Badass Virus In The Air

Badass virus In The Air

Last month, the U.S. marked 750,000 COVID-19 deaths, so unnecessary given the knowledge that existed to prevent many of them. Disease transmission became recognized as having aerosol transmission. Filters and UVC lights were placed in planes, businesses and everyone retired to their homes to work. Schools closed and masks became mandatory. Social distancing took on a specific meaning. New variants continued to surface. The arrival of emergency authorized vaccines, some better than others ushered in an era of controversy. Much research, at times retracted, has definitely established spread is aerosol. Specifics regarding the use of masks – how to wear, the number of layers has generated more science of disease transmission.

I want to share some numbers that can help honestly frame this pandemic -The CDC estimates that the flu has resulted in 9 to 41 million illnesses and 12,000 to 52,000 deaths annually between 2010 and 2020. And hospitals — institutions whose sole purpose is to heal — sometimes make us sicker. Healthcare-associated infections account for an estimated 1.7 million infections and 99,000 deaths each year. Advanced air filtration could definitely decrease hospital-acquired infections.

At this writing, Michigan hospitals are overwhelmed with COVID cases. Mass General Hospital has canceled elective procedures as beds and staff are needed to care for the influx of COVID-19 cases. As if that is not enough WHO announced a new variant of ‘concern’.

Omicron, as it was dubbed, will be in news but details require time and research to find out how transmissible and if vaccines protect.

No doubt there will be more information in the coming days about this variant that has the most changes in its genome than any previous variants. Thirty-two, 32, is the most consistent number of mutations so far identified. You probably want to know if it is in the US, sadly we rarely ‘type’ which SARS CoV-2 strain in patients. Isreal, Belgium, and South Africa do so much more. But I digress, back to air quality! Yes, airplanes filters are at times much better than hospital filters, however, the infected individual still must walk thru the airport. You say well how about a negative test? It is not known if the present tests can ‘pick-up’ that is recognize this new variant – ‘Omicron’. The incubation period -how long after exposure can a test show the virus is being shed in your breath, is not yet known. Yes, you can have the virus in your body but it has not multiplied enough to make you sick or turn a test positive. Hence a ‘negative’ test today may not mean much with this new variant.

PLEASE continue to social distance and properly wear a mask with at least 3 layers.

Little Known Body Facts

Approximately how often does it take for the lining of the stomach to replace itself?  4 to 5 days. The lining needs to protect itself. So has to change due to ‘juices’ that is the stomach enzymes are acid and along with abrasive foods does damage to the lining cells – hence we were built to change every 4-5 days

How long does it take a red blood cell to travel around the whole body at a normal heart rate? 30 to 60 seconds. Yes, our blood can circulate more than 1,000 times each day.

About how many muscles do you use when taking a single step forward? 200! In addition to the muscles in the leg, secondary muscles in the upper body also play a part.

The first-ever transfusion was in 1667 when the French physician Jean-Baptiste Denys transfused blood from an animal into a human. Which animal?  Lamb! The 15-year-old recipient received the transfusion after being bled with 20 leeches. He survived the procedure.

Little Known Body FactsWhat is the strongest muscle by weight in the human body? Masseter! With the help of the other muscles of mastication, this allows the average person to close their teeth with as much as 200 pounds of force with the molars.

 

 

What is the hardest substance in the human body? You got this – teeth enamel!

How much mucus does our healthy body produce each day? Don’t be grossed out but 1.5 liters or 6 3/8 cups worth. Normal activity of the body is made for protection, lubrication, hydration, and more. Also when our body is fighting an ‘invader’ mucus works to trap and prevent damage.

Hazards of ‘Bikini Medicine’

Hazards of 'Bikini Medicine'When I did my medical training, it was one size fits all. Yes, it was a while ago but quite sadly it has not changed. Studies and conditions are mostly carried out and explained based on the male body and you would not be incorrect to deduce that outcomes are less optimal in female patients. I attest to that.

Men and women’s bodies are not the same and should not be cared for in the same manner.

Now I am backed up by the University of Colorado’s Ludeman Family Center for Women’s Health Research publication. According to their article, in over 700 diseases women are under or delayed in their being diagnosed versus men. I first heard the term ‘bikini medicine’ on an NPR program in 2013. The idea is all human bodies in the practice of medicine are the same except in the areas covered by a bikini! Yes, some would say that is ‘sexist’. But the sex of a patient can influence how conditions present, from ADHD to women having heart attacks. You hopefully have heard a woman’s symptoms of a heart attack are totally different from those of a man. These differences, which I’ve covered in previous blog, might include a woman calmly saying her chest discomfort feels like her ‘bra is too tight, a symptom which likely means her heart is talking to her and saying a cardiac event is underway. Nausea, abdominal pain, or fatigue are also common symptoms in women who are experiencing cardiac events. Please read more if you are at risk. Don’t be the woman or loved one sent home or misdiagnosed. A study this year in Circulation determined that the supposed normal Blood Pressure is not accurate for women. It should be lower than the touted ‘120/’ . This is important when a woman presents with a Blood Pressure not elevated for a male, but it is in fact elevated for her.

The belief that men are easier to study has contributed greatly to a skewed application of outcomes. Data is always ‘pooled’. Although very recently women are being included in equal numbers in medical studies. Women’s Health Research at Yale was founded in 1998 to address the “knowledge gap” in understanding women’s health – ALL health, not just obstetrics and gynecology.

In a Journal of Women’s Health study from March of this year, analyses of data from 1.4 million patients, (January 1 and May 1, 2020) found symptom differences and hospitalization differences in women. For example ear, nose, and throat symptoms were more common in women. Few women received blood tests and chest X-rays and were less likely to be hospitalized. What exactly does this mean? Medical bias? Or immunities are different? Research and time will hopefully yield answers.

BOTTOM LINE Sex-specific difference in disease symptoms is real.

 

To Mask Or Not To Mask

to Mask Or Not to MaskI believe if a mask truly keeps me from spreading as well as absorbing someone’s virus – it is worth wearing. So what exactly does a mask achieve? Block by absorbing? Block like a wall causing bouncing out?

Findings suggest that absorptivity of mask materials is an important feature in providing protection from viruses such as SARS-CoV-2. The paper is published in Applied Materials & Interfaces, a journal of the American Chemical Society.

All too many studies have used dry particles to test mask permeability alone.
so many were published during the 2020-21 pandemic. In contrast, researchers in this investigation used a creative approach by using a virus nanoparticle suspended in artificial saliva. Spraying the suspension provides a much more realistic approach to truly compare the worth of mask materials. Thus, rather than viewing the mask as a simple screen, the study tests the adsorptive properties of the mask materials for trapping viruses in saliva droplets.

The properties of N-95 masks are well known but how about the ‘zillion’ types masks on most individuals?
Each material was characterized using a variety of methods including scanning electron microscopy and X-ray photoelectron spectroscopy. Mask was then wet with artificial salvia to replicate actual situations.

These researchers measured the likelihood of trapping and absorbing rather than just if the virus stopped. Masks absorb, thus trapping viruses.

They concluded after doing the same study without masks, that all masks have definite benefits. but you knew that!

Bottom Line -Wear/change/Wash your Mask

Medicine’s Weapons for the Pandemic – Add Capsule

An ever-increasing number of drugs, vaccines have found their way into the pandemic medical bag.

First, it was veterinary Ivermectin a 5-day course anti-parasitic agent against severe SARS-CoV-2 virus.

Then attention turned to the monoclonal antibodies for those with mild to moderate COVID-19. Early recognition and a quick doctor’s order, followed by rushing to a medical facility got you an outpatient IV over 45 min. These IV drugs target the virus’s spike protein that binds to our cells. Emergency use authorization (EUA) was given to Bamlanivimab, Estsevimab, Casirimab, Imdevimab (given subcutaneously), and Sotrovimab (interestingly this antibody is from a survivor of SARS CoV-1 in 2003). Studies since EUA have found that certain combinations might be optimal. Many fell out of use due to impotency with new viral variants. These ‘monoclonals’ prevent the development of severe disease. Just as the vaccines developed do not prevent you from contracting and transmitting the virus but can keep you from a severe case. We all know the % efficiency changes according to the latest study. What many forget is that not everyone achieves the acquired percentage immunity reported. so now booster vaccines after 6-8 months are recommended. However, if you have had the illness the direction is not clear.

Medicine's Weapons for the Pandemic Add CapsuleAnd now comes might pill! This pill, molnupiravir, has been called everything from a “game-changer” to “blockbuster.” A new weapon in the ever-expanding arsenal against COVID-19. The FDA approval could come in a matter of weeks. But is it all it’s been talked up to be? A capsule for those ‘ adults with mild-to-moderate COVID-19 who are at risk for severe disease or hospitalization’ says drug maker Merck. At present, the price is roughly $700 for each course of treatment. According to positive outcome studies actually treats the disease. If your symptoms started within 5 days & you ta=ke this antiviral your chances of hospitalization and the severe outcome are 50% less than if untreated. The worldwide study included the Delta, Gamma, and Mu variants have accounted for nearly 80% of the cases in the trial. all participants had at least one risk factor for poor outcome. A 5-day course of a twice a day dosage of 800 mg. capsule is recommended.

Time will tell if weapons that attack this virus by different means prove to outsmart the enemy.

“Infodemic” (information + epidemic) – Beware!

“Infodemic (information + epidemic) -BewareNo one disagrees that the dialogue on the pandemic is enormous. The challenges of misinformation and disinformation have been around long before the internet. Infodemic was coined in 2003. A tsunami of information hit us all. The current pandemic has generated so so much conversation and reveals. What is ‘IN’ today may be “OUT’ next week.

Does infodemic contribute to the mismatch of money spent on health care and life expectancy? 

In the American public health has been a reality of the haves and have nots. health is a paramount concern in almost all civilizations. And in a country that spends 17.7% of Gross Domestic Product (GDP) on health care. Along with Japan and several European countries, Canada, Singapore, Australia, and New Zealand also boast high life expectancy rates.

If born in the US in 2019 life expectancy of  78.9 – while Canada has 82.4 with 11.5 % of GDP going to health care.

Do we overdue risk in the US? Is it ‘out of an abundance of caution’ that motivates our litigious society?

Our government has multiple ‘authoritative’ entities all working to ensure a certain level of health for citizens. One of the cabinet seats is for the Department of Health & Human Services. An entity Center for Disease Control & Prevention (CDC) is dedicated to just with a budget of 6 billion. The Federal Drug Administration (FDA) has a budget is equivalent to $9.95 per American per year. 

“We’re not just fighting an epidemic; we’re fighting an infodemic”, said WHO Director-General Tedros Adhanom Ghebreyesus at the Munich Security Conference on Feb 15, 2021.

Yes, it became the wild west with everyone rushing research and sharing while publishing online with the caveat ‘without peer review’. This means a critical inspection by authoritative professionals in the field has not occurred. Almost all with the expressed intention of as rapid as a possible solution to tackle the newest viral threat – SARS CoV-2. But such papers can result in misuse of drugs, therapies, and prevention steps. Even the use of masks is a hot topic on the internet. 

Social and conventional media have allowed information and perhaps more misinformation without updates or corrections to be propagated. 

Breast Cancer Diagnosed

Yes, 1 in 8 US women will develop breast cancer. This means the average risk of a woman in the United States developing breast cancer sometime in her life is about 13%. So 7 out of 8 won’t! There are many types some more aggressive than others. Family history is a risk factor but in approximately 80% of cases, there is no family history. Men are not spared incidence in men 1 in 10 will develop mostly in their 60-70 age groups. Although at any age it can present. Abnormal hormone levels and gene mutations. Breast Cancer Diagnosed

FAMILY HISTORY

I mentioned above family history is a factor in some cases. It has been shown that if a ‘first-degree relative’ (a parent, sibling, or child) has had or has breast cancer, you are twice as likely to develop breast disease. Makes sense if you happen to have two first-degree relatives with breast disease your chances are higher.

AGE IS A FACTOR 

A study in the Journal of the American Medical Association (JAMA) found a measurable increase of cases each year since 1970. This was noted in American women ages 25 to 39. The cases were found to be advanced.  Young women’s tumors are likely to be more dangerous than older women’s cancers.

ABOUT MAMMOGRAPHY

It is known that up to age 50 women’s breasts are quite dense and typical ‘mammos’ testing would miss tiny cancers. Today we have digital technology which has tremendously improved making an accurate diagnosis. Even more recent is 3D mammography the makes slices thru the layers of breast tissue. Fewer cancers can be overlooked. Naturally, there are those concerned by the ‘higher’ number, does it mean more radiation? It thanks to programming only slightly more exposure.

Balancing exposure to radiation and the chance of missing cancer or delaying finding cancer and going thru surgery, chemo and/or radiation. The breast images of 3D mammograms are so much clearer, hence the false positives are far lower than with digital mammograms.

3D detects up to 41 percent more invasive cancers than 2D, according to large-scale clinical research published in the JAMA.

Dangerous Droplets

                              Fact  

– easier to catch a virus (ex. corona, influenza) in winter than in summer 

– that our breath condenses into droplets in the cold air.

– humidity helps a virus spread, in winter it is higher than in summer 

 

Latest

TU Wien (Vienna), in cooperation with the University of Padova research, has studied air that an infected person exhales when sneezing. They found that the infectious viruses are in liquid droplets of different sizes, with gas in between. The lab experiments used high-speed cameras and computer simulations to identify size and flow. They noted as each droplet burst an increase of humidity occurs, making the remaining droplets evaporate more slowly.

This naturally affects the flow and how long droplets hover.

This research can impact what exactly is social distancing. I believe from my review of the literature it is more than 6 feet. Furthermore, this sort of research and its results will impact the use and type of mask. I will be watching publications for more on this.

Conquer Anxiety With Exercise

Conquer Anxiety With Exercise

  • present in 10% world population

  • start early life 

  • women 2 times more than men

Exercise Relationship

Research states exercise can reduce anxiety events in individuals, but it is not known if exercise can deter this condition from starting.

A Swedish group of investigators published  (Frontiers in Psychiatry) their findings after studying 400,000 long-distance cross country skiers (both men and women) from 1989-2010. They compared them to non-skiers during the same times period. They reported a “significantly lower risk”  of developing anxiety in the long-distance skiers compared to non-skiers. The more physically active lifestyle individuals were at an almost 60% lower risk for starting with anxiety disorders. These findings were found in both sexes.

Interesting, especially me, was the finding that “highest performing female skiers had almost the double risk of developing anxiety disorders compared to the group which was physically active at a lower performance level.” But it was still lower than the development of anxiety disorder in the inactive women’s group. This was not seen in the men’s data analysis.

Likely exercise behaviors and anxiety symptoms are affected by personality traits, psychological factors, and of course genetics.

Questions arise is it long-distance skiing, is it skiing, being outdoors for protracted time, or is it the pure degree of exertion that factors? Will the association of exercise and anxiety vary by sport? Wither exerted indoor or outdoors matters?

More research for sure will follow, especially with a focus on youngsters. Nip this disorder in the bud, so to speak!

more info:Martina Svensson et al, Physical Activity Is Associated With Lower Long-Term Incidence of Anxiety in a Population-Based, Large-Scale Study, Frontiers in Psychiatry (2021). DOI: 10.3389/fpsyt.2021.714014