‘Silent’ COVID Infection Rate Much Higher Than Thought

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

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).

The Common Drug That Reduces COVID Risk In Seniors

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

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 Safe COVID-19 Vaccine Passes Phase 1 Trial

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

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 Kill COVID-19 If Used For This Long

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

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).

The Antiviral Drugs That Can Treat COVID-19

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

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 Material For A Homemade COVID-19 Mask

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

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).

COVID-19: Study Reveals A More Accurate Test

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

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).

This Essential Mineral Linked To COVID-19 Recovery

An essential mineral in the body have been linked to recovery of COVID-19 patients.

An essential mineral in the body have been linked to recovery of COVID-19 patients.

The body’s levels of selenium could have an impact on COVID-19 patients’ recovery, a study suggests.

Selenium is an essential trace mineral, meaning our body can’t make it therefore it must be obtained from the diet.

Despite the body only needing tiny amounts of selenium, its effect on human health has been underestimated.

The trace element plays an important role in the immune system and protecting the body from infections as well as thyroid function, reproduction, and preventing DNA damage.

Selenium is found in foods such as brazil nuts, seafood, meats, eggs, cacao, milk, cottage cheese, alfalfa, couscous, whole wheat pasta, and mushrooms.

Past studies have shown that the severity of several viral diseases in humans and animals can be influenced by selenium levels.

In HIV patients, for instance, low selenium status has been associated with the virus’s development to AIDS.

Researchers looked into the possible effect of selenium levels on the recovery of patients with COVID-19 virus in China.

Selenium levels in food depend on selenium content in the soil where the food is grown.

Due to large geographical differences in the soil, China is known to have higher and lower selenium levels than in other countries.

Professor Margaret Rayman, study co-author, said:

“Given the history of viral infections associated with selenium deficiency, we wondered whether the appearance of COVID-19 in China could possibly be linked to the belt of selenium deficiency that runs from the north-east to the south-west of the country.”

After analysing data on different regions, the research team found that patients with high selenium intake had a much higher chance to overcome COVID-19 infection.

Enshi, a city in Hubei Province, is an example since the population consumes higher amounts of selenium than any other part of China.

When looking at the percentage of recovery from the virus, the cure rate in Enshi was three times greater than other cities in the country.

In contrast, Heilongjiang Province has one of the lowest selenium intakes in the world.

COVID-19 death rates for this area were five times larger than other parts of country.

Analyses of nails or hair can show long-term intake of selenium.

By measuring selenium concentration in patients’ hair, the team found that the COVID-19 cure rate was highly linked to selenium status (selenium that is potentially active in the body).

Ms Kate Bennett, study co-author, said:

“There is a significant link between selenium status and COVID-19 cure rate, however it is important not to overstate this finding; we have not been able to work with individual-level data and have not been able to take account of other possible factors such as age and underlying disease.”

Dr Ramy Saad, study co-author, commented:

 “The correlation we have identified is compelling, particularly given previous research on selenium and infectious diseases.

As such, a careful and thorough assessment of the role selenium may play in COVID-19 is certainly justified and may help to guide ongoing public-health decisions.”

The recommended daily intake for selenium is 55 micrograms per day and selenium intake of more than 400 micrograms per day can be toxic.

The study was published in The American Journal of Clinical Nutrition (Zhang et al., 2020).

COVID-19 Symptoms Are Different In Older People

Older adults with COVID-19 infection found to display some unusual symptoms.

Older adults with COVID-19 infection found to display some unusual symptoms.

Shortness of breath, a continuous dry cough, and fever are the typical symptoms of coronavirus, but seniors might not have any of these.

Instead, they show different “atypical” signs of COVID-19, which could help healthcare providers to spot the disease in time.

Older adults, at the beginning of the infection, may behave unusually, as though they are not themselves.

Also, they may lose their appetite, sleep too much, feel dizzy, confused, uninterested, and occasionally, suddenly stop talking or pass out.

Dr. Camille Vaughan, section chief of geriatrics and gerontology at Emory University, said:

“With a lot of conditions, older adults don’t present in a typical way, and we’re seeing that with COVID-19 as well.”

Due to the aging process, the body appears to respond to infections and illnesses differently.

The immune response will weaken and the body’s temperature regulating system may work less efficiently in older individuals.

Professor Joseph Ouslander at Florida Atlantic University Schmidt College of Medicine, said:

“Underlying chronic illnesses can mask or interfere with signs of infection.

Some older people, whether from age-related changes or previous neurologic issues such as a stroke, may have altered cough reflexes.

Others with cognitive impairment may not be able to communicate their symptoms.”

Without knowing these factors, there is a chance that the initial signs of infection in older people are missed and they get worse.

There is also the risk of leaving home without knowing they are infected and spreading the disease.

Dr Quratulain Syed, a geriatrician in Atlanta, describes one of her patients who was a man in his 80s with diabetes, heart disease and moderate cognitive decline.

Within a few days the patient became completely lethargic and couldn’t walk, sometimes sneezing, but didn’t show any signs of cough or fever.

At hospital he tested positive for COVID-19 despite not showing the usual symptoms.

Dr Sam Torbati, medical director of the Ruth and Harry Roman Emergency Department at Cedars-Sinai Medical Center, said:

“They get weak and dehydrated and when they stand to walk, they collapse and injure themselves badly.

When we test them, we discover that what’s producing these changes is a central nervous system effect of coronavirus.”

Currently a small number of physicians are trying to collect more systematic data on COVID-19 symptoms exhibited in seniors.

Dr Sylvain Nguyen, a geriatrician at the University of Lausanne Hospital Center, in a paper to be published in the Swiss Medical Journal, provides a list of coronavirus’ common and uncommon symptoms in older patients.

The list includes lethargy, fatigue, painful swallowing, falls, low blood pressure, fainting, delirium, abdominal pain, vomiting, nausea, diarrhea, and loss of taste and smell.

The article is based on anecdotal evidence provided by physicians treating seniors with COVID-19.

The 3 Best Ways To Cope With COVID-19 Stress

Research into previous mass traumas reveals the best ways of coping with stress of COVID-19.

Research into previous mass traumas reveals the best ways of coping with stress of COVID-19.

Coping activities that increase the sense of control, coherence and connectedness are key to dealing with COVID-19 stress, new research concludes.

Typical coping activities include checking in with friends and loved ones, filtering news intake and planning daily activities.

All of these are ways of regaining control.

Planning daily activities, for example, helps reduce the sensation of drifting along without structure or purpose.

Other techniques that help regain control include making post-pandemic plans and journaling.

Feeling in control is one important way of coping, along with increasing coherence and connectedness, the researchers explain.

Increasing the sense of coherence means trying to make more sense of the world.

One way of doing this is to practice ‘acceptance-based coping’.

This involves using mindfulness to observe fears, anxieties and other emotional responses as they pass through the brain.

Finally, connectedness can be difficult to achieve given social distancing regulations.

However videoconferencing, telephone calls and social media can all help to keep in touch with others.

Even meditating by oneself, directing loving kindness towards the self can help increase the sense of connection to others.

Part of being compassionate towards the self is accepting that our own struggles are connected to others as we are going through the same thing together.

All these strategies have been found to help people deal with stress and bounce back.

These recommendations were inspired by research into how people dealt with other mass traumas, such as the 9/11 terror attacks.

Mr Craig Polizzi, the study’s first author, said:

“We also drew inspiration from our previous work with clients who have experienced traumas and how they have coped with traumatic events.”

People cope with traumas in different ways, so the strategies they use should be personalised, Mr Polizzi said:

“People are unique and the way they cope should be consistent with their needs and values.”

In the future, the research team hope to look at what psychological strategies people used to deal with the pandemic, along with their effectiveness.

Mr Polizzi said:

“It is also important to test the coping strategies we proposed in our article to see if people did use them to reduce distress during the pandemic, as well identify additional techniques individuals used to cope with stress to enhance recommendations for coping during future mass traumas.”

The study was published in the journal Clinical Neuropsychiatry (Polizzi et al., 2020).