Coronavirus treatment options and the impact on public policy
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DIY-HP-LED
Well-Known Member
Is your city reopening after coronavirus lockdown? Scientists say avoid these places
New peer-reviewed research says coronavirus droplets caused by talking remain in the air for 8-14 minutes.
www.marketwatch.com
‘Speaking causes airborne virus transmission’: Coronavirus study says droplets caused by talking can last 8-14 minutes
Published: May 14, 2020 at 4:35 p.m. ET
By
Quentin Fottrell
New peer-reviewed research gives more insight into COVID-19’s rapid contagion
Talking spreads coronavirus — and likely plays a part in its contagiousness.
That’s the conclusion of a new study released Thursday published in the peer-reviewed Proceedings of the National Academy of Sciences, the official journal of the National Academy of Sciences. “These observations confirm that there is a substantial probability that normal speaking causes airborne virus transmission in confined environments,” the study concludes.
‘Speech droplets generated by asymptomatic carriers of SARS-CoV-2 are increasingly considered to be a likely mode of disease transmission.’
— study published in the Proceedings of the National Academy of Sciences
The study adds to a growing body of research on why it’s important that people maintain social distancing and wear face masks. The response to COVID-19 has become a political issue. President Donald Trump and New York Gov. Andrew Cuomo have locked horns over when to reopen the economy.
“Speech droplets generated by asymptomatic carriers of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are increasingly considered to be a likely mode of disease transmission,” the study found. “Highly sensitive laser light scattering observations have revealed that loud speech can emit thousands of oral fluid droplets per second.”
In a closed, stagnant-air environment, they disappear from view after 8 minutes to 14 minutes, “which corresponds to droplet nuclei of ca. 4um diameter, or 12um to 21um droplets prior to dehydration,” the researchers wrote. One micrometer, um, is equivalent to one millionth of a meter. The coronavirus is 0.125 um. Medical-grade N95 masks are worn by medics because they can block particles of that size.
The scientists said that, while it’s long been recognized that respiratory viruses such as coronavirus can be transmitted via droplets generated by coughing or sneezing, it’s less widely known that normal speaking also produces thousands of oral fluid droplets. High viral loads of SARS-CoV-2 have been detected in oral fluids of COVID-19−positive patients, including asymptomatic ones.
Don’t miss:‘We will not have a vaccine by next winter.’ Like the 1918 Spanish flu, CDC says second wave of coronavirus could be worse. So what happens next?
Some public spaces appear to be more hostile environments to coronavirus than others, according to a separate study published in the journal Nature Research by a team of investigators, led by Ke Lan, professor and director of the State Key Laboratory of Virology at Wuhan University in the Chinese region where COVID-19, the disease caused by SARS-CoV-2, was first reported.
Room ventilation, open space, sanitization of protective apparel, and proper use and disinfection of toilet areas can help reduce droplet spread.
High-traffic areas are best to be avoided, especially where there’s moisture. After setting up traps for small aerosols (airborne particles) in two hospitals in Wuhan, the researchers found more coronavirus aerosols in patients’ bathrooms and in changing rooms for doctors. “The potential for aerosol transmission is poorly understood,” the researchers wrote.
The study had some good news for hospitals: There were fewer aerosols in isolation wards and patient rooms with good ventilation and thorough sanitization, that study found. “Our results indicate that room ventilation, open space, sanitization of protective apparel, and proper use and disinfection of toilet areas can effectively limit the concentration of SARS-CoV-2 RNA in aerosols,” they wrote.
more...
DIY-HP-LED
Well-Known Member
CDC releases scaled-back guidance on reopening after White House blocked earlier release
The new guidelines provide brief checklists meant to help key businesses and others operating in public reopen safely.
www.politico.com
CDC releases delayed guidance on reopening
The new guidance comes as dozens of governors, to varying degrees, have begun easing restrictions on businesses and social activities.
The CDC on Thursday released previously withheld guidance documents on reopening schools, restaurants and other places, one week after the White House ordered the agency to revise an earlier draft it deemed “too prescriptive."
The new CDC guidelines provide brief checklists meant to help key businesses and others operating in public reopen safely. In separate one-page documents, the CDC offers decision-making tools for schools, workplaces, camps, child care programs, mass transit systems and bars and restaurants.
The White House previously rejected a 17-page CDC draft that issued detailed recommendations for safely reopening, The Associated Press reported last week. A White House spokesperson at the time said the guide didn't comport with President Donald Trump's strategy of putting states in charge of reopening decisions.
The new guidance comes as dozens of governors, to varying degrees, have begun easing restrictions on businesses and social activities. Some states like Michigan and New Jersey are still under strict stay-at-home orders, while Georgia residents can get haircuts at salons and Texans are going back to movie theaters.
But public health experts — and even administration health officials — have disputed the notion that pockets of the country are ready to completely reopen their businesses and economies. The nation’s top infectious disease expert this week warned that reopening the country too early could yield “really serious” consequences if states don’t have the capacity to respond to new infections.
Last month, the White House set basic benchmarks for states to begin lifting their social distancing requirements, but most states have yet to meet that criteria.
Fogdog
Well-Known Member
Yeah, we won't mention that because we look down upon "rigorous and thorough". Around here we call them naysayers or wet blankets and criticize them for being stodgy .
Did somebody say colloidal silver? Man that's a great topic:
Health Benefits of Colloidal Silver
Is the natural remedy safe or dangerous?
What Is Colloidal Silver?
Colloidal silver is said to fight the flu, boost immunity, and even prevent cancer. Let's see what the science says about its safety, benefits, and side effects.
Silver had been used in medicine for centuries, touted as a cure-all for everything from tuberculosis and arthritis to herpes and cancer. Even today, many alternative practitioners believe that colloidal silver offers health benefits by supporting immune function and preventing or treating infections, both common and severe.
Oh sure there are naysayers, like the FDA but they are just big pharma shills.
As @DIY-HP-LED says, "If I want to believe then you are going to hear about it." This is a great therad.
Didn't Trump mention injecting Lysol?
Fogdog
Well-Known Member
People should double their vitamin D doses.CDC releases scaled-back guidance on reopening after White House blocked earlier release
The new guidelines provide brief checklists meant to help key businesses and others operating in public reopen safely.
CDC releases delayed guidance on reopening
The new guidance comes as dozens of governors, to varying degrees, have begun easing restrictions on businesses and social activities.
The CDC on Thursday released previously withheld guidance documents on reopening schools, restaurants and other places, one week after the White House ordered the agency to revise an earlier draft it deemed “too prescriptive."
The new CDC guidelines provide brief checklists meant to help key businesses and others operating in public reopen safely. In separate one-page documents, the CDC offers decision-making tools for schools, workplaces, camps, child care programs, mass transit systems and bars and restaurants.
The White House previously rejected a 17-page CDC draft that issued detailed recommendations for safely reopening, The Associated Press reported last week. A White House spokesperson at the time said the guide didn't comport with President Donald Trump's strategy of putting states in charge of reopening decisions.
The new guidance comes as dozens of governors, to varying degrees, have begun easing restrictions on businesses and social activities. Some states like Michigan and New Jersey are still under strict stay-at-home orders, while Georgia residents can get haircuts at salons and Texans are going back to movie theaters.
But public health experts — and even administration health officials — have disputed the notion that pockets of the country are ready to completely reopen their businesses and economies. The nation’s top infectious disease expert this week warned that reopening the country too early could yield “really serious” consequences if states don’t have the capacity to respond to new infections.
Last month, the White House set basic benchmarks for states to begin lifting their social distancing requirements, but most states have yet to meet that criteria.
Who needs all those dumb guidelines?
DIY-HP-LED
Well-Known Member
Here is an example of medications being used and studied as supportive therapeutics to help people survive and thus lower mortality rates.
Blood thinners like heparin and other medications to deal with cytokine storm are being used as this disease is better understood and supportive treatment and nursing protocols are developed.
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COVID-19 cytokine storm: the interplay between inflammation and coagulation
Coronavirus disease 2019 (COVID-19) has spread rapidly throughout the globe. It is associated with significant mortality, particularly in at-risk groups with poor prognostic features at hospital admission.1 The spectrum of disease is broad but among hospitalised patients with COVID-19, pneumonia, sepsis, respiratory failure, and acute respiratory distress syndrome (ARDS) are frequently encountered complications.1
The pathophysiology of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-induced ARDS has similarities to that of severe community-acquired pneumonia caused by other viruses or bacteria.2, 3 The overproduction of early response proinflammatory cytokines (tumour necrosis factor [TNF], IL-6, and IL-1β) results in what has been described as a cytokine storm, leading to an increased risk of vascular hyperpermeability, multiorgan failure, and eventually death when the high cytokine concentrations are unabated over time.4 Therefore, therapeutic strategies under investigation are targeting the overactive cytokine response with anticytokine therapies or immunomodulators, but this must be balanced with maintaining an adequate inflammatory response for pathogen clearance.
• View related content for this article
Activation of coagulation pathways during the immune response to infection results in overproduction of proinflammatory cytokines leading to multiorgan injury. Although the main function of thrombin is to promote clot formation by activating platelets and by converting fibrinogen to fibrin,5 thrombin also exerts multiple cellular effects and can further augment inflammation via proteinase-activated receptors (PARs), principally PAR-1.5 Thrombin generation is tightly controlled by negative feedback loops and physiological anticoagulants, such as antithrombin III, tissue factor pathway inhibitor, and the protein C system.5 During inflammation, all three of these control mechanisms can be impaired, with reduced anticoagulant concentrations due to reduced production and increasing consumption. This defective procoagulant–anticoagulant balance predisposes to the development of microthrombosis, disseminated intravascular coagulation, and multiorgan failure—evidenced in severe COVID-19 pneumonia with raised d-dimer concentrations being a poor prognostic feature and disseminated intravascular coagulation common in non-survivors.1, 6
The finding of increased d-dimer levels in patients with COVID-19 has prompted questions regarding co-existence of venous thromboembolism exacerbating ventilation–perfusion mismatch, and some studies have shown that pulmonary emboli are prevalent.7 However, due to increased risk of bleeding and despondence related to previous negative trials of endogenous anticoagulants in sepsis, clinicians might be reluctant to offer it to all. Outside of the prevention and management of venous thromboembolism, it is clear that effects of coagulation activation go beyond clotting and crosstalk between coagulation and inflammation can significantly affect disease progression and lead to poor outcome.
more...
Blood thinners like heparin and other medications to deal with cytokine storm are being used as this disease is better understood and supportive treatment and nursing protocols are developed.
-------------------------------------------------------------------------------------------------------------------------------------------
COVID-19 cytokine storm: the interplay between inflammation and coagulation
Coronavirus disease 2019 (COVID-19) has spread rapidly throughout the globe. It is associated with significant mortality, particularly in at-risk groups with poor prognostic features at hospital admission.1 The spectrum of disease is broad but among hospitalised patients with COVID-19, pneumonia, sepsis, respiratory failure, and acute respiratory distress syndrome (ARDS) are frequently encountered complications.1
The pathophysiology of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-induced ARDS has similarities to that of severe community-acquired pneumonia caused by other viruses or bacteria.2, 3 The overproduction of early response proinflammatory cytokines (tumour necrosis factor [TNF], IL-6, and IL-1β) results in what has been described as a cytokine storm, leading to an increased risk of vascular hyperpermeability, multiorgan failure, and eventually death when the high cytokine concentrations are unabated over time.4 Therefore, therapeutic strategies under investigation are targeting the overactive cytokine response with anticytokine therapies or immunomodulators, but this must be balanced with maintaining an adequate inflammatory response for pathogen clearance.
• View related content for this article
Activation of coagulation pathways during the immune response to infection results in overproduction of proinflammatory cytokines leading to multiorgan injury. Although the main function of thrombin is to promote clot formation by activating platelets and by converting fibrinogen to fibrin,5 thrombin also exerts multiple cellular effects and can further augment inflammation via proteinase-activated receptors (PARs), principally PAR-1.5 Thrombin generation is tightly controlled by negative feedback loops and physiological anticoagulants, such as antithrombin III, tissue factor pathway inhibitor, and the protein C system.5 During inflammation, all three of these control mechanisms can be impaired, with reduced anticoagulant concentrations due to reduced production and increasing consumption. This defective procoagulant–anticoagulant balance predisposes to the development of microthrombosis, disseminated intravascular coagulation, and multiorgan failure—evidenced in severe COVID-19 pneumonia with raised d-dimer concentrations being a poor prognostic feature and disseminated intravascular coagulation common in non-survivors.1, 6
The finding of increased d-dimer levels in patients with COVID-19 has prompted questions regarding co-existence of venous thromboembolism exacerbating ventilation–perfusion mismatch, and some studies have shown that pulmonary emboli are prevalent.7 However, due to increased risk of bleeding and despondence related to previous negative trials of endogenous anticoagulants in sepsis, clinicians might be reluctant to offer it to all. Outside of the prevention and management of venous thromboembolism, it is clear that effects of coagulation activation go beyond clotting and crosstalk between coagulation and inflammation can significantly affect disease progression and lead to poor outcome.
more...
DIY-HP-LED
Well-Known Member
Endocrinology | Medical News & Expert Insight | HCPLive
The endocrinology condition center is a comprehensive resource for clinical news and expert insights on endocrinology. Read more at HCPLive.
Anticoagulants Improve Odds of Survival in COVID Patients
PHOTO CREDIT: Mount Sinai Health System. Kaplan-Meier curve for hospitalized COVID-19 patients (A) and those requiring invasive mechanical ventilation (B). Colors indicate treatment-dose anticoagulation. Patients were right-censored if they were hospitalized at the time of data-freeze or discharged within the study period.
Researchers from the Mount Sinai COVID Informatics Center report improved survival rates in COVID patients treated with anticoagulants. Results of the study demonstrated that hospitalized COVID-19 patients treated with anticoagulants had improved outcomes both in and out of the intensive care unit setting, without a significant difference in bleeding.
The research was published in the Journal of the American College of Cardiology. Previous studies have shown that COVID positive patients frequently develop life-threatening blood clots, leading to potentially deadly thromboembolic events, and they authors say their findings could provide new insight on how to treat and manage coronavirus patients in the hospital.
"This research demonstrates anticoagulants taken orally, subcutaneously, or intravenously may play a major role in caring for COVID-19 patients, and these may prevent possible deadly events associated with coronavirus, including heart attack, stroke, and pulmonary embolism," said senior corresponding author Valentin Fuster, MD, PhD, Director of Mount Sinai Heart and Physician-in-Chief of The Mount Sinai Hospital in a statement. "Using anticoagulants should be considered when patients get admitted to the ER and have tested positive for COVID-19 to possibly improve outcomes.”
A team of investigators compared the survival rates of patients on blood thinners with those not on blood thinners in 2,773 confirmed COVID-19-positive patients admitted to five hospitals in the Mount Sinai Health System in New York City (The Mount Sinai Hospital, Mount Sinai West, Mount Sinai Morningside, Mount Sinai Queens, and Mount Sinai Brooklyn) between March 14 and April 11, 2020.
786 (28 percent) received a full-treatment dose of anticoagulants--one that is usually given to those who already have clots or are suspected to have clots. Treatment with anticoagulants was associated with improved hospital survival among COVID-19 patients both in and out of the intensive care unit setting. Of the patients who did not survive, those on anticoagulants lived longer than those not on anticoagulant therapy (an average of 21 days vs. 14 days). In ventilated patients, survival rates were markedly better in those patients on anticoagulants vs. those who did not receive the drugs. (62.7 percent compared to 29.1 percent for intubated patients treated with anticoagulants) and they also lived longer (9days compared to 21 days.)
more...
Dr.Amber Trichome
Well-Known Member
Hey there Diy. I had a dr appointment today and had a blood draw to check my thyroid and Vit D level. I will get the results tomorrow. I asked her what she would recommend if me D level was too low and she said a mega high dose pill to start. Interesting she jumped right to the vit D blood test .
I have no doubt my Vit D is low and I want that pill as soon as possible.
I have no doubt my Vit D is low and I want that pill as soon as possible.
DIY-HP-LED
Well-Known Member
Low vit D is associated with very bad covid-19 outcomes, particularly among younger patients, preliminary correlation studies though, but sunshine doesn't hurt, break out the bikini and take yer pills!
Dr.Amber Trichome
Well-Known Member
I have severe anxiety with the sun ever since I had basil cell skin cancer and had a huge chunk of my face removed with Mohls surgery leaving me with a scar that runs down my entire face . and I have many tattoos that I don’t want to get ruined by the sun either so I end up slapping on loads of sunscreen so the entire sun quenching process is a wash.
DIY-HP-LED
Well-Known Member
Ouch! I'm sorry to hear that Amber, looks like it's gonna be supplements, I take the liquid oil based kind, and for myself I take around 2,000 IUs a day. I get some sun when I can and often sit in the cold out back on the deck meditating for 20 in the sun. BTW vit D is a hormone precursor too and it affects your mood positively, I found that it seems to help a lot with muscle aches since I upped my daily dose. Making sure you get enough vitamin D is probably one of the best things you can do for your general health, check out the research I've posted on this thread or do your own.
DIY-HP-LED
Well-Known Member
One more of interest
"Strikingly, 100% of ICU patients less than 75 years old had VDI".
Vitamin D Insufficiency is Prevalent in Severe COVID-19
Background: COVID-19 is a major pandemic that has killed more than 196,000 people. The COVID-19 disease course is strikingly divergent. Approximately 80-85% of patients experience mild or no symptoms, while the remainder develop severe disease. The mechanisms underlying these divergent outcomes...
Vitamin D Insufficiency is Prevalent in Severe COVID-19
Sir Napsalot
Well-Known Member
I hate people who talk
DIY-HP-LED
Well-Known Member
T cells found in COVID-19 patients ‘bode well’ for long-term immunity
New findings suggest past infections may offer some protection against the novel coronavirus
T cells found in COVID-19 patients ‘bode well’ for long-term immunity
By Mitch LeslieMay. 14, 2020 , 9:00 PM
Science’s COVID-19 reporting is supported by the Pulitzer Center.
Immune warriors known as T cells help us fight some viruses, but their importance for battling SARS-CoV-2, the virus that causes COVID-19, has been unclear. Now, two studies reveal infected people harbor T cells that target the virus—and may help them recover. Both studies also found some people never infected with SARS-CoV-2 have these cellular defenses, most likely because they were previously infected with other coronaviruses.
“This is encouraging data,” says virologist Angela Rasmussen of Columbia University. Although the studies don’t clarify whether people who clear a SARS-CoV-2 infection can ward off the virus in the future, both identified strong T cell responses to it, which “bodes well for the development of long-term protective immunity,” Rasmussen says. The findings could also help researchers create better vaccines.
more...
Fogdog
Well-Known Member
what about the health promoting properties of honey?One more of interest
"Strikingly, 100% of ICU patients less than 75 years old had VDI".
Vitamin D Insufficiency is Prevalent in Severe COVID-19
Background: COVID-19 is a major pandemic that has killed more than 196,000 people. The COVID-19 disease course is strikingly divergent. Approximately 80-85% of patients experience mild or no symptoms, while the remainder develop severe disease. The mechanisms underlying these divergent outcomes...
www.medrxiv.org
Vitamin D Insufficiency is Prevalent in Severe COVID-19
DIY-HP-LED
Well-Known Member
I'll leave that one to you to expound upon on your very own Foggy's Folk remedies thread.
Strikingly, 100% of ICU patients less than 75 years old had VDI", is an interesting finding though and warrants further study.
DIY-HP-LED
Well-Known Member
COVID-19 and vitamin D: SoCal doctor explains the connection
Recent studies show people who were sickest for the longest amount of time in hospitals, also had the lowest levels of vitamin D. If so, what could you do to boost your levels?
COVID-19 and vitamin D: SoCal doctor explains the connection
What role does vitamin D play in the coronavirus pandemic? Studies out of China show those sickest for the longest duration of time in hospitals had the lowest levels of vitamin D.
Can vitamin D help protect you against the coronavirus? There's growing evidence that supports a connection between the two.
Dr. Anthony Cardillo, CEO Of Mend Urgent Care and ER physician, joined ABC7 via Skype to explain the latest research showing why vitamin D levels may be linked to a person's risk of COVID-19.
"Vitamin D is a phenomenal molecule in our bodies," said Cardillo. "Vitamin D does boost and modulate the immune system."
Cardillo said it's a pro-hormone that becomes a molecule and is able to go throughout our body. He points to studies out of China during the beginning of the pandemic for a potential connection between coronavirus and vitamin D.
"They started realizing that people that were the sickest in the hospital that had the longest duration of illness had the lowest levels of vitamin D. And these are retrospective observational studies that were done looking at the population in China that have gotten infected," said Cardillo.
He said it may also mean that sick people in general have low vitamin D levels, but nevertheless it's an important piece of information to keep in mind.
"We probably should be supplementing with to decrease our risk overall," said Cardillo.
So, how do we boost our vitamin D level?
"The first is sunshine. Being out and about in the sun will definitely cause your skin to synthesize vitamin D," said Cardillo. "Sunshine is the best way to get vitamin D levels elevated."
He suggested going into your backyard or taking a walk down the street, but always practicing physical distancing.
Cardillo said you can also supplement by ingesting vitamin D with your meals, such as with fortified milks and cereals, as well as fatty fishes.
A supplementation of 1,000-2,000 i.u. of vitamin D is good, but Cardillo warns people to only intake the recommend daily allowance because it is possible to overdose on vitamin D.
As for resuming doctor appointments, either in person or through telemedicine, some people are concerned about going to a lab to get tested.
"You want to be going to a lab that is being very mindful about how they are organizing their lab, meaning that they have restrictions in place about how many people can be in the lab at the same time. They have protocols in place with cleaning and making sure the lab is sanitized properly," said Cardillo.
Cardillo said he doesn't think people should be fearful of going to the doctor or labs because medical establishments are on top of ensuring safety. He said that not getting your blood drawn is more dangerous than going into a lab.
Dr.Amber Trichome
Well-Known Member
Yup blood work came back.
my V-D is only 27.2.
Normal range is 30-100.
I have decided to apply for some jobs in the Sunshine State. I will have to get over my fear of the sun. I was once a sun worshipper . A competitive outdoor swimmer , a life guard . I would bake in the sun 8 to 10 hours a day and in the ocean all day long.
Then later
Living in the Pacific Northwest for 6 years I got the seasonal acute depression and decided to move to Tucson Arizona to cure it.
That’s where my skin cancer was found and my relationship with The sun took an turn for the worse . Pure fear of it now for about 7 years. It’s time the sun is going to have to become a part of my life again . I just can’t go on like this anymore. If will be a challenging balance between stopping skin cancer and vitamin D deficiency. I will take the pills and hope they don’t hurt my stomach.
my V-D is only 27.2.
Normal range is 30-100.
I have decided to apply for some jobs in the Sunshine State. I will have to get over my fear of the sun. I was once a sun worshipper . A competitive outdoor swimmer , a life guard . I would bake in the sun 8 to 10 hours a day and in the ocean all day long.
Then later
Living in the Pacific Northwest for 6 years I got the seasonal acute depression and decided to move to Tucson Arizona to cure it.
That’s where my skin cancer was found and my relationship with The sun took an turn for the worse . Pure fear of it now for about 7 years. It’s time the sun is going to have to become a part of my life again . I just can’t go on like this anymore. If will be a challenging balance between stopping skin cancer and vitamin D deficiency. I will take the pills and hope they don’t hurt my stomach.
DIY-HP-LED
Well-Known Member
Broad brimmed hat, sunscreen for your face and only get as much sun as you need, study up on how to do it as safely as you can, there's always a best way.
I believe women have a higher normal range of vit d than men and it takes awhile for it to become incorporated into your immune system and cells, daily supplements are best. BTW look at some of the evidence for vit d and cancer prevention, it's pretty compelling for breast and colorectal cancer. Just google vit d and cancer and try to stick to reliable sources.