eMediNexus Coverage from: 
Dr KK Aggarwal,  23 March 2020
Coronavirus Live Count Map India

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Coronaviruses have same weight as other viruses

COVID-19 virus is physically larger and heavier than other known respiratory viruses. COVID-19 infects hosts through mucus droplets but its infectious range is lower than other viruses as its mass affects the distance it can travel before giving in to gravity. Coronaviruses can only travel about one to two meters, less than seven feet, before falling to the ground. More infectious viruses such as measles or chickenpox, are much lighter and remain airborne on tiny dust particles.

Only this virus has a unique link to bats

Scientists suspect that COVID-19 may have moved from bats to humans. Bats seem to have a unique ability to harbor several other viruses that can cause serious human diseases like Ebola, Marburg, Rabies, Hendra and Nipah.

In 2017, a research study  tested bats in Kenya and noted several novel coronaviruses with genomic sequences closely related to human coronaviruses.

There are strains of the new coronavirus spreading around the world

The World Health Organization has insisted that there is no evidence that the virus has been changing.

Viruses do mutate especially RNA viruses like SARS-CoV-2. When a person is infected with the coronavirus, it replicates in the affected person’s respiratory tract. Every time it does, nearly half a dozen genetic mutations take place, stated Ian Jones at the University of Reading, UK.

Xiaolu Tang at Peking University in Beijing and colleagues assessed the viral genome from 103 cases and noted common mutations at two locations on the genome. Two types of the virus were identified based on differences in the genome at these two regions: 72 were considered to be the “L-type” and 29 were classed “S-type”.

Another analysis by the team suggested that the L-type was derived from the older S-type. It is likely that the first strain emerged when the virus jumped from animals to humans. The second emerged soon after that. Both are associated with the current global outbreak. The L-type is more prevalent thus suggesting that it is more aggressive than the S-type.

One reason that the coronaviruses mutate so rapidly is that they have the longest genomes of all known RNA viruses. With more sections in their genome, there are more potential errors when the virus copies itself.

 At age 20, I need not worry

 In a review of over 4,000 U.S. patients diagnosed with COVID-19, an unexpected 20% of deaths were noted among adults aged 20-64 years, and 20% of those hospitalized were aged 20-44 years.

People above 65 years of age are expected to be most susceptible to COVID-19 infection; however, this study suggests that, at least in the U.S., a significant number of patients below 45 may need hospital admission and can even die of the disease.

In order to determine the rates of hospitalization, admission to an ICU, and death among patients with COVID-19 by age group, the Centers for Disease Control and Prevention evaluated 4,226 COVID-19 cases in the United States reported from Feb. 12 and March 16. [CDC COVID-19 Response Team. MMWR Morb Mortal Wkly Rep. 2020 Mar 18.

Drink water every 15 minutes

A post that has been copied and pasted by several Facebook accounts quotes a Japanese doctor who has recommended drinking water every 15 minutes to flush out any virus that might have entered the mouth. A version in Arabic has been shared more than 250,000 times.

Professor Trudie Lang at the University of Oxford has stated that there is "no biological mechanism" to support the idea that it is possible to wash a respiratory virus down into your stomach and kill it.

However, staying hydrated is generally a good advice, but not to flush the virus.

Drinkable silver

Unlike iron or zinc, silver has no function in the human body.

The use of colloidal silver was promoted on US televangelist Jim Bakkers show. Colloidal silver refers to tiny particles of the metal suspended in liquid. A guest on the show claimed that the solution kills some strains of coronavirus within 12 hours (admitting that it hadnt yet been tested on COVID-19).

Proponents claim that it can potentially treat all kinds of health conditions, act as an antiseptic, and that it helps the immune system. Silver is used in bandages applied to wounds.

However, theres clear advice from the US health authorities that theres no evidence that this type of silver solution is effective for any health condition. More importantly, it could cause serious side effects including kidney damage, seizures and argyria (a condition that turns the skin blue).

Vodka can be used as hand sanitizer

No,  vodka only contains 40% alcohol. You need minimum 60% alcohol.

 Drink MMS

 YouTuber Jordan Sather, has claimed that a "miracle mineral supplement", or MMS, can wipe out coronavirus.

It contains chlorine dioxide, which is a bleaching agent.

He had tweeted in January, "not only is chlorine dioxide (aka MMS) an effective cancer cell killer, it can wipe out coronavirus too".

The US Food and Drug Administration had warned last year about the dangers associated with drinking MMS. Health authorities in other countries have also issued alerts. The FDA has stated that it "is not aware of any research showing that these products are safe or effective for treating any illness". It warns that drinking them can cause nausea, vomiting, diarrhea and symptoms of severe dehydration.

 Once available in the private labs in India, the COVID-19 test will be very costly

 No. ICMR may cap price of each coronavirus test at Rs 4,500-Rs 5,000 for private labs.

You can escape by disobeying government directions in India

The Lucknow police has lodged an FIR against Bollywood singer Kanika Kapoor for alleged negligence in compliance of necessary directives to safeguard against the spread of deadly Coronavirus disease post her return from London earlier this month. She tested Covid-19 positive on Friday and left a chain of VIPs behind who had either put themselves on self-isolation or earmarked for monitoring by the administration.

Lucknow Commissioner of Police, Sujeet Pandey confirmed that an FIR was lodged at Sarojini Nagar police station under Indian Penal Code section 188, 269, 270 on the complaint of Chief Medical Officer, Lucknow. (Hindustan Times)

Section 188: Disobedience to order duly promulgated by public servant.

Section 269:- Negligent act likely to spread infection of disease dangerous to life

Section 270:- Malignant act likely to spread infection of disease dangerous to life

"Coronavirus is not in my area, so I can go out"

You don’t know it’s not in your area.  All tests are not being done so we don’t have an accurate idea of how many people – or what areas – have truly been affected.

Individuals can shed the virus for up to 2 weeks before they get sick.

Our situation could be similar to Italy and Germany where there is a shortage of ventilators for critically ill patients.

Coronavirus is just like the flu – it’ll all be ok.

The two viruses are different in ways that are significant and dangerous.

Flu has a vaccine; COVID-19 does not.

Flu has established treatments; COVID-19 does not.

Hydroxychloroquine and azithromycin have no role in COVID-19

Hydroxychloroquine (200 mg three times a day for 10 days) plus Azithromycin 500 mg once a day for ten days

Both chloroquine and hydroxychloroquine have been reported to inhibit SARS-CoV-2 in vitro, although hydroxychloroquine appears to have more potent antiviral activity [1].

Chloroquine is included in treatment guidelines from Chinas National Health Commission and was reportedly associated with reduced progression of disease and decreased duration of symptoms [2,3].  However, primary data supporting these claims have not been published [4].

In an open-label study of 36 patients with COVID-19, use of hydroxychloroquine (200 mg three times a day for 10 days) was associated with a higher rate of undetectable SARS-CoV-2 RNA on nasopharyngeal specimens at day 6 compared with no specific treatment (70% versus 12.5%) [5].

In this study, the use of azithromycin, in combination with hydroxychloroquine, appeared to have additional benefit, but methodologic concerns about the control groups for the study exist, and the biologic basis for using azithromycin in this setting is unclear.

Despite the limited clinical data, given the relative safety of short-term use of hydroxychloroquine (with or without azithromycin), the lack of known effective interventions, and the in vitro antiviral activity, it seems reasonable to use one or both of these agents in hospitalized patients with severe or risk for severe infection, particularly if they are not eligible for other clinical trials.

  1. Yao X, Ye F, Zhang M, et al. In Vitro Antiviral Activity and Projection of Optimized Dosing Design of Hydroxychloroquine for the Treatment of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Clin Infect Dis 2020.
  2. Gao J, Tian Z, Yang X. Breakthrough: Chloroquine phosphate has shown apparent efficacy in treatment of COVID-19 associated pneumonia in clinical studies. Biosci Trends 2020; 14:72.
  3. Colson P, Rolain JM, Lagier JC, et al. Chloroquine and hydroxychloroquine as available weapons to fight COVID-19. Int J Antimicrob Agents 2020; :105932.
  4. Cortegiani A, Ingoglia G, Ippolito M, et al. A systematic review on the efficacy and safety of chloroquine for the treatment of COVID-19. J Crit Care 2020.
  5. Gautret et al. (2020) Hydroxychloroquine and azithromycin as a treatment of COVID‐19: results of an open‐label non‐randomized clinical trial. International Journal of Antimicrobial Agents – In Press 17 March 2020 DOI:10.1016/j.ijantimicag.2020.105949.

The Marseille Study

The European Union Clinical Trials Register states that the Marseille study was accepted on 5th March by the National Medicines Safety Agency (ANSM). It could include up to 25 COVID-19 positive patients, with five aged 12–17 years, 10 aged 18–64 years, and 10 more aged 65 years or over.

Unblinded study revealed a strong reduction in viral load with hydroxychloroquine.

Six days later, the percentage of patients testing positive for COVID-19 who received hydroxychloroquine decreased to 25% compared to 90% for those who did not receive the treatment (untreated COVID-19 patients from Nice and Avignon).

On comparing untreated patients, those administered hydroxychloroquine and those given hydroxychloroquine plus azithromycin, there was a major reduction in the number of positive cases with the combination therapy.

At 6 days, among patients receiving combination therapy, the percentage of cases still carrying SRAS-CoV-2 was no more than 5%.

Azithromycin was added owing to its efficacy against complications from bacterial lung disease but also because it has been found to be effective in the laboratory against several viruses.

More detailed results of the study have been submitted for publication in the International Journal of Antimicrobial Agents.

Christian Perronne, head of infectious diseases, University Hospital Raymond Poincaré, Garches, Paris, stated:

"I really believe in hydroxychloroquine. It is a drug I find rather fascinating, that has been used for decades. There have been positive results in an in vitro study and a preliminary Chinese study in 100 patients which showed that hydroxychloroquine reduced the viral load, the symptoms lasted for less time, and they are not as severe. This could reduce the number of carriers, which I find interesting from an epidemiological perspective.

"I think from an ethical point of view, we should suggest it to all patients with severe disease who are hospitalized, under surveillance and on short treatment, paying attention to drug interactions, especially with drugs that prolong the QT interval.

Afterwards, in terms of adverse effects, at increased doses, it is possible that patients will have pain or fever, but it seems that the treatment is effective at lower doses, according to the Chinese data. In any case, the adverse effects of this compound are not dangerous." (Medscape)

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Dr KK Aggarwal

President CMAAO, HCFI and Past National President IMA

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