope that this trial will provide critical evidence as to whether this drug may be effective in combating the current pandemic, said the studys principal investigator Ravi K. Amaravadi, MD, an associate professor of Hematology-Oncology who has spent his career studying HCQ and related compounds.

For this trial, Amaravadi is working with a multidisciplinary team at Penn, including Benjamin S. Abella, MD, MPhil, a professor of Emergency Medicine, and Ian D. Frank, MD, associate chief of Infectious Diseases, as well as colleagues in Pathology and Laboratory Medicine, Cardiology, Statistics, and the Abramson Cancer Center.

The first sub-study of the trial will test HCQ in patients who are infected and are well enough to go home, but who need to be in quarantine. Quarantine can be prolonged for some people who have a worse case of the illness, and can impose significant economic, emotional, and psychological hardship on the patient and his or her family. Family members living with a quarantined COVID-19 patient are at high risk of getting the disease themselves. In order to be released from quarantine, they must meet certain criteria according to the Centers for Disease Control (CDC): patients must go 72 hours without a fever, see their symptoms improve, and go seven days since their symptoms first appeared. The primary goal of PATCH sub-study 1 is to find out whether the drug reduces the number of days the patient stays quarantined. Researchers were forced to overcome unique logistical hurdles, including arranging for virtual consents from patients and home delivery of HCQ doses.

The second sub-study of the trial will test HCQ in patients who are hospitalized with COVID-19 to see if it can reduce the time to discharge. Patients in this group will also be randomized into a high dose or low dose group. No one will receive a placebo. The correct dose of HCQ for treating COVID-19 is not currently known and this study will provide valuable information to answer that question. The third sub-study will test whether HCQ can work as a preventative medicine to stop infection in health care workers at risk of exposure to COVID-19. Researchers plan to enroll 200 workers in the sub-study.

The need for the third sub-study here is critical, as we try to keep the people working on the front lines of this pandemic healthy so they can continue to keep the nations health care infrastructure up and running, Abella said.

Given the rapid spread of the virus, researchers had to work quickly not only to organize the trial and get it approved from a regulatory standpoint, but also to solve practical problems. In the span of less than a month, they were able to secure funding, arrange for a donation of HCQ, and partner with a group to manufacture an appropriate placebo. The researchers say they are grateful to their partners, and also to their leadership for the support that helped it all come together.

This is an unprecedented time, and it will take unprecedented cooperation, resources, and leadership to get through it. This trial shows Penns ability to step up to meet that responsibility and investigate the scientific questions the world desperately needs to answer, said J. Larry Jameson, MD, PhD, dean of the Perelman School of Medicine.

Read this article:
Hydroxychloroquine evaluated to treat, prevent COVID-19: University of Pennsylvania trial - Outbreak News Today

(CNN) -- A newly-hatched study out of China, so raw that it's not yet been peer-reviewed, has some disturbing news for cat lovers.

Our furry feline friends appear to be susceptible to catching Covid-19, the disease caused by the coronavirus called SARS-CoV-2. Even worse, the cats in the study were able to infect each other, although they showed no signs of illness.

Ferrets were also able to "catch" the virus, although it didn't appear to harm them. Dogs, on the other hand, were not susceptible, according to the study. The virus showed up in the feces of five dogs, but no infectious virus was found. Pigs, chickens and ducks were also not very hospitable places for the virus.

But there's no need for cat or ferret lovers to panic, experts say. There's no evidence their pets could get very sick or die from the novel coroneavirus.

"Yes, people should embrace their pets. These researchers squirted the virus down the cats nose in high concentration, which is pretty artificial," said Dr. John Williams, chief of the division of pediatric infectious diseases at the University of Pittsburgh Medical Center Children's Hospital of Pittsburgh.

No realistic exposure

The lab experiment used a scenario that is completely unrealistic, experts say. First, researchers forced extremely high doses of virus up the nostrils of five 8-month-old domesticated cats.

Cats in our homes or even in the wild would never be exposed to that level of virus.

"That's a whole lot more than an average human would get," said infectious disease expert Dr. William Schaffner, a professor of preventative medicine and infectious disease at Vanderbilt University School of Medicine in Nashville.

"So this is an artificial circumstance and we don't know that it happens in nature at all," Schaffner added.

Two of the five cats were euthanized six days later. Researchers found virus particles in their upper respiratory systems.

The remaining three infected cats were put into a cage adjacent to three non-infected cats. One of those three cats later tested positive for the virus, while the other two did not. Still, the researchers felt that showed the virus could be transmitted via respiratory drops.

Or did it? None of the infected cats exhibited signs of illness. And even if they did pass the virus to each other, that doesn't mean they would be able to pass it on to humans.

That's what happened nearly two decades ago with a sister coronavirus called SARS-CoV, which causes the deadly pneumonia-like respiratory disease called SARS.

Just like now, science found cats could be infected with SARS-CoV and infect other cats. But the virus didn't transmit widely among house cats during the 2002 to 2004 pandemic, nor were there any known cases of transmission to humans.

Ferrets affected too

The study found ferrets were also "efficient" replicators of the virus -- meaning that the virus can easily grow and reproduce in their long, slinky bodies.

"SARS-CoV-2 can replicate in the upper respiratory tract of ferrets for up to eight days, without causing severe disease or death," the study said. The study did not look at a longer time frame.

That's good news for researchers looking for a way to test any future vaccines for SARS-CoV-2, also called the novel coronavirus.

"It's necessary to have an animal model to do initial tests of vaccines and understand how viruses cause disease. So, this will be useful to the field," Williams said.

It's actually not surprising that ferrets appear to respond to the novel coronavirus. A ferret's lung and airways are strikingly similar to a human's. In fact, biologically and physiologically ferrets are more similar to humans than they are to a mouse or rat.

"Ferrets are classical animals in which to study influenza -- it's been done for decades," Schaffner said. "If scientists were looking for an animal model, they would reach for the ferrets first."

What this means

Will your cat or ferret come down with coronavirus? Highly unlikely, experts say, pointing to the fact that we would certainly have heard of many cases in pets by now, considering the significant spread of the virus in the US and Europe.

Hong Kong has been quarantining animals belonging to people diagnosed with Covid-19 and have found only two cases of positive results in dogs. The dogs showed no signs of illness during the quarantine.

Rare as it may be, it appears one cat in Belgium may have gotten the virus in March from her owner, who was ill with Covid-19 after returning from a visit to Italy. But even though the cat had respiratory problems and high levels of the virus in vomit and feces, researchers aren't yet sure if the cat was sick from Covid-19 or another illness.

"While 2 dogs (Hong Kong) and 1 cat (Belgium) have been reported to have been infected with SARS-CoV-2, infectious disease experts and multiple international and domestic human and animal health organizations agree there is no evidence at this point to indicate that pets spread COVID-19 to other animals, including people," the American Veterinary Medical Association says on its website.

The AVMA and the U.S. Centers for Disease Control and Prevention recommend taking normal precautions when cleaning litter boxes and feeding animals.

"Out of an abundance of caution," the AVMA suggests anyone ill with COVID-19 symptoms limit contact at this time, "until more information is known about the virus."

Have another member of your household take care of walking, feeding, and playing with your pet, the AVMA states. If you have a service animal or you must care for your pet, then wear a facemask; dont share food, kiss, or hug them; and wash your hands before and after any contact with them.

The-CNN-Wire & 2020 Cable News Network, Inc., a WarnerMedia Company. All rights reserved.

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Study: Cats may get coronavirus, but experts say its nothing to worry about - KSAT San Antonio

During the early days of the coronavirus pandemic, the U.S. Centers for Disease Control and Prevention andWorld Health Organization made it clear that, unless you're sick or are a medical professional, you do not need to wear a face mask.

On February 29th, U.S. Surgeon General Jerome Adams tweeted:"Seriously people- STOP BUYING MASKS! They are NOT effective in preventing general public from catching #Coronavirus, but if healthcare providers can't get them to care for sick patients, it puts them and our communities at risk!"

Adams' message comes with good intentions. With COVID-19 cases soaring, doctors, nurses and other frontline health-care workers confront a severe shortage of masks and cautioning people against buying them can help offset the problem.

Butother countries have already taken aggressive measures to prevent the spread of COVID-19 by telling citizens to wear masks, even if the masksare homemade.

Last week, George Gao,director-general of the Chinese Center for Disease Control and Prevention, told ScienceMag.comthat the "big mistake in the U.S." is that people aren't wearing masks. "This virus is transmitted by droplets and close contact. Droplets play a very important role," he said. You've got to wear a mask, because when you speak, there are always droplets coming out of your mouth."

Gao has done significant research on virusesthat have fragile lipid membranes called envelopes a group that includes SARS-CoV-2 (the virus that causes COVID-19) and how they enter cells and move between species.

"Many people have asymptomatic or presymptomatic infections," he continued. "If they're wearing face masks, it can [help] prevent droplets that carry the virus from escaping and infecting others."

So far, U.S. health officials have not offered guidelines or regulations around homemade masks and since commercially made ones are almost impossible to find, your last resort is just starting making your own.

You can find a variety of mask designs online, but simple yet promising one comes from a recent study published in the medical journal Disaster Medicine and Public Health Preparedness.

Researchers analyzed 2008 studiesfrom Public Health England(which evaluated a range of household materials that, in the event of a pandemic, could be used by the general public to make masks) to create a D.I.Y. guide.

"These studies found that T-shirts and pillowcases made into a mask using the design [below] may act as a barrier against influenza, or help limit spread by a person with symptoms," according to the study's authors. "We have no data on COVID-19, but it's not unreasonable to assume similarity."

They also stressed that "the wearing of face masks will only offer limitedprotected, and should notbe considered as sufficient protection. Additional preventative measures need to be adopted."

Face mask template:

(Template and instructions C/O:Disaster Medicine and Public Health Preparedness. Click here to enlarge.)

Supplies:

Simplified version of step-by-step instructions:

Important reminders:

Most people have the basic materials tomake a mask right now. It's time to call forth the "can do" American spirit and encourage people stuck at home to start sewing.

Doing so can save existing stock for healthcare professionals as manufacturers ramp up production in the coming months. If you're healthy have any unused commercial or medical-grade masks lying around, consider donating them to local hospitals.

Instead of obsessing over ill-conceived mixed messages, let's starting viewing mask-wearing as an act of solidarity and make it the new norm (at least until this pandemic over).

Nir Eyalis a behavioral psychology expert and instructor at Stanford's Graduate School of Business. He is the author of the best-selling books"Indistractable: How to Control Your Attention and Choose Your Life"and "Hooked: How to Build Habit-Building Products" andhas written for Harvard Business Review, TIME and Psychology Today. Follow him on Twitter @NirEyal.

Check out: The best credit cards of 2020 could earn you over $1,000 in 5 years

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Why we should all start making our own face masks during coronavirusand an expert-approved guide on how - CNBC

By Dr. Hemant Gupta DaYM, BAMS and Amita Nathwani, MA

Last week, Eric Garcetti, the mayor of Los Angeles, gave the people of his city a message regarding masks: if you really must go out on the street, for whatever reason, cover your mouth and nose. This measure was given to begin the first step to protecting ones self from the virus.

As we study the impact of stopping the virus outbreak trajectory, the question remains; what can we, as ordinary citizens do to stay healthy in the midst of the exposure?

Enhancing the bodys natural defense system plays an important role in maintaining optimum health and while there is no medicine for COVID-19 as of now, taking preventive measures to boost our immunity is what is called for in these times.

Ayurvedic Medicine, a 5,000 year-old approach to health, which addresses both pathology and prevention, says it starts in the gut. Without a strong and healthy digestive system, with balanced flora and the necessary enzymes to help break down pathogens, our first line of defense is compromised.

Ayurveda has a number of immune building formulas which are recommended to support the immune system. It is important to note, however, Ayurvedas fundamental approach in using plants as medicine is that the individual person as a whole is who advocates the use of herbs instead of isolating, extracting, and administering active ingredients. Ayurveda supports the synergistic approach as opposed to the reductionist approach of each plant.

Before we get to the considerations of the intake of any formula or supplement capable of increasing immunity or fighting disease, we must stress the importance of starting with supporting a weak digestion. Without this step, the efficacy of the remedies will remain low, and the body will not be able to fully breakdown the needed nutrients.

One of the methods of diagnosis by Ayurveda is to determine its weakness by looking at the tongue. If there is a white coating or film, we recommend the following preemptive steps:

These actions over a period of a couple of days will help to increase digestion and help the body begin its ability to receive therapeutic remedies for building the immune system and fighting pathogens. Without this step, the efficacy of the remedies will remain low, and the body will not be able to fully breakdown the needed nutrients.

The second stage of building immunity is to ensure that you are avoiding all causative factors. Studies show that reducing stress through meditation, staying active, yoga and breathing exercises can significantly reduce inflammation in the body and therefore increase the bodys resistance to pathogens and disease. Healthy eating and getting an adequate amount of sleep is also imperative for the bodys natural resistance to be sustained.

In addition to the recommended CDC guidelines for minimizing exposure, Ayurveda offers help in protecting the nose, mouth or eyes, the first entry point of the COVID-19 virus. It is recommended to follow these simple procedures that can be practiced on a daily basis.

And finally, once the digestion is strong, causative factors are eliminated and preventative measures are in place, we can start recommending herbal formulas.

The classic Ayurvedic formula called Chywanprash, serves as a general tonic to increase what Ayurveda calls Ojas or immune building substance in the body. The formula is broken down into about 50 ingredients that work synergistically. Its primary ingredient is the Amla Berry, or Emblica officinalis, which supports antioxidant activity via the encouragement of collagen and elastic production. This formula is available everywhere online in Ayurvedic stores, in both a fresh and dried form, depending on the health needs of the patient.

In this way, Amla supports both the health of the outer skin and the inner skin that lines the gut, respiratory tract, and all mucus membranes of the body. Amla is also well known as a source for natural Vitamin C. Along with other immuno-modulating active plant ingredients like Ashwagandha, Guduchi and Holy Basil, this formula works synergistically to promote health.

Founding professor of John Hopkins University, Sir William Oslar said it best, Let us not treat the disease, but let us treat the patient who has the disease.

Dr. Hemant Gupta is a renowned scholar, researcher and practitioner of Ayurvedic Medicine. Along with a degree in Natural Medicine, Dr. Gupta completed his Masters in Kayachikitsa (Internal Medicine) from National Institute of Ayurveda in Jaipur.

Amita Nathwani is a practitioner and professor with a Masters in Ayurvedic Medicine. She is an adjunct faculty member with the Dr. Andrew Weil Center for Integrative Medicine and a Public Voices Fellow with the OpEd Project.

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The Ayurvedic approach to immunity and the coronavirus - Thrive Global

Dr. Steven Kalkanis, CEO of the Henry Ford Medical Group. (Photo: Courtesy of the Henry Ford Medical Group)

DETROIT According to a news release dated April 2, Henry Ford Health System will lead the first large-scale study in the United States of the effectiveness of an anti-malarial drug in preventing COVID-19 in healthcare workers and first responders who volunteer to participate.

The study of hydroxychloroquine used prophylactically could begin as early as next week, after a plea to the federal government by Detroit Mayor Michael Duggan and Metro Detroit healthcare experts.

This is going to be the first major, definitive study in healthcare workers and first responders of hydroxychloroquine as a preventative medication, said the studys organizer, Henry Ford Health Systems Dr. William W. ONeill, a world-renowned interventional cardiologist and researcher who has pioneered multiple treatments for heart disease. There has been a lot of talk about this drug, but only a small, non-blinded study in Europe. We are going to change that in Metro Detroit and produce a scientific answer to the question: Does it work?

Participation in the study is strictly on a volunteer basis. Greek-American Dr. Marcus Zervos, division head of Infectious Disease for Henry Ford Health System, will oversee this study with Dr. ONeill.

We are glad to see Henry Fords lead on this volunteer study that could help protect medical workers and first responders across southeast Michigan, Mayor Duggan said, acknowledging U.S. Food & Drug Administration Commissioner Dr. Stephen M. Hahn. I also deeply appreciate Dr. Hahns prompt support for this important effort.

Both health care workers and first responders will be enrolled at Henry Ford Hospital Detroit. Currently, there are no FDA-approved therapies to prevent or treat COVID-19. According to the U.S. Centers for Disease Control & Prevention, hydroxychloroquine (also known as hydroxychloroquine sulfate) is an FDA-approved arthritis medicine that also can be used to prevent or treat malaria. It is available in the United States by prescription only. The drug is sold under the brand name Plaquenil and it is also sold as a generic medicine. It is commonly used by patients with arthritis, lupus or other rheumatic conditions.

Metro Detroit has a history of stepping up when things get tough, said Dr. Adnan Munkarah, Henry Ford Health System Executive Vice President and Chief Clinical Officer. We have a commitment to do that right now to look at all options in a scientific way in the face of this worldwide pandemic.

The study, titled WHIP COVID-19 Study, is a 3,000+ subject look at whether the drug prevents front-line workers from contracting the virus. Once they provide a blood sample, the study subjects will receive vials with unidentified, specific pills to take over the next eight weeks: a once-a-week dose of hydroxychloroquine, a once-a-day dose, or a placebo (a pill that looks like the medication, but does not contain any medication or other active ingredients). The study medication was specially procured for this study and will not impact the supply of medication for people who already take the medication for other conditions.

Participants will not know what group they are in. They will then be contacted weekly and in person at week 4 and week 8 of the study to see if they are exhibiting any symptoms of COVID-19, including dry cough, fever or breathing issues, as well as any medication side effects. At eight weeks, they will be checked again for symptoms, medication side effects, and have blood drawn. Results will be compared among the three groups to see if the medication had any effect.

Given our broad clinical trials and translational research infrastructure, we are grateful to bring this type of large-scale effort to the COVID-19 battle, said Greek-American Dr. Steven Kalkanis, CEO, Henry Ford Medical Group and Senior Vice President and Chief Academic Officer of Henry Ford Health System. We see the heroics of the frontline responders in healthcare, public safety and service. Henry Ford Health System is poised to do anything we can to help them stay safe.

The FDA will provide the drug directly to Henry Ford Health System physicians to distribute. Recruiting has not yet begun. More information can be found at http://www.HenryFord.com/whipCOVID19.

The CDC describes hydroxychloroquine, which has been used for 75 years, as a relatively well-tolerated medicine. The most common adverse reactions reported are stomach pain, nausea, vomiting, and headache. These side effects can often be lessened by taking hydroxychloroquine with food. Hydroxychloroquine may also cause itching in some people. Minor side effects such as nausea, occasional vomiting, or diarrhea usually do not require stopping the antimalarial drug. Although rare, serious side effects can occur while taking this medication.

If the study finds the drug effective as a preventative medication for COVID-19, it is possible that the study could expand to include hydroxychloroquine in other COVID-19 treatment options, the doctors said. Henry Ford Health System doctors are prescribing hydroxychloroquine as an off-label treatment for only hospitalized COVID-19 positive patients who meet specific criteria as outlined by the hospital systems Division of Infectious Diseases. As required by the state of Michigans Department of Licensing and Regulatory Affairs, the physicians are documenting the prescribed use in the patients electronic medical record.

Henry Ford, as one of the regions major academic medical centers with more than $100 million in annual research funding, is already involved in numerous COVID-19 trials with partners around the world. Henry Ford is also becoming involved in an Abbott-led study of a rapid, point-of-care test for COVID-19. The equipment, about the size of a toaster, delivers positive results in as little as five minutes and negative results in 13 minutes.

Read more here:
Henry Ford Health System to Lead Nat'l Study of Drug's Effectiveness vs. COVID-19 - The National Herald

ZLIs Save a Billion Birds Campaign to Send Songbirds to Biodiversity Hotspots

NEW YORK, Apr. 06 /CSRwire/ - The Zoological Lighting Institute (ZLI) and its ZLI Save a Billion Birds! Campaign announced plans to offset expected devastation to wildlife due to the inevitable economic pressures stemming from the COVID-19 pandemic. By advocating and offering planning to achieve bird protections in the northern hemisphere, direct exploitation of impoverished biodiversity hotspots in the southern hemisphere will be offset by songbirds sent to these regions. ZLIs Save a Billion Birds! campaign now provides planning services and access to design services, that identify opportunities for corporations, private institutions and public agencies to effectively offset the devastating loss of birds internationally that most likely will, in post-pandemic days, get worse.

ZLI focuses upon the role of natural light in biology. The charity funds research as to how light affects animal physiology, animal senses and the ways in which it influences relationships between animals in space and time. ZLIs Save a Billion Birds! campaign gets a bit more specific, concentrating on these subjects as they matter for birds. As significant research suggests that artificial light at night (ALAN) and exposed transparent/reflective glass kill several billion birds (including birds representing over a thousand species) annually, ZLIs Save a Billion Birds! has expanded from serving as a research funding initiative to include solution facilitating resources <<https://zoolighting.org/subdepartment/zli-wildlife-friendly-design/>>. COVID-19 makes the urgency of such planning more evident than ever, as migratory birds are necessary to keep ecosystems functioning in areas most susceptible to the emergence of zoonotic diseases. The intent is to link corporations and government agencies to wildlife sensitive development, and to include the financial value of ecosystem services (over $44 trillion US Dollars by peer-reviewed estimates) within design and development decisions.

The emphasis is on bird-friendly planning, rather than bird-friendly product. Despite the devastating news of declining bird populations, bird-friendly design has been pursued on a project by project basis, often relying on the ad-hoc adoption of privately tested products. Yet just as preventative medicine requires a coordinated and international approach, preventative wildlife conservation requires planning and public engagement to mitigate and remove the devastating effects of ALAN and exposed glass. A recent study at Cornell University, showed that birds in developed areas are currently at higher risk than those in soon to be over-stressed areas <<https://news.cornell.edu/stories/2018/09/more-4-billion-birds-stream-overhead-during-fall-migration>>. Bird-friendly planning offers community leaders and responsible companies the opportunity to keep seemingly distant biodiversity hot-spots safer by taking meaningful action in our campuses, offices and development here at home. ZLIs Save a Billion Birds! advocacy of planning (rather than product) recognizes the financial realities of development as well, by providing a platform to engage audiences to help fund necessary change. Planning, and recognizing that birds are a resource in kind that can be sent back to over-stressed biodiversity hot-spots, is an underemphasized means of corporate social responsibility.

We have to take our cue from UNEP (the United Nations Environmental Program) and the CBD (Convention on Biological Diversity), offers ZLI Executive Director James Karl Fischer. In times of financial stress, people without substantial resources turn to nature for sustenance. Hunting, fishing, agriculture; all of these provide food from nature when none is available to be had from industrialized sources. But if wild populations arent managed or supported, individuals can do more harm than good. There are many ways to help of course, but it is important to save the animals in those ecosystems because when they are gone, they are gone, and people will starve while also creating future pandemics. No one is as disconnected from this as we like to imagine

Dr. Fischer continuesIn the northern hemisphere, people are connected to global wildlife habitat more than they realize. Many migratory birds that we see in our cities, backyards and parks are the same birds that help to keep local environments going in the southern hemisphere. If they are killed here, they do not contribute to the rainforests or other biodiversity hot-spots there. Losing birds makes it that much more difficult for habitats to recover from improper resource-acquisition damage. With rising likelihood of human suffering due to economic pressures, it is more important than ever to protect birds from meaningless threats in the north. That means paying attention to the billions of birds killed by glass and artificial light, and making the necessary adjustments to our buildings. That is what Save a Billion Birds! has always been about, but it is more important than ever that resourced groups, companies, institutions and governmental agencies take action now through preventative planning.

The United Nations has been clear as to the value of birds to the economy (see links below). The loss of migratory birds destroys ecosystems and lowers environmental quality, while requiring increased financial expenditures to make up for resources that nature would otherwise provide freely. Birds are essential to agriculture, disaster mitigation, and human health care through the ecological services that they provide (such as improved air and water quality). As we have seen, contact with stressed and monolithic wildlife populations enhances zoonotic diseases. Migratory birds face numerous threats as they travel from one nation to another, across the southern to northern hemisphere and back. Billions across the northern hemisphere die by striking glass, and so cannot replenish their value in African, South American and Southeast Asian biodiversity hotspots. Many specific alternatives to exposed exterior bird-killing glass are available to prevent bird deaths, but adoption depends on leadership and a strategy to effect it. ZLIs Save a Billion Birds! campaign seeks to create leaders willing to take on the challenge of protecting birds, and to engage sympathetic audiences and markets through their commitment to public health, safety and welfare.

ZLIs Save a Billion Birds! Send a Songbird Planning Program is available to private, corporate and institutional stakeholders, and is described at greater length at https://zoolighting.org/subdepartment/zli-wildlife-friendly-design/. An upcoming documentary film Save a Billion Birds! describes the need and process of bird-friendly planning, and will begin shooting in California and Chile, (in conjunction with coordinated versions from South Africa to the UK and Thailand to South Korea) as investments and sponsorships are secured. For more information about ZLIs Save a Billion Birds! campaign, and how to engage the charity to ensure that development mitigates biodiversity-loss, please ask to speak with one of ZLIs Save a Billion Birds! Campaign Committee Leaders directly at saveabillionbirds@zoolighting.org.

About The Zoological Lighting Institute:

A unique charitable 501 c(3) with a mission to Support the Sciences of Light and Life through the Arts for Animal Welfare and Wildlife Conservation, The Zoological Lighting Institute embraces the concept of PhotoDiversity, referring to the importance that the diversity of natural light holds for living things, as well as the importance of cultural, social and human diversity has for science and its application. With an international Board of Directors overseeing four departments, including Film & Media, Education, Sustainable Design and the PhotoSciences, The Zoological Lighting Institute is breaking new terrain in the application of science to address the under appreciated realm of light and life.

Current Campaigns include Beached, Bearanoia, Insect Apocalypse, Otohimes Time, Precious Light and Save a Billion Birds!. Please visit http://www.zoolighting.org for more information on Sponsorships, Donor Advisory Fund (DAF) Giving Opportunities and Matching Contribution Programs.

References and Resources:

https://www.unenvironment.org/news-and-stories/video/message-nature-coronavirushttps://www.cbd.int/financial/values/unitedkingdom-valueliterature.pdfhttps://science.sciencemag.org/content/366/6461/120https://www.muhlenberg.edu/academics/biology/faculty/klem/aco/Bird-window.htmlhttps://www.3billionbirds.orghttps://www.birds.cornell.edu/home/bring-birds-back/

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After the Pandemic: Inter-nationalist Wildlife Conservation Initiative - CSRwire.com

Henry Ford is leading a large-scale study on the effectiveness on malaria drugs in preventing COVID-19. // Stock photo

Detroits Henry Ford Health System on Thursday announced it will lead the first large-scale study in the U.S. of the effectiveness of an anti-malarial drug in preventing COVID-19 in health care workers and first responders who volunteer to participate.

The study of hydroxychloroquine used preventatively could begin as early as next week.

This is going to be the first major, definitive study in health care workers and first responders of hydroxychloroquine as a preventative medication, says Dr. William W. ONeill, a world-renowned interventional cardiologist and researcher who has pioneered multiple treatments for heart disease, and the studys organizer at Henry Ford. There has been a lot of talk about this drug, but only a small, non-blinded study in Europe. We are going to change that in metro Detroit and produce a scientific answer to the question: Does it work?

Dr. Marcus Zervos, division head of infectious disease at Henry Ford, will oversee the study with ONeill.

We are glad to see Henry Fords lead on this volunteer study that could help protect medical workers and first responders across southeast Michigan, says Detroit Mayor Mike Duggan, acknowledging U.S. Food and Drug Administration Commissioner Dr. Stephen M. Hahn. I also deeply appreciate Dr. Hahns prompt support for this important effort.

Health care workers and first responders will be enrolled at Henry Ford Hospital Detroit. There are currently no FDA-approved therapies to prevent or treat COVID-19. According to the U.S. Centers for Disease Control and Prevention, hydroxychloroquine, or hydroxychloroquine sulfate, is an FDA-approved arthritis medicine that can also be used to prevent or treat malaria. It is available in the U.S. by prescription only. It is sold under the drug name Plaquenil and is also sold as a generic medicine.

Metro Detroit has a history of stepping up when things get tough, says Dr. Adnan Munkarah, executive vice president and chief clinical officer of Henry Ford. We have a commitment to do that right now to look at all options in a scientific way in the face of this worldwide pandemic.

The study is called WHIP COVID-19 Study and is a more than 3,000-subject look at whether the drug prevents front-line workers from contracting the virus. Once they provide a blood sample, the study subjects will receive vials with unidentified pills to take over the following eight weeks. Participants could be given a once-a-week dose of hydroxychloroquine, a once-a-day dose, or a placebo. The study medicine was specially procured for the study and will not impact the supply of medicine for people who already take the medicine for other conditions.

Participants will not know what group they are in. They will be contacted weekly and in-person at week four and week eight of the study to see if they are exhibiting any symptoms of COVID-19 such as a dry cough, fever, or breathing issues, as well as medication side effects. At eight weeks, they will have blood drawn again. Results will be compared among the three groups to see if the medication had any effect.

Given ourbroadclinical trials and translational research infrastructure, we are grateful to bring this type of large-scale effort to the COVID-19 battle, says Dr. Steven Kalkanis, CEO of Henry Ford Medical Group and senior vice president and chief academic officer of Henry Ford Health System. We see the heroics of the frontline responders in health care, public safety, and service. Henry Ford Health System is poised to do anything we can to help them stay safe.

The CDC describes hydroxychloroquine, which has been used for 75 years, as a relatively well-tolerated medicine. The most common adverse reactions reported are stomach pain, nausea, vomiting, and headache. The side effects can often be lessened by taking hydroxychloroquine with food. Hydroxychloroquine may also cause itching in some people. Minor side effects including nausea, occasional vomiting, or diarrhea do not usually require stopping the drug. Serious side effects are rare but can occur.

If the study finds the drug effective as a preventative measure, it is possible the study could expand to include hydroxychloroquine in other COVID-19 treatment options. Henry Ford doctors are prescribing hydroxychloroquine as an off-label treatment for only hospitalized COVID-19 positive patients who meet specific criteria as outlined by the hospital systems Division of Infectious Diseases.

The FDA will provide the drug to the health system to distribute. Recruiting for the study has not yet begun. More information is available here.

Henry Ford has more than $100 million in annual research funding and is already involved in numerous COVID-19 trials with partners around the world.

The health system is a $6 billion integrated health system comprised of six hospitals, a health plan, and more than 250 other sites. It was established in 1915 and has 32,000 employees.

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Detroit's HFHS to Lead First Large-scale Study in US of Effectiveness of Anti-malarial Drug in COVID-19 Prevention - dbusiness.com

A century ago, after the 1918-1919 Spanish influenza pandemic, few Canadians had to be reminded about how deadly a respiratory viral infection could be. Estimates vary, but 50 million to 100 million people worldwide perished in the most devastating pandemic in history an event that, strangely, has largely receded from memory.

Older people will also remember the polio epidemics. The Crippler left in its wake close to 50,000 children, as well as adults, with varying degrees of muscle weakness and paralysis, and over 4,100 dead. These worsened across Canada from the late 1920s through the late 1950s during the years before polio vaccines were widely available.

During the 1980s and 1990s, HIV spread rapidly around the world. Acquired Immune Deficiency Syndrome (AIDS) was lethal until the development of treatment regimes, public education campaigns and other prevention measures.

In 2003, thousands of people fell ill, and many died, during an especially severe outbreak in Toronto that seemed to target hospitals and health care workers. This was SARS (Severe Acute Respiratory Syndrome), a pneumonia-like infection caused by a novel coronavirus (similar to COVID-19) that began in China and was imported into Canada.[3]

But until the COVID-19 pandemic contemporary urbanized societies were no longer especially preoccupied with the threat of widespread infectious disease outbreaks. While this prevailing sense of security is rooted in genuine confidence in public health protections and medical science, it also reveals a kind of social complacency and amnesia about the damage that infectious diseases are capable of inflicting.

SPANISH FLU

Among all of these earlier examples, the Spanish influenza pandemic was unique in its intensity and extent. Its story also offers powerful insights into the impact and aftermath of the COVID-19 pandemic. We understand much more today, but our well-being still depends not just on science, but also on a broad and deep understanding of the stories of past tragedies.

During the Middle Ages and through the 19th century, urban populations in much of Europe and Asia were regularly decimated by pandemics. Bubonic plague was one of the most deadly diseases, transmitted by fleas and parasites. According to the World Health Organization, the bubonic plague also known as The Black Death killed about 50 million people in 14th century Europe and continued to circulate for centuries.

Later on, the conditions of urban life as well as mass migration became key factors driving the rapid spread of highly infectious and deadly diseases such as smallpox, typhus and cholera. Successive epidemics of cholera swept through Europe and spread to North America on ships filled with migrants from Britain. In Canada, cholera arrived in the 1830s and triggered health emergencies in cities like Montreal and Toronto, prompting unprepared authorities to establish the earliest public health boards.

At the time no one knew how most infectious diseases spread from one individual to another. Scientists hadnt yet discovered bacteria or viruses (germs), the microscope hadnt been invented and the concept of vaccination was in its infancy. Colonial governments enacted draconian quarantine laws, but these often failed to be enforced by local officials.

BREAKTHROUGH

A turning point in the containment of infectious disease outbreaks occurred during a cholera epidemic in London, England, in 1854. Tens of thousands of Londoners had died of cholera epidemics in 1849 and 1853. During an 1854 cholera outbreak, a young physician named John Snow came up with the idea of mapping the addresses of victims in a west-end neighbourhood centred on Broad Street. When he analyzed his famous ghost map, he realized that many of the sick and dead lived close to an outdoor water pump that drew on a well contaminated by a nearby privy. Snows empirical observations, considered to be among the first breakthroughs of modern epidemiology, prompted local officials to remove the handle on the Broad Street water pump, a turning point in public health policy.

During the late 19th and early 20th centuries, many public health advocates and governments pushed to implement prevention-oriented improvements geared at limiting the spread of diseases. The mass production of vaccines and the advent of large-scale inoculation campaigns shifted the fight against infectious disease and epidemics into the realm of preventative medicine.

Routine vaccinations have become one of the principal prevention measures against a range of infectious diseases. Smallpox was declared eradicated from the globe in 1979, and polio is close to the same goal.

What are the connections between todays national and global public health practices and the pandemic that ravaged so much of the world in 1918? Epidemiologists today understand more about the vectors of infection because theyve examined how pandemic influenza spread from troops traveling to and from European battlefields. We drew on some of these lessons during and after the SARS pandemic, in 2003, although dramatic evidence thats surfaced during the COVID-19 pandemic about critical shortages of medical supplies and equipment reveal what can happen when shocking events recede from memory.

ABOUT

The Defining Moments Canada website provides a wealth of information about the way Canadians were affected by this pandemic.

Our goal is inoculate ourselves from the lethal consequences of collective amnesia. We seek to remember not just for its own sake, but to ward off the complacency that can leave our communities vulnerable to, and ravaged by, future epidemics.

John Lorinc is Senior Editor, Defining Moments Canada

Excerpted from Defining Moments Canada, published March 30, 2020.

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Infectious disease outbreaks: from The Plague to COVID-19 - Virden Empire Advance

TORONTO Increasingly frustrated health officials say they are prepared to take more aggressive measures to track and contain people with COVID-19 as the number of sick and dead continues to soar.

And that could involve employing some of the digital and mobile strategies seen in countries including Singapore and South Korea where suppression has been more successful, they suggest with caveats.

All of this is under review by various public health bodies, but a York University expert in infectious disease modelling warns that delayed action risks allowing the virus to continue its rapid spread, and force even more intense physical distancing measures.

That may be the painful lesson Canada needs to learn, said Jianhong Wu, an experienced modeller who has led multiple national projects on SARS, pandemic influenza, and immunization evaluation.

Every country has had to go through this first before they learned how serious it is, said Wu, a distinguished research professor whose work includes analysis of epidemic data in Wuhan, China, where the virus was first detected late last year.

The argument for more stringent contact tracing was laid bare in a directive from Ontarios chief medical officer of health this week. Dr. David Williams instructed the provinces public health units to use their authority to isolate COVID-19 cases and anyone with whom those infected people came into close contact.

Williams reiterated that in a press conference, noting the social contacts of those infected must also be traced and contained if were ever to bring the virus to heel.

Even if we were able to flatten the curve, the real grunt work of public health really then kicks into gear even more, explained Williams, referring to the famous line graph that depicts the steep rise in cases that would result without interventions.

(With) all these cases youre going to have to do a lot more contacting, more phone calling, more investigating.

Williams said his office is looking at how to add more staff, volunteers and the use of technology towards this effort.

That work will have to persist through the spring and summer in order to make sure infections dont spark flare-ups.

Were looking at quickly how to ramp that up not only for today, but tomorrow and in the future, because this is going to be very important in the days and weeks going ahead, said Williams.

Its very much intensive work, he added, and thats where technology can help. Whether that includes the use of mobile tracking tools to keep tabs on the infected is an open question, and one hes not ready to rule out.

We have many proposals coming in, and nothing is being rejected outright, said Williams.

Canadas biggest hurdle to tech-assisted tracking is public and political aversion to measures that threaten individual privacy, said Wu, but he argued public safety concerns should trump those worries here.

For now, Ontario Health Minister Christine Elliott has suggested the emphasis continues to be on people power. She said Thursday that she hoped medical students can help carry that load.

Such a strategy is already in use in Alberta, where approximately 300 University of Calgary medical students have bolstered that provinces ability to contact the infected and make sure they and their contacts self-isolate.

Dr. Richelle Schindler, a resident physician at the U of C who specializes in public health and preventative medicine, said by email that nursing students may be added to the monumental task, in which trackers chase individuals by phone but can send paramedics to check on those they cant reach.

Albertans who violate isolation orders face a $1,000 fine, but courts have been given increased powers to administer fines of up to $100,000 for a first offence and up to $500,000 for subsequent, more serious violations.

Student trackers must have clinical experience but also get two days of training before hitting the phones. They also get program credit for their time.

While the importance of contact tracing has received less attention than testing in Canada, Wu insisted it is a crucial step to suppressing an epidemic.

He noted that test results provide a snapshot of infections that are days, and even weeks, old. But contact tracing can indicate where the virus is as it jumps from person-to-person.

The public should know that if you want to go back to normal you have to know who is exposed, said Wu, pointing to regions in Asia where the use of mobile data is credited with allowing schools and busy markets to remain open.

Contact tracing generally involves notifying the infected and their close contacts, but really effective tracing would also notify contacts of those close contacts, said Wu.

Thats because by the time youve identified people who have the virus, their close contacts may already be infected and spreading it to others.

Then you can say that the community is safe we know who is impacted, or exposed, who is infected, and therefore you can go back to resuming some social activities, Wu said.

Toronto Public Healths associate medical officer of health said Thursday his unit is in the midst of scaling up tracing efforts by developing a web-based system that would allow more front-line staff to join the effort from home.

The Coronavirus Rapid Entry Case and Contact Management System would allow trackers to input essential case information that can be shared with the province.

Dr. Michael Finkelstein said Toronto currently has more than 100 staff following up with those who are infected and their contacts, and acknowledged that it becomes increasingly difficult to keep pace as cases grow.

But for now, mobile tracking of citizens is not part of Torontos strategy.

TPH is aware that some jurisdictions have used this technology and is investigating its use, said Finkelstein by email.

Wu described a synergistic relationship between three pillars of disease suppression: testing, tracing and social distancing. Where one falters, the others must compensate, he explained.

Even if contact tracing becomes less effective as community spread grows, people still need to know the level of infections and degree of exposure.

Its never too late so you can never give up, said Wu.

But I think we are at a stage that we really have to kick in the technologies and you really have to have the participation from the public.

This report by The Canadian Press was first published April 2, 2020.

With files from Allison Jones

Cassandra Szklarski, The Canadian Press

Coronavirus

Excerpt from:
The race to trace the spread of COVID-19 in Canada using disease trackers - Red Deer Advocate

Written by Anushka Jagtiani | New Delhi | Published: April 7, 2020 10:00:56 am

As we battle coronavirus, it is important to know that chronic ailments such as diabetes, heart diseases and obesity continue to increase at an alarming rate in India. Indianexpress.com caught up with physician and award-winning nutritionist Dr Vishakha Shivdasani on World Health Day for her perspective and advice on treating chronic illnesses and building immunity.

On this World Health Day, what health conditions (other than coronavirus) concern you the most?

The fact that diabetes and obesity are the fastest-growing epidemics in human history, and not very much is being done at a preventive level to change that.

Amongst the chronic diseases which one are the most widespread in India? Which ones are growing at an alarming rate?

Well, we are the diabetic capital of the world, though China seems to be beating us at that one. Besides Type 2 diabetes, other chronic ailments growing at an alarming rate are obesity, heart disease, polycystic ovarian disease and certain cancers.

What in your opinion has lead to this rapid increase in diabetes , obesity, and other chronic ailments?

Lifestyle. From the way we eat (high carbohydrates and omega 6 fats) to lack of exercise, to high levels of stress and inadequate sleep. All lead to chronic disease.

Can you elaborate more on the role of processed foods and refined sugar?

Processed foods kill. It is what causes chronic disease, and chronic disease puts us at risk for acute disease too.

Firstly, its a combination of sugar thats added to the processed carbs that in turn cause inflammation and compromises your immune function. Sugar is the enemy of a strong immune system.

Secondly, omega 6 fats that are added to processed food cause inflammation, resulting in chronic disease.

Most processed foods should not be labelled as foods. They should be called processed substances. Yes, a very small percentage of them might retain the whole grain and not use refined sugar. But most are first stripped off their original nutrients, through processing, then they are fortified with artificial vitamins and added chemicals used to increase their shelf life and make them taste good. Which is why they are so addictive. They also are often high in cheap omega 6 fats, refined vegetable and seed oils like soya oil and sunflower which are often hydrogenated and turn into trans fats. Those are the ones that cause heart disease. Not the consumption of good fats like olive, avocado and ghee. As a result, all fats get a bad name, which is wrong.

They can also be high in one of the worst forms of sugar-hfcs (high fructose corn syrup), which is the real trigger for inflammation and, therefore, of heart disease, diabetes and PCOS. Because these conditions are all inflammatory in origin, these sugars are also empty calories which mean they have zero nutritional value, but they cause sugar spikes, make you more hungry, and trigger weight gain, cause insulin resistance and diabetes. Yet you yet crave them. Its a vicious cycle.

ALSO READ | Try these simple 15-minute recipes for a healthy day ahead

Would you say Indians are less reliant on processed foods since we do believe in cooking fresh meals everyday, unlike the West? Or do you see a vast number of chronic diseases here as well, related to processed foods?

Post-lockdown, I went to the supermarket to get my essential groceries. It was so odd that the veggies and fruits and milk etc were freely available, but the aisles of Maggi and pasta, biscuits and bread and sodas were completely empty. Stocking up on junk food is not going to help us survive a pandemic. Lets rethink this strategy.

And sure we dont eat as much of processed meats, frozen foods and sodas as the West on a regular basis, but the consumption of breakfast cereals and white and brown breads, and specially biscuits is huge here. And pizzas, pasta and noodles consumption in urban India is also huge.

Which processed foods are the most harmful to consume?

The ones that are loaded with HFCS high fructose corn syrup obviously, but sugar has 56 different names. And most of the ones that say sugar free have sometimes not one but multiple forms of these sugars and the common man does not identify them as sugar but these are the ones that cause the most damage and lower immunity.

Foods which contain Omega 6 are also harmful as these are pro inflammatory. These are the ones that can cause heart disease.

Low-fat processed food is nothing but a big con. The only one benefiting from that is the food industry, so the first thing I do is take my patients off everything low-fat or fat-free.

Apart from being a GP you specialise in nutrition. Do you feel you can reverse some of these chronic ailments, often caused by lifestyle, using nutrition alone?

Most chronic illness can be reversed completely with lifestyle alone. So yes, I am not the pharma industrys favourite doctor and I am known as the doctor who reduces patients medication. But Im qualified to know when and how to do that and because the patient is directly under my supervision. I can change the medication if I spot a red flag. We have reversed so many Type II diabetics, PCOS cases and made patients drop up to 50 kg just with lifestyle interventions.

For diabetes or insulin resistance, how would you keep it under control with nutrition?

Its quite simple really. You just need to reduce the intake of carbohydrates significantly and make sure you have reasonable amount of protein but not too much (like several fads suggest) and have a good amount of good fats. Dont fear them, just make sure they are not hydrogenated vegetable oils and that they are good fats like ghee, olive oil or avocado oil.

ALSO READ | Coronavirus: Origin, symptoms, causes, treatment, precautions and other details about COVID-19

In these days of coronavirus, diabetics, asthmatics and those with cardiovascular disease are more at risk, why is that?

Covid-19 seems to affect people with compromised immune systems the most. Which is the case with most patients with these conditions. And these are also morbidities, which means you are unhealthy. And one is more likely to be hit hard if unhealthy.

What advise would you give them at a crucial time like this?

Up your immunity. Eat real food. Its your best natural defence to fight any pathogen, be it a bacteria or a virus. It may not stop you from getting the virus but its certainly your best chance to survive if you do get it. Drop the sugar. Add supplements like zinc, vitamin C, Omega 3 and Vitamin D. Also add natural anti-inflammatory foods which is available in every Indian kitchen like turmeric, black pepper, ginger, garlic and cinnamon. Drink lots of water, sleep well, exercise, but dont over-exercise. Over-exercising can backfire and reduce immunity.

Does our healthcare systems have the infrastructure to deal with the growing number of chronic diseases?

Nobody does. I think chronic lifestyle ailments are a huge financial burden on any government and from the looks of it, its only going to get worse. We are focused on medicine for symptoms not on prevention and lifestyle.

What would your advice be to the health ministry?

Lets form a governmental task force of doctors who practice functional medicine and incorporate lifestyle as first-line approach and develop programmes to make people healthy and not wait for them to fall sick and then treat them. Its really about preventative medicine.

The Indian Express is now on Telegram. Click here to join our channel (@indianexpress) and stay updated with the latest headlines

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Eat real food, its your best natural defence to fight any virus - The Indian Express

Coughing, wheezing, and shortness of breath are familiar symptoms for people who have asthma.

We know that viruses, including colds or influenza, can make asthma symptoms worse and potentially trigger an attack.

But what about SARS-CoV-2, the virus that causes coronavirus?

We don't know whether the new coronavirus would trigger an attack, but the assumption is that it would work like any other respiratory virus.

However, at this stage, there's no evidence to indicate that people with asthma even those with severe asthma are more prone than others to becoming seriously ill with a COVID-19 infection, said Jo Douglass, an asthma and allergy expert from the University of Melbourne and the Royal Melbourne Hospital.

"It doesn't seem that asthma is a particular risk for more severe or intensive care admission of COVID-19," Professor Douglass said.

Brian Oliver, a respiratory specialist at the University of Technology Sydney and the Woolcock Institute, agreed.

"I couldn't imagine this being good for asthma, but there's no evidence to say how bad it is for asthma at the moment," Professor Oliver said.

Of much greater risk, he said, is another respiratory disease known as chronic obstructive pulmonary disease or COPD.

But if you do have asthma, it is important you take medication to prevent a flare-up that could land you in hospital, both experts said.

"The best protection against flare-ups of asthma is to have well-controlled asthma at the start," Professor Douglass said.

To understand why, let's dive deep into your lungs and explain what asthma is and how the medicines help.

Asthma is a lung condition marked by recurrent episodes of coughing, wheezing and shortness of breath.

These symptoms are caused by a tightening or constriction of the muscles in the airways.

People with asthma tend to have more lung tissue than others.

"A person with asthma's lungs are remodelled in such a way that they almost become the equivalent of an elite athlete's," Professor Oliver said.

"The airways in the lung structure are changed in such a way that it makes them easier to contract."

Constriction of the airways is often triggered by an allergic inflammatory response to things like dust, pollen or mould.

It can also be triggered by inflammation caused by a virus (but you can also have asthma without having a virus and vice versa).

The inflammatory process that underlies allergic asthma or any other allergies like hay fever usually involves different types of immune system cells than those fighting viral infections, Professor Douglass said.

"It is a different sort of inflammation than what we see with viral infections in the majority of people."

Medications are designed to either relieve asthma symptoms or prevent asthma.

Reliever medications, also known as puffers, use a drug that relaxes the smooth muscles in your airway to relieve your symptoms.

They have no impact on your immune system.

But, Professor Oliver said, viruses in general can make these medications less effective and you can still have an asthma attack.

"On a molecular level, viruses do this by desensitising the pathway through which your puffer drug is designed to work," Professor Oliver explained.

"So if your bronchodilator [medication] isn't working, when you have symptoms [caused by inflammation in response to the virus], the drugs that should be helping you don't work as well."

Many people with asthma need to take a puffer in combination with a preventer or steroid-based inhaler to prevent asthma attacks.

This drug, which is designed to reduce inflammation in your lungs, is prescribed by your doctor and is taken every day.

While there have been some concerns raised over the impact of high dose oral steroids on the immune system, the inhaled doses used by most people with asthma are low and unlikely to have an effect, Professor Oliver said.

Professor Douglass agreed.

"There's no indication that inhaled steroids are [putting us] at increased risk at all that we're aware of, and I think they are the best protection we've got against having asthma exacerbations," she said.

She said it was important that people talked to their doctors and stayed on their inhaler medications to avoid exacerbations, which could be serious, or the need to go on oral steroids if a flare up happened.

"All doctors are keen to avoid the use of high-dose continuous oral corticosteroid medications, especially in the current setting of infections," Professor Douglass said.

Newer medicines that are based on human antibodies are good options for people with severe asthma, as they cut down the use of high dose oral steroids and prevent flare-ups, she added.

While around 10 per cent of Australians have been diagnosed with asthma it is often overlooked and misdiagnosed especially in adults.

If you haven't been diagnosed, signs to look out for include:

Some people may have been diagnosed but have undertreated asthma.

As a rule of thumb, using a puffer more than twice a week means your asthma is poorly controlled, Professor Douglass said.

"If you're needing [a puffer] more than twice a week you should be on a preventive [medication]," she said.

Other people may have also been diagnosed with asthma, but gone off their preventative medications because they haven't had an attack for a while.

"You can fool yourself into thinking it has gone away, Professor Oliver said.

"But the message is if you've had asthma, you should keep taking your preventive medications."

The recent cases of thunderstorm asthma highlight why.

"When we had the thunderstorm asthma ... a lot of people with asthma weren't taking that preventive medication and then did really badly," he said.

It was also important to realise, he said, that these medications have a finite shelf life.

"So contacting your GP and talking to them and getting medical advice is really important," he said.

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I have asthma. Am I more at risk of having a severe coronavirus infection? - ABC News

SOUTH CHINA SEA - Members of Navy Forward-Deployed Preventive Medicine Units (FDPMU) and Naval Medical Research Center (NMRC) embarked several 7th Fleet ships March 14 to help combat the risk of and provide laboratory batch testing for COVID-19 aboard the ships.

Teams are embarked on the amphibious assault ship USS America (LHA 6), the aircraft carrier USS Theodore Roosevelt (CVN 71), the U.S. 7th Fleet flagship USS Blue Ridge (LCC 19) and have the ability to batch test Sailors onboard who present with influenza-like illness symptoms, instead of only sending samples to be tested ashore.

This capability provides early-warning surveillance for the medical teams to be able to identify if a COVID-19 case is onboard a ship, but does not individually diagnose Sailors. If a batch were to test positive for COVID-19, the medical teams would take additional measures, such as isolating the Sailors whose samples were in the batch, and depending on the Sailors symptoms, potentially medically evacuating them off the ship to a shore facility for testing.

To date, no cases of COVID-19 have been diagnosed aboard any U.S. 7th Fleet Navy vessel.

The team here in 7th Fleet has taken COVID-19 seriously from the beginning and has many public health measures already in place, said Capt. Christine Sears, U.S. 7th Fleet surgeon. The FDPMU and NMRC augmentation teams provide additional depth in our ability to combat this virus.

Teams embarked the ships to provide at-sea testing and to ensure the U.S. 7th Fleet operating forces are ready to combat a possible outbreak while maintaining mission readiness. The teams provide additional capabilities in addition to the U.S. 7th Fleets isolation procedures.

The teams are comprised of a variety of specialized Navy Medicine personnel to ensure force health protection of the fleet, and may include: a microbiologist, medical laboratory technician, preventive medicine officer, preventive medicine technician.

As a medical service corps microbiology officer, this embark gives us the chance to demonstrate some of our skillsets to the fleet, and what we bring to the fight, said Lt. Cmdr. Rebecca Pavlicek, Blue Ridge COVID-19 testing team lead. This capability allows us, the Navy, to protect mission readiness and protection of our Sailors.

To ensuring force health protection of the fleet, other medical specialties or logistical components can be scaled up or down to meet mission specific requirements in the mitigation, health surveillance, and casualty prevention.

This is the most advanced laboratory capability that Navy Medicine has placed forward deployed, said Lt. Cmdr. Danett Bishop, leader and microbiologist for the preventative medicine team aboard America. We can make force health decisions in real time, enhancing the health of the crew while minimizing any potential outbreak of COVID-19.

The FDPMU teams aboard the USS America and the USS Blue Ridge are from Navy Environmental Preventative Medicine Unit 6 based out of Pearl Harbor, Hawaii, and work to facilitate and educate using preventive medicine practices and provide additional laboratory capabilities. The team embarked with USS Theodore Roosevelt is assigned to the Naval Medical Research Center based in Silver Spring, Maryland.

Currently, the teams are only authorized to perform surveillance testing and not individual testing. This means that the results cannot be linked to a particular patient for diagnostics, but would enable the team to detect COVID-19s presence on the ship based off of the results.

Since we are performing surveillance testing, the results of COVID-19 present, or not present can help inform the force health protection posture and provide valuable insight for the senior medical officer and outbreak response team, said Pavlicek.

The teams are equipped with two testing capabilities, including the BioFire Film Array and the Step One RT-PCR System. The BioFire Film Array will test for a dozen different respiratory diseases, while the Step One RT-PCR System allow for complex COVID-19 tests at sea, if necessary.

As the U.S. Navy's largest forward-deployed fleet, 7th Fleet operates roughly 50-70 ships and submarines and 140 aircraft with approximately 20,000 Sailors.

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Navy preventive medicine teams embark ships in 7th Fleet - navy.mil

(CNN) What are the telling signs that you may have the novel coronavirus, also known as Covid-19?

The main list of acute symptoms at this time is actually quite short and can appear anywhere from two to 14 days after exposure to the virus, according to the US Centers for Disease Control and Prevention.

Were emphasizing fever plus a notable lower respiratory tract symptom cough or trouble breathing, said infectious disease expert Dr. William Schaffner, a professor of preventative medicine and infectious disease at Vanderbilt University School of Medicine in Nashville.

CORONAVIRUS COVERAGE:

Being able to identify those symptoms and act upon them when necessary is critical. Heres what you need to know.

Fever is a key symptom, experts say. Dont fixate on a number, but know its really not a fever until your temperature reaches at least 100 degrees Fahrenheit (37.7 degrees Celsius) for children and adults.

There are many misconceptions about fever. Average daily temperature is 98.6 degrees Fahrenheit (37 degrees Celsius), but we all actually go up and down quite a bit during the day as much as half of a degree or a degree, said Dr. John Williams, chief of the division of pediatric infectious diseases at the University of Pittsburgh Medical Center Childrens Hospital of Pittsburgh.

So 99.0 degrees or 99.5 degrees Fahrenheit is not a fever, he stressed.

When you check for fever, dont rely on a temperature taken in the morning. Instead take your temp in the late afternoon and early evening.

Our temperature is not the same during the day. If you take it at eight oclock in the morning, it may be normal, Schaffner explained.

One of the most common presentations of fever is that your temperature goes up in the late afternoon and early evening its a common way that viruses produce fever.

Coughing is another key symptom, but its not just any cough, said Schaffner. It should be a dry cough that you feel in your chest.

Its not a tickle in your throat. Youre not just clearing your throat. Its not just irritated. Youre not putting anything out, youre not coughing anything up, Schaffner said.

The cough is bothersome, its coming from your breastbone or sternum. and you can tell that your bronchial tubes are inflamed or irritated, he added.

Shortness of breath can be a third and very serious manifestation of Covid-19, and it can occur on its own, without a cough. If your chest becomes tight or you begin to feel as if you cannot breathe deeply enough to get a good breath, thats a sign to act, experts say.

If theres any shortness of breath immediately call your health care provider, a local urgent care or the emergency department, said American Medical Association president Dr. Patrice Harris.

If the shortness of breath is severe enough, you should call 911, Harris added.

In addition to difficulty breathing or shortness of breath, the CDC lists emergency warning signs for Covid-19 as a persistent pain or pressure in the chest, bluish lips or face which indicates a lack of oxygen and any sudden mental confusion or lethargy and inability to rouse.

Get medical attention immediately, the CDC says.

This trifecta of symptoms fever, cough and shortness of breath are not the only signs of sickness that have been seen in cases of Covid-19.

Many other symptoms can resemble the flu, including headaches, digestive issues, body aches and fatigue, which can be severe. Still other symptoms can resemble a cold or allergies, such as a runny nose, sore throat and sneezing.

Most likely, experts say, you simply have a cold or the flu after all they can cause fever and cough too. One possible sign that you might have Covid-19 is if your symptoms, especially shortness of breath, dont improve after a week or so but actually worsen.

At this moment, the current guidance and this may change is that if you have symptoms that are similar to the cold and the flu and these are mild symptoms to moderate symptoms, stay at home and try to manage them with rest, hydration and the use of Tylenol, Harris said.

That advice does not apply if you are over age 60, since immune systems weaken as we age, or if you are pregnant anyone with concerns about coronavirus should call their healthcare provider, according to the CDC.

Its unclear whether pregnant women have a greater chance of getting severely ill from coronavirus, but the CDC has said that women experience changes in their bodies during pregnancy that may increase their risk of some infections.

In general, Covid-19 infections are riskier if you have underlying health conditions such as diabetes, chronic lung disease or asthma, heart failure or heart disease, sickle cell anemia, cancer (or are undergoing chemotherapy), kidney disease with dialysis, a body mass index (BMI) over 40 (extremely obese) or an autoimmune disorder.

Older patients and individuals who have underlying medical conditions or are immunocompromised should contact their physician early in the course of even mild illness, the CDC advises.

To be clear, you are at higher risk even if you are young if you have underlying health issues.

People under 60 with underlying illnesses, with diabetes, heart disease, immunocompromised or have any kind of lung disease previously, those people are more vulnerable despite their younger age, Schaffner said.

A history of travel to an area where the novel coronavirus is widespread (and those parts of the world, including the US, are going up each day) is obviously another key factor in deciding if your symptoms may be Covid-19 or not.

If you have no symptoms, please do not ask for testing or add to backlog of calls at testing centers, clinics, hospitals and the like, experts say.

We do not test people with no symptoms because its a resource issue, Schaffner said about the assessment center at Vanderbilt.

However, we are emphasizing that people who have this small cluster of important symptoms fever and anything related to the lower respiratory tract such as cough and difficulty breathing reach out to be evaluated.

If you do have those three signs, where should you go?

If you have insurance and youre looking for a provider or someone to call or connect with, theres always a number on the back of your insurance card; or if you go online, there is information for patients, Harris said.

If you dont have insurance, you can start with the state health department or the local community health centers, those are officially known as federally qualified health centers, Harris advised, adding that some states have a 1-800 hotline number to call.

If there is a testing and assessment center near you, you can go there directly, Schaffer said. Its always good to notify them that youre coming. Otherwise, you need to call your healthcare provider and they will direct you what to do.

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LIST: Here Are The Symptoms Of Coronavirus And When To Seek Help - CBS Baltimore

PADUCAH Each day, more information comes out about COVID-19. It's hard to know what's fact and what's fiction.

Dr. J. Kyle Turnbo has been visiting the Local 6 studio to answer your questions about the virus. Turnbo is triple board certified in family, occupational and preventative medicine.

He was back in the studio on Monday to help us better understand the novel coronavirus. During Local 6 at Five, he joined Local 6 evening anchor Todd Faulkner.

Turnbo explained the difference between isolation and quarantine.

Isolation

Isolation is for sick people who have the disease. Patients are put in isolation to keep them away from healthy people.

It helps prevent the direct spread spread of the virus. The goal for people in isolation is to keep them from having any contact with other people that they could spread the disease to. They only come out of isolation when they are no longer contagious. Dr. Turnbo says for COVID-19, that time period is typically 14 days.

Quarantine

Quarantine is for people who are well but were potentially exposed, because they were in contact with someone who has been diagnosed with the virus. Those who self-quarantine are not confirmed to have the disease or have no symptoms. In quarantine, people keep themselves away from others as a precaution.

If you are quarantined at home, Turnbo says you should stay home, separate yourself from others in your household, call ahead before you show up to your doctor's office to tell your medical provider about your concerns and follow their advice, cover your coughs and sneezes, wash your hands thoroughly, avoid sharing germs and monitor your symptoms.

For our other Q&A sessions with the doctor, check out the links below.

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Dr. Turnbo explains the difference between isolation and quarantine - WPSD Local 6

What a year last week was! Life still resembles itself, but only vaguely. I vowed not to touch the V-I-R-U-S keys in preparing this weeks column. Obviously, my fingers and my brain are not in sync or maybe they are: here I am writing about the developments of a mindboggling week.

Complicating matters, during those jumbly, confusing days when symptoms of the coronavirus were incessantly enumerated on TV, in the print press, and on social media, I was fogged and clogged by a full-blown cold. Through a cloud of wadded-up tissues and cough drop wrappers, I washed my hands and wiped down surfaces, while alternating between the uncertain certainty of COVID-19 and the back-to-sanity realization that I was simply suffering the Shirley-version of the common cold.

Longer than I should have, I allowed myself to be almost mentally incapacitated by the all-coronavirus-all-day coverage of the cable news outlets and the wildly-varying overreactions and underreactions I found on Facebook. I felt dismay at the panic to which too many of us succumbed and anger at the selfishness of some. Even as I worried about our elderly population in the high-risk category, I had to repeatedly remind myself I am an elderly person in the high-risk category!

Then I happened upon a news briefing by Governor DeWine. He and Dr. Amy Acton, Director of the Ohio Department of Health, presented the latest and most essential information I had heard anywhere in a calm but compelling manner. At that point, I took control of my media exposure, determining to listen to their daily 2 PM briefing as my major source of information along with one evening newscast for perspective.

I feel fortunate that our governor has surrounded himself with a team of medical professionals with whom he digs for facts. As reported in the UDC, Mike DeWine has been ahead of other elected officials across the nation, basing his approach to COVID-19 on the successful, life-saving approach of St. Louis during the deadly Spanish influenza of 1918.

My feelings of good fortune continue each time I listen to Dr. Acton speak. Armed with degrees in preventative medicine and public health, this mother of six has moved beyond the debacle testing has become in attempting to flatten the curve, in preparation for the surge yet to come: when hospital facilities and their limited supplies of personal protective equipment may very well be overwhelmed. Dr. Acton explains well, makes crucial points, talks down to no one, is clearheaded and forthright. By the way, two previous holders of her position were a lawyer and a marketing director.

Based on events of this past week, I agree with Governor DeWines assessment of his fellow Ohioans: We are resilient. We will rally. We will make it. When the governor closed the schools, administrations jumped into action to formulate delivery systems of breakfasts and lunches to their students. Unencumbered by state red tape, teaching staffs designed online lessons for their own students. All manner of websites popped up with virtual safaris and drawing lessons. When the governor closed dine-in restaurants, Facebook filled with carry-out and delivery instructions from local eateries. Some stores have established elderly-only shopping hours.

And we have so many heroes to support: as always, we thank the first-responders, but also the truck drivers and farmers as well as every healthcare professional willing to risk serving under the most difficult of conditions, many of which are yet to occur.

Sometimes the little things become even more important. There was a Facebook photo of a son visiting his father at the nursing home, each on either side of a window chatting on their cell phones. Another picture showed a little boy playing tic-tac-toe with his elderly neighbor on two sides of a glass door with grease pencils on a board outlined by painters tape. Snowbird friends of mine returning from Florida noted electronic billboards in every state recommending limited travel to stop the spread of COVID-19. Only in Ohio did they see the additional message of: We are all in this together.

I checked in with Ingrid in Germany, where toilet paper is also in short supply. She will not, for the foreseeable future, babysit for her granddaughters. Our conversation reminded me of my reason for promoting international exchange: people in all countries are much more similar than different. Residents of most nations have experienced/are experiencing/will experience COVID-19. Perhaps through sharing fears, concerns, and solutions with our global neighbors, we can all move a little closer to sharing in other areas of life on our planet.

At home, my Great-Depression-survivor father often criticized our pickiness about food: You are too well fed. His phrase eventually stretched to cover a general lack of appreciation for all that we have. For many, these extraordinary times are thus far an exercise in inconvenience although true sacrifice and shortage may be just down the road a piece. I recalled my fathers assessment, when a former student suggested the merely inconvenienced remember people whose lives are at stake, those with childcare flexibility remember people with no options, those of us settling in for quarantine remember people who have no home.

I think, however, that for the next weeks and months or however long this new normal continues for that amount of time I will hold on to the oft-repeated words of my mother: This, too, shall pass.

Shirley Scott, a 1966 graduate of Graham High School, is a native of Champaign County. After receiving degrees in English and German from Otterbein College, she returned to GHS in 1970 where she taught until retiring in 2010. From 1976-2001 she coordinated the German Exchange Program with the Otto-Hahn-Gymnasium in Springe.

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Facing it all together - Urbana Daily Citizen

Tired of washing your hands for 20 seconds each time? Fingers starting to prune or feel like sandpaper?

The world is counting on you to help stop the spread of Covid-19, the deadly new disease caused by SARS-CoV-2, or severe acute respiratory syndrome coronavirus 2.

Take heart that while you're scrubbing, you're also killing off a host of other nasty bacteria and potentially lethal viruses that have plagued humans for centuries -- including influenza and a number of different coronaviruses.

"There are four coronaviruses that circulate in humans regularly, almost every year," said virologist Dr. John Williams, chief of the division of pediatric infectious diseases at the University of Pittsburgh Medical Center Children's Hospital of Pittsburgh.

"And they mainly cause colds; in fact, they cause about a third of common colds. They don't kill people," he added.

Coronaviruses aren't the only nasty parasites that succumb to a vigorous application of soap and water. Influenza -- which kills millions around the world each year -- and the human metapneumovirus, which causes a respiratory infection that can lead to pneumonia, also break down and die.

How did such a simple thing as soap and warm water -- and alcohol-based sanitizers -- obtain such power over these parasites?

The answer lies in their "skin" and your scrubbing technique.

What soap and warm water do

Under the microscope, coronaviruses appear to be covered with pointy spires, giving them the appearance of having a crown or "corona" -- hence the name. Beneath the crown is the outer layer of the virus, which is made up of lipids, or what you and I would call fat.

Now imagine that coronavirus is your butter dish, covered with buttery fat.

"You try to wash your butter dish with water alone, but that butter is not coming off the dish," Williams explained. "You need some soap to dissolve grease. So soap or alcohol are very, very effective against dissolving that greasy liquid coating of the virus."

What does getting rid of that outer layer do to the germ?

"It physically inactivates the virus, so it can't bind to and enter human cells anymore," Wllliams said.

Just how soap accomplishes this feat is rather strange and fascinating science.

It's all about how soap molecules are formed -- each looks much like a tiny sperm, with a head and tail. The head bonds with water but the tail rejects it, preferring oil and fat.

Frantically trying to escape water, the tail of the soap is drawn to the fatty outer layer of the virus and begins to pry it open, much like we might use a crowbar to separate two pieces of wood.

Once the virus or bacteria splits open, it spills its guts into the soapy water and dies.

Water and scrubbing with your hands are important to this process because the combination creates more soap bubbles, which disrupt the chemical bonds that allow bacteria, viruses and other germs to stick to surfaces.

You want to scrub, build up bubbles and scrub some more, getting into every crack and crevice of your hands and fingers, including your fingernails, for 20 seconds, which is about as long as it takes to sing Happy Birthday twice. (But if you're tired of that ditty, there are songs from every decade you can sing instead.)

Now, when you rinse your hands, all the germs that have been hurt, trapped or killed by soap molecules are washed away.

"All those bubbles and foam ... literally pick germs up and wash them down the drain," said Dr. William Schaffner, a professor of preventative medicine and infectious disease at Vanderbilt University School of Medicine in Nashville.

You often hear that the water you wash with should be warm, but why? After all, even hot water does not kill bacteria or viruses until you get to a temperature that would scald the skin.

"Cold water will work, but you have to make sure you work really vigorously to get a lather and get everything soapy and bubbly," said chemist Bill Wuest, an associate professor at Emory University who studies disinfectants.

To do that, you might need to sing "Happy Birthday" three times instead of two.

"Warm water with soap gets a much better lather, more bubbles," Wuest said. "It's an indication that the soap is ... trying to encapsulate the dirt and the bacteria and the viruses in them."

What alcohol-based sanitizers do

Alcohol-based hand sanitizers can be as effective as soap if they are used properly, Schaffner explained.

"They need to have at least 60% alcohol in them," Schaffner said. "It's the alcohol that's the virus killer."

Just putting a little dollop in the palm of your hand and wiping quickly isn't good enough, Schaffner said.

"You've got to use enough and get it all over the surfaces," he said. "Rub it all over your hands, between your fingers and on the back of your hands."

"That's because alcohol is a different chemical property," Wuest said. "It helps break up the germ membranes, but you need to make sure it gets into direct contact with the bacteria or virus."

But there are situations in which soap and water are best, Williams said, because of the ability of soap and water to trap and wash microorganisms away.

"Alcohol is pretty effective at killing germs, but it doesn't wash away stuff," he said. "So you know, if somebody's just sneezed into their hand, and their hand is covered with mucus, they would have to use a lot more alcohol to inactivate that bacteria or virus.

"So if somebody's hands are visibly or grossly contaminated, soap and water are better," Williams said.

That's especially important because there are nasty germs and bacteria out there that don't have soft, fatty bellies that soap bubbles can attack -- such as hepatitis A virus, poliovirus, meningitis and pneumonia.

So the next time you wash your hands for the umpteenth time, take pride in all those soapy bubbles you're creating -- and enjoy the pleasure of imagining those microscopic, dead creatures circle the drain.

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Why soap, sanitizer and warm water work against Covid-19 and other viruses - The Albany Herald

Israel's inability to handle a pandemic crisis was known prior to the global outbreak of the coronavirus, according to information published Monday by the State Comptroller.The report focused on the possibility of an influenza pandemic but showed that Israel was not ready to fight any pandemic, including the novel coronavirus, while highlighting the countrys lack of strategic planning. Before the outbreak of the current pandemic, hospital occupancy rates in Israel were already the highest in the developed world, while its mortality rates from infectious diseases, which doubled in the past two decades alone, are not only higher than in every other developed country, they are 73% higher than the second-ranked country, said Prof. Dan Ben-David, president and founder of the Shoresh Institution for Socioeconomic Research and a faculty member at Tel Aviv Universitys Department of Public Policy. The healthcare system has been under-budgeted for many years, medical staff and all other resources were overloaded even before the pandemic, added Dr. Yotam Rosner, head of Information, Research and Development for Physicians for Human Rights. So, we are not fully prepared to handle the coronavirus.In general, the state comptroller report highlighted the lack of intensive care beds, medical staff and equipment, which would enable effective treatment in the case of a pandemic, and bolster capabilities to manage other major outbreaks. It also showed that hospitals are overcrowded year-round.The prime minister was quick to respond that the report is irrelevant to the current coronavirus outbreak, as there has been no such event in the last century and no country in the world could have predicted or prepared for the spread of the virus, while claiming that under his tenure the health system in Israel has been significantly improved. But Rosner said that the report sheds a bright light on Israels unreadiness for this epidemic. He said that some people have referred to the novel coronavirus as a black swan, though the coronavirus is not one. Rosner said that these types of epidemics occur in cycles around three times each century and health professionals know that. The report acknowledged that the system is overloaded, which we have said many, many times and means that there are no reserves whatsoever in hospital beds or ventilation machines and which means that effectively when we do have address this pandemic, everything else has to be stopped and delayed because now you need to direct all your medical staff toward this pandemic.Israel quickly postponed all voluntary medical procedures and cancelled any non-essential surgeries or other health visits. Moreover, Rosner explained that public healthcare does not center only around hospitals and clinics but also preventative medicine, public awareness and health literacy, all of which the report indicated were challenges. For example, the report indicated that during the recent global measles outbreak in 2018-2019, Israel had the seventh highest morbidity rate worldwide. Some 60% of 4,300 infected individuals were children aged up to nine years old. Three Israeli citizens died during the outbreak.Moreover, following a growing trend of anti-vaccine sentiment, the Health Ministry estimates that a total of 1.1%-1.7% of the population is not vaccinated against measles today, compared to 0.6% in 2011. During the recent measles outbreak, among infected patients aged between two and 19 years old, at least 49% were children of vaccine refusers. Half of all those infected were residents of Jerusalem, of which 80% were from the ultra-Orthodox Jewish community.Rosner said that communication between all minorities and subcultures and the Health Ministry is lacking and therefore all the populations that are in the periphery of society were even less prepared and the government is struggling to obtain their adherence. The level of health literacy is low, which means they are not following the guidelines, even ones that are crucial for them to follow, Rosner said. Their level of accessibility to the Health Ministry and their ability to prepare for quarantine is very low.For example, quarantine requires that people have a separate room for anyone infected or potentially infected, which does not exist for many communities and it is unclear what alternatives exist for them.Many in the Haredi (ultra-Orthodox) and Arab communities have ignored government directives to remain at home and police have been used multiple times to break up large gatherings by members of these communities. Rosner said that there is no strategic planning in healthcare and he compared it to the Defense Ministry, which recently released a five-year strategic plan that consists of its vision and goals. One of the reasons for that is that the budget is so small for the HMOs that they are already so overloaded and all of their financial resources are for the here and now and not for what is needed in five or 10 of 15 years, which could be a pandemic, he said.According to Rosner, every year the HMOs have to appeal to the Finance Ministry for additional funding just to pay for their day-to-day operations.Investing in a 10- or 15-year plan or innovation or infrastructure? It is almost difficult to imagine, he said. Health Ministry Direct-General Moshe Bar Siman Tov promised to study the comptroller report and learn from it. In the meantime, as Ben-David explained, We shut the country down to deal with something that we neglected for decades.

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Israels inability to handle coronavirus known before pandemic arrived - The Jerusalem Post

The chatter about a promising drug to fight Covid-19 started, as chatter often does (but science does not), on Twitter. A blockchain investor named James Todaro tweeted that an 85-year-old malaria drug called chloroquine was a potential treatment and preventative against the disease caused by the new coronavirus. Todaro linked to a Google doc hed cowritten, explaining the idea.

Plus: How can I avoid catching it? Is Covid-19 more deadly than the flu? Our in-house Know-It-Alls answer your questions.

Though nearly a dozen drugs to treat coronavirus are in clinical trials in China, just oneremdesivir, an antiviral that was in trials against Ebola and the coronavirus MERSis in full-on trials in the US. Nothing has been approved by the Food and Drug Administration. So a promising drug would be greatand even better, chloroquine isnt new. Its use dates back to World War II, and its derived from the bark of the chinchona tree, like quinine, a centuries-old antimalarial. That means the drug is now generic and is relatively cheap. Physicians understand it well, and theyre allowed to prescribe it for anything they want, not just malaria.

Todaros tweet got thousands of likes. The engineer/tech world picked up the idea. The widely-read blog Stratechery linked to Todaros Google document; Ben Thompson, the blogs editor, wrote that he was wholly unqualified to comment but that the anecdotal evidence favored the idea. Echoing the document, Thompson wrote that the paper was written in consultation with Stanford Medical School, the University of Alabama at Birmingham medical school, and National Academy of Sciences researchersnone of which is exactly true. (More on that in a bit.) One of Todaros coauthors, a lawyer named Gregory Rigano, went on Fox News to talk about the concept. Tesla and SpaceX CEO Elon Musk tweeted about it, citing an explanatory YouTube video from a physician whos been doing a series of coronavirus explainers. To be fair, Musk wasnt all-in on the idea absent more data, though he wrote that hed received a life-saving dose of chloroquine for malaria.

Its the definition of big if true. Part of the story of Covid-19, of the coronavirus SARS-CoV-2, is that it is novel. Humans dont have any immunity to it. Theres no vaccine, no drug approved to treat it. But if a drug did existif a cheap, easy drug can stave off the worst, ventilator-requiring, sometimes-fatal complications of coronavirus infection, or maybe prevent that infection in the first place, what are we all socially isolating for, like suckers?

That ifas the saying goesis doing a lot of work. The Covid-19 pandemic is causing, reasonably, a worldwide freak-out as scientists and policymakers race to find solutions, not always competently or efficiently. Its the kind of thing that rankles the engineer-disruptor mindset. Surely this must be an easily solved problem thats primarily the fault of bureaucracy, regulation, and people who dont understand science. And maybe the first two things are true. The third thing, though, is where the risks hide. Silicon Valley lionizes people who rush toward solutions and ignore problems; science is designed to find solutions by identifying those problems. The two approaches are often incompatible.

What happened here, specifically, is that Rigano sought Todaro out. Todaros tweet identified Rigano as being affiliated with Johns Hopkins; Riganos LinkedIn profile says hes on leave from a masters degree program there in bioinformatics, and has been an advisor to a program at Stanford called SPARK, which does translational drug discoveryfinding new uses and applications for approved drugs. I have a very unique background at the crossroads of law and science, Rigano tells me. I have been working with large pharmaceutical companies, universities, biotechs, and nonprofits in the development of drugs and medical products. He says those contacts told him about the use of chloroquine against Covid-19 in China and South Korea, so he started reading up on it.

(Johns Hopkins did not return a request for comment; a spokesperson for Stanford Medical School emails: Stanford Medicine, including SPARK, wasnt involved in the creation of the Google document, and weve requested that the author remove all references to us. In addition, Gregory Rigano is not an advisor with Stanford School of Medicine and no one at Stanford was involved in the study.)

It turns out that people have been pitching chloroquine as an antiviral for years. In the early 1990s researchers proposed it as an adjunct to early protease inhibitor drugs to help treat HIV/AIDS. A team led by Stuart Nichol, the head of the Special Pathogens Unit at the Centers for Disease Control and Prevention, published a paper in 2005 saying that the drug was effective against primate cells infected with SARS, the first big respiratory coronavirus to affect humans. Thats an in vitro test, not live animalsjust cells.

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Chloroquine May Fight Covid-19and Silicon Valleys Into It - WIRED