Tag Archives: Virus

VIDEOS: DIAGNOSING AND TREATING COVID-19 (MAYO)

Dr. Stacey Rizza, an Mayo Clinic infectious diseases specialist, discusses the various ways COVID-19 is diagnosed and treated.

COVID-19 can be diagnosed several ways when looking for active infection.

“The most common way that testing is done is with a swab into the nose or into the nasal pharyngeal area,” says Dr. Stacey Rizza, a Mayo Clinic infectious diseases expert.

“This polymerase chain reaction (PCR) test is essentially a test looking for the genetic material of the virus.” If it’s positive, it means that person is infected with SARS-CoV-2, the coronavirus that causes COVID-19.

COMMENTARY:

Dr. Stacey Rizza from Mayo Clinic gave the standard Academic recommendations for Covid Testing and treatment. I will comment on how this differs from the testing recommendations of Dr. Michael Mina from the Chan school at Harvard and the actual treatment given to Donald Trump as we speak.

I agree with the latter recommendations, and route that I would opt for, were I to catch Covid 19. TESTING, if it is to be Epidemiologically effective should offer results that are rapidly available so as to reduce spreading of the virus and treatment delay. One trouble with PCR- based tests is that they are slow. Another trouble, according to Dr. Mina, is that if they run for 40 cycles for maximum sensitivity, they may pick up viral shedding that is too minor to be infective, and may cause unnecessary precautions, such as quarantining. If they run for 35 or even 30 cycles to show only infective, actionable cases, they take several days, and even then labs do not usually report the number of cycles run, but only yes or no, positive or negative.

The RAPID TESTS detect viral protein are available within hours. They are less sensitive, but in Dr. Mina’s view, this can be a virtue, since only definitely infected patients are identified. They are cheaper, and can even be done on site. Frequent testing more than makes up for decreased sensitivity. Most tests currently available use only specimens from nasal swabs, which are uncomfortable.

SALIVA is almost as sensitive, and has one additional virtue, when it comes to testing school children. If school children are organized into learning “pods”, They can all spit into a common collector, and the pod tested preemptively, at least twice weekly. If positive The entire pod is individually tested to find who is positive. Of course if a full 20 kids are in a pod, The sensitivity of the protein test may be insufficient for positive to survive a 20-fold dilution, but this can be empirically worked out. Twice weekly testing vs. every other week is much better for reducing the number of the pod members infected at time of discovery, as the NYT has illustrated.

TREATMENT given to Donald Trump has so far consisted of more than Remdesivir. He is also receiving Corticosteroids, plus an experimental double antibody mixture, derived from both Covid Convalescent serum, and monoclonal antibodies from a “humanized” murine source. The antibodies should theoretically be given early. The corticosteroids are generally not given until a bit later, but with the reported drop in O2 sats, he may be later in the disease than we are led to believe. To my knowledge, he is not receiving his tweeted Hydroxychloroquine- azithromycin combination.

If I were infected, at age 88, I would also like the antibody treatment, but most likely would not be allowed to get it.

–Dr. C.

PODCAST: FEAR OF VACCINES, CONFUSION OVER ORIGINS OF CORONAVIRUS (sCIENCE)

Science Editor-in-Chief Holden Thorp joins host Sarah Crespi to discuss his editorial on preventing vaccine hesitancy during the coronavirus pandemic. Even before the current crisis, fear of vaccines had become a global problem, with the World Health Organization naming it as one of the top 10 worldwide health threats in 2019. Now, it seems increasingly possible that many people will refuse to get vaccinated. What can public health officials and researchers do to get ahead of this issue?

Also this week, Sarah talks with Science Senior Correspondent Jon Cohen about his story on Chinese scientist Shi Zhengli, the bat researcher at the center of the COVID-19 origins controversy—and why she thinks President Donald Trump owes her an apology.

Finally, Geert Van der Snickt, a professor in the conservation-restoration department at the University of Antwerp, talks with Sarah about his Science Advances paper on a new process for peering into the past of paintings. His team used a combination of techniques to look beneath an overpainting on the Ghent Altarpiece by Hubert and Jan Van Eyck—a pivotal piece that showed the potential of oil paints and even included an early example of painting from an aerial view.

CORONAVIRUS: RESPIRATORY-DROPLET CONTACT IS MAJOR WAY COVID-19 SPREADS

From the Wall Street Journal (June 16, 2020):

Health agencies have so far identified respiratory-droplet contact as the major mode of Covid-19 transmission. These large fluid droplets can transfer virus from one person to another if they land on the eyes, nose or mouth. But they tend to fall to the ground or on other surfaces pretty quickly.

Some researchers say the new coronavirus can also be transmitted through aerosols, or minuscule droplets that float in the air longer than large droplets. These aerosols can be directly inhaled.

Illustration: Erik Brynildsen

Sufficient ventilation in the places people visit and work is very important, said Yuguo Li, one of the authors and an engineering professor at the University of Hong Kong. Proper ventilation—such as forcing air toward the ceiling and pumping it outside, or bringing fresh air into a room—dilutes the amount of virus in a space, lowering the risk of infection.

Another factor is prolonged exposure. That’s generally defined as 15 minutes or more of unprotected contact with someone less than 6 feet away, said John Brooks, the Centers for Disease Control and Prevention’s chief medical officer for the Covid-19 response. But that is only a rule of thumb, he cautioned. It could take much less time with a sneeze in the face or other intimate contact where a lot of respiratory droplets are emitted, he said.

Read more

COVID-19: CASE SEVERITY IS DEPENDENT ON VIRAL LOAD

From the New York Times

….in the case of the new coronavirus, people who have no symptoms seem to have viral loads — that is, the amount of virus in their bodies — just as high as those who are seriously ill, according to some studies.

Harry Henri, a research assistant, working with blood samples from coronavirus patients at SUNY Downstate’s BioBank in Brooklyn.Credit…Misha Friedman for The New York Times

When experts recommend wearing masks, staying at least six feet away from others, washing your hands frequently and avoiding crowded spaces, what they’re really saying is: Try to minimize the amount of virus you encounter.

A few viral particles cannot make you sick — the immune system would vanquish the intruders before they could. But how much virus is needed for an infection to take root? What is the minimum effective dose?

And coronavirus patients are most infectious two to three days before symptoms begin, less so after the illness really hits.

Some people are generous transmitters of the coronavirus; others are stingy. So-called super-spreaders seem to be particularly gifted in transmitting it, although it’s unclear whether that’s because of their biology or their behavior.

On the receiving end, the shape of a person’s nostrils and the amount of nose hair and mucus present — as well as the distribution of certain cellular receptors in the airway that the virus needs to latch on to — can all influence how much virus it takes to become infected.

Read full article

COMMENTARY

DR. C’S MEDICINE CABINET: “OVERVIEW OF METABOLISM”

“Life is nothing but an electron looking for a place to rest”.

Albert Szent-Gyorgy

Overview of Metabolism – Seeing an Essence of Nanosystems in the Hum of a Vibrant City; the Skyscraper as Catalyst, and Thought as Electron

What did it take to bring the world to its’ knees? SARS-CoV2? We will never know, because we instituted DISTANCING to control the virus because the projected number of deaths were unacceptable.

The distancing and isolation did hold the number of deaths, still large, below projection. However, it DEVASTATED our Economy.

OUR WORLD is a  massive, cooperative, interdependent system, with hubs, factories, supply chains and a myriad of products. It is a COMPLEX SYSTEM.

I would like to use the world as an analogy, and compare it to another Complex System, the HUMAN BODY.

Our bodies are essentially a large pile of chemicals (mostly proteins) in a sack, our skin. These chemicals are constantly interacting with each other. If they grow to larger, more complex chemicals in a process we call anabolism, we take in more chemicals and energy by eating, and get bigger. If our chemicals get less numerous and complex in a process we call catabolism, we lose weight and get smaller.

Some of the proteins in our bodies are ENZYMES, and bring other proteins CLOSER TOGETHER, so that they can LINK TOGETHER  become more complex and PRODUCE things. Enzymes are a sine qua non of life. Without enzymes, life would slow so much as to be impossible. 

Let’s go back to our Society, Before Covid. 

Vast numbers of people are cooperating in close proximity, working together with machines, often supplied by other people far away, making things. This process takes place most efficiently in CITIES, where people are in closest proximity, doing things together.

Enter Covid. This interdependent process stops. What things that are produced are made to fight Covid. It is just like one of our cells infected by Covid: we have been HIJACKED  by the virus!

Lets’ GO BACK TO OUR CELLS. Our METABOLISM is like our teeming, cooperative CITIES, with SUPPLY CHAINS, factories and products. Our PROTEINS NEED PROXIMITY to function.

Some Proteins are at a critical HUB, and comprise a RATE-LIMITING step in the production line.

Many Vitamins and nutrients are COENZYMES, and act to ACCELERATE critical supply lines.

If the Hubs are OUT OF BALANCE and OVERACTIVE, many MEDICATIONS act to BLOCK THE ACTION of an enzyme to bring the system closer to balance.

Thus coordination, cooperation and careful monitoring to PREVENT A PROBLEM is superior to letting it break down and correcting the imbalance.

I hope that this Overview will be helpful. I will go through my MEDICINE CABINET to discuss a few of the 20,000 or so Medications approved by the FDA. I will also VIEW THE TEST RESULTS from my LABORATORY TESTS. NORMAL results show a SYSTEM IN BALANCE. Abnormal results show inefficiencies in the metabolism (supply chains, hubs), which need correction to restore balance.   

— Dr. C

HEALTH: “HOW THE BODY CLEARS COVID-19” (VIDEO)

Understanding how the body clears the new coronavirus is becoming more important as the U.S. begins to reopen. WSJ’s Daniela Hernandez explains how the body fights infection and why feeling better doesn’t equal being virus-free. Photo illustration: Laura Kammermann

COMMENTARY

This excellent video is well worth watching and listening to. It revisits how the immune system, both innate and adaptive responds to SARS CoV and other viruses.

It shows graphically how long the body takes to clear the the Covid 19 virus.

And it makes me, a susceptible 88 year old, even more alert to infection. We should keep our guards up.

Even if an effective vaccine is found, it will probably take its place, incorporated into influenza vaccine as an annual immunization.

Dr. C.