Category: COVID19

The types of face covering that could protect a person from coronavirus transmission risk.

Face masks and any other mouth and nose covers can lower the forward distance transmission risk of COVID-19 by 90 percent.

A group of engineers has examined seven types of protective face masks, such as homemade masks and surgical masks and found that all are effective in minimising COVID-19 spread.

Dr Cathal Cummins, study co-author, explained the results:

“Even our hand-made mask performed very well in preventing the frontal spread of the wearer’s exhaled breath.

While this is positive, wearers of hand-made face masks need to be aware that jets of air can leak out of the sides and back of their masks.

This could be particularly important when using masks on public transport, where sitting behind someone wearing a mask could be more of a hazard than sitting directly facing them.”

However, exhaled air could still escape from the sides and back of some face covers.

A background oriented schlieren (BOS) imaging technique was used to measure the direction and distance that air travels when a person coughs or breathes through a face covering.

The team discovered that all face masks with no outlet valve decrease how far a deep breath travels by over 90 percent.

Respirator masks worn by workers who are exposed to dust provide some protection but the valves could lead to the spread of infectious air in front.

Handmade covers and surgical masks were shown to minimise exhaled air travelling forwards but produced leakage jets below, above, behind, and to the sides.

In particular, strong backward jets were produced by coughing and breathing heavily.

The researchers found that only tight-fitting masks could block virus-filled droplets.

They also found that intense downward jets were discharged when wearing full-face shields only.

The team found that extubation, a routine medical procedure to remove a breathing tube used in patients on ventilators, increases the spread of coronavirus risk.

Coughing due to extubation would put practitioners at extreme risk of the virus as well as anyone close by.

Dr Felicity Mehendale, study co-author, said:

“It was reassuring to see the hand-made mask worked just as well as the surgical mask to stop the wearer’s breath flowing directly forwards.

This suggests that some hand-made masks can help to prevent the wearer from infecting the public.

But, the strong backward jets mean you need to think twice before turning your head if you cough while wearing a mask; and be careful if you stand behind or beside someone wearing a mask.”

The study was published in arXiv (Viola et al., 2020).

The most popular ways of dealing with the pandemic.

People are coping with the pandemic by increasing their use of self-care, a new survey finds.

Self-care strategies include exercising, stress management, healthy diet and other changes like giving up smoking.

Among the most popular types of self-care are creative activities, praying and having meaningful conversations with friends and family.

People are also eating more healthy foods and spending more time outdoors.

Dr Wayne Jonas, the study’s first author, said:

“The pandemic threatens the mental and physical well-being of every American.

People are seeking ways to manage their stress, but it isn’t enough.

As we adjust to a new normal, we need to foster a robust, patient-centered healthcare system to better promote self-care.”

The results come from an online poll of 2,051 people in the US.

Almost two-thirds of Americans said they are more focused on their mental health now than ever before.

Most Americans (80 percent) said that they will be more mindful of their self-care in the future.

Typical problems people are experiencing include:

• Social isolation (47 percent),
• lack of energy (30 percent),
• problems sleeping (29 percent),
• and less exercise (29 percent).

People also report being scared to seek medical attention they may need (55 percent).

Dr Jonas said:

“At a time when healthcare is needed the most, a majority of people are scared to seek it out.

This not only leaves them without critical immediate care, it also halts necessary preventative care that is vital to chronic disease prevention and management.

This change in healthcare access will likely have dangerous repercussions for the long-term health of our country.

These are also the same risk factors that increase serious illness from COVID-19.”

Dr Jonas summarised:

“The findings from this study show the critical need for a system that empowers individuals to maintain healthy habits they formed and emphasizes strategies that support self-care–like good nutrition, exercising, and stress reduction–alongside guidance from physicians.”

The Social Isolation Survey was conducted online by The Harris Poll on behalf of Samueli Integrative Health Programs.

An over-the-counter drug may put COVID-19 symptoms on a tight leash.

A commonly used medicine for treating indigestion could also be a worthy candidate to fight off coronavirus symptoms.

Famotidine is a prescription drug that is sold under various brand names including ‘Pepcid AC’.

The medicine relieves heartburn and acid reflux by reducing the production of stomach acid.

Famotidine dosage can be from 20 to 160 milligram taken up to four times a day.

A study suggests that famotidine can also minimise the symptoms of COVID-19 in patients with mild to moderate symptoms.

A small group of COVID-19 patients, within 24 to 48 hours of taking famotidine, experienced a quick improvement of symptoms and had recovered from the infection in 14 days.

A large clinical trial is going to test famotidine to see if it could be an effective medicine for treating SARS-CoV-2 infection.

The report includes 10 COVID-19 patients aged from 23 to 71 with different ethnicities who started taking famotidine during their sickness.

At the point of taking famotidine, some of them had been experiencing the coronavirus symptoms for 26 days.

Shortness of breath, cough, loss of taste and smell, headache, and fatigue were the common symptoms.

The average dose of famotidine was 80 mg taken three time per day and most recovered in 11 days.

All of them reported that their symptoms were improved less than 48 hours after taking famotidine and most symptoms were gone in 14 days.

All symptoms were improved, but respiratory problems including shortness of breath and cough disappeared much faster than systemic issues like fatigue.

Except for three patients who experienced mild side-effects, the rest did not have any side-effects from taking famotidine.

However, the authors caution:

“Our case series suggests, but does not establish, a benefit from famotidine treatment in outpatients with COVID-19.”

The effect of famotidine on the virus is not clear yet but there is a chance that somehow it disables the virus or changes the immune responses to the virus.

The authors said:

“Clinically, we unreservedly share the opinion that well designed and informative studies of efficacy are required to evaluate candidate medications for COVID-19 as for other diseases.”

Even so, a more detailed clinical trial is already started to look into the combined effect of the antimalarial drug hydroxychloroquine with famotidine in hospitalized patients with COVID-19.

The authors concluded:

“An outpatient study of oral famotidine that investigates efficacy for symptom control, viral burden and disease outcome and assesses the effects of medication use on long term immunity should be considered to establish if famotidine may be of use in controlling COVID-19 in individual patients while also reducing the risk of SARS-CoV-2 transmission.”

The study was published in the journal GUT (Janowitz et al., 2020).

Another feature of COVID-19 which makes the disease more mysterious.

The more we know about the coronavirus, the stranger it gets.

People with COVID-19 have been reported to show a wide range of symptoms, but some who become infected are symptomless.

Scientists have discovered that the ‘silent’ COVID-19 infection cases are far greater than we know.

Silent infections may be the most bizarre feature of COVID-19.

Since many people can be infectious but show no signs then the transmission rate will increase dramatically.

The typical symptoms, like high temperature and cough, can make a person aware of being infected and lower the odds of spreading it.

Still, it is not clear how the infection can be spread so rapidly without a cough or sneeze where the droplets containing the virus hit a surface.

But most infections are probably due to touching, talking, or breathing into someone’s face or on a surface like door knobs.

The discovery of a much higher incidence of symptomless COVID-19 cases comes from a study tracking isolated cruise ship passengers through the pandemic.

The study found that more than eight out of ten passengers and crew showed no signs of infection while testing positive.

The ship left Argentina in mid-March for a 21-day expedition to Antarctica.

Through these three weeks passengers were not allowed to board in countries with high cases of coronavirus infection.

Also, before embarkation their temperature was taken and there were plenty of hand sanitising stations on board.

On day 8 of cruising it was a case of fever which caused immediate control measures to be taken against infection.

Passengers were kept in their cabins and except for the delivery of meals all other daily services were stopped.

Also, crew members had to wear personal protective equipment if they came in contact with a sick person.

On day 20, a swab test was done on all the passengers and crew revealing that 59 percent of them were positive for coronavirus.

Only 19 percent of those tested positive had symptoms while 81 percent were symptomless.

Interestingly, for 28 days the ship had no contact with the outside environment meaning it was like an airtight container.

The authors expect that the incidence of coronavirus infection on cruise ships is considerably underestimated.

Therefore, they advise that passengers, after getting off a ship, should be monitored to avoid the possible spread of infection.

Professor Alan Smyth, commenting on the study, said:

“It is difficult to find a reliable estimate of the number of COVID positive patients who have no symptoms.

But the figure of 1% suggested by the WHO in early March falls far short of that found on the cruise ship.

As countries progress out of lockdown, a high proportion of infected, but asymptomatic, individuals may mean that a much higher percentage of the population than expected may have been infected with COVID.”

The study was published in the journal Thorax (Ing et al., 2020).

Coronavirus hospitalisation rates are much lower for those who are taking this drug.

Blood pressure drugs called angiotensin-converting enzyme (ACE) inhibitors could lower the risk of severe SARS-CoV-2 infection.

A study reveals that people who are infected with the COVID-19 virus but who are taking ACE inhibitors for blood pressure have a lower risk of hospitalization.

The research team analyzed data from 10,000 hypertensive patients who tested positive for the coronavirus.

These patients were taking one of the commonly used drugs for treating high blood pressure such as angiotensin receptor blockers (ARB), angiotensin-converting enzyme (ACE) inhibitors, or other antihypertensive agents.

They found that the risk of hospitalization reduced by 40 percent in older patients who were on ACE inhibitors.

The other antihypertensive agents including ARBs didn’t have any reducing effect on COVID-19 hospitalization rates for either older or younger patients.

Furthermore, neither ACE inhibitors nor other antihypertensive drugs could reduce the risk of dying in COVID-19 patients who were admitted to hospital.

Professor Harlan Krumholz, the study’s co-author, said:

“While not yet actionable, these findings provide an impetus to test whether this common, inexpensive class of drugs can mitigate the impact of the virus.”

Professor Krumholz added that a large clinical trial is starting soon and it plans to test the possible benefits of using ACE inhibitors to help fight coronavirus.

The study was published in medRxiv (Khera et al., 2020).

The first COVID-19 vaccine is safe for phase 2 human test and could be ready in six months.

The first vaccine against SARS-CoV-2 has completed the phase 1 clinical trial showing promising results and is moving on to phase 2.

The new COVID-19 vaccine was injected in 108 healthy adults and was found to be well-tolerated, safe, and produced a good immune response against the virus.

A phase 2 trial has been started to see if the results can be replicated in a larger population with no harmful effect after vaccination for 6 months.

Professor Wei Chen, study senior author, said:

“These results represent an important milestone.

The trial demonstrates that a single dose of the new adenovirus type 5 vectored COVID-19 (Ad5-nCoV) vaccine produces virus-specific antibodies and T cells in 14 days, making it a potential candidate for further investigation.

However, these results should be interpreted cautiously.

The challenges in the development of a COVD-19 vaccine are unprecedented, and the ability to trigger these immune responses does not necessarily indicate that the vaccine will protect humans from COVID-19.

This result shows a promising vision for the development of COVID-19 vaccines, but we are still a long way from this vaccine being available to all.”

Right now everybody thinks that vaccination is the best solution against the COVID-19 pandemic.

This has countries competing to be first in discovering the vaccine.

As a result, over 100 candidate COVID-19 vaccines are in development.

The Ad5-nCoV vaccine is one of the candidates and also the first one that has been tested in a human trial.

The vaccine contains a weak common cold virus known as adenovirus which causes a respiratory infection.

It provides the genetic material of the SARS-CoV-2 spike protein causing the immune system to produce antibodies that can identify spike proteins and so defeat the COVID-19 virus.

The Ad5-nCoV vaccine was administered to healthy adults in various doses with no SARS-CoV-2 infection.

All doses were tolerated and side-effects included fever, headache, muscle pain, fatigue, and mild pain caused by the injection which lasted for less than 2 days.

Twenty-eight days after vaccination, antibodies binding to the antigen increased by a four times in most subjects.

They either had SARS-CoV-2-neutralizing antibodies or a positive T cell response against the virus.

Professor Feng-Cai Zhu, the study’s first author, said:

“Our study found that pre-existing Ad5 immunity could slow down the rapid immune responses to SARS-CoV-2 and also lower the peaking level of the responses.

Moreover, high pre-existing Ad5 immunity may also have a negative impact on the persistence of the vaccine-elicited immune responses.”

The phase 2 trial of the Ad5-nCoV vaccine has already started to find out if the results can be reproduced in a larger population and among people over 60.

They also want to see if there are any serious side-effects six months after vaccination.

The study was published in The Lancet (Zhu et al., 2020).

Mouthwash could inactivate the coronavirus in the throat and minimise transmission.

Experts think that a 30-second regular rinsing with mouthwash could inactivate the coronavirus in the throat and minimise transmission and prevent infection, research finds.

Chemicals such as ethanol, cetylpyridinium, and povidone-iodine commonly found in dental mouthwashes can destroy the outer shell of fat of many enveloped viruses.

Coronaviruses are enveloped viruses, like influenza and HIV.

Therefore, a group of scientists in a review ask for an urgent clinical trial to test if the readily available mouthwashes can be effective in combating the COVID-19 virus.

Professor Valerie O’Donnell, the study’s first author, said:

“Safe use of mouthwash – as in gargling – has so far not been considered by public health bodies in the UK.

In test tube experiments and limited clinical studies, some mouthwashes contain enough of known virucidal ingredients to effectively target lipids in similar enveloped viruses.

What we don’t know yet is whether existing mouthwashes are active against the lipid membrane of SARS-CoV-2.

Our review of the literature suggests that research is needed as a matter of urgency to determine its potential for use against this new virus.

This is an under-researched area of major clinical need – and we hope that research projects will be quickly mobilised to further evaluate this.”

SARS-CoV-2 is an enveloped virus covered with lipids (fat) and common mouthwashes in general contain active ingredients like cetylpyridinium chloride to kill microorganisms.

Hence, regular oral rinsing with a dental mouthwash for 30 seconds and then spitting seem to be a good hygiene practice.

This is in line with other recommendations such as hand washing, using face covering, and social distancing rules to protect people from coronavirus.

Despite this, the World Health Organization (WHO) has debunked the idea that mouthwash can help prevent the COVID-19 infection.

A WHO spokesman said:

“There is no evidence that using mouthwash will protect you from infection with the new coronavirus.”

Some brands of mouthwash can eliminate certain microbes for a few minutes in the saliva in your mouth.

However, this does not mean they protect you from 2019-nCoV infection.”

It seems premature to reject the theoretical evidence on oral rinsing as a potential way to help lower transmission of SARS-CoV-2.

Professor O’Donnell also added:

“Mouthwash has not been tested against this new coronavirus yet.

People should continue to follow the preventive measures issued by the UK government, including washing hands frequently and maintaining social distance.

This study suggests further clinical studies could be worthwhile based on the theoretical evidence.”

The study was published in the Journal of Function (O’Donnell et al., 2020).

A combination of 3 different drugs could be an effective therapy for treating COVID-19 patients.

A combination of interferon beta-1b, ribavirin, and lopinavir-ritonavir could alleviate symptoms and reduce the duration of COVID-19.

A 14-day treatment with the three antiviral drugs has been shown to be safe, to ease symptoms, and shorten the period of illness in patients with mild to moderate COVID-19, a new study found.

Past experience in treating infectious diseases has shown that giving a combination of antiviral drugs to hospitalised patients is more productive and also reduces antiviral drug resistance compared to single-drug therapy.

Based on this approach, a clinical trial looked into possible treatments for the coronavirus disease using multiple antiviral drugs in 127 hospitalised patients who were at the early stage of infection.

The triple drug therapy suppressed the viral load (amount of virus in the patient’s body) effectively within seven days of taking the medication.

The duration was much less than the average 12 days in the other group who were on lopinavir-ritonavir only.

The study’s outcome also showed a much better clinical improvement in the triple drug group.

The treatment halved the recovery time from 8 days to 4 days.

The length of stay in hospital was reduced from 15 days to 9 days.

Professor Kwok-Yung Yuen, the study’s lead author, said:

“Our trial demonstrates that early treatment of mild to moderate COVID-19 with a triple combination of antiviral drugs may rapidly suppress the amount of virus in a patient’s body, relieve symptoms, and reduce the risk to health-care workers by reducing the duration and quantity of viral shedding (when the virus is detectable and potentially transmissible).

Furthermore, the treatment combination appeared safe and well tolerated by patients.”

Previously, studies on patients with severe acute respiratory syndrome (SARS) in 2003 found that lopinavir-ritonavir, commonly used for the treatment of HIV, together with ribavirin, used for treating hepatitis C, diminished respiratory failure and change of dying.

Interferon beta-1b, a treatment for multiple sclerosis (MS), can also lower viral load and help lung function in cases affected by Middle East respiratory syndrome (MERS) coronavirus infection.

Dr Jenny Lo, study co-author, said:

“These findings suggest that interferon beta 1-b may be a key component of the combination treatment and is worth further investigation for the treatment of COVID-19.

Interferons are naturally occurring proteins, produced in response to viral infection, and the hope is that interferon beta-1b will boost the body’s ability to fight SARS-CoV-2.

Future phase 3 trials will soon confirm or refute the usefulness of this candidate drug as a backbone treatment for COVID-19.”

The study was published in The Lancet (Hung et al., 2020).

The best type of fabric for a breathable but effective COVID-19 mask.

The best fabric for making a homemade COVID mask is a breathable material which low- and high-speed droplets can’t get through.

Experts at the Mechanical Science and Engineering University of Illinois have tested different common household fabrics.

They identified simple T-shirts as a potential material for homemade masks since they are made of breathable fabrics and are able to block droplets.

They also found that a two-layer mask made from new fabric that was a cotton-polyester mix works as well as a medical mask.

Coronavirus is thought to be spread by the transmission of respiratory droplets produced when an infected person talks and coughs, sneezes or even breathes.

The Centers for Disease Control and Prevention recommends wearing homemade cloth face coverings in public places.

However, the type of fabric and number of layers appear to be important in protecting against infection.

The droplets released come in different sizes and different speeds, therefore the fabric has to be resistant.

On the other hand, highly impermeable materials are generally less fit to breathe through.

A mask with poor breathability forces the air to move through the sides while giving a false sense of safety.

Professor Taher Saif and his team tested 10 common household fabrics to find out what fabric has both the droplet blocking ability and breathability required.

The masks were made from a variety of materials, such as polyester, cotton, silk and mixed fabrics.

They compared properties of these fabrics with the quality masks that reach medical or dental standards.

They found that for typical household fabrics, for example, a single layer of a T-shirt can block 40 percent of droplets.

When they used a new T-shirt made with 60 percent cotton and 40 percent polyester fabric in two layers, surprisingly, the droplet blocking was increased to 98 percent.

Breathing through the mask was easy while the efficiency was higher than the medical mask.

They suggest a two-layer cotton mask fabric can maximise both breathability and droplet resistance.

The study’s authors wrote:

“We found that most home fabrics substantially block droplets, even as a single layer.

With two layers, blocking performance can reach that of surgical mask without significantly compromising breathability.”

One difference between medical masks and household fabrics is that the first is made of hydrophobic material and the latter is hydrophilic.

Hydrophobic materials are water repellent whereas hydrophilic fabrics soak up water.

The study’s authors explain:

“Furthermore, we observed that home fabrics are hydrophilic to varying degrees, and hence soak water.

In contrast, medical masks are hydrophobic, and tend to repel water.

Incoming droplets are thus soaked and ‘held back’ by home fabrics, which might offer an as of yet untapped and understudied advantage of home-made cloth masks.

Overall, our study suggests that most double-layered cloth face coverings may help reduce droplet transmission of respiratory infections.”

The study was published in MedRxiv (Aydin et al., 2020).

A better method for COVID-19 testing than nasal swabs.

Saliva samples are more accurate in detecting SARS-CoV-2 in COVID-19 patients compared to a nasal swab, a new study reveals.

Researchers from the Yale School of Public Health suggest that taking a saliva test is a preferable approach than popular the nasopharyngeal (NP) swab.

The test is simple but saliva samples have to be taken from inside the mouth.

It is more sensitive and consistent in detecting the infection than the other tests.

Collecting the sample at home is a practical and fast way to identify the SARS-CoV-2 virus.

Dr Anne Louise Wyllie, the study’s first author, said:

“Taken together, our findings demonstrate that saliva is a viable and more sensitive alternative to nasopharyngeal swabs and could enable at-home self-administered sample collection for accurate large-scale SARS-CoV-2 testing.”

With the saliva test, the chance of missing those who show no symptoms is much lower than the nasal swab test.

Apparently, the saliva test, due to its precision, can also identify mild SARS-CoV-2 infections where other methods have failed.

NP swab is the accepted for determining many pathogens causing upper respiratory tract infections.

However, the study suggests that saliva testing is a better alternative.

The research team highlighted that collecting saliva samples doesn’t need trained medical staff and is reliable when self-administered.

In addition, saliva has similar sensitivity to NP swabs in spotting a variety of pathogens responsible for respiratory infections.

The NP test requires swabbing deep into the area of the throat behind the nasal cavity and mouth called the pharynx.

It is rotated for a specific time and removed after collecting secretions, then the sample is sent for analysis to a certified Laboratory.

The Food and Drug Administration (FDA) On April 13 authorized a saliva test for COVID-19 developed at RUCDR Infinite Biologics.

However, this approved test must be performed by a qualified person in a medical centre. 

The research team noted that a saliva test doesn’t need as many resources as is required for NP sampling like health care professionals and personal protective equipment.

Dr Wyllie said:

“With further validation, widespread use of saliva sampling could be transformative for public health efforts.”

Due to its consistency, the saliva test could be helpful to evaluate people’s health and safety so they would be able to go back to work.

Dr Nathan Grubaugh, study co-author, said:

“Once tests and laboratories are validated for using saliva, this could be rapidly implemented and immediately resolve many of the resource and safety issues with SARS-CoV-2 testing.”

The study was published in medRxiv (Wyllie et al., 2020).