Saturday, March 14, 2020

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The New Coronavirus Can Live On Surfaces For 2-3 Days — Here's How To Clean Them




When an infected person touches a surface, like a door handle, there's a risk they leave viruses stuck there that can live on for two to three days.
Andrew Harrer/Bloomberg via Getty Images
How long can the new coronavirus live on a surface, like say, a door handle, after someone infected touches it with dirty fingers? A study out this week finds that the virus can survive on hard surfaces such as plastic and stainless steel for up to 72 hours and on cardboard for up to 24 hours.
"This virus has the capability for remaining viable for days," says study author, James Lloyd-Smith, an assistant professor of ecology and evolutionary biology at the University of California, Los Angeles, who researches how pathogens emerge.
Although the World Health Organization had previously estimated the survival time on surfaces to be a "few hours to a few days" based on research on other coronaviruses, this is the first study by scientists at a federal laboratory to test the actual virus causing the current pandemic, SARS-CoV-2.
The study is out in preprint form and expected to be published.
Interestingly, some surfaces are less hospitable to SARS-CoV-2. For instance, the virus remained viable on copper for only about four hours.

It's useful to know how long it can stay alive of course, because the virus can contaminate surfaces when an infected person sneezes or coughs. Virus-laden respiratory droplets can land on doorknobs, elevator buttons, handrails or countertops — and spread the virus to anyone who then touches these surfaces.
To test the survival time of the virus, scientists at the Rocky Mountain Laboratories in Montana, part of the National Institutes of Health, conducted a series of experiments comparing the novel coronavirus with the SARS virus (a similar coronavirus that led to an outbreak back in 2003).
In the lab, "they'd pick up the virus from the surfaces that had been contaminated and then put [the virus] into cell cultures," he explains. Then the researchers documented whether the virus could infect those cells in the dish. They did this multiple times, for both the viruses, at various time points.
"Big picture, the [two viruses] look very similar to each other in terms of their stability in these environments," Lloyd-Smith says.
Lloyd-Smith says these findings establish a good ballpark estimate for the survivability of the virus on these surfaces. "In a laboratory experiment, the conditions are pretty carefully controlled and constant," he says. By comparison, "in the real world, conditions fluctuate" — conditions like temperature, humidity and light. So the survivability may vary, too.
For instance, if the virus contaminates a sunny windowsill or countertop, it may not last as long.
"Ultraviolet light can be a really powerful disinfectant and we get a lot of UVA light from the sun," says Daniel Kuritzkes an infectious disease expert at Brigham and Women's Hospital. "Direct sunlight can help rapidly diminish infectivity of viruses on surfaces," he says. He was not involved in the new research.
Much is still unknown about the virus's survivability on other types of surfaces like clothing, or carpeting. Kuritzkes says that based on prior research, it seems that "flat surfaces and hard surfaces are more friendly to viruses than cloth or rough surfaces."
And how about food? "Food is probably not a major risk factor here," Kuritzkes says. That's because most infection from the new coronavirus starts with the respiratory system, not the digestive tract. So infection comes from getting the virus on your hands and then touching your own eyes, nose and mouth. "Of more concern would be utensils, and plates and cups that might be handled by a large number of people in a cafeteria setting, for example," he says.
So, what can you do to protect yourself? Well, you've likely already heard this. Wash your hands. And wipe down shared surfaces.
Follow these tips for cleaning surfaces — your own and public ones.
Wipe right: Use ammonia or alcohol-based products. Skip the baby wipes
Maintaining awareness of the many surfaces you touch during the day and cleaning them with approved products will help curb the spread of the coronavirus.
Max Posner/NPR
"The good thing about COVID-19 is that it does not require any unique cleaning chemicals to disinfect hands and surfaces," says Andrew Janowski, an infectious disease expert at Washington University School of Medicine and St. Louis Children's Hospital. COVID-19 is the disease caused by the current coronavirus,
Good old-fashioned soap and water does the trick.
You can also use a wipe, but make sure you use an alcohol-based wipe, not baby wipes, which may not be effective, Janowski says.
And given that wipes are hard to come by at many stores at the moment, you can instead buy an EPA-registered disinfecting spray, such as one on this list from the Center for Biocide Chemistries, recommended by the Centers for Disease Control and Prevention and by Dr. David Warren, an infectious disease specialist at Washington University School of Medicine in St. Louis.
Or make a bleach-based spray yourself. You can make a DIY cleaning spray by mixing 4 teaspoons bleach per quart of water, according to the CDC.
Wash. Your. Hands. (Seriously!)
Yes, you've heard it a hundred times. So do it, already! Especially after you've been out in public, touching a lot of surfaces. Lather up with soap and scrub for 20 seconds. (Two times the "Happy Birthday" song, or sing "Baby Shark" — you'll get midway through Daddy Shark).
And be thorough. Spend some time rubbing the backs of your hands as well as the front, interlace your fingers and pull them through, soap up each thumb with the opposite hand and, finally, to keep your fingernails virus-free, lightly scratch them against your palm. (For more detail, listen to NPR Short Wave's Maddie Sofia give a lesson here.)
Hand-washing is so important that if everyone followed good hand-washing hygiene, it could prevent an estimated 1 in 5 respiratory infections, according to the CDC — that's the equivalent of about 6 million cases of the flu this year.
Hand sanitizer: DIY in a pinch?
Hand sanitizer is effective at killing viruses, too, although hand-washing is preferred, according to the CDC. If you can't get to a sink, hand sanitizer is a good backup plan — just make sure it's at least 60% alcohol.
Given the shortage of hand sanitizers in some stores and reports of price-gouging online, there's lots of interest in DIY hand sanitizer. We've seen lots of recipes calling for a combination of rubbing alcohol and aloe vera gel, like this one from Wired.
"On paper, if a recipe can maintain the alcohol concentration above 60%, it should be effective against SARS-COV-2," says Andrew Janowski, but he says getting it just right might be trickier than you think. If in doubt when making these homemade sanitizers, soap and water are still effective against the virus.
Your smartphone is like a third hand. Wipe it down

One way to fend off germs: Clean your phone. Your phone is your "third hand"; one that harbors the multitude of germs and bacteria we come into contact with each day.
Photo Illustration by Max Posner/NPR
So you've just washed your hands and you're feeling squeaky clean. Then you pick up your cellphone, and guess what? It's covered with potential pathogens.
"Studies have shown that smartphones surfaces are covered in bacteria, including bacteria that can cause serious infections like Staphylococcus species," says Judy Guzman-Cottrill, an infectious disease expert at Oregon Health & Science University.
And phones are often held close to the eyes, nose and mouth, where germs can enter the body. So wipe it down often.
And you don't have to rub down your phone for long if you're using an alcohol-based sanitizer. "Just a few seconds should be sufficient to disinfect," says Janowski.
Try this stinky trick to stop touching your face
Having trouble remembering not to touch your face? Try rubbing a raw onion after hand-washing.
Photo Illustration by Max Posner/NPR
Your face offers multiple entry points for the virus. So every time you touch your eyes, nose and mouth with grubby hands, you risk infection.
"If you have touched a table or a doorknob or some surface contaminated [with the virus] and then touch your eyes, nose or mouth, you have a chance of inoculating yourself with the virus," Kuritzkes says.
But, as a matter of habit, most of us touch our faces multiple times an hour without even realizing it.
So, here's an idea. "After you wash your hands really well, touch a piece of raw onion," says Catherine Belling of Northwestern University Feinberg School of Medicine. With this strong smell on your fingers, "you'll notice when you touch your face," she says. Sure, it may make you a tad antisocial, but it could be a good way to train yourself to touch less.

Sunday, March 8, 2020

To the edge of the cliff and back. With The Beatles - news


To the edge of the cliff and back. 


With The Beatles -


To the edge of the cliff and back. With The Beatles

Updated: Mar 08, 2020, 08:22 IST | Dr Mazda Turel | Mumbai

To take on a case where death or paralysis is a given, and life, a freak chance, takes confidence in expertise. But also, YouTubing, Whatsapping and faith in music

Representational picture
Representational picture
Dr. Mazda Turel No one in the entire continent is willing to operate on him," said Jonathan, on arriving from Africa with his younger brother Jude. I glanced at the MRI films and wasn't surprised. "Gosh," I thought, projecting composed confidence, as the two waited to hear the next words from me.
Jude was a 16-year-old pleasant kid. He had started having headaches a few years ago but had got a brain MRI done only recently, when he began to lose vision. The MRI showed a colossal 10 cm tumour within the ventricles of his brain, occupying 80 per cent of it.
Ventricles are cave-like cavities filled with cerebrospinal fluid that give buoyancy to the brain. They are the reason why you can carry 1.5 kg of it without feeling the weight, even if you are pig-headed. An obstruction in this normal pathway of fluid by a tumour within the ventricle results in raised intracranial pressure, which manifests as headache, vomiting, and problems with vision.
"This is a very complex and high-risk operation," I explained, after examining Jude and noticing that his right arm and leg were slowly losing mobility. There was a greater-than-usual chance of complications since the tumour was in a precarious location, straddling the centres of consciousness. It was enormous in size, and had voluminous vascularity. We went on to discuss the chances of death, paralysis, and even a vegetative state—all the possibilities that could arise despite the best of doctors taking on the case. "Whatever happens, don't let him die," Jonathan said quietly, pressing my forearm. I wanted to say, we won't but stuck to, "We'll do our best." I left the hospital that day with the image of that beast of a tumour in my head.
For the next two days, I studied Jude's scans from all angles, reading up about his specific kind of tumour, and watching surgical videos. It might be scary for a patient to learn that the surgeon YouTubed the technicalities of the operation the night before surgery, but if one sticks to credible sources, I find this mode of research extremely useful and one that offers clarity.
I also WhatsApped the scans to my seniors to check what approach they'd take. I received replies accompanied by the eye roll emoji, most likely at the monstrosity of the tumour.
The next morning, I was inside Jude's brain. The snowy spotless walls of the ventricle soon disappeared from sight as we saw the tumour rearing its ugly head in the form of a red ball of fire. Some tumours allow you to go around them but this one, we had to get into. From the moment we touched it, it started bleeding. The magnification of the microscope makes trickles of blood seem like roaring rivers. What seemed like a calm start instantly turned into a battlefield; it was like watching an episode of Man vs. Wild. The tumour had pearly lobules, and each of them, burst despite delicate handling, flooding the field of vision.
"Get another suction in here," I ordered to improve visibility. The nurses scrambled, sensing the tension building up. The monitors started beeping, suggesting a drop in blood pressure. The anaesthesiologists muttered in a whisper among themselves on how to tackle the situation. They ordered more blood and administered medication to keep the blood pressure stable.
Just when we thought we were in control, another tumour lobule exploded. The blood pressure shot up this time owing to an autonomic dysfunction. "Control the damn BP!" I barked.
Mature anaesthesiologists never shout back at the surgeon, knowing well the duress s/he is in. They also don't make it known if there is a problem at their end, even when things are out of control, unless they need us to stop. They efficiently go about pressing buttons, turning down the volume of alarms, connecting bottles of blood, and injecting drugs, like clockwork. The communication with the surgeon is constant, brief, and firm. Unfortunately, they don't get enough credit for their competence. Often, lives are saved by them, not us.
A famous surgeon once said, there are four degrees of intraoperative haemorrhage. One: "Why did I get involved with this operation?" Two: "Why did I become a surgeon?" Three: "Why did I study to become a doctor?" Four: "Why was I born?"
In this case, I surged directly from stage one to four.
The only way to control the bleeding from an aggressively vascular tumour is to remove it completely and briskly. This took around six hours and six units of blood. I think I also aged six years in that time.
Once we had removed it, the ventricles finally reappeared in all their glory and the cerebrospinal fluid flowed uninterrupted like an immaculate waterfall. The brain was soft and pulsating tenderly as we closed.
Jude woke up the next morning as we got him off the ventilator. He was paralyzed on the right side but movement improved dramatically over the next few days. By the end of the week, he was prancing, not realising we had almost lost him. His chirpy disposition helped him recover faster.
"Surgery is not an art, it's a personality disorder; that's why we do what we do repeatedly!" I told his brother, quoting a line I had once read.
"How did you pull off such a miracle, doc!" he asked, hugging me.
"We had the Beatles playing in the background," I said.
And we made the lyrics come true: Hey Jude, don't make it bad / Take a sad song and make it better...
The writer is practicing neurosurgeon at Wockhardt Hospitals and Honorary Assistant Professor of Neurosurgery at Grant Medical College and Sir JJ Group of Hospitals. You can reach him at mazda.turel@mid-day.com

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To the edge of the cliff and back. With The Beatles. Updated: Mar 08, 2020, 08:22 ISTDr Mazda TurelMumbai. To take on a case where death or paralysis is a ...

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Saturday, February 22, 2020

Conspiracy theorists are wrong – coronavirus exists in nature … the genomic sequence of the virus has been determined’

‘Conspiracy theorists are wrong – coronavirus exists in nature … the genomic sequence of the virus has been determined’

February 21, 2020, 2:00 am IST in TOI Edit Page | Edit Page, Q&A, World | TOI

The outbreak of a novel coronavirus infection, which originated in Wuhan in China in December last year and has spread to 29 countries already, is among the biggest health crises world has faced in recent times. But it may not be the last one. Stuart Siddell, an emeritus professor at the University of Bristol, who has been researching on coronaviruses for over 25 years, tells Durgesh Nandan Jha how increased contact between humans and wild animals has the potential to unleash more outbreaks caused by viruses previously restricted to animals:
Coronaviruses were discovered in 1960s. We have witnessed outbreaks caused by them in the past as well. What is so different this time?
When I started researching on coronaviruses, they weren’t considered a threat because it caused milder symptoms such as cough and cold in humans.
SARS (severe acute respiratory syndrome) and MERS (Middle-East respiratory syndrome), two coronaviruses that led to outbreaks in 2002 and 2012 respectively, did cause severe symptoms but their transmission rates were lower compared to COVID-19 – the name given to the novel coronavirus by WHO.
SARS started in Guangdong in China, affected around 8,000 people and killed 744. MERS coronavirus outbreak started in Jeddah in Saudi Arabia and remained restricted mostly to the region. It affected around 2,500.
However, in a span of merely three months since it was discovered, preliminary data suggests COVID-19 has affected over 75,000 people. The actual figure could be higher. The number of deaths due to COVID-19 is said to be around 2,000.
What could be the possible reason for higher transmission rate of COVID-19?
This could be because unlike SARS, which primarily affected the lungs, COVID-19 causes infection in the upper respiratory tract or throat. It is easier for the infection to spread from throat than deep down the lungs.
Every time a patient coughs or sneezes, the droplets containing the virus are released and they tend to spread. Mortality has been observed mainly in elderly people, those with pre-existing illnesses and low immunity.
Some conspiracy theorists suggest an accidental leak of a biological weapon in making could have led to this.
Conspiracy theories are totally false. The genomic sequence of COVID-19 has been determined and it confirms that the virus belongs to the one that exists in nature.
Coronaviruses are known to cause diseases in animals. SARS belonged to the same family as COVID-19. It was passed on to the civets from the bats and from there it spread to humans. COVID-19 is also supposed to have spread from bats.
Do you think the worst is over or there is still risk of further spread of the disease and outbreaks in other parts of the world?
That depends totally on containment of the disease in affected regions. We need to break the chain of transmission. Because, if the chain is maintained it is very easy for the disease to spread and lead to outbreaks in different parts of the world. It is important for countries to screen people travelling from the areas affected by the outbreak for possible infection. They should be isolated and kept quarantined until there is no risk of further transmission. India is already doing it. When I arrived at the airport to attend an international conference recently, the officials asked about my travel history and symptoms, if any.
Many people are blaming non-vegetarians for the outbreak of diseases previously restricted to animals. Is that a correct assessment of the situation?
No. Eating meat or not is not the issue. Viruses causing diseases in wild animals that act as their natural reservoirs, for example bats, can spread to intermediate species, the camels in the case of MERS, and then get transmitted to humans. It is also possible that humans may get it directly from the wild animals on direct contact while travelling to places where normally humans wouldn’t go earlier.
How can we prevent zoonotic diseases (caused from transmission of germs from animals to humans)?
We have to understand the biology of these viruses. We have to understand how they replicate in their natural hosts, like bats; how they mutate or what is necessary to stop their chain of transmission. If we know that, early action can be taken to develop good diagnostics and medical system for better control of transmission into humans and preventing such infections from causing outbreaks. Knowledge is key. When SARS outbreak happened in 2002-03, there was great interest and it was easier to get money to research on them.
By 2007-08, enthusiasm for funding this research went down as the virus and illness disappeared. Now, there is interest in funding for vaccine development for COVID-19. I feel it is better to invest money before the outbreak takes place than later.
DISCLAIMER : Views expressed above are the author's own.
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