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2 days ago - Droplets of bodily fluids - such as saliva or mucus - from an infected person are dispersed in the air or on surfaces by coughing or sneezing.
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The best way to protect yourself against COVID-19 is by frequently cleaning your hands. By doing this you eliminate viruses that may be on your hands and ...
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Taking care of each other becomes just as important as taking care of ourselves. Do not make assumptions about others based on perceived symptoms or racial.
India must cut the transmission chain of the virus to save its health system from collapse
With the virus
galloping to 116 countries/regions causing more than 118,000 cases and
4,291 deaths, as on Wednesday, March 11, the World Health Organisation
took the last logical step the same day to spotlight the threat posed by
the novel coronavirus (SARS-CoV-2) — by declaring it a pandemic.
The announcement came as no surprise. On Monday, the WHO chief did
caution that the “threat of a pandemic has become very real” based on
the number of countries reporting new cases. On Thursday, the numbers
rose further: 1,27,863 cases and 4,718 deaths. This announcement comes
after WHO, on January 30, declared the outbreak a “public health
emergency of international concern”. Soon thereafter, it raised the
global risk level to its highest — very high. If the spread to more
countries and the cases and deaths reported till the third week of
February were of concern, it has become alarming since then. On February
22, the WHO chief warned that the “window of opportunity for containing
the virus is narrowing”. Unfortunately, many countries did not take the
warning seriously; in the last two weeks, the cases reported have
increased 13-fold and countries reporting the virus have tripled.
Outside China, Italy (12,462), Iran
(10,075) and South Korea (7,869) have the most cases. Nearly 90% of
cases reported globally are in just four countries and cases reported
daily have seen a sharp drop in China and South Korea.
The
response to WHO’s new classification should not be one of panic but
must instead stir countries into changing the course of the pandemic.
While WHO had always asked all countries to take aggressive action in
viral containment, it has now become all the more important to take that
warning seriously. All countries are required to trace, detect, test,
isolate and treat cases to prevent a handful of cases from becoming
clusters, and for clusters from becoming widespread in the community and
overwhelming the health-care system. Even as India has done well in
this by testing, isolating, contact tracing and treating people, it has
so far restricted itself to people who have returned from abroad and
those who have come in contact with infected people. It may be prudent
for India to adopt a more aggressive approach by looking for cases in
the community to prevent the silent spread of the virus. In addition,
containment measures such as closing down schools and cancelling mass
gatherings in enclosed places should be done wherever necessary. Steps
such as suspending tourist visas for nearly a month starting March 13
and quarantining Indians if needed are welcome — thermal screening
cannot detect infected people who do not show symptoms yet. India should
pull out all the stops to cut the transmission chain as its fragile
public health-care system will collapse if cases rise exponentially.
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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.
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
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
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 ...
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.
