Vidcast:  https://youtu.be/NYEsUk9CufM

You’re worried you have CoVid19.  You’re feeling warm.  You have throat soreness.  You have a cough.  What to do?  

Take your temperature follow it daily as you track your symptoms.  If your oral temp is consistently above the normal 98.6˚F and your symptoms are persistent or escalating, call your doctor or the hospital and ask next steps.

When you do, they will have you came to the hospital or an isolation unit for a checkup and testing.  If  CoVid19 is suspected, isolate yourself.  If you’re with others, wear a mask or make one from your scarf.  

Even if an official CDC viral test isn’t available, professionals can test you.  A chest cat scan for pneumonia  has a diagnostic sensitivity of 97% for viral pneumonia.   A white blood count revealing low eosinophils occurs in 79% of CoVid positive pneumonia patients but in only 36% without the virus.

Expect to have a workup and close observation at the facility or at home if you’re well enough.  Studies of patients with severe CoVid19 infections show that the virus not only attacks the lungs but also the heart in 89% of cases, the liver in 78%, and the kidneys in 31%.  Managing these problems requires a well=equipped general hospital. 

Starting now, be aware of how you’re feeling.  Take your temperature daily and record it.  If you see worrisome signs, act!

Chest CT CoVid19 diagnosis: https://www.sciencedaily.com/releases/2020/02/200226151951.htm

Low eosinophils in CoVid19: https://www.medrxiv.org/content/10.1101/2020.02.13.20022830v1.full.pdf

CoVid19 organ damage: https://www.medrxiv.org/content/10.1101/2020.02.26.20028191v1

#covid19 #fever, #cough #pneumonia #epidemic

Vidcast:  https://youtu.be/zhAmBseKJ4w

Here are the latest CDC travels warnings.  None but essential travel to China, Iran, South Korea, and Italy.  None but essential travel for older persons or those with chronic disease to Japan.  

Considering the Chinese epidemic experience, you can predict that these destinations will likely not be suitable recreational travel destinations for another 4-6 months or more.  Should you recover from a verifiable case of CoVid19, you will likely be immune to further infection.  That is, if the virus fails to mutate into other forms capable of reinfecting you, you could then safely travel to these zones earlier.  Stay tuned for information about CoVid19 mutations.

https://www.cdc.gov/coronavirus/2019-ncov/travelers/index.html

https://travel.state.gov/content/travel/en/traveladvisories/traveladvisories.html/

#covid19 #coronavirus #epidemic #pandemic

Vidcast:  https://youtu.be/wc_ai6Ni73Q

Preventing CoVid19 from harming you and your family will involve personal and community efforts.  Personally, you must guard against contracting the virus and passing it on to others.  That involves keeping your fingers and hands from your face, repeated soap and water handwashing or use of alcohol hand sanitizers, avoid touching surfaces likely to harbor contaminated secretions like door handles and your phone, cough and sneeze into tissues, and stay home from work if you feel sick.

Stay away from crowded places if you can, and take special precautions in subway and rail stations as well as airports.  If you can, shop at odd hours.  Walk any walkable distances, and use your automobile for longer travel where feasible.

The Chinese instituted an early warning system for personal infection: a mandatory daily temperature check.  This is easy enough for all of us to do.  There are even electronic thermometers that link to your phone for as little as $11. 

At the first sign of a temperature elevation, get checked and, if necessary, tested.  This is one community effort that can help us all stay healthy

Now that we are seeing community spread throughout the US, expect to see tough city and town measures that combat exponential disease spread for as long as 2 to 4 months.  These may include public transit shutdowns, closure of public venues, and shopping restrictions to meter access and avoid crowds.  Plan ahead!

#covid19 #coronavirus #epidemic #pandemic

Vidcast: https://youtu.be/-rdbcwd4MlM

Efforts to stem the spread of CoVid19 have been successful in China.  The measures include: entertainment venues closed; public gatherings canceled; intra-city transit, mass and personal, halted; travel to and from the city prohibited;  and entire city shutdown and lockdown.  

Chinese cities that proactively employed similar measures before a first case report, enjoyed 37% fewer cases in the first week after that case report.  The most effective measures were stopping intra-city transit and closure of public entertainment and gathering.

Transmission Control Efforts: https://www.medrxiv.org/content/10.1101/2020.01.30.20019844v3.full.pdf

https://gizmodo.com/china-orders-mandatory-coronavirus-checks-in-wuhan-and-1841498598

#covid19 #epidemic #pandemic #coronavirus

Vidcast:  https://youtu.be/Q9a4NQc35xI

According to pre-published data online, as of late February there are 75 registered studies of CoVid19 disease underway.  97% are headed by Chinese organizations.  Only 11 trials have begun patient recruitment.  Trials include those testing Western medicine, Eastern medicine, and combinations.  

Two already initiated studies focus on the anti-viral nucleotide analog remdesivir: one involving those with mild/moderate disease and the other on those with severe disease.  In each 60 patients were treated with active agent and 60 were control receiving conventional supportive therapy only.  Studies are expected to end on 4/27/2020.  The expectation that this drug will help is based on test tube results that show it has a marked anti-viral effect.  

Other studies employing Western medicine are testing various other anti-viral agents alone and in combination.  Once more information about them is available, I will bring it to you.

Clinical trials: https://www.medrxiv.org/content/10.1101/2020.03.01.20029611v1.full.pdf

#covid19 #coronavirus #epidemic #pandemic

Vidcast:  https://youtu.be/81G-oRa44pU

The CoVid19 virus is moderately contagious. The CoVid19 reproductive number, number of vulnerable  persons expected to be infected from a single infected person, is 2 -3.  This number may be as high as nearly 7.  In comparison, the number for measles is 12-18, diphtheria  6-7, HIV 2-5, the flu 2-3 and Ebola 1.5-2.5.  

The incubation period is 2-14 days with a 5-6 day average.  The cases in each affected area double every 2 days.  The institution of travel and mass gathering restrictions has had a profound positive impact on the reproductive number and viral spread according to unpublished data on the MedRxiv site.

You can track the spread of CoVid19 around the world and through the US on the excellent Johns Hopkins CVid19 web page:

Johns Hopkins Live Coronavirus Stats: http://coronaviruslivestats.com

Reproductive rate of CoVid19: https://www.medrxiv.org/content/10.1101/2020.02.07.20021154v1.full.pdf

Incubation period: https://www.medrxiv.org/content/10.1101/2020.02.24.20027474v1

#covid19 #coronavirus #epidemic #pandemic

Vidcast:  https://youtu.be/Nz60NienuxM

Chinese mathematicians studying the CoVid19 disease dynamics predict that the hardest hit area, Wuhan, will see new cases trail off in April.  That’s a full 4 months after the beginning of disease transmission.  Their online, as yet unpublished data predicts, that for less hard hit Beijing and Shanghai, cases will cease about now in early March.  That’s about 3 months from the onset.  CoVid19 will decline in remainder of China by mid-March, that’s about 2 months from the beginning.  

So once CoVid19 arrives in a region, it will be a 4 month threat.  To be on the safe side, double that for elective travel plans if you are in a CoVid19-vulnerable group due to age or health.

Length of epidemic:  https://www.medrxiv.org/content/10.1101/2020.02.16.20023465v1.full.pdf

#covid19 #coronavirus #epidemic #pandemic

Vidcast:  https://youtu.be/AlG6nsoVV5Y

If you completed your childhood tetanus shot series, the old DPT and the more recent DTap, you are protected for life against tetanus, diphtheria, and pertussis or whooping cough.  Infectious disease researchers at the Oregon Health and Science University just published their analysis of World Health Organization data comparing illness in countries that do or do not recommend adult booster vaccinations.

The crunched numbers covering more than 11 billion person-years failed to show any reduction in tetanus or diphtheria in those populations that received vaccine boosters every 5 to 20 years.  It appears that childhood vaccinations, if completed, stimulate sufficient immune memory for a lifetime of protection. 

Ariel M Slifka, Byung Park, Lina Gao, Mark K Slifka, Incidence of Tetanus and Diphtheria in Relation to Adult Vaccination Schedules, Clinical Infectious Diseases, , ciaa017, https://doi.org/10.1093/cid/ciaa017

#tetanus #diphtheria #dpt #dtap #boosters

Vidcast:  https://youtu.be/MpvcfzFj7j8

Metformin, an oral drug for type 2 diabetes, enhances the therapeutic benefits of steroids while reducing their side effects.  A randomized, double blind British study just published in The Lancet looked at 53 participants taking 10-20 mg of prednisone over a 4 month period.

Those also receiving an escalating dose of metformin up to 850 mg 3 times a day, enjoyed improved anti-inflammatory steroid effects and reduced  metabolic side effects as well as fewer bouts of infection and a lower rate of hospitalization for complications.

Chronic steroid therapy is a godsend for those with arthritis, asthma, and cancer.  Adding metformin may just make it more effective and tolerable. 

The Lancet Diabetes & Endocrinology (2020). DOI: 10.1016/S2213-8587(20)30021-8 , http://www.thelancet.com/journals/landia/article/PIIS2213-8587(20)30021-8/fulltext

#steroids #metformin #arthritis #copd #asthma

Vidcast:   https://youtu.be/jMcs8Yu3fs8

Regular aspirin use lowers your risk of fractures and osteoporosis.  A just published Australian meta-analysis of 12 studies reviewed data from more than half million persons.

The analysis revealed a 17% lower risk of fracture at any site, long bones and spine, for those taking aspirin.  Aspirin users enjoyed higher bone mineral densities in their hips as well as in their lumbar spines.  The effect seemed independent of aspirin dosage though most were likely on low dose regimens.

Aspirin works this magic through its anti-inflammatory powers.  The investigators stop short of recommending a low dose regimen for osteoporosis prophylaxis, but, if your doctor agrees you can take it, it can’t hurt. 

Barker AL, Soh S, Sanders KM, et al Aspirin and fracture risk: a systematic review and exploratory meta-analysis of observational studies BMJ Open 2020;10:e026876. doi: 10.1136/bmjopen-2018-026876

#aspirin #osteoporosis #fracture