CMAAO Corona Facts and Myth Buster 36 |
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CMAAO Corona Facts and Myth Buster 36

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333: Ivermectin drug can stop the SARS-CoV2 virus growing in cell culture.

Australian researchers at Monash University in Melbourne have noted that a single dose of ivermectin was able to stop the SARS-CoV2 virus growing in cell culture. The Food and Drug Agency approves the drug as an anti-parasitic agent that is effective against viruses such as HIV, influenza, and Zika. The study was published in the journal Antiviral Research. [The Science Times]

334: Tonic water can prevent coronavirus

Accepted Name: Cinchona officinalis L.

Family: RUBIACEAE

Used in: Ayurveda, Unani, Homoeopathy, Chinese, Bitter and astringent

Habit: Tree

Distribution: This species is native to Ecuador, globally distributed in Columbia, Peru and Bolivia. It is cultivated in South India and Sri Lanka. It has been recorded in West Bengal and Tamil Nadu (Palni between an altitude range of (1600) 1800-2100 m., Nilgiris). It grows well at higher altitudes up to 2600 m in South India.       

English

crown bark, jesuits bark, loxa bark

Hindi

cinchona, kunain

Kannada

barkina

Malayalam

koyina, kvayna, sinkona

Sanskrit

kunayana, kunayanah, sinkona

Tamil

cinkona, curappattai, koyina

Telugu

Jvarapatta

BARK

CINCHONA CHHAL,

  

 

CINCHONA BARK, SINKONA BARK

  
  • Cinchona bark contains quinine and related chemicals. Experts recommend that only purified quinine or other appropriate medications can be used to prevent or control malaria.
  • Tonic water is a carbonated soft drink in which quinine is dissolved. Tonic water has been originally used as a prophylactic against malaria. It now has a significantly lower quinine content and is consumed for its distinctive bitter flavor, though sweetened version is also nowadays available. It is often used in mixed drinks, particularly in gin and tonic.
  • The US Food and Drug Administration (FDA) limits the quinine content in tonic water to 83 ppm (83 mg per liter if calculated by mass), while the daily therapeutic dose of quinine is in the range of 500–1000 mg, and 10 mg/kg every eight hours for effective malaria prevention (2100 mg daily for a 70 kg adult). It is often recommended to relieve leg cramps, but medical research suggests that care is needed in monitoring doses.
  • Cinchona bark has historical value to homoeopaths as being the drug which led Hahnemann to the discovery of THE law of cure, and enabled him to establish homoeopathy.

335: How many malaria-affected countries have reported cases of COVID-19?

Fact: Malaria-endemic countries in all WHO regions have reported cases of COVID-19. The WHO African Region, which accounts for more than 90% of the global malaria burden, has 37 countries with reported cases of the disease as of 25 March. Of these, 10 countries have reported local transmission of the disease.

336: What is the maximum case fatality rate?

Case fatality rate of 33.7% has been reported among nursing facility residents in King County, Washington [N Engl J Med 2020 Mar 27]

337: Ways of reusing or extending use of masks

  1. Ultraviolet light treatments to sterilize N95 masks.
  2. Vapor phase hydrogen peroxide to sanitize masks, enabling their reuse up to 20 times.
  3. Cloth or fabric face masks for home use can be sterilized by washing them in the washing machine.

Extended use: Practice of wearing the same N95 respirator repeatedly, without removing the respirator between the encounters with several patients.  It is implemented when multiple patients are infected, and patients are placed together in dedicated waiting rooms, clinics or hospital units.  Eye protection may also be used with the N95 respirator for extended use.

Reuse: Using the same N95 respirator for several encounters with patients but removing it (‘doffing’) between at least some of the encounters.  The respirator is stored in between encounters and reused. Face shields will be dedicatedly used by individual healthcare personnel. Disinfection of the face shield will be required between uses.

 Guiding Principles

Extended use is preferred over reuse. It is appropriate for team members following this extended use guidance to remove PPE during breaks and lunch periods. Items approved for reuse can be removed, stored and reused following break/meals.

Facemasks, N95 respirators and eye protection can be reused carefully and in a limited way during periods of limited supply. Facemasks that fasten by means of ties may not be able to be undone without tearing and should be considered only for extended use, rather than re-use.

The guidance is for reuse by a single person (no sharing), and applies to Facemask & N95 respirators.

Disposable N95 respirators may be reused or worn for extended use, as long as they are covered by face shield during aerosol generating procedure, or have reached the end of their use by being visibly soiled, obviously damaged or wet.

Room traffic to be limited where possible by ensuring that only those essential for patient care enter the room; strategies such as bundling of care, limiting or avoiding bedside clinical teaching, limiting operating room traffic, and use of telemedicine should be implemented, where possible.

Applicability

These guidelines apply to all healthcare personnel (HCPs) who require wearing respiratory protection during patient care or as a requirement of their work responsibilities.

 Guidance for Reuse N95

All supplies of N95 respirators are to be stored in locked or secured, designated areas to be issued to staff with a paper bag or container that allows breathability.

Once the disposable N95 respirator is donned, a full-face shield should be applied over the N95 respirator. Perform hand hygiene and remove the face shield. The front is potentially contaminated, so remove carefully by bending forward and using the elastic band.

Use a germicidal wipe as a surface upon which the face shield will be placed then remove face shield and disinfect before placing it on the prepared surface. Face shield is disinfected using a germicidal wipe

Storage of Previously Worn N95 Respirators:  After removing N95 respirators, inspect and discard if visibly soiled, has obvious damage or is wet.  The N95 respirators should be stored in a well-ventilated container (i.e., paper bag) with username & date marked.

A disposable N95 respirators can be worn for several hours and multiple shifts if not wet or damaged, and not involved in an aerosol-generating procedure.

[References Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health (NIOSH)

https://www.cdc.gov/niosh/topics/hcwcontrols/recommendedguidanceextuse.html; https://www.cdc.gov/niosh/topics/hcwcontrols/pandemic-planning.html This document was adapted from Guidance for Extended Use and Reuse of Facemasks, Respirators, and Protective Eyewear, University of Maryland/Nebraska Medicine]

CMAAO Corona Facts And Myth Buster 35

Most COVID-19 Cooperative Patients Can Be Managed Remotely; 80% need of healthcare providers and PPEs can be reduced

  1. Every family must buy SPO2 monitor
  2. Label house as COVID-positive so that the colony makes sure the patient does not violate the quarantine terms and conditions
  3. Self-quarantine at home will reduce need of healthcare workers and PPE
  4. Fall of SPO2 > 4% at rest or on exertion must be notified
  5. Wear surgical masks at home and take medicines as prescribed on teleconsultation

Yes: Most patients with COVID-19 infection can be managed by means of phone or video chat.

Telephone management is adequate for those with mild symptoms and uncomplicated infections. Video chat may be required for sicker patients, those with comorbidities, those whose social circumstances impact the illness, and those who are very anxious. Patients who are hard of hearing may prefer video to telephone.

All patients need SPO2 monitor, as the respiratory function can decline quickly, especially during the second week of infection.

Fever in patients with COVID-10 can exceed 38° C and last for more than five days, although as many as half of infected patients have no fever at presentation.

Symptoms that do not indicate COVID-19 infection include nasal congestion and allergy-like symptoms. Patients with seasonal flu will likely have body aches, while shortness of breath is a hallmark of COVID-19. Diarrhea and other gastrointestinal symptoms may be present, and infected patients may also report loss of appetite and anosmia.

Urgent assessment in person or on video would be required for patients with severe breathlessness or difficulty breathing, pain or pressure in the chest, blue lips or face, and a history suggestive of shock (such as cold and clammy with mottled skin, new confusion, becoming difficult to rouse, or significantly reduced urine output).

The respiratory rate may be measured via a good video connection. Video could possibly allow a more detailed assessment and prevent the need for an in-person visit. [BMJ]

320: How to use 0.1% bleach solution

Household bleach solutions can be used to effectively kill coronavirus. Be sure to check that it is safe to use on the surface you’re treating and follow instructions on the label. Keep the surface wet for several minutes and then thoroughly dry it to ensure the germs are killed.

321: Should paper masks be reused/washed and if so, how often?

For appropriate use, paper masks should not be reused or washed. Every time one takes a mask off or touches it, there are chances of contaminating it. As once breathes with a mask on, the moisture that is exhaled gets trapped in the mask. Moisture favors the growth of the novel coronavirus and other germs. For COVID-19, the CDC recommends wearing a mask if you are in a crowded area to protect yourself and others. A mask is not a replacement for keeping a safe distance -- at least 6 feet -- from others and washing hands frequently.

322: Can you get coronavirus from touching cash?

Yes. It is possible to get exposed to the COVID-19 virus while handling money contaminated by someone who is infectious. The same precautions are needed with cash as exercised while touching other objects or surfaces in public areas. After contact with money, wash your hands with soap and water or use an alcohol based hand sanitizer. Do not touch your face or eat food without cleaning your hands.

323: Is it safe to take aspirin to treat coronavirus symptoms?

Yes. For adults, it’s safe to take aspirin for pain or fever from COVID-19. Owing to concerns that anti-inflammatory drugs like ibuprofen and aspirin may worsen coronavirus symptoms, the World Health Organization had recommended against the use of these anti-inflammatory drugs. However, the recommendation was reversed later and it no longer recommends against ibuprofen or other anti-inflammatory drugs, including aspirin. Children and teenagers should not take aspirin as it can cause a life-threatening condition called Reye’s syndrome.

324: How does coronavirus affect someone with HIV?

Having a weak immune system puts you at a higher risk of infection and severe illness. It is frequently being asked if antiviral treatments for HIV can help protect against coronavirus.

It would seem likely that medications used to treat HIV would have some effect as some of them work similarly to treatments currently being tested/used for coronavirus.

When used, many are done under compassionate use. They are being used only in seriously ill COVID-19 patients. These medications target mechanisms around RNA, or the genetic make-up of the viruses including coronavirus.

HIV antiviral drugs are under investigation in severe COVID-19 cases. So far, they seem to have no benefit in reducing the amount SARS CoV-2 found in throat swabs or improve the time to recovery in severe COVID-19 patients.

325: Is it safe to take naproxen to treat coronavirus symptoms?

Yes. It’s safe to take naproxen for pain or fever in COVID-19 patients. Owing to initial concern that anti-inflammatory drugs like ibuprofen and naproxen could worsen coronavirus symptoms, the World Health Organization had recommended against their use. However, the recommendation was reversed later.

326: Are kids less likely to get coronavirus?

No one is safe from infection. Children get sick less frequently when they get infected with COVID-19. But everyone is at risk and they can get respiratory illnesses related to coronavirus. Kids, overall, have lower odds of having severe disease and be hospitalized than adults, but they can get infected and sick. There is nothing like zero risk of infection. Kids can get infected and transmit it to someone else.

Additionally, kids are less likely to sit still when they have mild symptoms, which puts everyone around them at risk for infection.

There is a subpopulation of kids that are at higher risk for getting sick. Those with severe underlying lung or immunocompromised conditions are more vulnerable.

327: Is my mail safe from coronavirus?

Research shows that the time for which coronaviruses can live on paper varies by strain. Some can live only for a few minutes while others may survive up to 5 days. The novel coronavirus spreads primarily through respiratory droplets after someone coughs or sneezes. It can spread from contaminated surfaces as well. It is better to wash your hands thoroughly after opening your mail and throwing away the envelopes.

328: Why do people with diabetes do worse with COVID-19 Infection?

According to a recent hypothesis, people with heart disease or diabetes may be at a high risk for severe coronavirus infection because they use ACE inhibitors. The researchers rationalized that using these meds might enhance attachment of SARs CoV-2 to lung tissue, making these people more susceptible to severe infection.

However, there’s no evidence in human or animal studies to show that these medications enhance attachment of the virus to ACE 2 receptors.

The American Heart Association has stated that there is no evidence, that it’s a hypothesis and has advised people not to stop taking ACEi, especially without talking to the doctor first.

329:  Can my pet get the coronavirus?

A recent report from China has revealed that two dogs have been infected with coronavirus. Neither animal had symptoms. Both are domestic animals of an owner who had COVID-19. The CDC has not yet received any reports of pets or other animals becoming sick with COVID-19.

There’s no evidence to suggest that pets can be a source of COVID-19 infection to humans or that the virus causes disease in dogs. However, it is advisable for pet owners to practice good hygiene practices and not to abandon their pets out of fear.

330: How much more at risk am I for coronavirus infection if I smoke or am a reformed smoker?

People who smoke or vape have a higher risk of infection and serious complications with COVID-19. Tobacco and marijuana can potentially damage the lungs and the immune system, increasing your susceptibility to the viruss attack on the lungs. Stopping smoking or vaping and reducing second hand exposure can prevent and lessen your risk of symptoms if you contract coronavirus.

331: Will this virus also mutate?

Some viruses have been known to frequently mutate. They can change their genetic makeup to help them survive better. However, coronavirus does not seem to be one of those. Mutation of the virus seems to be uncommon. This has two implications: First, if a virus mutates, it could become resistant to certain medications, making it more difficult to treat. Additionally, frequent mutations make it more difficult to develop a vaccine. The coronavirus doesn’t seem to mutate frequently. Therefore, it might make it easier to find a lasting treatment and vaccine.

332: What are signs of coronavirus in toddlers?

Kids and toddlers may present with runny nose, cough and fever. They may have stomach symptoms such as diarrhea. To prevent COVID-19 in kids, its important to teach them to wash their hands and observe social distancing, even with their friend next door. The coronavirus is very contagious. People can carry it and not develop symptoms. Therefore, its best to maintain social distance, especially with those who could get sick more easily, such as grandparents as well.

[Source: WebMD]

Dr KK Aggarwal

President CMAAO

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