Mar 20, 2020
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Health Frontiers Radio
COVID-19 Pandemic Update and Live Q&A
On March 11, COVID-19 was officially declared a pandemic by the World Health Organization, and it is proving to be much more disruptive and deadly than originally thought. Join the Health Frontiers Broadcast team for a live Q&A session as we review what is known about the virus, symptoms, treatments and prevention strategies that will serve you well in strengthening your resistance to viral or microbial threats.
Reported illnesses have ranged from very mild (including some with no reported symptoms) to severe, including illness resulting in death. While information so far suggests that most COVID-19 illness is mild, a recent report out of China suggested that serious illness occurs in 16% of cases. Older people and people of all ages with severe chronic medical conditions — like heart disease, lung disease, and diabetes, for example — seem to be at higher risk of developing serious COVID-19 illness. A CDC Morbidity & Mortality Weekly Report that looked at the severity of disease among COVID-19 cases in the United States by age group found that 80% of deaths were among adults 65 years and older with the highest percentage of severe outcomes occurring in people 85 years and older.
The CDC’s recent (2/25) warning regarding the emerging threat of a COVID-19 outbreak in the US was chilling indeed: “It is not a matter of if, but when it will spread in US communities, and Americans should prepare for “significant disruption” to their lives as a result”. The world is anxiously watching the progression of this new virus which is already having far-reaching implications on our economy, travel, schools, and politics.
What is a coronavirus?
Coronaviruses are a large family of viruses (including the common cold) so named because of the crown-like features on their surface.
The new COVID-19 virus was first detected in the Chinese city of Wuhan in December 2019 and has since spread globally. According to the Centers for Disease Control and Prevention, these first reported cases had links to a live animal market, suggesting the outbreak started from animal-to-person spread.
Coronaviruses are responsible for two other recent outbreaks: the 2003 SARS (severe acute respiratory syndrome) outbreak and the 2012 MERS (Middle East Respiratory Syndrome) outbreak.
Latest Data on Outbreak
As of March 20th, the number of confirmed cases worldwide was 254,996 and total deaths numbered 10,415 with 87,351 recovered. The virus outbreak seems to be most intense now in Western Europe, and the US has taken unprecedented steps to try to slow down transmission including the temporary closing of schools, restaurants, bars, malls, fitness centers and suspended public meetings of large groups, athletic events, etc.
Johns Hopkins University has created a real-time data tracking web page to track confirmed global COVID-19 cases which may be viewed by clicking this link:
What are the symptoms? How does it spread?
Patients with COVID-19 experience mild to severe respiratory illnesses. Symptoms include fever, cough, and difficulty breathing and can appear two to 14 days after exposure, according to the CDC.
Around 80 percent of confirmed Chinese cases were mild, the New York Times reported, and the overall fatality rate is around 2.3% in China. Comparatively, the seasonal flu has a mortality rate of about 0.1 percent.
The coronavirus mainly spreads from human to human. Like the common cold, the virus is transmitted when a person coughs or sneezes. It's also possible that a person can get COVID-19 by touching a surface with the virus on it before touching their mouth, face or eyes.
For confirmed coronavirus disease 2019 (COVID-19) cases, reported illnesses have ranged from mild symptoms to severe illness and death. Symptoms can include:
CDC believes at this time that symptoms of COVID-19 may appear in as few as 2 days or as long as 14 days after exposure. This is based on what has been seen previously as the incubation period of MERS-CoV viruses.
Q: Am I at risk for COVID-19 from a package or product shipping from China?
A: There is still a lot that is unknown about the newly emerged COVID-19 and how it spreads. Two other coronaviruses have emerged previously to cause severe illness in people (MERS-CoV and SARS-CoV). While we don’t know for sure that this virus will behave the same way as SARS-CoV and MERS-CoV, we can use the information gained from both of these earlier coronaviruses to guide us. In general, because of poor survivability of these coronaviruses on surfaces, there is likely a very low risk of spread from products or packaging that are shipped over a period of days or weeks at ambient temperatures. Coronaviruses are generally thought to be spread most often by respiratory droplets. Currently, there is no evidence to support the transmission of COVID-19 associated with imported goods and there have not been any cases of COVID-19 in the United States associated with imported goods.
The latest information will be provided on the Coronavirus Disease 2019 (COVID-19) website as it becomes available.
The best way to prevent illness is to avoid being exposed to this virus. However, as a reminder, the CDC always recommends everyday preventive actions to help prevent the spread of respiratory diseases, including:
In addition to these avoidance/prevention strategies, the key to surviving and thriving in the face of emerging viral and microbial threats is to do all you can to maximize your health, vitality and natural resistance with a strong and balanced immune system:
Could the old generic malaria drug hydroxychloroquine (Plaquenil, Sanofi-Aventis, among others), which is also used for the treatment of rheumatic disease, be an essential treatment for COVID-19?
This hypothesis, put forward by some, including Professor Didier Raoult of the IHU Méditerranée Infection in Marseille, was dismissed by other eminent infectious disease specialists and dismissed as fake news recently by the Ministry of Health.
Yet it resurfaced yesterday with the presentation on YouTube by Prof Raoult of positive results in a non-randomized, unblinded trial of 24 patients.
This follows encouraging in vitro results obtained by a Chinese team led by Xueting Yao, from Peking University Third Hospital, Beijing, China, which were published online by the journal Clinical Infectious Diseases on March 9th. However, the data were deemed insufficient by the infection community to recommend the compound as a treatment.
Moreover, chloroquine is not listed among the four treatments studied as part of the recently launched European clinical trial piloted by Inserm, which includes 3200 severe hospitalized patients, including 800 French patients.
Chloroquine was ruled out due to the risk of interactions with other medications for common comorbidities in infected patients, and because of possible adverse effects in patients undergoing resuscitation.
The Marseille Study
The European Union Clinical Trials Register shows that the Marseille study was accepted on 5th March by the National Medicines Safety Agency (ANSM). It could include up to 25 COVID-19 positive patients, comprising five aged 12–17 years, 10 aged 18–64 years, and 10 more aged 65 years or over.
While the data have not yet been published, and should, therefore, be interpreted with caution, this non-randomized, unblinded study showed a strong reduction in viral load with hydroxychloroquine.
After 6 days, the percentage of patients testing positive for COVID-19 who received hydroxychloroquine fell to 25% versus 90% for those who did not receive the treatment (a group of untreated COVID-19 patients from Nice and Avignon).
In addition, comparing untreated patients, those receiving hydroxychloroquine and those given hydroxychloroquine plus the antibiotic azithromycin, the results showed there was "a spectacular reduction in the number of positive cases" with the combination therapy, said Prof Raoult.
At 6 days, among patients given combination therapy, the percentage of cases still carrying SRAS-CoV-2 was no more than 5%.
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