Monday, July 20, 2020

Multifaceted COVID-19



“Chickenpox is a virus. Lots of people have had it, and probably don't think about it much once the initial illness has passed. But it stays in your body and lives there forever, and maybe when you're older, you have debilitatingly painful outbreaks of shingles. You don't just get over this virus in a few weeks, never to have another health effect. We know this because it's been around for years, and has been studied medically for years.

Herpes is also a virus. And once someone has it, it stays in your body and lives there forever, and anytime they get a little run down or stressed-out they're going to have an outbreak. Maybe every time you have a big event coming up (school pictures, job interview, big date) you're going to get a cold sore. For the rest of your life. You don't just get over it in a few weeks. We know this because it's been around for years, and been studied medically for years.

HIV is a virus. It attacks the immune system and makes the carrier far more vulnerable to other illnesses. It has a list of symptoms and negative health impacts that goes on and on. It was decades before viable treatments were developed that allowed people to live with a reasonable quality of life. Once you have it, it lives in your body forever and there is no cure. Over time, that takes a toll on the body, putting people living with HIV at greater risk for health conditions such as cardiovascular disease, kidney disease, diabetes, bone disease, liver disease, cognitive disorders, and some types of cancer. We know this because it has been around for years, and had been studied medically for years.

Now with COVID-19, we have a novel virus that spreads rapidly and easily. The full spectrum of symptoms and health effects is only just beginning to be cataloged, much less understood.
So far the symptoms may include:
Fever
Fatigue
Coughing
Pneumonia
Chills/Trembling
Acute respiratory distress
Lung damage (potentially permanent)
Loss of taste (a neurological symptom)
Sore throat
Headaches
Difficulty breathing
Mental confusion
Diarrhea
Nausea or vomiting
Loss of appetite
Strokes have also been reported in some people who have COVID-19 (even in the relatively young)
Swollen eyes
Blood clots
Seizures
Liver damage
Kidney damage
Rash
COVID toes (weird, right?)

People testing positive for COVID-19 have been documented to be sick even after 60 days. Many people are sick for weeks, get better, and then experience a rapid and sudden flare up and get sick all over again. A man in Seattle was hospitalized for 62 days, and while well enough to be released, still has a long road of recovery ahead of him. Not to mention a $1.1 million medical bill.

Then there is MIS-C. Multisystem inflammatory syndrome in children is a condition where different body parts can become inflamed, including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs. Children with MIS-C may have a fever and various symptoms, including abdominal pain, vomiting, diarrhea, neck pain, rash, bloodshot eyes, or feeling extra tired. While rare, it has caused deaths.

This disease has not been around for years. It has basically been 6 months. No one knows yet the long-term health effects, or how it may present itself years down the road for people who have been exposed. We literally *do not know* what we do not know.

For those in our society who suggest that people being cautious are cowards, for people who refuse to take even the simplest of precautions to protect themselves and those around them, I want to ask, without hyperbole and in all sincerity:
How dare you?

How dare you risk the lives of others so cavalierly. How dare you decide for others that they should welcome exposure as "getting it over with", when literally no one knows who will be the lucky "mild symptoms" case, and who may fall ill and die. Because while we know that some people are more susceptible to suffering a more serious case, we also know that 20 and 30-year-olds have died, marathon runners and fitness nuts have died, children and infants have died.

How dare you behave as though you know more than medical experts, when those same experts acknowledge that there is so much we don't yet know, but with what we DO know, are smart enough to be scared of how easily this is spread, and recommend baseline precautions such as:
Frequent hand-washing
Physical distancing
Reduced social/public contact or interaction
Mask wearing
Covering your cough or sneeze
Avoiding touching your face
Sanitizing frequently touched surfaces

The more things we can all do to mitigate our risk of exposure, the better off we all are, in my opinion. Not only does it flatten the curve and allow health care providers to maintain levels of service that aren't immediately and catastrophically overwhelmed; it also reduces unnecessary suffering and deaths, and buys time for the scientific community to study the virus in order to come to a more full understanding of the breadth of its impacts in both the short and long term.

I reject the notion that it's "just a virus" and we'll all get it eventually. What a careless, lazy, heartless stance.”


Sunday, July 19, 2020

https://youtu.be/ftfXfVpwzpMWorld Chess Day 2020 Talk by M.A.Aleem Neurologist #Trichy #Tamilnadu #India on "Brain and Chess" on 20.7.2020

India is in second place in COVID-19 Testing - M.A.Aleem BMJ 2020;370:m2817

Bmj British Medical Journal 

News


The Big Picture
Delhi prepares to hit 500 000 covid-19 cases


BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m2817 (Published 14 July 2020)


Cite this as: BMJ 2020;370:m2817



Rapid response
  


Re: Delhi prepares to hit 500 000 covid-19 cases

Dear Editor

India is in second place in COVID-19 Testing

In the 29th week of the COVID-19 Pandemic

World COVID-19 cases have surpassed 14 Million on 17.7.2020 As of today, 18.7.2020, the world has recorded 14, 215, 939 COVID-19 cases. The recovered cases are 8, 488, 484 in number and death was reported in 600, 036 cases as of today

About 48.09%.of the world COVID-19 cases are in three countries--the US, Brazil and India--duing this 29th week of the Pandemic. Likewise about 41.04% of COVID-19 related deaths are recorded in these three countries. The Indian COVID-19 related death rate is low at 2.5%

India has conducted the second largest number of coronavirus tests (12 million) after the US (42 million).

The US has done 45, 697, 029 total COVID-19 tests at the ratio of 138, 021 tests per 1 Million population

The Indian positivity rate of Covid-19 stands at 6.73 percent in the 1st week of July 2020.

Now India has done 12, 739, 490 total tests at the rate of 9228 tests per 1 Million population. The positivity rate at India is now around 8%.

India has registered its first 1 Million cases (1, 005, 637) and has recorded the highest single day of COVID-19 cases of 35, 468 with 680 deaths on 16.7.2020

For the first time the world has registered the highest single spike of 2.4 lakh (248, 871) and US has recorded the highest number of 73, 388 cases in a single day on 16.7.2020.

WHO has an advisory that has recommended a positivity rate of less than 5% for two weeks as an indicator that the epidemic is under control, allowing social restrictions to be gradually relaxed.

In Tamilnadu the positivity rate is at 9.91% and in Trichy is about 8 6%.

So it is better to continue the social restrictions along with personal and respiratory hygiene till vaccines are available.

Competing interests: No competing interests

18 July 2020

M.A Aleem

Emeritus Professor of Neurology * Visiting Specialist in Neurology ** Consultant Neurologist ***
The Tamilnadu Dr.M.G.R. Medical University * Dhanalakshami Srinivasan Medical College ** ABC Hospital ***
Chennai 600032* Perambalure 621212** Trichy 620018*** Tamilnadu India
@drmaaleem

Indian Food Helps to Beat #COVID-19 - M.A.Aleem BMJ 2020;370:m2840

Bmj British Medical Journal 

Editor's Choice

Covid-19: What we eat matters all the more now


BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m2840 (Published 16 July 2020)

Cite this as: BMJ 2020;370:m2840


Rapid response


Re: Covid-19: What we eat matters all the more now

Dear Editor

Indian Food Helps to Beat COVID-19

Indian food ingredients are very much helpful, during this COVID-19 Pandemic

Vitamin C and Zinc-rich food play an important role in boosting the immunity and can help to prevent infections like COVID-19.

Vitamin C rich food helps to stimulate the formation of antibodies. Citrus fruits, strawberries, red bell pepper and kiwi are all rich in vitamin C, which may help to fight COVID-19.

There are many zinc-dependent enzymes in our body and deficiency has been linked with immune dysfunction. Zinc-rich foods include beans, seeds, nuts, meat, poultry and seafood, which can help to beat COVID-19.

Intake of low carb diets is useful. A low carb diet will help slow down diabetes and focus on a protein-rich diet to keep you in good shape. And regularly consume vegetables and fruits rich in Beta carotene, Ascorbic acid & other essential vitamins. Certain foods like mushrooms, tomato, bell pepper and green vegetables like broccoli, spinach are also good options to build resilience in the body against infections including COVID-19.

Some natural immunity supplements in Indian food items including ginger, gooseberries (amla) and turmeric can also help during this COVID-19 Pandemic.

There are several herbs that can help in boosting immunity like garlic, basil leaves and black cumin. Certain seeds and nuts like sunflower seeds, flax seed, pumpkin seeds and melon seeds as excellent sources of protein and vitamin E are also very much useful.

Probiotics like Yoghurt, Yakult and fermented food are also excellent sources to rejuvenate the composition of gut bacteria, which is important for nutrient absorption by the body.

Intake of immunity boosting food along with social distancing and self hygiene are important to beat and break and COVID-19 infection.

Competing interests: No competing interests

18 July 2020

M.A. Aleem

Emeritus Professor of Neurology * Visiting Specialist in Neurology ** Consultant Neurologist ***
The Tamilnadu Dr.M.G.R. Medical University * Dhanalakshami Srinivasan Medical College ** ABC Hospital ***
Chennai 600032* Perambalure 621212** Trichy 620018*** Tamilnadu India
@drmaaleem